Conectar
by Yao-Yao Mao, Ke Zhang, Dan-Dan Zhao, Jia-Wei Cui, Zhan-Dong Lin, Cong-Yue Zhang, Yue-Min Nan
BackgroundClinical practice commonly uses the Yi-qi Huo-xue formula (YQHX), a traditional Chinese herbal medicine comprising eight herbal components, to treat liver fibrosis resulting from various etiologies. Nevertheless, this formula’s specific active constituents and underlying mechanisms of action remain to be fully elucidated.
MethodsThe drug components of YQHX and potential targets for liver fibrosis were identified via the screening of the various databases. Qualitative and quantitative identification of chemical components of drug-containing serum by Ultra Performance Liquid Chromatography (UPLC).Liver fibrosis was induced in mice through the intraperitoneal injection of carbon tetrachloride, followed by oral administration of YQHX. RNA-Seq quantified transcriptomic profiles in liver tissue.The degree of liver fibrosis was assessed via histopathology staining, the transcription and expression of relevant proteins were analyzed. Primary cells were isolated for in vitro experiments to validate the influence of YQHX on the associated signaling pathways.
ResultsNetwork pharmacology identified IL-1β, IL-6, and TNF-α as potential targets for YQHX in treating liver fibrosis.The UPLC detected multiple potential active components. In vivo experiments showed that YQHX reduced serum AST and ALT levels in liver fibrosis-induced mice, decreased liverIL-1β, IL-6, and TNF-α levels, and improved liver fibrosis.The results of transcriptomics suggest that YQHX can reduce the expression of “collagen-activated signaling pathway,” “MyD88-dependent toll-like receptor signaling pathway,” “fibrinolysis” and “toll-like receptor 4 signaling pathway”. Furthermore, YQHX reduced the aggregation of M1 macrophages in the portal area and the deposition of α-SMA. Primary bone marrow-derived cells successfully transformed into M1 macrophages after induction, and YQHX reduced the levels of IL-1β, IL-6, and TNF-α in the supernatant of M1 macrophage culture and decreased the activation of primary hepatic stellate cells indirectly co-cultured with the supernatant. Interestingly, TLR4 agonists weakened this inhibitory effect. Both in vitro and in vivo experiments demonstrated that YQHX could inhibit the expression of the TLR4/TRAF6/MyD88 pathway in M1 macrophages.
ConclusionWe reveal here the molecular mechanism and signaling pathway of YQHX in treating liver fibrosis by utilizing network pharmacology in conjunction with in vivo and in vitro experiments. The findings offer insights that may advance the clinical application of YQHX.
by Chenyu Zheng, Ming Fang, Yue Zhang, Xinyu Liu, Zhihuan Huang
Exposure to natural landscapes has been shown to affect both physiological and psychological well-being, with the extent of these effects varying across different landscape types. However, the underlying mechanisms remain poorly understood. The association among stress reduction, environments characteristics and individual differences requires further investigation, particularly considering the complexity of landscape attributes and the variability of personal responses. In this study, 98 university students participated in a survey to evaluate the effects of different landscape types on visual preference and fatigue recovery. Physiological data (blood pressure, heart rate), psychological data (Perceived Restorative Scale), and visual preferences were analyzed before and after participants viewed the images of eight representative landscape space types: mountain, field, waterscape, lawn, desert, forest, artificial nature, plant. The results indicated that landscape type significantly influenced both physiological responses and emotional states, as well as participants’ perceived recovery from stress. Among the eight landscape spaces, water features and forests were reported to be the most restorative. Compared to freshmen, juniors exhibited greater improvements in physical and psychological recovery, alongside more positive evaluations of the environments. Notably, the desert landscape elicited varied responses depending on participants’ grade level and gender, suggesting that restoration effects may be modulated by individual characteristics. This may reflect an evolutionary predisposition to prefer natural features that enhance survival. These findings contribute to environmental psychology and provide valuable insights for educational practice and environmental design.To systematically assess the effects of massage and touch on agitation in patients with dementia and to determine the optimal intervention design.
Agitated behaviour is the most common behavioural symptom in patients with dementia and can seriously affect the health status and quality of life of individuals with dementia and their caregivers. Massage and touch have been widely used as a non-pharmacological intervention to address the behavioural issues of dementia. However, current research findings on the effects of massage and touch on agitation in people with dementia are inconsistent.
A meta-analysis of randomised controlled trials.
This meta-analysis complied with PRISMA guidelines, and relevant literature up to January 2024 was systematically retrieved from PubMed, Embase, Web of Science, the Clinical Trials Registry, Cochrane Library and four Chinese databases. Statistical evaluations were performed utilising Review Manager 5.4, and the included studies' bias risks were assessed with the Cochrane Collaboration tool.
Seventeen randomised controlled trials involving 980 patients with dementia were included. The results of the meta-analysis showed that massage and touch could ameliorate agitation and behaviour problems in dementia. Subgroup analyses based on massage type showed that hand, head and foot massage significantly improved agitation. Massage and touch for ≤ 4 weeks were more effective in reducing agitated behaviour than those for > 4 weeks. Furthermore, subgroup analysis revealed that massages and touch were more effective for individuals with less severe dementia.
Massage and touch in the short term can effectively improve agitation in dementia patients, while hand, head and foot massage can effectively reduce agitation. Thus, clinical nursing staff and caregivers of individuals should be actively helped to apply massage and touch to their patients. However, more studies are needed to validate our results before we can give a more definitive recommendation.
This study suggests that massage and touch can be used as complementary treatments for agitation in people with dementia and encourages nursing staff and caregivers to apply massage and touch to better cope with the agitated behaviour of older adults with dementia.
No patient or public contribution.
PROSPERO registration number: CRD42024507133
This study aimed to compare the efficacy of non-pharmacological interventions in children with preoperative anxiety.
It is estimated that preoperative anxiety affects up to 60% of children which is associated with both immediate and long-term adverse outcomes. Several non-pharmacological interventions have been demonstrated to be effective, but further research is necessary to determine which is the most effective.
This study was conducted and reported in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 checklist.
We searched randomised controlled trials in twelve databases from which inception to March 31, 2024. The primary outcome was the severity of preoperative anxiety change from the baseline to the endpoint which is usually before the anaesthesia induction. Within the frequentist framework, a random-effects network meta-analysis (NMA) was used to compare the primary outcomes. The surface under the cumulative ranking curve (SUCRA) was used to rank each intervention separately. Subgroup and sensitivity analyses were carried out for the primary outcomes.
A total of 36 randomised controlled trials (RCTs) with 3182 paediatric patients were included. Based on the results, psychological + digital health intervention was significantly more effective than control groups and ranked highest. Combined parental presence during induction anaesthesia and video games (PPIA + VG) had significant benefits compared to almost all other interventions with the highest rank.
Psychological + digital health interventions, especially PPIA + VG, may be the most effective non-pharmacological interventions for reducing preoperative anxiety in children. It is necessary to conduct more RCTs to evaluate the efficacy of different non-pharmacological interventions.
Non-pharmacological interventions can effectively improve preoperative anxiety in children.
No patient or public contribution applies to this work.
PROSPERO CRD42024509512 (https://www.crd.york.ac.uk/PROSPERO/)
To investigate the relationship among dyadic coping, mental health and the individual and mutual influences on stroke survivors and their spouse caregivers.
A cross-sectional descriptive study was conducted in China from November 2019 to August 2020. The STROBE checklist was used to report the present study.
The analysis included 224 dyads of stroke survivors and their spouse caregivers in China. Data on stroke survivors and their spouse caregivers were collected using the Dyadic Coping Inventory (DCI), the Patient Health Questionnaire nine-item scale (PHQ-9) and the Generalised Anxiety Disorder seven-item scale (GAD-7). The dyadic analysis was conducted based on the Actor-Partner Interdependence Model (APIM).
Regarding actor effects, spouse caregivers' dyadic coping and perceived dyadic coping had a negative predictive effect on their own anxiety and depression. Stroke survivors' perceived dyadic coping had a negative effect on their own depression. Regarding partner effects, spouse caregivers' perceived dyadic coping also had a negative predictive effect on the depression of the patients. In contrast, stroke survivors' perceived dyadic coping was positively associated with spouse caregivers' anxiety and depression. These findings suggested that mental health of stroke survivors and their spouse caregivers was affected by various dyadic coping dimensions.
Our research has the potential to contribute to the understanding dyadic coping and mental health of stroke survivor-spouse caregiver dyads. The findings reveal that the coping strategies employed by stroke couples are closely related to the mental health of both partners.
This study provides evidence for the significant impact of dyadic coping on the psychological well-being of stroke survivors and their spouse caregivers. Therefore, dyadic interventions aiming at strengthening dyadic coping may have positive effects on their mental health.
This study directly involved the patients and family caregivers in hospital settings.
To describe a grading system that can be used to evaluate core competency of clinical nurse specialists (CNSs) at different levels.
Evaluate core competence of CNSs at different levels reflects the quality of nursing and the development of the nursing profession.
This research employed the Delphi method.
The STROBE checklist for observational cross-sectional studies was followed to report this research study. This study consisted of two main phases: a literature review and semistructured interviews. Individual semistructured interviews were conducted with 11 healthcare experts and two patients. Two rounds of questionnaire surveys were administered to 21 nursing experts using the Delphi method. The CNSs were classified as primary, intermediate or advanced based on their years of work, professional titles and educational qualifications.
The graded competency evaluation system consisted of five first-level indicators (clinical practice, consulting guidance and teaching, scientific research innovation, management and discipline development, and ethical decision-making), 15 second level indicators, and 40 third-level indicators. The authority coefficients (Cr) of the experts were .865 and .901. The Kendall's concordance coefficients of the three-level indicators were .417, .289 and .316 for primary CNSs; .384, .294 and .337 for intermediate CNSs; and .489, .289 and .239 for advanced CNSs.
The graded use evaluation system in clinical practice initially involves a comprehensive evaluation of the core abilities of CNSs. This is a tool for cultivating and grading the abilities of specialised nurses that can promote a practical upwards spiral.
The evaluation system can promote the scientific management and continuous improvement of CNSs in clinical nursing and can serve as a practical and objective reference for the effective management and development of CNSs.
Patients participated in the data collection process, during which they shared their health-seeking experience with our research team.
To investigate the prevalence of anxiety and depression symptoms in intensive care unit (ICU) patients with cardiovascular disease (CVD) and to explore which elements are risk factors for the development of anxiety and depression symptoms.
A cross-sectional study.
A total of 1028 ICU patients with CVD were enrolled in this cross-sectional study. Logistic regression was used to assess risk factors and associations between anxiety and depression symptoms, and mediation analysis was used to explore the effect of risk factors on the association between anxiety and depression symptoms. Reporting of the study followed the STROBE checklist.
The results showed that among ICU patients with CVD, 38.1% had anxiety symptoms, 28.7% had depression symptoms and 19.3% had both anxiety and depression symptoms, and there was a significant association between anxiety and depression symptoms. We also identified female gender, hypertension, hyperlipidemia and cardiac function class IV as independent risk factors for anxiety and depression symptoms. Importantly, these factors also mediated the association between anxiety and depression symptoms, emphasising their role in the psychological well-being of this patient group.
ICU patients with CVD were prone to anxiety and depression symptoms. Female gender, hypertension, hyperlipidemia and cardiac function class IV were identified as independent risk factors that also served as mediators in the relationship between anxiety and depression symptoms. Especially, cardiac function class IV emerged as a critical factor in this association.
It is imperative for critical care professionals to recognize the elevated risk of depression and anxiety among ICU patients with severe CVD, especially those with cardiac function class IV, hypertension, hyperlipidemia and females. Proactive and supportive measures are essential for this vulnerable group during their ICU stay to safeguard their mental health and prevent negative outcomes.
No Patient or Public Contribution.
To explore the role of family meetings for individuals living with dementia and their family caregivers.
Integrative review.
We conducted searches in the Cochrane Library, PubMed, CINAHL, and Embase databases (up to December 2022). Additionally, an ancestry search strategy was employed to supplement the retrieval of published literature related to family meetings or family conferences for people with dementia and their family caregivers.
The review integrated 11 articles, comprising seven quantitative studies, two qualitative studies, and two case reports. The findings did not indicate a significant improvement in end-of-life quality for individuals with dementia in the family meetings group compared to those receiving usual care. Limited evidence suggested some improvement in mental health outcomes for family caregivers. Both intervention and control groups incurred high care costs. However, family meetings appeared to delay nursing home placements for individuals with dementia. Two qualitative studies provided insights into the experiences of families and healthcare professionals participating in family meetings, highlighting opportunities and challenges in implementing such meetings. Additionally, two case reports offered specific and illustrative accounts of typical family meetings.
Family meetings can delay nursing home placements for elderly individuals with dementia. Families dealing with dementia perceive family meetings as an opportunity to collaborate with professionals in providing comprehensive care. Further research is needed to explore the effectiveness of family meetings in decision-making for families affected by dementia. Additionally, addressing timing and process coordination issues in family meetings is crucial for optimising their practices among families dealing with dementia.
In order to make family meetings more accessible to families of individuals with dementia, we offer the following recommendations for future research and practice: Rather than a blanket rejection, the decision regarding the participation of individuals with dementia in family meetings should be based on their specific condition and the needs of their family. Coordination and harmonisation of opinions and perceptions among family members of individuals with dementia can sometimes be complex for healthcare professionals. The involvement of family coordinators may simplify this process. To determine the optimal timing for holding family meetings that can better assist families dealing with dementia, we propose that the right to initiate a meeting be granted to the family. This allows them to convene with healthcare professionals and address their concerns at their convenience.
FreshRSS 