Exploring the roles of fear and powerlessness in the relationship between perceived risk of the COVID-19 pandemic and information-avoidance behavior.

The COVID-19 has seriously impacted various aspects of the society on a global scale. However, it is still unclear how perceived risk influences epidemic information-avoidance behavior which generally helps us understand public information avoidance. This study aimed to assess the relationship between the perceived epidemic risk and information-avoidance behavior and the mediating role of fear and powerlessness during the COVID-19 pandemic in China. A total of 557 Chinese respondents with COVID-19 treated in modular hospitals ranging from 16 to 72 years old were recruited and completed questionnaires in the face-to-face manner containing scales of the perceived epidemic risk of COVID-19, fear, powerlessness, and information-avoidance behavior. To test the conceptual model, we adopted structural equation modeling (SEM) with the perceived risk of the COVID-19 pandemic as a predictor, fear and powerlessness as mediating variables, and information-avoidance behavior as the outcome. The results indicated a significant and positive association between the perceived epidemic risk of COVID-19 and information-avoidance behavior. Powerlessness acted as the mediator between the perceived epidemic risk of COVID-19 and information-avoidance behavior. The perceived epidemic risk of COVID-19 influenced information-avoidance behavior through fear and powerlessness in turn. Findings from this study implied that public health managers should consider the mediating roles of negative emotions such as fear and powerlessness for coping with behaviors in public health emergencies, especially the information avoidance behaviors related to risk perception.

Money priming enhances sensitivity to the outcome feedback of decision-making under uncertainty: Evidence from an ERP study.

Money is the most common medium of exchange and plays an important role in our daily life. However, current literature has not yet specifically touched on the influence of money priming on decision-making behaviour under uncertainty and related neural mechanisms. In this study, we used event-related potentials with an adapted version of the Balloon Analogue Risk Task (BART) paradigm to examine brain activity related to the effects of money priming on outcome evaluation in decision-making under uncertainty. Reward positivity (RewP) and P300 components were analysed with respect to feedback valence (win vs. loss) and priming condition (money vs. neutral). The ERP results demonstrated that when individuals made decisions after having been primed with the monetary concept, the positive outcome feedback evoked a larger RewP component than after they had been primed with neutral stimuli. Conversely, there was no significant money priming effect when the outcome feedback was negative. In contrast, when individuals made decisions after having been primed with the monetary concept, the negative outcome feedback evoked a larger P300 than after they had been primed with neutral stimuli, whereas there was no significant money priming effect when the outcome feedback was positive. Our findings, thus, indicate that the brain response to money priming effects on the outcome evaluation in the BART occurs at both an early semi-automatic processing stage and a later cognitive appraisal stage. They further suggest that individuals prefer achieving financial gains at first and then focus on preventing financial losses in the money priming condition relative to the neutral priming condition.

Effects of rhEPO on Nrf2 and HO-1 expression in rats with acute kidney injury and its protective effects on kidney.

If the kidney suddenly loses its ability to remove waste, acute kidney injury (AKI) will occur that dangerous levels of waste may accumulate, and the chemical composition of the blood may become unbalanced. AKI usually develops rapidly within a few days and is very common in hospitalized patients, especially those in urgent need of intensive care. AKI can be fatal and requires serious treatment. However, it can be reversible. The purpose of this research was to investigate the effects of recombinant human erythropoietin (rhEPO) on the expression of nuclear factor E2-related factor 2 (Nuclear factor E2, Nrf2) and Heme oxygenase (HO-1) in rats AKI and its protective effects on the kidney. For this purpose, 40 SD rats were averagely and randomly divided into 4 groups: control group, sham operation group, model group, and rhEPO group. The rhEPO group was injected with 5% glucose mixed with rhEPO to form 3000 IU/ (kg/d) rhEPO. Except for the rhEPO group, three groups were injected with 5% glucose at the same dose level as the rhEPO group respectively. Before the third administration, the renal pedicle was clamped for 60 min and then perfused for 24 hours. Changes of Serum creatinine (Scr) and Urea nitrogen (BUN) of rats in each group were detected before and after modeling. Twenty-four hours after modeling, renal tissues of rats in each group were taken, and expressions of Nrf2 and HO-1 in renal tissues were detected by qRT-PCR and Western blot methods. There were no significant differences in Scr and BUN contents in the four groups before modeling (p> 0.05). There were no significant differences in Scr and BUN contents in the control group and sham operation group after modeling compared with those before modeling (p> 0.05). Expressions of Nrf2 and HO-1 in the rhEPO group were higher than those in the model group, the sham operation group and the control group (p< 0.05), while expressions of Nrf2 and HO-1 in model group were higher than those in sham operation group and control group (p< 0.05). There were no significant differences in expressions of Nrf2 and HO-1 between the sham operation group and the control group (p> 0.05). rhEPO can induce expressions of Nrf2 and HO-1 in AKI rats. RhEPO has a protective effect on the kidney, which may be related to expressions of Nrf2 and HO-1.

Effect of GM6001 on the expression of syndecan-1 in rats with acute kidney injury and its protective effect on the kidneys.

Expression of syndecan-1 (SDC-1) in rats with acute kidney injury and the protective effect of GM6001 on the kidney were investigated. Fifty SD rats were selected and randomly divided into control group (CG) (n=15), treatment control group (TCG) (n=10), module group (MG) (n=15) and treatment group (TG) (n=10). In TG, the model of acute renal injury (AKI) in rats was established after pretreatment of intraperitoneal injection of GM6001 one day before modeling. In MG, the same amount of saline was injected intraperitoneally one day before modeling and the same treatment was done on the day of modeling. In CG, the same amount of saline was injected intraperitoneally one day before modeling but the model was not made. In TCG, rats were pretreated with intraperitoneal injection of GM6001 one day before modeling but the model was not made. The contents of blood urea nitrogen (BUN) in serum, serum creatinine (SCR), uric acid (UA) and blood ß2-microglobulin (ß2-MG) were detected by ELISA. The content of SDC-1 in renal tissues was detected by qRT-PCR and western blotting. Expression of SDC-1 in renal tissue of 24 rats after modeling was lower than that of MG (P<0.050). SDC-1 expression was the highest in TG (P<0.05). Compared with before modeling, the contents of BUN, SCR, UA and ß2-MG in MG and TG increased (P<0.05). After modeling, the contents of serum BUN, SCR, UA and ß2-MG in TG were significantly lower than those in MG (P<0.05). The levels of SDC-1 in renal tissue of rats with acute kidney injury increased. After GM6001 treatment, SDC-1 levels can be improved and has a certain protective effect on the kidneys.

Circulating endothelial cells and chronic kidney disease.

Endothelial dysfunction may play a crucial role in initiation of the pathogenesis of vascular disease and atherosclerosis. The identification and quantification of circulating endothelial cells (CEC) have been developed as a novel marker of endothelial function. We describe, in great detail, mechanisms of endothelial dysfunction and CEC detachment. We also review the relationship between numbers of CEC and disease severity and response to treatment. In addition, we describe the possible clinical use of CEC in chronic kidney disease (CKD) and kidney transplantation. In summary, CEC have been developed as a novel approach to assess the endothelial damage. Measurement of the CEC level would provide an important diagnostic and prognostic value on the endothelium status and the long-term outcome of vascular dysfunction.

Association between circulating endothelial cells and carotid atherosclerosis in patients receiving maintenance hemodialysis.

Accelerated atherosclerosis is the major cause of mortality in maintenance hemodialysis (MHD) patients, and endothelial injury associated with MHD might contribute strongly to pathogenesis. The current study was designed to explore possible associations between circulating endothelial cells (CECs) and intima-media thickness of common carotid artery (CCA-IMT) as an indicator of carotid atherosclerosis. Sixty-two MHD patients and 26 age- and sex-matched healthy volunteers were recruited. The number of CECs was determined in peripheral blood using multiparametric flow cytometry. CCA-IMT and presence of plaques in the common carotid arteries were assessed with ultrasound. Laboratory tests results and the demographics were recorded. The finding indicated that numbers of CECs were higher in patients before hemodialysis (predialysis) compared with numbers in controls (P = 0.045). CCA-IMT was also significantly higher in patients than in controls (P < 0.01). A positive relationship was observed between predialysis CECs numbers and CCA-IMT (P < 0.01) in MHD patients. In multiple linear regression analysis, the relationship between the predialysis CECs level and CCA-IMT remained the same even if adjusting for confounding effects. Accordingly, the investigation indicates that the CECs level is positively associated with CCA-IMT in our hemodialysis patients. CECs might be an important marker to the severity of carotid atherosclerosis in MHD patients.

Cross-over study of influence of oral vitamin C supplementation on inflammatory status in maintenance hemodialysis patients.

BACKGROUND: Both vitamin C deficiency and inflammation are prevalent in maintenance hemodialysis (MHD) patients. In this study, we aimed to elucidate the effect of oral vitamin C supplementation on inflammatory status in MHD patients with low vitamin C level and high hypersensitive C-reactive protein (hs-CRP) level. METHODS: A total of 128 patients were recruited in our present study. Patients were divided into two groups. In group 1 (n = 67), patients were orally administered with 200 mg/day vitamin C in the first 3 months, and then the vitamin C supplementation was withdrawn in the next 3 months. In group 2 (n = 61), patients were not given vitamin C in the first 3 months, and then they were orally administered with 200 mg/day in the next 3 months. Levels of hs-CRP, prealbumin, albumin and hemoglobin as well as the EPO resistance index (ERI) were determined at the baseline and every 3 months throughout the study. Plasma vitamin C level was determined by high-performance liquid chromatography with UV detection. RESULTS: Among the 128 patients, 28 of them dropped out of the study before completion. Consequently, a total of 100 patients (group 1: n = 48; group 2: n = 52) were included in the final analysis. At the baseline, the plasma vitamin C level of all patients was less than 4 µg/mL. However, this proportion was decreased to 20% after the vitamin C supplementation for 3 months. Compared with patients without the vitamin C supplementation, a decreased level of hs-CRP and an increased level of prealbumin were induced by the vitamin C supplementation for 3 months in both groups. However, levels of these biomarkers returned to their original state after the supplementation was withdrawn. Same beneficial effects on plasma albumin, hemoglobin and ERI response to vitamin C supplementation were observed in the two groups without statistical significance. CONCLUSIONS: The inflammatory status in MHD patients with plasma vitamin C deficiency and high levels of inflammatory markers could be partially improved by long-term oral administration of small doses of vitamin C. TRIAL REGISTRATION: The clinical trial number: NCT01356433.

Association between vitamin C deficiency and dialysis modalities.

AIM: We designed a cross-sectional study to investigate plasma vitamin C level in patients who underwent maintenance haemodialysis (MHD) and continuous ambulatory peritoneal dialysis (CAPD) to explore whether there is a difference in vitamin C deficiency between MHD patients and CAPD patients. METHODS: This investigation included 382 dialysis patients without vitamin C supplement before the study. Demographic characteristics, laboratory tests, ascorbic acid and total plasma vitamin C level were measured. A linear regression model was built to explore the association between vitamin C deficiency and dialysis modalities after adjusting for age, dialysis vintage, gender, Charlson index, modality of dialysis and hsCRP. RESULTS: The range of plasma vitamin C level was from 0.48 µg/mL to 31.16 µg/mL. 35.9% (n = 137) patients had severe vitamin C deficiency (<2 µg/mL). Plasma vitamin C level was inversely associated with age and dialysis vintage. After age and dialysis vintage were adjusted, vitamin C deficiency was associated with MHD. R square for model fitting was relatively low, which implied that there were other vitamin C influencing factors not included in the model. CONCLUSIONS: Vitamin C deficiency is common in dialysis patients, especially in patients treated with MHD.

Low levels of vitamin C in dialysis patients is associated with decreased prealbumin and increased C-reactive protein.

BACKGROUND: Subclinical inflammation is a common phenomenon in patients on either continuous ambulatory peritoneal dialysis (CAPD) or maintenance hemodialysis (MHD). We hypothesized that vitamin C had anti-inflammation effect because of its electron offering ability. The current study was designed to test the relationship of plasma vitamin C level and some inflammatory markers. METHODS: In this cross-sectional study, 284 dialysis patients were recruited, including 117 MHD and 167 CAPD patients. The demographics were recorded. Plasma vitamin C was measured by high-performance liquid chromatography. And we also measured body mass index (BMI, calculated as weight/height(2)), Kt/V, serum albumin, serum prealbumin, high-sensitivity C-reactive protein (hsCRP), ferritin, hemoglobin. The relationships between vitamin C and albumin, pre-albumin and hsCRP levels were tested by Spearman correlation analysis and multiple regression analysis. Patients were classified into three subgroups by vitamin C level according to previous recommendation 12 in MHD and CAPD patients respectively: group A: < 2 ug/ml (< 11.4 umol/l, deficiency), group B: 2-4 ug/ml (11.4-22.8 umol/l, insufficiency) and group C: > 4 ug/ml (> 22.8 umol/l, normal and above). RESULTS: Patients showed a widely distribution of plasma vitamin C levels in the total 284 dialysis patients. Vitamin C deficiency (< 2 ug/ml) was present in 95(33.45%) and insufficiency (2-4 ug/ml) in 88(30.99%). 73(25.70%) patients had plasma vitamin C levels within normal range (4-14 ug/ml) and 28(9.86%) at higher than normal levels (> 14 ug/ml). The similar proportion of different vitamin C levels was found in both MHD and CAPD groups. Plasma vitamin C level was inversely associated with hsCRP concentration (Spearman r = -0.201, P = 0.001) and positively associated with prealbumin (Spearman r = 0.268, P < 0.001), albumin levels (Spearman r = 0.161, P = 0.007). In multiple linear regression analysis, plasma vitamin C level was inversely associated with log(10)hsCRP (P = 0.048) and positively with prealbumin levels (P = 0.002) adjusted for gender, age, diabetes, modality of dialysis and some other confounding effects. CONCLUSIONS: The investigation indicates that vitamin C deficiency is common in both MHD patients and CAPD patients. Plasma vitamin C level is positively associated with serum prealbumin level and negatively associated with hsCRP level in both groups. Vitamin C deficiency may play an important role in the increased inflammatory status in dialysis patients. Further studies are needed to determine whether inflammatory status in dialysis patients can be improved by using vitamin C supplements.