BACKGROUND: While emotional distress, encompassing anxiety and depression, has been associated with negative clinical outcomes, its impact across various clinical departments and general hospitals has been less explored. Previous studies with limited sample sizes have examined the effectiveness of specific treatments (e.g., antidepressants) rather than a systemic management strategy for outcome improvement in non-psychiatric inpatients. To enhance the understanding of the importance of addressing mental health care needs among non-psychiatric patients in general hospitals, this study retrospectively investigated the impacts of emotional distress and the effects of early detection and management of depression and anxiety on hospital length of stay (LOS) and rate of long LOS (LLOS, i.e., LOS >30 days) in a large sample of non-psychiatric inpatients. METHODS: This retrospective cohort study included 487,871 inpatients from 20 non-psychiatric departments of a general hospital. They were divided, according to whether they underwent a novel strategy to manage emotional distress which deployed the Huaxi Emotional Distress Index (HEI) for brief screening with grading psychological services (BS-GPS), into BS-GPS ( n = 178,883) and non-BS-GPS ( n = 308,988) cohorts. The LOS and rate of LLOS between the BS-GPS and non-BS-GPS cohorts and between subcohorts with and without clinically significant anxiety and/or depression (CSAD, i.e., HEI score ≥11 on admission to the hospital) in the BS-GPS cohort were compared using univariable analyses, multilevel analyses, and/or propensity score-matched analyses, respectively. RESULTS: The detection rate of CSAD in the BS-GPS cohort varied from 2.64% (95% confidence interval [CI]: 2.49%-2.81%) to 20.50% (95% CI: 19.43%-21.62%) across the 20 departments, with a average rate of 5.36%. Significant differences were observed in both the LOS and LLOS rates between the subcohorts with CSAD (12.7 days, 535/9590) and without CSAD (9.5 days, 3800/169,293) and between the BS-GPS (9.6 days, 4335/178,883) and non-BS-GPS (10.8 days, 11,483/308,988) cohorts. These differences remained significant after controlling for confounders using propensity score-matched comparisons. A multilevel analysis indicated that BS-GPS was negatively associated with both LOS and LLOS after controlling for sociodemographics and the departments of patient discharge and remained negatively associated with LLOS after controlling additionally for the year of patient discharge. CONCLUSION Emotional distress significantly prolonged the LOS and increased the LLOS of non-psychiatric inpatients across most departments and general hospitals. These impacts were moderated by the implementation of BS-GPS. Thus, BS-GPS has the potential as an effective, resource-saving strategy for enhancing mental health care and optimizing medical resources in general hospitals.
Humans ; Retrospective Studies ; Male ; Length of Stay/statistics & numerical data* ; Female ; Middle Aged ; Adult ; Psychological Distress ; Inpatients/psychology* ; Aged ; Anxiety/diagnosis* ; Depression/diagnosis*

Loss of protein homeostasis is a hallmark of cellular senescence, and ribosome pausing plays a crucial role in the collapse of proteostasis. However, our understanding of ribosome pausing in senescent cells remains limited. In this study, we utilized ribosome profiling and G-quadruplex RNA immunoprecipitation sequencing techniques to explore the impact of RNA G-quadruplex (rG4) on the translation efficiency in senescent cells. Our results revealed a reduction in the translation efficiency of rG4-rich genes in senescent cells and demonstrated that rG4 structures within coding sequence can impede translation both in vivo and in vitro. Moreover, we observed a significant increase in the abundance of rG4 structures in senescent cells, and the stabilization of the rG4 structures further exacerbated cellular senescence. Mechanistically, the RNA helicase DHX9 functions as a key regulator of rG4 abundance, and its reduced expression in senescent cells contributing to increased ribosome pausing. Additionally, we also observed an increased abundance of rG4, an imbalance in protein homeostasis, and reduced DHX9 expression in aged mice. In summary, our findings reveal a novel biological role for rG4 and DHX9 in the regulation of translation and proteostasis, which may have implications for delaying cellular senescence and the aging process.
G-Quadruplexes ; Cellular Senescence ; Ribosomes/genetics* ; Humans ; Animals ; Mice ; DEAD-box RNA Helicases/genetics* ; Protein Biosynthesis ; RNA/chemistry* ; Neoplasm Proteins

Objective: To investigate the effects of “Three Methods and Three Acupoints” (TMTP) Tuina therapy on spinal microcirculation in sciatic nerve injury (SNI). Methods: Thirty-six Sprague–Dawley rats were randomly assigned to four groups: normal, sham operation, model, and TMTP Tuina. Successful model induction was confirmed by observable hind limb lameness. After 20 sessions, hind limb grip strength and motor nerve conduction velocity (MNCV) were measured at baseline and following the 10th and 20th intervention. CD31 and α-SMA in the ventral horn of SNI model rats were detected using immunofluorescence. Motor neurons in the ventral horn were detected by Nissl staining. PTEN levels in the ventral horn were measured by ELISA, and PI3K, Akt, BDNF, VEGF, and HIF-1α expression was determined by RT-PCR. Spinal cord microcirculation was evaluated by western blotting analysis of the levels of Akt, p-Akt, BDNF, and VEGF. Results: Hind limb grip strength and MNCV significantly improved in the TMTP Tuina group compared to the model group (both P < .001). Morphology of ventral horn motor neurons in the TMTP Tuina group improved compared to the model group, with increased expressions of α-SMA (P = .002) and CD31 (P = .006). Western blot analysis indicated increased expression of VEGF (P = .005), p-Akt (P < .001), and BDNF (P = .008) in the ventral horn following Tuina treatment. RT-PCR analysis revealed increased expression of PI3K, Akt, BDNF, VEGF and HIF-1α (all P < .05). In contrast, expression of PTEN decreased compared to the model group (P < .001). Conclusion TMTP Tuina therapy may restore motor function in rats, enhance ventral horn motor neuron morphology, and promote angiogenesis and vascular smooth muscle proliferation. The mechanism may involve the activation of the PI3K/Akt signaling pathway.

To summarize the nursing experience of a patient with intestinal fistula after laparoscopic extended radical resection of rectal cancer plus ileostomy.Nursing points include:multi-disciplinary joint formulation of systemic treatment and nursing plan;using fistula isolation technology to isolate and drain digestive fluid;implementing incision segmentation management to promote infection control and tissue growth.After careful treatment and nursing care,the intestinal fistula was closed after 38 days of surgery,and the wound healed after 52 days of surgery.

As individuals age, the desire to address skin aging in the face and neck becomes increasingly prevalent among those interested in enhancing their appearance.Microfocused ultrasound offers a non-invasive approach to address concerns such as wrinkles and sagging skin.This article presents a thorough examination of the mechanisms and principles underlying microfocused ultrasound technology, its effectiveness in combating signs of aging in various regions of the face and neck, its potential synergies with other treatment modalities, and its benefits and possible side effects.The objective is to provide guidance for healthcare professionals in utilizing microfocused ultrasound for facial and neck rejuvenation.

Objective To explore the analgesic initiation mechanism of three-manipulation and three-acupoint tuina in model rats with minor chronic constriction injury(CCI).Methods Fifty-six SD rats were divided randomly into eight groups:normal group,sham group,model 1 group,model 2 group,tuina 1 group,tuina 2 group,tuina 1+transient receptor potential vanilloid-1(TRPV1)antagonist group,and tuina 2+transient receptor potential ankyrin 1(TRPA1)antagonist group.The model,tuina,and tuina+antagonist groups were established with minor CCI models.The tuina and tuina+antagonist groups received the three-method three-point intervention(point method,dial method,kneading method,Yinmen point,Chengshan point,Yanglingquan point)7 days after modeling.The model and sham groups were subjected to grasping restraint,and the normal group received no intervention.After the respective interventions,each group was tested for changes in mechanical withdrawal threshold(MWT)and thermal withdrawal latency(TWL)to detect different types of pain.The nitric oxide(NO)content of the dorsal root ganglion(DRG)was determined by the nitrate reductase method,and changes in protein and gene expression levels of components of the TRPV1/TRPA1-NO-cGMP-protein kinase G(PKG)signaling pathway in the DRG of each group were determined by enzyme-linked immunosorbent assay,Western blot,and qPCR.Results Compared with the model group,MWT and TWL were prolonged in the tuina 1 and tuina 2 groups.Expression levels of TRPV1,TRPA1,NO,soluble guanylate cyclase-β,cGMP,and PKG1 in the DRG were significantly decreased in the tuina 1,tuina 2,tuina 1+TRPV1 antagonist,and tuina 2+TRPA1 antagonist groups.Conclusions Tuina can effectively improve the symptoms of thermal and mechanical hyperalgesia caused by peripheral nerve injury after one-time intervention.Tuina can exert immediate and continuous analgesic effects via the TRPV1/TRPA1-NO-cGMP-PKG signaling pathway.

Alzheimer’s disease (AD) is a neurodegenerative disease that has become increasingly serious with the aging of human society. It has become an important factor that hinders the development of society, making early diagnosis and intervention of great significance. In recent years, with the continuous development of computer technology, deep learning has shown superior performance in processing AD big data, identifying effective detection indices, and improving detection accuracy. In this paper, the research progress of deep learning in early diagnosis of AD in areas such as neuroimaging data, electroencephalogram, blood and genetic data, and multimodal fusion data was mainly introduced. Common deep learning models were summarized, and future research directions in this field were discussed.

Objective:The aim of this study is to examine the impact of inosine pretreatment in pregnant rats on as-trocyte(Ast)responses in the maternal inflammation-induced periventricular leukomalacia(PVL)model in offspring.Methods:The pregnant rats were divided into Control,PVL,and IN-PVL groups.In the PVL group,pregnant rats at gestational day 17(E17)received intraperitoneal injections of lipopolysaccharide(LPS)at a dose of 350 μg/kg for 2 days.In the IN-PVL group,pregnant rats at E1 were administered an inosine solution(1 mg/ml,25 ml/day)for 16 days followed by intraperitoneal injections of LPS for 2 days.Newborn 7-day-old rat brains from each group of pregnant rats were collected,and the protein expression of myelin basic protein(MBP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1 β(IL-1β),interleukin-4(IL-4),interleukin-10(IL-10),glial fibrillary acidic protein(GFAP),complement 3(C3),S100 calcium binding protein A10(S100A10),platelet-derived growth factor(PDGF),chemokine ligand 1(CXCL1),and connexin 43(Cx43)were detected by immunofluorescence staining or Western Blot.Results:The PVL group exhibited a decrease in myelin MBP color area and an increase in hypertrophic Ast in contrast to the Control group.Additionally,protein expression levels of proinflammatory factors(TNF-α,IL-6,IL-1β),GFAP,A1 Ast marker C3,and Ast linker Cx43 were significantly elevated in the PVL group compared to the Control group(P＜0.05).Conversely,protein expression levels of anti-inflammatory factors(IL-4,IL-10),MBP,A2 Ast marker S100A10,and Ast secreted products(PDGF,CXCL 1)were significantly decreased in the PVL group com-pared to the Control group(P＜0.05).Inosine pretreatment effectively reversed the expression levels of these proteins(P＜0.05).Conclusion:Inosine pretreatment of pregnant rats improved cerebral hypomyelination in offspring PVL neonatal rats by regulation of Ast responsiveness and the secretion of pro-myelinating substances.