Relationship between preoperative psychological stress and shortterm prognosis in elderly patients with femoral neck fracture

BACKGROUND Older adults are at high risk of femoral neck fractures(FNFs).Elderly patients face and adapt to significant psychological burdens,resulting in different degrees of psychological stress response.Total hip replacement is the preferred treatment for FNF in elderly patients;however,some patients have poor postoperative prognoses,and the underlying mechanism is unknown.We speculated that the postoperative prognosis of elderly patients with FNF may be related to preoperative psychological stress.AIM To explore the relationship between preoperative psychological stress and the short-term prognosis of elderly patients with FNF.METHODS In this retrospective analysis,the baseline data,preoperative 90-item Symptom Checklist score,and Harris score within 6 months of surgery of 120 elderly patients with FNF who underwent total hip arthroplasty were collected.We analyzed the indicators of poor short-term postoperative prognosis and the ability of the indicators to predict poor prognosis and compared the correlation between the indicators and the Harris score.RESULTS Anxiety,depression,garden classification of FNF,cause of fracture,FNF reduction quality,and length of hospital stay were independent influencing factors for poor short-term postoperative prognoses in elderly patients with FNF(P<0.05).The areas under the curve for anxiety,depression,and length of hospital stay were 0.742,0.854,and 0.749,respectively.The sensitivities of anxiety,depression,garden classification of FNF,and prediction of the cause of fracture were 0.857,0.786,0.821,and 0.821,respectively.The specificities of depression,FNF quality reduction,and length of hospital stay were the highest at 0.880,0.783,and 0.761,respectively.Anxiety,depression,and somatization scores correlated moderately with Harris scores(r=-0.523,-0.625,and-0.554;all P<0.001).CONCLUSION Preoperative anxiety,depression,and somatization are correlated with poor short-term prognosis in elderly patients with FNF and warrant consideration.

Study on the correlation between abdominal infection and psychological stress in children based on nucleic acid detection

BACKGROUND Diagnosing and treating abdominal infection in children remains a challenge.Nucleic acid detection,as a rapid and accurate diagnosis tool,has great significance in this field.AIM To investigate the diagnosis and treatment of abdominal infection by nucleic acid detection and its possible correlation with psychological stress in children.METHODS A total of 50 pediatric patients diagnosed with abdominal infections between September 2020 and July 2021 were included in this study.Intra-abdominal pus samples were collected for pathogen culture,drug susceptibility testing,and broad-spectrum bacterial nucleic acid testing.Psychological stress,anxiety,depression,and coping styles were assessed using the coping with a disease(CODI)scale.RESULTS Based on susceptibility testing,a regimen of cefazoxime,piperacillin/tazobactam,and metronidazole or ornidazole achieved 100%effectiveness in treating appendicitis.Psychological assessments revealed a positive correlation between pressure level and both anxiety(r=0.324,P=0.001)and depressive disorders(r=0.325,P<0.001).Acceptance and distancing as coping strategies were negatively correlated with anxiety and depression,while negative emotional responses were strongly associated with increased anxiety(r=0.574,P<0.001)and depression(r=0.511,P=0.001).Coping strategies such as illusion and escape showed no significant correlation with emotional outcomes.CONCLUSION Nucleic acid testing helps in the diagnosis of abdominal infections in children,and also focuses on children's mental health.

Advances in the Study of Psychological Stress and Eating Behavior in Children and Adolescents

With the rapid development and change in society,children and adolescents are facing more and more psychological pressure,which comes not only from academic performance and interpersonal relationships but also from family environment,social expectations and other aspects.Psychological stress not only affects the mental health of children and adolescents but is also closely related to their eating behavior.Therefore,exploring the relationship between psychological stress and eating behaviors is of great significance in promoting the physical and mental health development of children and adolescents.Based on this,the study reviewed the research progress on the relationship between psychological stress and eating behavior of children and adolescents in recent years.The relationships between psychological stress and general eating behaviors,abnormal eating behaviors and eating disorders were successively reviewed,and the related physiological mechanisms were explored with a view to providing a scientific basis for mental health education and eating behavior intervention for children and adolescents.

Impact of psychological stress on irritable bowel syndrome

Psychological stress is an important factor for the development of irritable bowel syndrome(IBS). More and more clinical and experimental evidence showed that IBS is a combination of irritable bowel and irritable brain. In the present review we discuss the potential role of psychological stress in the pathogenesis of IBS and provide comprehensive approaches in clinical treatment. Evidence from clinical and experimental studies showed that psychological stresses have marked impact on intestinal sensitivity, motility, secretion and permeability, and the underlying mechanism has a close correlation with mucosal immune activation, alterations in central nervous system, peripheral neurons and gastrointestinal microbiota. Stress-induced alterations in neuro-endocrine-immune pathways acts on the gut-brain axis and microbiota-gut-brain axis, and cause symptom flare-ups or exaggeration in IBS. IBS is a stresssensitive disorder, therefore, the treatment of IBS should focus on managing stress and stress-induced responses. Now, non-pharmacological approaches and pharmacological strategies that target on stress-related alterations, such as antidepressants, antipsychotics, miscellaneous agents, 5-HT synthesis inhibitors, selective 5-HT reuptake inhibitors, and specific 5-HT receptor antagonists or agonists have shown a critical role in IBS management. A integrative approach for IBS management is a necessary.

Effects of psychological stress on small intestinal motility and expression of cholecystokinin and vasoactive intestinal polypeptide in plasma and small intestine in mice

AIM: To investigate the effects of psychological stress on small intestinal motility and expression of cholecystokinin (CCK) and vasoactive intestinal polypeptide (VIP) in plasma and small intestine, and to explore the relationship between small intestinal motor disorders and gastrointestinal hormones under psychological stress. METHODS: Thirty-six mice were randomly divided into psychological stress group and control group. A mouse model with psychological stress was established by housing the mice with a hungry cat in separate layers of a two-layer cage. A semi-solid colored marker (carbon-ink) was used for monitoring small intestinal transit. CCK and VIP levels in plasma and small intestine in mice were measured by radioimmunoassay (RIA). RESULTS: Small intestinal transit was inhibited (52.18±19.15% vs70.19±17.79%, P<0.01) in mice after psychological stress, compared to the controls. Small intestinal CCK levels in psychological stress mice were significantly lower than those in the control group (0.75±0.53 μg/g vs1.98±1.17 μg/g, P<0.01), whereas plasma CCK concentrations were not different between the groups. VIP levels in small intestine were significantly higher in psychological stress mice than those in the control group (8.45±1.09 μg/g vs7.03±2.36 μg/g, P<0.01), while there was no significant difference in plasma VIP levels between the two groups. CONCLUSION: Psychological stress inhibits the small intestinal transit, probably by down-regulating CCK and up-regulating VIP expression in small intestine.

Effect of psychological stress on gastric motility assessed by electrical bio-impedance

AIM:To evaluate gastric motility using electrical bioimpedance(EBI) and gastric changes as a result of stress induced by psychological tests.METHODS:A group of 57 healthy women,aged 40-60 years,was recruited,and a clinical history and physical examination were performed.The women were free from severe anxiety,chronic or acute stress,severe depression,mental diseases and conditions that affect gastric activity.The women were evaluated under fasting conditions,and using a four-electrode configuration,the gastric signals were obtained through a BIOPAC MP-150 system.The volunteers were evaluated using the following paradigm:basal state,recording during the Stroop Test,intermediate resting period,recording during the Raven Test,and a final resting period.We analyzed the relative areas of the frequency spectrum:A1(1-2 cpm),A2(2-4 cpm),A3(4-8 cpm),and A4(8-12 cpm),as well as the median of area A2 + A3.The data were analyzed by an autoregressive method using a Butterworth filter with MatLab and Origin.Analysis of variance(ANOVA) and Friedman ANOVA(for nonparametric variables) were performed;in addition,pairs of groups were compared using the T dependent and Wilcoxon T tests.RESULTS:The results of the main values of area A2 were not significantly different comparing the five steps of the experimental paradigm.Nevertheless,there was a tendency of this A2 region to decrease during the stress tests,with recuperation at the final resting step.When an extended gastric region was considered(1-4 cpm),significant differences with the psychological stress tests were present(F = 3.85,P = 0.005).The A3 region also showed significant changes when the stress psychological tests were administered(F = 7.25,P < 0.001).These differences were influenced by the changes in the adjacent gastric region of A2.The parameter that we proposed in previous studies for the evaluation of gastric motility by electrical bio-impedance(EBI) was the median of the area under the region from 2 to 8 cpm(A2 + A3).The mean values of these frequencies(median of the A2 + A3 area) with the stress test showed significant changes(F = 5.5,P < 0.001).The results of the WilcoxonT test for the A4 area parameter,which is influenced by the breathing response,changed significantly during the Raven stress test(P < 0.05).CONCLUSION:We confirm that the gastric response to acute psychological stress can be evaluated by short-term EBI.

Effects of psychological stress on small intestinal motility and bacteria and mucosa in mice

AIM: To investigate the effects of psychological stress on small intestinal motility and bacteria and mucosa in mice, and to explore the relationship between small intestinal dysfunction and small intestinal motility and bacteria and mucosa under psychological stress. METHODS: Sixty mice were randomly divided into psychological stress group and control group. Each group were subdivided into small intestinal motility group (n= 10), bacteria group (n = 10), and D-xylose administered to stomach group (n= 10). An animal model with psychological stress was established housing the mice with a hungry cat in separate layers of a two-layer cage. A semi-solid colored marker (carbon-ink) was used for monitoring small intestinal transit. The proximal small intestine was harvested under sterile condition and processed for quantitation for aerobes (Escherichia coli) and anaerobes (Lactobacilli). The quantitation of bacteria was expressed as Iog10(colony forming units/g). D-xylose levels in plasma were measured for estimating trie damage of small intestinal mucosa. RESULTS: Small intestinal transit was inhibited (39.80±9.50% vs 58.79±11.47%,P<0.01) in mice after psychological stress, compared with the controls. Psychological stress resulted in quantitative alterations in the aerobes (E.coli). There was an increase in the number of E coli in the proximal small intestinal flora (1.78±0.30 log10(CFU/g) vs 1.37±0.21 log10(CFU/g), P<0.01), and there was decrease in relative proportion of Lactobacilli and E.coli of stressed mice (0.53±0.63 vs 1.14±1.07,P<0.05), while there was no significant difference in the anaerobes (Lactobacilli) between the two groups (2.31±0.70 log10 (CFU/g) vs 2.44±0.37 log10(CFU/g), P>0.05). D-xylose concentrations in plasma in psychological stress mice were significantly higher than those in the control group (2.90±0.89 mmol/L vs 0.97±0.33 mmol/L, P<0.01). CONCLUSION: Small intestinal dysfunction under psychological stress may be related to the small intestinal motility disorder and dysbacteriosis and the damage of mucosa probably caused by psychological stress.

Serotonin regulates brain-derived neurotrophic factor expression in select brain regions during acute psychological stress

Previous studies suggest that serotonin （5-HT） might interact with brain-derived neurotrophic factor （BDNF） during the stress response. However, the relationship between 5-HT and BDNF expression under purely psychological stress is unclear. In this study, one hour before psychological stress exposure, the 5-HT1A receptor agonist 8-OH-DPAT or antagonist MDL73005, or the 5-HT2A receptor agonist DOI or antagonist ketanserin were administered to rats exposed to psychological stress. Immunohistochemistry and in situ hybridization revealed that after psychological stress, with the exception of the ventral tegmental area, BDNF protein and mRNA expression levels were higher in the 5-HT1A and the 5-HT2A receptor agonist groups compared with the solvent control no-stress or psychological stress group in the CA1 and CA3 of the hippocampus, prefrontal cortex, central amygdaloid nucleus, dorsomedial hypothalamic nucleus, dentate gyrus, shell of the nucleus accumbens and the midbrain periaqueductal gray. There was no significant difference between the two agonist groups. In contrast, after stress exposure, BDNF protein and mRNA expression levels were lower in the 5-HT1A and 5-HT2A receptor antagonist groups than in the solvent control non-stress group, with the exception of the ventral tegmental area. Our findings suggest that 5-HT regulates BDNF expression in a rat model of acute psychological stress.

Anti-infective therapy durations predict psychological stress and laparoscopic surgery quality in pelvic abscess patients

BACKGROUND The degree of psychological stress and the difficulty and efficacy of laparoscopic surgery differ in patients with pelvic abscesses after different durations of antiinfection treatment.AIM To compare and analyse the effects of different durations of anti-infective therapy on patients’preoperative psychological stress level and the clinical efficacy of laparoscopic surgery in patients with pelvic abscesses to offer a reference for the selection of therapy plans.METHODS A total of 100 patients with pelvic abscesses who were admitted to the Department of Gynecology of Suzhou Ninth Hospital affiliated to Soochow University(Suzhou Ninth People's Hospital)from January 2018 to December 2022 were retrospectively enrolled.According to the different durations of antiinfective therapy,they were divided into Group S(50 patients,received antiinfective therapy for 24-48 h)and Group L(50 patients,received anti-infective therapy for 48-96 h).Baseline data,state-trait anxiety score at admission and before surgery,self-rating anxiety scale(SAS)+self-rating depression scale(SDS)score,surgery time,adhesion grading score,intraoperative blood loss,presence or absence of intraoperative intestinal injury,ureteral injury or bladder injury,postoperative body temperature,length of hospital stay,and presence or absence of recurrence within 3 mo after surgery,chronic pelvic pain,incision infection,dysmenorrhea,menstrual disorder or intestinal obstruction were compared between the S group and the L group.RESULTS There was no significant difference in the background data between the S group and the L group(P<0.05).There was no significant difference in the state-trait anxiety score or SAS+SDS score between the S group and the L group on admission(P<0.05).The state-trait anxiety score and SAS+SDS score of the S group were lower than those of Group L after receiving different durations of anti-infective therapy(P<0.05).There was no significant difference in the incidence of intestinal,ureteral or bladder injury between the S group and the L group(P<0.05).The surgery time of Group S was shorter than that of Group L,and the adhesion score and intraoperative blood loss volume were lower than those of Group L(P<0.05).There was no significant difference in the incidence of incision infection,dysmenorrhea,menstrual disorder or intestinal obstruction between the S group and the L group(P<0.05).The postoperative body temperature of Group S was lower than that of Group L(P<0.05),and the hospital stay was shorter than that of Group L(P<0.05).The incidences of recurrence and chronic pelvic pain within 3 mo after surgery were lower than that of Group L(P<0.05).CONCLUSION Twenty-four to forty-eight hours of anti-infective therapy is better than 48-96 h of anti-infective therapy for patients with pelvic abscesses because the degree of psychological stress is lower,which is more conducive to achieving better outcomes after laparoscopic surgery.

CHANGES OF PSYCHOLOGICAL STRESS STATE AND THE EFFECT OF ACPUNCTURE INTERVENTION IN ARMED ANTI-TERRORISM POLICEMEN

Objective:To observe psychological changes of the armed policemen under stress state and the effect of acupuncture intervention for exploring possible measures in raising the armed policemen's capability in dealing with the suddenly-occurred accidents. Methods: In the first part of the study for observing psychological changes, a total of 90 volunteer armed policemen participating in anti-terrorism maneuver were randomly and evenly divided into anti-chemical weapon group, flight reconnaissance group and hostage-rescuing group. 30 logistic personals were selected to form control group. Symptom Checklist-90 (SCL-90) questionnaire was used to assess the psychological state of these anti-terrorism policemen. In the second part of the study for observing the effect of acupuncture, 60 policemen with anxiety and depression who were determined by Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were randomly and evenly divided into non-acupuncture and acupuncture groups, and other 30 policemen with normal psychological state were selected to form control group. Two weeks before anti-terrorism maneuver, participants of acupuncture group were asked to receive continuous acupuncture treatment of bilateral Neiguan (内关 PC 6) and Zusanli (足三里 ST 36), once daily, 15 min every time. Results:Comparison among the first 4 groups displayed that the total scores, scores of body feeling reactions, interpersonal relation, depression, anxiety, terror, and psychological problems of flight reconnaissance and hostage-rescuing groups were significantly higher than those of control group (P<0.05-0.01), suggesting that the psychological stress pressure was strongest in flight reconnaissance policemen and secondary in hostage-rescuing policemen, followed by anti-chemical weapon policemen. Following administration of acupuncture intervention, scores of both SDS and SAS in acupuncture group were considerably lower than those of non-acupuncture group (P< 0.01), showing that acupuncture intervention could reduce psychological stress reactions in the armed policemen undergoing anti-terrorism exercise. Conclusion: Before anti-terrorism exercise,neerly all the armed policemen have different degrees of psychological problems, while acupuncture intervention can improve their psychological state.

Fang-Xia-Dihuang decoction inhibits breast cancer progression induced by psychological stress via down-regulation of PI3K/AKT and JAK2/STAT3 pathways:An in vivo and a network pharmacology assessment

Background:The development and prognosis of breast cancer are intricately linked to psychological stress.In addition,depression is the most common psychological comorbidity among breast cancer survivors,and reportedly,Fang-Xia-Dihuang decoction(FXDH)can effectively manage depression in such patients.However,its pharmacological and molecular mechanisms remain obscure.Methods:Public databases were used for obtaining active components and related targets.Main active components were further verified by ultra-high-performance liquid chromatography-high-resolution mass spectrometry(UPLC-HRMS).Protein–protein interaction and enrichment analyses were taken to predict potential hub targets and related pathways.Molecule docking was used to understand the interactions between main compounds and hub targets.In addition,an animal model of breast cancer combined with depression was established to evaluate the intervention effect of FXDH and verify the pathways screened by network pharmacology.Results:174 active components of FXDH and 163 intersection targets of FXDH,breast cancer,and depression were identified.Quercetin,methyl ferulate,luteolin,ferulaldehyde,wogonin,and diincarvilone were identified as the principal active components of FXDH.Protein–protein interaction and KEGG enrichment analyses revealed that the phosphoinositide-3-kinase–protein kinase B(PI3K/AKT)and Janus kinase/signal transducer and activator of transcription(JAK2/STAT3)signaling pathways played a crucial role in mediating the efficacy of FXDH for inhibiting breast cancer progression induced by depression.In addition,in vivo experiments revealed that FXDH ameliorated depression-like behavior in mice and inhibited excessive tumor growth in mice with breast cancer and depression.FXDH treatment downregulated the expression of epinephrine,PI3K,AKT,STAT3,and JAK2 compared with the control treatment(p<0.05).Molecular docking verified the relationship between the six primary components of FXDH and the three most important targets,including phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha(PIK3CA),AKT,and STAT3.Conclusion:This study provides a scientific basis to support the clinical application of FXDH for improving depression-like behavior and inhibiting breast cancer progression promoted by chronic stress.The therapeutic effects FXDH may be closely related to the PI3K/AKT and JAK2/STAT3 pathways.This finding helps better understand the regulatory mechanisms underlying the efficacy of FXDH.

Psychological stress and long-term blood pressure variability of military young males:The cardiorespiratory fitness and hospitalization events in armed forces study

BACKGROUND Acute stress might increase short-term heart rate variability and blood pressure variability(BPV);however,chronic stress would not alter short-term BPV in animal models.AIM To examine the association of psychological stress with long-term BPV in young male humans.METHODS We prospectively examined the association of chronic psychological stress with long-term BPV in 1112 healthy military males,averaged 32.2 years from the cardiorespiratory fitness and hospitalization events in armed forces study in Taiwan.Psychological stress was quantitatively evaluated with the Brief Symptom Rating Scale(BSRS-5),from the least symptom of 0 to the most severe of 20,and the five components of anxiety,insomnia,depression,interpersonal sensitivity,and hostility(the severity score in each component from 0 to 4).Longterm BPV was assessed by standard deviation(SD)for systolic and diastolic blood pressure(SBP and DBP),and average real variability(ARV),defined as the average absolute difference between successive measurements of SBP or DBP,across four visits in the study period from 2012 to 2018(2012-14,2014-15,2015-16,and 2016-18).RESULTS The results of multivariable linear regressions showed that there were no correlations of the BSRS-5 score with SDSBP,SDDBP,ARVSBP,and ARVDBP after adjusting for all the covariates[β(SE):-0.022(0.024),-0.023(0.026),-0.001(0.018),and 0.001(0.020),respectively;P>0.05 for all].In addition,there were also no correlations between each component of the BSRS score and the long-term BPV indexes.CONCLUSION Our findings suggest that chronic psychological stress might not be associated with long-term BPV in military young male humans.

Comparative study on ghrelin level change and its related factors in hypertensive elders with psychological distress

Objective To investigate the change of plasma ghrelin level and explore the related factors of ghrelin alteration in elderly hypertensive patients with psychological distress.Methods A total of 300 elders,who were screened with Hamilton Anxiety Scale(HAMA),Hamilton Rating Scale for Depression(HAMD),and the Symptom Checklist-90(SCL-90)for psychological stress and somato-psychological manifestations respectively,were divided into hypertension group(n=148)and non-hypertension group(n=152).Their blood samples were collected to measure the plasma level of ghrelin and total cortisol on the same day.Results The incidences of anxiety and depression were 27.7% and 11.7%,respectively,in all the enrolled elders.However,the rates of psychological distress,particularly anxiety,were significantly higher in the hypertensive elders than in the non-hypertensive ones(43.2% vs.12.5%).Anxiety was positively related to the cortisol level but negatively related to the plasma ghrelin level,and the latter two were negatively correlated with each other.Conclusion Chronic increase of plasma cortisol induced by long-term anxiety can lead to the reduction of ghrelin level,which then adversely affects blood pressure in elders with psychological distress.Therefore,ghrelin might be a selective antihypertensive medicine for hypertensive elders with anxiety.

Role of ghrelin in cognitive impairment of hypertensive elders with chronic psychological distress

Objective:To investigate ghrelin level change in combination with psychological stress in the hypertensive old people with cognitive impairment and to explore its effect as well as possible mechanism.Methods:The study population of 300 elders was divided into 2 groups,148 with hypertension and 152 non-hypertension,who were screened for psychological distress and cognition function,and had blood drawn to measure plasma levels of ghrelin and total cortisol on the same day.Results:The rates of anxiety and cognitive impairment were higher in the hypertension elders,which were negatively correlated with plasma ghrelin level,resulted from chronic cortisol response to anxiety.Conclusion:Chronic plasma cortisol increase to long-term anxiety leads a reduce in ghrelin level which then adversely affects blood pressure and cognitive function in old people.So measuring ghrelin of elders may be a diagnostic tool to predict cognitive development and ghrelin may be a selective antihypertensive medicine for cognitive impairment elders with or without chronic psychological stress.

The association of salivary alpha-amylase, heart rate variability, and psychological stress on objectively measured sleep behaviors among college students

Objective:This study aimed to evaluate sleep behaviors among college students,to assess salivary alpha-amylase(sAA)and heart rate variability(HRV)in association with stress,and to investigate sleep-related factors including sAA,HRV,and stress among them.Methods:Saliva samples for sAA assessment and HRV measurements in the supine position were taken between 3 PM and 6 PM.The level of prolonged psychological stress for the previous week was evaluated using the Korean version of the Global Assessment of Recent Stress(GARS-K),and sleep behaviors were assessed using an actigraphy device.Results:A total of 86 healthy college students participated in this study.Sleep behaviors of the college students were not good,with 84%sleep efficiency(SE)and 62.7 min wake after sleep onset(WASO).The average sAA level was 65.8 U/mL in the participants.Although neither the sAA level nor HRV indices were significantly correlated with prolonged psychological stress,decreased normalized high frequency(nHF)on HRV was independently associated with a higher level of stress when adjusted for age and sex.Higher stress(r=-0.276,P=0.011)and lower sAA(r=0.266,P=0.030)had significant correlations with shorter time in bed;however,it was sAA that was independently associated with time in bed(β=0.244,p=0.044).Decreased nHF(β=0.245,P=0.027)and higher body mass index(BMI)(β=-0.224,P=0.043)were independently related to and poorer SE.Conclusions:Poor sleep behaviors were associated with decreased parasympathetic activity,a physiological change to psychological stress,rather than with psychological stress itself among college students.Thus,sAA and HRV should be considered as significant factors for impaired sleep behaviors in relation to psychological stress.

Psychological Stress and Nursing Intervention of Sick Children

Holistic nursing is guided by modern nursing concept and framed by nursing procedures, providing high quality nursing according to patients’ psychological, physiological, social and cultural needs. To develop holistic nursing in pediatrics is to develop nursing services for the purpose of satisfying the various clinical needs and psychological nursing of children. It is of great significance to establish holistic nursing concept, provide high quality nursing service for hospitalized children, and take targeted psychological intervention to alleviate their adverse psychological stress, which can improve treatment compliance and clinical efficacy, and shorten the length of hospital stay. In this paper, scientific and effective psychological nursing stress intervention means are used to improve the psychological anti-stress level of hospitalized children, and nursing intervention means are put forward, contribute to the maintenance of children’s mental health and the development of children’s mental health work and also to provide a theoretical basis for the intervention and treatment of children with psychological stress.

Role of brain-derived neurotrophic factor and neuronal nitric oxide synthase in stress-induced depression

BACKGROUND： Accumulated evidence indicates an important role for hippocampal dendrite atrophy in development of depression, while brain-derived neurotrophic factor （BDNF） participates in hippocampal dendrite growth. OBJECTIVE： To discuss the role of BDNF and neuronal nitric oxide synthase （nNOS） in chronic and unpredictable stress-induced depression and the pathogenesis of depression. DESIGN, TIME AND SETTING： Randomized, controlled animal experiment. The experiment was carded out from October 2006 to May 2007 at the Department of Animal Physiology, College of Life Science, Shaanxi Normal University. MATERIALS： Thirty-seven male Sprague-Dawley rats weighing 250-300 g at the beginning of the experiment were obtained from Shaanxi Provincial Institute of Traditional Chinese Medicine （Xi＇an, China）. BDNF antibody and nNOS antibody were provided by Santa Cruz （USA）. K252a （BDNF inhibitor） and 7-NI （nNOS inhibitor） were provided by Sigma （USA）. METHODS： Animals were randomly divided into five groups： Control group, chronic unpredicted mild stress （CUMS） group, K252a group, K252a＋7-NI group and 7-NI＋CUMS group. While the Control, K252a and K252a＋7-NI groups of rats not subjected to stress had free access to food and water, other groups of rats were subjected to nine stressors randomly applied for 21 days, with each stressor applied 2-3 times. On days 1, 7, 14 and 21 during CUMS, rats received microinjection of 1 μL of physiological saline in the Control and CUMS groups, 1 ~ L of K252a in the K252a group, 1 μL of K252a and 7-NI in the K252a＋7-NI group, and 1 μL of 7-NI in the 7-NI＋CUMS group. We observed a variety of alterations in sucrose preference, body weight change, open field test and forced swimming test, and observed the expression of BDNF and nNOS in rat hippocampus by immunohistochemistry; MAIN OUTCOME MEASURES： ① A variety.of behavioral alterations of rats; ② The expression of BDNF and nNOS in rat hippocampus. RESULTS： Compared with the Control group, the behavior of the CUMS rats was significantly depressed, the expression of BDNF decreased （P 〈 0.01） but the expression of nNOS increased （P 〈 0.01）. The behavior of rats given intra-hippocampal injection of BDNF inhibitor was significantly depressed and the expression of nNOS was significantly increased （P 〈 0.01）. Intra-hippocampal injections of an nNOS inhibitor reversed the depression-like behavioral changes induced by CUMS or intra-hippocampal injection of BDNF inhibitor. CONCLUSION： CUMS induced a decrease in expression of BDNF and an increase in expression of NO in the hippocampus, which may lead to depression.

Effects of mindfulness meditation on trait mindfulness,perceived stress,emotion regulation,and quality of life in hemodialysis patients:A randomized controlled trial

Objective:This study aimed to examine the effects of mindfulness meditation on trait mindfulness,perceived stress,emotion regulation,and quality of life in end-stage renal disease patients undergoing hemodialysis.Methods:An experimental study with repeated measures design was conducted among a sample of 74 end-stage renal disease patients undergoing hemodialysis between January and May 2021 in the dialysis center at Jahra hospital,Kuwait.The patients were randomly assigned to the experimental(n?37)and control groups(n?37).The experimental group participated in 30-min mindfulness meditation sessions(three sessions a week for five weeks)held during their hemodialysis sessions;the participants in the control group were instructed to sit with their eyes closed and relaxed for 30 min three times a week for five weeks during hemodialysis sessions.The dependent variables of both groups were measured at baseline(T0),middle of intervention(T1),and end of intervention(T2)using the Mindful Attention Awareness Scale(MAAS),Perceived Stress Scale(PSS),Emotion Regulation Questionnaire(ERQ),and Kidney Disease Quality of Life(KDQOL-36)questionnaire.The study was registered in the ClinicalTrial.gov(Identifier:NCT05176730).Results:The repeated measures ANOVA(within-subject)results for the experimental group showed that mindfulness meditation had significantly decreased perceived stress by the end of the intervention.Also,mindfulness meditation improved mindfulness,emotion regulation,and kidney disease-related quality of life in the experimental group,and this improvement occurred significantly at both T1 and T2.The repeated measures ANOVA(within and between-subject)results showed that the experimental group,as compared to the control group,had lower perceived stress,higher trait mindfulness,higher emotional regulation,and higher kidney disease-related quality of life over time.Conclusions:The positive findings of this study offer health policy-makers and hospital administrators a promising tool to use with patients undergoing hemodialysis as a way to manage stress and improve quality of life.However,this study should be replicated in multiple settings with follow-up assessments.

Why do we not reverse the path?Stress can cause depression,reduction of brain-derived neurotrophic factor and increased inflammation

The aim of this paper is to describe the direction of the link between stress,depression,increased inflammation and brain-derived neurotrophic factor(BDNF)reduction.We hypothesize that severe stress or prolonged stress can be the driving factor that promote the onset of depression.Both stress and depression,if not resolved over time,activate the production of transcription factors that will switch on pro-inflammatory genes and translate them into cytokines.This cascade fosters systemic chronic inflammation and reduced plasma BDNF levels.Since people with depression have a 60%increased risk of developing type 2diabetes(T2D)and show high levels of inflammation and low levels of BDNF,we hypothesize possible reasons that might explain why T2D,depression and dementia are often associated in the same patient.

Adolescents’perceived stress of COVID-19 and self-compassion in Saudi Arabia:A cross-sectional study

Objectives Worldwide,the COVID-19 pandemic has significantly impacted mental health challenges for adolescent populations.The current study aims to examine the levels of perceived stress of COVID-19 and self-compassion and their relationship among adolescents in Saudi Arabia.Methods This study employed a cross-sectional online survey of adolescents from secondary schools in Asir,Saudi Arabia.Instruments that we distributed online included the modified Perceived Stress Scale(PSS-10)and the Self-Compassion Scale(SCS),in addition to demographic and health-related questions.A total of 500 adolescents completed the survey.Results Adolescents in the study reported an average moderate perceived stress level of 18.6(SD=6.67)and an average moderate self-compassion level of 3.22(SD=0.53).A significant correlation is also found between the two variables(r=−0.460,P<0.001).This negative correlation indicates that lower levels of perceived stress are significantly correlated with higher levels of self-compassion.Conclusion The study results show that the perceived stress of COVID-19 is inversely correlated with self-compassion in Saudi adolescents.Further research is needed to explore how to enhance adolescents’self-compassion.School nurses’role should be given full play in this area.