Effects of interventions for enhancing resilience in cancer patients: A systematic review and network meta-analysis.

BACKGROUND: Various interventions appear to enhance cancer patients' resilience. However, the best intervention options are still unknown. This systematic review and network meta-analysis aimed to examine the impact of different interventions on resilience and identify the most effective interventions. METHODS: Nine major English and Chinese databases were systematically retrieved for randomized controlled trials (RCTs) published from inception to 13 November 2023. The outcome was resilience. The analysis was conducted using Software Review Manager 5.4, R 4.2.3, and STATA 14.0. RESULTS: The network meta-analysis included 32 RCTs and evaluated 12 interventions. Regarding effectiveness, compared to routine care, the relative effect sizes of attention and interpretation therapy, cyclic adjustment training, cognitive intervention, expressive therapy, positive psychological intervention, social support intervention, and work-environment therapy had statistically significant enhancing resilience, with the SMD (95%CI) of 1.42 (0.75, 2.07), 1.97 (0.76, 3.18), 1.26 (0.76, 1.77), 0.93 (0.08, 1.78), 1.02 (0.55, 1.50), 1.01 (0.48, 1.56), 1.65 (0.94, 2.37), respectively. Considering the rank probability, statistical power, and efficacy, the most effective interventions for improving resilience were attention and interpretation therapy, cognitive intervention, and positive psychological intervention. With the limited quantity of RCTs, the effectiveness of cyclic adjustment training and work-environment therapy still needs to be explored. CONCLUSIONS: Attention and interpretation therapy was the first best choice for boosting resilience out of the 12 interventions. Cognitive intervention and positive psychological intervention were also better choices for improving cancer patients' resilience. Due to the low quality and quantity of included RCTs, the need for multi-center, higher-quality trials with larger samples should be carried out. PROSPERO ID: CRD42023434223. The study did not receive funding support.

Microglial P2Y12 Signaling Contributes to Cisplatin-induced Pain Hypersensitivity via IL-18-mediated Central Sensitization in the Spinal Cord.

Administration of cisplatin and other chemotherapy drugs is crucial for treating tumors. However, cisplatin-induced pain hypersensitivity is still a critical clinical issue, and the underlying molecular mechanisms have remained unresolved to date. In this study, we found that repeated cisplatin treatments remarkedly upregulated the P2Y12 expression in the spinal cord. Expression of P2Y12 was predominant in the microglia. Pharmacological inhibition of P2Y12 expression markedly attenuated the cisplatin-induced pain hypersensitivity. Meanwhile, blocking the P2Y12 signal also suppressed cisplatin-induced microglia hyperactivity. Furthermore, the microglia Src family kinase/p38 pathway is required for P2Y12-mediated cisplatin-induced pain hypersensitivity via the proinflammatory cytokine IL-18 production in the spinal cord. Blocking the P2Y12/IL-18 signaling pathway reversed cisplatin-induced pain hypersensitivity, as well as activation of N-methyl-D-aspartate receptor and subsequent Ca2+-dependent signals. Collectively, our data suggest that microglia P2Y12-SFK-p38 signaling contributes to cisplatin-induced pain hypersensitivity via IL-18-mediated central sensitization in the spinal, and P2Y12 could be a potential target for intervention to prevent chemotherapy-induced pain hypersensitivity. PERSPECTIVE: Our work identified that P2Y12/IL-18 played a critical role in cisplatin-induced pain hypersensitivity. This work suggests that P2Y12/IL-18 signaling may be a useful strategy for the treatment of chemotherapy-induced pain hypersensitivity.

A study of character strengths, work engagement and subjective well-being in Chinese registered nurses.

BACKGROUND: Nurses displayed low levels of subjective well-being and high turnover intention. How to enhance the subjective well-being and decrease the turnover rate of nurses is of great importance. However, little is known about whether work engagement mediates between character strengths and subjective well-being. The study aims to explore character strengths, work engagement and subjective well-being in nurses, and to determine whether work engagement plays a mediating role between the relationship. MATERIAL AND METHODS: From December 2017 to December 2018, 450 Chinese registered nurses completed the character strengths scale, work engagement scale, and subjective well-being scale. The relationship between study variables was tested by Pearson correlation. The mediating effect of work engagement was tested by the bootstrap method. RESULTS: The results indicated the following: (1) the 4 elements of character strengths and work engagement were significantly and positively correlated with subjective well-being; (2) character strengths could significantly predict both work engagement and subjective well-being; (3) work engagement played a mediating role in this relationship. CONCLUSIONS: Character strengths affect subjective well-being in Chinese registered nurses, and work engagement plays a mediating variable among the relations. Therefore, nurses are encouraged to foster their character strengths and improve their level of work engagement for their subjective well-being. Following the results, the study recommends that nursing managers be aware of the importance of using character strengths in nursing work, taking actions to excavate nurses' character strengths and encouraging nurses to use character strengths in clinical work to promote engagement and well-being. In the meantime, interventions to improve the level of subjective well-being based on nurses' character strengths should be considered. Med Pr. 2022;73(4):295-304.

Stem Cell Therapy for Neuropathic Pain: A Bibliometric and Visual Analysis.

Purpose: Neuropathic pain is intractable and current treatment modalities are ineffective to cure this intractable pain, which has become a global problem. In recent years, there have been an increasing number of studies on stem cell therapy for neuropathic pain that have shown enormous potential. Using a visual analysis approach of the existing literature on stem cell therapy for neuropathic pain, we hope to understand the current research status and hot issues in this field and to provide valuable predictions for future research in this field. Methods: We used Citespace software to visually analyze 291 articles and reviews indexed by the Web of Science Core Collection Database exploring stem cell-based treatment of neuropathic pain from 1995 to 2021. The Gunnmap online world map evaluated the number of countries and regional articles separately. Microsoft Excel 2016 was used to generate a graph of trends in annual publications. Results: Visualization analysis revealed that the number of publications has increased yearly. The top three countries in terms of number of articles published are United States, China, and Japan. Analysis of highly co-cited articles revealed that the contents of these articles primarily involved the expression of IL-1ß, IL-10, NPY, TRPA1, p-p38, p-ERK1/2, TGF-ß, PKCδ, CaMKIIɑ, P2X4, P2X7 and TNF-ɑ. Keywords and citation burst analysis demonstrated that activation, regeneration, chemotherapy, and expression are likely the research hotspots and future directions of stem cell research in neuropathic pain. Conclusion: Stem cell therapy may be a potential means of future treatment of neuropathic pain. The study of the mechanisms underlying stem cell therapy for neuropathic pain is still a focus of future research.

Relationship between cervical angle and temporomandibular disorders in young and middle-aged population.

OBJECTIVE: To verify temporomandibular disorders (TMDs) and cervical angles in a young and middle-aged population. METHODS: Ninety participants were included, 45 of whom had TMDs. The participants were diagnosed according to the Research Diagnostic Criteria for TMDs. Lateral cervical radiographs were taken, and relevant cervical angles were measured. The general characteristics of the TMD group and control group were analyzed using chi-square analysis, and the relationship between cervical angles and TMDs was evaluated using the unpaired t-test. RESULTS: The decrease in C2-C7 Cobb and increase in the posterior occipitocervical angle (POCA) were associated with the incidence of TMDs (p < 0.0001). CONCLUSION: This study revealed that the cervical angle was related to TMDs. People with a long-time habit of head bending posture had a decrease in C2-C7 Cobb and an increase in the POCA. This group of people was more likely to develop TMDs.

Vascular endothelial growth factor-A/vascular endothelial growth factor2 signaling in spinal neurons contributes to bone cancer pain.

Tumor metastasis to bone is often accompanied by a severe pain syndrome (cancer-induced bone pain, CIBP) that is frequently unresponsive to analgesics, which markedly reduces patient quality of life and cancer treatment tolerance in patients. Prolonged pain can induce hypersensitivity via spinal plasticity, and several recent studies have implicated the involvement of vascular endothelial growth factor-A (VEGF-A) signaling in this process. Here, we speculated that CIBP is associated with VEGF-A/VEGFR2 signaling in the spinal cord. A mouse model of CIBP was established by intramedullary injection of Lewis lung carcinoma (LLC) cells in the mouse femur. Pain sensitization and potential amelioration via VEGF-A/VEGFR2 blockade were measured using paw withdrawal threshold to mechanical stimulation and paw withdrawal latency to thermal. Spinal VEGF-A/VEGFR2 signaling was blocked by intrathecal injection of the VEGF-A antibody or the specific VEGFR2 inhibitor ZM323881. Changes in the expression levels of VEGF-A, VEGFR2, and other pain-related signaling factors were measured using western blotting and immunofluorescence staining. Mice after LLC injection demonstrated mechanical allodynia and thermal hyperalgesia, both of which were suppressed via anti-VEGF-A antibody or ZM323881. Conversely, the intrathecal injection of exogenous VEGF-A was sufficient to cause pain hypersensitivity in naïve mice via the VEGFR2-mediated activation of protein kinase C. Moreover, the spinal blockade of VEGF-A or VEGFR2 also suppressed N-methyl-D-aspartate receptor (NMDAR) activation and downstream Ca2+-dependent signaling. Thus, spinal VEGF-A/VEGFR2/NMDAR signaling pathways may be critical mediators of CIBP.

Back propagation neural network model for medical expenses in patients with breast cancer.

OBJECTIVE: Breast cancer seriously endangers women's life and health, and brings huge economic burden to the family and society. The aim of this study was to analyze the medical expenses and influencing factors of breast cancer patients, and provide theoretical basis for reasonable control of medical expenses of breast cancer patients. METHODS: The medical expenses and related information of all female breast cancer patients diagnosed in our hospitals from 2017 to 2019 were collected. Through SSPS Clementine 12.0 software, the back propagation (BP) neural network model and multiple linear regression model were constructed respectively, and the influencing factors of medical expenses of breast cancer patients in the two models were compared. RESULTS: In the study of medical expenses of breast cancer patients, the prediction error of BP neural network model is less than that of multiple linear regression model. At the same time, the results of the two models showed that the length of stay and region were the top two factors affecting the medical expenses of breast cancer patients. CONCLUSION: Compared with multiple linear regression model, BP neural network model is more suitable for the analysis of medical expenses in patients with breast cancer.