Anemia, Iron-Deficiency ; blood ; Area Under Curve ; Dopamine ; metabolism ; Humans ; Hydrocortisone ; blood ; Immunity, Humoral ; Inflammation ; Leukocyte Count ; Lymphocyte Count ; Lymphocytes ; cytology ; Neutrophils ; cytology ; ROC Curve ; Restless Legs Syndrome ; blood ; Sympathectomy ; Time Factors

Depression is an important post-stroke sequela with negative impact on mortality, functional outcome and quality of life. Changes in cytokines have been hypothesized to be associated with the etiology of post-stroke depression (PSD). The altere dhypothalamic-pituitary-adrenal (HPA) functioning is associated with the onset of depression. The activity of HPA could induce the fluctuations of cortisol levels. In this study, we prospectively checked interleukin 6 (IL-6) and cortisol levels in patients with early ischemic stroke. It was hypothesized that early serum IL-6 and cortisol fluctuations in stroke patients were the predictions of PSD. Totally, 100 participants were selected from stroke inpatients consecutively admitted to the Department of Neurology, Tongji Hospital from July 2014 to December 2015. Fifty health people served as the controls. The serum of all the patients was collected at 8:00 am and 4:00 pm respectively one week after stroke. The serum of controls was collected only at 8:00 am. The levels of IL-6 were analyzed by enzyme-linked immunosorbent assay kit, and those of cortisol were detected by chemiluminescence immunoassay. On the 3rd week after stroke, the patients were enrolled to the PSD group and non-PSD group based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and The Hamilton Depression Rating Scale (HAMD-21, score>7). The IL-6 level (13.24±2.89 ng/L) was elevated significantly in PSD groups as compared with that in non-PSD group and control group respectively (P<0.05 for both), but there was no significant difference in the IL-6 level between non-PSD group and control group. The patients in both PSD group and non-PSD group had significantly elevated morning cortisol levels in comparison with those in the control group (P<0.05; for PSD, non-PSD and control: 508.86±119.51, 420.83±70.04 and 340.40±76.30 nmol/L respectively). Moreover, afternoon cortisol levels in PSD group were significantly higher than those in non-PSD group, and the morning baseline cortisol levels in these two groups were similar (P>0.05). It was suggested that PSD generally runs a chronic course and is related to a variety of adverse health outcomes including increased disability, morbidity and mortality. This study will help the screening of potential PSD in the early stage.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Depression ; blood ; etiology ; physiopathology ; Female ; Humans ; Hydrocortisone ; blood ; Hypothalamo-Hypophyseal System ; metabolism ; Interleukin-6 ; blood ; Male ; Middle Aged ; Stroke ; blood ; complications ; physiopathology

OBJECTIVETo investigate the nutritional status in acute stage ischemic stroke and its relation to disease severity and prognosis of patients.

METHODSFifty patients with ischemic stroke were admitted in hospital within 48 h after onset. National Institute of Health stroke scale (NIHSS) was used to assess the severity of stroke. Physical index and laboratory index were measured on d1, d7 and d14 after admission. Physical index included body weight, body mass index, triceps skin folds, upper arm circumference and arm muscle circumference. Laboratory index included prealbumin, high sensitivity C-reactive protein (hs-CRP), complement C3 and cortisol. The severity of metabolic disturbance was expressed as the difference of biochemical indexes between the d7 and d1. All cases were followed up for 6 months. The prognosis of stroke was evaluated with modified Rankin (mRankin) scores.

RESULTSNo significant changes of physical indexes were found between d7 and d1. The levels of prealbumin and complement C3 on d7 after admission were significantly decreased compared to d1 (198.8 mg/L±20.3 mg/L vs 286.7 mg/L±23.8 mg/L and 0.6 g/L±0.1 g/L vs 1.0 g/L±0.1 g/L, respectively, both P<0.05). The levels of hs-CRP and cortisol at d7 were significantly increased compared to d1 (495.2 nmol/L±39.5 nmol/L vs 24.1 mg/L±5.2 mg/L and 396.4 nmol/L±41.3 nmol/L vs 5.1 mg/L±1.2 mg/L, respectively, both P<0.05). On d14 after admission hs-CRP (13.2 mg/L±4.5 mg/L) and cortisol levels (463.4 nmol/L±32.1 nmol/L) were still significantly higher than d1 (both P<0.05). However, there were no difference in prealbumin (259.2 mg/L±22.8 mg/L) and complement C3 (0.8 g/L±0.2 g/L) levels between d1 and d14 after admission. Correlation analysis revealed that the NIHSS scores and mRankin scores were correlated with nutrition metabolism disturbances (P<0.05).

CONCLUSIONNutrition metabolism disturbances in patients with acute ischemic stroke are related to the disease duration, the severity and prognosis of stroke.

C-Reactive Protein ; metabolism ; Complement C3 ; metabolism ; Humans ; Hydrocortisone ; blood ; Nutritional Status ; Prealbumin ; metabolism ; Prognosis ; Severity of Illness Index ; Stroke ; diagnosis ; physiopathology

OBJECTIVETo study the changes in serum cortisol levels in adolescents with type 1 diabetes (T1DM) and elevated depressive symptoms.

METHODSTwenty-eight adolescents with T1DM and 31 healthy peers were assessed for depressive symptoms using a depression self-rating scale developed by the Epidemiological Survey Center. Selected subjects were classified into four groups: T1DM with elevated depressive symptoms group (n=15), T1DM without elevated depressive symptoms group (n=13), elevated depressive symptoms without T1DM group (n=15), and normal control group (n=16). Fasting blood samples were collected in the morning, and the levels of serum cortisol were compared among the four groups. The correlations of serum levels of cortisol and glycosylated hemoglobin A1c (HbA1c) with the score of depression self-rating scale were evaluated by Pearson correlation analysis.

RESULTSThe fasting serum cortisol levels in the 28 T1DM patients were significantly higher than in the 31 healthy peers (P<0.01). The fasting cortisol levels in the T1DM with elevated depressive symptoms group were significantly higher compared with those in the elevated depressive symptoms without T1DM group and normal control group (P<0.01). In adolescents with T1DM, serum HbA1c level was positively correlated with the score of depression self-rating scale (r=0.481, P=0.010).

CONCLUSIONSThe fasting serum cortisol levels in adolescents with T1DM and elevated depressive symptoms are significantly increased, suggesting that the patients with comorbidity of T1DM and depression develop dysfunction of the corticotropin-releasing hormone-adrenocorticotropic hormone-cortisol axis. The elevated depressive symptoms may be associated with a poor control of glucose metabolism.

Adolescent ; Adrenocorticotropic Hormone ; physiology ; Child ; Corticotropin-Releasing Hormone ; physiology ; Depression ; blood ; etiology ; Diabetes Mellitus, Type 1 ; blood ; Female ; Glucose ; metabolism ; Glycated Hemoglobin A ; analysis ; Humans ; Hydrocortisone ; blood ; Male

OBJECTIVETo investigate the effect of Chinese medicine (CM) Schisandra chinensis on interleukin (IL), glucose metabolism, and pituitary-adrenal and gonadal axis of rats after strenuous navigation and exercise.

METHODSA total of 45 Sprague-Dawley rats were randomized into the quiet control group, the stress group, and the CM group (15 in each group). The CM group received 2.5 g/kg of Schisandra chinensis twice per day for one week before modeling. Except the quiet controls, rats were trained using the Bedford mode for 10 days. On the 11th day, they performed 3 h of stressful experimental navigation and 3 h of strenuous treadmill exercise. The levels of serum testosterone (T), cortisol (CORT), luteinizing hormone (LH), IL-1, IL-2, and IL-6 were tested by radioimmunoassay and enzyme-linked immunosorbent assay, respectively. The adrenal cortex ultrastructure was observed using electron microscopy.

RESULTSCompared with the quiet control group, after navigation and strenuous exercise, blood glucose was increased, and T level was decreased in the stress group (both P<0.01). The blood glucose, CORT, IL-1 and IL-2 levels were significantly reduced in the CM group (P<0.05 or P<0.01) as compared with the stress group. Electron microscopy revealed that the rats in the CM group had a smaller decrease in adrenal intracellular lipid droplets and higher levels of apoptosis than those in the stress group.

CONCLUSIONSSchisandra chinensis can reduce serum CORT and blood glucose levels in stressed rats. It appears to protect the cell structure of the adrenal cortex, and offset the negative effects of psychological stress and strenuous exercise related to immune dysfunction. Schisandra chinensis plays a regulatory role in immune function, and can decrease the influence of stress in rats.

Adrenal Cortex ; pathology ; ultrastructure ; Animals ; Blood Glucose ; metabolism ; Glucose ; metabolism ; Gonads ; drug effects ; metabolism ; Hydrocortisone ; blood ; Interleukin-1 ; blood ; Interleukin-2 ; blood ; Interleukin-6 ; blood ; Interleukins ; blood ; Luteinizing Hormone ; blood ; Male ; Physical Conditioning, Animal ; Pituitary-Adrenal System ; drug effects ; metabolism ; Plant Extracts ; pharmacology ; Rats, Sprague-Dawley ; Schisandra ; chemistry ; Swimming ; physiology ; Testosterone ; blood

OBJECTIVETo investigate the effects of different anesthesia depth on stress response in elderly patients undergoing elective laparoscopic surgery for colorectal cancer.

METHODSA total of 105 ASA I-III patients aged 60-91 years undergoing elective laparoscopic surgery for colorectal cancer with general anesthesia were randomized into 3 groups, namely group A with a target Narcotrend index (NI) maintained at D0 level, group B with a NI at D2 level, and group C with a NI at E1 level. The anesthetics (profopol and remifentanil) were adjusted according to Narcotrend monitoring results to maintain the specified anesthesia depth. The patients' heart rate (HR) and mean artery pressure (MAP) were recorded before anesthesia (T0), before intubation (T1), immediately after intubation (T2), at 2 min before pneumoperitoneum (T3), 2 min after pneumoperitoneum (T4), at the end of the surgery (T5) and extubation (T6). Serum levels of cortisol, adrenocorticotropic hormone (ACTH), endothelin-1 (ET-1), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) were measured by standard ELISA and radioimmunoassay before anesthesia (Ta), at the end of the surgery (Tb) and 1 day after the surgery (Tc).

RESULTSHR and MAP in group A increased significantly at T2, T4, and T6 compared to those at T0 (P<0.05), and were higher than those in group B and group C (P<0.05). The MAP in all the 3 groups all decreased at T1 and T3 (P<0.05 or P<0.01), and was markedly lower in group C than in groups A and B (P<0.05). The incidence of hypertension was significantly higher in group A than in groups B and C (P<0.05), while the incidence of hypotension was much higher in group C (P<0.01). There were no obvious differences in serum levels of cortisol, ACTH, CRP, IL-6, TNF-a, or ET-1 among the groups at Ta (P>0.05). The serum levels of ACTH in the 3 groups all significantly increased at Tb and Tc (P<0.01). CRP, IL-6 and TNF-a levels in group A were increased at Tb and Tc (P<0.05 or P<0.01) and significantly higher than those in groups B and C (P<0.05 or P<0.01). Cortisol in groups A and B increased at Tb and Tc (P<0.05) to a significantly higher level than that in group C (P<0.01). ET-1 level in group C at Tb and Tc was lower than those in groups A and B (P<0.05 or P<0.01).

CONCLUSIONSMaintaining the anesthesia depth for a NI at the D2 and E1 level can both attenuate the stress response in elderly patients undergoing laparoscopic surgery for colorectal cancer, but the hemodynamic stability can be better at a D2 level.

Adrenocorticotropic Hormone ; blood ; Aged ; Aged, 80 and over ; Anesthesia, General ; methods ; Blood Pressure ; C-Reactive Protein ; metabolism ; Colorectal Neoplasms ; surgery ; Elective Surgical Procedures ; Endothelin-1 ; blood ; Heart Rate ; Humans ; Hydrocortisone ; blood ; Interleukin-6 ; blood ; Laparoscopy ; Middle Aged ; Piperidines ; administration & dosage ; Propofol ; administration & dosage ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVE: To observe the effects of different maintain doses of Dexmedetomidine on plasma cortisol and glucose during anesthesia recovery period in patients undergoing uvulopalatopharyngoplasty under sevoflurane inhalation anesthesia. METHOD: In this prospective, randomized, double-blind study, 120 ASA I and II patients undergoing selective uvulopalatopharyngoplasty under general anesthesia were included. The patients were randomly allocated to three groups (n = 40): Dexmedetomidine low maintain dose group (D1), Dexmedetomidine high maintain dose group (group D2) and control group (group C). The Dexmedetomidine groups and control group were given Dexmedetomidine 1 microg/kg and normal saline in 20 ml within 15 min just before induction of anesthesia. Then Dexmedetomidine were maintained at 0.2 microg x kg(-1) x h(-1) and 0.7 microg x kg(-1) x h(-1) in group D1 and group D2 and were withdrawed 5 min before the end of operation, the same maintained speed of normal saline was given in group C. BIS value was maintained at 40-60 by adjusting the inhaled concentration of sevoflurane. Anesthetic was withdrawed 10 min before the end of operation. Thus, plasma cortisol concentration and blood glucose was needed to be detected just before anesthesia (T0), tracheal extubation (T1), 5 min after extubation (T2) and 15 min after extubation (T3). Duration of operation and anesthesia, consumption of sevoflurane, emergence time, extubation time, the occurrence of dysphoria, bucking and hypoxemia (SpO2 < 90%) during extubation were recorded. RESULT: Compared with group C, MAP and HR at T1, plasma cortisol concentration and blood glucose at T1 - T3 were all significantly lower in group D1 and group D2 (P < 0.05), and so were the consumption of sevoflurane and the occurrence of dysphoria (P < 0.05). The emergence time and extubation time were significantly prolonged in group D2 compared with group D1 and group C (P < 0.05). There was no significant difference in the occurrence of bucking and hypoxemia in three groups (P > 0.05). CONCLUSION In the patients undergoing UPPP under sevoflurane inhalation anesthesia, Dexmedetomidine infused at 0.2 microg x kg(-1) x h(-1) maintains a stable hemodynamics without respiratory depression, alleviates stress response during extubation and reduces both the consumption of sevoflurane and the occurrence of dysphoria without prolonging emergence time and extubation time.
Adult ; Anesthesia Recovery Period ; Anesthesia, Inhalation ; Blood Glucose ; metabolism ; Dexmedetomidine ; administration & dosage ; Double-Blind Method ; Female ; Humans ; Hydrocortisone ; blood ; Hypnotics and Sedatives ; administration & dosage ; Male ; Methyl Ethers ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; Palate, Soft ; surgery ; Pharynx ; surgery ; Sevoflurane ; Uvula ; surgery

OBJECTIVETo study the effect of Jiaweisinisan (JWSNS), a traditional Chinese herbal medicinal recipe, on gastric mucosal ultrastructure and brain-gut axis in rat models of chronic psychological stress and elucidate the mechanism of JWSNS for ameliorating stress-induced gastrointestinal dysfunction.

METHODSSixty rats were randomly assigned into normal control group, model group, 3 JWSNS groups (high, moderate, and small doses), and omeprazole group (n=10). Rat models of chronic psychological stress were established by random stressful stimulations, and following the corresponding interventions, plasma adrenocorticotropic hormone (ACTH) and cortisol (CORT) levels were detected using radioimmunoassay, and the mRNA expressions of gastrin receptor in the gastric tissue (GASR) and vasoactive intestinal peptide II receptor (VIPR2) in the jejunal tissue were examined using RT-PCR. Transmission electron microscopy was employed to examine the ultrastructural changes in the gastric mucosa tissue cells of the glandular stomach area and alterations in the intercellular junctions.

RESULTSElectron microscopy revealed obvious damages in gastric mucosal epithelial cell organelles and nuclei in the model rats. These damages were ameliorated after treatments with JWSNS and omeprazole. Compared with the model group, the 3 JWSNS groups and omeprazole group all showed significantly lowered plasma ACTH and CORT levels, increased gastrin receptor mRNA expression and decreased jejunal VIPR2 mRNA expression (P<0.05 or 0.01).

CONCLUSIONJWSNS can obviously ameliorate the pathologies of the gastric mucosa cells, regulate the state of brain-gut axis, and modulate the gastric gastrin receptor and jejunal VIPR2 mRNA expressions in rats with chronic psychological stress.

Adrenal Cortex Hormones ; blood ; Adrenocorticotropic Hormone ; blood ; Animals ; Drugs, Chinese Herbal ; pharmacology ; Gastric Mucosa ; metabolism ; pathology ; ultrastructure ; Hydrocortisone ; blood ; Jejunum ; metabolism ; Male ; Rats ; Rats, Wistar ; Receptors, Bombesin ; metabolism ; Receptors, Vasoactive Intestinal Peptide, Type II ; metabolism ; Stress, Psychological ; pathology

OBJECTIVETo find out a set of practical,objective, and quantitative laboratory indices of climacteric syndrome (CS) patients of Shen deficiency syndrome (SDS), thus studying the essence of SDS from the perspective of laboratory medicine.

METHODSRecruited were 40 CS patients of SDS (or of SDS as main syndrome) as the SDS group, while another 40 healthy subjects were recruited as the control group. Their serum samples were collected. Serum levels of total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (TESTO), estradiol (E2), prolactin (PRL), progesterone (PROG), cortisol (CORT), immunoglobulin M (IgM), immunoglobulin G (lgG), Complement 3 (C3), complement hemolysis 50% (CH50), angiotensin converting enzyme (ACE), aldosterone (ALD), serum alkaline phosphatase (ALP), and bone Gla-protein (BGP) were measured by automatic electrochemical luminescence assay analyzer, automatic chemiluminescence assay analyzer, automatic biochemistry analyzer, and automatic enzyme-linked immunosorbent assay (ELISA) analyzer. The correlation between syndrome types and laboratory indices were judged by gradual discriminant analyses.

RESULTS(1) Compared with the control group,serum levels of CORT, TESTO, E2, TT3, FT3, FT4, TSH, C3, CH50, ALP, and BGP significantly decreased in the SDS group (P < 0.01, P < 0. 05), while FSH, LH, and ACE significantly increased (P < 0.05). (2) The index with stronger capacity for diagnosing CS patients of SDS was ranked from high to low as CH50, PROG, TSH, TESTO, BGP, CORT, and C3, with their contribution rate of the discriminant function being 95.9%. (3) Discriminant analysis equation of CS patients of SDS was Y = -25.904 - 0.468CH50 + 0.002PROG + 0.182TSH + 9.690TESTO + 1.015BGP + 0.016CORT + 33.581 C3.

CONCLUSIONS(1) CS patients of SDS were closely correlated with thyroid hypothalamus-pituitary-adrenal axis, hypothalamus-pituitary-adrenal axis, renin-renin-angiotensin-aldosterone system,the immune function, and bone formation, and etc. (2) CH50 might be of a high sensibility marker for diagnosing CS patients of SDS. (3) Discriminant analysis equations of laboratory medicine index may be used in preliminary diagnosis and auxiliary certificate of CS patients of SDS.

Case-Control Studies ; Climacteric ; metabolism ; Discriminant Analysis ; Estradiol ; blood ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Hydrocortisone ; blood ; Luteinizing Hormone ; blood ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Pituitary-Adrenal System ; Progesterone ; metabolism ; Prolactin ; blood ; Renin-Angiotensin System ; Testosterone ; blood ; Thyrotropin ; blood ; Thyroxine ; blood ; Triiodothyronine ; blood

OBJECTIVETo investigate the influence of Yiqi Huatan Decoction (, YHD) on a model of depression in rats under different pathological conditions.

METHODSThirty-two male SD rats were randomly divided into 4 groups of 8: normal, model, YHD, and maprotiline. The model group, YHD group and maprotiline group used separate feeding and rats were exposed to chronic and unpredictable stress to build the depression model. From day 2, the YHD group and maprotiline group were respectively given YHD (7 g/kg) and maprotiline (10 mg/kg) by gastrogavage once daily. The normal and model groups were given the same volume of drinking water. The medication duration were 21 days. At the end of the experiment, the serum levels of copper and zinc were determined by atomic absorption spectroscopy, plasma concentrations of adrenocorticotropic hormone (ACTH) and cortisol (COR) were detected by radioimmunoassay, and levels of norepinephrine (NE), dopamine (DA), and 5-hydroxytryptamine (5-HT) in the hypothalamus were analysed by high performance liquid chromatography-eletricochemistry.

RESULTSCompared with the content of copper and zinc in the serum of rats in the normal group, serum copper levels in model rats were significantly increased and zinc content was significantly reduced (both P<0.05). Plasma concentrations of ACTH and COR in the model group were significantly increased compared with those in the normal group (P<0.05, P<0.01). The contents of NE, DA, and 5-HT in the hypothalamus of rats in the model group were significantly reduced compared with those of the normal group (P<0.05 or P<0.01). Compared with those in the model group, the serum copper content and plasma concentrations of ACTH and COR were significantly decreased (all P<0.05); meanwhile, serum zinc content and hypothalamic contents of NE, DA, and 5-HT were significantly increased in rats of the YHD group (all P<0.05). The same effects were also shown in the maprotiline group except for 5-HT (all P<0.05)

CONCLUSIONThe pharmacological actions of YHD for depression might be related to improving trace-element anomalies, reversing endocrine dysfunction, and modulating the disorders of monoaminergic neurotransmitters.

Adrenocorticotropic Hormone ; blood ; Animals ; Behavior, Animal ; drug effects ; Copper ; blood ; Depression ; blood ; drug therapy ; Dopamine ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Hydrocortisone ; blood ; Hypothalamus ; drug effects ; metabolism ; Male ; Norepinephrine ; metabolism ; Rats ; Rats, Sprague-Dawley ; Serotonin ; metabolism ; Zinc ; blood