[Objective]Depression is a common mental illness with a profound impact on physical health.Depression has been associated with a higher risk of bacterial infection;however,whether this relationship is causal and how depression affects infection remains unclear.Therefore,we aimed to investigate the effects of depressive phenotype in infected mice by constructing a chronic unpredictable mild stress(CUMS)model.[Methods]Mice were induced with CUMS for 4 weeks.The depressive phenotype was evaluated using behavioral tests.Subsequently,the mice were intraperitoneally injected with Klebsiella pneumoniae to establish bacterial infection.Serum and abdominal tissues were collected 48 h after infection.Hematoxylin-eosin(HE)staining was used to observe the pathological changes in the tissues,and enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of inflammatory factors.In addition,the fecal samples collected before infection were analyzed for 16S rDNA gene of gut microbiota,and the expression levels of NF-κB/NLRP3 signaling pathway in colon tissues of uninfected mice were detected.[Results]Behavioral tests showed that compared with the control mice,CUMS mice had significantly lower body weight(P<0.0001,t=5.426),lower sucrose preference rate(P<0.001,t=4.937),increased swimming stationary time(P<0.001,t=16.37),and decreased time spent in the central area of the open field(P<0.01,t=3.575).Survival analysis showed that compared with the control mice,the survival rate of CUMS mice significantly decreased after infection(P<0.05).Additionally,histochemical staining showed that tissue damage in the liver(P<0.05,t=4.025),kidney(P<0.05,t=2.828),and mesentery(P<0.01,t=5.367)significantly increased.Furthermore,ELISA results showed that the levels of the inflammatory cytokines IL-6(P<0.01,t=3.365),IL-1β(P<0.01,t=4.061),TNF-α(P<0.01,t=4.460)and LPS(P<0.0001,t=27.24)were elevated.The difference was statistically significant.According to 16S rDNA sequencing,CUMS-induced changes in the intestinal bacterial community structure of mice,making them significantly different from the control mice.Compared with the control mice,the expression levels of NF-κB(P<0.01,t=6.825)and NLRP3(P<0.001,t=9.561)were upregulated in CUMS mice.[Conclusion]The CUMS model was successfully constructed and CUMS mice developed more severe bacterial infection.Gut microbiota was dysregulated and the expression of NF-κB/NLRP3 signaling pathway was up-regulated in CUMS mice,which was related to the susceptibility to bacterial infection.

BACKGROUND: This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines, named Scientific, Transparent and Applicable Rankings tool (STAR), and test its reliability, validity, and usability. METHODS: This study set up a multidisciplinary working group including guideline methodologists, statisticians, journal editors, clinicians, and other experts. Scoping review, Delphi methods, and hierarchical analysis were used to develop the STAR tool. We evaluated the instrument's intrinsic and interrater reliability, content and criterion validity, and usability. RESULTS: STAR contained 39 items grouped into 11 domains. The mean intrinsic reliability of the domains, indicated by Cronbach's α coefficient, was 0.588 (95% confidence interval [CI]: 0.414, 0.762). Interrater reliability as assessed with Cohen's kappa coefficient was 0.774 (95% CI: 0.740, 0.807) for methodological evaluators and 0.618 (95% CI: 0.587, 0.648) for clinical evaluators. The overall content validity index was 0.905. Pearson's r correlation for criterion validity was 0.885 (95% CI: 0.804, 0.932). The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min. CONCLUSION The instrument performed well in terms of reliability, validity, and efficiency, and can be used for comprehensively evaluating and ranking guidelines.
Reproducibility of Results ; Surveys and Questionnaires ; Practice Guidelines as Topic ; Humans

Our previous investigation suggested that faster seventh cervical nerve (C7) regeneration occurs in patients with cerebral injury undergoing contralateral C7 transfer. This finding needed further verification, and the mechanism remained largely unknown. Here, Tinel's test revealed faster C7 regeneration in patients with cerebral injury, which was further confirmed in mice by electrophysiological recordings and histological analysis. Furthermore, we identified an altered systemic inflammatory response that led to the transformation of macrophage polarization as a mechanism underlying the increased nerve regeneration in patients with cerebral injury. In mice, we showed that, as a contributing factor, serum amyloid protein A1 (SAA1) promoted C7 regeneration and interfered with macrophage polarization in vivo. Our results indicate that altered inflammation promotes the regenerative capacity of the C7 nerve by altering macrophage behavior. SAA1 may be a therapeutic target to improve the recovery of injured peripheral nerves.
Animals ; Brachial Plexus ; Brachial Plexus Neuropathies/surgery* ; Humans ; Mice ; Nerve Transfer ; Peripheral Nerves ; Spinal Nerves

Our previous investigation suggested that faster seventh cervical nerve (C7) regeneration occurs in patients with cerebral injury undergoing contralateral C7 transfer. This finding needed further verification, and the mechanism remained largely unknown. Here, Tinel’s test revealed faster C7 regeneration in patients with cerebral injury, which was further confirmed in mice by electrophysiological recordings and histological analysis. Furthermore, we identified an altered systemic inflammatory response that led to the transformation of macrophage polarization as a mechanism underlying the increased nerve regeneration in patients with cerebral injury. In mice, we showed that, as a contributing factor, serum amyloid protein A1 (SAA1) promoted C7 regeneration and interfered with macrophage polarization in vivo. Our results indicate that altered inflammation promotes the regenerative capacity of the C7 nerve by altering macrophage behavior. SAA1 may be a therapeutic target to improve the recovery of injured peripheral nerves.

Objective:To explore the association between precollege sexual abuse experiences at different periods and adult attachment in college students.Methods:In October 2018,a total of 4 034 college students were selected from 4 colleges in Hefei City by using the stratified cluster sampling method. A self-designed questionnaire was used to investigate the demographic characteristics, sexual abuse experience, and attachment style of participants. Multivariate linear regression analysis was performed to analyze the association between different periods, types of precollege sexual abuse experiences and attachment style in college students.Results:The rate of total precollege sexual abuse, noncontact sexual abuse, and contact sexual abuse was 14.1% (569), 12.7% (512) and 5.4% (219), respectively. Multivariate linear regression analysis showed that secure attachment [β(95% CI)=-0.205 (-0.292, -0.117)] was negatively correlated with total precollege sexual abuse experiences, whereas anxiety attachment [β(95% CI)=0.211 (0.110, 0.310)], avoidant attachment [β(95% CI)=0.117 (0.020, 0.216)] were positively correlated with total precollege sexual abuse experiences. The number of periods of precollege noncontact sexual abuse was negatively correlated with secure attachment [β(95% CI)=-0.106(-0.171, -0.041)]and positively correlated with anxiety attachment [β(95% CI)=0.158 (0.084, 0.231)]and avoidant attachment [β(95% CI)=0.080 (0.008, 0.152)]. The noncontact [β(95% CI)=0.427 (0.018, 0.775)] and contact sexual abuse [β(95% CI)=0.468 (0.251, 0.687)] in high school were positively correlated with anxiety attachment ( P<0.05). Conclusion:Different periods, types of precollege sexual abuse experiences were all associated with adult attachment in college students.

Objective:To explore the association between precollege sexual abuse experiences at different periods and adult attachment in college students.Methods:In October 2018,a total of 4 034 college students were selected from 4 colleges in Hefei City by using the stratified cluster sampling method. A self-designed questionnaire was used to investigate the demographic characteristics, sexual abuse experience, and attachment style of participants. Multivariate linear regression analysis was performed to analyze the association between different periods, types of precollege sexual abuse experiences and attachment style in college students.Results:The rate of total precollege sexual abuse, noncontact sexual abuse, and contact sexual abuse was 14.1% (569), 12.7% (512) and 5.4% (219), respectively. Multivariate linear regression analysis showed that secure attachment [β(95% CI)=-0.205 (-0.292, -0.117)] was negatively correlated with total precollege sexual abuse experiences, whereas anxiety attachment [β(95% CI)=0.211 (0.110, 0.310)], avoidant attachment [β(95% CI)=0.117 (0.020, 0.216)] were positively correlated with total precollege sexual abuse experiences. The number of periods of precollege noncontact sexual abuse was negatively correlated with secure attachment [β(95% CI)=-0.106(-0.171, -0.041)]and positively correlated with anxiety attachment [β(95% CI)=0.158 (0.084, 0.231)]and avoidant attachment [β(95% CI)=0.080 (0.008, 0.152)]. The noncontact [β(95% CI)=0.427 (0.018, 0.775)] and contact sexual abuse [β(95% CI)=0.468 (0.251, 0.687)] in high school were positively correlated with anxiety attachment ( P<0.05). Conclusion:Different periods, types of precollege sexual abuse experiences were all associated with adult attachment in college students.

Objective: To explore the effects of precollege peer bullying at different stages, on quality of life (QOL) among college students. Methods: A stratified cluster sampling method was used to select participants in October, 2018. Cluster sampling method was adopted to recruit a sample of 4 034 college students from four universities in Hefei city, Anhui province. Relations between peer bullying at different stages before entering college, and the quality of life, were investigated. t test and analysis of variance were used to compare the differences of QOL in different groups. Multiple linear regression models were used to assess the associations between various types of peer bullying at different stages and the QOL at precollege days. Results: Among all the 4 034 college students under study, mean scores of the 4 dimensions of QOL appeared as physical (12.61±2.02), psychological (14.09±2.62), social relationship (13.72±2.71) and environment (13.77±2.46), respectively. After adjusting the confounding factors, data from multiple linear regression showed that, factors as verbal bullying victimization during primary school (β=-0.21)/secondary school (β=-0.27)/or at both periods (β=-0.56), relational (β=-0.21) and physical (β=-0.38) bullying victimization in secondary school, and physical bullying victimization in both periods (β=-0.67) were negatively correlated with the physical dimension of QOL. Verbal bullying victimization in both periods (β=-0.41) and relational bullying victimization in secondary school (β=-0.42) were negatively correlated with psychological dimension of QOL. Factors as relational (β=-0.32) and physical (β=-0.51) bullying victimization in secondary school, physical/cyber bullying victimization in both periods (β=-0.57) were negatively correlated with the social dimension of QOL. Verbal bullying victimization during primary school (β=-0.20) and both periods (β=-0.46), relational bullying perpetration during primary school (β=-0.35) or at both periods (β=-0.90) were negatively correlated with the environmental dimension of QOL (All P<0.05). Index related to bullying victimization (β=-0.33, -0.36, -0.30, -0.33) and bullying perpetration β=-0.28, -0.31, -0.23, -0.28) were both negatively correlated to all the 4 dimensions (physical, psychological, social relationship and environment) of QOL (P<0.001). Conclusions Various forms of peer bullying experiences occurring before college, were associated with the decreased scores of QOL in different domains, among the university students. Programs on prevention and control of peer bullying in different stages before college days seemed important thus should be strengthened.

Objective: To investigate the correlation between childhood maltreatment and quality of life (QOL) in nursing girls in Anhui Province, so as to provide reference for improving QOL of nursing girls. Methods: The stratified cluster sampling method was used to select students of grade 1 to 3 in nursing major from 2 colleges and 2 specialized colleges by self-administered questionnaire in Anhui province. The questionnaire was conducted to analyze the relationship between childhood abuse and neglect and QOL of female nursing students. Multiple linear regression model was used to assess the associations between childhood maltreatment and QOL. Results: Among 2 549 female nursing students, the mean scores of 4 dimensions of QOL were physical (12.85±2.01), psychological (13.86±2.40), social relationship (12.83±2.84) and environment (13.37±2.21). The scores of QOL among college students were higher than specialized college students, high grade students were higher, and those who have a good relationship with their parents were higher(P<0.01). The prevalence rates of childhood physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect were 4.9%, 10.6%, 7.3%, 6.7% and 4.1%, respectively. The scores of QOL were lower among female nursing students with childhood maltreatment than those without childhood maltreatment(P<0.01). The results of multiple linear regression analysis showed that the number of childhood abuse and neglect were negatively correlated with physical, psychological and environmental dimension of QOL, and the number of childhood maltreatment were significantly dose-responsive to quality of life(P<0.05). Conclusion The female nursing students are still greatly neglected, and the experience of childhood maltreatment is negatively related to the quality of life among female nursing students.

Objective: To explore the role of hypothalamus Polycomb Group (PcG) gene (Eed, Ezh) methylation in the relationship between bisphenol A (BPA) exposure during pregnancy and premature puberty in female offspring. Methods: A total of 40 pregnant CD-1 mice were randomly and averagely assigned into four groups: control group (corn oil) and low, middle and high BPA-exposed groups (the poisonous doses were 8 mg/kg, 40 mg/kg, and 200 mg/kg, respectively) by random number table method. Each group was administered by gavage from gestational day (GD) 1 to 18. The vaginal opening of female offspring was observed from postnatal day (PND) 21 to 33. All female offsprings were sacrificed, and hypothalamus was remained on the PND 34. The methylation levels of Eed and Ezh in the hypothalamus were measured. The early puberty of CD-1 mice was evaluated by the rate of vaginal opening in advance, initial time of vaginal opening, the first estrus occurrence and vaginal opening days in advance. The path model was used to explore the role of Eed and Ezh gene methylation in the early puberty of female offspring with maternal BPA exposed including the number of days of vaginal opening in advance as a dependent variable and BPA exposure as an independent variable. Results: The rate of vaginal opening on the 28 day in each maternal BPA-exposure group [low, middle and high BPA-exposed groups were 40.00% (29/72), 47.62% (25/53) and 37.84% (20/53), respectively] was higher than that rate in the control group [14.06%(9/64)]. Similarly, the P₅₀(P₂₅, P₇₅) values of initial time of vaginal opening in low, middle and high BPA-exposed group were 28 (26, 30), 28 (26, 29), 28 (26, 30) days, respectively and the P₅₀(P₂₅, P₇₅) values of the first estrus occurrence in low, middle and high BPA-exposed group were 31 (27, 32), 30 (27, 31), 31 (28, 33) days, respectively, which were earlier than those in the control group [initial time of vaginal opening was 30(28, 31) days, and the first estrus occurrence was 32(30, 33) days] (all P values<0.05). Compared with the control group (the methylation levels of Eed1, Eed2, Ezh2 were 1.47%, 1.26%, 2.56%, respectively), the methylation levels of Eed1 (1.61%-1.82%), Eed2 (1.36%-1.43%) and Ezh2 (2.87%-3.05%) in female offspring were significantly higher in BPA-exposed groups (all P values<0.05). The results of path model analysis showed that BPA had no direct influence on puberty in advance, but had an indirect effect on puberty in advance (indirect effect path coefficient was 0.045 and 0.142, respectively) by mediating methylation of Eed2, and Ezh2. Conclusion Early puberty in female offspring induced by maternal exposure to BPA during pregnancy through the increased methylation levels of hypothalamus PcG gene (Eed, Ezh) in female offspring.

Objective: To explore the relationship between childhood abuse, adult attachment and borderline personality disorder (BPD) in college students, and to provide reference for promoting the physical and mental health of college students. Methods: We selected undergraduate students from four colleges in Hefei, a total of 4 034 college students were surveyed by the childhood trauma questionnaire short form(CTQ-SF), the state adult attachment measure (SAAM) and the Personality Diagnostic Questionnaire(PDQ). Results: BPD was found in 4.2% of subjects, 4.5% of males and 3.7% of females. The score of BPD in non-single-parent families was lower than that in single-parent families, in families with average family economic status was lower than that in families with poor and good family economic status, and in families with medium father education level was lower than that in fathers with low and high education level(Z=-2.30, 29.25, 9.63, P<0.05). Childhood abuse, avoidant attachment and anxious attachment positively predicted BPD(β=0.21, 0.10, 0.23, P<0.01), secure attachment negatively predicted BPD(β=-0.15, P<0.01). Adult attachment played a partial mediating role in the effects of childhood abuse on BPD, with the mediating effect accounting for 16.7% of the total effect. Conclusion Adult attachment plays a mediating role in the effects of childhood abuse on BPD.