Study on psychological resilience and associated influencing factors in lung cancer patients with bone metastases

BACKGROUND Evaluating the psychological resilience of lung cancer(LC)patients helps understand their mental state and guides future treatment.However,there is limited research on the psychological resilience of LC patients with bone me-tastases.AIM To explore the psychological resilience of LC patients with bone metastases and identify factors that may influence psychological resilience.METHODS LC patients with bone metastases who met the inclusion criteria were screened from those admitted to the Third Affiliated Hospital of Wenzhou Medical University.The psychological scores of the enrolled patients were collected.They were then grouped based on the mean psychological score:Those with scores lower than the mean value were placed in the low-score group and those with scores equal to or greater than the mean value was placed in the high-score group.The baseline data(age,gender,education level,marital status,residence,monthly income,and religious beliefs),along with self-efficacy and medical coping mode scores,were compared.RESULTS This study included 142 LC patients with bone metastases admitted to our hospital from June 2022 to December 2023,with an average psychological resilience score of 63.24±9.96 points.After grouping,the low-score group consisted of 69 patients,including 42 males and 27 females,with an average age of 67.38±9.55 years.The high-score group consisted of 73 patients,including 49 males and 24 females,with a mean age of 61.97±5.00 years.χ2 analysis revealed significant differences between the two groups in education level(χ2=6.604,P=0.037),residence(χ2=12.950,P=0.002),monthly income(χ2=9.375,P=0.009),and medical coping modes(χ2=19.150,P=0.000).Independent sample t-test showed that the high-score group had significantly higher self-efficacy scores(t=3.383,P=0.001)and lower age than the low-score group(t=4.256,P<0.001).Furthermore,multivariate logistic regression hazard analysis confirmed that self-efficacy is an independent protective factor for psychological resilience[odds ratio(OR)=0.926,P=0.035,95%confidence interval(CI):0.862-0.995],while age(OR=1.099,P=0.003,95%CI:1.034-1.169)and medical coping modes(avoidance vs confrontation:OR=3.767,P=0.012,95%CI:1.342-10.570;resignation vs confrontation:OR=5.687,P=0.001,95%CI:1.974-16.385)were identified as independent risk factors.A predictive model based on self-efficacy,age,and medical coping modes was developed.The receiver operating characteristic analysis showed an area under the curve value of 0.778(95%CI:0.701-0.856,P<0.001),indicating that the model has good predictive performance.CONCLUSION LC patients with bone metastases are less psychologically resilient than the general population.Factors such as self-efficacy,age,and medical coping modes influence their psychological resilience.Patients with low self-efficacy,old age,and avoidance/resignation coping modes should be closely observed.

A systematic analysis of pneumatosis cystoids intestinalis

AIM:To increase the understanding,diagnosis and treatment of pneumatosis cystoides intestinalis(PCI)and to find the characteristics and potential cause of the disease in China.METHODS:We report here one case of PCI in a 70-year-old male patient who received a variety of treatment methods.Then,we systematically searched the PCI eligible literature published from an available Chinese database from May 2002 to May 2012,including CBM,CBMDisc,CMCC,VIP,Wanfang,and CNKI.The key words were pneumatosis cystoides intestinalis,pneumatosis,pneumatosis intestinalis,pneumatosis coli and mucosal gas.The patients' information,histories,therapies,courses,and outcomes were reviewed.RESULTS:The study group consisted of 239 PCI cases(male:female = 2.4:1)from 77 reported incidents.The mean age was 45.3 ± 15.6 years,and the median illness course was 6 mo.One hundred and sixty patients(66.9%)were in high altitude areas.In addition,43.5%(104/239)of the patients had potential PCI-related disease,and 16.3% had complications with intestinal obstruction and perforation.The most common symptom was abdominal pain(53.9%),followed by diarrhea(53.0%),distention(42.4%),nausea and vomiting(14.3%),bloody stool(12.9%),mucous stool(12.0%)and constipation(7.8%).Most multiple pneumocysts developed in the submucosa of the colon(69.9%).The efficacy of the treatments by combined modalities,surgery,endoscopic treatment,conservative approach,oxygen,and antibiotics were 100%,100%,100%,93.3%,68.3% and 26.3%,respectively.CONCLUSION:PCI can be safely managed by conservative treatments,presents more frequently in males,in the large bowel and submucosa,than in females,in the small intestine and subserosa.High altitude residence maybe associated with the PCI etiology.

Dynamic changes of behaviors, dentate gyrus neurogenesis and hippocampal miR-124 expression in rats with depression induced by chronic unpredictable mild stress

The depression-like behavior phenotype,neurogenesis in the dentate gyrus and miR-124 expression in the hippocampus are the focus of current research on the pathogenesis of depression and antidepressant therapy.The present study aimed to clarify the dynamic changes of depression-like behavior,dentate gyrus neurogenesis and hippocampal miR-124 expression during depression induced by chronic stress to reveal pathological features at different stages of depression and to further provide insight into depression treatment.Chronic unpredictable mild stress depression models were established by exposing Sprague-Dawley rats to various mild stressors,including white noise,thermal swimming,stroboscopic illumination,soiled cages,pairing with three other stressed animals,cold swimming,tail pinch,restraint and water and food deprivation.Chronic unpredictable mild stress model rats underwent dynamic observation from 1 to 8 weeks and were compared with a control group(normal feeding without any stressors).To observe changes in the depression-like behavior phenotype during chronic unpredictable mild stress-induced depression,a sucrose preference test was used to evaluate the degree of anhedonia.An open-field test was used to evaluate locomotor activity and anxiety status.Compared with the control group,chronic unpredictable mild stress rats lost weight but did not have a depression-like behavioral phenotype at 1-4 weeks.Chronic unpredictable mild stress rats presented decreased sucrose preference and locomotor activity at 5-8 weeks.In addition,chronic unpredictable mild stress rats did not have significant anxiety-like behavior during 1-8 weeks of modeling.To observe neurogenesis dysfunctions and changes in neuronal number in the dentate gyrus during chronic unpredictable mild stress-induced depression,markers(DCX and DCX/BrdU)of neural proliferation and differentiation and the neuronal marker NeuN were assessed by immunofluorescence.Compared with the control group,neurogenesis and the neuronal number in the dentate gyrus did not change from 2 to 6 weeks;however,neural proliferation and differentiation in the dentate gyrus decreased,and the number of neurons decreased until the eighth week in the chronic unpredictable mild stress group.Real-time quantitative reverse transcription polymerase chain reaction assays and fluorescence in situ hybridization were used to measure the expression of hippocampal miR-124 during chronic unpredictable mild stress-induced depression.The results showed that the expression of hippocampal miR-124 was unchanged during the first 4 weeks but increased from 5 to 6 weeks and decreased from 7 to 8 weeks compared with the control group.These findings indicate that during chronic unpredictable mild stress-induced depression,the behavioral phenotype,miR-124 expression in the hippocampus,neurogenesis in the dentate gyrus and neuronal numbers showed dynamic changes,which suggested that various pathological changes occur at different stages of depression.All experimental procedures and protocols were approved by the Experimental Animal Ethics Committee of Guangzhou University of Chinese Medicine of China in March 2015.

Adjuvant sorafenib after heptectomy for Barcelona Clinic Liver Cancer-stage C hepatocellular carcinoma patients

AIM: To investigate the efficacy and safety of adjuvant sorafenib after curative resection for patients with Barcelona Clinic Liver Cancer(BCLC)-stage C hepatocellular carcinoma(HCC).METHODS: Thirty-four HCC patients, classified as BCLC-stage C, received adjuvant sorafenib for highrisk of tumor recurrence after curative hepatectomy at a tertiary care university hospital. The study group was compared with a case-matched control group of 68 patients who received curative hepatectomy for HCC during the study period in a 1:2 ratio.RESULTS: The tumor recurrence rate was markedly lower in the sorafenib group(15/34, 44.1%) than in the control group(51/68, 75%, P = 0.002). The median disease-free survival was 12 mo in the study group and 10 mo in the control group. Tumor number more than 3, macrovascular invasion, hilar lymph nodes metastasis, and treatment with sorafenib were significant factors of disease-free survival by univariate analysis. Tumor number more than 3 and treatment with sorafenib were significant risk factors of diseasefree survival by multivariate analysis in the Cox proportional hazards model. The disease-free survival and cumulative overall survival in the study group were significantly better than in the control group(P = 0.034 and 0.016, respectively). CONCLUSION: Our study verifies the potential benefit and safety of adjuvant sorafenib for both decreasing HCC recurrence and extending disease-free and overall survival rates for patients with BCLC-stage C HCC after curative resection.

Preparation of chitosan-polyaspartic acid-5-fluorouracil nanoparticles and its anti-carcinoma effect on tumor growth in nude mice

AIM: To prepare chitosan-polyaspartic acid-5-fluorouracil (CTS-Pasp-5Fu) nanoparticles and investigate its anti-carcinoma effect and toxicity. METHODS: CTS-Pasp-5Fu nanoparticles were synthesized by ionic gelatification. Male BABL/c nude mice were injected with SGC-7901 gastric carcinoma cell line mass to establish a human gastric carcinoma model. They were randomly allocated into 4 groups: CTS-Pasp-5Fu (containing 5-Fu 1.25 mg/kg), 5-Fu (1.25 mg/kg), CTS-Pasp and normal saline groups. Tumor weight was measured and assay of colony forming unit-granulocyte and macrophage (CFU-GM) was performed. The structural change of cells and tissues was observed and the Bax and Bcl-2 genes were detected. RESULTS: Compared with normal saline, the inhibition rates of tumor growth for the CTS-Pasp, 5-Fu and CTS-Pasp-5Fu groups were 5.58%, 58.69% and 70.82%, respectively. The tumor inhibition rates for the CTS-Pasp, 5-Fu and CTS-Pasp-5Fu groups were 5.09%, 65.3% and 72.79%, respectively. There was a significant decrease in the number of CFU-GMformation and increase of total bilirubin, and alanine aminotransferase in the 5-Fu group, but no change in those of the other three groups. There was no change in white blood cell count and creatinine among the four groups. Pathological section of liver and nephridial tissues showed that the damage in the 5-Fu group was more severe than that in the CTS-Pasp-5Fu group. 5-Fu and CTS-Pasp-5Fu groups could both down-regulate the Bcl-2 expression and up-regulate the Bax expression to different extent, and the accommodate effect of CTS-Pasp-5Fu was more obvious than 5-Fu. CONCLUSION: The tumor inhibition rate of CTS-Pasp-5Fu nanoparticles is much higher than that of 5-Fu alone.

Exploration of the mechanism by which icariin modulates hippocampal neurogenesis in a rat model of depression

Icariin(ICA) has a significant capacity to protect against depression and hippocampal injury,but it cannot effectively cross the bloodbrain barrier and accumulate in the brain.Therefore,the mechanism by which ICA protects against hippocampal injury in depression remains unclear.In this study,we performed proteomics analysis of cerebrospinal fluid to investigate the mechanism by which ICA prevents dysfunctional hippocampal neurogenesis in depression.A rat model of depression was established through exposure to chronic unpredictable mild stress for 6 weeks,after which 120 mg/kg ICA was administered subcutaneously every day.The results showed that ICA alleviated depressive symptoms,learning and memory dysfunction,dysfunctional neurogenesis,and neuronal loss in the dentate gyrus of rats with depression.Neural stem cells from rat embryonic hippocampi were cultured in media containing 20% cerebrospinal fluid from each group of rats and then treated with 100 μM corticosterone.The addition of cerebrospinal fluid from rats treated with ICA largely prevented the corticosterone-mediated inhibition of neuronal proliferation and differentiation.Fifty-two differentially expressed proteins regulated by chronic unpredictable mild stress and ICA were identified through proteomics analysis of cerebrospinal fluid.These proteins were mainly involved in the ribosome,PI3 K-Akt signaling,and interleukin-17 signaling pathways.Parallel reaction monitoring mass spectrometry showed that Rps4 x,Rps12,Rps14,Rps19,Hsp90 b1,and Hsp90 aa1 were up-regulated by chronic unpredictable mild stress and down-regulated by ICA.In contrast,Htr A1 was down-regulated by chronic unpredictable mild stress and up-regulated by ICA.These findings suggest that ICA can prevent depression and dysfunctional hippocampal neurogenesis through regulating the expression of certain proteins found in the cerebrospinal fluid.The study was approved by the Experimental Animal Ethics Committee of Guangzhou University of Chinese Medicine of China in March 2017.

All roads lead to Rome-a review of the potential mechanisms by which exerkines exhibit neuroprotective effects in Alzheimer’s disease

Age-related neurodegenerative disorders such as Alzheimer’s disease(AD)have become a critical public health issue due to the significantly extended human lifespan,leading to considerable economic and social burdens.Traditional therapies for AD such as medicine and surgery remain ineffective,impractical,and expensive.Many studies have shown that a variety of bioactive substances released by physical exercise(called“exerkines”)help to maintain and improve the normal functions of the brain in terms of cognition,emotion,and psychomotor coordination.Increasing evidence suggests that exerkines may exert beneficial effects in AD as well.This review summarizes the neuroprotective effects of exerkines in AD,focusing on the underlying molecular mechanism and the dynamic expression of exerkines after physical exercise.The findings described in this review will help direct research into novel targets for the treatment of AD and develop customized exercise therapy for individuals of different ages,genders,and health conditions.

Potential application of ultrasound-guided thermal ablation in rare liver tumors

Background: With the advances of imaging techniques, the detection rate of rare liver tumor is increased. However, the therapeutic strategies of the rare liver tumors remain limited. Methods: We analyzed twelve pathologically confirmed rare liver tumors in 8 patients. All of the patients underwent ultrasound(US) guided biopsy and subsequent thermal ablation. The tumors were ablated according to the preoperative plans and monitored by real-time US. CT/MRI fused with contrast enhanced US(CEUS) or three-dimensional(3 D) US-CEUS images were used to guide and assess the ablation zone more accurately during thermal ablation. The rate of technical efficacy was assessed based on the contrast-enhance CT/MRI(CECT/MRI) results one month after ablation. Local tumor progression(LTP), recurrence and complications were followed up and recorded. Results: Among these twelve nodules, nine were subject to US-guided thermal ablation, whereas the other three inconspicuous nodules were subject to CEUS-guided thermal ablation. Intra-procedure CT/MRI-CEUS or 3 D US-CEUS fusion imaging assessments demonstrated that the ablation zone sufficiently covered the original tumor, and no immediate supplementary ablation was required. Additionally, no major complications were observed during the follow-up period. The postoperative CECT/MRI confirmed that the technique success rate was 100%. Within the surveillance period of 13 months, no LTP or recurrence was noted. Conclusions: US-guided thermal ablation was feasible and safe for rare liver tumors. The use of fusion imaging technique might make US-guided thermal ablation as effective as surgical resection, and this technique might serve as a potential therapeutic modality for rare liver tumors in the future.

Gastric body diaphragm-like stricture as a rare complication of nonsteroidal anti-inflammatory drugs

Increased risk due to nonsteroidal anti-inflammatory drugs (NSAIDs) therapy has been observed in patients. Although diaphragm-like stricture in the small bowel and colon induced by NSAIDs therapy has been rarely reported, gastric body diaphragm-like stricture has not been reported. We describe the first case of gastric body diaphragm-like stricture due to NSAIDs in a 44-year-old male patient who was successfully treated by an endoscopic approach to avoid complicated surgery. This case highlights new insight into the disadvantages of NSAIDs and provides new data for future clinical studies.

Primary lymphoblastic B-cell lymphoma of the stomach:A case report

Primary stomach lymphoblastic B-cell lymphoma (B-LBL) is a rare tumor. We describe a primary stomach B-LBL in a 38 years old female who presented with nonspecific complaints of fatigue and vomiting for 2 mo. Gastrofiberscopy revealed a large gastric ulcer, which was successfully resected. Pathology showed a lymphoblastic cell lymphoma arising from the stomach, and there was no evidence of disease at any extrastomach site. Immunohistochemical staining and gene rearrangement studies supported that the stomach tumor was a clonal B-cell lymphoma. Therefore, the diagnosis of B-LBL was made based on the stomach specimen.

Low Grade Fibromyxoid Sarcomas and Multiple Myeloma in the Same Patient： One Case Report and Literature Review

IntroductionMultiple myeloma （MM） is a neoplastic plasma cell dyscrasia char-acterized by anemia; a monoclonal protein（M-protein） in the serum and/or urine; abnormal bone radiographs and bone pain;hypercal-cemia; and renal insuf.ciency or failure.According to the results of immunoelectrophoresis, patients are separated to Ig type （IgG, IgA, IgD, IgE and IgM）; light chain; nonsecretory.

Unconventional Fluorescent and Multi-responsive Polyethyleneimine with LCST and UCST Behavior:Synthesis,Characterization and Biological Applications

Non-aromatic fluorescent and multi-responsive materials,exhibiting inherent fluorescence emission and controlled phase change,have garnered significant attention in recent years.However,the underlying interaction between their fluorescent properties and phase transition remains unclear.In this study,we synthesized a series of catalyst-free aza-Michael addition-based polyethyleneimine(RFPEI)materials by reacting polyethyleneimine(PEI)with N-isopropyl acrylamide(NIPAM).The resulting RFPEI was comprehensively characterized,and demonstrated dual-phase transition behavior(LCST and UCST)in water,which could be finely tuned by adjusting its composition or external factors such as pH.Notably,upon UV irradiation(365 nm),RFPEI exhibited strong fluorescence emission.We further investigated the effects of NIPAM grafting percentage to PEI,polymer concentration,and pH on the LCST/UCST and fluorescent properties of RFPEI aqueous solutions.Moreover,we showcased the great potential of RFPEI as a versatile tool for physiological cell imaging,trace detection,and controlled release of doxorubicin.Our study presents a novel class of stimuli-responsive fluorescent materials with promising applications in the field of biomedicine.

Predictive value of Th17 and Treg cells at baseline for HBsAg loss in chronic hepatitis B patients with low HBsAg quantification treated with pegylated interferon and nucleos(t)ide analogue

Background and aims:The primary goal of chronic hepatitis B(CHB)treatment is to reduce hepatitis B surface antigen(HBsAg).T helper 17(Th17)and regulatory T(Treg)cells are essential for the development of CHB.However,how Th17 and Treg cells contribute to HBsAg loss is still unknown.Therefore,this study aimed to search for the predictive value of Th17 and Treg cells for HBsAg loss in CHB patients with low HBsAg quantification.Methods:The study included 99 hepatitis B e antigen(HBeAg)-negative CHB patients who had completed a year of nucleos(t)ide analogue(NA)monotherapy and had received both NA and pegylated interferon(PEG-IFN)treatment for less than 96 weeks(96 wk).In the cured group,48 patients lost HBsAg within 48 wk,while 51 patients did not(uncured group).Blood samples and clinical data were collected for research.Results:During PEG-IFN and NA combination therapy,the proportion of Th17 cells in the cured group increased significantly,while the proportion of Treg cells in the uncured group increased.From 0 to 24 wk,the proportion of Th17 cells in the cured group was significantly higher than in the uncured group,while the opposite was true for Treg cells.Patients with alanine aminotransferase(ALT)2.5 upper limit of normal(ULN)at 12 wk had a higher proportion of Th17 cells and a lower proportion of Treg cells than those with ALT<2.5 ULN at 12 wk.Additionally,the proportion of Th17 cells is inversely associated with the level of HBsAg,whereas the level of Treg cells is positively related to HBsAg quantification.The clinical cure index,including age,HBsAg quantification,and the proportions of Th17 and Treg cells,had a higher area under the curve(0.957)for predicting HBsAg loss when compared to the proportions of Th17 and Treg cells and HBsAg quantification alone.Conclusions:Combined with quantification of HBsAg,the proportions of Th17 cells and Treg cells at baseline can be used as good predictors of HBsAg loss in patients with low HBsAg quantification treated with NA and PEG-IFN.

Alleviating Skin Barrier Disruption,Skin Inflammation,and Pruritus:A Moisturizing Spray Containingβ-Glucan and Panthenol

Objective:Inflammatory skin diseases were proved to be associated with dry skin-induced pruritus.However,the relationship between skin inflammation,skin barrier function,and pruritus remains unclarified.The present study aimed to explore this relationship using an acetone-ether-water(AEW)mouse model,and to investigate the anti-itch effects of the combined application ofβ-glucan and panthenol in a moisturizing spray in this mouse model.Methods:A dry skin-induced chronic pruritus mouse model was established by repeated AEW treatment of the skin.The pruritic behavior,skin barrier function,and expression of molecules related to pruritus and inflammation in topical lesions were measured.The effects of a spray containingβ-glucan and panthenol were observed.Thet test and one-way analysis of variance were used to evaluate differences between groups.Results:AEW treatment triggered spontaneous scratching with significantly increased numbers of scratching bouts,and disrupted the skin barrier with a significant increase in transepidermal water loss values and a significant decrease in filaggrin gene(FLG)expression(allP<0.01).AEW treatment also significantly increased the expression of NOD-like receptor family pyrin domain containing 3,apoptosis-associated speck-like protein containing a CARD,caspase-1,interleukin-1β,and tumor necrosis factor-α,as well as the pruritus-associated molecules nerve growth factor,cathepsin S,and thymic stromal lymphopoietin in the skin(allP<0.01).Application of the spray containingβ-glucan and panthenol significantly alleviated these responses,resulting in a reduced number of scratching bouts in 1 hour,reduced transepidermal water loss values,increased filaggrin mRNA expression,and reduced mRNA levels of NOD-like receptor family pyrin domain containing 3,apoptosis-associated speck-like protein containing a CARD,caspase-1,interleukin-1β,tumor necrosis factor-α,cathepsin S,thymic stromal lymphopoietin,and nerve growth factor in skin lesions(allP<0.05).Conclusion:The present results suggest a relationship between damaged skin barrier function,pruritus,and inflammation.Addingβ-glucan and panthenol to moisturizing skincare products may alleviate pruritus induced by dry skin,improve the damaged skin barrier function,and reduce the inflammatory state in local skin areas.

沉淀聚合制备含有机硅聚脲多孔材料

通过甲苯二异氰酸酯(TDI)与α,ω-氨丙基二硅氧烷(APDS)在水-丙酮混合溶剂中沉淀聚合制备了含有机硅聚脲多孔材料(PUS).研究了两单体质量比和混合溶剂中水/丙酮质量比及反应温度对PUS产率及形貌的影响.使用扫描电镜和红外光谱及核磁共振对PUS的形貌及化学结构进行了表征.结果表明,在反应温度30°C和水/丙酮质量比为3/7条件下,改变APDS/TDI的质量比,可控制PUS的形貌.当APDS/TDI配比小于3/7时可制得为无规则形状的多孔结构PUS;而APDS/TDI高于3/7时可制得PUS多孔微球;APDS/TDI配比为4/6时多孔微球粒径分布最为均一,其比表面为106 m^2/g.此外,微球粒径随着水/丙酮配比及反应温度的升高而逐渐减小.对PUS热性能表征结果表明其具有良好的耐热性.

Yb^(3+)-and Er^(3+)-doped Y_(2)O_(3) microcrystals for upconversion photoluminescence and energy transfer with enhancements of near-ultraviolet emission

Yb^(3+)and Er^(3+)were doped into Y_(2)O_(3) to form Y_(2)O_(3):Yb^(3+),Er^(3+)microcrystals.The effect of doping concentration of Yb^(3+)was studied.The near-ultraviolet(UV)upconversion(UC)emission spectra of Y_(2)O_(3):Yb^(3+),Er^(3+)were studied under 1.55-μm excitation.The near-UV UC emissions centered at 391 and 418 nm were enhanced by Yb^(3+)under 1.55-μm laser excitation.Er^(3+)generally acts as activator and is not used as sensitizer in the reference Er^(3+)-doped oxides.In the present upconversion process under the 1.55-μm laser excitation,the energy transfer from Er^(3+)to Yb^(3+)and then Yb^(3+)to Er^(3+)was observed.Dopant Er^(3+)acted as not only activator but also sensitizer.The energy transfer between Er^(3+)and Yb^(3+)enhanced the near-UV UC emission of our materials.

PTSD:Past,present and future implications for China

There has been a long history since human beings began to realize the existence of post-traumatic symptoms.Posttraumatic stress disorder(PTSD),a diagnostic category adopted in 1980 in the Diagnostic and Statistical Manual of Mental Disorders-III,described typical clusters of psychiatric symptoms occurring after traumatic events.Abundant researches have helped deepen the understanding of PTSD in terms of epidemiological features,biological mechanisms,and treatment options.The prevalence of PTSD in general population ranged from 6.4%to 7.8%and was significantly higher among groups who underwent major public traumatic events.There has been a long way in the studies of animal models and genetic characteristics of PTSD.However,the high comorbidity with other stress-related psychiatric disorders and complexity in the pathogenesis of PTSD hindered the effort to find specific biological targets for PTSD.Neuroimage was widely used to elucidate the underlying neurophysiological mechanisms of PTSD.Functional MRI studies have showed that PTSD was linked to medial prefrontal cortex,anterior cingulate cortex and sub-cortical structures like amygdala and hippocampus,and to explore the functional connectivity among these brain areas which might reveal the possible neurobiological mechanism related to PTSD symptoms.For now,cognitive behavior therapy-based psychotherapy,including combination with adjunctive medication,showed evident treatment effects on PTSD.The emergence of more effective PTSD pharmacotherapies awaits novel biomarkers from further fundamental research.Several natural disasters and emergencies have inevitably increased the possibility of suffering from PTSD in the last two decades,making it critical to strengthen PTSD research in China.To boost PTSD study in China,the following suggestions might be helpful:(1)establishing a national psychological trauma recover project,and(2)exploring the mechanisms of PTSD with joint effort and strengthening the indigenized treatment of PTSD.

Military-related posttraumatic stress disorder and mindfulness meditation:A systematic review and meta-analysis

Purpose:Posttraumatic stress disorder(PTSD)is a significant global mental health concern,especially in the military.This study aims to estimate the efficacy of mindfulness meditation in the treatment of military-related PTSD,by synthesizing evidences from randomized controlled trials.Methods:Five electronic databases(Pubmed,EBSCO Medline,Embase,PsychINFO and Cochrane Library)were searched for randomized controlled trials focusing on the treatment effect of mindfulness meditation on military-related PTSD.The selection of eligible studies was based on identical inclusion and exclusion criteria.Information about study characteristics,participant characteristics,intervention details,PTSD outcomes,as well as potential adverse effects was extracted from the included studies.Risk of bias of all the included studies was critically assessed using the Cochrane Collaboration's tool.R Statistical software was performed for data analysis.Results:A total of 1902 records were initially identified and screened.After duplicates removal and title&abstract review,finally,19 articles in English language with 1326 participants were included through strict inclusion and exclusion criteria.The results revealed that mindfulness meditation had a significantly larger effect on alleviating military-related PTSD symptoms compared with control conditions,such as treatment as usual,present-centered group therapy and PTSD health education(standardized mean difference(SMD)=-0.33;95%CI[-0.45,-0.21];p<0.0001).Mindfulness interventions with different control conditions(active or non-active control,SMD=-0.33,95%CI[-0.46,-0.19];SMD=-0.49,95%CI[-0.88,-0.10],respectively),formats of delivery(group-based or individual-based,SMD=-0.30,95%CI[-0.42,-0.17],SMD=-0.49,95%CI[-0.90,-0.08],respectively)and intervention durations(short-term or standard duration,SMD=-0.27,95%CI[-0.46,-0.08],SMD=-0.40,95%CI[-0.58,-0.21],respectively)were equally effective in improving military-related PTSD symptoms.Conclusion:Findings from this meta-analysis consolidate the efficacy and feasibility of mindfulness meditation in the treatment of military-related PTSD.Further evidence with higher quality and more rigorous design is needed in the future.

The impact of the COVID-19 pandemic on the mental health of young people:A comparison between China and the United Kingdom

Purpose:As COVID-19 spreads globally and affects people's health,there are concerns that the pandemic and control policies may have psychological effects on young people(age from 17 to 35 years).This psychological impact might vary in different countries,and thus we compared the prevalence of self-reported psychological distress,loneliness and posttraumatic stress symptoms(PTSS)among young people in the United Kingdom(UK)and China at the beginning of the COVID-19 pandemic.Methods:Data of this study came from two sources.One source was the first wave of COVID-19 study in Understanding Society,a special wave of the UK household longitudinal study,which provided the high-quality,national-wide representative panel data.The sample comprised 1054 young people.The other source was an online survey on the mental health of 1003 young people from Shanghai,a highly developed area in China.The questionnaire included questions on the prevalence of common mental disorders(cut-off score≥4),loneliness and potential PTSS(cut-off≥33).Univariable analyses were conducted to test the differences in the self-reported prevalence of psychological distress and loneliness between the two groups.Multivariable logistic regression analyses were run to explore the predictors of psychological distress and loneliness among all the young people from England and Shanghai.Results:Among the samples with self-reported psychological distress,the UK sample accounted for 34.4%(n=1054)and the Chinese sample accounted for 14.1%(n=1003).The difference between the two groups was statistically significant(p<0.001).Additionally,57.1%of people in the UK and 46.7%in China reported that they sometimes or often felt lonely,of which the difference is statistically significant(p<0.001).Regression analysis of the entire samples showed that nationality,gender,psychotherapy and loneliness were significant predictors of 12-item General Health Questionnaire scores,while the variables of age and living alone were not.Significant predictors of self-reported loneliness were the nationality,gender,age,living alone and psychotherapy.In China,123(12.3%)young people,49 men(11.3%)and 74 women(13.0%),met the criteria of PTSS symptoms(cut-off scores≥33).These scores were only collected in China.Conclusion:This evidence suggests that mental health and loneliness reported by young people were lower in China than that in the UK during the studied period.More research is needed to understand these differences.If the differential negative psychological impacts are confirmed,country-specific measures of prevention and intervention should be adopted to improve the mental health of young people under the ongoing impact of the pandemic.

Theoretical Characteristics of Tibetan Medicine

Similar to traditional Chinese medicine(TCM),Tibetan medicine emphasizes the concepts of holism,balance,and etiology.With the individual as the nexus of macro-and micro-ecologies,multi-layered systemic etiologies,inform therapeutic pharmacologies for cultivating network effects to induce the healing response.Tibetan medicine approaches health and healing through perspectives that frame the balance achieved in the internal world as inextricably linked to balance in the external world,and vice versa,that includes expressions of mind and consciousness.The external world refers to the broader context of the natural world as comprised of matter and energy expressed through five elemental dynamics(Chi.Tu,Shui,Huo,Feng and Kong;Tib.Sa,Chu,Mé,r Lung and Kha)describing principles of solidity,cohesion,heat,motility,and interactive space,or earth,water,fire,wind and space,respectively.The internal world refers to the local context of the physical mass and biochemical cascades of energy transfers comprising the human body,its behaviors and functions,including cognitive factors,as also expressed through the five elemental dynamics.The external and internal systems merge as a unified whole,where the five elemental dynamics characterize materio-energetic exchanges between the broader and local ecologies of individual body and natural world,as well as social relations,mental affects,and contextual conditions.The interdependence,opposition,restriction and transformation among three physiological systems known as nyépa(Three Causal Factors)-r Lung,Tripa and Béken(pronounced lōōng,trīpa,baekan,respectively)-are used to discuss the balance of the whole.The causal origins of disease are explained through disturbances to these systems as a combination of afflictive mental factors,physiologic imbalances,and disturbing conditions from the natural world,such as environmental toxins,pathogens,and exposures.Of the three causal origins,afflictive mental factors are particularly emphasized as important etiological conditioning influences.Initiation and progression of disease is divided into four stages:baseline stage,initiating stage,developing stage,and maturing stage.Each stage has an explicit therapeutic paradigm for treatment,recovery,and health maintenance demonstrating the distinct theoretical framework for disease treatment in Tibetan medicine as specific to individual body,particular disease etiology,and constitutionally-directed unique compound metabolism pharmacodynamically.