Objective:To explore the risk factors for malnutrition after a traumatic brain injury and to construct a model which usefully predicts that risk.Methods:This was a retrospective study of 374 patients with a craniocerebral injury for whom the relevant clinical data were available. Based on their nutritional status, they were stratified into a malnutrition group ( n=220) and a control group ( n=154). Univariate and multivariate logistic regressions were evaluated seeking to identify the independent risk factors associated with malnutrition, and a prediction model was constructed based on the results. The model′s discrimination ability and accuracy were assessed using a receiver operating characteristics (ROC) curve. Results:A total of 220 patients (58.8%) developed malnutrition. Multifactorial logistic regression analysis showed that the independent risk factors for malnutrition were: age ≥60 years, pulmonary infection, dysphagia, cognitive impairment, a GCS score ≤8, or a Barthel index ≤40. In the ROC curve analysis, the area under the curve quantifying the model′s ability to predict malnutrition was 0.924 (95% CI: 0.896, 0.951), with a sensitivity of 0.868 and a specificity of 0.857, indicating its good prediction performance. Conclusions:Age ≥60 years, pulmonary infection, dysphagia, cognitive impairment, a GCS score ≤8 or a Barthel index ≤40 are independent predictors of malnutrition after a traumatic brain injury. The prediction model constructed based on those risk factors has demonstrated useful predictive power for malnutrition.

Objective:To explore the risk factors for malnutrition after a traumatic brain injury and to construct a model which usefully predicts that risk.Methods:This was a retrospective study of 374 patients with a craniocerebral injury for whom the relevant clinical data were available. Based on their nutritional status, they were stratified into a malnutrition group ( n=220) and a control group ( n=154). Univariate and multivariate logistic regressions were evaluated seeking to identify the independent risk factors associated with malnutrition, and a prediction model was constructed based on the results. The model′s discrimination ability and accuracy were assessed using a receiver operating characteristics (ROC) curve. Results:A total of 220 patients (58.8%) developed malnutrition. Multifactorial logistic regression analysis showed that the independent risk factors for malnutrition were: age ≥60 years, pulmonary infection, dysphagia, cognitive impairment, a GCS score ≤8, or a Barthel index ≤40. In the ROC curve analysis, the area under the curve quantifying the model′s ability to predict malnutrition was 0.924 (95% CI: 0.896, 0.951), with a sensitivity of 0.868 and a specificity of 0.857, indicating its good prediction performance. Conclusions:Age ≥60 years, pulmonary infection, dysphagia, cognitive impairment, a GCS score ≤8 or a Barthel index ≤40 are independent predictors of malnutrition after a traumatic brain injury. The prediction model constructed based on those risk factors has demonstrated useful predictive power for malnutrition.

Objective:To investigate whether short chain fatty acid(SCFAs) intervention has an antidepressant effect by improving gut microbiota dysregulation and regulating the TLR4/MyD88/NF-κB inflammatory pathway in depression model mice.Methods:Totally 60 SPF grade male C57BL/6 J mice aged 6-8 weeks were randomly divided into three groups: control group, depression model group, and SCFAs group, with 20 mice in each group.The mice in depression model group and SCFAs group were given the chronic unpredictable mild stress (CUMS) stimulations for 8 weeks to establish the depression model.From the 6th week, SCFAs group mice were given a mixed solution of short chain fatty acid salts for drinking, until modeling was completed, meanwhile mice in the model group were given 0.78% NaCl solution for drinking.The depression-like behavior was assessed using the sucrose preference test (SPT) and forced swimming test (FST) following modeling, and the open field test (OFT) was employed to evaluate the anxiety-like behavior of mice.16S rRNA gene sequence was used to analyze the gut microbiota of mice.The activation of astrocytes and TLR4/MyD88/NF-κB inflammatory pathway in hippocampus was determined by immunofluorescence staining and Western blot.SPSS 26.0 was used for statistical analysis, one-way ANOVA was used for comparison among the three groups, and LSD- t test was used for further pairwise comparisons. Results:There were statistically significant differences in the sugar water preference rate, the immobility time in FST, and the percentage of activity time in OFT among the three groups ( F=10.554, 10.912, 12.599, all P<0.05).The the sugar water preference rate and the percentage of activity time in OFT of the depression model group were both lower than those of the control group (both P<0.05), and the immobility time in FST was higher than that of the control group ( P<0.05).The sugar water preference rate in SCFAs group((84.7±3.5)%, (75.3±6.0)%)and the percentage of activity time in OFT((7.4±1.4)%, (3.2±0.9)%) were both higher than those in the depression model group(both P<0.05 ), while the immobility time in FST was shorter than that in the depression model group((110.5±21.5) s, (148.0±20.1) s, P<0.05).There was a statistical difference in the β diversity of gut microbiota among three groups ( P=0.001).At the family level, compared with the depression model group, the relative abundance of Rikenellaceaee and Bacteroidaceae increased in the SCFAs group, while the relative abundance of Clostridia_UCG-014 decreased.At the genus level, the relative abundance of Clostridia_UCG-014 and Prevotella decreased, while the relative abundance of Alistipes increased (all P<0.05).The immunofluorescence results showed that there was a statistically significant difference in GFAP expression levels among the three groups of mice ( F=16.565, P=0.004).The GFAP expression in the depression model group was higher than that in the control group and SCFAs group (both P<0.05).The Western blot results showed that there were statistically significant differences in the expression levels of TLR4, MYD88, and NF-κB ptoteins in the hippocampal tissue of the three groups ( F=70.59, 174.39, 14.40, all P<0.05).The protein levels of TLR4, MyD88, and NF-κB in the depression model group were all higher than those in the control group and SCFAs group (all P<0.05). Conclusion:SCFAs can ameliorate the depressive-like behavior in depression model mice and reduce the activation of astrocytes in the hippocampus, which may be associated with the improvement of dysregulated gut microbiota and down-regulation of the TLR4/MyD88/NF-κB pathway protein.

Objective:To explore the relationship between marital status and mild cognitive impairment in older adults.Methods:This study is a cluster random sampling.From January to December 2020, a questionnaire survey was conducted among older adults aged 60 years and over in four cities of Hebei Province.Finally, 2690 older adults with mild cognitive impairment and normal cognitive function were enrolled.The older adults were divided into 2 groups according to their marital status: married and living with their spouses(group E1), divorced or living alone(group E2). The mini-mental state examination(MMSE)scores of older adults in the two groups were compared.Moreover, the cognitive differences of older adults between the two groups and the interaction of marital status, social activities and life events on cognitive outcomes were analyzed.Results:The married older adults with partners had better cognitive preservation( P<0.01). The more life events were more likely to cause cognitive impairment( P<0.01), and the interaction of marital status, social activities and life events had a significant impact on cognition( P<0.01). Older men who were married and lived with spouse had better cognition than older women who were married and lived with spouse( P<0.05 in Model 3). The cognition of widowed elderly women was better than those of widowed elderly men( P<0.1 in Model 1; P<0.1 in Model 2). Among elderly men, the cognition of those married and living with spouse was better than that those of widowed( P<0.01 in models 1 and 2, P<0.1 in model 3). Among elderly women, those married and living with spouse had better cognitive outcomes than those widowed( P<0.01 in Model 1, P<0.01 in Model 2). Conclusions:Marital companionship is a protective factor for the cognition of older adults, and there are gender differences in the impact of marital status on cognition in late life.

Objective:To investigate the effect of salvianolic acid on depressive behavior in depression model rats induced by chronic mild stress (CMS) and its mechanism.Methods:Fifty healthy male clean grade Sprague-Dawley(SD) rats were divided into five groups according to a random number table with 10 in each group: control group (nCMS+ Nal group), CMS+ normal saline group (CMS+ Nal group), CMS+ fluoxetine group (CMS+ Flu group), CMS+ salvia acid group (CMS+ Sal group), CMS+ fluoxetine+ Salvia acid group (CMS+ Flu+ Sal group). Except the control group, the rats in the other four groups were all received CMS modeling for 21 days. Twenty-one days after CMS modeling, rats were intraperitoneally injected with 0.9% normal saline (10 mg·kg -1·d -1), fluoxetine (20 mg·kg -1·d -1), salvia acid(40 mg·kg -1·d -1), fluoxetine(20 mg·kg -1·d -1)+ salvia acid(40 mg·kg -1·d -1)for 21 days. During the administration period, rats in the other four groups continued to receive CMS intervention for 21 days. Forced swimming test and sucrose preference test were conducted at baseline (day 0), after modeling (day 21) and after intervention (day 42) so as to evaluate depression like behavior. Then the rats were sacrificed and the hippocampus and prefrontal cortex were taken. The mRNA levels of Toll like receptor 4 (TLR4) and myeloid differentiation primary response 88 (MyD88) were detected by RT-qPCR. The cytokines including interleukin-1β(IL-1β), interleukin-2(IL-2), interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) were detected by Luminex technique.SPSS 21.0 was used for statistical analysis.Repeated measurement ANOVA was used for behavioral data analysis, one-way ANOVA was used for molecular index data analysis, and Spearman was used for correlation analysis. Results:The results of repeated measurement ANOVA showed that the interaction effects between group and time of body mass, sucrose preference, forced swimming immobility time were significant at baseline, after modeling and after intervention ( F=18.238, 6.921, 7.591, all P<0.05). After modeling, compared with nCMS+ Nal group, the rats in CMS+ Flu group, CMS+ Sal group, CMS+ Flu+ Sal group and CMS+ Nal group had lower body weight, lower sucrose preference rate and longer forced swimming immobility time (all P<0.05). After intervention, compared with CMS+ Nal group(body weight (350.15±41.65)g, sucrose preference(52.95±11.13)%, static time(91.40±15.22)s), the body weight((378.21±30.78)g, (385.12±43.19)g, (391.41±31.21)g, (402.33±18.67)g, all P<0.05) and sucrose preference((69.30±15.56)%, (68.12±10.99)%, (71.18±9.51)%, (75.47±11.55)%, all P<0.05) of CMS+ Flu group, CMS+ Sal group, CMS+ Flu+ Sal group and nCMS+ Nal group were all increased, while the forced swimming immobility time ((68.81±21.74)s, (66.10±25.51)s, (63.53±22.32)s, (71.21±21.41)s, all P<0.05) were shorter (all P<0.05). After intervention, among the body weight, sucrose preference and the immobility time of CMS+ Flu group、CMS+ Sal group and CMS+ Flu+ Sal group, there were no differences between each two groups(all P>0.05). After intervention, the levels of TLR4 mRNA and MyD88 mRNA in prefrontal cortex and hippocampus of CMS+ Flu group, CMS+ Sal group, CMS+ Flu+ Sal group and nCMS+ Nal group were all lower than those in CMS+ Nal group (all P<0.05). In prefrontal cortex, the levels of TLR4 mRNA (0.715±0.358) and MyD88 mRNA (0.739±0.233) in CMS+ Flu+ Sal group were lower than those in CMS+ Sal group (1.943±0.606, 1.815±0.897) (both P<0.05). The level of TLR4 mRNA in prefrontal cortex and hippocampus of rats were positively correlated with the level of MyD88 mRNA and TNF-α level and forced swimming immobility time and negatively correlated with sucrose preference rate (prefrontal cortex r=0.915, 0.041, 0.027, -0.178, all P<0.05; hippocampus r=0.810, 0.070, 0.011, -0.153, all P<0.05). Conclusion:The antidepressant effect of salvianolic acid is presumedly achieved by inhibiting the immunoinflammatory response mediated by the TLR4/Myd88 signaling pathway in CMS rats.

Objective:To explore the association between polymorphism of Histone Deacetylase 2 (HDAC2) gene and alcohol use disorder (AUD) in male people of Han nationality for seeking suitable single nucleotide loci(SNP), and provide reference for early diagnosis and intervention of alcohol use disorder(AUD).Methods:A total of 194 male AUD patients of Han nationality (case group) and 310 normal men of Han nationality (control group) were selected for the study. The genomic DNA of peripheral blood of the subjects in the two groups was extracted, and 13 SNP loci of HDAC2 gene were obtained from HapMap database. The subjects in the two groups were genotyped by Agena MassARRAY SNP genotyping method.SPSS 25.0 was used to statistically analyze the differences of genotype frequency and allele frequency between the two groups, and Haploview 4.2 software was used for linkage disequilibrium and haploid analysis. The multiple test correction was carried out by the replacement test with 50 000 replacement times.Results:The genotype frequency of the 3 SNP loci(rs9481408, rs6568819, rs9488289) of HDAC2 gene were statistically significant different between the case group and the control group (all P<0.05). Further analysis found that the three loci were significantly correlated with AUD in the recessive genetic model between case group and control group(T/T vs C/C-C/T: OR=1.78, 95% CI: 1.05-3.03, P=0.033; T/T vs C/C-C/T: OR=1.79, 95% CI: 1.05-3.03, P=0.032; G/G vs C/C-C/G: OR=1.85, 95% CI: 1.09-3.13, P=0.022). Seven SNP haplotypes were constructed and the association odds ratio of GATCTGCAATAA between the case group and control group was 2.44, and the difference was statistically significant ( P<0.05). Conclusion:The SNP loci rs9481408, rs6568819, rs9488289 in the HDAC2 gene and haplotype GATCTGCCAATAA are associate with AUD in male people of Han nationality. These results indicated that the HDAC2 gene is one of the susceptibility genes of AUD.

Objective:This study aims to explore the change of blood and brain telomere length and the effect of salvianolic acid B on it in a rat chronic mild stress (CMS) model of depression.Methods:A total of 45 Sprague-Dawley (SD) male rats were randomly divided into 5 groups using a random number table, which were the control group, CMS group, fluoxetine group, salvianolic acid B group, and combined medication group, with nine rats in each group. All rats received CMS for 6 weeks. After successfully establishing the depression model (day 22 to day 42 after enrollment), each rat was intraperitoneally injected with 0.9% normal saline, salvianolic acid B (40 mg·kg -1·d -1), and/or fluoxetine (20 mg·kg -1·d -1) respectively according to its belonging group. The body mass of each group was tested before admission and every weekend after admission. The depressant-like behaviors were evaluated using sucrose preference test (SPT) and forced swimming test (FST) before (day-1 and-2) and after the depression model established (day 21 and 22) and after treatment (day 42 and 43) respectively. The relative telomere length in the blood, hippocampus, cortex, and cerebellum were analyzed using RT-PCR, respectively. Two-factor repeated analysis of variance was used to analyze the differences in body mass, sucrose preference, and immobility time among the five groups. The Kruskal-Wallis H test was used to compare the relative telomere length among the five groups. The Spearman's rank correlation test was used to analyze the correlation between the telomere length and body mass, sucrose preference, and immobility time at different body parts. Results:After 3 weeks of intervention, compared with those in the CMS group, rats in the salvianolic acid B group, fluoxetine group, and combination medication group showed increased body mass ( P=0.049, P=0.008, P=0.036), raised sucrose preference value ( P=0.089, P=0.094, P=0.041), and shortened forced swimming immobility time (all P<0.01). Compared with the control group, the CMS group presented statistically significantly shortened blood relative telomere length (8.53 (3.95) vs. 0.12 (0.23), P<0.01, Bonferroni adjusted P=0.002). The relative telomere length of the bilateral hippocampus, cortex, and cerebellum did not significantly differ between the control group and the CMS group. Compared with the CMS group, the relative telomere length in the salvianolic acid B group ( P=0.005, Bonferroni adjusted P=0.051), fluoxetine group ( P<0.01, Bonferroni adjusted P=0.005), and combined medication group ( P=0.001, Bonferroni adjusted P=0.007) increased significantly in the blood sample but not in different brain regions. Spearman correlation analysis showed that there was no correlation between the telomere length of different body parts and the body weight, sucrose preference value, and forced swimming immobility time that assessed after the intervention. Conclusion:The shortened telomeres length in the peripheral blood in depression model rats cannot indicate the change of telomere length in the brain. Salvianolic acid B can block the shortening of blood telomere length in depression model rats, with comparable efficacy of fluoxetine.

Objective:To observe the effect of computerized cognitive remediation therapy(CCRT) in the patients with mild cognitive impairment (MCI).Methods:A randomized, single-blinded clinical study was carried out from the April to June in 2019. 46 patients who met MCI criteria were randomly allocated into a CCRT group ( n=24) and a control group ( n=22). In CCRT group, the CCRT was conducted five times a week (30 minutes each time) for a total of 8 weeks (40 times), while a natural observation was performed in the control group. All the subjects were assessed by the Mini-Mental State Examination(MMSE) and the Montreal Cognitive Assessment(MoCA) before and after the treatment. The Wilcoxon test in the paired rank-sum test of two related samples was used to evaluate the effect of CCRT on MCI before and after the intervention, and the Mann-Whitney U test in the rank-sum test of two independent samples was used to compare the differences in MMSE and MoCA scores between the two groups. Results:Before treatment, there were no statistically significant differences in MMSE, MoCA total scores and each factor between the CCRT group and the control group ( P>0.05). A total of 21 patients in CCRT group completed CCRT treatment. After 8 weeks of treatment, the difference between two groups in the total score of MMSE ( Z=-2.83), attention and calculation( Z=-2.58), time orientation( Z=-2.00) and visual spatial function ( Z=-2.45) scores were higher than those before the treatment ( P<0.05); the difference between two groups in MoCA total score ( Z=-3.40), visual space and executive function( Z=-3.41), attention ( Z=-3.09) were higher than those before the treatment ( P<0.05). Conclusion:CCRT may improve the cognitive function of MCI patients, especially the attention and visuospatial functions.

Objective:This study aims to explore the change of blood and brain telomere length and the effect of salvianolic acid B on it in a rat chronic mild stress (CMS) model of depression.Methods:A total of 45 Sprague-Dawley (SD) male rats were randomly divided into 5 groups using a random number table, which were the control group, CMS group, fluoxetine group, salvianolic acid B group, and combined medication group, with nine rats in each group. All rats received CMS for 6 weeks. After successfully establishing the depression model (day 22 to day 42 after enrollment), each rat was intraperitoneally injected with 0.9% normal saline, salvianolic acid B (40 mg·kg -1·d -1), and/or fluoxetine (20 mg·kg -1·d -1) respectively according to its belonging group. The body mass of each group was tested before admission and every weekend after admission. The depressant-like behaviors were evaluated using sucrose preference test (SPT) and forced swimming test (FST) before (day-1 and-2) and after the depression model established (day 21 and 22) and after treatment (day 42 and 43) respectively. The relative telomere length in the blood, hippocampus, cortex, and cerebellum were analyzed using RT-PCR, respectively. Two-factor repeated analysis of variance was used to analyze the differences in body mass, sucrose preference, and immobility time among the five groups. The Kruskal-Wallis H test was used to compare the relative telomere length among the five groups. The Spearman's rank correlation test was used to analyze the correlation between the telomere length and body mass, sucrose preference, and immobility time at different body parts. Results:After 3 weeks of intervention, compared with those in the CMS group, rats in the salvianolic acid B group, fluoxetine group, and combination medication group showed increased body mass ( P=0.049, P=0.008, P=0.036), raised sucrose preference value ( P=0.089, P=0.094, P=0.041), and shortened forced swimming immobility time (all P<0.01). Compared with the control group, the CMS group presented statistically significantly shortened blood relative telomere length (8.53 (3.95) vs. 0.12 (0.23), P<0.01, Bonferroni adjusted P=0.002). The relative telomere length of the bilateral hippocampus, cortex, and cerebellum did not significantly differ between the control group and the CMS group. Compared with the CMS group, the relative telomere length in the salvianolic acid B group ( P=0.005, Bonferroni adjusted P=0.051), fluoxetine group ( P<0.01, Bonferroni adjusted P=0.005), and combined medication group ( P=0.001, Bonferroni adjusted P=0.007) increased significantly in the blood sample but not in different brain regions. Spearman correlation analysis showed that there was no correlation between the telomere length of different body parts and the body weight, sucrose preference value, and forced swimming immobility time that assessed after the intervention. Conclusion:The shortened telomeres length in the peripheral blood in depression model rats cannot indicate the change of telomere length in the brain. Salvianolic acid B can block the shortening of blood telomere length in depression model rats, with comparable efficacy of fluoxetine.

Objective:To observe the effect of computerized cognitive remediation therapy(CCRT) in the patients with mild cognitive impairment (MCI).Methods:A randomized, single-blinded clinical study was carried out from the April to June in 2019. 46 patients who met MCI criteria were randomly allocated into a CCRT group ( n=24) and a control group ( n=22). In CCRT group, the CCRT was conducted five times a week (30 minutes each time) for a total of 8 weeks (40 times), while a natural observation was performed in the control group. All the subjects were assessed by the Mini-Mental State Examination(MMSE) and the Montreal Cognitive Assessment(MoCA) before and after the treatment. The Wilcoxon test in the paired rank-sum test of two related samples was used to evaluate the effect of CCRT on MCI before and after the intervention, and the Mann-Whitney U test in the rank-sum test of two independent samples was used to compare the differences in MMSE and MoCA scores between the two groups. Results:Before treatment, there were no statistically significant differences in MMSE, MoCA total scores and each factor between the CCRT group and the control group ( P>0.05). A total of 21 patients in CCRT group completed CCRT treatment. After 8 weeks of treatment, the difference between two groups in the total score of MMSE ( Z=-2.83), attention and calculation( Z=-2.58), time orientation( Z=-2.00) and visual spatial function ( Z=-2.45) scores were higher than those before the treatment ( P<0.05); the difference between two groups in MoCA total score ( Z=-3.40), visual space and executive function( Z=-3.41), attention ( Z=-3.09) were higher than those before the treatment ( P<0.05). Conclusion:CCRT may improve the cognitive function of MCI patients, especially the attention and visuospatial functions.