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.

Unlocking the power of physical activity in easing psychological distress

The severity of the current global mental health situation and the importance of maintaining psychological well-being call for more powerful,convenient,and efficient solutions for addressing psychological issues and relieving mental stress.Physical activity not only effectively improves physical fitness and reduces negative emotions such as anxiety and depression but also increases the improvement of psychological health and sense of well-being.At the same time,physical activity interventions for mental health have unique advantages,including reducing the side effects of psychological interventions and increasing necessity,convenience,and cost-effectiveness,as well as flexible adaptability across multiple methods,groups,and age ranges,providing stronger support for relieving psychological stress and addressing psychological issues.Although physical activity is an important intervention measure in relieving psychological stress,its value and role in mental health care seem to have not yet received sufficient attention,and its potential remains to be further revealed.Given the significant advantages and effectiveness of physical activity in mental health intervention practices,it is necessary to stimulate its potential in relieving psychological stress through various means in future studies to better safeguard the public’s physical and mental health.Developing guidelines for physical activity for improved mental health,enhancing organic integration with other intervention measures,and providing necessary respect,encouragement,and support are important directions to consider.

Reciprocal Association between Psychological Distress and PTSD and Their Relationship with Pre-Displacement Stressors among Displaced Women

It is established in the psychological literature that pre-displacement stressors,PTSD symptoms,and psycholo-gical distress are associated among internally displaced persons.However,existing studies have not demonstrated the mechanism underlying these associations.This study compared two explanatory models;one with PTSD symptoms severity explaining the indirect association between pre-displacement stressors and psychological dis-tress,and the other with psychological distress explaining the indirect relationship between pre-displacement stressors and PTSD symptoms severity.In a cross-sectional design,631 women(Mean age=31.18±8.59)were conveniently and purposely selected from the displaced women harboured in two camps in Borno State,Nigeria,due to the Boko-Haram insurgency.Data were collected utilizing structured questionnaires and subjected to path analyses.Results demonstrated that PTSD symptoms severity and psychological distress indirectly explained their respective and independent association with pre-displacement stressors.However,PTSD symptoms had a statis-tically larger standardized indirect effect size,greater indirect effect percentage,and bigger kappa-squared(k2)effect size than psychological distress.PTSD symptoms and psychological distress may have a reciprocal influence on each other from pre-displacement stressors.However,PTSD symptoms can better explain the association between pre-displacement stressors and psychological distress than the other way around.These outcomes have important implications for the psychological treatment of displaced persons.

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.

Mediating role of physical activity in the relationship between psychological distress and intimate relationships among stroke patients

BACKGROUND Stroke patients often experience psychological distress,which can impact their intimate relationships with spouses,subsequently influencing their treatment and recovery.Physical activity is considered a key rehabilitation method for stroke patients.This paper aims to analyze whether psychological distress affects intimate relationship between spouses through physical activity.AIM To explore the mediating effect of physical activity between psychological distress and intimate relationship in stroke patients.METHODS A total of 256 stroke patients who underwent treatment at the First People’s Hospital of Shangqiu between July 2021 and July 2022 were enrolled in this study.The participants completed questionnaires,including the Kessler Psychological Distress Scale(K10),the Quality of Relationship Index(QRI),International Physical Activity Questionnaire,and a general information questionnaire.Data analysis were performed using SPSS 23.0.The Harman test was employed to detect common method deviations,and Spearman correlation was used for correlation analysis.The mediating effect was assessed using Process 3.4.1,with significance testing of the regression coefficients conducted using the bias-corrected percentile Bootstrap method(5000 iterations,95%confidence interval).Statistical significance was set at P<0.05.RESULTS The results showed that patients scored an average of 21.61±6.44 points on the K10,32.40±6.19 points on the QRI;the median physical activity level according to the International Physical Activity Questionnaire was 1861(566,2846)MET·min/w.The level of physical activity(the physical activity intensity of the patients reflected by the Interna-tional Physical Activity Questionnaire-Long Form scale)negatively correlated with psychological distress and intimacy(P<0.05),and positively correlated with each other(P<0.05),with the correlation stronger at lower physical activity levels compared to higher ones.The mediating effect of physical activity between psychological distress and intimate relationship was calculated to be 40.23%.Bootstrap analysis further validated the results.The mediating effect of psychological distress on intimate relationships through physical activity level was-0.284,with a confidence interval of-0.409 to-0.163,excluding 0,confirming a significant mediating effect of psychological distress on intimate relationships.CONCLUSION Physical activity significantly affects relationship between psychological distress and intimate relationships among stroke patients.Addressing the role of physical activity may have implications for improving patient outcomes and rehabilitation strategies.

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 trauma,posttraumatic stress disorder and traumarelated depression:A mini-review

There are various types of traumatic stimuli,such as catastrophic events like wars,natural calamities like earthquakes,and personal trauma from physical and psychological neglect or abuse and sexual abuse.Traumatic events can be divided into type I and type II trauma,and their impacts on individuals depend not only on the severity and duration of the traumas but also on individuals’self-evaluation of the traumatic events.Individual stress reactions to trauma include posttraumatic stress disorder(PTSD),complex PTSD and trauma-related depression.Trauma-related depression is a reactive depression with unclear pathology,and depression occurring due to trauma in the childhood has gained increasing attention,because it has persisted for a long time and does not respond to conventional antidepressants but shows good or partial response to psychotherapy,which is similar to the pattern observed for PTSD.Because trauma-related depression is associated with high risk of suicide and is chronic with a propensity to relapse,it is necessary to explore its pathogenesis and therapeutic strategy.

Who Is More Vulnerable?The Age-Period-Cohort Effect of Psychological Distress among Urban Residents in China

How does psychological distress evolve over time?This study utilizes cross-sectional data from the China General Social Survey from 2010 to 2017 to explore the differences in psychological distress among Chinese residents at various ages,periods,and cohorts.The dummy variable method and random effects hierarchical age-period-cohort model were employed to isolate the age,period,and cohort effects that impacted the psychological distress of Chinese urban residents.First,in terms of the age effect,the psychological distress experienced by residents tends to increase initially and then decrease with age.Middle-aged individuals,around 40 years old,often face a particularly severe form of psychological distress known as the“midlife crisis.”Additionally,middle-aged people who have larger families may experience more significant psychological distress due to increased family burdens.Second,in terms of the period effect,the psychological distress experienced by residents has been on the rise due to the continued development of society.Those who are at a disadvantage in market competition and work longer hours may be particularly vulnerable to increased psychological distress.Thirdly,the cohort effect refers to the different social behaviors and attitudes exhibited by individuals of different generations.In terms of this effect,psychological distress initially decreased and then increased among those born between 1945 and 1990.Individuals born in the 1980s and 1990s experienced higher levels of psychological distress,with internet use having a greater negative impact.Additionally,the positive effect of income on their psychological distress was reduced.The psychological distress of Chinese urban residents is affected by a variety of time-related factors,which are closely related to Chinese clan culture,market competition and social changes.The heavy family burden imposed by traditional clan culture,the different working conditions created by market competition,and the emergence of new lifestyles,such as internet use during social changes,have led to diverse psychological distress experiences among residents across different ages,time periods,and cohorts.In the future,longitudinal studies are needed to strengthen the robustness of the conclusions and consider the long-term impact of the COVID-19 pandemic.Mental health support should pay specific attention to the psychological distress of middle-aged individuals,long-time workers,and internet users.

Identify Psychological Distress among Cancer Patients: A Study at Kilimanjaro Christian Medical Center (KCMC) in Moshi Municipality, Kilimanjaro Tanzania

Introduction: The major objective of this study was to identify the Psychological Distress among Cancer Patients at KCMC in Moshi Municipality, Kilimanjaro Tanzania. The specific objectives were to identify the psychological distress among cancer patients at KCMC, and to explore relationship between demographic characteristics of cancer patients and psychological distress. Methodology: The study used a sample of 175 respondents. The study was cross-sectional design, a quantitative approach. The data gathered for the study were analyzed using quantitative data analyzing software SPSS version 20 and were visually presented using descriptive statistics such as frequency distribution of tables, and figures. Result: The findings of the study showed that majority of the respondents (cancer patients) 105 (60.0%) were experiencing psychological distress among the cancer patients. The cancer patients who are divorced and widow them experience anxiety (p-value 0.01) significant. Those who were low in education were significantly affected with (p-value 0.03) anxiety and (p-value 0.01) depression. The variable in economic;the less satisfaction were significantly (p-value 0.01) were experience adjustment disorder. Conclusion and Recommendation: The study recommends that it is important to involve psychologists in the treatment team among the cancer patients to address psychological distresses they experience. Also Oncology Department should develop interest of doing research on psychological distress management because study showed 60% cancer patients suffer with psychological distress. .

Research on the Intervention of Internet+ Health Education Model on Hemodialysis Patients with Psychological Distress

Objective:To observe the status quo of patients’psychological distress,and to explore the effect of Internet+health education model(IHEM)on patients who experienced psychological distress during their first hemodialysis treatment,with the goal of reducing their psychological distress and improving their quality of life.Methods:IHEM was conducted on 120 first-time hemodialysis patients for 3 months while a distress thermometer and a list of questionnaires were used to screen patients and provide corresponding psychological intervention.The incidence rate of psychological distress was analyzed statistically to explore the difference in psychological distress at various periods.Results:The incidence rate(score≥4)of psychological distress in first-time hemodialysis patients was 46.67%,and their distress was mainly rooted in physical,emotional,practical problems(economy,time,and energy),etc.Through IHEM,the psychological distress scores of the patients decreased to 3.29±1.02 at one month after their discharge,and the incidence rate was 32.14%;the psychological distress scores of the patients were 2.29±1.02 at 3 months after their discharge,and the incidence rate was 21.14%.The difference before and after the intervention was statistically significant(P<0.05).Conclusion:A psychological distress thermometer can timely detect the degree and causes of psychological distress among first-time hemodialysis patients,and the use of IHEM may significantly alleviate the psychological distress among hemodialysis patients.

Resolving Specific Psychological Stressors Can Instantly Reduce or Relieve Chronic Neck Pain and Upper Back Pain: Case Reports

Introduction: The goal of this study was to use a novel approach to pain relief which includes a participant using their mind to reduce or relieve their neck pain in a matter of minutes and taking continuous thermal medical imaging scans during the process to capture any concurrent temperature changes at the location of the self-reported pain. Previous studies using multidisciplinary approaches have shown that it is possible for a person to achieve a moderate reduction in pain over a period of time (typically two or more months). However, in this innovative study, the goal was to demonstrate rapid pain relief (in a matter of minutes) using only the mind. Case report: For this study, six subjects were selected, all of whom were experiencing long-term chronic neck pain. The subjects consisted of five adult females and one adult male. Several of the subjects also had pain that radiated into their upper back region. Each subject participated in one talk therapy session during which the subject’s neck was actively scanned by a thermal imaging (TI) camera that was programmed to take a new thermal image every thirty (30) seconds. The goal of the talk therapy session was to create a strong emotional shift by encouraging the subject to let go of negative emotions and replace buried painful feelings with feelings of positive expectation and optimism. Then, as the subject created this emotional shift, the goal was to observe if this change affected the subject’s self-reported physical pain, as well as noting any visible effects in thermal images. Results: All six subjects reported that they were able to relieve some or all of their pain by the end of the talk therapy session. As they did, there was simultaneously a significant decrease in temperature recorded on the TI images in the corresponding location in their neck and upper back region. This suggested that the pain relief the subjects reported was not merely “mind over matter”, since there were marked physiological changes taking place. Discussion and Conclusion: It’s worth noting that three of the subjects had moments during their talk therapy session where they thought about a specific painful memory that increased their negative emotions. At that moment, their self-reported pain also increased, and simultaneously, the infrared camera detected an increase in temperature in the corresponding location where the subjects reported increased pain. Subsequently, when the subjects were able to change the painful memory and once again move towards feelings of optimism, they reported pain relief, and simultaneously, the TI camera reported a decrease in temperature. Neither this potential outcome nor any other potential outcome was discussed with the subjects before or during the session. This research shows that talk therapy may be used as a new therapeutic option for people not only with neck pain, but possibly other types of pain, and that under certain circumstances, the results can be rapid.

Evaluation of Postoperative Psychological Distress and Its Driving Factors in Patients with Oral and Maxillofacial Malignant Tumors

Objective:To explore and analyze the evaluation and driving factors of postoperative psychological pain inpatients with oral and maxillofacial malignant tumors.Methods:Relevant data were collected from 80 patients with oral and maxillofacial malignant tumors who attended the outpatient clinic for follow-up consultations between May 2021 to May 2023.The patients used the psychological distress thermometer(DT)to circle words that best described their experiences in the past week,assigning a numerical value(0-10)to indicate their pain level on each day.The scoring results were employed to assess the psychological pain in these patients.A self-developed patient basic information questionnaire was utilized to record demographic details.Logistic regression analysis was employed to evaluate patients two weeks after surgery,focusing on the assessment of psychological distress and the identification and location of driving factors.Results:Following evaluation,the results revealed that the average postoperative DT score for the 80 patients with oral and maxillofacial malignant tumors was 4.53±1.98 points.Scores<4 points indicated no psychological pain(Group N)in 48 cases,while scores≥4 points indicated psychological pain(Group Y)in 32 cases.The differences in postoperative DT scores among patients with varying educational levels,fears and worries about disease progression,economic problems,sleep problems,level of hope,and oral pain were statistically significant(P<0.05).Multiple linear regression analysis results indicated that education level,fear and worry about disease progression,economic problems,sleep problems,level of hope,and oral pain are driving factors of postoperative psychological pain in patients with oral and maxillofacial malignant tumors(P<0.05).Conclusion:The postoperative psychological pain level in patients with oral and maxillofacial malignant tumors is at a moderate level.Educational level,fear and worry about disease progression,economic problems,sleep problems,level of hope,and oral pain were identified as driving factors for postoperative psychological pain in these patients.

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.

The Relationship between Workplace Stressors and Job Strain with Psychological Distress among Employed Malaysian Breast Cancer Survivors

Evidence showed occupational factors may contribute distress to breast cancer survivors, however, very few studies focused on the occupational factors and job strain among breast cancer survivors. This study examined the relationship between job strain and workplace stressors with psychological distress among employed breast cancer survivors after the completion of their medical treatment. Study subject were outpatients of 2 hospitals and members of 4 breast cancer support groups. They were requested to fill up the Job Content Questionnaires (JCQ), the Hospital Anxiety and Depression Scale (HADS) and the Distress Thermometer (DT) were filled up by the selected respondents. On simple logistic regression, psychological job demand and job strain were significantly associated with anxiety, distress on HADS-T and DT at (p < 0.001). While, psychological job demand (p < 0.001), social support (p = 0.047) and job strain (p < 0.001) were significantly associated with depression. Results showed survivors with high job strain has 4.74 time the odds of having anxiety (p < 0.001). Survivors with high psychological job demand have 8.08 time the odds of getting depression (p < 0.001). On the other hand, social support served as a protective factor of depression, (p = 0.041). Survivors with high psychological job demand were 4.4 time the odds of having distress (HADS-T) (p = 0.012). As a conclusion, survivors who experienced high psychological job demand, low social support and high job strain were reported with anxiety, depression or psychological distress.

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.

Involvement of parasympathetic pelvic efferent pathway in psychological stress-induced defecation

AIM:To investigate the role of the pelvic nerve pathway in stress-induced acceleration of colorectal transit and defecation in rats.METHODS:Surgical transection of rectal nerves(rectal branches of the pelvic nerve),vagotomy(Vag) or adrenalectomy(Adx) were performed bilaterally in rats.Number of fecal pellet output of these rats was measured during 1-h water avoidance stress(WAS).To evaluate the colonic transit,rats were given phenol red through the catheter indwelled in the proximal colon and subjected to WAS.After WAS session,entire colon and rectum were isolated and distribution of phenol red was measured.Distal colonic and rectal transit was evaluated using glass bead.Rats were inserted the glass bead into the distal colon and evacuation rate of the bead was measured.Neural activation was assessed by immunohistochemical staining of c-Fos and PGP9.5 in colonic whole-mount preparations of longitudinal muscle myenteric plexus(LMMP).RESULTS:In the sham-operated rats(sham op),WAS significantly increased defecation and accelerated colorectal transit with marked elevation of plasma corticosterone level.Compared with sham-operated rats,increase in the excretion of fecal pellets during WAS was significantly reduced by rectal nerve transection(RNT)(sham op:6.9 ± 0.8 vs RNT:4.3 ± 0.6,P < 0.05) or Vag(sham op:6.4 ± 0.8 vs Vag:3.7 ± 1.1,P < 0.05),although corticosterone level remained elevated.Adx-rats significantly increased the defecation despite the lower corticosterone level.Distribution pattern of phenol red showed RNT inhibited distal colonic and rectal transit accelerated by WAS,while Vag inhibited proximal colonic transit.Suppression of distal colonic and rectal transit by RNT was further confirmed by the bead evacuation rate(sham op:80.0% vs RNT:53.8%).WAS significantly increased the number of c-Fos-immunoreactive neural cells in the LMMP of the proximal and distal colon,whereas c-Fos expression was decreased by RNT in the distal colon(sham op:9.0 ± 2.0 vs RNT:4.4 ± 1.0,P < 0.05) and decreased by Vag in the proximal colon.CONCLUSION:Pelvic nerve conveys WAS stimuli from the brain to the distal colon,and directly activate the myenteric neurons,followed by the increase of its motility.

Psychological Distress, Social Support and Medication Adherence in Patients with Ischemic Stroke in the Mainland of China

Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the few studies that have specifically focused on psychosocial factors in the context of stroke, poststroke depression is demonstrated to significantly influence stroke outcomes. Associations of stroke with psychological symptoms other than depression have rarely been evaluated. This study was aimed to investigate the changes of psychological stress, social support and medication adherence in patients with ischemic stroke in the mainland of China. In this study, 90 patients with hemiplegia one year after first-ever middle cerebral artery infarction（stroke group） in the Zhongnan Hospital of Wuhan University from June 2008 to June 2011 were recruited for interview. Ninety age- and sex-matched normal volunteers（control group） were also examined at the same period. The psychological distress was assessed by the Symptom Checklist 90（SCL-90）, the social support by the Social Support Rating Scale（SSRS）, and medication adherence by Morisky＇s self-reported inventory, respectively. Group differences were analyzed using unpaired-t test and chi-squared test. The results showed that total mean scores of the SCL-90 in the stroke group were higher than those in the control group（P〈0.01）. Except two dimensions, paranoid ideation and psychoticism, mean scores of the rest dimensions（including somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, and phobic anxiety） of SCL-90 were significantly higher in the stroke group than those in the control group（P〈0.05, or P〈0.01）. The objective support, subjective support, support availability and total social support scores in the stroke group were significantly higher than those in the control group（P〈0.05, or P〈0.01）. Those in the ＂SCL-90 total scores 〉150 group＂ were significantly higher than in the ＂SCL-90 total scores 〈100 group＂ and the ＂SCL-90 total scores between 100 to 150 group＂（P〈0.05, or P〈0.01）. Those in the ＂SCL-90 total scores between 100 to 150 group＂ were significantly higher than in the ＂SCL-90 total scores 〈100 group＂（P〈0.05）. In 90 patients with ischemic stroke, 26（28.89%） patients obtained high medication adherence, 47（52.22%） patients medium medication adherence, and 17（18.89%） patients low medication adherence, respectively. Among these stroke patients, there were 17（50.00%） patients with high medication adherence in the ＂SCL-90 total scores 〉150 group＂, 28（75.67%） patients with medium medication adherence in the ＂SCL-90 total scores between 100 to 150 group＂, and 12（61.16%） patients with low medication adherence in the ＂SCL-90 total scores 〈100 group＂, respectively. There was significant difference in the medication adherence rate among the different SCL-90 scores groups in these stroke patients（P〈0.05 or P〈0.01）. It was led to conclude that ischemic stroke patients one year after hemiplegia have psychological distress, low level of social support and poor medication adherence in the mainland of China. Therefore, it is necessary to mobilize the government, medical institutions and various social support groups to offer psychological interventions to relieve the stress of patients with ischemic stroke, and improve their medication adherence.

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.

Rational-emotive behavioral intervention helped patients with cancer and their caregivers to manage psychological distress and anxiety symptoms

There is a dearth of evidence-based data on how psychological distress and death anxiety symptoms experienced by cancer patients and caregivers are treated in developing regions. This article sheds light on the report of the findings from a 2016 study that revealed a rational-emotive behavioral intervention helped a select group of cancer patients and their family caregivers to manage problematic assumptions, psychological distress, and death anxiety symptoms in Nigeria.Based on my experience as a co-investigator and corresponding author of this previous study, I addressed the challenges of conducting such a study and the implications for future research in this article. This article encourages future researchers to replicate the study and endeavor to overcome the limitations of the previous study. Funders were also encouraged to ensure increased access to funds for conducting similar studies with cancer patients and their family caregivers in developing countries and other parts of the world.

Application of ERAS Concept Combined with Psychological Stress Intervention in Laparoscopic Urological Surgery Nursing

Enhanced recovery after surgery (ERAS), a series of evidence-based optimization measures during the perioperative period, to reduce patients’ physical and psychological traumatic stress responses, to reduce complications, to shorten the length of hospital stay, to reduce the risk of readmission and mortality, and ultimately to promote rapid patient resuscitation, is adopted. The negative emotional experience of patients may aggravate the surgical stress response, interfere with the endocrine system and nervous system, cause the imbalance of internal environment, and have a negative impact on the surgical effect. This paper uses the concept of ERAS in combination with psychological stress interventions, perioperative psychological nursing instruction, reduces the laparoscopic surgery in patients with psychological stress reaction on the immune function of cells, improves the body’s immune function, improves the body of bacteria such as vitamin attack resistance, reduces the risk of complications such as infection, and accelerates the process of patient rehabilitation. Here is the report.