Family members of patients in a vegetative state have relatively high rates of anxiety and distress. It is important to recognize the problems faced by this population and apply psychological interventions to help them. This exploratory study describes the psychological stress experienced by family members of patients in a vegetative state. We discuss the effectiveness of a psychological crisis intervention directed at this population and offer suggestions for future clinical work. A total of 107 family members of patients in a vegetative state were included in the study. The intervention included four steps: acquisition of facts about each family, sharing their first thoughts concerning the event, assessment of their emotional reactions and developing their coping abilities. The Symptom Check List-90 was used to evaluate the psychological distress of the participants at baseline and one month after the psychological intervention. Differences between the Symptom Check List-90 scores at the baseline and follow-up evaluations were analyzed. All participants in the study had significantly higher Symptom Check List-90 factor scores than the national norms at baseline. There were no significant differences between the intervention group and the control group at baseline. Most of the Symptom Check List-90 factor scores at the one-month follow-up evaluation were significantly lower than those at baseline for both groups; however, the intervention group improved significantly more than the control group on most subscales, including somatization, obsessive-compulsive behavior, depression, and anxiety. The results of this study indicate that the four-step intervention method effectively improves the mental health of the family members who received this treatment and lessens the psychological symptoms of somatization, obsessive-compulsive behavior, depression and anxiety.

Adiponectin, an adipocyte-derived adipokine, exerts anti-inflammatory effects in the brain, but its specific function in type 2 diabetes mellitus(T2DM) has not been elucidated. Based on the common physiological and pathological mechanisms of T2DM and depression, this study revealed the protective effect of AdipoRon on T2DM-related depressive behavior and its molecular biological mechanism in vivo. Our results showed that AdipoRon treatment enhanced the sucrose consumption of T2DM mice in sucrose preference experiment, reduced the immobility time in the forced swimming experiment, and increased the total movement distance and cross times in the open field experiment. AdipoRon treatment inhibited the apoptosis of hippocampal cells, increased the number of synapses in the prefrontal cortex and hippocampus, and enhanced the density of dendritic spines in CA1 region of T2DM mice. AdipoRon could reduce NLRP3, ASC and IL-1β levels in the hippocampus and prefrontal cortex, increase the ratio of p-AMPK/AMPK and decrease p-mTOR/mTOR expression in T2DM mice. Furthermore, AdipoRon treatment increased the ratio of LC3II/LC3I and the expression of AdipoR1 in the prefrontal cortex and hippocampus of T2DM mice. All of these findings support the idea that AdipoRon reduces neuroinflammation and stimulates autophagy in T2DM mice via activating the AdipoR1/AMPK/mTOR pathway. AdipoRon may be a novel therapeutic agent for T2DM complicated depression.

Background: There are few thorough studies assessing predictors of severe encephalitis, despite the poor prognosis and high mortality associated with severe encephalitis. The study aims to evaluate the clinical predictors of mortality and poor outcomes at hospital discharge in patients with severe infectious encephalitis in intensive care units. Method: In two Chinese hospitals, a retrospective cohort study comprising 209 patients in intensive care units suffering from severe infectious encephalitis was carried out. Univariate and multivariate logistic regression analyses were used to identify the factors predicting mortality in all patients and poor outcomes in all survivors with severe infectious encephalitis. Results: In our cohort of 209 patients with severe encephalitis, 22 patients died, yielding a mortality rate of 10.5%. Cerebrospinal fluid pressure ≥ 400mmH₂O (OR = 7.43), abnormal imaging (OR = 3.51), abnormal electroencephalogram (OR = 7.14), and number of rescues (OR = 1.12) were significantly associated with an increased risk of mortality in severe infectious encephalitis patients. Among the 187 survivors, 122 (65.2%) had favorable outcomes, defined as the modified Rankine Scale (mRS) score (0 ~ 3), and 65(34.8%) had poor outcomes (mRS scores 4 ~ 5). Age (OR = 1.02), number of rescues (OR = 1.43), and tubercular infection (OR = 10.77) were independent factors associated with poor outcomes at discharge in all survivors with severe infectious encephalitis. Conclusions: Multiple clinical, radiologic, and electrophysiological variables are independent predictive indicators for mortality and poor outcomes in patients with severe encephalitis in intensive care units. Identifying these outcome predictors early in patients with severe encephalitis may enable the implementation of appropriate medical treatment and help reduce mortality rates.

Treatment Equality May Lead to Harmonious Patient–Doctor Relationship During COVID-19 in Mobile Cabin Hospitals