Association between pulse pressure and carotid plaques in old adults with uncontrolled hypertension: results from a community-based screening in Hangzhou, China.

BACKGROUND: There is a broad pulse pressure (PP) and a high prevalence of carotid plaques in old adults. Previous studies have indicated that PP is strongly associated with carotid plaque formation. This study aimed to explore this association in old adults with uncontrolled hypertension. METHODS: 1371 hypertensive patients aged ≥ 60 years with uncontrolled hypertension were enrolled in a community-based screening in Hangzhou, China. Carotid plaques were assessed using ultrasonography. Logistic regression models were used to estimate the association between PP and carotid plaques by odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Carotid plaques were detected in 639 (46.6%) of subjects. Multiple plaques were found in 408 (63.8%) and soft plaques in 218 (34.1%). Elevated PP was associated with a high prevalence of carotid plaques. After adjusting for traditional risk factors, compared to patients within the lowest tertile of PP, those within the highest tertiles had an increased risk of carotid plaques (OR 2.061, CI 1.547-2.745). For each 1-SD increase, the risk increased by 40.1% (OR 1.401, CI 1.237-1.587). There was a nonlinear association between PP and carotid plaques (P nonlinearity = 0.039). The risk increased rapidly after the predicted PP level reached around 60 mmHg. The associations were stronger among participants with multiple and soft plaques. CONCLUSIONS: Our findings suggested that PP was independently associated with carotid plaques in old adults with uncontrolled hypertension who have an increased risk of atherosclerosis.

Study on the Spatiotemporal Evolution and Driving Factors of Ecological Security in Stages Based on the DPSIRM-SBM Model: A Case Study of the Yangtze River Economic Belt.

Scientific assessment of urban ecological security (ES) is an important prerequisite to realize regional sustainable development. Previous studies lack the consideration of quality and poor systematic correlation, which could not reflect the internal dynamic relationship. On the basis of considering the time lag, this study divided the research process into the natural operation stage and the management feedback stage based on the driving forces, pressures, state, impacts, responses, management (DPSIRM) framework model and DEA theory, so as to effectively overcome the above shortcomings. Finally, we analyzed the spatio-temporal characteristics and influencing factors of the ES level of 108 cities in the Yangtze River Economic Belt (YREB) during 2005-2019. The results showed that: (a) both two stages showed a slow and fluctuating upward trend in time series, and the level of urban ES in the management feedback stage was significantly higher than that in the natural operation stage; (b) with the passage of time, the spatial distribution of ES in the natural operation stage gradually developed towards the middle and downstream of the YREB, while the management feedback stage mainly evolved from the midstream to the edge area; (c) the level of urban ES presented a different degree of spatial agglomeration phenomenon, and showed an increasing trend over time; and (d) the key influencing factors gradually changed from pressure to response during 2005-2019. This research aims to provide an innovative perspective for the measurement of urban ES, and provide scientific reference for improving urban ecological sustainable development.

Remnant cholesterol and the risk of carotid plaque in hypertension: results from a community-based screening among old adults in Hangzhou, China.

Elevated remnant cholesterol (RC) is considered a risk factor for atherosclerotic cardiovascular disease, but the evidence on this association applies to the Chinese population with hypertension is limited. We aimed to explore the association between RC levels and carotid plaque in old adults with hypertension. 8523 hypertensive patients aged ≥ 60 years with serum lipids and carotid ultrasonography data were included in this community-based screening. Fasting RC was calculated as total cholesterol minus high-density lipoprotein cholesterol minus low-density lipoprotein cholesterol (LDLC). The associations of RC levels with carotid plaque risk were evaluated using Logistic regression and restricted cubic spline models. Carotid plaque was screened in 4821 (56.56%) subjects. After multivariable-adjusted, RC was significantly related to carotid plaque [Odd ratio (OR)] = 1.043 per 0.1 mmol/L increase, 95% confidence interval (CI): 1.030-1.056). The highest versus the lowest quartile of RC was 1.928 (1.673-2.223) for carotid plaque. A nonlinear association was found between serum RC levels and the risk of carotid plaque (P for nonlinearity < 0.001). Moreover, an RC > 0.78 mmol/L differentiated patients at a higher risk of carotid plaque compared to those at lower concentrations, regardless of whether LDLC was on target at 2.59 mmol/L. In old adults with hypertension, elevated RC was positively associated with carotid plaque, independent of LDLC and other conventional risk factors.

Improvement of the functional properties of insoluble dietary fiber from corn bran by ultrasonic-microwave synergistic modification.

A comprehensive investigation aimed to access the impacts of ultrasonic, microwave, and ultrasonic-microwave synergistic modification on the physicochemical properties, microstructure, and functional properties of corn bran insoluble dietary fiber (CBIDF). Our findings revealed that CBIDF presented a porous structure with loose folds, and the particle size and relative crystallinity were slightly decreased after modification. The CBIDF, which was modified by ultrasound-microwave synergistic treatment, exhibited remarkable benefits in terms of its adsorption capacity, and cholate adsorption capacity. Furthermore, the modification improved the in vitro hypoglycemic activity of the CBIDF by enhancing glucose absorption, retarding the starch hydrolysis, and facilitating the diffusion of glucose solution. The findings from the in vitro probiotic activity indicate that ultrasound-microwave synergistic modification also enhances the growth-promoting ability and adsorbability of Lactobacillus acidophilus and Bifidobacterium longum. Additionally, the level of soluble dietary fiber was found to be positively correlated with CBIDF adsorbability, while the crystallinity of CBIDF showed a negative correlation with α-glucosidase and α-amylase inhibition activity, as well as water-holding capacity, and oil-holding capacity.

Covid-19 vaccination coverage and associated factors among older hypertensive patients in Hangzhou, China.

BACKGROUND: Vaccination could provide effective protection against coronavirus disease 2019 (COVID-19). This study aims to describe the COVID-19 vaccination coverage and influential factors in Chinese older hypertensive patients. METHODS: Using a cross-sectional design, participants were randomly selected from the electronic health records system during the pandemic era in Hangzhou, China. Logistic regression models were employed to compute the OR and 95% CI in order to assess the relationships between variables and the extent of COVID-19 vaccination coverage. RESULTS: As of 3 August 2022, among a sample of 77 970 individuals, 75.11% had completed the full COVID-19 vaccination, while 57.66% had received a booster dose. Disparities in coverage were observed across genders, regions and age groups. Unhealthy lifestyles, cardiovascular disease, cancer, uncontrolled blood pressure, abnormal fasting plasma glucose, dyslipidemia and renal dysfunction were risk factors for COVID-19 vaccination coverage. The coverage rates continuously declined along with the number of risk factors. The ORs for full and booster vaccination in subjects with ≥4 risk factors were 2.55 (2.12∼3.07) and 2.60 (2.16∼3.13), compared to individuals without risk factors. CONCLUSION: The COVID-19 vaccination program for older hypertensive patients must be strengthened further. Emphasis should be placed on patients who reside in urban areas, have comorbidities or multiple risk factors.

The effectiveness of COVID-19 vaccination against all-cause mortality in patients with type 2 diabetes mellitus: The observation during the initial period of the cancellation of the "Dynamic Zero Policy" in mainland China.

AIMS: This study aims to assess the effectiveness of COVID-19 vaccination against all-cause death in patients with type 2 diabetes mellitus (T2DM). METHODS: Subjects were patients with T2DM who were administered by general practitioner (GP). Use electronic exchange platform to obtain the information on COVID-19 vaccination, all-cause deaths and risk factors. Logistic regression models were used to calculate the odd ratio (OR) and 95% CI for the association between COVID-19 vaccination and mortality. The vaccine effectiveness (VE) was calculated as (1- adjusted OR) × 100%. RESULTS: A total of 26,916 subjects had 53.81%, 17.65%, and 23.43% coverage for the booster, full, and partial COVID-19 vaccination, reported 328 deaths and a mortality of 1.2%. The adjusted OR (95%CI) was 0.85(0.60-1.21) for those received partial vaccination, 0.31(0.22-0.43) for those received full vaccination, and 0.12(0.08-0.18) for those received booster vaccination, compared to the unvaccinated individuals. The VE (95%CI) was 88.00%(82.30-91.80) of booster vaccination, 69.30%(56.60-78.30) of full vaccination, and 17.60%(-17.10-42.00) of partial vaccination. CONCLUSION: COVID-19 vaccination could effectively prevent the all-cause death in patients with T2DM during the omicron variant outbreak period, after the cancellation of the "Dynamic Zero Policy" in mainland China.

The factors correlated with COVID-19 vaccination coverage in Chinese hypertensive patients managed by community general practitioner.

This study aims to describe COVID-19 vaccination coverage and its influential factors in hypertensive patients who were administered by community general practitioners in China. A cross-sectional survey was carried out using data from electronic health record systems. The subjects were hypertensive patients who had been involved in the health management of the Essential Public Health Service (EPHS) program in Hangzhou City, China. As of Aug 3, 2022, the full and booster vaccination rates were 77.53% and 60.97% in randomly selected 96,498 subjects. There were disparities across regions, age, and gender in the distribution of COVID-19 vaccination coverage. Obesity and daily alcohol consumption were factors in the promotion of COVID-19 vaccination. Current smoking, non-daily physical exercise, irregular medication adherence, and comorbidities were risk factors for COVID-19 vaccination. Coverage rates have decreased depending on the number of risk factors. The ORs (95% CI) were 1.78 (1.61 ~ 1.96) of full vaccination and 1.74 (1.59 ~ 1.89) of booster vaccination in subjects with ≥4 risk factors, compared to those without risk factors. In summary, the progress of COVID-19 vaccination among community hypertensive patients lagged behind that of the general population during the same period. Individuals who lived in urban areas, were elderly, and had an irregular medication adherence, comorbidities, and multiple risk factors should be highlighted in the COVID-19 vaccination campaign.

The effect of mindfulness-based interventions during pregnancy on postpartum mental health: A meta-analysis.

BACKGROUND: Mindfulness helps reduce negative emotions, but its ability to prevent postpartum psychological problems remains unclear. This study aimed to assess the effects of mindfulness-based interventions (MBIs) during pregnancy on postpartum mental health, especially postpartum depression. METHODS: Online databases regarding the effect of mindfulness on pregnancy were searched and a meta-analysis was conducted. RESULTS: Eight randomized controlled trials (RCTs) and a self-controlled study were included. We found consistent results showing that MBIs significantly improve the depressive symptoms of all pregnant women in both the case-control (SMD = -0.90, 95 % CI (-2.71, -1.82), p = 0.01) and self-control (SMD = 1.24, 95 % CI (0.37, 2.11), p = 0.005) comparisons. However, MBIs were ineffective for high-risk pregnant women with severe depressive symptoms before delivery in both the case-control (SMD = -1.07, 95 % CI (-3.40, 1.25), p = 0.36) and self-control comparisons (SMD = 2.10, 95 % CI (-0.26, 4.47), p = 0.08). Furthermore, MBIs did not have significant advantages over other intervention methods (SMD = -0.45, 95 % CI (-1.17, 0.28), p = 0.23). LIMITATIONS: There were few high-quality RCTs, and the sample size was small. CONCLUSION: MBIs can relieve maternal depressive and anxiety symptoms, especially for the prevention of postpartum depression in healthy pregnant women. However, MBIs do not have significant advantages over other interventions and may not be useful for all pregnant women. These findings contribute to the optimization of perinatal mental health intervention programs and the improvement of pregnancy outcomes, playing an important guiding role in clinical decision-making.

The Association of Outdoor Walking Per Week with Mental Health and Costs of Psychotropic Drugs in Adults.

Regular walking confers many physical health benefits, including a reduced risk of disease-specific and all-cause mortality and better physical fitness. However, less is known about its role in mental health. Thus, the aims of this study were to determine the associations of outdoor walking per week with costs of psychotropic drugs used and mental health in adults. 500 adults aged 18 to 64 years in Hangzhou (China) reported sex, age, the name of the psychotropic drugs used and their dosage, and outdoor walking during the past 7 days. The cost that a person spends on buying psychotropic drugs for a month was considered psychotropic drugs costs. Overall mental health was assessed using the Chinese Version of the 12-Item General Health Questionnaire. The levels of walking in participants taking psychotropic were significantly lower than participants who did not taking psychotropic (p = 0.002). There was a significant negative correlation between mental health scores and minutes of walking per week and a significant positive correlation between the number of psychotropic drugs used and walking per week (p < 0.05). However, no particular associations were found between costs of psychotropic drug used and walking per week. Outdoor walking is prospectively associated with better overall mental health in adults. Then, awareness should be raised about the possible positive effects of outdoor walking on the mental health of adults.

Association between lifestyle and dietary preference factors and conventional adenomas and serrated polyps.

Introduction: Both conventional adenoma (AD) and serrated polyp (SP) were known precursor lesions of colorectal cancer (CRC). Modifiable lifestyle factors were significantly associated with CRC risk, but whether these factors were related to the risk of different precursors of CRC needed to be clarified. This study aimed to evaluate the risks of AD and SP caused by lifestyle factors and compare the risk differences between AD and SP. Methods: The study population was from the CRC screening cohort in Hangzhou, China. A total of 458,457 eligible individuals volunteered to undergo initial screening including the fecal immunochemical test (FIT) and the CRC risk assessment. Finally, 13,993 participants who had undergone colonoscopy tests and had been diagnosed at designated hospitals were selected in this study. All participants were required to fill out a questionnaire during the initial screening for collecting their information. The generalized estimate equation (GEE) model was used to assess the association between lifestyle factors/dietary preferences and AD/SP. Results: The body mass index (BMI) and smoking were positively associated with the risks of only SP (BMI: OR = 1.50, 95%CI: 1.23-1.84; smoking: OR = 1.29, 95%CI: 1.07-1.55), only AD (BMI: OR = 1.53, 95%CI: 1.28-1.82; OR = 1.24, 95%CI: 1.11-1.39), and synchronous SP and AD (BMI: OR = 1.97, 95%CI: 1.40-2.75; smoking: OR = 1.53, 95%CI: 1.27-1.85). In the case-group comparison, smoking was more strongly associated with the risk of synchronous SP and AD than only AD. Alcohol drinking was positively associated with the risk of AD (OR = 1.28, 95%CI: 1.14-1.44), but no statistically significant difference was observed in risks in the case-group comparison. Furthermore, whole-grain intake was associated with a decreased risk of only AD (OR = 0.78, 95%CI: 0.65-0.93). However, white meat intake was positively associated with risks of only SP when compared with AD cases (OR = 1.60, 95%CI: 1.15-2.23). Conclusion: The current study identified common risk factors such as BMI and smoking as well as different risks of certain factors (e.g., alcohol drinking and whole-grain intake) for SP and AD. However, there were still some factors, especially diet-related factors, that have not been fully elucidated in their association with the two lesions. Further research is needed in future to confirm and develop prevention strategies for different lesions.

Updates on fluorescent probes and open-field imaging methods for fluorescence-guided cytoreductive surgery for epithelial ovarian cancer: A review.

Fluorescence-guided surgery has emerged as a promising imaging technique for real-time intraoperative tumour delineation and visualisation of submillimetre tumour masses in cytoreductive surgery for epithelial ovarian cancer (EOC). Researchers have developed several EOC-targeted fluorescent probes, most of which are currently in the preclinical stage. Interestingly, imaging devices designed for open surgery are proof of concept. This review summarises the recent advances in EOC-targeted fluorescent probes and open-field fluorescence imaging strategies and discusses the challenges and potential solutions for clinical translation.

Nomogram to predict postoperative complications after cytoreductive surgery for advanced epithelial ovarian cancer: A multicenter retrospective cohort study.

Objective: To establish nomograms to predict the risk of postoperative complications following cytoreductive surgery in patients with advanced epithelial ovarian cancer (AEOC). Methods: A multicenter retrospective cohort study that included patients with FIGO stage IIIC-IV epithelial ovarian cancer who underwent cytoreductive surgery was designed. By using univariate and multivariate analyses, patient preoperative characteristics were used to predict the risk of postoperative complications. Multivariate modeling was used to develop Nomograms. Results: Overall, 585 AEOC patients were included for analysis (training cohort = 426, extrapolation cohort = 159). According to the findings, the training cohort observed an incidence of postoperative overall and severe complications of 28.87% and 6.10%, respectively. Modified frailty index (mFI) (OR 1.96 and 2.18), FIGO stage (OR 2.31 and 3.22), and Surgical Complexity Score (SCS) (OR 1.16 and 1.23) were the clinical factors that were most substantially associated to the incidence of overall and severe complications, respectively. The resulting nomograms demonstrated great internal discrimination, good consistency, and stable calibration, with C-index of 0.74 and 0.78 for overall and severe complications prediction, respectively. A satisfactory external discrimination was also indicated by the extrapolation cohort, with the C-index for predicting overall and severe complications being 0.92 and 0.91, respectively. Conclusions: The risk of considerable postoperative morbidity exists after cytoreductive surgery for AEOC. These two nomograms with good discrimination and calibration might be useful to guide clinical decision-making and help doctors assess the probability of postoperative complications for AEOC patients.

Botulinum toxin A (BoNT/A) for the treatment of depression: A randomized, double-blind, placebo, controlled trial in China.

BACKGROUND: Depression is characterized by low moods, anhedonia, and social avoidance. Effective and acceptable treatments are required for depression. Positive effects on mood have been observed in patients with depression after treatment with botulinum toxin A (BoNT/A). METHODS: A total of 88 patients with depression were randomly assigned to BoNT/A (n = 56) and placebo (saline, n = 22) groups. The primary objective was to determine the change in the 17-item version of the Hamilton Depression Rating Scale (HAMD), 12 weeks after the treatments when compared with the baseline. RESULTS: The BoNT/A and placebo groups did not differ significantly in all the collected baseline characteristics. However, there was a significant improvement in the depressive symptoms of the BoNT/A group compared to those of the placebo group throughout the 12-week follow-up period. This was according to the measurements of HAMD (F (1, 370) = 9.094, P = 0.0027), Self-rating Depression Scale (SDS) (F (1, 370) = 11.26, P < 0.001), Hamilton Anxiety Scale (HAMA) (F (1, 410) = 8.673, P = 0.0034) and Self-rating Anxiety Scale (SAS) (F (1, 379) = 5.788, P = 0.017). Furthermore, the effectiveness was even higher at the end of the study period. LIMITATIONS: The limitations include the absence of a multicenter study and an inadequate number of cases. Additionally, the mechanism of BoNT/A antidepression was not studied. CONCLUSION: This study showed that a single treatment with BoNT/A may accomplish a strong and sustained alleviation of depression in patients.

Effect of Particle Size on Physicochemical Properties and in vitro Hypoglycemic Ability of Insoluble Dietary Fiber From Corn Bran.

This study was designed for determining the effect of particle size on the functional properties of corn bran insoluble dietary fiber (IDF). Results showed that some physicochemical properties were improved with the decrease in particle size. The structure of the IDF was observed by the scanning electron microscope (SEM), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FT-IR). The surface was found wrinkled and sparse, the particle size was smaller, the crystallinity of IDF had increased slightly, and more -OH and C-O groups were exposed. Moreover, the corn bran IDF with a smaller particle size had a better hypoglycemic effect in vitro, and the inhibitory activity of α-glucosidase and α-amylase were also increased significantly with the decrease in particle size (p < 0.05). When the IDF was 300 mesh, the inhibitory rate of α-glucosidase was 61.34 ± 1.12%, and the inhibitory rate of α-amylase was 17.58 ± 0.33%. It had increased by 25.54 and 106.83%, respectively compared to the control treatment (CK) group. In addition, correlation analysis found that the particle size was highly negatively correlated with some functional properties of IDF (p < 0.05), and the content of cellulose was positively correlated with the functional properties of IDF except WHC (p < 0.05). To sum up, reducing particle size was suitable for the development of high value-added IDF products. This study also revealed the potential value of corn bran IDF and provided a new idea for the diversified application of IDF.

Prediction Models for Complete Resection in Secondary Cytoreductive Surgery of Patients With Recurrent Ovarian Cancer.

The most advanced epithelial ovarian cancer develops recurrent disease despite maximal surgical cytoreduction and adjuvant platinum-based chemotherapy. Treatment with secondary cytoreductive surgery (SCS) combined with chemotherapy or with chemotherapy alone for patients with platinum-sensitive recurrent ovarian cancer (ROC) is currently under heated discussion. Encouragingly, the results of the AGO DESKTOP III Study and the SOC1/SGOG-OV2 trial, which have been published recently, showed a striking advantage in terms of overall survival (OS) and progression-free survival (PFS) of ROC patients undergoing SCS compared to chemotherapy alone; moreover, a benefit of SCS exclusively for patients with complete gross resection (CGR) was particularly highlighted. CGR is considered the ultimate goal of SCS, on condition that the balance between maximal survival gain and minimal operative morbidity is maintained. Several models have been proposed to predict the rate of CGR, such as the MSK criteria, the AGO score, and the Tian model, over the last 15 years. This summary is mainly about the several previously published prediction models for CGR in SCS of ROC patients and discusses the effectiveness and limitations of these prediction models.

Cross-Sectional Analysis of the Involvement of Interleukin-17A in Diabetic Retinopathy in Elderly Individuals with Type 2 Diabetes Mellitus.

BACKGROUND: To investigate the correlation between serum interleukin-17A (IL-17A) levels and diabetic retinopathy (DR) in elderly individuals with type 2 diabetes mellitus (T2DM). METHODS: The study included 194 elderly patients (94 males and 100 females) with T2DM. Digital retinal photography as well as fundus fluorescein angiography was employed to distinguish between nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). In addition, multiple logistic regression analysis was conducted to determine the correlation between serum IL-17A levels and DR status. RESULTS: The average age of the study cohort was 69.14 ± 6.33 years, of which 52.08% were male. The study participants with the highest IL-17A (Q4) levels had higher TC, DBP, and low-density lipoprotein cholesterol (LDL-C) values than those the other groups. Analysis using unadjusted and adjusted linear regression revealed that the effect size of 1.09 for DR in the unadjusted model indicates that IL-17A is associated with an increase of 1.09 in DR (mmol/L) (ß 1.09, 95% confidence interval (CI) 1.03, 1.16). Using the minimum-adjusted model (the model 2), as IL-17A increased, DR was higher by 1.11 (ß 1.11, 95% CI 1.04, 1.18). With the fully adjusted model (the model 3), for each additional IL-17A increase, DR was higher by 1.15 (ß 1.15, 95% CI 1.06, 1.24). CONCLUSION: Serum IL-17A levels are apparently positively correlated to DR in Chinese elderly individuals with T2DM.

The blood pressure control and arteriosclerotic cardiovascular risk among Chinese community hypertensive patients.

The present study aimed to describe the blood pressure (BP) control rate and 10-years arteriosclerotic cardiovascular disease (ASCVD) risk estimation among community hypertensive patients. A total of 196,803 subjects were enrolled. The control rates calculated as the intensive (SBP < 130 mmHg and DBP < 80 mmHg) and standard (SBP < 140 mmHg and DBP < 90 mmHg) threshold. Multivariable logistic analysis was employed to assess the associations between cardiovascular factors and BP control. Sensitivity, specificity and Youden's index were used to identify the ability of high risk of ASCVD estimation by different thresholds. The control rate was 16.34% and 50.25% by the intensive and standard threshold, respectively. Besides regular medication, the risk factors for BP control included older age, male, unhealthy lifestyle, obesity, dyslipidemia and abnormal FPG. 25.08% of subjects had high risk of 10-years ASCVD estimation. The sensitivity, specificity and Youden's index of intensive threshold was 84.37%, 16.15% and 0.51%, and were significantly different from 50.55%, 50.42% and 0.98% of the standard threshold, respectively. Half of community hypertensive patients did not control BP, and nearly a quarter have high risk of 10-years ASCVD risk estimation. The intensive threshold resulted in a one-third reduction in the control rate compared to the standard threshold. No matter which threshold was used, a single BP control status seemed not a suitable indicator for identification of high risk of 10-years ASCVD risk estimation.

The safety and efficacy of botulinum toxin A on the treatment of depression.

OBJECTIVES: Effective strategy for the treatment of depression is limited. This study was to evaluate the safety and efficacy of botulinum toxin A (BoNT/A) in the treatment of depression. METHODS: Seventy-six patients were assigned to the BoNT/A group (n = 52) and sertraline control group (n = 24). For the BoNT/A group, BoNT/A was injected into the frowning muscle, depressor muscle, occipital frontalis muscle, lateral canthus, and bilateral temporal region at 20 sites. Five units per site and a total of 100 units of BoNT/A were given. Patients in the sertraline control group were medicated with sertraline 50-200 mg (114.58 ± 52.08 mg) per day. Depression was assessed by the 17-item Hamilton Depression Scale (HAMD-17), 14-item Hamilton Anxiety Scale (HAMA-14), Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS). All participants were followed up for 12 weeks. RESULTS: Scores of HAMD, HAMA, SDS, and SAS decreased significantly in both BoNT/A and sertraline groups after treatment for 12 weeks. Overall, there were no differences in decreased magnitude between the two groups (p > .05). The HAMA, SDS, and SAS results showed that the onset time of BoNT/A was earlier than that of sertraline. Side effects rates were 15.38% for BoNT/A and 33.33% for sertraline. CONCLUSION: This study demonstrated significant antidepressant effects of BoNT/A. The efficacy of BoNT/A was comparable with established antidepressant sertraline. The onset time of BoNT/A was earlier than sertraline, and the proportion of side effects was less than sertraline. Therefore, BoNT/A could be a safe and effective option for the treatment of depression.

Performance validation of the Mayo triage algorithm applied to individualize surgical management of advanced epithelial ovarian cancer.

OBJECTIVE: To externally validate the performance of the Mayo triage algorithm applied to treatment strategy management in advanced epithelial ovarian cancer (AEOC) patients. METHODS: AEOC patients who underwent primary debulking surgery (PDS) were included and were divided into two groups based on the Mayo triage algorithm: "high risk" and "triage appropriate". The surgery outcomes and complications of the patients were compared between the two groups. RESULTS: 179 consecutive AEOC patients were enrolled for analysis, including 32 patients in the high-risk group and 147 patients in the triage-appropriate group. The results showed that patients in the high-risk group were older, had worse physical status and had lower preoperative serum albumin than those in the triage-appropriate group (P<0.01). The high-risk group had a lower proportion of women who underwent intermediate/high complexity surgery (38% vs. 72%, P<0.01) as well as a lower proportion of women who underwent optimal resection (50% vs. 71%, P<0.05). Furthermore, the incidence of 30-day complications (28% vs. 5%, P<0.01) and the proportion of patients who were unable to undergo adjuvant chemotherapy after PDS (22% vs. 2%, P<0.01) were both significantly higher in the high-risk group than in the triage-appropriate group. In addition, compared to the triage-appropriate group, the 90-day mortality rate in the high-risk group was also notably higher, but the difference was not statistically significant (6% vs. 1%, P=0.15). CONCLUSION: The validity of the Mayo triage algorithm for treatment decision-making in AEOC was externally confirmed in this study. This short-term complication assessment tool could be effectively used for the individualized primary management of high-risk AEOC patients. The feasibility of the Mayo triage algorithm for use in long-term management should be further explored.

Association between stereopsis deficits and attention decline in patients with major depressive disorder.

Cognitive and sensory deficits were considered a core feature of major depressive disorder (MDD). However, few studies investigated stereopsis integrity in patients with MDD. Thus, the objectives of this study investigated stereopsis integrity and its correlations with cognitive function and depressive symptom in patients with MDD. 90 patients with MDD and 116 healthy controls (HCs) were enrolled in this study. Their stereoacuity was evaluated using the Titmus Stereopsis Test as well as assessing their cognitive function and depressive symptom by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Hamilton Depression Scale (HAMD). Log seconds of arc was significantly higher in patients than HCs (1.92 ± 0.41 versus 1.67 ± 0.16, t = 5.35, p < 0.0001). The percentage of patients with correct stereopsis detection was markedly declined in 400 (z = 3.06, p = 0.002), 200 (z = 3.84, p < 0.001), 140 (z = 4.73, p < 0.001), 100 (z = 4.58, p < 0.001), 80 (z = 5.06, p < 0.001), 60 (z = 4.72, p < 0.001), 50 (z = 4.24, p < 0.001), and 40 (z = 4.85, p < 0.001) seconds of arc compared with HCs. Log seconds of arc was significantly correlated with the RBANS total score (r = -0.38, p < 0.0001), subscores of attention (r = -0.49, p < 0.0001) and language (r = -0.33, p = 0.001) rather than HAMD score (r = 0.03, p = 0.78) in MDD patients. In addition, log seconds of arc was significantly related to the RBANS total score (r = -0.58, p < 0.0001) and language score (r = -0.45, p = 0.006) rather than attention score (r = -0.30, p = 0.07) in HCs. Further stepwise multivariate regression analyses showed the negative correlation of log seconds of arc with attention score (ß = -0.80, t = -3.95, p < 0.0001) rather than HAMD score (ß = -0.008, t = -0.09, p = 0.93) in MDD patients. However, there was no relationship between log seconds of arc and attention score in HCs (ß = 1.52, t = 1.19, p = 0.24). Our results identified the marked deficits of stereopsis in MDD patients that were tightly correlated with their attention functioning rather than depressive symptom.