The cross-cultural adaptation and psychometric properties of the Graded Chronic Pain Scale-Revised-Simplified Chinese version.

Chronic pain is a prevalent issue worldwide and is a significant contributor to human suffering and disability. The Graded Chronic Pain Scale-Revised has exhibited favorable reliability and validity. However, its applicability yet to be explored in China. We aimed to create a simplified Chinese version of the Graded Chronic Pain Scale-Revised for chronic pain patients by conducting cross-cultural adaptation and psychometric evaluation. This study employs a two- phase design. In phase 1, the Graded Chronic Pain Scale-Revised was cross-culturally translated and adapted in accordance with international guidelines. In phase 2, the simplified Chinese version of the Graded Chronic Pain Scale-Revised was administered to 417 participants along with Numerical Rating Scale to assess its psychometric properties. The final analysis consisted of data from 376 participants. The scale had a Cronbach's α coefficient of 0.944. Moreover, the scale exhibited excellent content validity and was divided into two dimensions: identifying high impact chronic pain; and the Pain, Enjoyment, and General Activities subscale. Exploratory and confirmatory factor analyses revealed that these dimensions had a good model fit. Additionally, the simplified Chinese version of the Graded Chronic Pain Scale-Revised demonstrated good convergent and discriminant validity. The receiver operating characteristic curve demonstrated that grades 2 and 3 had a good predictive effect on limiting participants' work ability, and the area under the receiver operating characteristic curve was equal to 0.91. The present study demonstrates the successful adaptation of the Graded Chronic Pain Scale-Revised into Simplified Chinese, with the revised version exhibiting favorable psychometric properties. This scale addresses the shortcomings of domestic chronic pain grading assessment tools, providing a valuable instrument for evaluating the severity of chronic pain in Chinese clinical practice and serving as a reference and basis for other research related to chronic pain.

HDAC3 Inhibition Promotes Antitumor Immunity by Enhancing CXCL10-Mediated Chemotaxis and Recruiting of Immune Cells.

It is generally believed that histone deacetylase (HDAC) inhibitors, which represent a new class of anticancer agents, exert their antitumor activity by directly causing cell-cycle arrest and apoptosis of tumor cells. However, in this study, we demonstrated that class I HDAC inhibitors, such as Entinostat and Panobinostat, effectively suppressed tumor growth in immunocompetent but not immunodeficient mice. Further studies with Hdac1, 2, or 3 knockout tumor cells indicated that tumor-specific inactivation of HDAC3 suppressed tumor growth by activating antitumor immunity. Specifically, we found that HDAC3 could directly bind to promotor regions and inhibit the expression of CXCL9, 10, and 11 chemokines. Hdac3-deficient tumor cells expressed high levels of these chemokines, which suppressed tumor growth in immunocompetent mice by recruiting CXCR3+ T cells into the tumor microenvironment (TME). Furthermore, the inverse correlation between HDAC3 and CXCL10 expression in hepatocellular carcinoma tumor tissues also suggested HDAC3 might be involved in antitumor immune regulation and patient survival. Thus, our studies have illustrated that HDAC3 inhibition suppresses tumor growth by enhancing immune cell infiltration into the TME. This antitumor mechanism may be helpful in guiding HDAC3 inhibitor-based treatment.

Motivational interviewing to improve the self-care behaviors for patients with chronic heart failure: A randomized controlled trial.

OBJECTIVES: This study aimed to investigate the effect of motivational interviewing on the self-care behaviours in patients with chronic heart failure. METHODS: Sixty-two hospitalized patients with chronic heart failure were recruited in this study from April 2014 to April 2015 from a hospital. Twenty-nine patients were in the intervention group, and 33 patients were in the control group. Patients in the intervention group received four sessions of motivational interviewing, whereas those in the control group received traditional health education. At 2, 4, and 8 weeks post-discharge, the intervention group underwent telephone follow-up based on motivational interviewing, whereas the control group underwent routine telephone follow-up. Primary outcome was measured using the Self-care of Heart Failure Index at baseline and at 2 months post-discharge. RESULTS: Before intervention, the self-care behaviours scores were 79.00 ±â€¯48.80 in the intervention group and 88.68 ±â€¯29.26in the control group. No statistically significant differences were found between two groups in scores for each subscale and total scale (P > 0.05). After intervention, the scores of self-care behaviours in the two groups were both improved at 155.13 ±â€¯35.65 for the intervention group and 115.44 ±â€¯22.82 for the control group with statistically significance (P < 0.01). The score of self-care behaviours increased by 76.13 point in the intervention group on average, whereas 26.76 point in the control group. There was significant difference between increases in scores of self-care behaviours in two groups (P < 0.01). CONCLUSIONS: The self-care behaviours of patients with chronic heart failure could be improved effectively through motivational interviewing.

[Changes of the characteristics of sleep apnea in heart failure patients and the associated factors].

OBJECTIVE: To investigate the changes of the characteristics of sleep apnea in heart failure patients with periodic breathing disorder and to explore the influencing factors. METHODS: According to the characteristics of sleep apnea after polysomnography (PSG) for 2 nights, 54 patients with heart failure were divided into 3 groups: obstructive sleep apnea (OSA), central sleep apnea (CSA) and OSA-CSA switching groups, with 18 patients each. t test was used for comparison between the first and the second PSG data, left ventricular ejection fraction (LVEF), periodic breathing cycle length (PBCL) and lung to finger circulation time (LFCT) in the same patient. Analysis of variance was performed for comparison within groups and Pearson correlation test was used for correlation analysis between 2 variables. RESULTS: When the events of sleep apnea changed from OSA to CSA, the mean wake and sleep stage II (S2) PtcCO(2) decreased significantly [(41.0 +/- 1.3) cm H(2)O vs (34.9 +/- 1.0) cm H(2)O, 1 cm H(2)O = 0.098 kPa, P < 0.01;(42.1 +/- 1.2) cm H(2)O vs (36.3 +/- 1.1) cm H(2)O, P < 0.01], while PBCL and LCFT increased significantly [(51.9 +/- 2.1) s vs (62.3 +/- 1.9) s, P < 0.01, (54.4 +/- 1.8) s vs (65.3 +/- 1.6) s, P < 0.01]. Furthermore, there was a significant decrease in LVEF [(32.1 +/- 2.5)% vs (19.9 +/- 3.5)%, P < 0.05], and LVEF was negatively correlated with PBCL and LFCT (r = 0.687, P < 0.05;r = -0.591, P < 0.05). When sleep apnea changed from CSA to OSA, the mean wake and S2 PtcCO(2) increased significantly [(39.2 +/- 0.5) cm H(2)O vs (42.7 +/- 1.0) cm H(2)O, P < 0.05], while PBCL and LFCT decreased significantly [(61.5 +/- 3.4) s vs (49.7 +/- 2.8) s, P < 0.05, (66.1 +/- 2.1) s vs (52.1 +/- 1.6) s, P < 0.01)]. In addition, there was a negative correlation between PtcCO(2) and PBCL (r = -0.586, P < 0.05). However, PtcCO(2) showed no significant correlation with LFCT (r = -0.381, P > 0.05). There were no statistical differences between the first and the second mean wake and S2 PtcCO(2), PBCL and LFCT in the OSA and the CSA group, but AHI showed a significant correlation with LVEF in the CSA group (r = -0.474, P < 0.05). CONCLUSIONS: The characteristics of sleep apnea can change when periodic breathing happens in heart failure patients with OSA or CSA. The change can be affected by wake and sleep PtcCO(2), PBCL and LFCT, and possibly by heart function.

Subjective sleepiness in heart failure patients with sleep-related breathing disorder.

BACKGROUND: Previous studies show that sleep-related breathing disorder (SRBD) is common in patients with heart failure (HF) and is associated with increased mortality. This study aimed to determine whether there was significant difference of subjective daytime sleepiness between HF patients with and without SRBD. METHODS: We enrolled, prospectively, 195 consecutive HF patients with left ventricular ejection fractions (LVEF) < or = 45% and all subjects underwent polysomnography to measure the sleep structure between 2005 and 2008. Patients were then assigned to those with SRBD including obstructive and central sleep apnea (apnea-hypopnea index (AHI) > or = 5/hour of sleep) and those without SRBD (AHI < 5/hour) according to the sleep study. The subjective sleepiness was assessed with Epworth sleepiness scale (ESS). RESULTS: Among 195 HF patients, the prevalence of obstructive sleep apnea (OSA) was 53% and of central sleep apnea (CSA) was 27%. There was no significant difference of ESS scores between patients without SRBD (NSA) and with SRBD (NSA vs OSA: 6.7 +/- 0.6 vs 7.6 +/- 0.4, P = 0.105 and NSA vs CSA: 6.7 +/- 0.6 vs 7.4 +/- 0.5, P = 0.235, respectively), indicating that SRBD patients had no more subjective daytime sleepiness. Compared with NSA, patients with SRBD had increased arousal index (ArI) (NSA vs OSA: 14.1 +/- 1.4 vs 26.3 +/- 1.5, P < 0.001 and NSA vs CSA: 14.1 +/- 1.4 vs 31.3 +/- 3.5, P < 0.001, respectively), more awake number after sleep onset (NSA vs OSA: 19.2 +/- 1.5 vs 26.2 +/- 1.4, P = 0.01 and NSA vs CSA: 19.2 +/- 1.5 vs 36.9 +/- 4.4, P < 0.001, respectively), and reduced proportion of slow-wave sleep (SWS) (NSA vs OSA: 13.8 +/- 1.7 vs 9.3 +/- 0.7, P = 0.024 and NSA vs CSA: 13.8 +/- 1.7 vs 8.9 +/- 0.9, P = 0.024, respectively). CONCLUSIONS: OSA and CSA remain common in patients with HF on optimal contemporary therapy. Patients with both HF and SRBD have no significant subjective daytime sleepiness compared with patients without SRBD, despite of significantly increased awake number, arousal and decreased proportion of deep sleep stages. It is not a credible way and means to exclude SRBD in patients with HF according to the absence of subjective daytime sleepiness.