ObjectiveThis study aims to test a Chinese cross-cultural adaptation of the English version of the Person-Centred Care Assessment Tool (P-CAT) and evaluate its psychometric properties.DesignP-CAT was translated/back-translated using established procedures before the psychometric evaluation of the Chinese version was made.SettingTwo hospitals covering urban and suburban areas of Kunming in the Yunnan province of China.Participants152 female hospital staff completed the survey.Main outcome measure(s)Construct validity and reliability, including internal consistency and test–retest reliability, were assessed among a sample of hospital staff.ResultsThe factor analysis resulted in a two-component solution that consisted of two subscales. The corrected item-total correlations for all of the items ranged from 0.14 to 0.44, with six items not meeting the cut-off level for item-total correlation (>0.3). The Chinese P-CAT demonstrated strong reliability, with a Cronbach’s alpha of 0.91–0.94 for the scales and a test–retest reliability coefficient of 0.88 for the overall scale scores. The intraclass correlation was 0.92 (95% CI 0.90 to 0.95).ConclusionP-CAT appears to be a promising measure for evaluating staff perceptions of person-centredness in Chinese hospital environments. The results show that P-CAT can be a useful tool for improving the quality of healthcare in terms of person-centred care in the Chinese context.

ObjectivesThe aim of the study was to evaluate the psychometric properties of a Chinese translation of the English version of the Person-centred Climate Questionnaire – Staff version (PCQ-S) for Chinese palliative care staff in a hospital context.DesignThis was a cross-sectional design. The 14-item English PCQ-S was translated and backtranslated using established procedures. Construct validity and reliability including internal consistency and test-retest reliability were assessed among hospital staff. Construct validity was tested using principal component analysis (PCA), internal consistency was assessed using Cronbach’s alpha, and test-retest reliability was evaluated with the weighted kappa (Kp), Pearson correlation coefficient (r) and intra-class correlation coefficient (ICC).SettingThis study was conducted in three hospitals in Kunming, the capital of Yunnan province in south-west China.ParticipantsA sample of hospital staff (n=163) on duty in the palliative care departments of three hospitals in Kunming consented to participate in the study.ResultsThe 14-item Chinese PCQ-S consists of the three subscales also present in other language versions. It showed strong internal consistency, with a Cronbach’s alpha of 0.94 for the total scale, 0.87 for the safety subscale, 0.90 for the everydayness subscale and 0.88 for the community subscale. The Chinese PCQ-S had high test-retest reliability as evidenced by a high Kp coefficient and a high correlation coefficient for all scales between test and retest scores, on ‘a climate of safety’ (Kp=0.77, r=0.88, p<0.01), ‘a climate of everydayness’ (Kp=0.82, r=0.91, p<0.01), ‘a climate of community’ (Kp=0.75, r=0.79, p<0.01), and on overall scale scores (Kp=0.85, r=0.93, p<0.01). The ICC to evaluate the test-retest reliability was 0.97 (95% CI 0.95 to 0.98).ConclusionsThe Chinese version of the PCQ-S showed satisfactory reliability and validity for assessing staff perceptions of person-centred care in Chinese hospital environments.

Anxiety-like symptoms are common symptoms of methamphetamine (METH) users, especially in the acute withdrawal period, which is an important factor for the high relapse rate during METH acute withdrawal. Exercise has been demonstrated to relieve anxiety-like symptoms during METH withdrawal, but the underlying mechanisms of this anti-anxiety effect are still unclear. Activated microglia and abnormal neuroinflammation play an important role in the pathogenesis of anxiety-like symptoms after METH withdrawal. Moreover, peripheral immune factors were also significantly associated with anxiety symptoms. However, the effects of treadmill exercise on microglial function and neuroinflammation in the striatum and hippocampus during acute METH withdrawal have not been reported. In the current study, we found severe peripheral immune dysfunction in METH users during acute withdrawal, which may in part contribute to anxiety symptoms during METH acute withdrawal. We also showed that 2 weeks of METH exposure induced anxiety-like symptoms in the acute withdrawal period. Additionally, METH exposure resulted in increased microglial activation and proinflammatory cytokines released in the mouse striatum and hippocampus during acute withdrawal. We next evaluated the effects of treadmill exercise in countering anxiety-like symptoms induced by METH acute withdrawal. The results showed that anxiety-like symptoms induced by acute METH withdrawal were attenuated by coadministration of treadmill exercise. In addition, treadmill exercise counteracted METH-induced microglial activation in the mouse striatum and various subregions of the hippocampus. Furthermore, treadmill exercise also reversed the increase in proinflammatory cytokines induced by acute METH withdrawal in the mouse striatum, hippocampus and serum. Our findings suggest that the anti-anxiety effect of treadmill exercise may be mediated by reducing microglial activation and regulating central and peripheral inflammatory responses.

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Background Hypertension is a common complication in injection drug users (IDU), especially a high proportion of resistant hypertension occurs among them. However, the involving mechanisms remain largely unknown. Methods We here investigated the key signaling moieties in resistant hypertension in drug users. Analyses were performed with high-throughput transcriptomic sequencing data of peripheral blood from individuals with drug-sensitive hypertension (Ctrl-DS), IDU with resistant hypertension (IDU-DR), and IDU with sensitive hypertension (IDU-DS). Results We showed that 17 and 1 genes in IDU-DS, 48 and 4 genes in IDU-DR were upregulated and downregulated compared Ctrl-DS, and 2 and 4 genes were upregulated and downregulated in IDU-DR compared with IDU-DS, respectively ( p ≤ 0.01 and |log 2 (FC)| ≥ 1). Differentially expressed genes (DEGs) between Ctrl-DS and IDU-DS were mainly involved in Gene ontology terms of immunoglobulin complex and blood microparticle. DEGs between IDU-DS and IDU-DR were mainly involved in immune system process and immunoglobulin complex. DEGs between Ctrl-DS and IDU-DR were mainly involved in immunoglobulin complex, blood microparticle and cytoplasmic vesicle lumen. We identified 2 gene clusters (brown modules, MEbrown; turquoise module, MEturquoise) correlated with IDU-DR and a gene cluster (magenta module, MEmagenta) correlated with IDU-DS by weighted gene co-expression network analysis (WGCNA). Functional analysis demonstrated that pathways of focal adhesion and focalin-1-rich granule lumen were involved in the development of IDU-DR, and the cytosolic large ribosomal subunit may relate to IDU-DR. Further, immune cell infiltration analysis demonstrated that the abundance of dendritic cells (DCs), natural Treg cells (nTreg), and exhausted T cells (Tex) in IDU-DR and IDU-DS, naïve CD8 + T cells in IDU-DS was significantly different compared with that in Ctrl-DS. The abundance of cytotoxic T cells (Tc) was significantly different between IDU-DS and IDU-DR. Conclusion Our findings indicated a potential function of immunoregulation mechanisms for resistant hypertension.

Antiretroviral therapy (ART) is the most generally used to treat human immunodeficiency virus (HIV)-infected patients. However, some patients experience incomplete immune reconstitution and fail to restore CD4+ T cell counts after treating with ART. Herein, we investigated the characters of CD4+CD8+ double-positive (DP) T cells at the transcriptomic level by analyzing single-cell RNA sequencing of peripheral blood mononuclear cells from HIV-infected immunological non-responders (INRs) and immunological responders (IRs). We identified eight DP T cell clusters and grouped into three populations CD4highCD8low, CD4lowCD8high, and CD4lowCD8low, respectively. Decreased proportion of DP T cells was detected in INRs, including CD4highCD8low DP T cells in the process of cellular differentiation, the latter demonstrated a reduced source of DP T cells in INRs. CD4highCD8low DP T cells in IRs and INRs as a heterogenous population, were distinct on the expression of GZMA/B/H, LAG3, NKG7 and GNLY, which related to the function of cell activation and cellular differentiation, cytotoxicity and programmed cell death. These data provide a comprehensive analysis of gene signatures of CD4highCD8low DP T cells associated with failed immune reconstitution after HIV infection, which could be useful in developing new cure strategies for HIV-infected patients.

Background: Hypertension patients with drug use have a low susceptibility to hypotensor. The pathogenesis and metabolic characteristics of hypertension in drug users remain unknown. Methods: We performed high-throughput sequencing for transcriptome and metabolome of peripheral blood from 30 hypertension patients with drug use (HBP-DU) and 30 hypertension patients without drug use (HBP). Results: Differentially expressed genes (DEGs) between the HBP and HBP-DU groups were mainly involved in the pathways of toll-like receptor (TLR) cascades, FCERI signaling, and interleukin signaling. Differentially metabolites (DMs) were significantly enriched in the pathways of alanine and histidine metabolism. We identified a gene cluster (turquoise module, MEturquoise) correlated with the HBP-DU group, which has a similar function to DEGs. The abundance of CD4+ T cells and CD8+ T cells was significantly decreased in the HBP-DU group. Conclusions: These results indicated a potential function of histidine, immune cells, and the pathway of toll-like receptor cascades in drug use hypertension.

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