Depression is one of the most common psychological consequences of caregiving. Caring for patients with severe mental illness (SMI) adds significant challenges to family caregivers’ mental health. The purpose of this study was to describe the prevalence of depression among caregivers of SMI patients in rural areas of Sichuan province of China, to examine the influence of social support and care burden on depression, and to explore the intermediary effect of care burden between social support and depression among caregivers of SMI patients. Data were collected from 256 primary caregivers of SMI patients in rural Sichuan Province in China. We used structural equation modeling (SEM) to test the hypothesized relationship among the variables. We found that a total of 53.5% of caregivers had depression. Both care burden (β = 0.599, 95%CI: 0.392–0.776) and social support (β = −0.307, 95%CI: (−0.494)–(−0.115)) were directly related to depression, while social support had a direct association with care burden (β = −0.506, 95%CI: (−0.672)–(−0.341)). Care burden mediated the relationship between social support and depression. For the socio-demographic variables, gender, education level and per capita annual income of household had significant correlations with depression (p < 0.05). The results strongly demonstrated that social support and care burden were predictors of depression, especially social support. Policymakers should fully recognize the role of primary family caregivers in caring for SMI patients and promote interventions to decrease care burden and reduce caregivers’ depression by improving social support and network. More attention should be given to female caregivers and caregivers with lower education and lower household income levels.

Sphingosine 1-phosphate (S1P) is involved in multiple pathological processes, including fibrogenesis. S1P participates in mouse liver fibrogenesis via a paracrine manner. Herein, we investigated the involvement of S1P in human liver fibrosis. Human fibrotic samples were obtained from livers of patients undergoing liver transplantation. Expression of sphingosine kinase (SphK1), collagen (Col) α1(I), Col α1(III), α-smooth muscle actin, and p-Smad2/3 was characterized by immunofluorescence, real-time RT-PCR, high-content analysis, or Western blot analysis in the fibrotic liver, human bone marrow-derived mesenchymal stem cells, and human hepatogenic profibrotic cells. The effect of SphK1 was assessed using siSphK1 or SphK-specific inhibitor. SphK1, which was expressed in human fibrotic liver myofibroblasts, could be detected in human bone marrow-derived mesenchymal stem cells or human hepatogenic profibrotic cells activated by transforming growth factor β1 (TGF-β1). TGF-β1 evoked the activation of SphK1, increased intracellular S1P, and up-regulated expression of SphK1, Col α1(I), and Col α1(III) in a TGF-β receptor-dependent manner. TGF-β1 induced expression of Col α1(I) and Col α1(III) via SphK1, which was mediated by intracellular S1P, independent of S1P receptors. TGF-β1 evoked nuclear translocation of p-Smad2 and p-Smad3 in TGF-β receptor-dependent, but SphK1-independent, manner. In conclusion, intracellular S1P plays a crucial role in the TGF-β1-induced expression of Col α1(I) and Col α1(III), which is required for human fibrosis development. S1P exerts its effects in S1P receptor-independent manner.

HuR expression and cytoplasmic localization were increased in fibrotic livers. S1P induced migration of human bone marrow Mesenchymal Stem Cells via S1PR3 and HuR. HuR regulated S1PR3 mRNA expression by binding with S1PR3 mRNA 3'UTR. S1P induced HuR phosphorylation and cytoplasmic translocation via S1PR3. HuR regulated S1PR3 expression by competing with miR-30e.

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Background Healthcare workers, who protect and improve the health of individuals, are critical to the success of health systems and achieving national and global health goals. To respond effectively to the healthcare needs of populations, healthcare workers themselves must be in a good state of health. However, healthcare workers face various psychosocial pressures, including having to work night shifts, long working hours, demands of patient care, medical disputes, workplace violence, and emotional distress due to poor interactions with patients and colleagues, and poor promotion prospects. Constant exposure to these psychosocial hazards adversely impacts healthcare workers’ health. Consequently, this study aimed to examine the influence of effort-reward imbalance, job satisfaction, and work engagement on self-rated health of healthcare workers. The results would be conducive to providing policy guidance to improve the health of healthcare workers. Methods We analysed the data of 1327 participants from The Chinese Sixth National Health and Services Survey in Sichuan Province that was conducted from August 2018 to October 2018. Structural equation modelling was used to test the hypothesized relationships among the variables. Results Only 40.1% of healthcare workers rated their health as ‘relatively good’ or ‘good’. Effort-reward imbalance had a significant negative correlation with self-rated health (β = − 0.053, 95% CI [− 0.163, − 0.001]). The associations of effort-reward imbalance and work engagement with self-rated health were both mediated by job satisfaction (95% CI [− 0.150, − 0.050] and [0.011, 0.022]), and work engagement mediated the relationship between effort-reward imbalance and self-rated health (95% CI [− 0.064, − 0.008]). Conclusion In order to improve the health of healthcare workers, administrators should balance effort and reward and provide opportunities for career development and training. In addition, health managers should help healthcare workers realize the significance and value of their work and keep them actively devoted to their work through incentive mechanisms.

RNA-binding protein HuR mediates transforming growth factor (TGF)-β1-induced profibrogenic actions. Up-regulation of Sphingosine kinase 1 (SphK1) is involved in TGF-β1-induced activation of hepatic stellate cells (HSCs) in liver fibrogenesis. However, the molecular mechanism of TGF-β1 regulates SphK1 remains unclear. This study was designed to investigate the role of HuR in TGF-β1-induced SphK1 expression and identify a new molecular mechanism in liver fibrogenensis. In vivo, HuR expression was increased, translocated to cytoplasm, and bound to SphK1 mRNA in carbon tetrachloride- and bile duct ligation-induced mouse fibrotic liver. HuR mRNA expression had a positive correlation with mRNA expressions of SphK1 and fibrotic markers, α-smooth muscle actin (α-SMA) and Collagen α1(I), respectively. In vitro, up-regulation of SphK1 and activation of HSCs stimulated by TGF-β1 depended on HuR cytoplasmic accumulation. The effects of TGF-β1 were diminished when HuR was silenced or HuR cytoplasmic translocation was blocked. Meanwhile, overexpression of HuR mimicked the effects of TGF-β1. Furthermore, TGF-β1 prolonged half-life of SphK1 mRNA by promoting its binding to HuR. Pharmacological or siRNA-induced SphK1 inhibition abrogated HuR-mediated HSC activation. In conclusion, our data suggested that HuR bound to SphK1 mRNA and played a crucial role in TGF-β1-induced HSC activation.