Acute Augmented Effect of Virtual Reality (VR)-Integrated Relaxation and Mindfulness Exercising on Anxiety and Insomnia Symptoms: A Retrospective Analysis of 103 Anxiety Disorder Patients With Prominent Insomnia.

BACKGROUND: Anxiety disorder is one of the most common mental disorders and often accompanied with sleep disturbance which can in turn exacerbate anxiety symptoms, creating a vicious cycle. In addition to psychopharmacological therapy, the effectiveness of psychotherapy as cognitive behavioral therapy (CBT) for treating anxiety disorders and insomnia has been well documented and widely accepted, but it is labor-intensive and costly. However, virtual reality (VR)-integrated CBT may improve this condition but needs more evidences to support its extensive application in routine clinical practice. OBJECTIVES: This explorative study was aimed to conduct a retrospective analysis to evaluate the acute (2 weeks) augmented effect of VR-integrated relaxation and mindfulness exercising in improving anxiety and insomnia symptoms for patients who were diagnosed with anxiety disorders and concurrently with prominent insomnia symptoms and admitted to the Department of Psychiatry, The Affiliated Guangdong Second Provincial General Hospital of Jinan University during January 2021 to June 2021. METHODS: All patients who were admitted to the department of psychiatry during January 1, 2021 to June 30, 2021 were screened with inclusion criteria and exclusion criteria, and the sociodemographic and clinical data of those included patients were collected from the electronic medical record system of the hospital using a self-designed case report form (CRF). Subjects who were administrated with medication alone were designated as conventional group, and those receiving treatment of medication combined with VR-integrated CBT (VR relaxation and mindfulness exercising) as VR group. The baseline and 2-week posttreatment data were compared between the two groups. RESULTS: In total, there were 103 patients (70 female, 68%) included in the study. Among all, 68 (66.02%) were designated as the "VR group," and 35 (33.98%) as the "conventional group." The majority of patients (67%) were diagnosed with generalized anxiety disorder (GAD). Twenty-three (22.3%) patients had a comorbid diagnosis with primary insomnia, and insomnia was just one of the accompanying symptoms with anxiety for the rest 80 subjects. No statistically significant differences were found between VR and conventional groups in all baseline sociodemographic and clinical characteristics except for occupation. There were statistically significant differences for the remission rates of anxiety symptoms or insomnia symptoms and reduction of Hamilton Anxiety Rating Scale or Insomnia Severity Index total scores between conventional and VR groups. Greater remission rates or score reductions were found in VR group than in conventional group either for anxiety or for insomnia. Robust differences still existed when controlled for the variable "occupation." CONCLUSIONS: Two-week augmented VR-integrated relaxation and mindfulness exercising is acutely beneficial for relieving both anxiety and insomnia symptoms and worth being recommended for routine clinical practice. Further prospective and randomized study compared to traditional CBT to explore its acute and long-term effect on anxiety and insomnia is needed.

Electrophysiological Changes on Laryngeal Motor Neuropathways Cause Voice Disorders for Postradiotherapy Patients with Nasopharyngeal Carcinoma.

OBJECTIVE: This study explored electrophysiological changes in the laryngeal motor neuropathway and determined whether lesions in the laryngeal motor cortex (LMC) and its descending tract contribute to voice deterioration and peripheral nerve palsy in patients with nasopharyngeal carcinoma (NPC) postradiotherapy (RT). STUDY DESIGNS: Prospective cohort study. METHODS: Twenty-two patients with NPC at 2 to 4years post-RT (8 female and 14 male), 22 patients with NPC at 8 to 10years post-RT (8 female and 14 male), and 22 healthy individuals (9 female and 13 male) were selected to test their magnetic evoked potentials (MEP), motor nerve conduction, and voice quality using transcranial magnetic stimulation, laryngeal electromyography, and the XION DiVAS acoustic analysis software. Three groups were matched according to approximate age. Multiple comparisons were performed among the three groups. RESULTS: The voice quality of post-RT patients with NPC deteriorated compared to that of healthy individuals. Bilateral LMC and their corticonuclear tracts to the bilateral ambiguous nuclei of post-RT patients with NPC were impaired according to multigroup comparisons of MEP amplitudes, latencies, and resting motor thresholds. The vagus and recurrent laryngeal nerves (RLN) of post-RT patients with NPC were impaired according to multigroup comparisons of the amplitude and latencies of the compound muscle action potential and latencies of f-waves. CONCLUSIONS: The voice quality of patients with NPC deteriorated after RT. The pathogenesis of post-RT voice deterioration may involve radiation-induced injuries to the vagus, RLN, and bilateral LMC. Furthermore, radiation-induced injuries to the bilateral LMC may contribute to vagus and RLN palsies. These findings support the use of transcranial approaches to treating voice disorders and peripheral nerve palsies in post-RT patients with NPC. TRIAL REGISTRATION: ChiCTR2100054425; Electrophysiological Study of Vocal-Fold Mobility Disorders After Radiotherapy for NPC Patients via Magnetic Evoked Potential and Their Correlation with Voice Quality Assessment; https://www.chictr.org.cn/bin/project/edit?pid=144429.

Use of cyclodextrin-modified gold nanoparticles for enantioseparations of drugs and amino acids based on pseudostationary phase-capillary electrochromatography.

The application of chemical-modified gold nanoparticles (GNPs) as chiral selector for the enantioseparation based on pseudostationary phase-CEC (PSP-CEC) is presented. GNPs modified by thiolated beta-CD were characterized by NMR and FT-IR. The nanoparticle size was determined to be of 9.5 nm (+2.5 nm) by Transmission Electron Microscopy (TEM) and UV spectra. Four pairs of dinitrophenyl-labeled amino acid enantiomers (DL-Val, Leu, Glu and Asp) and three pairs of drug enantiomers (RS-chlorpheniramine, zopiclone and carvedilol) were analyzed by using modified GNPs as the chiral selector in PSP-CEC. Good theoretical plate number (up to 2.4x10(5) per meter) and separation resolution (up to 4.7) were obtained even with low concentration of modified GNPs (0.8-1.4 mg/mL). The corresponding concentration of beta-CD in the buffer was only 0.30-0.53 mM, which was much lower than the optimum concentration of 15 mM if pure beta-CD was used as chiral selector. Our results showed that thiolated beta-CD modified GNPs have more sufficient interaction with the analytes, resulting in significant enhancement of enantioseparation. The study shed light on potential usage of chemical modified GNPs as chiral selector for enantioseparation based on PSP-CEC.

Dual-enzyme, co-immobilized capillary microreactor combined with substrate recycling for high-sensitive glutamate determination based on CE.

A new method for high-sensitive determination of glutamate was developed and evaluated based on CE by using dual-enzyme co-immobilized capillary microreactor combined with substrate recycling. The capillary microreactor was prepared by covalently co-immobilizing glutamate dehydrogenase (GDH) and glutamic pyruvic transaminase (GPT) on the inner surface of a capillary and was characterized by SEM, ultraviolet-visible spectroscopy, and fluorescence spectroscopy. The GDH-GPT co-immobilized capillary microreactor showed great stability and reproducibility. The apparent K(m) for glutamate with GDH-GPT coupled reaction was determined to be 0.61+/-0.06 mM but 2.56+/-0.24 mM when only GDH was immobilized. Glutamate determination was based on on-column monitoring UV absorption at 340 nm of the reaction product reduced nicotinamide adenine dinucleotide, of which peak area was directly related to the glutamate concentration. The response of the present co-immobilized GDH-GPT assay for glutamate is greatly enhanced over single enzyme system, and a 15.7-fold improvement in sensitivity was obtained. The detection limit of the proposed method is 0.15 muM glutamate (S/N=3). Selectivity for glutamate is good over most of the 20 amino acids. Finally, this method was successfully applied to determine the glutamate content in rat plasma and serum samples.

Capillary electrophoresis-integrated immobilized enzyme microreactor utilizing single-step in-situ penicillinase-mediated alginate hydrogelation: Application for enzyme assays of penicillinase.

Rapid, low-cost and efficient assays for penicillinase activity and inhibition are of vital importance for therapeutics and diagnostics of bacterial resistance to antibiotics. Herein we report a novel approach for on-line enzyme assays for penicillinase utilizing capillary electrophoresis-integrated immobilized enzyme reactors (CE-IMERs). The CE-IMERs are fabricated based on penicillinase-mediated alginate hydrogelation, allowing single-step in-situ encapsulation of enzymes without any additional manipulation process. We show that the fabricated CE-IMERs have high enzyme loading capacity with approximately 61.8% of the original penicillinase in the sol mixture being encapsulated in the "egg-box" hydrogel matrix. Excellent intraday and interday stability and batch-to-batch reproducibility are proved, indicating the reliability of our method for accurate on-line enzyme assays for penicillinase. Enzymatic activities and inhibition of immobilized penicillinase are analyzed, the results of which are in good agreement with those using free enzymes. The proposed method is successfully used for determination of penicillin in pork samples, indicating the potential applications for analysis of complicated real samples.