Virtual reality-based cognitive-behavioural therapy for the treatment of anxiety in patients with acute myocardial infarction:a randomised clinical trial

Background The presence of mental health conditions is pervasive in patients who experienced acute myocardial infarction(AMI),significantly disrupting their recovery.Providing timely and easily accessible psychological interventions using virtual reality-based cognitive-behavioural therapy(VR-CBT)could potentially improve both acute and long-term symptoms affecting their mental health.Aims We aim to examine the effectiveness of VR-CBT on anxiety symptoms in patients with AMI who were admitted to the intensive care unit(ICU)during the acute stage of their illness.Methods In this single-blind randomised clinical trial,participants with anxiety symptoms who were admitted to the ICU due to AMI were continuously recruited from December 2022 to February 2023.Patients who were Han Chinese aged 18-75 years were randomly assigned(1:1)via block randomisation to either the VR-CBT group to receive VR-CBT in addition to standard mental health support,or the control group to receive standard mental health support only.VR-CBT consisted of four modules and was delivered at the bedside over a 1-week period.Assessments were done at baseline,immediately after treatment and at 3-month follow-up.The intention-to-treat analysis began in June 2023.The primary outcome measure was the changes in anxiety symptoms as assessed by the Hamilton Anxiety Rating Scale(HAM-A).Results Among 148 randomised participants,70 were assigned to the VR-CBT group and 78 to the control group.The 1-week VR-CBT intervention plus standard mental health support significantly reduced the anxiety symptoms compared with standard mental health support alone in terms of HAM-A scores at both post intervention(Cohen’s d=−1.27(95%confidence interval(CI):−1.64 to−0.90,p<0.001)and 3-month follow-up(Cohen’s d=−0.37(95%CI:−0.72 to−0.01,p=0.024).Of the 70 participants who received VR-CBT,62(88.6%)completed the entire intervention.Cybersickness was the main reported adverse event(n=5).Conclusions Our results indicate that VR-CBT can significantly reduce post-AMI anxiety at the acute stage of the illness;the improvement was maintained at the 3-month follow-up.Trial registration number The trial was registered at www.chictr.org.cn with the identifier:ChiCTR2200066435.

NATIONAL SURVEY ON PREVALENCE OF CANCER PAIN

Objective. To collect nationwide basic data about cancer related pain. Methods. Sixty cancer patients in each province were randomly selected to participate in this survey. The subjects represented all stages of cancer, tumor sites, and different demographic characteristics. Two self- designed structured questionnaires including reasons, types of pain and pain management were used by patients and physicians respectively. Subjects were asked to report whether he/she had experienced any type of cancer related pain and filled out the equivalent questionnaire. The severity of pain was assessed by using“ visual analogue scale” . Original data input and analysis were using EPI- INFO software package. Results. The result showed that 61.6％ (958/1555) of patients had different types of cancer related pain. Majority of pain (85.1％ ) were caused by advanced cancer. The major reasons (64.4％ ) for poor management or impedimental factors of pain care are due to patient including over- concern on opioid analgesic addiction, reluctance to report pain or refused to use opioid analgesic until at times when pain is intolerable; 26.8％ belonged to physician’s reasons including fear to cause addiction on opioid and lack of knowledge about cancer pain management; 16.2％ are due to lack of different kinds of opioid analgesic for use and 16.1％ belonged to drug regulation. Conclusions. The results showed that majority of patients (61.6％ ) had different types of cancer related pain. In most of patients, cancer pain was relieved when they were treated. The major reason for under- treatment or impeded factors for effective relief of cancer pain was fear of opioid addiction by both medical professionals and patients.

Psychological impact of the COVID-19 pandemic on healthcare workers:a cross-sectional study in China

Background Healthcare workers fighting against the coronavirus disease 2019(COVID-19)pandemic are under tremendous pressure,which puts them at an increased risk of developing psychological problems.Aims This study aimed to investigate the prevalence of psychological problems in different healthcare workers(ie,physicians,medical residents,nurses,technicians and public health professionals)during the COVID-19 pandemic in China and explore factors that are associated with the onset of psychological problems in this population during this public health crisis.Methods A cross-sectional,web-based survey was conducted in February 2020 among healthcare workers during the COVID-19 pandemic.Psychological problems were assessed using the Generalized Anxiety Disorder Scale,Patient Health Questionnaire and Insomnia Severity Index.Logistic regression analyses were used to explore the factors that were associated with psychological problems.Results The prevalence of symptoms of anxiety,depression,insomnia and the overall psychological problems in healthcare workers during the COVID-19 pandemic in China was 46.04%,44.37%,28.75%and 56.59%,respectively.The prevalence of the overall psychological problems in physicians,medical residents,nurses,technicians and public health professionals was 60.35%,50.82%,62.02%,57.54%and 62.40%,respectively.Compared with healthcare workers who did not participate in front-line work,front-line healthcare workers had a higher risk of anxiety,insomnia and overall psychological problems.In addition,attention to negative or neutral information about the pandemic,receiving negative feedback from families and friends who joined front-line work,and unwillingness to join front-line work if given a free choice were three major factors for these psychological problems.Conclusions Psychological problems are pervasive among healthcare workers during the COVID-19 pandemic.Receiving negative information and participating in front-line work appear to be.important risk factors for psychological problems.The psychological health of different healthcare workers should be protected during the COVID-19 pandemic with timely interventions and proper information feedback.

Cross-sectional survey following a longitudinal study on mental health and insomnia of people with sporadic COVID-19

BACKGROUNDIn the post-pandemic era, the emergence of sporadic cases of coronavirus disease 2019 (COVID-19) and the scale of the pandemic are unpredictable. Therefore, the impact ofsporadic cases of COVID-19 and isolation measures on mental health and sleep in different groupsof people need to be analyzed.AIMTo clarify the severity of psychological problems and insomnia of staff and community residentsaround a hospital with sporadic cases of COVID-19, and their relationship with quarantinelocation and long-term changes.METHODSA cross-sectional survey was conducted on community residents and medical staff. Many of thesemedical staff had been subjected to different places of quarantine. Community residents did notexperience quarantine. Hospital anxiety and depression scale (HADS), acute stress disorder scale(ASDS) and insomnia severity index (ISI) were used to evaluate anxiety and depression, acutestress disorder symptoms, and the severity of insomnia. Additionally, we conducted a 1-yearfollow-up study on medical staff, with related scales measurement immediately after and one yearafter the 2-wk quarantine period.RESULTSWe included 406 medical staff and 226 community residents. The total scores of ISI and subscale inHADS of community residents were significantly higher than that of medical staff. Furtheranalysis of medical staff who experienced quarantine showed that 134 were quarantined in hotels,70 in hospitals and 48 at home. Among all subjects, the proportions of HADS, ASDS and ISI scoresabove normal cutoff value were 51.94%, 19.17% and 31.11%, respectively. Multivariable logisticregression analysis found that subjects with higher total ASDS scores had a greater risk to developanxiety and depression. The total ISI score for medical staff in hotel quarantine was significantlyhigher than those in home quarantine. Total 199 doctors and nurses who completed the 1-yearfollow-up study. Compared with baseline, HADS and ASDS scores decreased significantly oneyear after the end of quarantine, while ISI scores did not change significantly.CONCLUSIONSporadic COVID-19 cases had a greater psychological impact on residents in surroundingcommunities, mainly manifested as insomnia and depressive symptoms. Hotel quarantineaggravated the severity of insomnia in medical staff, whose symptoms lasted ≥ 1 year.

Morphine attenuates frustration-like behavior induced by sucrose reward deprivation in rats

In this study, a T-maze-based frustration model in rats was established using sucrose-reward deprivation, The results revealed that rats maintained a 75% preference for the sucrose-reward arm in the reward phase. During the sucrose-deprivation frustration phase, both the preference for the sucrose-deprivation arm （62.5%） and time spent waiting in the sucrose-deprivation arm decreased. Acute injection of morphine increased the preference in a dose-dependent fashion, and prolonged the waiting duration in the sucrose-deprivation arm. These findings indicate that morphine specifically inhibited the frustration response induced by sucrose reward deprivation. To further elucidate the pharmacological mechanisms involved, the opioid receptor antagonist naloxone was given to model rats prior to the injection of morphine. The results revealed that naloxone administration markedly attenuated the anti-frustration-like effects of 3 mg/kg morphine treatment. These findings suggest that morphine attenuates the frustration-like response to reward deprivation in rats through the opioid receptor.

Non-coding RNAs expression in SARS-CoV-2 infection:pathogenesis,clinical significance,and therapeutic targets

The coronavirus disease 2019(COVID-19)pandemic has been looming globally for three years,yet the diagnostic and treatment methods for COVID-19 are still undergoing extensive exploration,which holds paramount importance in mitigating future epidemics.Host non-coding RNAs(ncRNAs)display aberrations in the context of COVID-19.Specifically,microRNAs(miRNAs),long non-coding RNAs(lncRNAs),and circular RNAs(circRNAs)exhibit a close association with viral infection and disease progression.In this comprehensive review,an overview was presented of the expression profiles of host ncRNAs following SARS-CoV-2 invasion and of the potential functions in COVID-19 development,encompassing viral invasion,replication,immune response,and multiorgan deficits which include respiratory system,cardiac system,central nervous system,peripheral nervous system as well as long COVID.Furthermore,we provide an overview of several promising host ncRNA biomarkers for diverse clinical scenarios related to COVID-19,such as stratification biomarkers,prognostic biomarkers,and predictive biomarkers for treatment response.In addition,we also discuss the therapeutic potential of ncRNAs for COVID-19,presenting ncRNA-based strategies to facilitate the development of novel treatments.Through an in-depth analysis of the interplay between ncRNA and COVID-19 combined with our bioinformatic analysis,we hope to offer valuable insights into the stratification,prognosis,and treatment of COVID-19.

Abnormal function of the posterior cingulate cortex in heroin addicted users during resting-state and drug-cue stimulation task

Background Previous animal and neuroimaging studies have demonstrated that brain function in heroin addicted users is impaired. However, the posterior cingulate cortex （PCC） has not received much attention. The purpose of this study was to investigate whether chronic heroin use is associated with craving-related changes in the functional connectivity of the PCC of heroin addicted users. Methods Fourteen male adult chronic heroin users and fifteen age and gender-matched healthy subjects participated in the present study. The participants underwent a resting-state functional magnetic resonance imaging （fMRI） scan and a cue-induced craving task fMRI scan. The activated PCC was identified in the cue-induced craving task by means of a group contrast test. Functional connectivity was analyzed based on resting-state fMRI data in order to determine the correlation between brain regions. The relationship between the connectivity of specific regions and heroin dependence was investigated. Results The activation of PCC, bilateral anterior cingulate cortex, caudate, putamen, precuneus, and thalamus was significant in the heroin group compared to the healthy group in the cue-induced craving task. The detectable functional connectivity of the heroin users was stronger between the PCC and bilateral insula, bilateral dorsal striatum, right inferior parietal Iobule （IPL） and right supramarginal gyrus （P 〈0.001） compared to that of the healthy subjects in the resting-state data analysis. The strength of the functional connectivity, both for the PCC-insula （r=0.60, P 〈0.05） and for PCC-striatum （t=0.58, P 〈0.05）, was positively correlated with the duration of heroin use. Conclusion The altered functional connectivity patterns in the PCC-insula and PCC-striatum areas may be regarded as biomarkers of brain damage severity in chronic heroin users.

参与美沙酮维持治疗的海洛因成瘾者自我报告的抑郁症状严重程度:一项横断面调查（英文）

背景:美沙酮维持治疗(methadone maintenance treatment,MMT)是一种公认的有效降低毒瘾的措施。美沙酮维持治疗可以减少海洛因成瘾戒断症状,并因此可以提供心理和社会支持,对吸毒者的康复至关重要。目标:比较目前正在接受MMT的海洛因成瘾者和没有接受MMT的海洛因成瘾者之间的抑郁症状严重程度。方法:本研究运用了Beck-13(13-item version of the Beck Depression Inventory,BDI-13)抑郁自评量表和人口学历史资料调查表,对中国三个城市9个美沙酮治疗中心的929例正在接受MMT的海洛因成瘾患者(平均已接受9个月MMT治疗)和已经在中心注册参加MMT治疗但尚未开始的238例海洛因成瘾患者进行评估。结果:与正在接受MMT的成瘾者中有68%(628/929)报告抑郁症状相比,79%(188/238)的未治疗成瘾者报告有抑郁症状(X2=11.69,p<0.001)。未经治疗组的BDI评分中位数(四分位区间)是10.4(7.9-11.4),而MMT组BDI评分中位数是8.0(5.7-11.6),两者有显著差异(Z=2.75,p=0.006)。在MMT组内,自我报告的抑郁症状严重程度与参加MMT时间呈负相关(rs=-0.24,Z=2.88,p=0.004)。多元线性回归分析发现,在控制所有人口学变量后,治疗组的抑郁症状严重程度仍然轻于非治疗组。在控制MMT疗效后,自我报告家庭关系较差(β=0.118,t=6.56,p<0.001)以及离异(β=0.120,t=3.73,p<0.001)的海洛因成瘾患者抑郁症状较严重。结论:中度至重度抑郁症状常见于海洛因成瘾患者。MMT治疗与海洛因成瘾患者抑郁症状较轻相关,但需要采用前瞻性随机对照试验来确定MMT是否确实改善了海洛因成瘾患者的抑郁症状。与家庭成员的关系较差也与海洛因成瘾患者的抑郁症状有关,这表明对海洛因成瘾患者的治疗需要纳入一些方法来帮助海洛因成瘾患者修复由于他们成瘾造成的社会关系割裂。

中国物质滥用的基因研究进展(英文)

The importance of genetic factors in substance addiction has long been established.The rationale for this work is that understanding of the function of addiction genes and delineation of the key molecular pathways of these genes would enhance the development of novel therapeutic targets and biomarkers that could be used in the prevention and management of substance abuse.Over the past few years,there has been a substantial increase in the number of genetic studies conducted on addiction in China;these studies have primarily focused on heroin,alcohol,and nicotine dependence.Most studies of candidate genes have concentrated on the dopamine,opioid,and serotonin systems.A number of genes associated with substance abuse in Caucasians are also risk factors in Chinese,but several novel genes and genetic risk factors associated with substance abuse in Chinese subjects have also been identified.This paper reviews the genetic studies of substance abuse performed by Chinese researchers.Genotypes and alleles related to addictive behavior in Chinese individuals are discussed and the contributions of Chinese researchers to the international corpus of knowledge about the genetic understanding of substance abuse are described.

HIV infection among new synthetic drug abusers： a pilot study in Beijing

Background Following the increased human immunodeficiency virus （HIV） notification （infection） rates via sexual transmission and increased abuse of new synthetic drugs instead of heroin in China, a study on HIV infections and risk factors among synthetic drugs and heroin users in Beijing was conducted to provide a cue for further development of targets and strategies of HIV/AIDS control and prevention for different drug populations. Methods A total of 428 subjects including 224 heroin users and 204 new synthetic drug users was recruited from communities in Beijing by convenience sampling. A X2 test was used to compare HIV and syphilis infections between the two subpopulations. Logistic regression models were used to evaluate factors related to HIV, syphilis infections and abuse of synthetic drugs. Results Unbalanced distributions of demographics were detected between the two subpopulations. Compared with heroin users, most users of synthetic drugs were migrants, single and of younger age （age 〈30 years）. Ten HIV infections and twenty-four syphilis infections were confirmed among 428 subjects. No significant difference in HIV infection was found between the two subpopulations （crude odds ratio （OR） =0.46, 95% confidence interval （CI）： 0.07-15.80 and adjusted odds ratio （AOR） =1.26, 95% Ch 0.09-18.28） while four times as many syphilis infections were identified among users of synthetics drugs （AOR=3.92, 95% CI： 1.06-14.56）. HIV and syphilis infections appeared to work synergistically.The migrants who were of Han ethnicity, single and who had stayed in Beijing for more than six months were more likely to abuse synthetics drugs. Conclusions The new synthetic drug users and heroin users are different subpopulations. We optimistically speculate that HIV has not yet been introduced into the former in Beijing, but considering higher syphilis infections in synthetic drug users and the role of syphilis in HIV infection, synthetic drug users, as a possible and important driver of the HIV/AIDS epidemic in Beijing, should be paid more attention in HIV prevention and control strategies.

Piceatannol enhances Beclin-1 activity to suppress tumor progression and its combination therapy strategy with everolimus in gastric cancer

The effects and regulation of Beclin-1-an autophagy-related protein-have not been fully defined, however, a negative correlation has been reported between Beclin-1 expression and carcinogenesis. Meanwhile, no compound has been shown to directly inhibit its activity. Here, we evaluate piceatannol, a naturally occurring polyphenolic compound, as a potential targeting agonist of Beclin-1, to assess its efficacy as an antitumor agent against gastric cancer. More specifically, we determine the effects of piceatannol treatment on cell viability using a monitoring system and colony forming assay. Piceatannol was found to efficiently inhibit the proliferation of several human gastric cancer cell lines. Autophagic flux is increased by piceatannol treatment, and correlates with inhibition of cell proliferation and colony formation. Additionally, microscale thermophoresis and surface plasmon resonance results show a direct interaction between piceatannol and Beclin-1, which reduces the phosphorylation activity of Beclin-1 at the Ser-295 site. Notably, piceatannol impairs the binding of Beclin-1 to Bcl-2 and enhances the recruitment of binding of UV radiation resistance-associated gene protein, which further triggers Beclin-1-dependent autophagy signaling. An increase in autophagic activity via treatment with the mTOR inhibitor, everolimus, effectively sensitizes piceatannol-induced antitumor effects. Xenograft models confirmed that piceatannol inhibits tumor development and elicits a potent synergistic effect with everolimus in vivo. Taken together, the findings of this study strongly support the application of combinatorial piceatannol and everolimus therapy in future clinical trials for gastric cancer patients.

Complement Factor H Displays Opposite Expression Patterns Under Two Situations of Methamphetamine Administration:Acute Exposure and Chronic Dependence

Dear Editor,Methamphetamine(METH)is a highly addictive central nervous system stimulant that has severe physical and psychological side-effects,including loss of appetite,hyperactivity,dysphoria,and depression[1].Due to its illegal production,distribution,sale,and possession it has become a worldwide burden.METH is directly toxic to dopaminergic and serotoninergic neurons,resulting in excitotoxicity,oxidative stress,and other processes[2].Research on biomolecules associated with these processes will be useful for identifying potential markers,exploring the mechanism of METH dependence,and even developing prevention and treatment strategies.

Astrocytes:the neglected stars in the central nervous system and drug addiction

With the advent of improved tools to examine the astrocytes,which have been believed to play a supportive role in the central nervous system(CNS)for years,their participation in the operation of the CNS and drug addiction was unveiled.Assisting the formation and function of the CNS,astrocytes are involved in physiological and pathological brain activities.Drug addiction is a pervasive psychiatric disorder,characterized by compulsive drug-taking behavior and high rate of relapse,impacting individual health and society stability and safety.When exposed to drugs of abuse,astrocytes go through a series of alterations,contributing to the development of addiction.Here we review how astrocytes contribute to the CNS and drug addiction.We hope that understanding the interaction between addictive drugs and astrocytes may help discover new mechanisms underlying the addiction and produce novel therapeutic treatments.

Causal relationships between chronotype and risk of multiple cancers by using longitudinal data and Mendelian randomization analysis

Dear Editor,Cancer is the second leading cause of death worldwide,and the cancer situation is becoming more complicated(Zhou et al.,2022).The International Agency for Research on Cancer(IARC)Monographs Working Group classified night shift work as probably carcinogenic(Group 2A)to humans in2019(Ward et al.,2019).

Chinese herbal medicine enhances sexual function and c-Fos/nNOS expression in the nucleus accumbens of orchidectomized rats

OBJECTIVE: To determine whether the central nervous system is involved in the effect of Chinese herbal medicine on sexual function recovery in orchidectomized rats.METHODS: Orchidectomized rats were administered intragastrically with a decoction of "kidneynourishing" Chinese herbal medicine once per day for 28 days. Accessory genital organ weight, plasma testosterone, and mating behavior were investigated. The expression of c-Fos and neuronal nitric oxide synthase(n NOS) in neuronal cells in the nucleus accumbens(NAc) was analyzed by immunohistochemistry.RESULTS: There was a decrease in accessory genital organ weight, plasma testosterone, and sexual behavior, as well as a low number of c-Fos-positive cells and a large n NOS-positive cell area in orchidectomized rats. Administration of the herbal medicine increased accessory genital organ weight, testosterone level, mating behavior, and c-Fos-positive cell number, while it decreased the n NOS-positive cell area in orchidectomized rats.CONCLUSION: An increase of plasma testosterone after administration of "kidney-nourishing" herbal medicine might contribute to the elevated sexual function and activity in orchidectomized rats. In addition, a central nervous system mechanism, such as the functional alteration of NAc, might be involved.