Association of sleep behavior with depression: a cross-sectional study in northwestern China

BackgroundThis study aimed to examine the association between sleep duration, sleep problems, and depression in Northwest China.MethodDepression was diagnosed at the hospital and self-reported by the participants in the baseline survey. Sleep duration and problems, including difficulty initiating and maintaining sleep, early morning awakening, daytime dysfunction, use of sleeping pills or drugs, and any sleep problems, were obtained by a self-reported questionnaire. Logistic regression was used to estimate odds ratios (ORs) with corresponding 95% confidence intervals (CIs) for exploring the association between sleep duration, sleep problems, and depression, adjusting for demographic and socioeconomic characteristics and health behaviors. The association between depression and sleep duration was also evaluated continuously with restricted cubic spline curves based on logistic models.Results36,515 adults from Regional Ethnic Cohort Study in Northwest China were included. About 24.04% of participants reported short sleep duration (<7 h), and 15.64% reported long sleep duration (≥9 h). Compared with standard sleep duration (7–9 h), short sleep duration was associated with a higher risk of depression (OR: 1.69, 95%CI: 1.26–2.27, p = 0.001). Self-reported sleep problems were also related to four times depression risk increased (OR: 4.02, 95%CI: 3.03–5.35, p < 0.001) compared with no sleep problems. In addition, a nonlinear relationship was found between sleep duration and depression after adjusting covariates (p = 0.043).ConclusionSleep duration and sleep problems are associated with depression. Enough sleep time and healthy sleep habits in life course might be a practical health promotion approach to reduce depression risk in Northwest Chinese adults. A further study from cohort study is needed to verify the temporal association

Associations between long-term blood pressure trajectory and all-cause and CVD mortality among old people in China

BackgroundOptimal blood pressure (BP) management strategy among the elderly remains controversial, with insufficient consideration of long-term BP trajectory. This study aimed to identify BP trajectory patterns as well as terminal BP trajectory among the Chinese elderly and to explore the relationships between BP trajectories and all-cause mortality and cardiovascular disease (CVD) mortality.MethodsWe included 11,181 participants older than 60 at baseline (mean age, 80.98 ± 10.71) with 42,871 routine BP measurements from the Chinese Longitudinal Healthy Longevity Survey. Latent class trajectory analysis and Cox proportional hazard model were conducted to identify trajectory patterns and their associations with mortality. Furthermore, we also applied mixed-effects model to identify terminal BP trajectories among the elderly.ResultsCompared with stable at normal high level trajectory, excess systolic BP (SBP) trajectory with decreasing trend was associated with a 34% (HR = 1.34, 95% CI: 1.23–1.45) higher risk of all-cause mortality. Considering the competing risk of non-CVD death, excess BP trajectory with decreasing trend had a more pronounced effect on CVD mortality, in which HR (95% CI) was 1.67 (1.17, 2.37). Similar results were also found in diastolic BP (DBP), pulse pressure (PP), and mean arterial pressure (MAP) trajectories. We further conducted a mixed-effects model and observed that SBP and PP trajectories first increased and began to decline slightly six years before death. In contrast, DBP and MAP showed continuous decline 15 years before death.ConclusionLong-term BP trajectory was associated with all-cause mortality, especially CVD mortality. Keeping a stable BP over time may be an important way for CVD prevention among the elderly

Brain Activities Responding to Acupuncture at ST36 (zusanli) in Healthy Subjects: A Systematic Review and Meta-Analysis of Task-Based fMRI Studies

PurposeStomach 36 (ST36, zusanli) is one of the important acupoints in acupuncture. Despite clinical functional magnetic resonance imaging (fMRI) studies of ST36 acupuncture, the brain activities and the neural mechanism following acupuncture at ST36 remain unclear.MethodsLiterature searches were conducted on online databases, including MEDLINE, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang database, WeiPu database, and China Biology Medicine, for task-based fMRI studies of acupuncture at ST36 in healthy subjects. Brain regions activated by ST36 acupuncture were systematically evaluated and subjected to seed-based d mapping meta-analysis. Subgroup analysis was conducted on control procedures, manual acupuncture, electrical acupuncture (EA), and acupuncture-specific activations. Meta-regression analysis was performed to explore the effects of needle retention time on brain activities following ST36 acupuncture stimulation. The activated brain regions were further decoded and mapped on large-scale functional networks to further decipher the clinical relevance of acupuncturing at ST36.ResultsA total of sixteen studies, involving a total of 401 right-handed healthy participants, that satisfied the inclusion criteria were included in the present meta-analysis. Meta-analysis showed that acupuncturing on ST36 positively activates the opercular part of the right inferior frontal gyrus (IFG.R), left superior temporal gyrus (STG.L), and right median cingulate/paracingulate gyri (MCG.R) regions. Needle retention time in an acupuncture session positively correlates with the activation of the left olfactory cortex, as shown in meta-regression analysis. Subgroup analysis revealed that EA stimulation may be a source of heterogeneity in the pooled results. Functional network mappings showed that the activated areas were mapped to the auditory network and salience network. Further functional decoding analysis showed that acupuncture on ST36 was associated with pain, secondary somatosensory, sound and language processing, and mood regulation.ConclusionAcupuncture at ST36 in healthy individuals positively activates the opercular part of IFG.R, STG.L, and MCG.R. The left olfactory cortex may exhibit positive needle retention time-dependent activities. Our findings may have clinical implications for acupuncture in analgesia, language processing, and mood disorders.Systematic Review Registrationhttps://inplasy.com/inplasy-2021-12-0035

Inequalities in the geographic distribution of hospital beds and doctors in traditional Chinese medicine from 2004 to 2014

Abstract Objectives This study identifies inequities in the provincial-level geographical distribution of traditional Chinese Medicine (TCM) hospital beds and doctors in China from 2004 to 2014. This provides policy implications of the optimal allocation of TCM health care resources. Methods Our study used province level data on TCM hospital beds and doctors from 2004 to 2014. These data were obtained from the China TCM Yearbook 2004–2014 and the China Statistical Yearbook 2004–2014.Global and local spatial autocorrelation was performed by using Moran’s index and the local Moran’s index to describe the spatial distribution of TCM hospital beds (doctors) as well as their density. A Gini coefficient was used to estimate inequalities in the geographic distribution of TCM hospital beds (doctors) based on their density. Correlations of the Gini coefficients between TCM hospital beds and doctors were calculated by Pearson correlation analysis. Results All indicators of TCM hospital beds and doctor density have increased over the past 11 years. The number of TCM hospital beds per 10,000 populations increased the fastest. Geographical clustering was not obvious in the density distribution of TCM hospital beds or doctors, as no significant spatial autocorrelation was found. Gini coefficients showed that from 2004 to 2014 the distribution of TCM hospital beds per 10,000 population and doctors per 10,000 populations were equitable between different regions. A large gap existed in the distribution inequality of TCM hospital beds (doctors) per square kilometer among different regions. Conclusion Targeted health policy with equitable distribution of TCM hospital beds (doctors) per square kilometer and the balance and coordination of related resources should be a priority in shaping China’s healthcare system reform

Overall survival analysis.

<p>Overall survival analysis.</p

Evaluation of <i>K-ras</i> and <i>p53</i> expression in pancreatic adenocarcinoma using the cancer genome atlas

<div><p>Genetic alterations in <i>K-ras</i> and <i>p53</i> are thought to be critical in pancreatic cancer development and progression. However, <i>K-ras</i> and <i>p53</i> expression in pancreatic adenocarcinoma have not been systematically examined in The Cancer Genome Atlas (TCGA) Data Portal. Information regarding <i>K-ras</i> and <i>p53</i> alterations, mRNA expression data, and protein/protein phosphorylation abundance was retrieved from The Cancer Genome Atlas (TCGA) databases, and analyses were performed by the cBioPortal for Cancer Genomics. The mutual exclusivity analysis showed that events in <i>K-ras</i> and <i>p53</i> were likely to co-occur in pancreatic adenocarcinoma (Log odds ratio = 1.599, <i>P</i> = 0.006). The graphical summary of the mutations showed that there were hotspots for protein activation. In the network analysis, no solid association between <i>K-ras</i> and <i>p53</i> was observed in pancreatic adenocarcinoma. In the survival analysis, neither <i>K-ras</i> nor <i>p53</i> were associated with both survival events. As in the data mining study in the TCGA databases, our study provides a new perspective to understand the genetic features of <i>K-ras</i> and <i>p53</i> in pancreatic adenocarcinoma.</p></div

Disease-free survival analysis.

<p>Disease-free survival analysis.</p

Mutation diagram of <i>K-ras</i> in pancreatic adenocarcinoma.

<p>Mutation diagram of <i>K-ras</i> in pancreatic adenocarcinoma.</p

Mutation diagram of <i>p53</i> in pancreatic adenocarcinoma.

<p>Mutation diagram of <i>p53</i> in pancreatic adenocarcinoma.</p