The Effects of Health Education and the Sunrise Model of Nursing Care on Blood Pressure Control and Psychological Status in Elderly Patients with Hypertension.

Objective: Our aim was to investigate the effect of health education and a positive attitude nursing model on blood pressure (BP) control and psychological status in elderly patients with hypertension (HTN). Methods: A total of 80 elderly patients with HTN in the Affiliated Hangzhou First People's Hospital in China were selected as the study participants. They were randomly divided into a control group and an observation group, with 40 patients in each group. The control group received the routine nursing intervention, while the observation group received health education and the positive attitude nursing intervention based on the nursing care in the control group. The BP control effect, changes in systolic and diastolic BP, psychological status and nursing satisfaction were compared in the 2 groups. Results: The BP control rate in the control group was 77.5% and was 95.0% in the observation group, which was significantly better (P < .05). Before the intervention, there was no significant difference in average systolic and diastolic BP between the 2 groups (P > .05); after the intervention, average systolic and diastolic BP in the observation group were significantly lower than in the control group (P < .05). Before the intervention, there was no significant difference in Self-rating Anxiety Scale (SAS) and Self-rating Anxiety Scale (SDS) scores between the 2 groups (P > .05). After the intervention, the SAS and SDS scores in the observation group were significantly better than those in the control group (P < .05). The nursing satisfaction in the control group was 75.0% and was 95.0% in the observation group, which was significantly higher (P < .05). Conclusion: Compared with routine nursing intervention, the health education and positive attitude nursing intervention can further improve BP control, psychological status and satisfaction and recognition level of elderly patients with HTN; it can be an important clinical nursing intervention.

miR-124 Exacerbates depressive-like behavior by targeting Ezh2 to induce autophagy.

On the basis of our previous research, miR-124 and autophagy have been shown to be associated with depression and antidepressant treatment, respectively. However, whether miR-124 is involved in depressive-like behavior and antidepressant efficacy through regulating autophagy remains poorly understood. The chronic unpredictable mild stress (CUMS) depression model in mice was established, and then intraperitoneal fluoxetine injections (10 mg/kg) were administered for a duration of 4 weeks. The behavioral changes induced by CUMS were evaluated by the tail suspension test, open field test, sucrose preference test, and elevated plus maze test. Quantitative real-time PCR was used to detect expression levels of miR-124 and its three precursor genes in hippocampus of mice. Western blotting was used to detect the expressions of Ezh2 and autophagy proteins (P62, Atg3, Atg7, LC3-I, and LC3- II) in hippocampus of mice. Depression-like behaviors were successfully induced in CUMS models and reversed by SSRI treatments. The expression levels of miR-124 and its precursor gene ( miR-124-3 ) were significantly increased in the hippocampus of CUMS mice, while the expression levels were significantly decreased after 4 weeks of fluoxetine treatment. The mRNA and protein expressions of Ezh2, a validated target of miR-124, were decreased in the hippocampus of CUMS mice, and the fluoxetine treatment could reverse the expressions. A correlation analysis suggested that miR-124 had a significant negative correlation with Ezh2 mRNA expression. The protein levels of LC3-II/I, P62, and Atg7, which were found to be regulated by Ezh2, were increased in the hippocampus of CUMS mice and decreased after fluoxetine treatment. We speculated that autophagy was enhanced in the CUMS model of depression and might be mediated by miR-124 targeting Ezh2.

Characteristics of Chinese women in need of enhanced sexual health attention and at risk of hypoactive sexual desire disorder.

BACKGROUND: The target population for women's sexual health services in China was unclear. To identify high-risk individuals with psychological barriers to sexual health-seeking behaviors and those at high risk of hypoactive sexual desire disorder (HSDD), we investigated correlates of Chinese women's unwillingness to communicate sexual health, the shame of sexual health-related disorders, sexual distress, and HSDD. METHODS: An online survey was conducted from April to July 2020. RESULTS: We received 3443 valid responses online (effective rate 82.6%). Participants were mainly Chinese urban women of childbearing age (median 26 years old, Q1-Q3 23-30). Women who knew little about sexual health knowledge (aOR 0.42, 95%CI 0.28-0.63) and were ashamed (aOR 0.32-0.57) of sexual health-related disorders were less willing to communicate sexual health. Age (aOR 4.29, 95%CI 2.26-8.17), low income (aOR 1.52-2.11), family burden (aOR 1.34-1.43), and living with friends (aOR 1.39, 95%CI 1.02-1.91) were independent correlates of women's shame about sexual health-related disorders while living with a spouse (aOR 0.66, 95%CI 0.51-0.86) or children (aOR 0.77, 95%CI 0.62-0.96) were correlated with less shame. Age (aOR 0.98, 95%CI 0.96-0.99) and a postgraduate degree (aOR 0.45, 95%CI 0.28-0.71) were linked with less sexual distress of low sexual desire while having children (aOR 1.38-2.10), intense work pressure (aOR 1.32, 95%CI 1.10-1.60) and heavy family burden (aOR 1.43, 95%CI 1.07-1.92) increased women's odds of having distress. Women with a postgraduate degree (aOR 0.42, 95%CI 0.19-0.90), more knowledge about sexual health (aOR 0.53-0.67), and decreased sexual desire caused by pregnancy, recent childbirth, or menopausal symptoms (aOR 0.60, 95%CI 0.41-0.85) were less likely to have HSDD, while they were more likely to have HSDD when their decreased sexual desire was due to other sexual issues (aOR 2.56, 95%CI 1.84-3.57) and partners' sexual problems (aOR 1.72, 95%CI 1.23-2.39). CONCLUSION: Sexual health education and related services need to focus on psychological barriers of women with older age, insufficient knowledge of sexual health, intense work pressure, and poor economic conditions. The medical staff need to pay attention to the sexual health of women with intense work or life pressure and a history of gynecological disease. Low sexual desire is not equal to the sexual desire problem, which should be noticed in the future.

Barriers to sexual health-seeking behaviors for Chinese women.

PURPOSE: Cognitive barriers to Chinese women's sexual health-seeking behaviours remained unclear. Therefore, we conducted this study to investigate the characteristics of the sexual health beliefs of Chinese women to clarify why they were reluctant to seek help for sexual issues. METHODS: An online survey was undertaken from April to July 2020. RESULTS: A total of 3443 valid responses were gleaned (the effective rate was 82.6%), the participants of which were mainly Chinese urban women of childbearing age. Up to 66.0% (n=2271, the standardized rate was 66.8%~73.4%) felt ashamed of sexual health-related disorders. Most women (49.4%, n=1700) were strongly motivated to seek help for sexual issues but also had a great psychological impediment. Women with low motivation and a great psychological impediment were rare (6.4%, n= 219). CONCLUSIONS: The shame of sexual health-related disorders was the main barrier to sexual health-seeking behaviours for Chinese women, which should be given enough attention in related health services and sexual education.

Efficacy, Safety, and Tolerability of Ansofaxine (LY03005) Extended-Release Tablet for Major Depressive Disorder: A Randomized, Double-Blind, Placebo-Controlled, Dose-Finding, Phase 2 Clinical Trial.

BACKGROUND: Ansofaxine (LY03005) extended-release tablet is a potential triple reuptake inhibitor of serotonin, norepinephrine, and dopamine. This study assessed the efficacy, safety, and appropriate dosage of ansofaxine for the treatment of major depressive disorder (MDD). METHODS: A multicenter, randomized, double-blind, placebo-controlled, dose-finding, Phase 2 clinical trial was conducted in China. Eligible patients with MDD (18-65 years) were randomly assigned to receive fixed-dose ansofaxine extended-release tablets (40, 80, 120, or 160 mg/d) or placebo for 6 weeks. The primary outcome measure was a change in the total score on the 17-item Hamilton Depression Rating Scale from baseline to week 6. RESULTS: A total of 260 patients were recruited from October 2015 to September 2017, and 255 patients received the study drug as follows: 40 mg (n = 52), 80 mg (n = 52), 120 mg (n = 51), and 160 mg (n = 51) ansofaxine and placebo (n = 49). Significant differences were found in mean changes in 17-item Hamilton Depression Rating Scale total scores at week 6 in the 4 ansofaxine groups vs placebo (-12.46; χ2 = -9.71, P = .0447). All doses of ansofaxine were generally well-tolerated. Treatment-related adverse events occurred in 141 patients (303 cases), yielding incidence rates of 51.92%, 65.38%, 56.86%, and 62.75% in the 40-, 80-, 120-, and 160-mg ansofaxine groups and 38.78% in the placebo group. CONCLUSION: Active doses (40, 80, 120, and 160 mg/d) of ansofaxine in a controlled setting were safe, tolerated, and effective in improving depression symptoms in MDD patients.

A Real-World Study of Risk Factors for QTc Prolongation in Schizophrenia Patients Receiving Atypical Antipsychotics.

PURPOSE: The risk of sudden cardiac death in patients receiving atypical antipsychotics may be related to QTc prolongation. The aim of this study was to investigate the risk factors for QTc prolongation to prevent QTc prolongation and guide clinical practice. METHODS: All electrocardiogram recordings of 913 schizophrenia patients who were receiving atypical antipsychotics were reviewed for prolonged QTc and associated conditions. Binary logistic regression analysis was used to investigate risk factors for QTc prolongation. RESULTS: Logistic regression analysis demonstrated that sex (odds ratio [OR], 0.386; P = 0.010), age (OR, 1.047; P = 0.000), high-density lipoprotein (OR, 0.257; P = 0.014), and antipsychotics dose (OR, 1.040; P = 0.036) were significantly associated with QTc prolongation. CONCLUSIONS: In patients with male sex, elder age, low high-density lipoprotein, or large antipsychotics dose, QTc should be monitored more frequently.

Association between Tumor Necrosis factor-Alpha(TNF-a) polymorphisms and Schizophrenia: an updated meta-analysis.

BACKGROUND: Previous studies have explored associations between Tumour Necrosis factor-Alpha (TNF-a) polymorphisms and Schizophrenia. Their results were controversial. We conducted a meta-analysis to clarify the association between TNF-a - 308 G/A(rs1800629), -1031T/C(rs1799964), -863C/A(rs1800630) and -857 C/T (rs1799724) polymorphisms and Schizophrenia. METHODS: All the studies that investigated the association between TNF-a polymorphisms and Schizophrenia published before 15 October 2020 were included in. The literature were comprehensively searched and identified in 2 English databases and 2 Chinese databases. The odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. RESULTS: For -1031 T/C polymorphism, at the overall analysis, significantly decreased Schizophrenia risk was found in T allele in the allele model (p = 0.006, OR = 0.88) and increased Schizophrenia risk was found in TC + CC genotype in the dominant model (p = 0.005, OR = 1.17). Similarly, the same results were obtained when pooled analyses were included in high-quality studies (allele model: p = 0.005, OR = 0.86; dominant model: p = 0.007, OR = 1.20). In addition, when stratified by ethnicity, the results showed that in allele model, the T allele decreased Schizophrenia risk in East Asian (p = 0.031, OR = 0.90). CONCLUSION: The association may most likely result from less-credible, rather than from true associations or biological factors on the TNF-a - 1031 T/C polymorphism with Schizophrenia risk.KeypointsFor -1031T/C polymorphism, at the overall analysis, significantly decreased schizophrenia risk was found in T allele in the allele model, and increased schizophrenia risk was found in TC + CC genotype in the dominant model.In allele model, the T allele decreased schizophrenia risk in East Asian when stratified by ethnicity, and in the dominant model, TC + CC genotype increased schizophrenia risk in East Asian.

Sex differences between serum total bilirubin levels and cognition in patients with schizophrenia.

BACKGROUND: Cognitive deficits are common in patients with schizophrenia (SCZ). Abnormal serum total bilirubin (TBIL) levels have been involved in cognitive deficits associated with neuropsychiatric diseases such as mild cognitive impairment and subcortical ischemic vascular disease. However, this relationship has not yet been fully investigated in patients with SCZ. Therefore, the aim of this study was to investigate the association between the serum TBIL concentration and cognitive deficits in SCZ patients and to determine whether a sex difference exists in the association. METHODS: A total of 455 participants were eligible and included in this cross-sectional study. Cognition was evaluated using the Montreal Cognitive Assessment. Serum TBIL concentration was measured with an automatic biochemistry analyzer according to the routine protocol in the hospital medical laboratory. RESULTS: Serum TBIL levels were lower in the cognition impairment group than in the cognition normal group in male patients. In contrast, serum TBIL levels tended to be increased in the cognition impairment group in female patients, although the difference was not significant. Further stepwise multiple regression analysis stratified by sex showed that serum TBIL was independently and positively associated with cognitive function in male patients but not in female patients. Moreover, the association between serum TBIL level and cognitive function was also identified by the propensity score matching (PSM) method in male patients, but not in female patients. CONCLUSION: These findings suggest that lower serum TBIL levels may be associated with cognitive impairment in male SCZ patients.

Investigation on tribological behaviors of biodegradable pure Zn and Zn-X (Li, Cu, Ge) binary alloys.

As a potential biodegradable implant material, zinc (Zn) alloys have attracted increasing attention due to their good biocompatibility and moderate degradation rate. Zn and its alloys are expected to become candidate materials for medical devices. The metals implanted in the human body will inevitably undergo friction in the human body before it is completely degraded. Friction and wear are essential factors which may cause medical devices' service failure. However, there are still few studies on the friction and wear properties of biodegradable Zn-based alloys in the human body, and most studies just focus on the mechanical properties, degradation properties and biocompatibility of the alloys. Thus, it is crucial to study the friction and wear properties of Zn and its alloys. In the present work, we investigated the tribological properties of biodegradable pure Zn and Zn-X (Li, Cu, Ge) alloys. Our study found that under simulated body fluid and dry friction conditions, the addition of alloying elements Li and Cu can improve the friction properties of Zn. Among the four metals, Zn-0.5Li alloy has the lowest friction coefficient and the best wear resistance. Hank's solution has lubricating and corrosive effects. That is to say, when the alloy is rubbed in Hank's solution, it can not only be protected by the lubrication of the solution, but also tribocorrosion will occur as well.

Analysis of Time-Course, Dose-Effect, and Influencing Factors of Antidepressants in the Treatment of Acute Adult Patients With Major Depression.

OBJECTIVE: Model-based meta-analysis was used to describe the time-course and dose-effect relationships of antidepressants and also simultaneously investigate the impact of various factors on drug efficacy. METHODS: This study is a reanalysis of a published network meta-analysis. Only placebo-controlled trials were included in this study. The change rate in depression rating scale scores from baseline was used as an efficacy indicator because a continuous variable is more likely to reflect subtle differences in efficacy between drugs. RESULTS: A total 230 studies containing 64 346 patients were included in the analysis. The results showed that the number of study sites (single or multi-center) and the type of setting (inpatient or noninpatient) are important factors affecting the efficacy of antidepressants. After deducting the placebo effect, the maximum pure drug efficacy value of inpatients was 18.4% higher than that of noninpatients, and maximum pure drug efficacy value of single-center trials was 10.2% higher than that of multi-central trials. Amitriptyline showed the highest drug efficacy. The remaining 18 antidepressants were comparable or had little difference. Within the approved dose range, no significant dose-response relationship was observed. However, the time-course relationship is obvious for all antidepressants. In terms of safety, with the exception of amitriptyline, the dropout rate due to adverse events of other drugs was not more than 10% higher than that of the placebo group. CONCLUSION: The number of study sites and the type of setting are significant impact factors for the efficacy of antidepressants. Except for amitriptyline, the other 18 antidepressants have little difference in efficacy and safety.

Model-based analysis of therapeutic efficacy of blonanserin and risperidone in schizophrenia patients and effects on prolactin: A randomized double-blind study.

This study examined randomized controlled trial data for blonanserin and risperidone in Chinese schizophrenia patients (N = 264). Data related to historical changes in the Positive and Negative Syndrome Scale (PANSS) were used to successfully construct a longitudinal Emax model. Results: (a) The efficacy of the two drugs was similar after week 8, showing a small difference in PANSS reduction. (b) Using the model, we predicted that each 5-point increase in the baseline FPOS (positive score in PANSS five-factor subscales) leads to a decrease in the PANSS total scores at week 8 for 2 points in patients administered blonanserin. (c) The effect of blonanserin on prolactin (PRL) elevation was less. The model was used to predict that prolactin elevations in patients administered risperidone were 2.41-fold of those in patients administered blonanserin. (d) Model quantitation showed that gender is a risk factor for prolactin elevation. Prolactin elevations in female patients were 2.95-fold of the value in male patients administered the same drug. The model demonstrated Blonanserin has similar antischizophrenic efficacy and less serum prolactin rising compared to risperidone in Chinese patients.

Microstructure, mechanical properties, and in vitro behavior of biodegradable Zn-1Mg-0.1Ca and Zn-1Mg-0.5Ca.

In the present study, the microstructure, mechanical properties, corrosion behavior, wettability, haemocompatibility, and cytocompatibility of the as-cast and as-rolled biodegradable Zn-1Mg-0.1Ca and Zn-1Mg-0.5Ca have been systematically investigated to evaluate their feasibility as potential biodegradable materials. The results demonstrated that the Zn-1Mg-0.1Ca have significantly improved mechanical properties, with the yield strength (YS), ultimate tensile strength (UTS), and elongation of as-rolled Zn-1Mg-0.1Ca are (209.04 ± 28.31) MPa, (331.51 ± 40.06) MPa, and (35.43 ± 3.53)%, respectively. Wettability test results demonstrated that the Zn-1Mg-0.1Ca and Zn-1Mg-0.5Ca have hydrophilic surfaces that can enhance cell responses and tissue-implant interactions. The haemocompatibility evaluation showed that the hemolysis ratio of Zn-1Mg-0.1Ca have a low hemolysis ratio of 0.6%; the platelets remain sphere morphology and are not activated. High cell viability indicates the cytocompatibility of the as-rolled Zn-1Mg-0.1Ca alloy. The Zn-1Mg-0.1Ca alloy can be considered as new suitable biodegradable Zn-based alloys for further biomedical applications.

Measurement and mapping of the electromagnetic radiation in the urban environment.

People are increasingly exposed to electromagnetic radiation with the rapid development of technologies such as broadcasting and mobile communication system. There is a concern that long-term exposure at low levels may be associated with various non-specific physical symptoms and ecological effects on animals and plants. It is extremely important to measure and analyze the electromagnetic radiation levels in order to protect people from the possible effects of electromagnetic radiation. A large-scale assessment of the effects of electromagnetic radiation on health or on ecology requires the ambient electromagnetic radiation levels over areas too vast to cover with conventional measurement methods. In this article, detailed information about the measurement tools and measurement method are given. The electromagnetic radiation exposure levels were measured on the main streets in the dense urban areas of Beijing, the capital of China. We apply ordinary kriging as an interpolation technique to assess the electromagnetic radiation exposure in large outdoor areas based on car-mounted measurements along the surrounding roads. The electromagnetic radiation exposure levels for larger areas can be investigated visually on the electromagnetic pollution map, which can assist decision makers by identifying the hotspots.

PE17 protein from Mycobacterium tuberculosis enhances Mycobacterium smegmatis survival in macrophages and pathogenicity in mice.

The capacity of Mycobacterium tuberculosis to survive and cause disease is strongly correlated with its ability to escape multiple defense strategies in hosts. In particular, M. tuberculosis has the remarkable capacity to survive within the hostile environment of macrophages. Here, we found that the PE17 (Rv1646) protein promoted intracellular survival of M. smegmatis in peritoneal macrophages from mice. Further experiments confirmed that the recombinant PE17 protein was localized in the cell wall of M. smegmatis. Results from the macrophage infection model showed that PE17 significantly downregulated pro-inflammatory cytokines (interleukin-6, interleukin-12, and tumer necrosis factor-α) secretion from macrophages induced by M. smegmatis and promoted macrophage necrosis. Furthermore, a C57BL/6 mouse infection model confirmed that PE17 significantly prolonged the survival of M. smegmatis in vivo and aggravated lesions in organs of infected mice. Moreover, persistent high levels of interferon-γ and interleukin-1ß in infected mice indicated that the bacteria were not easily removed in vivo. Overall, our present results suggested that the PE17 may act as an important pathogenic factor in M. tuberculosis.

Quantifying placebo responses in clinical evaluation of neuropsychiatric symptoms in Alzheimer's disease.

PURPOSE: This study aimed to establish a non-linear mixed effects model to quantitatively analyze the placebo responses of neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD). METHODS: A comprehensive literature search was conducted in public databases. Placebo-controlled randomized AD clinical trials using the neuropsychiatric inventory (NPI) score as the primary or secondary outcome were included. Non-linear mixed effects model was used to describe the time course of the placebo responses of NPS in AD clinical trials. Potential affecting factors were tested as covariates. RESULTS: A total of 32 clinical studies (involving 3942 subjects) were included in model-based analysis. We found that the maximal placebo responses of NPS were reached at week 4 approximately, after which rebound effects appeared. The baseline NPI score had a significant impact on the placebo responses. Higher baseline NPI score tended to cause greater reductions in NPI score at week 8 and a smaller degree of rebound. For AD patients whose normalized baseline NPI score was 10 points and 30 points, the reduction in normalized NPI score at week 8 was estimated to be 0.83 and 7.43 points, respectively; and the rebound rate after week 8 was estimated to be 0.1 points/week and 0.08 points/week, respectively. CONCLUSIONS: The duration of 4 weeks is sufficient to determine the drug efficacy for assessing NPS in AD clinical trials. The baseline NPI score was a key factor associated with placebo responses of NPS, which should be considered when designing future clinical trials and conducting comparisons across trials.

Quantitative efficacy of three antipsychotic drugs for schizophrenia based on a real-world study in China.

Atypical antipsychotics exert remarkable long-term efficacy on the personal and social functions of schizophrenic patients. However, quantitative information on the social function of schizophrenic patients treated with atypical antipsychotics is scarce in the current clinical guidelines. In this study, we established pharmacodynamic models to quantify the time-efficacy relationship of three antipsychotic drugs based on the data from a real-world study conducted in China. A total of 373 schizophrenic patients who received antipsychotic monotherapy with olanzapine (n = 144), risperidone (n = 160), or aripiprazole (n = 69) were selected from a three-year prospective, multicenter study. The follow-up times were 13, 26, 52, 78, 104, 130, and 156 weeks after baseline. A time-efficacy model was developed with nonlinear mixed effect method based on changes in Personal and Social Performance (PSP) score compared with the baseline level. Crucial pharmacodynamic parameters, including maximum efficacy and drug onset time, were used to distinguish the efficacy of the three drugs. We quantified the time course of PSP improvement in patients after treatment with these three antipsychotics: olanzapine, risperidone, and aripiprazole reached an Emax value of 80.3%, 68.2%, and 23.9% at weeks 56.7, 29.2, and 36.8, respectively. General psychotic symptoms, onset frequency, and illness course were identified as significant factors affecting the efficacy of these drugs. The newly constructed models provide an evidence of the benefit of long-term maintenance therapy with atypical antipsychotics in individualized schizophrenia treatment in China.

Expression alteration of microRNAs in Nucleus Accumbens is associated with chronic stress and antidepressant treatment in rats.

BACKGROUND: Nucleus Accumbens (NAc) is a vital brain region for the process of reward and stress, whereas microRNA plays a crucial role in depression pathology. However, the abnormality of NAc miRNA expression during the stress-induced depression and antidepressant treatment, as well as its biological significance, are still unknown. METHODS: We performed the small RNA-sequencing in NAc of rats from three groups: control, chronic unpredictable mild stress (CUMS), and CUMS with an antidepressant, Escitalopram. We applied an integrative pipeline for analyzing the miRNA expression alternation in different model groups, including differential expression analysis, co-expression analysis, as well as a subsequent pathway/network analysis to discover both miRNA alteration pattern and its biological significance. RESULT: A total of 423 miRNAs were included in analysis.18/8 differential expressing (DE) miRNA (adjusted p < 0.05, |log2FC| > 1) were observed in controls Vs. depression/depression Vs. treatment, 2 of which are overlapping. 78% (14/18) of these miRNAs showed opposite trends of alteration in stress and treatment. Two micro RNA, miR-10b-5p and miR-214-3p, appeared to be hubs in the regulation networks and also among the top findings in both differential analyses. Using co-expression analysis, we found a functional module that strongly correlated with stress (R = 0.96, P = 0.003), and another functional module with a moderate correlation with anhedonia (R = 0.89, P = 0.02). We also found that predicted targets of these miRNAs were significantly enriched in the Ras signaling pathway, which is associated with both depression, anhedonia, and antidepressant treatment. CONCLUSION: Escitalopram treatment can significantly reverse NAc miRNA abnormality induced by chronic stress. However, the novel miRNA alteration that is absent in stress pathology also emerges, which means that antidepressant treatment is unlikely to bring miRNA expression back to the same level as the controls. Also, the Ras-signaling pathway may be involved in explaining the depression disease etiology, the clinical symptom, and treatment response of stress-induced depression.

Changing of Chinese psychiatrists' attitudes toward consent process to treatment and its association with the China's National Mental Health Law.

OBJECTIVE: Few studies have addressed informed consent in Chinese psychiatric practice. We wished to explore psychiatrists' attitudes toward informed consent in Shanghai after promulgation of the first national law for mental health care in China: the National Mental Health Law. METHOD: A total of 398 psychiatrists were recruited from seven psychiatric hospitals in Shanghai. Their anthropometric data were collected. A confidential, self-report questionnaire addressing attitudes toward the informed consent process was completed by all participants. RESULTS: Most respondents would like to inform patients/guardians of the diagnosis (95.2%), treatment plan (93.5%), treatment goals and potential adverse effects of prescribed medications (94.7%), and alternative treatment plans (71.9%). In addition, 58.4% of psychiatrists thought that the informed consent process for physical restraint was difficult to follow. According to logistic regression, psychiatrists not trained to use the National Mental Health Law were more likely to have a negative attitude toward the informed consent process compared with those trained (adjusted odds ratio = 0.21; 95% confidence interval: 0.07-0.59; p = 0.003). CONCLUSIONS: Psychiatrists trained to use the National Mental Health Law had more positive attitudes toward the informed consent process. Lack of such training could affect the attitudes of psychiatrists toward the informed consent process in China.

Efficacy and Safety of Agomelatine vs Paroxetine Hydrochloride in Chinese Han Patients with Major Depressive Disorder: A Multicentre, Double-Blind, Noninferiority, Randomized Controlled Trial.

PURPOSE: The purpose of this study is to investigate the efficacy, safety, and tolerability of agomelatine and paroxetine in Chinese Han patients with major depressive disorder (MDD). METHODS: A 8-week, double-blind, randomized, parallel study was conducted in 14 medical centers in mainland China from December 2011 to September 2012. A total of 264 subjects with a primary Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of MDD were randomly assigned to receive agomelatine 25-50 mg/d (n = 132) or paroxetine 20-40 mg/d (n = 132). The primary efficacy was evaluated by the decrease of Hamilton Depression Rating Scale (HAM-D17) scores. The secondary measurements of efficacy included Hamilton Anxiety Rating Scale, Montgomery-Asberg Depression Rating Scale, Sheehan Disability Scale, Clinical Global Impressions-Severity, and Clinical Global Impressions-Improvement. The laboratory test abnormity, and observed and self-reported adverse events were all assessed as the measurements of safety and tolerability. RESULTS: Both the agomelatine and paroxetine groups showed significant improvement from baseline to the end point (P < 0.05) without between-group differences (P > 0.05). The mean decrease of HAM-D17 of agomelatine group was not inferior to the paroxetine group over the 8-week treatment (agomelatine 15.26 ± 6.44 vs paroxetine 14.87 ± 5.89, δ = 2.0; µA-µB 95% confidence interval, -1.13 to 1.91). The percentage of responders at the last postbaseline assessment was similar in the 2 groups on both HAM-D17 (agomelatine 66.15% vs paroxetine 63.49%) and Clinical Global Impressions-Improvement (agomelatine 79.09% vs paroxetine 80.36%). The anxiety (Hamilton Anxiety Rating Scale) and sleep symptoms (sleep items of HAM-D17) of the patients were improved significantly in the 2 groups at week 8 without between-group differences (P > 0.05). The incidence of overall adverse events was similar in the 2 groups (agomelatine 49.62% vs paroxetine 56.15%, P > 0.05). The incidence of adverse events in skin and subcutaneous tissue was higher in the paroxetine group than in the agomelatine group (none in agomelatine and 4.62% in paroxetine, P = 0.0144). CONCLUSIONS: Agomelatine showed equivalent antidepressant efficacy to paroxetine in treating MDD patients after 8 weeks of treatment with an acceptable safety.

Indirect Phase Transformation of CuO to Cu2O on a Nanowire Surface.

The reduction of CuO nanowires (NWs) to Cu2O NWs undergoes an indirect phase transformation on the surface: from single crystalline CuO, to a disordered Cu2-δO phase, and then to crystalline Cu2O. A 9-12 nm disordered Cu2-δO is formed on the NW surface by exposing CuO NWs to CO at 1 Torr, 300 °C for 30 min. After 60 min, this layer decreases to 2-3 nm and is eliminated after 180 min. Energy dispersive X-ray spectroscopy using a scanning tunneling electron microscope and across a single NW reveals the disordered layer to be O-rich with respect to Cu2O with a maximum at. % Cu:O = 1.8. X-ray photoelectron spectroscopy shows adsorbed CO on the surface as evidence of the reduction reaction. Micro-Raman spectroscopy tracks the transformation in NWs as a function of reduction time. A CO enabled surface reduction reaction coupled to diffusion-limited transport of "nonlattice" O to the surface is proposed as a mechanism for Cu2-δO formation. The initial buildup of out-diffusing O to the surface appears to aid the formation of the disordered surface layer. The transformation follows Ostwald-Lussac's law which predicts formation of unstable phases over stable phases, when phase transformation rates are limited by kinetic or diffusional processes. The study provides a generalized approach for facile growth of few nanometer transient layers on multivalent, metal oxide NW surfaces.