Objective To explore biological elements of early awaking in depression.Methods The plasma concentration of cortisol was measured by immunoradioassay in the morning in 59 depressive patients,and how many hours the depressive patients awake earlier than normal was evaluated.Results The plasma concentration of eortisol in the morning of early awaking group Was hisher than no early awaking group[(377.32±14.54)μm/L vs(324.15±16.44)μm/L,P＜0.05].There Was rectilinear correlation between the hours that the pafients awake earlier than normal and the plasma concentration of cortisol in the moming(r=0.353.P=0.006.n=59).There was linear regression between the hours that the patients awake earlier than normal and the plasma concentration of cortisol in the morning(β=0.006,P=0.006,n=59).Conclusion The high plasma concentration of eortisol in the morning probably leads to early awaking in depression.

ObjectiveTo compare the efficacy and safety of pregabalin and gabapentin in treatment of patients with diabetic peripheral neuropathic pain.MethodsSixty patients with diabetic peripheral neuropathic pain were allocated into pregabalin group(30 cases ) and gabapentin group (30 cases) for a 4-week period treatment by random digits table method.The efficacy was measured with visual analogue scale (VAS) score,while the side effects were evaluated.ResultsVAS score in both groups was significantly lower at the end of 1st,2nd or 4th week after treatment than that before treatment [pregabalin group:( 4.05 ±0.93),(2.73 ±0.72),(2.06 ±0.58) scores vs.(7.45 ±0.82) scores; gabapentin group:(5A2 ±0.88),(2.93 ± 0.80),(2.19 ± 0.64) scores vs.(7.68 ± 0.84) scores] (P ＜ 0.01 ).VAS score in pregabalin group was lower than that in gabapentin group at the end of 1st week significantly (P＜ 0.01 ).Not only there was no significant difference in VAS score at the end of 2nd or 4th week between two groups,but also in response rates at the end of 4th week (P ＞ 0.05 ).The rate of adverse reaction in pregabalin group was significantly lower than that in gabapentin group [16.67％ (5/30) vs.36.67％( 11/30)] ( P ＜ 0.01 ).ConclusionPregabalin is as effective as gabapentin in treatment of patients with diabetic peripheral neuropathic pain,but it has faster effect and less adverse events than gabapentin.

Objective To study the feature of regional cerebral metabolism rate of glucose (rCMRglc) in patients with Alzheimer’s disease (AD) and the value of positron emission tomography (PET) scanning in diagnosis of AD. Methods 13 AD patients and 13 health controls ,Who matched in age,sex and education years,were scanned with PET. Results (1) Watching by naked eyes,there was mild decreasing of rCMRglc at parietal lobe in healthy elders. While in AD patients,there was widely decreasing of cerebral metabolism rate of glucose. The most significant region was parietal lobe, the next was temporal lobe,and the last was frontal lobe. (2) Detecting with PET and dealing with statistical parametric mapping (SPM) of 99 software,there was more significant decreasing of rCMRglc in regions 7,23,30,31 of cingulate gyrus,region 39 and 40 of pario-occipital lobe,region 20 of temporal lobe and region 6,8,9 of frontal lobe in AD group( P

OBJECTIVETo investigate the features of regional cerebral metabolic rate of glucose (rCMRglc) in patients with mild cognitive impairment (MCI) by positron emission-tomography and its relationship with neuropsychological test.

METHODSPositron emission tomography, mini-mental state examination and Wechsler memory scale were applied in 10 patients with MCI and 10 healthy volunteers as the control group.

RESULTSScores of mini-mental state examination and Wechsler memory scale in MCI patients were lower than those in the control group (P < 0.01). rCMRglc of the left orbital gyrus, right middle temporal gyrus and right putamen was lower in the MCI group than in the control group (P < 0.05). Correlation analysis in the MCI group indicated that rCMRglc of many brain regions such as the orbital gyrus, putamen, left hippocampus and parahippocampal gyrus, cingulate gyrus, left amygdaloid body, precentral gyrus, postcentral gyrus, and medial occipitotemporal gyrus in MCI patients, were correlated negatively with age; while the rCMRglc of many parts of the brain such as the left putamen, temporal lobe, anterior cingulate gyrus, left insular lobe, amygdaloid body, precentral gyrus, postcentral gyrus and medial occipitotemporal gyrus were correlated positively with mini-mental state examination; and rCMRglc of the left putamen, temporal lobe, left insular lobe, precentral gyrus and postcentral gyrus were correlated positively with Wechsler memory scale. The right putamen, the right inferior temporal gyrus, precentral gyrus, and left postcentral gyrus were correlated positively with the length of education. However, only rCMRglc of the left amygdaloid body were correlated positively with gender.

CONCLUSIONThe rCMRglc was lower in the orbital gyrus and putamen of MCI patients. Their rCMRglc were correlated with their cognitive impairment severity, age, length of education and sex.

Aged ; Brain ; metabolism ; Cognition Disorders ; metabolism ; psychology ; Female ; Glucose ; metabolism ; Humans ; Male ; Middle Aged ; Neuropsychological Tests ; Tomography, Emission-Computed

Objective To explore the correlation between the total burden of cerebral small vessel disease and poor prognosis of branch atheromatous disease(BAD)in elderly patients.Methods A total of 114 BAD patients admitted to Shanghai Eighth People's Hospital between January 2021 and March 2023 were enrolled,and according to mRS score at 90 d after onset,they were divided into a good prognosis group(mRS score ≤2,67 cases)and a poor prognosis group(mRS score＞2,47 cases).The clinical and imaging characteristics were analyzed,and the relationship between total cerebral small vessel disease burden and clinical prognosis of BAD was investigated using lo-gistic regression analysis.ROC curve analysis was used to determine the threshold of the total cere-bral small vessel disease burden for predicting adverse outcomes and to evaluate its sensitivity and specificity.Results The good prognosis group had younger age,smaller proportion of diabetes,lower SBP,NIHSS score at admission and white matter hyperintensities,and reduced ratio of cerebral microbleeds than the poor prognosis group(P＜0.05,P＜0.01).Statistical difference was observed in the total cerebral small vessel disease burden between the two groups(P＜0.01).Binary logistic regression analysis showed that the total cerebral small vessel disease burden score and NIHSS score at admission were independent predicators of poor prognosis in BAD patients(OR=3.350,95％CI:1.439-7.798,P=0.005;OR=2.814,95％CI:1.586-4.993,P=0.001).ROC curve analysis indicated that the total cerebral small vessel disease burden had a cut-off val-ue of 1.5,and the sensitivity and specificity for predicting poor prognosis was 63.8％and 86.6％,respectively,for BAD patients.Conclusion The total cerebral small vessel disease burden is an in-dependent predictor for poor prognosis of BAD patients.