Mental Health in China: Stigma,Family Obligations,and the Potential of Peer Support

Some people with mental illness in China do not receive treatment. We explored how stigma and familial obligation influenced accessibility of social support for patients with depression in China and the potential acceptability of peer support programs. Semi-structured qualitative interviews were conducted with five psychiatrists and 16 patients receiving care for depression from a large psychiatric hospital in Jining, Shandong Province of China. Patients with mental illness reported barriers that prevented them from (a) receiving treatment and (b) relying on informal social support from family members, including stigma, somatization, and community norms. Circumventing these barriers, peer support (i.e., support from others with depression) was viewed by patients as an acceptable means of exchanging information and relying on others for support. Formative research on peer support programs to examine programming and activities may help reduce the burden of unmet mental health care needs in China.     

Human bone marrow mesenchymal stem cells-derived exosomes protect against nerve injury via regulating immune microenvironment in neonatal hypoxic-ischemic brain damage model

Neonatal hypoxic-ischemic (HI) brain injury is a serious injury caused by various perinatal factors, which has become a heavy mental burden to the family. The molecular mechanism underlying neonatal hypoxic-ischemic brain injury remains largely unknown. Human bone marrow mesenchymal stem cells (hBMSCs) have caused wide public concern due to the immunomodulatory properties. Exosomes can polarize human microglia and thus changed it into an anti-inflammatory phenotype to reduce the release of pro-inflammatory factors. However, it is unclear whether hBMSCs-exosomes have effect on neonatal hypoxic-ischemic brain injury. In this study, we aimed at investigating the role of hBMSCs-exosomes in regulating immune response and nerve injury in neonatal hypoxic-ischemic brain damage model. In the research, we identified the exosome secretion of hBMSCs could transferred into human microglia (HMC). Moreover, we determined the importance of hBMSCs-exosomes in regulating HMC polarization and inflammatory response. Our research findings might provide a new insight into slowing the disease progression of neonatal hypoxic-ischemic brain injury.     

The Optimum Doses of and Injection Locations for Periprostatic Nerve Blockade for Transrectal Ultrasound Guided Biopsy of the Prostate: A Prospective,Randomized, Placebo Controlled Study

PurposeWe evaluated the efficiency of various amounts of local anesthesia and various numbers of injection sites to determine the most effective pain control with the least number of injections and the amount of injected medium in patients who underwent transrectal ultrasound guided prostate biopsy.Materials and MethodsTransrectal ultrasound guided 8 core biopsy of the prostate was performed in 175 consecutive men. Patients were randomized into 7 groups with 25 per group. Group 1 received 5 cc saline and groups 2 to 7 received 2.5, 5 or 10 cc 1% lidocaine injected as local anesthesia at basal or basal plus apical locations. The patients were then evaluated for pain and other complications to determine whether there was a difference regarding groups.ResultsMean pain scores were significantly lower than in saline group for all anesthesia injected groups except group 2 with a 2.5 cc bilateral basal injection. The most effective pain control was achieved by 10 cc anesthetic injections. Basal plus apical injections were not superior than only basal injections for pain control. There was no significant difference in the hematuria, hematospermia, rectal bleeding or infection rate among the groups. Increasing the number of injections and amount of lidocaine had no effect on complication rates.ConclusionOur placebo controlled, prospective, randomized study indicated that 10 cc local anesthetic injections supply significantly better pain control than lower doses for periprostatic nerve blockade during prostate biopsy. Although bilateral basal plus apical 10 cc lidocaine injections resulted in the lowest mean pain score, there was no statistically significant difference from 10 cc bilateral basal injections.     

Computed Tomography‒Guided Microwave Ablation Combined with Osteoplasty for the Treatment of Bone Metastases: A Multicenter Clinical Study

PurposeTo evaluate the efficacy and safety of combined microwave ablation (MWA) and osteoplasty as a palliative therapy for painful bone metastases.Materials and MethodsAs an extension of a previous limited single-center study, a retrospective review was conducted for 147 patients (77 male, 70 female) with painful bone metastases who underwent MWA combined with osteoplasty. In total, 102 (69.4%), 41 (27.9%), and 4 (2.7%) patients had spinal metastases, extraspinal metastases, and both, respectively. Treatment efficacy was determined by comparing visual analog scale (VAS) scores, daily morphine equivalent opioid consumption, and Oswestry disability index (ODI) scores before treatment and during the follow-up period (mean follow-up, 9.8 months; range 3–16).ResultsThe mean VAS score significantly declined from 6.4 ± 2.3 before treatment to 3.2 ± 2.1, 1.9 ± 1.6, 1.8 ± 1.6, 1.8 ± 1.6, and 1.9 ± 1.6 at 24 hours, 1 week, 4 weeks, 12 weeks, and 24 weeks after treatment, respectively (P < .01). Furthermore, the mean daily morphine equivalent opioid consumption was significantly reduced from 81.5 ± 32.8 mg before treatment to 40.0 ± 20.6, 32.4 ± 10.2, 26.4 ± 10.0, 21.5 ± 8.3, and 19.3 ± 7.4 mg. The mean ODI score also declined after treatment (P < .0001). Major complications occurred in 4 of 147 patients, with 1 pathologic fracture, 1 nerve injury, and 2 mild skin infections. Minor cement leakages were observed at 69 sites (32.8%).ConclusionsMWA combined with osteoplasty is an effective and safe treatment for painful bone metastases.     

Treatment with NAD+ inhibited experimental autoimmune encephalomyelitis by activating AMPK/SIRT1 signaling pathway and modulating Th1/Th17 immune responses in mice

Nicotinamide adenine dinucleotide (NAD⁺) plays vital roles in mitochondrial functions, cellular energy metabolism and calcium homeostasis. In this study, we investigated the effect of NAD⁺ administration for the treatment of experimental autoimmune encephalomyelitis (EAE) in C57BL/6 mice. EAE, a classical animal model of multiple sclerosis (MS), was induced by subcutaneous injection of myelin oligodendrocyteglycoprotein (MOG). The mice were treated with 250 mg/kg (body weight) NAD⁺ in PBS administered intraperitoneally once daily. We observed that NAD⁺ treatment could lessen the severity of EAE. Additionally, NAD⁺ treatment attenuated pathological injuries of EAE mice. We also found that the AMP-activated protein kinase (AMPK)/silent mating-type information regulation 2 homolog 1(SIRT1) pathway was activated in the NAD⁺-treated mice and NAD⁺ treatment suppressed pro-inflammatory T cell responses. Our findings demonstrated that NAD⁺ could be an effective and promising agent to treat multiple sclerosis and its effects on other autoimmune diseases should be explored.     

Expression of the calcium sensing receptor in human peripheral blood T lymphocyte and its contribution to cytokine secretion through MAPKs or NF-κB pathways

The calcium-sensing receptor (CaSR) has been reported to play an important role in many tissues and organs. However, studies about the expression and function of CaSR in T lymphocytes are still not very lucid. In this study, we investigated the above-mentioned issues using RT-PCR, immunofluorescence staining, Western blotting, and the ELISA techniques. We found that the CaSR protein was expressed, and mainly located in the membrane in the normal human peripheral blood T lymphocytes. GdCl₃ (an agonist of CaSR) increased the dose-dependency of the CaSR expression, which was abolished by NPS2390 (an inhibitor of CaSR). GdCl₃ and Ca²⁺ increased the phosphorylation of extracellular signal-regulated kinase (ERK)1/2 (one subgroup of MAPKs) and P65 (subunit of NF-κB),but, they had no significant effects on the JNK and P38 subgroups of MAPKs. Meantime, GdCl₃ and Ca²⁺ stimulated both the IL-6 and TNF-β releases and their mRNA expressions. However, these effects of GdCl₃ and Ca²⁺ were inhibited by NPS2390, U0126 (MAPKs pathway inhibitor) or Bay-11-7082 (NF-κB pathway inhibitor). These results suggested that CaSR was functionally expressed in the T cells, and the activated CaSR contributed to the cytokine secretion through the partial MAPK and NF-κB pathways.     

Vitamin D receptor rs2228570 polymorphism and susceptibly to ovarian cancer: a meta-analysis

The role of vitamin D receptor (VDR) rs2228570 polymorphism on the risk of ovarian cancer has been studied in many studies, but the relationship between VDR rs2228570 polymorphism and ovarian cancer is still unclear. We thus performed a meta-analysis of published studies to provide a comprehensive assessment of the association. Fourteen individual studies with a total of 10,964 subjects were finally included into the meta-analysis. We assessed the association by calculating the pooled odds ratio (OR) with 95 % confidence intervals (95 % CI). There was no heterogeneity among those included studies. Meta-analysis of 14 studies showed that the VDR rs2228570 polymorphism was associated with risk of ovarian cancer under three main comparison models (T versus C: OR?=?1.09, 95 % CI 1.03 to 1.15, P?=?0.004; TT versus CC: OR?=?1.17, 95 % CI 1.04 to 1.32, P?=?0.01; and TT/CT versus CC: OR?=?1.12, 95 % CI 1.03 to 1.21, P?=?0.007). Subgroup analysis in Caucasians further identified the obvious association. There was no evidence of publications bias. These data from the meta-analysis suggest that VDR rs2228570 polymorphism is associated with risk of ovarian cancer in Caucasians. More studies are warranted to assess the association between the VDR rs2228570 polymorphism and ovarian cancer in Asians and Africans.     

ResGANet: Residual group attention network for medical image classification and segmentation

In recent years, deep learning technology has shown superior performance in different fields of medical image analysis. Some deep learning architectures have been proposed and used for computational pathology classification, segmentation, and detection tasks. Due to their simple, modular structure, most downstream applications still use ResNet and its variants as the backbone network. This paper proposes a modular group attention block that can capture feature dependencies in medical images in two independent dimensions: channel and space. By stacking these group attention blocks in ResNet-style, we obtain a new ResNet variant called ResGANet. The stacked ResGANet architecture has 1.51–3.47 times fewer parameters than the original ResNet and can be directly used for downstream medical image segmentation tasks. Many experiments show that the proposed ResGANet is superior to state-of-the-art backbone models in medical image classification tasks. Applying it to different segmentation networks can improve the baseline model in medical image segmentation tasks without changing the network architecture. We hope that this work provides a promising method for enhancing the feature representation of convolutional neural networks (CNNs) in the future.     

冠心病患者人格特质的研究进展

冠心病是一种常见心血管疾病。有研究表明人格特质对冠心病发病及预后具有显著影响。本文就近年来对冠心病患者人格特质的相关研究进行综述,以期从心理学角度为冠心病的相关临床护理提供指导。