Network analysis of the relationships between depressive symptoms and social participation activities among Chinese older adults and its implications for nursing

Objective:Network analysis was used to explore the complex inter-relationships between social participation activities and depressive symptoms among the Chinese older population,and the differences in network structures among different genders,age groups,and urban-rural residency would be compared.Methods:Based on the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey(CLHLS),12,043 people aged 65 to 105 were included.The 10-item Center for Epidemiologic Studies Depression(CESD)Scale was used to assess depressive symptoms and 10 types of social participation activities were collected,including housework,tai-chi,square dancing,visiting and interacting with friends,garden work,reading newspapers or books,raising domestic animals,playing cards or mahjong,watching TV or listening to radio,and organized social activities.R 4.2.1 software was used to estimate the network model and calculate strength and bridge strength.Results:21.60%(2,601/12,043)of the participants had depressive symptoms.The total social participation score was negatively associated with depressive symptoms after adjusting for sociodemographic factors.The network of social participation and depressive symptoms showed that“D9(Inability to get going)”and“S9(Watching TV and/or listening to the radio)”had the highest strength within depressive symptoms and social participation communities,respectively,and“S1(Housework)”,“S9(Watching TV and/or listening to the radio)”,and“D5(Hopelessness)”were the most prominent bridging nodes between the two communities.Most edges linking the two communities were negative.“S5(Graden work)-D5(Hopelessness)”and“S6(Reading newspapers/books)-D4(Everything was an effort)”were the top 2 strongest negative edges.Older females had significantly denser network structures than older males.Compared to older people aged 65e80,the age group 81e105 showed higher network global strength.Conclusions:This study provides novel insights into the complex relationships between social participation and depressive symptoms.Except for doing housework,other social participation activities were found to be protective for depression levels.Different nursing strategies should be taken to prevent and alleviate depressive symptoms for different genders and older people of different ages.

Sex differences in the risk of retinopathy of prematurity:a systematic review,frequentist and Bayesian meta‑analysis,and meta‑regression

Background Retinopathy of prematurity(ROP)is generally considered to be more frequent in males than in females.However,it is not known whether sex differences in ROP affect all degrees of the condition,are global and have changed as neonatology has developed.We aimed to conduct a systematic review and meta-analysis of studies addressing sex differences in the risk of developing ROP.Methods PubMed/MEDLINE and Embase databases were searched.The frequentist,random-effects risk ratio(RR)and 95%confidence interval(CI)were calculated.Bayesian model averaged(BMA)meta-analysis was used to calculate the Bayes factors(BFs).The BF10 is the ratio of the probability of the data under the alternative hypothesis(H1)over the probability of the data under the null hypothesis(H0).Results We included 205 studies(867,252 infants).Frequentist meta-analysis showed a positive association between male sex and severe ROP(113 studies,RR=1.14,95%CI=1.07–1.22)but no association with any ROP(144 studies,RR=1.00,95%CI=0.96–1.03).BMA showed extreme evidence in favor of H1 for severe ROP(BF10=71,174)and strong evidence in favor of H0 for any ROP(BF10=0.05).The association between male sex and severe ROP remained stable over time and was present only in cohorts from countries with a high or high-middle sociodemographic index.Conclusions Our study confirms the presence of a male disadvantage in severe ROP but not in less severe forms of the disease.There are variations in the sex differences in ROP,depending on geographical location and sociodemographic level of the countries.

Experimental study on the mechanism of sex difference in the risk of torsade de pointes

Background Torsade de pointes (TdP) is a form of polymorphic ventricular tachycardia featuring prolonged QT intervals. Female gender is associated with an increased risk of TdP. However, the causes of the sex difference in risk are poorly understood. Recently, transmural dispersion of repolarization (TDR) has been implicated in the genesis of TdP. Consequently, we compared TdP incidence and TDR between male and female rabbit hearts in order to investigate the mechanism of sex difference in TdP risk in rabbits in vitro. Methods By means of monophasic action potential recording techniques, the monophasic action potential of the epicardium, midmyocardium, and endocardium were simultaneously recorded using specially designed plunge-needle electrodes placed across the left ventricular free wall of both female (n=8) and male (n=8) rabbit hearts purfused by the Langendorff method. TdP was induced by bradycardia, d-sotalol, and low-K +, Mg 2+ Tyrode solution. Results TDR measurements in all three myocardial layers of male and female rabbit hearts were (18±2) ms and (21±2) ms, respectively (n=8, P>0.05). After perfusion with d-sotalol, the 90% monophasic action potential duration was prolonged in both male and femlae rabbits. TDR in male and female rabbit hearts increased to (29±2) ms and (61±2) ms, respectively, a difference that is significant. Eight female rabbit hearts had early afterdepolarization and 7 of them developed TdP. Seven male rabbit hearts had early after depolarization, but only one of these hearts developed TdP.Conclusion Greater TDR may play an important role in the higher incidence of TdP in female rabbit hearts.

Sphingolipid profiles and their relationship with inflammatory factors in asthmatic patients of different sexes

Background:Asthma is a heterogeneous disease with distinct prevalence and manifestation between sexes.This study was to identify sex-specific features of asthma via metabolomic analysis of sphingolipids.Methods:Forty-two asthma patients(27 women and 15 men)admitted to the Peking University Third Hospital from January 2015 to December 2015 were enrolled.Peripheral venous blood was collected for metabolomic analysis by targeted liquid chromatography-mass spectrometry.Sex hormones(estradiol,progesterone,testosterone,and androstenedione)and multiple inflammatory factors(periostin,leptin,IgE,IL-4,IL-5,IL-10,IL-13,IL-17A,and IFN-γ)were also assessed.The eosinophil percentage in induced sputum was also detected.All these data were applied to comparative analysis between sexes.Results:Testosterone was negatively related to periostin(ρ=-0.420,P=0.009)and IL-5(ρ=-0.540,P=0.012),while estradiol was positively related to the blood eosinophil percentage(ρ=0.384,P=0.025).Among the eighteen species of sphingolipids detected in the 42 patients,five ceramide(Cer)species(Cer16:0,Cer:20:0,Cer22:0,Cer24:0,and Cer26:0)and one sphingomyelin(SM)species(SM38:0)were significantly higher in male than in female patients.Further investigation found that the correlation between Cer20:0 and IL-5 was positive in males(ρ=0.943,P=0.005)but negative in females(ρ=-0.561,P=0.030).Conclusions:Testosterone was negatively correlated with eosinophil inflammatory factors,but estradiol was positively correlated.Male asthma patients had higher ceramide and sphingomyelin levels than female patients.Different sexes had opposite correlations with ceramide and IL-5,respectively,suggesting that therapeutic strategies targeting ceramide should be different between sexes.

Effect of low-frequency electroacupuncture on pancreatic endocrine system in patients with simple obesity

Objective： To observe different efficacies of low-frequency electroacupuncture（EA） on pancreatic endocrine system in male and female patients with simple obesity due to spleen deficiency-related dampness. Methods： A total of 80 simple obesity patients were assigned to a male group（n=37） and a female group（n=43）. Both groups received a 30-minute low-frequency EA at Yinlingquan（SP 9）, Sanyinjiao（SP 6）, Zusanli（ST 36）, Fenglong（ST 40）, Quchi（LI 11）, Tianshu（ST 25）, Zhongwan（CV 12）, Shuifen（CV 9）, Qihai（CV 6） and Guanyuan（CV 4）. The treatment was done once a day, and 10 times made up a course of treatment. Patients in both groups were treated for 2 courses. Then the changes in body mass index（BMI）, serum insulin, insulin antibodies and leptin level in the two groups were observed and analyzed. Results： After treatment, the BMI, serum insulin, insulin antibodies and leptin levels were significantly reduced in both groups（P〈0.01 or P〈0.05）; the BMI and serum insulin concentration were more significantly reduced in the male group than those in the female group（both P〈0.01）; and the leptin level was more significantly reduced in the female group than that in the male group（P〈0.01）. Conclusion： EA can significantly regulate BMI and pancreatic endocrine system in both men and women with simple obesity; however, there is a gender difference： better effect for men in reducing BMI and serum insulin and better effect for women in reducing serum leptin level.

Association between serum uric acid level and mortality in China

Background:Whether there is an association between serum uric acid(SUA)level and risk of mortality in the general population remains unclear.Based on the China National Survey of Chronic Kidney Disease linked to mortality data,a population-based cohort study was performed to investigate the association between SUA level and all-cause mortality,cardiovascular disease(CVD)mortality,and cancer mortality in China.Methods:The survival status of participants in the cross-sectional survey was identified from January 1,2006 to December 31,2017.Only 33,268 individuals with complete SUA data among the 47,204 participants were included in the analysis.We determined the rates of all-cause mortality,CVD mortality,and cancer mortality.We used Cox proportional hazards regression models to evaluate the effect of the SUA level on mortality.Results:During a total of 297,538.4 person-years of follow-up,1282 deaths occurred.In the Cox proportional hazards regression model,the rate of all-cause mortality,CVD mortality,and cancer mortality had a U-shaped association with SUA levels only in men,whereas no significant associations were detected in women.For all-cause mortality in men,the multivariable-adjusted hazard ratios(HRs)in the first,second,and fourth quartiles compared with the third quartile were 1.31(95%confidence interval[CI]1.04–1.67),1.17(95%CI 0.92–1.47),and 1.55(95%CI 1.24–1.93),respectively.For CVD mortality,the corresponding HRs were 1.47(95%CI 1.00–2.18),1.17(95%CI 0.79–1.75),and 1.67(95%CI 1.16–2.43),respectively.For the cancer mortality rate,only a marginally significant association was detected in the fourth quartile compared with the third quartile with an HR of 1.43(95%CI 0.99–2.08).Conclusions:The association between SUA and mortality differed by sex.We demonstrated a U-shaped association with SUA levels for all-cause and CVD mortalities among men in China.

A comparative study of the effect of low-frequency electroacupuncture on blood lipids between men and women with simple obesity

Objective:To observe the difference of the effect of low-frequency electroacupuncture(EA)on blood lipids between male and female patients with simple obesity due to damp induced by spleen deficiency.Methods:Eighty patients with simple obesity were recruited,including 37 males and 43 females,to receive low-frequency EA by selecting Yinlingquan(SP 10),Sanyinjiao(SP 6),Zusanli(ST 36),Fenglong(ST 40),Quchi(LI 11),Tianshu(ST 25),Zhongwan(CV 12),Shuifen(CV 9),Qihai(CV 6)and Guanyuan(CV 4),with needles retained for 30 min.The treatment was given once a day,10 sessions as a treatment course,for 2 courses in total.The contents of body fat percentage(F%),total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL),low-density lipoprotein(LDL),blood glucose(Glu)and adiponectin(ADPN)in serum were observed to see the changes,and the two groups were compared and analyzed.Results:After the treatment,F%,and serum contents of TC,TG,LDL,Glu and ADPN dropped significantly in the two groups(P〈0.05 or P〈0.01)and the serum content of HDL increased significantly in male group(P〈0.05).The decrease of F%in female group was more significant than that in male group(P〈0.01);the decrease of ADPN in male group was more significant than that in female group(P〈0.05).Conclusion:EA can regulate the disordered blood lipids in male and female patients with simple obesity,with certain differences between genders.The decrease of subcutaneous fat content is more significant in females than that in males,while the decrease of ADPN is more significant in males.