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Xiang Y.-T.,Capital Medical University | Xiang Y.-T.,Chinese University of Hong Kong | Zhang L.,Capital Medical University | Wang G.,Capital Medical University | And 19 more authors.
Bipolar Disorders | Year: 2013

Objectives: Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD), which may lead to inappropriate treatment and poor outcomes. This study aimed to compare demographic and clinical features between patients with MDD and those with BD, but being misdiagnosed as MDD, in China. Methods: A total of 1487 patients diagnosed with MDD were consecutively evaluated in 13 psychiatric hospitals or psychiatric units of general hospitals nationwide in China. The patients' sociodemographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. The Mini-International Neuropsychiatric Interview (MINI) was used to establish DSM-IV diagnoses, and identify patients with MDD and those with BD, but being misdiagnosed with MDD. Results: The proportions of BD (all types), bipolar I disorder (BD-I), and bipolar II disorder (BD-II) misdiagnosed as MDD in clinical practice were 20.8%, 7.9%, and 12.8%, respectively. Multiple logistic regression analyses revealed that compared to MDD patients, BD-I was characterized by more atypical depressive features (increased appetite, increased sleep, and weight gain) [odds ratio (OR) = 2.0, 95% confidence interval (CI): 1.2-3.2], more psychotic symptoms (OR = 2.1, 95% CI: 1.3-3.5), more lifetime depressive episodes (OR = 1.1, 95% CI: 1.1-1.2), and earlier age of onset (OR = 0.97, 95% CI: 0.9-0.99); BD-II was characterized by more psychotic symptoms (OR = 2.1, 95% CI: 1.4-3.1) and earlier age of onset (OR = 0.96, 95% CI: 0.9-0.97). In addition, compared to BD-II patients, BD-I patients were characterized by more frequent depressive episodes per year (OR = 3.1, 95% CI: 1.5-6.6). Conclusions: Depressive episodes in the context of BD-I and BD-II, among those who were misclassified as MDD, present some different clinical features compared to MDD. This finding should be taken into account in guiding diagnostic practices in China. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

Yang J.,China Three Gorges University | Chen L.,Yichang Central Peoples Hospital | Ding J.,China Three Gorges University | Rong H.,Shenzhen Mental Health Center | And 2 more authors.
Molecular Biology Reports | Year: 2012

High mobility group box-1 (HMGB1), a potent mediator of inflammation, is known to regulate cellular events through binding to the multiple cell-surface receptors, including RAGE and TLRs. However, the role of TLR4 and details of HMGB1 signaling in vascular smooth muscle cells (VSMCs) migration has not been reported so far. The present study was designed to investigate the hypothesis that HMGB1-induced VSMCs migration is mediated via activation of phosphoinositide 3-kinase/Akt (PI3K/Akt) signalling pathway through TLR4. VSMCs from rat thoracic aorta were studied. HMGB1 (0.1-1000 ng/ml) stimulated VSMCs migration in a dose-dependent manner, with the highest value (about 3.5-fold increase). Incubation of VSMCs with 100 ng/ml caused a rapid increase in PI3K activity and Akt phosphorylation. Migration of VSMCs toward HMGB1 was significantly inhibited by silencing of TLR4 (P\0.05). We also found pretreated cells with TLR4 siRNA or the PI3 K inhibitor LY294002 could markedly block PI3K/Akt pathway activation and VSMCs migration mediated by HMGB1 (P both\0.05). In conclusion, HMGB1 induces migration of VSMCs through a TLR4-dependent PI3 K/Akt signaling pathway, which suggests a possible molecular mechanism for HMGB1 may contribute to neointima formation in restenosis after vascular damage.© Springer Science+Business Media B.V. 2011.

Yang M.,Central South University | Yang M.,Shenzhen Mental Health Center | Mamy J.,Central South University | Gao P.,Hunan Judicial Police Vocational College | Xiao S.,Central South University
PLoS ONE | Year: 2015

Background: Relapse among abstinent drug users is normal. Several factors are related to relapse, but it remains unclear what individuals' actual life circumstances are during periods of abstinence, and how these circumstances facilitate or prevent relapse. Objective: To illuminate drug users' experiences during abstinence periods and explore the real-life catalysts and inhibitors contributing to drug use relapse. Method: Qualitative in-depth interviews were conducted with 20 drug users recruited from a compulsory isolated drug rehabilitation center in Changsha. The interviews were guided by open-ended questions on individuals' experiences in drug use initiation, getting addicted, treatment history, social environment, abstinence, and relapse. Participants were also encouraged to share their own stories. Interviews were digitally recorded and fully transcribed. The data of 18 participants who reported abstinence experiences before admission were included in the analyses. The data were analyzed using a thematic analysis with inductive hand coding to derive themes. Results: Most drug users were able to successfully abstain from drugs. During abstinence, their lives were congested with challenges, such as adverse socioeconomic conditions, poor family/social support, interpersonal conflicts, and stigma and discrimination, all of which kept them excluded from mainstream society. Furthermore, the police's system of ID card registration, which identifies individuals as drug users, worsened already grave situations. Relapse triggers reported by the participants focused mainly on negative feelings, interpersonal conflicts, and stressful events. Craving was experienced but not perceived as a relapse trigger by most participants. Conclusions: This study of in-depth interview with drug users found evidence of situations and environments they live during abstinence appear rather disadvantaged, making it extremely difficult for them to remain abstinent. Comprehensive programs on relapse prevention that acknowledge these disadvantages are implicated. © 2015 Yang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Chen S.,Shenzhen University | Guo Y.,Shenzhen University | Yu H.,Shenzhen University | Ge Z.,Shenzhen University | And 3 more authors.
Journal of Materials Chemistry | Year: 2012

Due to the outbreaks of infectious diseases caused by different pathogenic bacteria and development of antibiotic resistance, researchers are actively searching for new antibacterial agents. Synergistic antibacterial effects provide a new way to prepare antibacterial systems to fight resistant bacteria. In this study, novel copper (Cu)/titanium dioxide (TiO 2)/chitosan (CS) (CTC) three-component nanoparticles were facilely prepared via photocatalytic reduction on the basis of the synergistic antibacterial principle. The structure, antibacterial activity and antibacterial mechanism of CTC were investigated systematically. The results showed that this hybrid material exhibits excellent antibacterial ability against Escherichia coli and Staphylococcus aureus due to the synergistic antibacterial effect of the Cu, TiO 2 and CS components in the nanoparticles. The minimal inhibition concentrations (MIC) of CTC against E. coli and S. aureus are only 5.22 μg mL -1 and 2.61 μg mL -1, respectively, much lower than the two-component systems. Thus, the encouraging results presented in this study demonstrate great potential applications of CTC as an alternative candidate for an antibacterial agent with high antibacterial activity. © 2012 The Royal Society of Chemistry.

Chiu H.F.K.,Chinese University of Hong Kong | Xiang Y.-T.,Chinese University of Hong Kong | Xiang Y.-T.,Capital Medical University | Dai J.,Chinese University of Hong Kong | And 8 more authors.
Psychiatry Research | Year: 2012

This study aimed to determine the prevalence of basic forms of sleep disturbance (DIS: difficulty initiating sleep; DMS: difficulty maintaining sleep; and EMA: early morning awakening) as well as insomnia (defined as sleep disturbance accompanied by distress or daily functioning impairment), their socio-demographic and clinical correlates, and the treatment patterns in young Chinese rural people. A sample of 1642 subjects was recruited in Mianyang and interviewed using standardized instruments. Basic socio-demographic and clinical data were collected. The prevalence of at least one type of reported sleep disturbance was 8.0%, while the prevalence of at least one type of insomnia was 2.7%. In multivariate analyses, age between 30 and 34 years, having psychiatric disorders, poorer physical domain of quality of life (QOL), better social QOL domain, depressive symptoms and lower social support were independently associated with more frequent sleep disturbance. At the same time, age between 30 and 34 years, female sex, poorer physical QOL domain, better social QOL domain, depressive symptoms, lower life satisfaction, lower social support and more life events were independently associated with more frequent insomnia. Self-reported sleep disturbances are common among young Chinese residents. The low percentage of treated community residents might suggest a need to promote accessible and easily implemented interventions. © 2012 Elsevier Ireland Ltd.

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