Fear, Stress, Susceptibility, and Problematic Social Media Use Explain Motivation for COVID-19 Preventive Behaviors Among Patients With Stroke and Their Caregivers

The COVID-19 pandemic presented significant challenges for individuals who experienced stroke and their caregivers. It is essential to understand the factors affecting preventive behavior in these populations. Therefore, the present study examined the factors that influenced COVID-19 preventive behavior and motivation for COVID-19 vaccine uptake among patients with stroke and their caregivers. A cross-sectional study comprising 191 participants (81 patients with stroke and 110 caregivers) was carried out. Participants completed a survey assessing fear of COVID-19, stress, perceived susceptibility, problematic social media use, preventive behaviors, and motivation for vaccine uptake. Statistical analyses included descriptive statistics, Pearson correlations, and multiple linear regressions. Motivation for COVID-19 vaccine uptake was significantly positively correlated with problematic social media use (r = 0.225, P = .002), perceived susceptibility (r = 0.197, P = .008), and fear of COVID-19 (r = 0.179, P = .015), but negatively correlated with stress (r = -0.189, P = .010). Caregivers, compared to patients, showed a lower level of preventive behavior (standardized coefficient = -0.23, P = .017). Furthermore, higher levels of fear were associated with increased preventive behavior (standardized coefficient = 0.22, P = .006), while greater stress correlated with lower preventive behavior (standardized coefficient = -0.38, P < .001). Among patients with stroke and their caregivers, motivation of COVID-19 vaccine uptake and preventive behaviors were influenced by factors such as fear, perceived susceptibility, social media use, and stress. By using strategies such as targeted education, support, and communication campaigns, healthcare providers and policymakers may be able to enhance the well-being of patients with stroke and their caregivers during future pandemics.

Psychometric Properties of the Spiritual Coping Strategies Scale-Chinese Version (SCSS-C) for Adults in Taiwan

This study examined the psychometric properties of the Spiritual Coping Strategies Scale-Chinese version (SCSS-C) in Taiwanese adults. A convenience sample of 232 participants in Taiwan completed an online survey, and 45 of the 232 participants completed the SCSS-C again over a 2 week interval. The content validity index of the SCSS-C was 0.97. Parallel analysis and exploratory factor analysis results revealed two factors (religious coping and non-religious coping). The internal consistency of the SCSS-C was satisfactory (α = 0.88 to 0.92). Test-retest reliability was satisfactory (r = 0.68 to 0.89). The psychometric properties of the SCSS-C were found to be acceptable for use in Taiwanese adults.

The association of care burden with motivation of vaccine acceptance among caregivers of stroke patients during the COVID-19 pandemic: mediating roles of problematic social media use, worry, and fear

BACKGROUND

The aim of the present study was to investigate the relationship between care burden and motivation of COVID-19 vaccine acceptance among caregivers of patients who have experienced a stroke and to explore the mediating roles of social media use, fear of COVID-19, and worries about infection in this relationship.

METHODS

A cross-sectional survey study with 172 caregivers of patients who had experienced a stroke took part in a Taiwan community hospital. All participants completed the Zarit Burden Interview, Bergen Social Media Addiction Scale, Worry of Infection Scale, Fear of COVID-19 Scale, and Motors of COVID-19 Vaccine Acceptance Scale. Multiple linear regression model was applied to construct and explain the association among the variables. Hayes Process Macro (Models 4 and 6) was used to explain the mediation effects.

RESULTS

The proposed model significantly explained the direct association of care burden with motivation of COVID-19 vaccine acceptance. Despite the increased care burden associated with decreased vaccine acceptance, problematic social media use positively mediated this association. Moreover, problematic social media use had sequential mediating effects together with worry of infection or fear of COVID-19 in the association between care burden and motivation of vaccine acceptance. Care burden was associated with motivation of vaccine acceptance through problematic social media use followed by worry of infection.

CONCLUSIONS

Increased care burden among caregivers of patients who have experienced a stroke may lead to lower COVID-19 vaccines acceptance. Moreover, problematic social media use was positively associated with their motivation to get COVID-19 vaccinated. Therefore, health experts and practitioners should actively disseminate accurate and trustworthy factual information regarding COVID-19, while taking care of the psychological problems among caregivers of patients who have experienced a stroke.

Burdens on caregivers of patients with stroke during a pandemic: relationships with support satisfaction, psychological distress, and fear of COVID-19

BACKGROUND

Caregivers have faced unprecedented circumstances throughout the COVID-19 pandemic, but previous research only minimally addresses the caregivers' burden. Therefore, this study aimed to investigate the relationship between caregiver burden, psychological stress, satisfaction with support, and fear of COVID-19 in caregivers of patients with stroke during the pandemic.

METHODS

A cross-sectional survey study with total of 171 caregivers of patients with stroke in a community hospital in Taiwan. All participants completed the Zarit Burden Interview, Depression, Anxiety, Stress Scale (DASS-21), satisfaction of support survey, and Fear of COVID-19 Scale. Pearson correlations were used to examine the bivariate correlations between study variables. Then, with the control of demographic confounders, a multiple linear regression model was applied with significant variables to construct and explain caregiver burden.

RESULTS

The proposed model significantly explained the caregiver burden of caregivers of patients with stroke. Specifically, the caregiver burden was negatively correlated with satisfaction with family support, but positively with psychological distress and the fear of COVID-19.

CONCLUSIONS

Caregivers of patients with stroke will suffer a greater burden if they have lower satisfaction with family support, experienced higher psychological distress, and perceived more fear of the COVID-19 pandemic. Health professionals must address these concerns, support caregivers, and enhance available resources.

Validation of Stroke Risk Factors in Patients with Acute Ischemic Stroke, Transient Ischemic Attack, or Intracerebral Hemorrhage on Taiwan’s National Health Insurance Claims Data

Purpose

Taiwan has changed the coding system to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding since 2016. This study aimed to determine the optimal algorithms for identifying stroke risk factors in Taiwan’s National Health Insurance (NHI) claims data.

Patients and Methods

We retrospectively enrolled 4538 patients hospitalized for acute ischemic stroke (AIS), transient ischemic attack (TIA), or intracerebral hemorrhage (ICH) from two hospitals’ stroke registries, which were linked to NHI claims data. We developed several algorithms based on ICD-10-CM diagnosis codes and prescription claims data to identify hypertension, diabetes, hyperlipidemia, atrial fibrillation (AF), and ischemic heart disease (IHD) using registry data as the reference standard. The agreement of risk factor status between claims and registry data was quantified by calculating the kappa statistic.

Results

According to the registry data, the prevalence of hypertension, diabetes, hyperlipidemia, AF, and IHD among all patients was 77.5%, 41.5%, 47.9%, 12.1%, and 7.1%, respectively. In general, including diagnosis codes from prior inpatient or outpatient claims to those from the stroke hospitalization claims improved the agreement. Incorporating prescription data could improve the agreement for hypertension, diabetes, hyperlipidemia, and AF, but not for IHD. The kappa values of the optimal algorithms were 0.552 (95% confidence interval 0.524–0.580) for hypertension, 0.802 (0.784–0.820) for diabetes, 0.514 (0.490–0.539) for hyperlipidemia, 0.765 (0.734–0.795) for AF, and 0.518 (0.473–0.564) for IHD.

Conclusion

Algorithms using diagnosis codes alone are sufficient to identify hypertension, AF, and IHD whereas algorithms combining both diagnosis codes and prescription data are more suitable for identifying diabetes and hyperlipidemia. The study results may provide a reference for future studies using Taiwan’s NHI claims data.

Measurement Invariance of the Sexual Orientation Microaggression Inventory across LGB Males and Females in Taiwan: Bifactor Structure Fits the Best

The present study examined the factor structure and concurrent validity of the traditional Chinese version of the Sexual Orientation Microaggression Inventory (SOMI) among lesbian, gay, and bisexual (LGB) individuals in Taiwan. In total, 1000 self-identified LGB individuals completed the SOMI, HIV and Homosexuality Related Stigma Scale (HHRSS), and Acceptance and Action Questionnaire-II (AAQ). Different factor structures (including one-factor, four-factor, bifactor, and higher-order factor structures) were evaluated using confirmatory factor analysis. The bifactor structure significantly outperformed all others on the SOMI. The bifactor structure with one general factor and four trait factors was found to be measurement invariant across biological sex with satisfactory fit indices. The SOMI general factor was significantly associated with HHRSS-Homosexuality score and AAQ score. The findings indicate that the SOMI is a psychometrically sound instrument for Taiwan sexual minority groups. More specifically, SOMI can be used to accurately assess microaggression among LGB individuals. The measure on microaggression may also provide insights for healthcare providers about LGB individuals' sexuality-related stigma. Moreover, healthcare providers and relevant stakeholders can use the SOMI to understand how LGB individuals perceive and feel microaggression.

Validation of ICD-10-CM Diagnosis Codes for Identification of Patients with Acute Hemorrhagic Stroke in a National Health Insurance Claims Database

Purpose

The performance of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes for identifying acute hemorrhagic stroke in Taiwan’s National Health Insurance claims database has not been assessed. This study aimed to construct and validate the case definitions for acute hemorrhagic stroke based on ICD-10-CM diagnostic codes.

Patients and Methods

From January 2018 to December 2019, all inpatient records with ICD-10-CM code of I60 or I61 in any field of the discharge diagnoses were retrieved from the hospitalization claims data and all hospitalizations with a final diagnosis of subarachnoid hemorrhage (SAH) or intracerebral hemorrhage (ICH) were identified from the stroke registry databases. The clinical diagnosis in the stroke registry was treated as the reference standard. For hospitalizations not recorded in the stroke registry, manual review of the medical records and images was done to ascertain the diagnosis. The positive predictive value (PPV) and sensitivity of various case definitions for acute hemorrhagic stroke were estimated.

Results

Among the 983 hospitalizations, 860, 111, and 12 were determined to be true-positive, false-positive, and false-negative episodes of acute hemorrhagic stroke, respectively. The PPV and sensitivity of the ICD-10-CM codes of I60 or I61 for identifying acute hemorrhagic stroke were 88.6% and 98.6%, respectively. The PPV increased to 98.2%, whereas the sensitivity decreased to 93.1% when acute hemorrhagic stroke was defined as hospitalizations in which the primary diagnosis field contained I60 or I61. Hemorrhagic transformation of ischemic stroke and concomitant cerebrovascular diseases other than SAH or ICH were the main reasons for a false-positive and false-negative diagnosis of acute hemorrhagic stroke, respectively.

Conclusion

This study demonstrated the performance of ICD-10-CM codes for identifying acute hemorrhagic stroke and may offer a reference for future claims-based stroke studies.

Performance of ICD-10-CM Diagnosis Codes for Identifying Acute Ischemic Stroke in a National Health Insurance Claims Database

Purpose

The validity of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding for the identification of acute ischemic stroke (AIS) in Taiwan’s National Health Insurance claims database has not been investigated. This study aimed to construct and validate the case definition algorithms for AIS based on ICD-10-CM diagnostic codes.

Patients and Methods

This study identified all hospitalizations with ICD-10-CM code of I63* in any position of the discharge diagnoses from the inpatient claims database and all patients with a final diagnosis of AIS from the stroke registry between Jan 2018 and Dec 2019. Hospitalizations in the claims data that could be successfully linked to those in the registry data were regarded as true episodes of AIS. Otherwise, their electronic medical records and images were manually reviewed to ascertain whether they were true episodes of AIS. Using the true episodes of AIS as the reference standard, the positive predictive value (PPV) and sensitivity of various case definition algorithms for AIS were calculated.

Results

A total of 1227 hospitalizations were successfully linked. Among the 155 hospitalizations that could not be linked, 54 were determined to be true episodes of AIS. Using ICD-10-CM code of I63* in any position of the discharge diagnoses to identify AIS yielded a PPV and sensitivity of 92.7% and 99.4%, respectively. The PPV increased to 99.8% with >12% decrease in the sensitivity when AIS was restricted to those with I63* as the primary diagnosis. When AIS was defined to be I63* as the primary, first secondary, or second secondary diagnosis, both PPV and sensitivity were greater than 97%.

Conclusion

This study demonstrated the validity of various case definition algorithms for AIS based on ICD-10-CM coding and can provide a reference for future claims-based stroke research.

Effects of different pharmacologic smoking cessation treatments on body weight changes and success rates in patients with nicotine dependence: A network meta-analysis

Smoking cessation is a public health priority to reduce smoking-related morbidity and mortality. However, weight gain is a known primary reason for not trying to quit smoking. The aim of the current study was to investigate differences in weight gain associated with different pharmacological smoking cessation interventions. Randomized controlled trials (RCTs) that reported weight gain related to pharmacologic treatments for smoking cessation were analysed using network meta-analysis with a random effects model. Thirty-one RCTs with 5650 participants were included. Ten drugs and 22 regimens were identified. Nicotine patches plus fluoxetine, topiramate with/without nicotine patches, nicotine patches plus methylphenidate, nicotine spray/gum/lozenges, high-dose nicotine patches (42 mg/21 mg), naltrexone with/without nicotine patches, or bupropion with/without nicotine patches were associated with less weight gain than the placebo/control arm. Nicotine patches plus fluoxetine were associated with the least weight gain of all smoking cessation treatments. In addition, the nicotine patch plus topiramate and nicotine inhaler was associated with the best success rate and the least dropout rate, respectively. Overall, the nicotine patch 14 mg plus fluoxetine 40 mg, nicotine patch 14 mg plus fluoxetine 20 mg, and topiramate 200 mg would be the three best pharmacologic treatments based upon both weight gain effect and success rate.

Population-based study suggests an increased risk of Alzheimer'sdisease in Sjögren's syndrome

This population-based study was designed to estimate and compare the risk of Alzheimer’s disease (AD) between patients with primary Sjögren’s syndrome (SS) and non-SS patients during a 10-year follow-up period. This is a retrospective cohort study. Data were obtained from the Taiwan’s National Health Insurance Research Database. We identified 4463 primary SS patients and 22,315 non-SS patients; patients were matched by sex, age, and the year of index use of health care. Each patient was studied to identify the subsequent manifestation of AD. Cox proportional hazard regression was used to study the subsequent manifestation of AD, and Kaplan-Meier survival curves were used to compare survival probability. During the 10-year follow-up period, 7 primary SS and 13 non-SS patients developed AD. During the 10-year follow-up period, the risk of AD was 2.68-fold higher in the primary SS cohort with an overall adjusted hazard ratio (HR) of 2.69 (95% CI 1.07–6.76), after adjusting for demographics and comorbidities. Within the 10-year period, patients with primary SS showed a 2.69-fold increased risk of developing AD. This risk increases with time, and the relative risk of AD is higher in older patients with primary SS.

The hypothermic effects of dl-tetrahydropalmatine in rats

Systemic administration of dl-tetrahydropalmatine (THP; 10-50 mg x kg(-1) intraperitoneally) produced a proportional decrease in both colonic temperature and release of hypothalamic serotonin (5-hydroxytryptamine (5-HT)) in rats at room temperature. The hypothermia was brought about by cutaneous vasodilation and decreased metabolism. The THP- induced hypothermia was significantly attenuated in rats with brain 5-HT depletion produced by control injection of 5,7-dihydroxytryptamine or in rats with 5-HT2A receptor activation produced by 1-(2,5-dimethoxy-4-iodophenyl) -2-aminopropane, or in rats with 5-HT1A receptor antagonist produced by (-)-pindolol. The results suggest involvement of serotoninergic antagonism in the THP-induced hypothermia in rats

Radix Angelica Sinensis extracts ameliorate scopolamine- and cycloheximide-induced amnesia, but not p-chloroamphetamine-induced amnesia in rats

The effects of the methanolic extract of Radix Angelica Sinensis (Umbellifera) (abbreviated as RAS extract) and n-hexane fraction of RAS extract (RAS(H) fraction) on the various drugs-induced amnesia in rats were studied by using passive avoidance task. RAS extract (1 g/kg) significantly prolonged the shortened step-through latency induced by SCOP and CXM, but not PCA. Furthermore, RAS(H) fraction (1 g/kg) also significantly prolonged the shortened step-through latency induced by SCOP and CXM but not PCA. RAS extract at any dose alone did not influence the step-through latency in the training trial produced by non-shocked rats, but it plus PCA prolonged the latency compared with PCA alone. However, RAS(H) fraction (1 g/kg) prolonged the latency in the training trial produced by non-shocked rats, but it plus any induced drugs did not differ from any induced drugs alone. These results suggest that the attenuating effects of RAS extract on the various drugs-induced amnesia were related to the memory processes. n-Hexane fraction of RAS extract might be one of the active fractions of RAS extract in the treatment of amnesia.

Reversal caused by n-butylidenephthalide from the deficits of inhibitory avoidance performance in rats

The present study was designed to investigate the mechanism of action of n-butylidenephthalide on the deficits of inhibitory avoidance performance induced by drugs in rats with piracetam as a positive control. n-Butylidenephthalide attenuated the scopolamine-induced and mecamylamine-induced acquisition impairment, and also attenuated the acquisition impairment induced by scopolamine plus mecamylamine. Furthermore, scopolamine methylbromide, a peripheral cholinergic muscarinic receptor antagonist, did not block the counteracting effect of n-butylidenephthalide on the scopolamine-induced acquisition impairment. n-Butylidenephthalide attenuated the impairment of inhibitory avoidance performance induced by the central acetylcholinergic neurotoxin AF64A administered intracisternally. From the above results, we suggest that n-butylidenephthalide attenuated the deficits of inhibitory avoidance performance induced by drugs, which are the effects related to activating the central but not the peripheral cholinergic neuronal system via muscarinic and nicotinic receptors.

The ameliorating effect of the water layer of Fructus Schisandrae on cycloheximide-induced amnesia in rats: interaction with drugs acting at neurotransmitter receptors

Our previous study indicated that the water layer present in Fructus Schisandra(FS(w)) at 10 and 25 mg kg(-1)significantly counteracted cycloheximide (CXM)-induced amnesia. Therefore, the mechanism of action of the ameliorating effect of FS(w)on CXM-induced amnesia in the passive avoidance task was investigated in rats. The ameliorating effect of FS(w)on CXM-induced amnesia was depressed by scopolamine. The serotonin releaser, p -chloroamphetamine significantly antagonized the ameliorating effect of FS(w)on CXM-induced amnesia. Furthermore, the ameliorating effect was also inhibited by the 5-HT(1A)receptor agonist 8-OH-DPAT, but potentiated by the 5-HT(2)receptor antagonist ritanserin. Finally, the GABA(A)receptor antagonist bicuculline blocked the ameliorating effect of FS(w). These results suggest that the beneficial effect of FS(w)on CXM-induced amnesia is amplified by treatment with serotonergic 5-HT(2)receptor antagonists, but reduced by serotonergic 5-HT(1A)receptor agonists as well as GABA(A)and cholinergic receptor antagonists.

Anti-hepatitis B virus effects of wogonin isolated from Scutellaria baicalensis

By using an HBV-producing cell line (MS-G2) in vitro culture system, we found that wogonin isolated from Scutellaria baicalensis can suppress HBV surface antigen production (P < 0.001) without evidence of cytotoxicity. By assaying the endogenous HBV DNA polymerase activity, we found that both the relaxed circular and the linear forms of HBV DNA are significantly reduced in the wogonin-treated group. Wogonin deserves to be further evaluated for the treatment of human HBV infection.

Anxiolytic effect of seed of Ziziphus jujuba in mouse models of anxiety

The aim of the present study was to investigate the ethanolic extract of Semen Ziziphi jujuba (SZJE) induced anxiolytic effect. The SZJE was orally administered to male ICR mice, at 0.5, 1.0 and 2. 0 g/kg, 30 min before the behavioral evaluation in the black and white test (BWT) and elevated plus maze (EPM). The SZJE at the dosage 0.5-2.0 g/kg increased the first time entry, total changes and times spent in the white chamber of the BWT. The SZJE at the dosage 0.5-1.0 g/kg increased the percentage of time-spent and the percentage of arm entries in the open arms of the EPM and decreased the percentage of time-spent and the percentage of arm entries in the closed arms of the EPM. Furthermore, the SZJE at the dosage of 1. 0 g/kg prolonged the hexobarbital-induced sleeping time in mice and decreased the locomotor activity in rats. These results suggested that SZJE possessed anxiolytic effect at lower dose and sedative effect at higher dose.

The ameliorating effects of the cognitive-enhancing Chinese herbs on scopolamine-induced amnesia in rats

Ameliorating effects were investigated of the cognitive-enhancing Chinese herbs administered orally for 1 week-Panax ginseng (PG), Panax notoginseng (PNG), Dioscorea opposita (DO), Gastrodia elata (GE), Salvia miltiorrhiza (SM), Acorus gramineus (AG), Coptis chinensis (CC), Polygonum multiflorum (PM), Cyperus rotundus (CR) and Psoralea corylifolia (PC)-on the scopolamine (SCOP)-induced amnesia by using a passive avoidance task in rats. Of ten Chinese herbs, only PG, PNG, GE and CC prolonged the SCOP-shortened STL. These results revealed that PG, PNG GE and CC administered orally for 1 week improved the SCOP-induced learning and memory deficit in rats.

Anti-inflammatory and neuroprotective effects of magnolol in chemical hypoxia in rat cultured cortical cells in hypoglycemic media

Our previous studies demonstrated that magnolol protects neurons against chemical hypoxia by KCN in cortical neuron-astrocyte mixed cultures (14). In the present study, we examined whether the neuroprotective effect of magnolol involve modulating inflammatory mediators, prostaglandin E2 (PGE2) and nitric oxide (NO), induced by KCN (hypoxia) or KCN plus lipopolysaccharide (LPS). In glucose-absent (hypoglycemia) media, KCN or KCN plus LPS induced increases in lactate dehydrogenase (LDH) activity by 32% and 34%, and PGE2 production by 12% and 32%, respectively. Both LDH and PGE2 increases were suppressed by 100 microM magnolol. In addition, although KCN or LPS alone did not increase NO generation, KCN plus LPS increased NO generation. This increase was reduced by 100 microM magnolol or 10 microM L-NAME, but the LDH increase and PGE2 production were not reduced by L-NAME. These findings suggest that the protective effects of magnolol against brain damage by KCN or KCN plus LPS in hypoglycemic media may involve inhibition of PGE2 production, but inhibition of NO generation may not be important.

Effects of Fructus schizandrae on cycloheximide-induced amnesia in rats

The effects of Fructus Schisandrae (Schizandra Chinensis, (FS) on cycloheximide (CXM)-induced amnesia by using a passive avoidance task were studied in rats. FS at 0.25 and 0.75 g/kg administered for 1 week significantly prolonged the CXM-shortened step-through latency (STL). Of the fractions (n-hexane, chloroform and water), only the water fraction at 25 mg/kg administered for 1 week prolonged the CXM-shortened STL. These results suggest that the water fraction is the main active fraction of FS.

The neuroprotective effect of DL-tetrahydropalmatine in rat heatstroke

After the onset of heatstroke, rats with saline injection displayed hyperthermia, decreased mean arterial pressure, decreased cerebral blood flow, increased brain monoamine release, and increased neuronal damage score compared with those of normothermia, control rats. The heatstroke-induced hyperthermia, arterial hypotension, cerebral ischemia, brain monoamine overload, and cerebral neuronal injury were attenuated by pretreatment with dl-tetrahydropalmatine. The data indicate that DL-tetrahydropalmatine pretreatment provides neuroprotective effect in heatstroke.

Effects of Fructus schizandrae on cycloheximide-induced amnesia in rats

The effects of Fructus Schisandrae (Schizandra Chinensis, (FS) on cycloheximide (CXM)-induced amnesia by using a passive avoidance task were studied in rats. FS at 0.25 and 0.75 g/kg administered for 1 week significantly prolonged the CXM-shortened step-through latency (STL). Of the fractions (n-hexane, chloroform and water), only the water fraction at 25 mg/kg administered for 1 week prolonged the CXM-shortened STL. These results suggest that the water fraction is the main active fraction of FS.

Effects of palmatine on isometric force and intracellular calcium levels of arterial smooth muscle

The effects of palmatine on isometric force and intracellular free calcium levels ([Ca2+]i) were determined in isolated rat arterial strips. Palmatine dose-dependently relaxed the contractile responses stimulated by phenylephrine (PE) in aortic strips. In contrast, it only partially relaxed aortic strips contracted by 51 mM KCl. Pretreatment with palmatine shifted the dose-response curves of PE both rightwards and downwards in a dose-dependent manner. When Ca2+-free solution and re-addition of Ca2+ were applied to assess PE-induced phasic and tonic contractions, palmatine was found to be effective in inhibiting both contractions. The effects of palmatine on intracellular calcium levels were measured with the bioluminescent calcium indicator aequorin in rat tail artery strips. Palmatine caused a concomitant, dose-dependent decrease in PE-activated isometric force and [Ca2+]i, resulting in small changes in the [Ca2+]i-force relationship. These results suggest that vasodilatory effect of palmatine was mediated by reducing [Ca2+]i as well as affecting [Ca2+]i sensitivity of the contractile apparatus. Palmatine-induced [Ca2+]i decreases appeared to involve decreases in both Ca2+ release from intracellular stores and Ca2+ influx through calcium channels.

Catecholaminergic mechanisms-mediated hypothermia induced by magnolol in rats

Intraperitoneal administration of magnolol (25-100 mg/kg) produced a dose-related fall in rats' colonic temperature. The magnolol-induced hypothermia was attenuated by pretreatment with intracerebroventricular 6-hydroxydopamine (200 microg/rat). The L-DOPA (200 mg/kg, i.p.) plus benserazide (50 mg/kg, i.p.)-induced hyperthermia was attenuated by magnolol. On the other hand, the alpha-methyltyrosine (100 mg/kg, i.p.)-induced hypothermia was potentiated by magnolol. Furthermore, magnolol (50 mg/kg, i.p.) decreased the dopamine and norepinephrine release in the hypothalamus, but did not change the concentrations for their metabolites (3,4-dihydroxyphenylacetic acid and homovanillic acid). The data suggest that magnolol decreases colonic temperature by reducing catecholaminergic activity in rat hypothalamus.

Magnolol decreases body temperature by reducing 5-hydroxytryptamine release in the rat hypothalamus

1. The effects of magnolol, isolated and purified from the cortex of Magnolia officinalis Rehd. et Wils, on thermoregulation and hypothalamic release of 5-hydroxytryptamine (5-HT) by in vivo microdialysis were assessed in normothermic rats and in febrile rats treated with interleukin-1 beta. 2. Intraperitoneal administration of magnolol (25-100 mg/kg) produced a decrease in colon temperature, an increase in foot skin temperature, a decrease in metabolic rate and a decrease in the endogenous release of 5-HT in the rat hypothalamus. 3. Depletion of rat brain 5-HT, produced by intracerebroventricular pretreatment with 5,7-dihydroxytryptamine, attenuated the magnolol-induced hypothermia, cutaneous vasodilation and decreased metabolism. 4. Intracerebroventricular administration of (+/-)-2,5-dimethoxy-4-iodoamphetamine (a 5-HT2 receptor agonist; 5-10 micrograms/5 microL) increased basal colon temperature and reversed the magnolol-induced hypothermia. 5. The increases in both colon temperature and hypothalamic 5-HT release produced by interleukin-1 beta injection were attenuated by treatment with magnolol. 6. The data suggest that magnolol decreases body temperature (due to increased heat loss and decreased heat production) by reducing 5-HT release in rat hypothalamus.

Ameliorating effect of p-hydroxybenzyl alcohol on cycloheximide-induced impairment of passive avoidance response in rats: interactions with compounds acting at 5-HT1A and 5-HT2 receptors

The effect of p-hydroxybenzyl alcohol (HBA) on cycloheximide (CXM)-induced impairment in the step-through passive avoidance task was investigated in rats and compared to the effect of the nootropic piracetam. HBA and piracetam significantly counteracted the CXM-induced shortening of retention latencies. The effect of HBA was a bell-shaped dose-response curve with a maximal effect of 5 mg/kg. The counteractive effect of HBA was not depressed by either scopolamine or mecamylamine. The serotonin (5-HT) releaser, p-chloroamphetamine, and presursor, 5-hydroxytryptophan, significantly antagonized the counteractive effect of HBA on the CXM-induced shortening of retention latencies. Furthermore, the counteractive effect was also inhibited by the 5-HT1A receptor agonist 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) and the 5-HT2 receptor agonist 1-(2,5-dimethoxy-4-iodophenyl)-2 aminopropane [(+/-)-DOI], but potentiated by the 5-HT1 receptor antagonist (+/-)-pindolol and the 5-HT2 receptor antagonist ritanserin. There results suggest that the beneficial effect of HBA on CXM-induced impairment is amplified by treatment with serotonergic receptor antagonists but reduced by serotonergic 5-HT1A and 5-HT2 receptor agonists, and insensitive to cholinergic manipulations.

Biphasic effects of pu-chung-i-chi-tang on sedation and excitation

The biphasic effects of Pu-Chung-I-Chi-Tang (PCT) on sedation and excitation in acute treatment or after one-week consecutive treatment were studied. The results indicated that PCT produces sedation in acute treatment and excitation after one-week consecutive treatment. The sedative mechanism of PCT in acute treatment might be due to an increase in serotonergic activity and a decrease in dopaminergic activity. However, the excitatory mechanism of PCT after one-week consecutive treatment might involve the increase in dopaminergic activity and the decrease in serotonergic activity.

Effect of long-term administration of berberine on scopolamine-induced amnesia in rats

The effect of berberine (BER) on scopolamine (SCOP)-induced amnesia was investigated in a step-through passive avoidance task in rats. It was observed that BER at the doses of 0.1 and 0.5 g/kg after 7-day or 14-day administration significantly improved SCOP-induced amnesia. The anti-amnesic effect of BER after 14-day administration on the SCOP-induced amnesia was significantly augmented by physostigmine or neostigmine, and completely reversed by scopolamine N-methylbromide. These results suggest that the antiamnesic effect of BER after 14-day administration may be related to the increase in the peripheral and central cholinergic neuronal system activity.

Gastrodin and p-hydroxybenzyl alcohol facilitate memory consolidation and retrieval, but not acquisition, on the passive avoidance task in rats

Gastrodin (GAS) and p-hydroxybenzyl alcohol (HBA) which is an aglycone of gastrodin, are active ingredients of Gastrodia elata Blume. In this study, we attempted to investigate the effects of acute administration of GAS and HBA on learning and memory processes such as acquisition, consolidation and retrieval, on the passive avoidance task in rats; piracetam was used as a positive control. Scopolamine, impairing learning acquisition, shortened the step-through latency in the retention test in rats. GAS and HBA did not prolong the step-through latency induced by scopolamine in the passive avoidance task, but piracetam could prolong the step-through latency induced by scopolamine. Cycloheximide, impairing memory consolidation, shortened the step-through latency in the retention test in rats. GAS at 50 mg/kg, HBA at 5 mg/kg and piracetam at 100 mg/kg could prolong the step-through latency induced by cycloheximide in the passive avoidance task. Apomorphine, impairing memory retrieval, shortened the step-through latency in the retention test in rats. GAS at 5 mg/kg, HBA at 1 mg/kg and piracetam at 300 mg/kg could prolong the step-through latency induced by apomorphine in the passive avoidance task. From the above results, we concluded that the facilitating effects of HBA on learning and memory are better than those of GAS. In conclusion, GAS and HBA can improve cycloheximide- and apomorphine-induced amnesia, but not scopolamine-induced acquisition impairment in rats. Thus, GAS and HBA can facilitate memory consolidation and retrieval, but not acquisition. The facilitating effects of GAS and HBA are different from those of piracetam.

Inhibitory effects of (+/-)-tetrahydropalmatine on thyrotropin-stimulating hormone concentration in hyperthyroid rats

The effects of (+/-)-tetrahydropalmatine ((+/-)-THP) on the hypothalamus-pituitary-thyroid system in rats were investigated. Thyroid function experiments indicated that (+/-)-THP produces significant decreases in thyroid function in hyperthyroid rats after 14 days of treatment. These effects were the same as those of propylthiouracil. However, propylthiouracil also decreased thyroid function in normal rats. Measurements of thyrotropin-stimulating hormone (TSH) demonstrated that (+/-)-THP decreased TSH in hyperthyroid rats after 14 days of treatment; however, propylthiouracil increased TSH in hyperthyroid rats. (+/-)-THP had no influence on TSH, or thyroid and pituitary weight in normal and hyperthyroid rats. We conclude that (+/-)-THP has an antithyroid function and the mechanism of action may be related to the inhibition of TSH in the pituitary.

Effects of Gastrodia elata and its active constituents on scopolamine-induced amnesia in rats

The effects of the rhizome of Gastrodia elata Blume (Orchidaceae) (abbreviated as GE) and its active constituents on learning and memory by using the one-trial passive avoidance task were studied in rats. At the 1.0 g/kg dose administered for one week, the methanol extract of GE significantly prolonged the shortened step-through latency induced by scopolamine in the passive avoidance task. Furthermore, at the 50.0 mg/kg dose administered for one week, the ethyl acetate and n-butanol fractions of the methanol extract prolonged the shortened step-through latency induced by scopolamine in rats. Gastrodin, isolated from the n-butanol fraction of the methanol extract, and p-hydroxybenzyl alcohol, isolated from the ethyl acetate fraction of the methanol extract, also significantly prolonged the shortened step-through latency induced by scopolamine on the passive avoidance task. These results suggested that gastrodin and p-hydroxybenzyl alcohol may be the active constituents of GE.

Antihypertensive effects of DL-tetrahydropalmatine: an active principle isolated from Corydalis

1. The effects of DL-tetrahydropalmatine (DL-THP) on cardio-vascular function and hypothalamic release of monoamines were assessed in rats under urethane anaesthesia. 2. Intravenous administration of DL-THP (1-10 mg/kg) produced hypotension, bradycardia, a decrease in hypothalamic serotonin and noradrenaline release and an increase in hypothalamic dopamine release in rats. 3. Intrahypothalamic administration of DOI (a serotonergic 5-HT2 receptor antagonist) or apomorphine (a dopamine D2-receptor agonist) produced the opposite effects and reversed DL-THP-induced hypotension and bradycardia. 4. The data suggest that DL-THP acts through the 5-HT2 and/or D2-receptor antagonism in the hypothalamus to induce hypotension and bradycardia in rats.

Increase of locomotor activity by acupuncture on Bai-Hui point in rats

The effect of acupuncture on locomotor activity was investigated in rats. Stimulation with acupuncture inserted in Bai-Hui point, which is located at the vertex of the head, increased the spontaneous locomotor activity of rats measured in ANIMEX meter. This effect was obtained in rats which received acupuncture significantly at 60 min later as compared with sham-treated control. The sleeping time induced by hexobarbital was also reduced markedly in rats receiving acupuncture. An activation of the central nervous system by acupuncture at Bai-Hui point can thus be considered. This action was unrelated to opioids because naloxone failed to modify it. Increase in locomotor activity was abolished by an intraperitoneal (i.p.) injection of alpha-methyl-p-tyrosine (200 mg/kg) at 2 h before insertion of acupuncture. Deprenyl at the dose sufficient to elevate monoamine enhanced this action of acupuncture. Mediation of cerebral monoamines can also be considered. This view was supported by the dose-dependent inhibition of chlorpromazine. Action of acupuncture was not observed in apomorphine (0.5 mg/kg, i.p.)-treated rats, probably due to an activated receptor of dopamine. Otherwise, action of acupuncture was enhanced by para-chlorophenylalanine, the depleter of endogenous 5-hydroxytryptamine (5-HT), and eliminated by 5-hydroxytryptophan, the precursor of 5-HT, in the initial stage of insertion. Participation of 5-HT can be considered as an initial way in rats that received acupuncture at Bai-Hui point. These results suggested that stimulation of Bai-Hui point with acupuncture can activate central neurotransmission of monoamines to increase the spontaneous locomotor activity in rats.

Effects of Hemerocallis flava on motor activity and the concentration of central monoamines and its metabolites in rats

In this study, we used behavioral and biochemical methods to investigate the effects of Hemerocallis flava (Liliaceae) (abbreviated as HF) on motor activity and the concentration of monoamines in rats. The water fraction of the resuspended HF extract was most active in reducing the motility in rats. The water fraction of the HF extract enhanced the reduction of locomotor activity produced by alpha-methyl-p-tyrosine and 5-hydroxytryptophan, but it reduced the increase of locomotor activity produced by L-dopa plus benserazide and p-chlorophenylalanine. Furthermore, the water fraction of the HF extract significantly decreased the concentration of norepinepherine in the cortex and the concentration of dopamine and serotonin in the brain stem. It also increased the concentration of vanilylmandelic acid in the cortex, homovanillic acid and 5-hydroxyindole-acetic acid in the brain stem. These results suggest that the reduction of locomotor activity produced by the water fraction of HF extract may be related to the decrease in the concentration of norepinepherine in the cortex and the concentration of dopamine and serotonin in brain stem.

p-Hydroxybenzyl alcohol attenuates learning deficits in the inhibitory avoidance task: involvement of serotonergic and dopaminergic systems

p-Hydroxybenzyl alcohol (HBA), an aglycone of gastrodin, is an active ingredient of Gastrodia elata BLUME. In this study, we investigated the action of HBA on acquisition of an inhibitory avoidance response in rats and used piracetam as a positive control. The results indicated that scopolamine, a cholinergic receptor antagonist, injected before training impaired retention. HBA did not attenuate the scopolamine-induced impairment, but piracetam did. p-Chloroamphetamine, a serotonin releaser, injected before training impaired retention. HBA at 5 mg/kg and piracetam at 100 mg/kg could counteract the p-chloroamphetamine-induced deficit. Apomorphine, a dopaminergic receptor agonist, also impaired retention. HBA at 5 mg/kg and piracetam at 300 mg/kg could ameliorate the apomorphine-induced amnesia. The above results indicated that HBA, different from piracetam, can attenuate impairments induced by p-chloroamphetamine and apomorphine, but had no effect on impairment induced by scopolamine in an inhibitory avoidance task in rats. Such findings suggest that HBA may act through suppressing dopaminergic and serotonergic activities and thus improves learning.

Hypotensive and bradycardic effects of dl-tetrahydropalmatine mediated by decrease in hypothalamic serotonin release in the rat

In anesthetized rats, intravenous administration of dl-tetrahydropalmatine (dl-THP, 1-10 mg/kg) elicited proportional hypotension, bradycardia and decreases in hypothalamic serotonin (5-HT) release (measured by carbon-fiber electrodes in combination with voltammetry). In addition, postsynaptic blockade of 5-HT2 receptors with cyproheptadine (2-5 mg/kg, i.v.) or ketanserin (2-5 mg/kg, i.v.) produced both hypotension and bradycardia, while stimulation of 5-HT2 receptors with 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI) (10-250 mg/kg, i.v.) produced both hypertension and tachycardia. The dl-THP-induced hypotension and bradycardia could be reversed by DOI treatment. The data indicate that dl-THP decreases both arterial pressure and heart rate through a serotonergic release process in the hypothalamus.

DL-tetrahydropalmatine-produced hypotension and bradycardia in rats through the inhibition of central nervous dopaminergic mechanisms

The effects of DL-tetrahydropalmatine (THP; a main active substance of the Chinese herb corydalis), haloperidol (a dopamine D2 receptor antagonist), apomorphine and amphetamine on cardiovascular function and striatal dopamine (DA) release were compared in rats under general anesthesia. Intravenous administration of THP (1-10 mg/kg) or haloperidol (0.5-1.25 mg/kg) produced hypotension, bradycardia and increased DA release in the striatum. On the other hand, amphetamine (0.5-1.25 mg/kg) produced hypertension, tachycardia and increased striatal DA release. However, intravenous injection of apomorphine (0.5-1.25 mg/kg) produced hypotension, bradycardia and decreased striatal DA release. In addition, the THP-induced hypotension was attenuated by pretreatment with spinal transection or amphetamine, while the THP-induced bradycardia was attenuated by pretreatment with bilateral vagotomy or amphetamine. Thus, it appears that THP acts through DA D2 receptor antagonism to induce hypotension and bradycardia in rats.

Effects of ginseng on the blood chemistry profile of dexamethasone-treated male rats

Ginseng, a panacea in the Orient, has been widely investigated in the last two decades and found to possess a wide range of pharmacological activities including anti-fatigue properties, a transient regulatory action on metabolism and blood pressure, and an increase in the hypothalamo-pituitary-adrenocortical activities. However, a panoramic clinical chemistry study including adrenal and thyroid functions has never been done before. Two experiments with the same design but different concentrations of dexamethasone were performed in this study. The results obtained from the two experiments indicated that ginseng administration at this regime did not influence the blood chemistry profiles in normal rats, but significantly decreased AST and ALT levels from those in dexamethasone-treated ones. It implies that ginseng has a liver-protective effect. Meanwhile, ginseng therapy restores the adrenal and thyroid functions of rats inhibited by dexamethasone treatment.

Effects of palmatine on motor activity and the concentration of central monoamines and its metabolites in rats

We used behavioral and biochemical methods to investigate the sedative effect of palmatine on locomotor activity and the concentration of monoamine in rats. It was found that palmatine enhanced the hypomotility induced by alpha-methyl-p-tyrosine, reserpine and 5-hydroxytryptophan, but reduced the hypermotility produced by L-dopa plus benserazide and p-chlorophenylalanine. Furthermore, palmatine significantly decreased the concentration of dopamine and homovanillic acid in the cortex and the concentration of serotonin in the brain stem, and it increased the concentration of 5-HT in the cortex and 5-hydroxyindole acetic acid in the brain stem. These results suggest that the sedative mechanism of palmatine may be related to the decrease in the concentration of catecholamine in the cortex and serotonin in brain stem and the increase in the concentration of 5-HT in the cortex.

Isolation and typing of herpes simplex virus from clinical specimens collected at National Taiwan University Hospital, 1981-1990

From 1981 to 1990, 10,167 clinical specimens were collected at National Taiwan University Hospital from the cases with suspected viral infections. Three hundred of herpes simplex virus (HSV) were isolated from these samples (isolation rate; 3.0%). One hundred and fifty-one strains were isolated from non-genital, and 149 strains from genital areas. HSV strains were typed by direct immunofluorescence staining technique. The type specific monoclonal antibodies were used in the test. Most of the HSV strains isolated from non-genital areas were type 1 (HSV-1) (147/151, 97.4%) whereas most of the strains from genital areas were type 2 (HSV-2) (140/149, 94.0%). All nine strains of HSV-1 isolated from genital areas were from female patients. The predominance of HSV-1 in non-genital area infections, and of HSV-2 in genital area infections, did not change during the ten years under review.

Long-term reno-cardiovascular effects of orally administered aconiti tuber in humans

The reno-cardiovascular effects of Aconiti Tuber were studied. In a controlled, double-blind, and randomized clinical trial, it was found that in 9 months, Aconiti Tuber, after preparation (120 degrees C, 40 min), (1) had no apparent adverse effects, (2) showed positive inotropic, positive chronotropic, and vasodilator effects, (3) increased renal blood flow, and glomerular filtration rate, Na+/Cl-/K+ excretions. The renal function test results could be interpreted as secondary to hemodynamic changes. We conclude that specially prepared Aconiti Tuber may be a promising cardiotonic agent.

Effects of paweiwan on streptozotocin-induced hyperglycemia in rats

The ancient Chinese remedy of Paweiwan was used by patients with polyuria, polydipsia, and polyphagia. The present study investigated the hypoglycemic effects of Paweiwan using streptozotocin-induced hyperglycemic rats. The effects on serum glucose in a 4-day course, in a 7-week course, on the standard oral glucose tolerance test, and on the liver glycogen content were studied. In the glucose tolerance test, chlorpropamide and insulin were used as the positive controls and 0.5% CMC (Carboxymethylcellulose) was used as the negative control. We found that Paweiwan decreased the baseline glucose concentration, ameliorated the blood glucose elevation after glucose challenge, and increased liver glycogen content. The results may imply that Paweiwan increases glucose entrance into cells.

Effects of san-huang-hsieh-hsin-tang on central monoaminergic and GABAergic systems in rats

In this paper, the effects of San-Huang-Hsieh-Hsin-Tang on central monoaminergic and GABAergic systems were studied in rats. It was found that San-Huang-Hsieh-Hsin-Tang significantly (1) prolonged the period from the onset of clonic to tonic convulsions induced by picrotoxin, (2) prolonged the sleep duration induced by hexobarbital, (3) inhibited central catecholaminergic activity, (4) promoted central GABAergic activity, and (5) decreased the turnovers of central norepinephrine and dopamine.

Hemodynamic effects of orally administered Sunitang in humans

The hemodynamic effects of Sunitang, an ancient Chinese remedy for general weakness, weak pulse, and cold extremities, were studied. In study, 1, 10 patients with left ventricular failure received Sunitang in single oral doses of 250, 500, and 1000 mg in a double-blind manner. Sunitang showed dose-related positive inotropic, chronotropic, and vasodilator effects. The effects reached their maximum within 30 to 60 minutes and lasted for 6 hours. In study 2, 77 patients with left ventricular failure who had not been treated satisfactorily by the conventional methods entered a controlled (parallel design), double-blind study for 1 month. When they entered the study they were in steady states. They continued their original medications throughout the month. Sunitang showed additional positive inotropic, chronotropic, and vasodilator effects. In this study no apparent adverse effects of Sunitang were noted. We conclude from these results that Sunitang may be useful in heart failure and bradycardia.

Suanzaorentang versus diazepam: a controlled double-blind study in anxiety

The ancient Chinese remedy Suanzaorentang was originally described in Kin-Kue-Yao-Lueh for patients with weakness, irritability and insomnia. In our preliminary observations on suanzaorentang, it seemed to be a promising anxiolytic remedy. A controlled comparative double-blind clinical trial was set up to assess the anxiolytic effect of suanzaorentang. Suanzaorentang (250 mg t.i.d.) and diazepam (2 mg t.i.d.) had almost the same anxiolytic effect. However, suanzaorentang, but not diazepam, improved the psychomotor performance during the daytime. No significant subjective side effects were observed during treatment with suanzaorentang. All laboratory tests, including liver function tests (serum SGOT, SGPT, albumin, globulin, bilirubin), renal function tests (BUN, serum creatinine), electrolyte balances (serum K+, Na+, Cl-, Ca++), serum cholesterol-triglyceride-HDL-c, thyroid function test (serum T4), chest P-A X-ray film, blood-urine-stool routine examinations (BUS routines), were unaltered after one week's administration of the compound.

Suanzaorentang, and anxiolytic Chinese medicine, affects the central adrenergic and serotonergic systems in rats

Previously, we found that the ancient Chinese remedy of Suanzaorentang was a promising anxiolytic drug (Chen and Hsieh, 1985; Chen and Hsieh, 1985a). We also found that Suanzaorentang decreased the turnover rate of central monoamines and central catecholaminergic activity (Hsieh, et al., 1986). In this study, we found that 5-hydroxytryptophan (5-HTP) induced decrease in locomotor activity was significantly antagonized by Suanzaorentang, p-chlorophenylalanine (p-CPA) induced increase in locomotor activity was significantly inhibited by Suanzaorentang, Suanzaorentang had no significant effects on baclofen, muscimol, aminooxyacetic acid (AOAA) and thiosemicarbazide induced changes in locomotor activity, Suanzaorentang significantly decreased vanillylmandelic acid (VMA) in striatum and hippocampus, homovanillic acid (HVA) in hippocampus and 5-hydroxyindol acetic acid (5-HIAA) in striatum and hypothalamus, Suanzaorentang significantly reversed the alpha-methyltyrosine (alpha-MT) produced decrease in DA concentrations in striatum and hippocampus, and (6) Suanzaorentang significantly reversed the p-CPA produced decrease in 5-HT concentrations on amygdala. These facts implied that Suanzaorentang might decrease the serotonergic activity but have no significant effect on GABAergic activity. The main locus of action might be in the limbic system.