Prevalence and risk factors of sleep disturbances among patients with lung cancer: systematic review and meta-analysis.

PURPOSE: Patients with lung cancer endure the most sleep problems. Understanding the prevalence and risk factors of sleep disturbances in lung cancer populations is critical in reducing symptom burden and improving their quality of life. This systematic review aimed to determine the prevalence and risk factors of sleep disturbances in patients with lung cancer. METHODS: Seven electronic databases were systematically screened for studies on the prevalence or risk factors of sleep disturbances in patients with lung cancer. Subgroup analyses were conducted to investigate significant heterogeneity (I2 > 50%) across studies. RESULTS: Thirty-seven studies were found eligible. The pooled prevalence was 0.61 (95% CI = [0.54-0.67], I2 = 96%, p < 0.00001). Seven risk factors were subject to meta-analyses. Significant differences were found for old age (OR = 1.23; 95% CI = [1.09-1.39], p = 0.0006,I2 = 39%), a low education level (OR = 1.17; 95%CI = [1.20-2.66], p = 0.004, I 2 = 42%), fatigue (OR = 1.98; 95%CI = [1.23-3.18], p = 0.005, I 2 = 31%), pain (OR = 2.63; 95% CI = [1.35-5.14], p = 0.005, I 2 = 91%), tumor stage of III or IV (OR = 2.05; 95%CI = [1.54-2.72], p < 0.00001, I 2 = 42%), anxiety (OR = 1.62; 95%CI = [1.22-2.14], p = 0.0008, I2 = 78%), and depression (OR = 4.02; 95% CI = [1.39-11.61], p = 0.01, I2 = 87%). After the included studies were withdrawn one after the other, pain (OR = 3.13; 95% CI = [2.06-4.75], p < 0.00001, I 2 = 34%) and depression (OR = 5.47; 95% CI = [2.65-11.30], p < 0.00001) showed a substantial decrease of heterogeneity. Meanwhile, the heterogeneity of anxiety symptoms remained unchanged. CONCLUSION: Results showed that sleep disturbances were experienced in more than 60% of patients with lung cancer. The comparatively high prevalence of sleep disturbances in this population emphasizes the need to adopt measures to reduce them. Significant associations were found between sleep disturbances and various factors, including age, education level, fatigue, pain, cancer stage, anxiety, and depression. Among these factors, depression emerged as the most significant. Future research should concentrate on identifying high-risk individuals and tailored interdisciplinary interventions based on these risk factors.

Preparation and functional properties of rice bran globulin-chitooligosaccharide-quercetin-resveratrol covalent complex.

BACKGROUND: As the major protein (approximately 36%) in rice bran, globulin exhibits excellent foaming and emulsifying properties, endowing its useful application as a foaming and emulsifying agent in the food industry. However, the low water solubility restricts its commercial potential in industrial applications. The present study aimed to improve this protein's processing and functional properties. RESULTS: A novel covalent complex was fabricated by a combination of the Maillard reaction and alkaline oxidation using rice bran globulin (RBG), chitooligosaccharide (C), quercetin (Que) and resveratrol (Res). The Maillard reaction improved the solubility, emulsifying and foaming properties of RBG. The resultant glycosylated protein was covalently bonded with quercetin and resveratrol to form a (RBG-C)-Que-Res complex. (RBG-C)-Que-Res exhibited higher thermal stability and antioxidant ability than the native protein, binary globulin-chitooligosaccharide or ternary globulin-chitooligosaccharide-polyphenol (only containing quercetin or resveratrol) conjugates. (RBG-C)-Que-Res exerted better cytoprotection against the generation of malondialdehyde and reactive oxygen species in HepG2 cells, which was associated with increased activities of antioxidative enzymes superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) through upregulated genes SOD1, CAT, GPX1 (i.e. gene for glutathione peroxidase-1), GCLM (i.e. gene for glutamate cysteine ligase modifier subunit), SLC1A11 (i.e. gene for solute carrier family 7, member 11) and SRXN1 (i.e. gene for sulfiredoxin-1). The anti-apoptotic effect of (RBG-C)-Que-Res was confirmed by the downregulation of caspase-3 and p53 and the upregulation of B-cell lymphoma-2 gene expression. CONCLUSION: The present study highlights the potential of (RBG-C)-Que-Res conjugates as functional ingredients in healthy foods. © 2024 Society of Chemical Industry.

Relationship of depression and loneliness with quality of life in rural widowed elderly women living alone. / å†œæ‘ä¸§å¶ç‹¬å± è€å¹´å¥³æ€§æŠ‘éƒã€å­¤ç‹¬æ„Ÿä¸Žç”Ÿæ´»è´¨é‡çš„å ³ç³».

OBJECTIVES: Rural widowed elderly women living alone may face higher risks of depression and loneliness than general elderly people, which will have an impact on their quality of life. This study aims to explore the correlation of depression and loneliness with quality of life among rural widowed elderly women living alone. METHODS: A two-stage cluster sampling method was used to select 234 rural widowed older women living alone in Longshan county, Xiangxi autonomous prefecture, Hunan Province, and a questionnaire survey was conducted with the General Situation Questionnaire, the Geriatric Depression Scale-15 (GDS-15), the University of California, Los Angeles (UCLA) Loneliness Scale-8 (ULS-8), and the 36 Items Short Form Health Survey (SF-36). RESULTS: The ages of 234 rural widowed older women living alone were (73.29±7.36) years. Among them, 103 (44.0%) women were detected as depressed, 114 (48.7%) were not lonely or mildly lonely, 111 (47.4%) were moderately lonely, and 9 (3.9%) were severely lonely. The total quality of life scores were 63.39±19.70. Depression and loneliness were negatively correlated with quality of life (all P<0.001). After adjusting for confounding factors, multiple linear regression analysis showed that age, number of acute and chronic diseases, personal monthly income, depression, and loneliness independently impacted the quality of life among rural widowed older women (all P<0.05). CONCLUSIONS: Depression and loneliness can affect the quality of life of rural widowed older women living alone. In healthy aging efforts, the quality of life of these rural widowed older women can be improved by strengthening the management of underlying illnesses, increasing income, and alleviating depression and loneliness.

Local Tumor Ischemia-Reperfusion Mediated By Ultrasound-Targeted Microbubble Destruction Enhances The Anti-Tumor Efficacy Of Doxorubicin Chemotherapy.

BACKGROUND: Ultrasound-targeted microbubble destruction (UTMD) has been shown to be a promising noninvasive technique to change the tumor circulation, thus providing a potential method to increase reactive oxygen species (ROS) levels in tumors by inducing tumor tissue ischemia-reperfusion (IR). In this study, we investigated the feasibility of local tumor IR through UTMD to enhance the anti-tumor efficacy of doxorubicin (DOX) chemotherapy. METHODS: UTMD was used to induce local tumor IR. After the major blood supply of the tumor was restored, DOX was intravenously injected into the tumor-bearing mice. The superoxide dismutase (SOD) and catalase (CAT) activity and ROS levels were examined, and the anti-tumor efficacy was evaluated. RESULTS: UTMD blocked the circulation to the tumor for 30 mins. Slow reperfusion began to occur after 30 mins, and major blood supply was restored after 1 hr. The blood perfusion of the tumor completely recovered at 2 hrs. The activity of SOD in the tumors was significantly decreased at 2 hrs and 1 day after IR treatment with or without DOX treatment. The CAT activity showed no obvious changes at 2 hrs after IR treatment, whereas a significant decrease was found after 1 day in both the IR and DOX/IR groups. Moreover, higher levels of ROS were produced in the IR group and IR/DOX group. In vivo anti-tumor study indicated that the local tumor IR strategy may significantly enhance the anti-tumor efficacy of DOX chemotherapy. CONCLUSION: UTMD provides a novel, simple and non-invasive technique for tumor IR. In combination with chemotherapy, UTMD may have high great potential to improve the anti-tumor efficacy of chemotherapeutic drugs.

Mechanisms of enhanced antiglioma efficacy of polysorbate 80-modified paclitaxel-loaded PLGA nanoparticles by focused ultrasound.

The presence of blood-brain barrier (BBB) greatly limits the availability of drugs and their efficacy against glioma. Focused ultrasound (FUS) can induce transient and local BBB opening for enhanced drug delivery. Here, we developed polysorbate 80-modified paclitaxel-loaded PLGA nanoparticles (PS-80-PTX-NPs, PPNP) and examined the enhanced local delivery into the brain for glioma treatment by combining with FUS. Our result showed PPNP had good stability, fast drug release rate and significant toxicity to glioma cells. Combined with FUS, PPNP showed a stronger BBB permeation efficiency both in the in vitro and in vivo BBB models. Mechanism studies revealed the disrupted tight junction, reduced P-glycoprotein expression and ApoE-dependent PS-80 permeation collectively contribute to the enhanced drug delivery, resulting in significantly stronger antitumour efficacy and longer survival time in the tumour-bearing mice. Our study provided a new strategy to efficiently and locally deliver drugs into the brain to treat glioma.

Multivariate analysis of metastasis­related risk factors for patients with gastroenteropancreatic neuroendocrine tumors based on clinicopathological and endoscopic features.

Gastroenteropancreatic neuroendocrine tumors (GEP­NETs) are relatively uncommon. Unfortunately, epidemiological studies on the incidence of GEP­NETs worldwide have reported a marked increase in the detection of these tumors. Although they often exhibit relatively indolent clinical courses, GEP­NETs have the potential for lethal progression, especially in patients who present with advanced disease. Early detection and surgical removal is currently the only reliable curative treatment for GEP­NET patients. The objective of this study was to analyze the clinicopathological characteristics of GEP­NETs and explore the metastasis­related risk factors of patients with GEP­NETs. One hundred and forty­six patients diagnosed pathologically with GEP­NETs from January 2001 to January 2015 at the Second Xiangya Hospital of Central South University were retrospectively evaluated. We retrieved and analyzed information concerning clinical characteristics and metastasis­related risk factors, and used Chi­square test and logistic regression analysis to analyze the clinicopathological characteristics of GEP­NETs and explore the association between tumor metastasis and possible related risk factors. The results revealed that the most common clinical manifestations were abdominal pain (n=88), alteration in the character of stool (n=58) and melaena (n=33). Rectum (91/146, 62.3%) and stomach (19/146, 13.0%) were the main sites of metastasis. Both Chi­square test and logistic regression analysis showed that tumor size (P<0.05), tumor type (P=0.008) and peritumoral lymphatic vessel density (LVD) (P=0.004) were significantly correlated with tumor metastasis. Neither Chi­square test nor logistic regression analysis indicated that gender (P>0.05), age (P>0.05), tumor location (P>0.05), tumor number (P>0.05), chromaffin granule protein A [chromogranin A (CgA), P>0.05], synaptophysin (Syn, P>0.05) or intratumoral LVD (P>0.05) had a significant correlation with tumor metastasis. Chi­square test revealed that tumor grade was significantly correlated with tumor metastasis. In conclusion, GEP­NETs may occur in multiple sites of the digestive system and lack specific clinical manifestations. Tumor size, tumor type, peritumoral LVD, total LVD and tumor grade are metastasis­related risk factors for GEP­NET patients.