Effects of Lycium barbarum polysaccharide on cytokines in adolescents with subthreshold depression:a randomized controlled study

Strong evidence has accumulated to show a correlation between depression symptoms and inflammatory responses.Moreover,anti-inflammatory treatment has shown partial effectiveness in alleviating depression symptoms.Lycium barbarum polysaccharide(LBP),derived from Goji berries,exhibits notable antioxidative and anti-inflammatory properties.In our recent double-blinded randomized placebo-controlled trial,we found that LBP significantly reduced depressive symptoms in adolescents with subthreshold depression.It is presumed that the antidepressant effect of LBP may be associated with its influence on inflammatory cytokines.In the double-blinded randomized controlled trial,we enrolled 29 adolescents with subthreshold depression and randomly divided them into an LBP group and a placebo group.In the LBP group,adolescents were given 300 mg/d LBP.A 6-week follow up was completed by 24 adolescents,comprising 14 adolescents from the LBP group(15.36±2.06 years,3 men and 11 women)and 10 adolescents from the placebo group(14.9±1.6 years,2 men and 8 women).Our results showed that after 6 weeks of treatment,the interleukin-17A level in the LBP group was lower than that in the placebo group.Network analysis showed that LBP reduced the correlations and connectivity between inflammatory factors,which were associated with the improvement in depressive symptoms.These findings suggest that 6-week administration of LBP suppresses the immune response by reducing interleukin-17A level,thereby exerting an antidepressant effect.

Overexpression of Sirt6 ameliorates sleep deprivation induced-cognitive impairment by modulating glutamatergic neuron function

Sleep benefits the restoration of energy metabolism and thereby suppo rts neuronal plasticity and cognitive behaviors.Sirt6 is a NAD+-dependent protein deacetylase that has been recognized as an essential regulator of energy metabolism because it modulates various transcriptional regulators and metabolic enzymes.The aim of this study was to investigate the influence of Sirt6 on cerebral function after chronic sleep deprivation(CSD).We assigned C57BL/6J mice to control or two CSD groups and subjected them to AAV2/9-CMV-EGFP or AAV2/9-CMV-Sirt6-EGFP infection in the prelimbic cortex(PrL).We then assessed cerebral functional connectivity(FC) using resting-state functional MRI,neuron/astrocyte metabolism using a metabolic kinetics analysis;dendritic spine densities using sparse-labeling;and miniature excitato ry postsynaptic currents(mEPSCs) and action potential(AP) firing rates using whole-cell patchclamp recordings.In addition,we evaluated cognition via a comprehensive set of behavioral tests.Compared with controls,Sirt6 was significantly decreased(P<0.05) in the PrL after CSD,accompanied by cognitive deficits and decreased FC between the PrL and accumbens nucleus,piriform cortex,motor co rtex,somatosensory co rtex,olfactory tubercle,insular cortex,and cerebellum.Sirt6 ove rexpression reve rsed CSD-induced cognitive impairment and reduced FC.Our analysis of metabolic kinetics using [1-13C] glucose and [2-13C] acetate showed that CSD reduced neuronal Glu4and GABA2synthesis,which could be fully restored via forced Sirt6 expression.Furthermore,Sirt6 ove rexpression reversed CSD-induced decreases in AP firing rates as well as the frequency and amplitude of mEPSCs in PrL pyramidal neurons.These data indicate that Sirt6 can improve cognitive impairment after CSD by regulating the PrL-associated FC network,neuronal glucose metabolism,and glutamatergic neurotransmission.Thus,Sirt6 activation may have potential as a novel strategy for treating sleep disorder-related diseases.

Efficacy of Lycium barbarum polysaccharide in adolescents with subthreshold depression: interim analysis of a randomized controlled study

Subthreshold depression is a highly prevalent condition in adolescents who are at high risk for developing major depressive disorder.In preclinical models of neurological and psychiatric diseases,Lycium barbarum polysaccharide(LBP)extracted from Goji berries had antidepressant effects including but not limited to anti-oxidative and anti-inflammatory properties.However,the effect of LBP on subthreshold depression is unclear.To investigate the clinical efficacy and safety of LBP for treating subthreshold depression in adolescents,we conducted a randomized,double-blind,placebo-controlled trial(RCT)with 29 adolescents with subthreshold depression recruited at The Fifth Affiliated Hospital of Guangzhou Medical University.The participants were randomly assigned to groups where they received either 300 mg LBP(LBP group,n=15,3 boys and 12 girls aged 15.13±2.17 years)or a placebo(placebo group,n=14,2 boys and 12 girls aged 15±1.71 years)for 6 successive weeks.Interim analyses revealed that the LBP group exhibited a greater change in Hamilton Depression Scale(HAMD-24)scores relative to the baseline and a higher remission rate(HAMD-24 total score≤7)at 6 weeks compared with the placebo group.Scores on the Beck Depression Inventory-II(BDI-II),Pittsburgh Sleep Quality Index(PSQI),Kessler Psychological Distress Scale(Kessler),and Screen for Child Anxiety-Related Emotional Disorders(SCARED)were similar between the LBP and placebo groups.No side effects related to the intervention were reported in either group.These results indicate that LBP administration reduced depressive symptoms in adolescents with subthreshold depression.Furthermore,LBP was well tolerated with no treatment-limiting adverse events.Clinical trials involving a larger sample size are needed to further confirm the anti-depressive effects of LBP in adolescents with subthreshold depression.This study was approved by the Medical Ethics Committee of the Fifth Affiliated Hospital of Guangzhou Medical University(Guangzhou,China;approval No.L2019-08)on April 4,2019 and was registered on ClinicalTrials.gov(identifier:NCT04032795)on July 25,2019.

Occupational burnout in nurses:a concept analysis

Objective:This paper aims to clarify the concept of occupational burnout(OB)as well as develop appropriate methods to relieve or prevent OB in the nursing profession.Methods:Walker and Avant's eight-step approach of concept analysis was applied.Results:OB was defined as a chronic form of work-related stress.Accurately,it was characterized by emotional exhaustion,depersonalization/cynicism,and reduced personal accomplishment/inefficacy.Antecedents of burnout included(a)demographic characteristics;(b)chronic exposure to work-related stressors;(c)quantitative and qualitative job demands;(d)lack of job resources;and(e)personality traits.Consequences involved(a)individual’s unfavorable quality of life;(b)negative impact on the organization;and(c)poor services quality.Although the Maslach Burnout Inventory(MBI)is perceived as an ideal tool to measure burnout and hence,it is used worldwide,whether this instrument fits to measure this concept for nurses has still not yet been verified and thus further research is needed.Conclusions:By proposing a comprehensive definition of the concept,this analysis contributes to recognition of the process of OB of nurses.All nurses are vulnerable to OB.Hence,burnout in nursing needs to be recognized as a critical factor in the delivery of safe patient care.It proposes that the prevention of OB would be achieved through team communication training,mindfulness group,education,etc.

Physical restraint using,autonomy,ethics among psychiatric patients in nursing practice in China

The application of physical restraint for patients represents ethical dilemmas for psychiatric nurses in terms of maintaining the safety of all(clients and staff)while at the same time curtailing the individual’s autonomy.This article aimed to provide a sound knowledge of ethical positions and strategies for psychiatric nurses to address ethical issues of physical restraint according to the ethical principles of autonomy,beneficence,nonmaleficence,and ethical theories.Given that nursing workforce was limited and workload among psychiatric nurses was heavy,physical restraint was one of the coercive interventions managing aggressive behavior.In relation to address ethical dilemmas,it was proposed to acquire informed consent of physical restraint from the individuals and provide person‑centered care.Effective communication and negotiation with patients could help to strike a balance between patients’autonomy and nurses’accountability when using physical restraint.In addition,guidelines and targeted intervention strategies need to be developed to regulate and reduce the implementation of restraint.Finally,a collaboration among nurses,psychiatrists,and families is essential to protect patients’autonomy concerning physical restraint use.

The positive and negative emotion functions related to loneliness:a systematic review of behavioural and neuroimaging studies

Loneliness is associated with high prevalences of major psychiatric illnesses such as major depression.However,the underlying emotional mechanisms of loneliness remained unclear.We hypothesized that loneliness originates from both decreases in positive emotional processing and increases in negative emotion processing.To test this,we conducted a systematic review of 29 previous studies(total participants n=19560,mean age=37.16 years,female proportion=59.7%),including 18 studies that included ques-tionnaire measures of emotions only,and 11 studies that examined the brain correlates of emotions.The main findings were that loneliness was negatively correlated with general positive emotions and positively correlated with general negative emotions.Fur-thermore,limited evidence indicates loneliness exhibited negative and positive correlations with the brain positive(e.g.the striatum)and negative(e.g.insula)emotion systems,respectively,but the sign of correlation was not entirely consistent.Additionally,loneli-ness was associated with the structure and function of the brain emotion regulation systems,particularly the prefrontal cortex,but the direction of this relationship remained ambiguous.We concluded that the existing evidence supported a bivalence model of lone-liness,but several critical gaps existed that could be addressed by future studies that include adolescent and middle-aged samples,use both questionnaire and task measures of emotions,distinguish between general emotion and social emotion as well as between positive and negative emotion regulation,and adopt a longitudinal design that allows us to ascertain the causal relationships between loneliness and emotion dysfunction.Our findings provide new insights into the underlying emotion mechanisms of loneliness that can inform interventions for lonely individuals.

Cerebral processing of emotions in phantom eye pain patients:An event related potential study

Purpose Phantom eye pain(PEP)is a major clinical problem after eye removal with no standard treatment protocol to date.As pain is a multidimensional experience associated with emotional and cognitive components,this study aimed to explore the possible neuropsychological mechanisms of PEP in a perspective of emotional cognition,in order to provide a basis for clinical treatment.Methods Visual oddball event-related potentials(ERPs)under different external emotional stimuli(Disgust,Fear,Sadness,Happiness,Erotica and Neutral)were tested in 12 patients and 12 healthy volunteers.Participants'affective states were measured with the Mood Disorder Questionnaire(MDQ),the Hypomania Checklist-32(HCL-32),and the Plutchik–van Praag Depression Inventory(PVP).The amplitudes and latencies of N1,P2,N2 and P3 components were analyzed by three-way ANOVA,i.e.,group(2)×emotion(6)×electrode(3).Multiple comparisons were performed using Bonferroni's test.Results Longer N1 latencies,increased N1 amplitudes;shorter P2 latencies under Disgust and Happiness,decreased P2 amplitudes;shorter N2 latencies under Erotica,increased N2 amplitudes were found in patients compared with controls.There was no main effect of group or interaction effect on P3 latencies and P3 amplitudes.The MDQ and HCL-32 scores were lower,and the N1 latencies under Sadness were negatively correlated with PVP scores in patients.Conclusions PEP patients showed reversed patterns in exogenous attention allocation and enhanced involuntary attention to emotional stimuli compared with controls.This study demonstrated cortical processing of emotions in PEP patients and could provide a basis for developing emotional intervention therapy.