The Impact of Cohort Management on Disease Perception, Fear of Disease Progression, Nutritional Status, and Quality of Life in Patients with Lymphoma.

Objective: This study aims to investigate the impact of cohort management on illness perception, fear of disease progression, nutritional status, and quality of life among patients with lymphoma. Methods: A total of 128 cases of lymphoma patients admitted to Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, between April 2020 and November 2021 were included as research participants. The patients were randomly assigned to two groups: a 64-member control group and a 64-member observation group. The observation group received group management, while the control group received standard nursing care. Before and after the intervention, assessments were conducted to evaluate disease perception, fear of disease progression, nutritional status, and quality of life, with comparisons made between the two groups. Results: No clinically significant differences (P > .05) were observed between the two groups regarding gender, age, chemotherapy cycles, clinical stage, disease type, or other general characteristics. Disease awareness showed no significant disparity between groups pre-intervention (P > .05), but post-intervention, the observation group exhibited marked improvement (P < .05). Initially, fear of disease progression did not differ significantly between groups (P > .05), but post-intervention, the observation group demonstrated lower scores in total fear of disease progression, social, family, and physical health domains compared to the control group (P < .05). While nutritional status comparisons initially resulted in no significant differences (P > .05), levels of serum albumin, prealbumin, hemoglobin, lymphocytes, and ferritin were notably higher in the observation group post-intervention (P < .05). Quality of life assessments showed no significant disparity pre-intervention (P > .05); however, post-intervention, the observation group experienced significantly reduced dyspnea, insomnia, and appetite loss (P < .05). Conclusion: Participation in cohort management interventions benefits lymphoma patients by enhancing emotional coping and improving nutritional health and quality of life.

Sufficient condition for reliable logic operations in an over damped bistable system driven by Gaussian white noise.

In this paper, we investigate an overdamped bistable system subject to Gaussian white noise and logical inputs. By solving and estimating the steady distribution of the corresponding Fokker-Planck equation and considering the two essential features of the reliable logic operations (RLOs)-initial value independence and sign invariance-we establish the sufficient condition for RLO occurrence and identify parametric resonance phenomena in the system. Our numerical simulations confirm the reliability and accuracy of the theoretical results. This work offers insights into enhancing the accuracy of stochastic systems, particularly in the realm of logical stochastic resonance, thereby contributing to advancements in understanding and controlling stochastic dynamical systems.

Transcriptional activation of CSTB gene expression by transcription factor Sp3.

CSTB has been reported to be associated with the pathogenesis of many malignant tumors, especially hepatocellular carcinoma (HCC). However, how the expression of this gene is regulated is largely unknown. We initially cloned and analyzed the promoter region of the CSTB gene by luciferase assay and the Sp3 binding site (CCCCGCCCCGCG) was found in it. The results of electrophoretic mobility shift assay (EMSA) and chromatin immunoprecipitation (ChIP) experiments verified that the transcription factor, Sp3 could bind to the " CCCCGCCCCGCG ″ site of the CSTB gene promoter. We showed that the overexpression of Sp3 significantly increased the endogenous mRNA and protein expression levels of CSTB, whereas knockdown of Sp3 decreased the mRNA and protein expression levels according to quantitative real-time PCR (qRT‒PCR) and western blotting. In conclusion, CSTB gene expression is closely regulated by transcription factor Sp3, which may be a potential mechanism for the dysregulation of CSTB expression in HCC.

Astrocyte-Ablation of Mtnr1b Increases Anxiety-Like Behavior in Adult Male Mice.

BACKGROUND: Astrocytes are essential for synaptic transmission, and their dysfunction can result in neuropsychiatric disorders such as anxiety and depression. Many studies have shown that global knockout of Melatonin receptor 2 (Mtnr1b) is associated with the development of various mental disorders. AIM: This study aimed to investigate the effects of astrocyte ablation of Mtnr1b on cognitive function and anxiety-like behavior in mice, as well as the potential biological mechanisms. METHODS: A conditional Cre-loxP system allowing deletion of Mtnr1b from astrocytes was developed to investigate the specific role Mtnr1b. Control and Mtnr1b cKO𝐺𝑓𝑎𝑝 mice were selected for cognitive function behavioral testing (Morris water maze test, novel object recognition test) and emotion-related behavioral testing (open field, elevated plus maze). After testing, brain tissue was collected and examined by immunofluorescence for the expression of neuronal nuclei (NeuN), glutamate decarboxylase 67 (GAD67), and vesicular glutamate transporter 1 (vGluT1). RNA-seq was performed on hippocampal tissue from control and Mtnr1b cKO𝐺𝑓𝑎𝑝 mice to identify differentially expressed genes. Additional confirmation of differential gene expression was performed using real-time quantitative polymerase chain reaction (qRT-PCR). RESULTS: Mtnr1b cKO𝐺𝑓𝑎𝑝 mice were not significantly different from control mice in the Morris water maze and novel object recognition tests. Results from the open field and elevated plus maze tests showed that Mtnr1b cKO𝐺𝑓𝑎𝑝 mice exhibited significantly more anxiety-like behavior than did controls. Immunofluorescence revealed that the number of mature neurons did not differ significantly between Mtnr1b cKO𝐺𝑓𝑎𝑝 mice and controls. The expression of GAD67 in the hippocampal CA1 and CA3 areas of Mtnr1b cKO𝐺𝑓𝑎𝑝 mice was significantly lower than in the control group, but no significant difference was detected for vGluT1 expression. RNA-seq and qRT-PCR results showed that Mtnr1b knockout in astrocytes led to a decrease in the levels of gamma-aminobutyric acid sub-type A (GABAA) receptors and Kir2.2. CONCLUSIONS: The astrocyte-specific knockout in Mtnr1b cKO𝐺𝑓𝑎𝑝 mice results in anxiety-like behavior, which is caused by down-regulation of gamma-aminobutyric acid-ergic (GABAergic) synaptic function.

Psychological status is associated with the perceived illness stigma in Chinese systemic lupus erythematosus patients.

Systemic lupus erythematosus (SLE) might affect all aspects of life including perceived stigma, but research on perceived stigma is still in its infancy among SLE patients. The objective of this study was to assess the relationships among socioeconomic status, clinical parameters, disease activity, quality of life, depression, and the perceived stigma in Chinese patients with SLE. A total of 133 SLE patients (mean age: 39.36 ± 12.91 years) were included in this cross-sectional study. All data were collected consecutively by face-to-face questionnaires from January 2021 to January 2022. SLE patients completed questionnaires for demographic or clinical variables, the 10-cm Visual Analog Scale for pain, the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) for disease activity, the patient health questionnaire-9 (PHQ-9) for depression, the Perceived Devaluation Discrimination (PDD) Scale for the perceived stigma, and the Short Form 12 health survey (SF-12) for quality of life. Independent sample t-test, Spearman or Pearson correlations analysis, and the multivariable linear regression model were used to analyze these data. The mean PDD scale score in the SLE patients was 2.79 ± 0.33, which were statistically significant compared with the midpoint (2.50 ± 0.38) of the scale (P < 0.05). The perceived stigma was significantly correlated with income, pain, disease activity, depression, and quality of life. The SF-12 mental composite summaries (MCS) score and depression were the important predictors of the perceived stigma by the multivariable linear regression. This study demonstrates that psychological status is significantly associated with the perceived illness stigma in Chinese SLE patients; dealing with this stigma may be important in promoting optimal coping for these patients.

Mitochondrial DNA variant spectrum and the association with chronic tic disorders.

BACKGROUND AND PURPOSE: Tic disorders (TDs) are childhood onset neuropsychiatric disorders characterized by single or multiple sudden, rapid, recurrent, and motor tics and/or vocal tics. Several nuclear genes that are involved in mitochondrial functions suggest a potential role of mitochondria in TDs. METHODS: To evaluate the association of mitochondrial DNA (mtDNA) variants with TDs, we screened the whole mitochondrial genomes in 493 TD patients and 109 age- and sex-matched healthy controls using next generation sequencing technology. RESULTS: A total of 1918 mtDNA variants including 1220 variants in patients only, 154 variants in controls only, and 544 variants shared by both cases and controls were identified. We found a higher number of overall mtDNA variants in TD patients (p = 0.00028). The variant density in MT-ATP6/8 and MT-CYB coding regions showed a significant difference between TD patients and controls (p = 0.0025 and p = 0.003, respectively). Furthermore, we observed a significant association of 15 common variants with TD based on an additive model, including m.14766C > T, m.14783 T > C, m.14905G > A, and m.15301G > A in MT-CYB; m.4769A > G, m.10398A > G, m.12705C > T, and m.12850A > G in MT-ND genes; m.7028C > T in MT-CO1; m.8701A > G in MT-ATP6; two variants with m.16223C > T, m.5580 T > C in noncoding regions; and three rRNA variants with m.1438A > G and m.750A > G in RNR1, and m.2352 T > C in RNR2. CONCLUSIONS: Our data provide evidence of mtDNA variants associated with TDs. The accumulation of the heteroplasmic levels may increase the risk of TDs. Replication studies with larger samples are necessary to understand the pathogenesis of TDs.

Role of SIRT2 in regulating the dexamethasone-activated autophagy pathway in skeletal muscle atrophy.

The proteolytic autophagy system is involved in a major regulatory pathway in dexamethasone (Dex)-induced muscle atrophy. Sirtuin 2 (SIRT2) is known to modulate autophagy signaling, exerting effects in skeletal muscle atrophy. We examined the effects of SIRT2 on autophagy in Dex-induced myoatrophy. Tostudy this, mice were randomly distributed among the normal, Dex, and sirtinol groups. C2C12 cells were differentiated into myotubes and transduced with lentivirus carrying Sirt2-green fluorescent protein (GFP) or Sirt2 short hairpin RNA (Sirt2-shRNA)-GFP. To evaluate the mass and function of skeletal muscles, we measured myofiber cross-sectional area, myotube size, gastrocnemius (GA) muscle wet mass:body mass ratio (%), and time to exhaustion. The expression levels of SIRT2, myosin heavy chain, microtubule-associated protein 1 light chain 3 (LC3), and Beclin-1 were measured using Western blotting and quantitative reverse transcription - polymerase chain reaction. Inhibition of SIRT2 markedly attenuated GA muscle mass and endurance capacity. The same phenotype was observed in Sirt2-shRNA-treated myotubes, as evidenced by their decreased size. Conversely, overexpression of SIRT2 alleviated Dex-induced myoatrophy in vitro. Moreover, SIRT2 negatively regulated the expression of LC3b and Beclin-1 in skeletal muscles. These findings suggest that SIRT2 activation protects myotubes against Dex-induced atrophy through inhibition of the autophagy system; this phenomenon may serve as a target for treating glucocorticoid-induced myopathy.

The Validity of the GLIM Criteria for Malnutrition in Hospitalized Patients with Gastric Cancer.

BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) has recently proposed a consensus on the criteria to diagnose malnutrition. The validity of the new criteria to detect malnutrition is still being explored. Therefore, this study aimed to verify the validity of the GLIM criteria for malnutrition in hospitalized patients with gastric cancer (GC) using the Patient-Generated Subjective Global Assessment (PG-SGA) as a comparator. METHODS: This is a cross-sectional study involving 217 GC inpatients. Nutrition assessment was performed during their hospitalization with both the GLIM criteria and the PG-SGA. Consistency of the assessment results and their correlation with the quality of life in patients were evaluated. RESULTS: A moderate concordance (K = 0.483, P < 0.001) was founded between the two methods for malnutrition diagnosis. Spearman correlation analysis confirmed the significant association (P < 0.05) between most aspects of the quality of life and nutrition status regarding either the GLIM criteria or the PG-SGA. In multivariate linear regression, adjusted for confounding variables, the quality of life was significantly associated with nutrition status by the GLIM criteria (B = 5.63, 95% CI: 0.09-11.16, P = 0.046), and by the PG-SGA (B = 13.53, 95% CI: 7.78-19.27, P < 0.001). CONCLUSIONS: This study provides a new understanding of the validity of the GLIM criteria in hospitalized GC patients. In the study, we have found that the new GLIM criteria are of concurrent and clinical validity in GC inpatients, suggested by the comparison with the PG-SGA and its correlation with the quality of life.

CSTB accelerates the progression of hepatocellular carcinoma via the ERK/AKT/mTOR signaling pathway.

Hepatocellular carcinoma (HCC) is a significant contributor to global cancer-related deaths, leading to high mortality rates. However, the pathogenesis of HCC remains unclear. In this research, by the bioinformatics data analysis, we found that elevated CSTB expression correlated with advanced disease and predicted diminished overall survival (OS) in HCC patients. We subsequently verified the oncogenic role of CSTB as well as the potential underlying mechanisms in HCC through a series of in vitro experiments, such as CCK-8 assays, cloning assays, flow cytometry, Transwell assays, and western blotting. Our findings illustrated that the silencing of CSTB effectively suppressed cellular proliferation by inducing cell cycle arrest in the G2 phase and impaired HCC cell invasion and migration by stimulating epithelial-mesenchymal transition (EMT). Additionally, we analyzed the pathways enriched in HCC using RNA sequencing and found that the ERK/AKT/mTOR signaling pathway was related to increased CSTB expression in HCC. Finally, we confirmed the tumorigenic role of CSTB via in vivo experiments. Thus, our findings revealed that silencing CSTB inhibited the HCC progression via the ERK/AKT/mTOR signaling pathway, highlighting new perspectives for investigating the mechanisms of HCC.

Perceptions of utilizing a symptom self-management app for breast cancer patients receiving outpatient chemotherapy.

PURPOSE: Breast cancer (BC) patients who are undergoing outpatient chemotherapy encounter difficulties in symptom self-management at home. We have developed a mobile app with the support of self-regulation activities and nurse-led social service to empower self-management of BC patients during outpatient chemotherapy. The study aimed to explore the perceptions of breast cancer patients and nurses in utilizing an app with the functions of proactive nursing support and empowerment. METHODS: This is a qualitative study including group interviews with nurses and patients with breast cancer receiving outpatient chemotherapy. A total of eleven patients and five nurses were enrolled from August 2022 to October 2022. Thematic analysis was adopted to analyze the interview transcripts. Main themes and related sub-themes were drawn from the transcripts. RESULTS: Barriers (the lack of a contractual spirit) and facilitators (social support and native high-adherence) to app usage were identified. Following the six-week program, patients underwent various transformations such as improved health awareness and a tendency to pay more attention to psychological symptoms. This program also led to various changes in the nurses, including a transformation from taking the reactive emergency calls to a proactive approach of incorporating a self-regulation process and social support. CONCLUSIONS: The findings from the group interviews stressed the importance of integrating technology and nursing social support in facilitating patient symptom self-management.

Feasibility of a mobile health app-based self-management program for Chinese patients with breast cancer receiving chemotherapy: A randomized controlled pilot study.

Objective: There are currently an increasing number of mobile health (mHealth) programs offered to patients with breast cancer undergoing chemotherapy, but their rate of adherence to app usage has remained low. This study aimed to examine the feasibility of an mHealth app-based program such as the adherence rate of app usage and determine the preliminary effects on self-efficacy, quality of life, symptom burden and healthcare utilization in these patients. Methods: We conducted a randomized controlled pilot trial. Ninety-six participants were randomly allocated into either an intervention group or a control group (routine care plus a placebo app). The intervention group engaged in a 6-week self-regulation activity and received nurse-led social support via the app. The intention-to-treat principle was adopted. The generalized estimating equation was utilized to analyze the between-group, within-group and interaction effectiveness of this program. Results: Totally 96 participants were enrolled from 16 May to 23 August 2022. The average rate of adherence to app usage increased from 4.8% at week 3 to 51.2% at week 6. There was a statistically significant reduction in the physiological efficacy scores of the intervention (p < .001) and control groups (p < .001) at week 6, compared with the baseline. At week 6, the intervention group reported a significantly lower symptom burden (p = .042) and significantly better physical well-being than the control group (p = .024). Conclusions: It is feasible to perform an mHealth app-based self-management program for patients with breast cancer receiving chemotherapy. Nurses can utilize this program to facilitate patient self-management of symptoms during chemotherapy. Registration: Clinicaltrials.gov, https://clinicaltrials.gov, (NCT05192525).

Optimal timing for awake prone positioning in Covid-19 patients: Insights from an observational study from two centers.

BACKGROUND: The widespread application and interest in awake prone positioning stems from its ease and availability and its ability to enhance patients' oxygenation. Nevertheless, due to the absence of consensus over the regimen of awake prone positioning, the efficacy of awake prone positioning remains uncertain. OBJECTIVE: To explore the optimal regimen for awake prone positioning, including the timing of initiation, ideal daily duration, and strategies for improving patient comfort and encouraging adherence. DESIGN: Retrospective observational study. SETTING(S): Two university-affiliated hospitals in Shanghai. PARTICIPANTS: Between December 2022 and February 2023, a total of 475 patients with COVID-19-related pneumonia who received awake prone positioning were observed. METHODS: The data were collected from the hospital's electronic medical record system. The differentiation efficiency of peripheral blood oxygen saturation [SpO2]:fractional oxygen concentration in inspired air [FiO2] ratio at first awake prone positioning for different outcomes was tested by the area under the receiver operating characteristic curve. The Cox proportional hazard regression model was used to analyze the relationship between time to occurrence of 28-day outcomes and collected variables. Kaplan-Meier curves were plotted with the percentage of 28-day outcomes according to the SpO2:FiO2 ratio at first awake prone positioning after controlling covariates through Cox regression. RESULTS: The best efficiency in predicting patient outcomes was achieved when the cutoff SpO2:FiO2 ratio at first awake prone positioning was 200. Patients with a reduced SpO2:FiO2 ratio (≤200) experienced more adverse respiratory outcomes (RR = 5.42, 95%CI [3.35, 8.76], p < 0·001) and higher mortality (RR = 16.64, 95%CI [5.53, 50.13], p < 0.001). Patients with a SpO2:FiO2 ratio of ≥200 at first awake prone positioning, longer duration between first awake prone positioning and admission, more awake prone positioning days, and better awake prone positioning completion were significantly protected from 28-day adverse respiratory outcomes and mortality. CONCLUSIONS: Initiating awake prone positioning with a SpO2:FiO2 ratio exceeding 200, increasing the number of awake prone positioning days, prolonging the time between first awake prone positioning and admission, and achieving better completion of awake prone positioning were found to be significantly associated with reduced adverse respiratory outcomes and mortality. REGISTRATION: ClinicalTrials.gov; No.: NCT05795751; URL: www. CLINICALTRIALS: gov.

Determinants of Depressive Symptoms Among Patients with Rheumatoid Arthritis in China: A Structural Equation Model.

Background: This study aimed to examine how personality traits, social support and clinical features including pain, disease activity, functional status, sleep quality, and fatigue influence on depressive symptoms in Chinese rheumatoid arthritis (RA) patients. Methods: This study was conducted from November, 2022 to June, 2023 among Chinese RA patients. Pain, disease activity, functional status, sleep quality, fatigue, social support, personality traits, and depressive symptoms were assessed. The following relationships among three hypotheses were analyzed by structural equation model (SEM): H1: clinical features have a direct effect on depressive symptoms; H2: personality traits might work as a mediator between clinical features and depression; H3: social support is related to depressive symptoms, being a direct effect or an indirect effect through clinical features or personality traits. Results: The final model including 326 RA patients presented a good fit (χ2=103, χ2/df=1.69; GFI=0.96; AGFI=0.93; CFI=0.97; TLI=0.96; RMSEA=0.046). Clinical features had a total effect of 0.59 on depressive symptoms, of which ß=0.33 (P=0.013) was an indirect effect through personality traits, indicating a mediating influence between this relationship; moreover, there was a significant direct association between clinical features and depressive symptoms (ß=0.26; P=0.022). Personality traits (ß=-0.65; P<0.001) had a much stronger relation with depressive symptoms than with clinical features. Social support had a total effect of 0.81 on personality traits, being a direct effect of ß=0.52 (P<0.001) and an indirect effect of ß=0.29 (P<0.001) through clinical features. The final proposed model explained 77% of the variance of depressive symptoms. Conclusion: Personality traits had a considerable influence upon depressive symptoms, while social support seemed to have a major effect on personality traits. It is necessary to apply comprehensive assessment and interventions of patients' personality traits, clinical features, as well as social support, which could optimize their mental health.

Network analysis of depression and anxiety symptoms in Chinese rheumatoid arthritis patients.

Background: Rheumatoid arthritis (RA) patients are susceptible to comorbid anxiety and depression. From the network model perspective, comorbidity is due to direct interactions between depression and anxiety symptoms. The objective of this study was to assess the network structure of depression and anxiety symptoms in Chinese RA patients and identify the central and bridge symptoms as well as how depression and anxiety symptoms are related to quality of life (QoL) in the network. Methods: A total of 402 Chinese RA patients were included in this study. Depression and anxiety symptoms were measured by the Hospital Anxiety and Depression Scale (HADS). R software was used to estimate the network. Specifically, we computed the predictability, expected influence (EI) and bridge expected influence (BEI) for each symptom and showed a flow network of "QoL". Results: Our network revealed that the strongest edge was D2 "See the bad side of things" and D3 "Not feeling cheerful" across the whole network. For centrality indices, D3 "Not feeling cheerful" and D6 "Feeling down" had the highest EI values in the network, while A4 "Trouble relaxing" and D6 "Feeling down" had the highest BEI values of their respective community. As to "QoL", the strongest direct edge related to it was A1 "Nervousness". Conclusions: "Feeling down" and "Not feeling cheerful" emerged as the strongest central symptoms, while "Trouble relaxing" and "Feeling down" were bridge symptoms in the anxiety-depression network of RA patients. Intervention on depression and anxiety symptoms in nurses should prioritize these symptoms.

The mechanism of LZ-8-mediated immune response in the mouse model of Parkinson's disease.

Parkinson's disease (PD) is associated with microscopic changes in the brain, particularly substantia nigra (SN). Ganoderma lucidum immunoregulatory protein (rLZ-8) is might confer protective effects against PD. We developed a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced murine model of PD and determined the effects of rLZ-8 on molecular and cellular components of SN and whole brain tissue. The levels of SOD, GSH-Px, p-JAK2 and p-STAT3 in the brain tissue and SN were downregulated, while IL-6, IL-1ß, and TNF-α and MDA were upregulated. These effects were significantly reversed upon treatment rLZ-8. In summary, oxidative stress and inflammatory response in PD can be alleviated using rLZ-8.

Application of artificial intelligence in glioma researches: A bibliometric analysis.

Background: There have been no researches assessing the research trends of the application of artificial intelligence in glioma researches with bibliometric methods. Purpose: The aim of the study is to assess the research trends of the application of artificial intelligence in glioma researches with bibliometric analysis. Methods: Documents were retrieved from web of science between 1996 and 2022. The bibliometrix package from Rstudio was applied for data analysis and plotting. Results: A total of 1081 documents were retrieved from web of science between 1996 and 2022. The annual growth rate was 30.47%. The top 5 most productive countries were the USA, China, Germany, France, and UK. The USA and China have the strongest international cooperative link. Machine learning, deep learning, radiomics, and radiogenomics have been the key words and trend topics. "Neuro-Oncology", "Frontiers in Oncology", and "Cancers" have been the top 3 most relevant journals. The top 3 most relevant institutions were University of Pennsylvania, Capital Medical University, and Fudan University. Conclusions: With the growth of publications concerning the application of artificial intelligence in glioma researches, bibliometric analysis help researchers to get access to the international academic collaborations and trend topics in the research field.

Regulation of the Human IL-10RB Gene Expression by Sp8 and Sp9.

BACKGROUND: Interleukin-10 (IL-10) is a classic anti-inflammatory cytokine that exerts its effects via the receptor complexes IL-10RA and IL-10RB. Loss of IL-10RB results in many diseases. Moreover, IL-10RB is closely associated with neuronal survival and synaptic formation. However, the regulation of IL-10RB gene expression remains elusive. OBJECTIVE: To investigate whether the expression of IL-10RB gene is increased in brain of Alzheimer's disease (AD) and its transcriptional regulation. METHODS: We examined the gene expression of AD patient brain from public database and detected the protein expression of AD model mouse brain by western blot. We constructed a variety of reporter gene plasmids with different lengths or mutation sites, tested the promoter activity and defined the functional region of the promoter with the luciferase reporter assay. The protein-DNA binding between transcription factors and the promoter was analyzed using chromatin immunoprecipitation (ChIP) and electrophoretic mobility shift assay (EMSA). RESULTS: We found that the IL-10RB is elevated in the brain of AD patient and AD model mice. The minimal promoter of the IL-10RB gene is located in the -90 to +51 bp region (relative to the transcriptional start site) and is sufficient for high-level expression of the IL-10RB gene. Transcription factors Sp8 and Sp9 bind to the IL-10RB promoter in vitro. The overexpression or knockdown of Sp8 and Sp9 affected the IL-10RB promoter activity and its gene expression. CONCLUSION: Our study functionally characterized the promoter of the IL-10RB gene and demonstrated that Sp8 and Sp9 regulated its expression.

Development and Application of Global Health Events-Mental Stress Scale for Assessment of Medical Staff's Acute Mental Stress Responses.

Background: Medical workers have been increasingly involved in emergent public health events, which can lead to severe stress. However, no standardized, officially recognized, unified tool exists for mental distress measurement in medical workers who experienced the public health events. Purpose: In the present study, we propose the Global Health Events-Mental Stress Scale (GHE-MSS), as a revised version of the Impact of Event Scale-Revision (IES-R), for assessment of medical workers' acute mental stress responses within one month and their chronic mental stress responses within six months after major health events. Patients and methods: The IES-R was slightly modified, developed, and its reliability and validity were tested using the Delphi survey, primary survey with 115 participants, formal survey with 300 participants, and clinical evaluation with 566 participants. Results: Exploratory factor analysis and confirmatory factor analysis confirmed a promising validity of the scale. The values of Cronbach's alpha coefficient, the Spearman-Brown coefficient, and the retested Cronbach's alpha coefficient of the scale applied for the clinical evaluation were 0.88, 0.87, and 0.98, respectively, which confirmed a good internal consistency and stability. The results of the goodness-of-fit test indicated a good adaptation of the model. A correlation analysis was conducted to assess the correlation between the GHE-MSS and the PCL-C, which had a correlation coefficient of 0.68 (P<0.01). Conclusion: GHE-MSS can be applied with a promising reliability and validity for the assessment of the acute mental stress response of medical workers experiencing public health events. This method can also be used for the screening of mental stress-associated disorders.

Changes of Cytokines in Children With Tic Disorder.

Tic disorder (TD) is a common childhood-onset disease associated with abnormal development of brain networks involved in the motor and sensory processing. The underlying pathophysiological mechanisms in TD are still unclear. An involvement of immune mechanisms in its pathophysiology has been proposed. This study investigates the association between the changes of cytokines and the etiology and development of TD. Different expressions of cytokines in a larger number of samples in our study may provide new insights to the field. The levels of cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ) were evaluated in 1,724 patients who were clinically diagnosed with TD from 1 to 17.5 years old and 550 were from 6 months to 14.5 years old in the control group. We assessed the levels of cytokines according to the patient's medication status and the severity of the disease. Of the cytokines we investigated, the serum IL-6 concentration of children with TD was significantly higher than that of the control group, while the levels of other cytokines were lower in TD patients. In the patient group whose YTGSS score ranged from 1 to 9, the IL-4, IL-10, and IFN-γ levels increased in medication group compared to unmedication group. Our data suggested that the cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ) may play an important role in the etiology and the severity in TD. Whether drug intervention in the early stage of tic disorder has a better effect on children needs further research.

Depression has an impact on disease activity and health-related quality of life in rheumatoid arthritis: A systematic review and meta-analysis.

OBJECTIVE: The aim of this study was to explore the impact of depression on pain, disease activity, functional disability and quality of life in patients with rheumatoid arthritis (RA). METHODS: English (PubMed, the Cochrane Library, Web of Science and PsycINFO) and Chinese (Wan Fang Database and Chinese National Knowledge Infrastructure) databases were systematically and independently searched from their inception until 30 September, 2019. Studies evaluating the impact of depression on pain, disease activity, functional disability and quality of life with the use of the Short Form-36 questionnaire (SF-36) scoring system were included. Statistical analyses were performed with Revman5.3. Data were pooled using a fixed or random-effects model according to heterogeneity. RESULTS: A total of 7 identified studies matched the inclusion criteria, reporting on a total of 1078 patients with RA in the analysis. The total Disease Activity Score in 28 joints was significantly higher in patients with depression than in patients without depression [standardized mean difference (SMD) =0.47, 95% CI 0.10-0.85, P = .01]. All SF-36 dimensions (physical function, role physical function, emotional role function, vitality, mental health, social function, body pain, general health, physical component scale, mental component scale) were lower in patients with depression than in groups without depression. Interestingly, the results of this meta-analysis showed no significant difference between patients with and without depression in pain (SMD = 0.57, 95% CI - 0.03-1.17, P = .06) and functional disability (SMD = 0.48, 95% CI - 0.03-0.99, P = .43). CONCLUSION: This meta-analysis showed that RA patients with depression tended to have higher disease activity and lower quality of life than patients without depression.