A multicenter, randomized controlled study on the efficacy of agomelatine in ameliorating anhedonia, reduced motivation, and circadian rhythm disruptions in patients with major depressive disorder (MDD)

OBJECTIVE

To evaluate the clinical efficacy and safety of Agomelatine in improving symptoms in patients with major depressive disorder (MDD), providing more scientific evidence for the treatment of depression, and offering more effective therapeutic options for patients.

METHODS

A total of 180 MDD patients in acute phase from 10 psychiatric hospitals of Grade three in Zhejiang Province were enrolled in this 12-week study with the competitive and consecutive pattern, and they were randomized into two different groups treated with flexible-dosage antidepressants of selective serotonin reuptake inhibitors (SSRI) or agomelatine, respectively. The subjects were evaluated with psychological scales of HAMD-17, HAMA, SHAPS for anhedonia, MFI-20 for fatigue, PQSI for sleep quality and MEQ for disturbances in chronobiologic rhythms at baseline, 2, 4, 8 and 12-weekend points, and TESS was used for side-effect. The results were analyzed with repeated measurement analysis of variance.

RESULTS

The two groups each had 90 participants, and there were no significant differences at baseline. The scores of various assessment scales showed statistically significant time main effects during the visits (P < 0.01). The Agomelatine group demonstrated faster efficacy within 2 weeks, with better improvement in SHAPS, MEQ, and PSQI compared to the SSRIs group. However, the remission rate at 12 weeks was lower in the Agomelatine group than in the SSRIs group (63.3% and 72.2%), but the difference between the groups was not statistically significant. The Agomelatine group had fewer adverse reactions (14.4% and 16.7%), but there was a slightly higher incidence of liver function impairment (6.7% and 4.4%), with no statistically significant difference between the groups.

CONCLUSION

Agomelatine, as a novel antidepressant, shows certain advantages in improving depression and anxiety symptoms and is comparable to SSRIs in terms of safety. However, its long-term efficacy and safety on MDD or other depressive subtypes still require further observation and research.

Psychological trauma, posttraumatic stress disorder and trauma-related depression: A mini-review

There are various types of traumatic stimuli, such as catastrophic events like wars, natural calamities like earthquakes, and personal trauma from physical and psychological neglect or abuse and sexual abuse. Traumatic events can be divided into type I and type II trauma, and their impacts on individuals depend not only on the severity and duration of the traumas but also on individuals’ self-evaluation of the traumatic events. Individual stress reactions to trauma include posttraumatic stress disorder (PTSD), complex PTSD and trauma-related depression. Trauma-related depression is a reactive depression with unclear pathology, and depression occurring due to trauma in the childhood has gained increasing attention, because it has persisted for a long time and does not respond to conventional antidepressants but shows good or partial response to psychotherapy, which is similar to the pattern observed for PTSD. Because trauma-related depression is associated with high risk of suicide and is chronic with a propensity to relapse, it is necessary to explore its pathogenesis and therapeutic strategy.

Transcutaneous electrical acupoint stimulation for post-traumatic stress disorder: Assessor-blinded, randomized controlled study

AIM

Transcutaneous electrical acupoint stimulation (TEAS) has the potential to alleviate post-traumatic stress disorder (PTSD). The purpose of this study was to determine whether adding TEAS to sertraline or cognitive behavioral therapy (CBT) could improve the anti-PTSD efficacy.

METHODS

In this randomized controlled trial, 240 PTSD patients (60 in each group) were assigned to receive simulated TEAS combined with sertraline (group A) or with CBT (group B), active TEAS combined with CBT (group C), or active TEAS combined with CBT plus sertraline (group D) for 12 weeks. The outcomes were measured using the Clinician-Administered PTSD Scale, PTSD Check List-Civilian Version, and 17-item Hamilton Rating Scale for Depression.

RESULTS

While PTSD symptoms reduced over time in all patients, groups C and D had markedly greater improvement in both PTSD and depressive measures than groups A and B in all post-baseline measurement points, with moderate to very large effect sizes of 0.484-2.244. Groups C and D also had a significantly higher rate than groups A and B on clinical response (85.0% and 95.0% vs 63.3% and 60.0%, P < 0.001) and on remission (15.0% and 25.0% vs 3.3% and 1.7%, P < 0.001). The incidence of adverse events was similar between groups A and D and between groups B and C.

CONCLUSIONS

Additional TEAS augments the anti-PTSD and antidepressant efficacy of antidepressants or CBT, without increasing the incidence of adverse effects. TEAS could serve as an effective intervention for PTSD and comorbid depression. This trial was registered with www.chictr.org (no.: ChiCTR1800017255).

Design of spintronic materials with simple structures

A brief comparison of conventional electronics and spintronics is given. The key features of half metallic binary compounds with the zincblende structure are presented, using MnAs as an example. We discuss the interactions responsible for the half metallic properties. Special properties of superlattices and a digital ferromagnetic heterostructure incorporating zincblende half metals are also discussed.

Quantification of selected aroma-active compounds in strawberries by headspace solid-phase microextraction gas chromatography and correlation with sensory descriptive analysis

Selected aroma-active compounds in strawberries were quantified using headspace solid-phase microextraction and gas chromatography. Ten strawberry cultivars grown in California and Oregon were studied. The standard curves were built in a synthetic matrix and quantification was achieved using multiple internal standards. Odor activity values (OAVs) of the aroma compounds were calculated to understand their contribution to the overall aroma. Although the concentrations of the aroma compounds varied depending on the cultivars, in general, ethyl butanoate, mesifurane, ethyl hexanoate, ethyl 3-methylbutanoate, hexyl acetate, and gamma-dodecalactone had the highest OAVs. Descriptive sensory analysis was performed by a trained panel of 10 members. A PCA plot was built to understand the aroma contribution of principal components. The chemical results were compared with sensory data. The OAV of esters correlated well with the floral, pineapple, and banana notes. The green notes did not correlate with the concentration or OAVs of aldehydes or C6 alcohols. It is assumed that the higher amounts of green, sulfur, musty, and waxy notes in some cultivars were due to the lack of fruity notes.

Quantification of trace volatile sulfur compounds in milk by solid-phase microextraction and gas chromatography-pulsed flame photometric detection

Volatile sulfur compounds have been reported to be responsible for the sulfurous off-flavors generated during the thermal processing of milk; however, their analysis has been a challenge due to their high reactivity, high volatility, and low sensory threshold. In this study, reactive thiols were stabilized and the volatile sulfur compounds in milk were extracted by headspace solid-phase microextraction, and analyzed by gas chromatography and pulsed-flame photometric detection. Calibration curves for 7 sulfur-containing compounds were constructed in milk by the standard addition technique. Raw, pasteurized, and UHT milk samples with various fat contents were analyzed. Compared with raw and pasteurized samples, UHT milk contained substantially higher concentrations of hydrogen sulfide, methanethiol, carbon disulfide, dimethyl trisulfide, and di-methyl sulfoxide. The high odor activity values calculated for methanethiol and dimethyl trisulfide suggested that these 2 compounds, in addition to di-methyl sulfide reported in a previous study, could be the most important contributors to the sulfurous note in UHT milk.

Half-metallic digital ferromagnetic heterostructure composed of a delta-doped layer of Mn in Si

We propose and investigate the properties of a digital ferromagnetic heterostructure consisting of a delta-doped layer of Mn in Si, using ab initio electronic-structure methods. We find that (i) ferromagnetic order of the Mn layer is energetically favorable relative to antiferromagnetic, and (ii) the heterostructure is a two-dimensional half-metallic system. The metallic behavior is contributed by three majority-spin bands originating from hybridized Mn-d and nearest-neighbor Si-p states, and the corresponding carriers are responsible for the ferromagnetic order in the Mn layer. The minority-spin channel has a calculated semiconducting gap of 0.25 eV. The band lineup is found to be favorable for retaining the half-metal character to near the Curie temperature. This kind of heterostructure may be of special interest for integration into mature Si technologies for spintronic applications.

Quantitative Determination of Thermally Derived Off-Flavor Compounds in Milk Using Solid-Phase Microextraction and Gas Chromatography

Many volatile compounds generated during the thermal processing of milk have been associated with cooked, stale, and sulfurous notes in milk and are considered as off-flavor by most consumers. A headspace solid-phase microextraction (HS-SPME)/gas chromatographic technique for the quantitative analysis of thermally derived off-flavor compounds was developed in this study. The extraction temperature, time, and sample amount were optimized using a randomized 2(3) central composite rotatable design with 2 central replicates and 2 replicates in each factorial point along with response surface methodology. Calibration curves were constructed in milk using the standard addition technique, and then used to quantify 20 off-flavor compounds in raw, pasteurized, and UHT milk samples with various fat contents. The concentrations of these volatiles in raw and pasteurized milk samples were not significantly different. However, dimethyl sulfide, 2-hexanone, 2-heptanone, 2-nonanone, 2-undecanone, 2-methylpropanal, 3-methylbutanal, heptanal, and decanal were found at higher concentrations in UHT milk as compared with raw and pasteurized milk samples. In addition, the concentration of methyl ketones was greater in UHT milk with higher fat content. The calculated odor activity values suggested that 2,3-butanedione, 2-heptanone, 2-nonanone, 2-methylpropanal, 3-methylbutanal, nonanal, decanal, and dimethyl sulfide could be important contributors to the off-flavor of UHT milk. The HS-SPME technique developed in this study is accurate and relatively simple, and can be used for the quantification of thermally derived off-flavor compounds in milk.

Aroma Compounds in Sweet Whey Powder

Aroma compounds in sweet whey powder were investigated in this study. Volatiles were isolated by solvent extraction followed by solvent-assisted flavor evaporation. Fractionation was used to separate acidic from nonacidic volatiles. Gas chromatography/mass spectrometry and gas chromatography/olfactometry were used for the identification of aroma compounds. Osme methodology was applied to assess the relative importance of each aroma compound. The most aroma-intense free fatty acids detected were acetic, propanoic, butanoic, hexanoic, heptanoic, octanoic, decanoic, dodecanoic, and 9-decenoic acids. The most aroma-intense nonacidic compounds detected were hexanal, heptanal, nonanal, phenylacetaldehyde, 1-octen-3-one, methional, 2,6-dimethylpyrazine, 2,5-dimethylpyrazine, 2,3-dimethylpyrazine, 2,3,5-trimethylpyrazine, furfuryl alcohol, p-cresol, 2-acetylpyrrole, maltol, furaneol, and several lactones. This study suggested that the aroma of whey powder could comprise compounds originating from milk, compounds generated by the starter culture during cheese making, and compounds formed during the manufacturing process of whey powder.

Effect of migration and related environmental changes on serum lipid levels in southwestern Chinese men

To determine migration-related differences in serum lipid levels and to estimate the contribution of environmental factors to these differences, the authors conducted a cross-sectional study among 1,222 residents of southwestern China in 1988 and 1989: 521 Yi farmers living in a remote rural area, 340 Yi migrants to an urban setting, and 361 Han people living in the same urban setting. Serum total and high density lipoprotein cholesterol and serum triglyceride were measured after a 14-hour fast. Information on age, cigarette smoking, alcohol consumption, and physical activity was obtained by questionnaire. Diet was assessed by use of three 24-hour diet recalls. The Yi farmers had the lowest age-adjusted serum lipid levels among the three groups, white the Yi migrants and their Han counterparts had similar lipid levels. After adjustment for age, body mass index, cigarette smoking, alcohol drinking, and dietary nutrient intake, the difference in serum lipid profile between the Yi migrants and the Yi farmers was substantially reduced. These results indicate that rural-urban migration is associated with higher serum lipid levels. This migration-related difference in serum lipids can be partially explained by changes in lifestyle and dietary nutrient intake. The authors conclude that environmental factors are important determinants of population serum lipid levels in southwestern Chinese.

Dietary macronutrients and blood pressure in southwestern China

OBJECTIVES

To study the relationship between dietary macronutrients and blood pressure.

DESIGN

A cross-sectional study.

SETTING

Liangshan, southwestern China.

PARTICIPANTS

Three hundred and twelve Yi farmers living in a remote mountainous area, and 264 Yi migrants and 251 Han people living in an urban setting.

MAIN OUTCOME MEASUREMENTS

Blood pressure and dietary nutrient intake, obtained by asking the subjects to recall their nutrient consumption during the previous 24 h, were measured on three consecutive days.

RESULTS

After adjusting for age, body mass index, alcohol use, urinary excretion of sodium, total energy intake and area of residence and after correcting for the effects of regression dilution bias, a 1 SD higher intake of dietary total protein (39 g) was associated with lower systolic (-3.55 mmHg), and diastolic (-2.16 mmHg) blood pressures. Likewise, a 1 SD higher fiber intake (10 g) was significantly associated both with a lower systolic (-2.20 mmHg) and with a lower diastolic (-2.08 mmHg) blood pressure.

CONCLUSION

Diets higher in protein and fiber content are associated with a lower blood pressure in the present population sample. The present results indicate that dietary intake of macronutrients might be important in the development and prevention of high blood pressure.

The contribution of urinary cations to the blood pressure differences associated with migration

People living in unacculturated societies have a low average blood pressure and little rise in blood pressure with age. In a community-based survey in southwestern China, the authors assessed the contribution of urinary cation excretion to differences in blood pressure between an unacculturated group (Yi farmers) and migrants to an urban environment, as well as urban controls from a different ethnic group (Han). In March 1989, blood pressure and overnight urinary electrolyte levels were measured on 3 consecutive days in 313 Yi farmers, 265 Yi migrants, and 253 urban Han residents, all male. Of the urinary electrolytes, a higher sodium:potassium ratio best explained the higher blood pressure in the migrants. Yi farmers had lower systolic (106.7 mmHg vs. 114.8 mmHg, respectively) and diastolic (66.2 mmHg vs. 71.3 mmHg, respectively) blood pressures than Yi migrants. However, even after adjustment for age, body mass index, alcohol intake, and urinary sodium, potassium, calcium, and magnesium excretion, Yi farmers continued to have lower average blood pressures than Yi migrants. In pooled analyses of all three groups, urinary sodium and calcium were positively related and urinary potassium and magnesium were inversely related to blood pressure. Migration is associated with a higher blood pressure that is only partially explained by higher levels of adiposity and alcohol and sodium intake and lower levels of potassium and magnesium intake.

Oats and buckwheat intakes and cardiovascular disease risk factors in an ethnic minority of China

The relationship of oats and buckwheat intake to cardiovascular disease risk factors was studied in 850 Yi people, an ethnic minority in southwest China. Blood pressure was measured on 3 consecutive days. Serum total cholesterol, high-density-lipoprotein (HDL) cholesterol, and triglycerides were measured after a 14-h fast. Oats and buckwheat intakes were assessed by questionnaire. In multiple-regression analysis, oats intake (100 g/d) was associated with lower body mass index (-0.25, in kg/m2; P < 0.05), systolic (-3.1 mm Hg, P < 0.001) and diastolic (-1.3 mm Hg, P < 0.01) blood pressure, and HDL cholesterol (-0.13 mmol/L, P < 0.001). Buckwheat intake (100 g/d) was associated with lower serum total cholesterol (-0.07 mmol/L, P < 0.01) and low-density-lipoprotein cholesterol (-0.06 mmol/L, P < 0.05) and a higher ratio of HDL to total cholesterol (0.01, P < 0.05). These findings suggest a role for oats and buckwheat consumption in the prevention and treatment of both hypertension and hypercholesterolemia.

Body mass and blood pressure in a lean population in southwestern China

Body mass has been consistently associated with blood pressure in acculturated populations but not in lean populations with low blood pressures. In southwestern China, in 1989, the authors studied the relation between body mass and blood pressure in three community-based random samples: rural Yi farmers (5,023 men, 3,218 women); Yi migrants (1,656 men, 919 women); and Han Chinese living in an urban setting (2,173 men, 1,516 women). The Yi farmers had virtually no obesity or hypertension and had little rise in blood pressure with age. The Yi migrants and Han had a steeper slope of blood pressure with age and consequently more hypertension. For men and women, respectively, mean body mass index (weight (kg)/height (m)2) was 20.6 and 21.0 in the Yi farmers, 21.3 and 21.4 in the Yi migrants, and 21.0 and 21.4 in the Han. Both systolic and diastolic blood pressure were positively related to body mass index in all six ethnicity-sex groups, and the association remained statistically significant after adjustment for age, heart rate, smoking, alcohol intake, and physical activity. The change in mean blood pressure for each kg/m2 increase in body mass index, after adjustment for community of residence, was 1.47 mmHg for systolic pressure and 1.13 mmHg for diastolic pressure. The association between body mass index and blood pressure was greater in men than in women and greater in Yi migrants and Han than in Yi farmers. The percentages of hypertension attributable to overweight (body mass index > or = 25) among the Yi farmers, Yi migrants, and Han, respectively, were 4.1%, 34.1%, and 24.0% for men and 0%, 26.2%, and 28.9% for women. Thus, even in this lean Chinese population with a low mean blood pressure, body mass was positively and independently associated with increased blood pressure.

Alcohol use and blood pressure in an unacculturated society

Alcohol intake has been associated with higher blood pressure in acculturated populations but not in unacculturated societies. We performed a cross-sectional survey of a random community sample of 5023 male Yi rural farmers and 1656 Yi and 2173 Han men living in an urban setting. Average alcohol intake among drinkers was 36.4 g/d in Yi farmers, 56.5 g/d in Yi migrants, and 38.7 g/d in Han men. Age-adjusted mean diastolic blood pressure was 66.9, 70.5, and 71.7 mm Hg, respectively. Diastolic blood pressure was higher at higher alcohol intakes in all three groups (all P < .001). After adjustment for age, body mass index, heart rate, smoking, and physical activity, the change (95% confidence interval) in diastolic blood pressure for each standard drink was 0.50 (0.38-0.62), 0.31 (0.18-0.43), and 0.24 (0.07-0.40) mm Hg for Yi farmers, Yi migrants, and Han men, respectively. The percentage of variance in diastolic blood pressure explained by alcohol intake was 5% for Yi farmers, 4% for Yi migrants, and 2% for Han men. In a random sample of 831 men, these associations were independent of urinary sodium, potassium, calcium, and magnesium and sodium-potassium ratio. In the Yi farmers, associations were less strong for systolic blood pressure and no longer significant after adjustment. Approximately 33% of hypertension could be attributed to daily alcohol use in the Yi groups compared with 9.5% in the Han people.(ABSTRACT TRUNCATED AT 250 WORDS)

Agreement between overnight and 24-hour urinary cation excretions in southern Chinese men

Agreement between overnight and 24-hour urinary sodium, potassium, calcium, and magnesium excretion was studied in a sample of 63 normotensive Southwestern Chinese men: 30 Yi farmers and 33 urban residents in April 1989. Overnight (8-hour) and 24-hour urine specimens were collected on 3 consecutive days. Estimated correlation coefficients between 24-hour and overnight mean true values were 0.863 and 0.906 for sodium, 0.736 and 0.816 for potassium, 0.902 and 0.725 for calcium, and 0.733 and 0.703 for magnesium in Yi farmers and urban residents, respectively. Hourly overnight urinary sodium and potassium excretion rates were significantly lower than the corresponding hourly 24-hour urinary excretion rates: -0.60 and -1.99 mmol/hour for sodium, -1.24 and -0.48 mmol/hour for potassium (all p < 0.05) in Yi farmers and urban residents, respectively. In multiple regression analyses, the differences between 24-hour and overnight urinary sodium and potassium excretion rates were significantly and positively related to differences between 24-hour and overnight creatinine excretion rates. The ratios of intraindividual to interindividual variance were lower for 24-hour collections than for overnight collections for sodium and calcium, but the differences in these ratios for potassium and magnesium were small. For sodium and calcium, twice as many overnight as 24-hour collections were required to estimate the correlation between cations and blood pressure with the same accuracy; for potassium and magnesium, overnight and 24-hour collections were equally accurate. These results indicate that in normotensive populations such as the one studied, overnight urine collections may be used to estimate 24-hour cation excretion. The underestimate of cation excretion by assessments based on collection of overnight specimens may be due to either a lower creatinine clearance or a lower intake of cations at night.

Migration, blood pressure pattern, and hypertension: the Yi Migrant Study

Rural-urban migration provides an ideal opportunity to examine the effects of environment and genes on blood pressure. The effect of migration on the Yi people of China was studied. The Yi people live in a remote mountain area in southwestern China. In 1989, blood pressure was measured in 14,505 persons (8,241 Yi farmers, 2,575 urban Yi migrants, and 3,689 Han urban residents) aged 15-89 years. Different patterns were seen for men and women. Among the men, Yi farmers had the lowest mean blood pressure, the least rise in blood pressure with age (systolic blood pressure, 0.13 mmHg/year; diastolic blood pressure, 0.23 mmHg/year), and the lowest prevalence of hypertension (0.66%). In contrast, both Yi migrant men and Han men had higher levels of mean blood pressure, rise in blood pressure with age (Yi migrants: systolic pressure, 0.33 mmHg/year; diastolic pressure, 0.33 mmHg/year; Han: systolic pressure, 0.36 mmHg/year; diastolic pressure, 0.23 mmHg/year), and prevalence of hypertension (Yi migrants, 4.25%; Han, 4.91%). Among the women, however, mean systolic pressure was higher in Yi farmers than in Yi migrants or in Han. Diastolic pressure was similar among the three groups. However, the Yi farmer women's age-related rise in blood pressure (systolic pressure, 0.06 mmHg/year; diastolic pressure, 0.14 mmHg/year) and their prevalence of hypertension (0.33%) were lower than those in the other two groups. Yi migrant women had an intermediate rise in blood pressure with age (systolic pressure, 0.37 mmHg/year; diastolic pressure, 0.23 mmHg/year) and prevalence of hypertension (2.40%). Han women had the greatest rise in blood pressure with age (systolic pressure, 0.56 mmHg/year; diastolic pressure, 0.36 mmHg/year) and the highest prevalence of hypertension (4.76%). For both men and women, the above differences were only partially explained by age, body mass index, heart rate, smoking, and alcohol use. This study, using standardized methods, demonstrates an important effect of migration on rise in blood pressure with age and on the prevalence of hypertension.