Part Ⅰ: Rapid Interaction Between Glucocorticoids And Norepinephrine On Excitatory Synaptic Regulation Of Magnocellular Neurons In Hypothalamic Supraoptic Nucleus Part Ⅱ: Post-traumatic Stress Disorder, Depression And Anxiety Among Adolescent Students

Exposure of humans to a variety of stressors activates the sympathoadrenal system (SAS) and the hypothalamic-pituitary-adrenocortical (HPA) system. Norepinephrine (NE) and glucocorticoids (GCs) turn out to be two of the most important stress hormones. The interaction of these two hormones has been studied in many fields. Both GCs and NE transmitter systems play important roles in the regulation of oxytocin and vasopressin release in hypothalamic supraoptic nucleus (SON).Locus coeruleus (LC)-NE signaling is mainly involved in the primary stress reaction mediating a rapid fight–or–flight response, and the HPA axis is activated in a second, slower step of the stress response, leading to increased secretions of glucocorticoids (GCs). However, in the past a few decades, there has been increasing evidence for instantaneous non-genomic GC's action in the acute stress. One of the most important characters of non-genomic effect is short latencyGCs secreted during stress and feed back onto the hypothalamus to rapidly suppress neuroendocrine activation, including oxytocin and vasopressin secretion. Stinumation of noradrenergic projections have been implicated in the secretory regulation of vasopression and oxytocin neurons in the paravertricular (PVN) and SON. SON composed of Magnocellular neurons (MNCs). The Synapses which regulate the cell activity finally integrated onto MNCs. Modulation of spontaneous miniature excitatory post-synaptic currents (mEPSCs) could control the output of oxytocin and vasopressin. The aim of the study was to determine whether there is an interaction between GCs and NE in the regulation of mEPSCs in SON MNCs. Whole-cell patch clamp recording was used in an acute hypothalamic slice preparation.The results showed (1) GCs elicited a rapid, opposing action on synaptic glutamate release onto MNCs in SON with no sex difference.(2) Bath application of NE caused a robust increase in glutamate release onto MNCs of SON. (3) NE (100μM) had a priming effect.(4) When we combined NE and GC together, dexamethasone (DEX), as a synthetic GCs receptor agonist, was applied 10 min after NE application for 20 min (<30 min), which did not influence the effect of NE.(5) While DEX was pre-incubated for 5 min before NE(10μM)applying (30 seconds), the increased glutamate release was blocked by DEX. The frequency of glutamatergic EPSCs was from 138% to 13% of control. The change of amplitude and decay time was not observed during the whole time.The regulation of GCs on the effect NE indicates that the increased hormones release induced by hyper-secreted NE during acute stress may be controlled by GCs, and this may be part of the rapid inhibitory feedback effects of GCs during acute stress. OBJECTIVE: The aim of this study was to screen the symptoms of post-traumatic stress disorder (PTSD), depression and anxiety in adolescent students in Beichuan county two years after experiencing the 2008 Wenchuan Earthquake in China and to investigate the prevalence, overlap and risk factors of these symptoms. METHODS: A cluster sampling design was employed in the study. Totally 1,153 students of grades 4-9 were selected from the primary schools and secondary schools located in Beichuan County. The students were evaluated by the Child Posttraumatic Stress Reaction Index (CPTSD-RI), Zung`s Self-rating Depression Scale (SDS), Spielberger`s State Anxiety (SANX), Simplified Coping Style questionnaire (SCSQ), perceived social support scale (PSSS) and a self made general information form. RESULTS: Among 1,265 valid respondents, we found that the point prevalence rates of PTSD, depression and anxiety were 23.59%, 22.98% and 27.23%, respectively. Among the 272 students with PTSD, 138 (50.74%) had symptoms of depression, 144 (52.94%) had symptoms of anxiety, and 98 (36.03%) had comorbid depression and anxiety. Binary logistic regression analysis suggested that not only earthquake-related experiences, but also post-earthquake life experiences and pre-earthquake mental state among adolescent survivors contributed to the risk factors of PTSD, depression and anxiety. Moreover, the more perceived social support they obtain the better health status they keep. CONCLUSION: 1)The symptoms of PTSD, depression and anxiety in adolescents may continue for years after earthquake. 2)The comorbidity of PTSD, depression and anxiety was 0.08%. 3) The risk factors included not only the earthquake relating experience, but also the some pre- and post-earthquake experience, such as the change of the parents personality and emotion and so on. Hence, besides the adolescent survivors themselves, mental health workers should also care about the mental health condition of their parents. It is important to build an efficient society support system.