Mental health and insomnia problems in healthcare workers after the COVID-19 pandemic:A multicenter cross-sectional study

BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.

Vagus Nerve Stimulation for Pediatric and Adult Patients with Pharmaco-resistant Epilepsy

Background：Over past two decades,vagus nerve stimulation （VNS） has been widely used and reported to alleviate seizure frequency worldwide,however,so far,only hundreds of patients with pharmaco-resistant epilepsy （PRE） have been treated with VNS in China's Mainland.The study aimed to evaluate the effectiveness of VNS for Chinese patients with PRE and compare its relationship with age cohort and gender.Methods：We retrospectively assessed the clinical outcome of 94 patients with PRE,who were treated with VNS at Beijing Fengtai Hospital and Beij ing Tiantan Hospital between November 2008 and April 2014 from our database of 106 consecutive patients.The clinical data analysis was retrospectively examined.Results：Seizure frequency significantly decreased with VNS therapy after intermittent stimulation of the vagus nerve.At last follow-up,we found McHugh classifications of Class Ⅰ in 33 patients （35.1％）,Class Ⅱ in 27 patients （28.7％）,Class Ⅲ in 20 patients （21.3％）,Class Ⅳ in 3 patients （3.2％）,and Class Ⅴ in 11 patients （l 1.7％）.Notably,8 （8.5％） patients were seizure-free while ≥50％ seizure frequency reduction occurred in as many as 60 patients （63.8％）.Furthermore,with regard to the modified Engel classification,12 patients （12.8％） were classified as Class Ⅰ,l l patients （11.7％） were classified as Class Ⅱ,37 patients （39.4％） were classified as Class Ⅲ,34 patients （36.2％） were classified as Class Ⅳ.We also found that the factors of gender or age are not associated with clinical outcome.Conclusions：This comparative study confirmed that VNS is a safe,well-tolerated,and effective treatment for Chinese PRE patients.VNS reduced the seizure frequency regardless of age or gender of studied patients.

Hippocampus chronic deep brain stimulation induces reversible transcript changes in a macaque model of mesial temporal lobe epilepsy

Background:Deep brain stimulation(DBS)has seizure-suppressing effects but the molecular mechanisms underlying its therapeutic action remain unclear.This study aimed to systematically elucidate the mechanisms underlying DBS-induced seizure suppression at a molecular level.Methods:We established a macaque model of mesial temporal lobe epilepsy(mTLE),and continuous high-frequency hippocampus DBS(hip-DBS)was applied for 3 months.The effects of hip-DBS on hippocampus gene expression were examined using high-throughput microarray analysis followed by bioinformatics analysis.Moreover,the microarray results were validated using quantitative real-time polymerase chain reaction(qRT-PCR)and Western blot analyses.Results:The results showed that chronic hip-DBS modulated the hippocampal gene expression.We identified 4119 differentially expressed genes and assigned these genes to 16 model profiles.Series test of cluster analysis showed that profiles 5,3,and 2 were the predominant expression profiles.Moreover,profile 5 was mainly involved in focal adhesion and extracellular matrix-receptor interaction pathway.Nine dysregulated genes(Arhgap5,Colla2,Itgbl^Pik3rl,Lama4,Fnl,Col3al,Itga9,and Shc4)and three genes(Colla2,Itgbl,and Flna)in these two pathways were further validated by qRT-PCR and Western blot analyses,respectively,which showed a concordance.Conclusion:Our findings suggest that hip-DBS could markedly reverse mTLE-induced abnormal gene expression.Findings from this study establish the basis for further investigation of the underlying regulatory mechanisms of DBS for mTLE.

Internal Pallidum and Subthalamic Nucleus Deep Brain Stimulation for Oromandibular Dystonia

Dystonia is a neurologic disorder characterized by sustained involuntary movements or abnormal posture. Oromandibular dystonia is a form of focal dystonia that is characterized by forceful contractions of face, jaw, or tongue.