Background Depression is a common comorbidity in Parkinson's disease(PD)and Lewy body dementia(LBD).However,studies examining the rate of incident depression in the period preceding and following the diagnosis of ...Background Depression is a common comorbidity in Parkinson's disease(PD)and Lewy body dementia(LBD).However,studies examining the rate of incident depression in the period preceding and following the diagnosis of PD and LBD are lacki ng in the literature.Aims To quantify the incidence of depression in the period preceding and following the diagnosis of PD and LBD.Methods We conducted a retrospective case-control study.Specifically,we used Danish registers to identify all patients with a diagnosis of PD or LBD in the period from 2007 to 2019.These patients were matched by age,calendar year of diagnosis and sex with up to three patients diagnosed with rheumatoid arthritis(RA),chronic kidney disease(CKD)or osteoporosis,respectively.The outcome was incident depression.The incidence of depression was assessed for up to 10 years before and up to 10 years after the diagnosis of PD or LBD.Hazard rates of incident depression for patients with PD or LBD,both before and after diagnosis,were compared with those for patients with RA,CKD or osteoporosis using a Coxproportional hazards model.Results We identified 17711 patients with PD or LBD.Their median age was 74.98(68.10-80.85)years,and39.92%were females.These patients were matched to 19556,40842 and 47809 patients with RA,CKD and osteoporosis,respectively.From 7 to 8 years before diagnosis to 5 years after diagnosis,patients with PD and LBD consistently had higher hazard rates of incident depression than all comparator groups.Conclusions These findings are compatible with depression being an early manifestation of the neurodegenerative changes eventually leading to PD and LBD and imply that incident depression at a late age should raise awareness of potential PD and LBD.展开更多
BACKGROUND The characteristics of cerebral hemodynamic indexes of patients with different types of auditory verbal hallucinations(AVHs)was not clear.AIM To explore the characteristics of cerebral hemodynamic indexes o...BACKGROUND The characteristics of cerebral hemodynamic indexes of patients with different types of auditory verbal hallucinations(AVHs)was not clear.AIM To explore the characteristics of cerebral hemodynamic indexes of patients with different types of AVHs and construct the risk nomogram prediction model of patients with different types of AVHs.METHODS Patients with different types of verbal hallucinations who visited Wenzhou Seventh People’s Hospital were retrospectively selected from March 2021 to March 2023,and these patients were classified into 117 cases of schizophrenia(SCZ)with AVHs,108 cases of post-traumatic stress disorder(PTSD)with AVHs,and 105 cases of recurrent depressive disorder with AVHs according to type.Transcranial doppler was performed to measure the hemodynamic parameters of the anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA),basilar artery(BA)and vertebral artery(VA).Logistic regression modelling was used to explore the factors affecting patients with different types of AVHs and odds ratio,95%confidence interval(CI).A clinical prediction model was constructed,and the efficacy of the clinical prediction model was evaluated by using receiver operating characteristic,Hosmer-Lemeshow Goodness-of-Fit test,calibration curves and decision curve analysis.RESULTS The differences between the three groups of patients in mean velocity(Vm)-MCA,end-diastolic velocity(Vd)-MCA,Vm-ACA,pulsatility index(PI)-ACA,Vm-PCA,peak systolic velocity(Vs)-PCA,Vd-PCA,Vm-BA,Vs-BA,Vd-BA,PI-BA,resistance index(RI)-BA,Vm-VA,Vs-VA,Vd-VA,PI-VA,and RI-VA indexes were statistically significant.Rising Vm-ACA is an independent risk factor for SCZ with AVHs,and falling Vm-VA,Vd-MCA,and Vd-VA are independent risk factors for SCZ with AVHs.Rising Vm-ACA,Vm-PCA,Vs-PCA,Vd-PCA,Vm-BA,and Vs-BA are independent risk factors for PTSD with AVHs,and Vm-MCA,Vs-MCA,Vd-MCA,PI-PCA,and RIBA are independent protective factors for PTSD with AVHs.Elevated Vm-MCA,Vd-MCA,RI-BA,Vm-VA,and Vd-VA were independent risk factors,and elevated Vm-ACA,Vs-ACA,Vm-PCA,Vs-PCA,and Vd-PCA were independent protective factors.The areas under the curve of the three models were 0.82(95%CI:0.76-0.87),0.88(95%CI:0.83-0.92),and 0.81(95%CI:0.77-0.86),respectively;the Hosmer-Lemeshow Goodness-of-Fit test of the calibration curves of the three models suggests that P>0.05.CONCLUSION Monitoring the cerebral hemodynamic indexes of patients with AVHs is of practical significance in determining the type of mental disorder,which helps clinicians identify the type of AVHs and adopt more efficient treatment strategies to help patients recover.展开更多
Subthreshold depression is a highly prevalent condition in adolescents who are at high risk for developing major depressive disorder.In preclinical models of neurological and psychiatric diseases,Lycium barbarum polys...Subthreshold depression is a highly prevalent condition in adolescents who are at high risk for developing major depressive disorder.In preclinical models of neurological and psychiatric diseases,Lycium barbarum polysaccharide(LBP)extracted from Goji berries had antidepressant effects including but not limited to anti-oxidative and anti-inflammatory properties.However,the effect of LBP on subthreshold depression is unclear.To investigate the clinical efficacy and safety of LBP for treating subthreshold depression in adolescents,we conducted a randomized,double-blind,placebo-controlled trial(RCT)with 29 adolescents with subthreshold depression recruited at The Fifth Affiliated Hospital of Guangzhou Medical University.The participants were randomly assigned to groups where they received either 300 mg LBP(LBP group,n=15,3 boys and 12 girls aged 15.13±2.17 years)or a placebo(placebo group,n=14,2 boys and 12 girls aged 15±1.71 years)for 6 successive weeks.Interim analyses revealed that the LBP group exhibited a greater change in Hamilton Depression Scale(HAMD-24)scores relative to the baseline and a higher remission rate(HAMD-24 total score≤7)at 6 weeks compared with the placebo group.Scores on the Beck Depression Inventory-II(BDI-II),Pittsburgh Sleep Quality Index(PSQI),Kessler Psychological Distress Scale(Kessler),and Screen for Child Anxiety-Related Emotional Disorders(SCARED)were similar between the LBP and placebo groups.No side effects related to the intervention were reported in either group.These results indicate that LBP administration reduced depressive symptoms in adolescents with subthreshold depression.Furthermore,LBP was well tolerated with no treatment-limiting adverse events.Clinical trials involving a larger sample size are needed to further confirm the anti-depressive effects of LBP in adolescents with subthreshold depression.This study was approved by the Medical Ethics Committee of the Fifth Affiliated Hospital of Guangzhou Medical University(Guangzhou,China;approval No.L2019-08)on April 4,2019 and was registered on ClinicalTrials.gov(identifier:NCT04032795)on July 25,2019.展开更多
Strong evidence has accumulated to show a correlation between depression symptoms and inflammatory responses.Moreover,anti-inflammatory treatment has shown partial effectiveness in alleviating depression symptoms.Lyci...Strong evidence has accumulated to show a correlation between depression symptoms and inflammatory responses.Moreover,anti-inflammatory treatment has shown partial effectiveness in alleviating depression symptoms.Lycium barbarum polysaccharide(LBP),derived from Goji berries,exhibits notable antioxidative and anti-inflammatory properties.In our recent double-blinded randomized placebo-controlled trial,we found that LBP significantly reduced depressive symptoms in adolescents with subthreshold depression.It is presumed that the antidepressant effect of LBP may be associated with its influence on inflammatory cytokines.In the double-blinded randomized controlled trial,we enrolled 29 adolescents with subthreshold depression and randomly divided them into an LBP group and a placebo group.In the LBP group,adolescents were given 300 mg/d LBP.A 6-week follow up was completed by 24 adolescents,comprising 14 adolescents from the LBP group(15.36±2.06 years,3 men and 11 women)and 10 adolescents from the placebo group(14.9±1.6 years,2 men and 8 women).Our results showed that after 6 weeks of treatment,the interleukin-17A level in the LBP group was lower than that in the placebo group.Network analysis showed that LBP reduced the correlations and connectivity between inflammatory factors,which were associated with the improvement in depressive symptoms.These findings suggest that 6-week administration of LBP suppresses the immune response by reducing interleukin-17A level,thereby exerting an antidepressant effect.展开更多
Sleep benefits the restoration of energy metabolism and thereby suppo rts neuronal plasticity and cognitive behaviors.Sirt6 is a NAD+-dependent protein deacetylase that has been recognized as an essential regulator of...Sleep benefits the restoration of energy metabolism and thereby suppo rts neuronal plasticity and cognitive behaviors.Sirt6 is a NAD+-dependent protein deacetylase that has been recognized as an essential regulator of energy metabolism because it modulates various transcriptional regulators and metabolic enzymes.The aim of this study was to investigate the influence of Sirt6 on cerebral function after chronic sleep deprivation(CSD).We assigned C57BL/6J mice to control or two CSD groups and subjected them to AAV2/9-CMV-EGFP or AAV2/9-CMV-Sirt6-EGFP infection in the prelimbic cortex(PrL).We then assessed cerebral functional connectivity(FC) using resting-state functional MRI,neuron/astrocyte metabolism using a metabolic kinetics analysis;dendritic spine densities using sparse-labeling;and miniature excitato ry postsynaptic currents(mEPSCs) and action potential(AP) firing rates using whole-cell patchclamp recordings.In addition,we evaluated cognition via a comprehensive set of behavioral tests.Compared with controls,Sirt6 was significantly decreased(P<0.05) in the PrL after CSD,accompanied by cognitive deficits and decreased FC between the PrL and accumbens nucleus,piriform cortex,motor co rtex,somatosensory co rtex,olfactory tubercle,insular cortex,and cerebellum.Sirt6 ove rexpression reve rsed CSD-induced cognitive impairment and reduced FC.Our analysis of metabolic kinetics using [1-13C] glucose and [2-13C] acetate showed that CSD reduced neuronal Glu4and GABA2synthesis,which could be fully restored via forced Sirt6 expression.Furthermore,Sirt6 ove rexpression reversed CSD-induced decreases in AP firing rates as well as the frequency and amplitude of mEPSCs in PrL pyramidal neurons.These data indicate that Sirt6 can improve cognitive impairment after CSD by regulating the PrL-associated FC network,neuronal glucose metabolism,and glutamatergic neurotransmission.Thus,Sirt6 activation may have potential as a novel strategy for treating sleep disorder-related diseases.展开更多
Objective:This paper aims to clarify the concept of occupational burnout(OB)as well as develop appropriate methods to relieve or prevent OB in the nursing profession.Methods:Walker and Avant's eight-step approach ...Objective:This paper aims to clarify the concept of occupational burnout(OB)as well as develop appropriate methods to relieve or prevent OB in the nursing profession.Methods:Walker and Avant's eight-step approach of concept analysis was applied.Results:OB was defined as a chronic form of work-related stress.Accurately,it was characterized by emotional exhaustion,depersonalization/cynicism,and reduced personal accomplishment/inefficacy.Antecedents of burnout included(a)demographic characteristics;(b)chronic exposure to work-related stressors;(c)quantitative and qualitative job demands;(d)lack of job resources;and(e)personality traits.Consequences involved(a)individual’s unfavorable quality of life;(b)negative impact on the organization;and(c)poor services quality.Although the Maslach Burnout Inventory(MBI)is perceived as an ideal tool to measure burnout and hence,it is used worldwide,whether this instrument fits to measure this concept for nurses has still not yet been verified and thus further research is needed.Conclusions:By proposing a comprehensive definition of the concept,this analysis contributes to recognition of the process of OB of nurses.All nurses are vulnerable to OB.Hence,burnout in nursing needs to be recognized as a critical factor in the delivery of safe patient care.It proposes that the prevention of OB would be achieved through team communication training,mindfulness group,education,etc.展开更多
The application of physical restraint for patients represents ethical dilemmas for psychiatric nurses in terms of maintaining the safety of all(clients and staff)while at the same time curtailing the individual’s aut...The application of physical restraint for patients represents ethical dilemmas for psychiatric nurses in terms of maintaining the safety of all(clients and staff)while at the same time curtailing the individual’s autonomy.This article aimed to provide a sound knowledge of ethical positions and strategies for psychiatric nurses to address ethical issues of physical restraint according to the ethical principles of autonomy,beneficence,nonmaleficence,and ethical theories.Given that nursing workforce was limited and workload among psychiatric nurses was heavy,physical restraint was one of the coercive interventions managing aggressive behavior.In relation to address ethical dilemmas,it was proposed to acquire informed consent of physical restraint from the individuals and provide person‑centered care.Effective communication and negotiation with patients could help to strike a balance between patients’autonomy and nurses’accountability when using physical restraint.In addition,guidelines and targeted intervention strategies need to be developed to regulate and reduce the implementation of restraint.Finally,a collaboration among nurses,psychiatrists,and families is essential to protect patients’autonomy concerning physical restraint use.展开更多
Loneliness is associated with high prevalences of major psychiatric illnesses such as major depression.However,the underlying emotional mechanisms of loneliness remained unclear.We hypothesized that loneliness origina...Loneliness is associated with high prevalences of major psychiatric illnesses such as major depression.However,the underlying emotional mechanisms of loneliness remained unclear.We hypothesized that loneliness originates from both decreases in positive emotional processing and increases in negative emotion processing.To test this,we conducted a systematic review of 29 previous studies(total participants n=19560,mean age=37.16 years,female proportion=59.7%),including 18 studies that included ques-tionnaire measures of emotions only,and 11 studies that examined the brain correlates of emotions.The main findings were that loneliness was negatively correlated with general positive emotions and positively correlated with general negative emotions.Fur-thermore,limited evidence indicates loneliness exhibited negative and positive correlations with the brain positive(e.g.the striatum)and negative(e.g.insula)emotion systems,respectively,but the sign of correlation was not entirely consistent.Additionally,loneli-ness was associated with the structure and function of the brain emotion regulation systems,particularly the prefrontal cortex,but the direction of this relationship remained ambiguous.We concluded that the existing evidence supported a bivalence model of lone-liness,but several critical gaps existed that could be addressed by future studies that include adolescent and middle-aged samples,use both questionnaire and task measures of emotions,distinguish between general emotion and social emotion as well as between positive and negative emotion regulation,and adopt a longitudinal design that allows us to ascertain the causal relationships between loneliness and emotion dysfunction.Our findings provide new insights into the underlying emotion mechanisms of loneliness that can inform interventions for lonely individuals.展开更多
Purpose Phantom eye pain(PEP)is a major clinical problem after eye removal with no standard treatment protocol to date.As pain is a multidimensional experience associated with emotional and cognitive components,this s...Purpose Phantom eye pain(PEP)is a major clinical problem after eye removal with no standard treatment protocol to date.As pain is a multidimensional experience associated with emotional and cognitive components,this study aimed to explore the possible neuropsychological mechanisms of PEP in a perspective of emotional cognition,in order to provide a basis for clinical treatment.Methods Visual oddball event-related potentials(ERPs)under different external emotional stimuli(Disgust,Fear,Sadness,Happiness,Erotica and Neutral)were tested in 12 patients and 12 healthy volunteers.Participants'affective states were measured with the Mood Disorder Questionnaire(MDQ),the Hypomania Checklist-32(HCL-32),and the Plutchik–van Praag Depression Inventory(PVP).The amplitudes and latencies of N1,P2,N2 and P3 components were analyzed by three-way ANOVA,i.e.,group(2)×emotion(6)×electrode(3).Multiple comparisons were performed using Bonferroni's test.Results Longer N1 latencies,increased N1 amplitudes;shorter P2 latencies under Disgust and Happiness,decreased P2 amplitudes;shorter N2 latencies under Erotica,increased N2 amplitudes were found in patients compared with controls.There was no main effect of group or interaction effect on P3 latencies and P3 amplitudes.The MDQ and HCL-32 scores were lower,and the N1 latencies under Sadness were negatively correlated with PVP scores in patients.Conclusions PEP patients showed reversed patterns in exogenous attention allocation and enhanced involuntary attention to emotional stimuli compared with controls.This study demonstrated cortical processing of emotions in PEP patients and could provide a basis for developing emotional intervention therapy.展开更多
文摘Background Depression is a common comorbidity in Parkinson's disease(PD)and Lewy body dementia(LBD).However,studies examining the rate of incident depression in the period preceding and following the diagnosis of PD and LBD are lacki ng in the literature.Aims To quantify the incidence of depression in the period preceding and following the diagnosis of PD and LBD.Methods We conducted a retrospective case-control study.Specifically,we used Danish registers to identify all patients with a diagnosis of PD or LBD in the period from 2007 to 2019.These patients were matched by age,calendar year of diagnosis and sex with up to three patients diagnosed with rheumatoid arthritis(RA),chronic kidney disease(CKD)or osteoporosis,respectively.The outcome was incident depression.The incidence of depression was assessed for up to 10 years before and up to 10 years after the diagnosis of PD or LBD.Hazard rates of incident depression for patients with PD or LBD,both before and after diagnosis,were compared with those for patients with RA,CKD or osteoporosis using a Coxproportional hazards model.Results We identified 17711 patients with PD or LBD.Their median age was 74.98(68.10-80.85)years,and39.92%were females.These patients were matched to 19556,40842 and 47809 patients with RA,CKD and osteoporosis,respectively.From 7 to 8 years before diagnosis to 5 years after diagnosis,patients with PD and LBD consistently had higher hazard rates of incident depression than all comparator groups.Conclusions These findings are compatible with depression being an early manifestation of the neurodegenerative changes eventually leading to PD and LBD and imply that incident depression at a late age should raise awareness of potential PD and LBD.
文摘BACKGROUND The characteristics of cerebral hemodynamic indexes of patients with different types of auditory verbal hallucinations(AVHs)was not clear.AIM To explore the characteristics of cerebral hemodynamic indexes of patients with different types of AVHs and construct the risk nomogram prediction model of patients with different types of AVHs.METHODS Patients with different types of verbal hallucinations who visited Wenzhou Seventh People’s Hospital were retrospectively selected from March 2021 to March 2023,and these patients were classified into 117 cases of schizophrenia(SCZ)with AVHs,108 cases of post-traumatic stress disorder(PTSD)with AVHs,and 105 cases of recurrent depressive disorder with AVHs according to type.Transcranial doppler was performed to measure the hemodynamic parameters of the anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA),basilar artery(BA)and vertebral artery(VA).Logistic regression modelling was used to explore the factors affecting patients with different types of AVHs and odds ratio,95%confidence interval(CI).A clinical prediction model was constructed,and the efficacy of the clinical prediction model was evaluated by using receiver operating characteristic,Hosmer-Lemeshow Goodness-of-Fit test,calibration curves and decision curve analysis.RESULTS The differences between the three groups of patients in mean velocity(Vm)-MCA,end-diastolic velocity(Vd)-MCA,Vm-ACA,pulsatility index(PI)-ACA,Vm-PCA,peak systolic velocity(Vs)-PCA,Vd-PCA,Vm-BA,Vs-BA,Vd-BA,PI-BA,resistance index(RI)-BA,Vm-VA,Vs-VA,Vd-VA,PI-VA,and RI-VA indexes were statistically significant.Rising Vm-ACA is an independent risk factor for SCZ with AVHs,and falling Vm-VA,Vd-MCA,and Vd-VA are independent risk factors for SCZ with AVHs.Rising Vm-ACA,Vm-PCA,Vs-PCA,Vd-PCA,Vm-BA,and Vs-BA are independent risk factors for PTSD with AVHs,and Vm-MCA,Vs-MCA,Vd-MCA,PI-PCA,and RIBA are independent protective factors for PTSD with AVHs.Elevated Vm-MCA,Vd-MCA,RI-BA,Vm-VA,and Vd-VA were independent risk factors,and elevated Vm-ACA,Vs-ACA,Vm-PCA,Vs-PCA,and Vd-PCA were independent protective factors.The areas under the curve of the three models were 0.82(95%CI:0.76-0.87),0.88(95%CI:0.83-0.92),and 0.81(95%CI:0.77-0.86),respectively;the Hosmer-Lemeshow Goodness-of-Fit test of the calibration curves of the three models suggests that P>0.05.CONCLUSION Monitoring the cerebral hemodynamic indexes of patients with AVHs is of practical significance in determining the type of mental disorder,which helps clinicians identify the type of AVHs and adopt more efficient treatment strategies to help patients recover.
基金financially supported by the National Natural Science Foundation of China,No.81671347(to KL)The Science and Technology Program of Guangzhou,China,No.202007030012(to KFS and KL)。
文摘Subthreshold depression is a highly prevalent condition in adolescents who are at high risk for developing major depressive disorder.In preclinical models of neurological and psychiatric diseases,Lycium barbarum polysaccharide(LBP)extracted from Goji berries had antidepressant effects including but not limited to anti-oxidative and anti-inflammatory properties.However,the effect of LBP on subthreshold depression is unclear.To investigate the clinical efficacy and safety of LBP for treating subthreshold depression in adolescents,we conducted a randomized,double-blind,placebo-controlled trial(RCT)with 29 adolescents with subthreshold depression recruited at The Fifth Affiliated Hospital of Guangzhou Medical University.The participants were randomly assigned to groups where they received either 300 mg LBP(LBP group,n=15,3 boys and 12 girls aged 15.13±2.17 years)or a placebo(placebo group,n=14,2 boys and 12 girls aged 15±1.71 years)for 6 successive weeks.Interim analyses revealed that the LBP group exhibited a greater change in Hamilton Depression Scale(HAMD-24)scores relative to the baseline and a higher remission rate(HAMD-24 total score≤7)at 6 weeks compared with the placebo group.Scores on the Beck Depression Inventory-II(BDI-II),Pittsburgh Sleep Quality Index(PSQI),Kessler Psychological Distress Scale(Kessler),and Screen for Child Anxiety-Related Emotional Disorders(SCARED)were similar between the LBP and placebo groups.No side effects related to the intervention were reported in either group.These results indicate that LBP administration reduced depressive symptoms in adolescents with subthreshold depression.Furthermore,LBP was well tolerated with no treatment-limiting adverse events.Clinical trials involving a larger sample size are needed to further confirm the anti-depressive effects of LBP in adolescents with subthreshold depression.This study was approved by the Medical Ethics Committee of the Fifth Affiliated Hospital of Guangzhou Medical University(Guangzhou,China;approval No.L2019-08)on April 4,2019 and was registered on ClinicalTrials.gov(identifier:NCT04032795)on July 25,2019.
基金supported by the National Natural Science Foundation of China,No.81671347(to KL)the Science and Technology Program of Guangzhou of China,No.202007030012(to KFS and KL)the Science and Technology Program of Guangzhou of China,No 202102020735(to RW).
文摘Strong evidence has accumulated to show a correlation between depression symptoms and inflammatory responses.Moreover,anti-inflammatory treatment has shown partial effectiveness in alleviating depression symptoms.Lycium barbarum polysaccharide(LBP),derived from Goji berries,exhibits notable antioxidative and anti-inflammatory properties.In our recent double-blinded randomized placebo-controlled trial,we found that LBP significantly reduced depressive symptoms in adolescents with subthreshold depression.It is presumed that the antidepressant effect of LBP may be associated with its influence on inflammatory cytokines.In the double-blinded randomized controlled trial,we enrolled 29 adolescents with subthreshold depression and randomly divided them into an LBP group and a placebo group.In the LBP group,adolescents were given 300 mg/d LBP.A 6-week follow up was completed by 24 adolescents,comprising 14 adolescents from the LBP group(15.36±2.06 years,3 men and 11 women)and 10 adolescents from the placebo group(14.9±1.6 years,2 men and 8 women).Our results showed that after 6 weeks of treatment,the interleukin-17A level in the LBP group was lower than that in the placebo group.Network analysis showed that LBP reduced the correlations and connectivity between inflammatory factors,which were associated with the improvement in depressive symptoms.These findings suggest that 6-week administration of LBP suppresses the immune response by reducing interleukin-17A level,thereby exerting an antidepressant effect.
基金National Natural Science Foundation of China,Nos.81771160 (to ZZ),81671060 (to CC),31970973 (to JW),21921004 (to FX)Translational Medicine and In terdisciplinary Research Joint Fund of Zhongnan Hospital of Wuhan University,No.ZNJC201934 (to ZZ)。
文摘Sleep benefits the restoration of energy metabolism and thereby suppo rts neuronal plasticity and cognitive behaviors.Sirt6 is a NAD+-dependent protein deacetylase that has been recognized as an essential regulator of energy metabolism because it modulates various transcriptional regulators and metabolic enzymes.The aim of this study was to investigate the influence of Sirt6 on cerebral function after chronic sleep deprivation(CSD).We assigned C57BL/6J mice to control or two CSD groups and subjected them to AAV2/9-CMV-EGFP or AAV2/9-CMV-Sirt6-EGFP infection in the prelimbic cortex(PrL).We then assessed cerebral functional connectivity(FC) using resting-state functional MRI,neuron/astrocyte metabolism using a metabolic kinetics analysis;dendritic spine densities using sparse-labeling;and miniature excitato ry postsynaptic currents(mEPSCs) and action potential(AP) firing rates using whole-cell patchclamp recordings.In addition,we evaluated cognition via a comprehensive set of behavioral tests.Compared with controls,Sirt6 was significantly decreased(P<0.05) in the PrL after CSD,accompanied by cognitive deficits and decreased FC between the PrL and accumbens nucleus,piriform cortex,motor co rtex,somatosensory co rtex,olfactory tubercle,insular cortex,and cerebellum.Sirt6 ove rexpression reve rsed CSD-induced cognitive impairment and reduced FC.Our analysis of metabolic kinetics using [1-13C] glucose and [2-13C] acetate showed that CSD reduced neuronal Glu4and GABA2synthesis,which could be fully restored via forced Sirt6 expression.Furthermore,Sirt6 ove rexpression reversed CSD-induced decreases in AP firing rates as well as the frequency and amplitude of mEPSCs in PrL pyramidal neurons.These data indicate that Sirt6 can improve cognitive impairment after CSD by regulating the PrL-associated FC network,neuronal glucose metabolism,and glutamatergic neurotransmission.Thus,Sirt6 activation may have potential as a novel strategy for treating sleep disorder-related diseases.
基金This project was supported by Medical Research Fund of Guangdong Province(No.A2018440).
文摘Objective:This paper aims to clarify the concept of occupational burnout(OB)as well as develop appropriate methods to relieve or prevent OB in the nursing profession.Methods:Walker and Avant's eight-step approach of concept analysis was applied.Results:OB was defined as a chronic form of work-related stress.Accurately,it was characterized by emotional exhaustion,depersonalization/cynicism,and reduced personal accomplishment/inefficacy.Antecedents of burnout included(a)demographic characteristics;(b)chronic exposure to work-related stressors;(c)quantitative and qualitative job demands;(d)lack of job resources;and(e)personality traits.Consequences involved(a)individual’s unfavorable quality of life;(b)negative impact on the organization;and(c)poor services quality.Although the Maslach Burnout Inventory(MBI)is perceived as an ideal tool to measure burnout and hence,it is used worldwide,whether this instrument fits to measure this concept for nurses has still not yet been verified and thus further research is needed.Conclusions:By proposing a comprehensive definition of the concept,this analysis contributes to recognition of the process of OB of nurses.All nurses are vulnerable to OB.Hence,burnout in nursing needs to be recognized as a critical factor in the delivery of safe patient care.It proposes that the prevention of OB would be achieved through team communication training,mindfulness group,education,etc.
文摘The application of physical restraint for patients represents ethical dilemmas for psychiatric nurses in terms of maintaining the safety of all(clients and staff)while at the same time curtailing the individual’s autonomy.This article aimed to provide a sound knowledge of ethical positions and strategies for psychiatric nurses to address ethical issues of physical restraint according to the ethical principles of autonomy,beneficence,nonmaleficence,and ethical theories.Given that nursing workforce was limited and workload among psychiatric nurses was heavy,physical restraint was one of the coercive interventions managing aggressive behavior.In relation to address ethical dilemmas,it was proposed to acquire informed consent of physical restraint from the individuals and provide person‑centered care.Effective communication and negotiation with patients could help to strike a balance between patients’autonomy and nurses’accountability when using physical restraint.In addition,guidelines and targeted intervention strategies need to be developed to regulate and reduce the implementation of restraint.Finally,a collaboration among nurses,psychiatrists,and families is essential to protect patients’autonomy concerning physical restraint use.
基金supported by the National Natural Science Foundation of China (grant numbers 82371558)to R.S.
文摘Loneliness is associated with high prevalences of major psychiatric illnesses such as major depression.However,the underlying emotional mechanisms of loneliness remained unclear.We hypothesized that loneliness originates from both decreases in positive emotional processing and increases in negative emotion processing.To test this,we conducted a systematic review of 29 previous studies(total participants n=19560,mean age=37.16 years,female proportion=59.7%),including 18 studies that included ques-tionnaire measures of emotions only,and 11 studies that examined the brain correlates of emotions.The main findings were that loneliness was negatively correlated with general positive emotions and positively correlated with general negative emotions.Fur-thermore,limited evidence indicates loneliness exhibited negative and positive correlations with the brain positive(e.g.the striatum)and negative(e.g.insula)emotion systems,respectively,but the sign of correlation was not entirely consistent.Additionally,loneli-ness was associated with the structure and function of the brain emotion regulation systems,particularly the prefrontal cortex,but the direction of this relationship remained ambiguous.We concluded that the existing evidence supported a bivalence model of lone-liness,but several critical gaps existed that could be addressed by future studies that include adolescent and middle-aged samples,use both questionnaire and task measures of emotions,distinguish between general emotion and social emotion as well as between positive and negative emotion regulation,and adopt a longitudinal design that allows us to ascertain the causal relationships between loneliness and emotion dysfunction.Our findings provide new insights into the underlying emotion mechanisms of loneliness that can inform interventions for lonely individuals.
基金supported by National Natural Science Foundation of China(No.82000948)National Natural Science Foundation of China(No.U20A20386)+2 种基金National Key Research and Development Program of China(No.2019YFC0118400)Zhejiang Provincial Key Research and Development Plan(No.2019C03020)National Natural Science Foundation of China(No.81870635).
文摘Purpose Phantom eye pain(PEP)is a major clinical problem after eye removal with no standard treatment protocol to date.As pain is a multidimensional experience associated with emotional and cognitive components,this study aimed to explore the possible neuropsychological mechanisms of PEP in a perspective of emotional cognition,in order to provide a basis for clinical treatment.Methods Visual oddball event-related potentials(ERPs)under different external emotional stimuli(Disgust,Fear,Sadness,Happiness,Erotica and Neutral)were tested in 12 patients and 12 healthy volunteers.Participants'affective states were measured with the Mood Disorder Questionnaire(MDQ),the Hypomania Checklist-32(HCL-32),and the Plutchik–van Praag Depression Inventory(PVP).The amplitudes and latencies of N1,P2,N2 and P3 components were analyzed by three-way ANOVA,i.e.,group(2)×emotion(6)×electrode(3).Multiple comparisons were performed using Bonferroni's test.Results Longer N1 latencies,increased N1 amplitudes;shorter P2 latencies under Disgust and Happiness,decreased P2 amplitudes;shorter N2 latencies under Erotica,increased N2 amplitudes were found in patients compared with controls.There was no main effect of group or interaction effect on P3 latencies and P3 amplitudes.The MDQ and HCL-32 scores were lower,and the N1 latencies under Sadness were negatively correlated with PVP scores in patients.Conclusions PEP patients showed reversed patterns in exogenous attention allocation and enhanced involuntary attention to emotional stimuli compared with controls.This study demonstrated cortical processing of emotions in PEP patients and could provide a basis for developing emotional intervention therapy.
