Sociodemographic, clinical and treatment characteristics of current rapid-cycling bipolar disorder: a multicenter Chinese study

BACKGROUND

Rapid cycling bipolar disorder (RCBD), characterized by four or more episodes per year, is a complex subtype of bipolar disorder (BD) with poorly understood characteristics.

METHOD

This multicenter, observational, longitudinal cohort study enrolled 520 BD patients across seven psychiatric institutions in China from January 2013 to January 2014. Participants were divided into RCBD and non-RCBD (NRCBD) groups based on the frequency of mood episodes in the preceding year. Data collection utilized a standardized form, supplemented by a medical record review, focusing on sociodemographic, clinical, and treatment characteristics. Statistical analysis involved independent samples t-tests, Kruskal-Wallis H tests, Chi-square or Fisher's exact tests, with Bonferroni correction applied to account for multiple comparisons, and multivariable logistic regression to identify characteristics associated with RCBD.

RESULTS

Among the BD cohort, 9.4% were identified as current RCBD. Compared to NRCBD, RCBD patients had a shorter duration from the first psychiatric consultation to the diagnosis of BD, a reduced duration of their longest period of euthymia, a lower proportion of lifetime hospitalization history due to BD, and less use of electroconvulsive therapy (ECT) within the last 12 months. Additionally, they presented higher baseline scores on the Mood Disorder Questionnaire (MDQ) and the Brief 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). However, after applying the Bonferroni correction, these differences were not statistically significant. Multivariable logistic regression analysis identified three factors that were independently associated with RCBD: time from first psychiatric consultation to BD diagnosis (Odds Ratio [OR] = 0.512, P = 0.0416), lifetime hospitalization history due to BD (OR = 0.516, P = 0.0476), and ECT treatment within the past 12 months (OR = 0.293, P = 0.0472).

CONCLUSION

This study revealed that the duration from first psychiatric consultation to BD diagnosis, lifetime hospitalization history due to BD, and ECT treatment in the past year were associated with RCBD. Recognizing these factors could contribute to enhance the early identification and clinical outcomes of RCBD. Trial Registration Number Registry ClinicalTrials.gov NCT01770704. Date of Registration: First posted on January 18, 2013.

Agomelatine in the treatment of anhedonia, somatic symptoms, and sexual dysfunction in major depressive disorder

Objective

This study evaluated the treatment outcomes of agomelatine on anhedonic state, anxiety/somatic symptoms, and sexual function in Chinese patients with major depressive disorder (MDD).

Method

In total, 93 adult patients with MDD were enrolled, and 68 of them were included in a prospective, open-label, multicenter clinical study. All patients received agomelatine monotherapy during a 9-week treatment phase. The effectiveness of the treatment was reflected by the improvement of anhedonia and somatic symptoms based on the 17-item Hamilton Depression Rating Scale (HAMD-17). In addition, the Arizona Sexual Dysfunction Scale (ASEX), Sheehan Disability Scale (SDS), and Short Form of Quality-of-Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF) were administered to all participants at baseline and at the 3-, 6-, and 9-week follow-ups.

Results

After 9 weeks of treatment with agomelatine, the response and remission rates were 73.5% and 39.7%, respectively. Somatic symptoms significantly improved at week 9 (p < 0.001), and significant effects were also observed on the HAMD anhedonia items (p < 0.001). The patients exhibited lower levels of disease severity (the SDS score dropped from 15.52 ± 4.7 to 7.09 ± 5.62 at week 9; the ASEX score dropped from 21.89 ± 4.06 to 16.19 ± 4.79, p < 0.001) and higher levels of QOL (the Q-LES-Q-SF score dropped from 41.02 ± 5.99 to 50.49 ± 8.57, p < 0.001) during the follow-up. Furthermore, treatment with agomelatine improved depressive symptoms without causing serious adverse events.

Conclusion

These analyses indicate that agomelatine is a treatment option for improving anhedonic status, anxiety/somatic symptoms, and sexual dysfunction in MDD patients.

TRAF3 plays a role in lupus nephritis by regulating Th17 cell and Treg cell balance as well as NF-κB signaling pathway in mice

Lupus nephritis (LN) occurs with inflammatory lesion in patients suffering from systemic lupus erythematosus (SLE). Tumor necrosis factor (TNF) receptor associated factor 3 (TRAF3) is an important mediator in inflammation. To explore the roles of TRAF3 in LN, the LN mouse model was firstly established with intraperitoneal (i.p.) injection of pristine. Our results found that the amount of urinary protein was increased evidently at day 28, and renal damage occurred in the LN mouse model, but the TRAF3 knockdown reduced the urinary protein and alleviated the inflammatory lesion. The proinflammatory cytokines TNF-α, IL-1β, IL-17a, IFN-γ and IgM, IgG antibody were enriched, but there was little amount of IL-10 in the LN mouse model. Moreover, the amount of CD40+ B cells, CD4+ T cells sub-type, Th17 cells were abundant, and the proteins TRAF3, TRAF2, NF-κBp52, IKKα, ICAM1 in the kidney were highly expressed in the LN mouse model. However, TRAF3 knockdown enhanced the production of IL-10 and reduced the amount of pro-inflammatory cytokines, immunoglobulin, and the protein expressions of TRAF3, TRAF2, NF-κBp52, IKKα, ICAM1. In conclusion, TRAF3 plays a role in LN by regulating Th17 cell and Treg cell balance as well as NF-κB signaling pathway in mice.

[Evaluation of Advanced Nitrogen Removal from Coking Wastewater Using Sulfide Iron-containing Sludge as a Denitrification Electron Donor]

In general, it is difficult to reach the total nitrogen discharge standard in the effluent after municipal and industrial wastewater treatment. The problems hindering advanced denitrification include an unstable C/N ratio in the influent wastewater, increased hydraulic loading with increasing reflux ratio, reduced reaction kinetics, high energy consumption, and secondary pollution and high sludge yield resulting from addition of organic carbon sources. Therefore, deep denitrification with the advantages of energy savings and easy operation is urgently needed. To address these issues, chemical iron sulfide sludge, collected after the pretreatment of sulfur-containing industrial wastewater, was used as a solid-phase electron donor to perform advanced denitrification using autotrophic denitrifiers. In this study, the secondary biological effluent of coking wastewater was the influent for denitrification and the performance of denitrification, transformation of sulfide and iron in the sludge, and microbial community changes were investigated. The optimal reaction conditions and effect range of the technology for deep denitrification of wastewater were then calculated. When the concentrations of NO₃^--N and NO₂^--N in the influent were (74.54±0.57) and (1.11±0.19) mg·L^-1, respectively, the corresponding concentrations in the effluent were reduced to (2.78±1.08) and (2.87±0.71) mg·L^-1, respectively, with a hydraulic retention time (HRT) of 18 h. The removal rate of TON (NO₃^--N+NO₂^--N) was as high as 90.0%, of which the reduction rate of NO₃^--N and the accumulation rate of NO₂^--N were 12.06 and 7.74 mmol·(L·d)^-1, respectively. This study showed that the use of chemical sulfide iron sludge as an electron donor for deep denitrification is of practical importance, as it could simplify the subsequent treatment of sulfur- and iron-rich chemical sludge, finally reaching the goal of resource utilization.

Observations on the expression of human papillomavirus major capsid protein in HeLa cells

Background

The goal of this study was to identify the nature of the inclusion bodies that have been found in HeLa cells (cervical cancer immortal cell line) by electron microscope and to determine whether the major capsid protein (L1) of human papillomavirus (HPV) can be expressed in HPV-positive uterine cervix cancer cells.

Methods

HPV L1 protein expression in HeLa cells was detected with anti-HPV L1 multivalent mice monoclonal antibody and rabbit polyclonal anti-HPV L1 antibody by ELISA, light microscope immunohistochemistry, electron microscope immunocytochemistry and Western blotting assays. Reverse transcriptional PCR (RT-PCR) was performed to detect the transcription of L1 mRNA in HeLa cells. The immortalized human keratinocyte HeCat was used as the negative control.

Results

HPV L1 proteins reacted positively in the lysate of HeLa cells by ELISA assays. HRP labeled light microscope immunohistochemistry assay showed that there was a strong HPV L1 positive reaction in HeLa cells. Under the electron microscope, irregular shaped inclusion bodies, assembled by many small and uniform granules, had been observed in the cytoplasm of some HeLa cells. These granules could be labeled by the colloidal gold carried by HPV L1 antibody. The Western blotting assay showed that there was a L1 reaction strap at 80–85 kDa in the HeLa cell lysates, hence demonstrating the existence of HPV18 L1 in HeLa cells. RT-PCR assay showed that the L1 mRNA was transcribed in HeLa cells.

Conclusions

The inclusion bodies found in the cytoplasm of HeLa cells are composed of HPV18 L1 protein. Since HeLa cell line is a type of cervical cancer cells, this implies that HeLa cells have the ability to express HPV L1 proteins.

Research and application of heart sound alignment and descriptor

The research and application of heart sound (HS) analysis for cardiovascular disease (CVD) diagnosis has attracted more attention recently. Unlike other relevant HS analysis research, such as HS detection/component segmentation, HS feature extraction/classification etc., the proposed research treats HS as a whole and focuses mainly on comparing the similarity of acoustical characteristics reflecting pathological condition between two HSs, one of which is HS under test and another is the HS with known CVD. The concrete procedure refers to alignment of the HS into sequence and evaluating the similarity index through complexity and similarity analysis. In accordance with specific characteristics of HS, several relevant technologies such as musical instrument digital interface (MIDI), binary coding, N-gram, Lempel-Ziv (L-Z) complexity as well as super-symmetric comparison distance (SCD) similarity metric etc. are researched to be adapted and cascaded to realize the aforementioned target successfully. The contribution lies in that the aligning schemes including binary and N-gram are thoroughly investigated and then testing results witnessing the superiority of using N-gram in proposed approach are presented. The success of such a novel approach would not only assign a the new life to the traditional auscultation CVD diagnosis, but also simplify CVD diagnosis greatly leading to extensive application of such an efficient non-invasive physical diagnostic method in e-home healthcare.