BackgroundPatients with irritable bowel syndrome (IBS) have significantly reduced quality of life (QOL). Although intestinal and extraintestinal symptoms, as well as comorbid psychological disorders, may reduce the QOL of IBS patients, the primary determinant of QOL in these patients remains unclear. This study aimed to identify the main factors affecting QOL in patients with IBS with diarrhea (IBS-D).MethodsConsecutive patients meeting the Rome III Diagnostic Criteria for IBS-D were enrolled in this study. Patients with organic diseases were excluded. The intestinal symptoms, psychological states and QOL of these patients were evaluated using IBS-specific symptom questionnaires, the Hamilton Depression Scale (HAMD), the Hamilton Anxiety Scale (HAMA), and the Chinese version of the IBS-QOL instrument. Overall scores for intestinal symptoms were calculated by frequency and degree.ResultsThis study enrolled 227 IBS-D patients, of mean age 44.68 ± 10.81 years. Their mean overall IBS-QOL score was 71.68 ± 18.54, with the lowest score being for food avoidance (53.71 ± 26.92). Overall IBS-QOL score correlated negatively with overall scores of intestinal symptoms and HAMD and HAMA scores (p < 0.001 each). Overall intestinal symptoms scores correlated negatively with HAMD and HAMA scores (p < 0.001 each). Scores of HAMD, HAMA and structural factors (i.e., anxiety/somatization, cognitive disorder, psychomotor retardation, psychic anxiety, and somatic anxiety) were significantly higher in female than in male patients (p < 0.01). Food avoidance and social reaction scores of female patients were significantly lower than those of male patients (p < 0.05 each). The degree of defecation urgency, frequency of passing mucus and psychomotor retardation were independent factors predicting reduced QOL in IBS-D patients.ConclusionIntestinal symptoms and psychological factors jointly reduce the QOL of IBS-D patients, with gender differences in the impact of both factors on QOL.

CD8(+) T cells have low cytotoxic activity; nevertheless, they are a significant and previously underappreciated source of inflammatory cytokine production in polyps. Different Tc cell subset domination may contribute to distinctly biased granulocyte inflammation in eosinophilic and non-eosinophilic polyps.

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently,

To examine the relationship between physical appearance concern and psychological distress in female adolescent patients with systemic lupus erythematosus (SLE) was the aim of this study. A total of 84 adolescent SLE female patients and 80 age-matching healthy adolescents were evaluated for levels of appearance concern and a range of illness-specific measures to determine how these demographic and clinical variables were related to the dependent variable psychological distress. The Systemic Lupus Erythematosus Disease Activity Index was used to assess disease activity. Assessment of depression was conducted through the children depression inventory (CDI). Appearance concern was measured using the SelfPerception Profile for Children. The total CDI was 18.5± 4.3, indicating that these patients had more depressive symptoms, comparing with age-and sex-matched healthy controls. Furthermore, a total of 32 (38.1 %) patients had CDI larger than 19 points, indicating that they have relatively higher risk in developing depression. The CDI in control group was significantly lower than that in the SLE group (11.4±1.7 vs. 18.5±4.3, t09.93, p<0.05). Using correlation and multiple regression analyses, we found that both appearance concern and age were predictive of depression in patients with SLE, and the former was highly correlated. This indicates that appearance concern may be associated with depression in female adolescent SLE patients. The results suggest that appearance concern is strongly associated with depression in female adolescent patients with SLE and should be routinely assessed.

Background/Aims A strong correlation between depression and irritable bowel syndrome with diarrhea (IBS-D) has been identified. The aim of this study is to identify the correlations among depression, structural factors, gastrointestinal (GI) and extra-GI symptoms, and efficacy of neuromodulators in patients with IBS-D. Methods Patients meeting the Rome III Diagnostic Criteria for IBS-D were enrolled. The intestinal symptoms and psychological states were evaluated using IBS-specific symptom questionnaires and Hamilton Depression Rating Scale. Results In total, 410 patients with IBS-D were enrolled, 28.8% (118/410) had comorbid depression. Patients with depression did not readily experience improvement in abdominal pain/discomfort after defecation, and had a higher prevalence of passing mucus, overlapping functional dyspepsia, and extra-GI symptoms. The structural factor "mental disorders" significantly correlated with main bowel symptom score and degree of pre-defecation abdominal pain/discomfort. No structural factor significantly correlated with bowel movements or stool form. Patients who had passing mucus, overlapping functional dyspepsia and extra-GI painful symptoms have higher score of "anxiety/somatization." Patients with sexual dysfunction have higher score of "retardation symptoms." In total, 28.3% of patients with IBS-D were prescribed neuromodulators. Baseline scores of "anxiety/somatization" and "retardation symptoms" positively correlated with improvement of diarrhea after paroxetine, and "sleep disturbances" positively correlated with improvement of abdominal pain/discomfort and diarrhea after mirtazapine. Conclusions Comorbid depression and higher scores of structural factors might aggravate GI and extra-GI symptoms other than bowel movements and stool form. Structural factors of Hamilton Depression Rating Scale correlated with efficacy of paroxetine and mirtazapine in patients with IBS-D.

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Background Cold‐inducible RNA‐binding protein (CIRP) is a newly identified damage‐associated molecular pattern molecule. Its roles beyond promoting inflammation and in human diseases are poorly understood. This study aimed to investigate the involvement of CIRP in chronic rhinosinusitis with nasal polyps (CRSwNP). Methods Immunohistochemistry, quantitative RT‐PCR, and ELISA were used to detect the expression of CIRP and matrix metalloproteinases (MMPs) in sinonasal mucosal samples and nasal secretions. Human nasal epithelial cells (HNECs) and THP‐1 cells, a human monocytic/macrophage cell line, were cultured to explore the regulation of CIRP expression and MMP expression. Results Cytoplasmic CIRP expression in nasal epithelial cells and CD68+ macrophages in sinonasal tissues, and CIRP levels in nasal secretions were significantly increased in both patients with eosinophilic and noneosinophilic CRSwNP as compared to those in control subjects. IL‐4, IL‐13, IL‐10, IL‐17A, TNF‐α, Dermatophagoides pteronyssinus group 1, and lipopolysaccharide induced the production and secretion of CIRP from HNECs and macrophages differentiated from THP‐1 cells. CIRP promoted MMP2, MMP7, MMP9, MMP12, and vascular endothelial growth factor A (VEGF‐A) production from HNECs, macrophages differentiated from THP‐1 cells, and polyp tissues, which was inhibited by the blocking antibody for Toll‐like receptor 4, but not advanced glycation end products. The expression of MMPs and VEGF‐A in tissues correlated with CIRP levels in nasal secretions in patients with CRSwNP. Conclusions The upregulated production and release of CIRP from nasal epithelial cells and macrophages may contribute to the edema formation in both eosinophilic and noneosinophilic CRSwNP by inducing MMP and VEGF‐A production from epithelial cells and macrophages.

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