Background: Depressive symptoms are prevalent and cause poor health outcomes in patients with heart failure. Studies show that the physical symptoms of heart failure are associated with depressive symptoms. However, little is known about the underlying mechanisms of this relationship. Aims: The purpose of our study was to examine the associations between physical symptoms, illness perceptions, coping strategies and depressive symptoms and to test the multiple mediation effects of illness perceptions and coping strategies on the relationship between physical symptoms and depressive symptoms in patients with heart failure. Methods: Physical symptoms, illness perceptions, coping strategies and depressive symptoms were assessed using self-reported questionnaires among 302 patients (64.2±11.9 years, 54% male) with heart failure in a tertiary general hospital. A serial multiple mediation model was tested using the PROCESS macro for SPSS. Results: Depressive symptoms were positively correlated with physical symptoms ( r=0.487, p<0.01), illness perceptions ( r=0.499, p<0.01) and acceptance–resignation coping ( r=0.580, p<0.01). The relationship between physical symptoms and depressive symptoms was mediated by illness perceptions (indirect effect: 0.036, confidence interval (0.014, 0.059)) and by acceptance-resignation (indirect effect: 0.034, confidence interval (0.019, 0.053)), respectively, and by these two in serial (indirect effect: 0.021, confidence interval (0.013, 0.033)). Conclusion: Patients with heart failure who have more physical symptoms are vulnerable to the development of depression. Healthcare providers should implement interventions focused on changing illness perceptions and reducing acceptance–resignation coping to relieve depressive symptoms.
Background:Leakage of the intestinal mucosal barrier may cause translocation of bacteria, then leading to multiorgan failure. This study hypothesized that rhubarb monomers might protect the gut mucosal barrier in sepsis through junction proteins.Methods:Healthy male Sprague-Dawley rats (weighing 230–250 g) under anesthesia and sedation were subjected to cecal ligation and perforation (CLP). After surgical preparation, rats were randomly assigned to eight groups (n = 6 or 8 each group): sham group (Group A: normal saline gavage); sepsis group (Group B: normal saline gavage); Group C (intraperitoneally, dexamethasone 0.5 mg/kg) immediately after CLP surgery; and rhubarb monomer (100 mg/kg in normal saline)-treated groups (Group D: rhein; Group E: emodin; Group F: 3,8-dihydroxy-1-methyl-anthraquinone-2-carboxylic acid; Group G: 1-O-caffeoyl-2-(4-hydroxy-O-cinnamoyl)-D-glucose; and Group H: daucosterol linoleate). Animals were sacrificed after 24 h. Intestinal histology, lactulose, mannitol concentrations were measured, and zonula occludens (ZO)-1, occludin and claudin-5 transcription (polymerase chain reaction), translation (by Western blot analysis), and expression (by immunohistochemistry) were also measured.Results:Intestinal histology revealed injury to intestinal mucosal villi induced by sepsis in Group B, compared with Group A. Compared with Group A (0.17 ± 0.41), the pathological scores in Groups B (2.83 ± 0.41, P < 0.001), C (1.83 ± 0.41, P < 0.001), D (2.00 ± 0.63, P < 0.001), E (1.83 ± 0.41, P < 0.001), F (1.83 ± 0.75, P < 0.001), G (2.17 ± 0.41, P < 0.001), and H (1.83 ± 0.41, P < 0.001) were significantly increased. Lactulose/mannitol (L/M) ratio in Group B (0.046 ± 0.003) was significantly higher than in Group A (0.013 ± 0.001, P < 0.001) while L/M ratios in Groups C (0.028 ± 0.002, P < 0.001), D (0.029 ± 0.003, P < 0.001), E (0.026 ± 0.003, P < 0.001), F (0.027 ± 0.003, P < 0.001), G (0.030 ± 0.005, P < 0.001), and H (0.026 ± 0.002, P < 0.001) were significantly lower than that in Group B. ZO-1, occludin and claudin-5 transcription, translation, and expression in Group B were significantly lower than that in Group A (P < 0.001), but they were significantly higher in Groups C, D, E, F, G, and H than those in Group B (P < 0.05).Conclusion:Rhubarb monomer treatment ameliorated mucosal damage in sepsis via enhanced transcription, translation, and expression of junction proteins.
Background: Previous investigators have demonstrated that uncertainty in illness is associated with quality of life (QoL) in patients with chronic illness. However, little is known about the mechanism underlying the relationship in patients with heart failure. Objective: The aim of this study was to examine the multiple mediating effects of perceived stress and coping strategies on the relationship between uncertainty in illness and QoL in patients with heart failure. Methods: We conducted a cross-sectional study in 302 patients with heart failure recruited at a general hospital in China from October 2016 to September 2017. Uncertainty in illness, perceived stress, coping strategies, and QoL were assessed using self-reported questionnaires. The multiple mediation model was tested using the PROCESS macro for SPSS. Results: Of the 302 patients, 51.7% had poor physical QoL and 45.7% had poor mental QoL (physical component summary or mental component summary score of <50 points). Uncertainty in illness had a significantly negative indirect effect on mental QoL through perceived stress and acceptance-resignation (indirect effect, −0.02; 95% confidence interval, −0.04 to −0.01). Uncertainty in illness also had a significantly negative indirect effect on mental QoL via perceived stress only (indirect effect, −0.18; 95% confidence interval, −0.26 to −0.09). Conclusions: Poor QoL is prevalent in patients with heart failure. Perceived stress and acceptance-resignation are important mediating factors between uncertainty in illness and mental QoL in patients with heart failure. Interventions aimed at reducing perceived stress and acceptance-resignation coping may be beneficial for improving mental QoL in patients with heart failure.
All‐solid‐state polymer lithium‐ion batteries are ideal choice for the next generation of rechargeable lithium‐ion batteries due to their high energy, safety and flexibility. Among all polymer electrolytes, PEO‐based polymer electrolytes have attracted extensive attention because they can dissolve various lithium salts. However, the ionic conductivity of pure PEO‐based polymer electrolytes is limited due to high crystallinity and poor segment motion. An inorganic filler SiO2 nanospheres and a plasticizer Succinonitrile (SN) are introduced into the PEO matrix to improve the crystallization of PEO, promote the formation of amorphous region, and thus improve the movement of PEO chain segment. Herein, a PEO18−LiTFSI−5 %SiO2−5 %SN composite solid polymer electrolyte (CSPE) was prepared by solution‐casting. The high ionic conductivity of the electrolyte was demonstrated at 60 °C up to 3.3×10−4 S cm−1. Meanwhile, the electrochemical performance of LiFePO4/CSPE/Li all‐solid‐state battery was tested, with discharge capacity of 157.5 mAh g−1 at 0.5 C, and capacity retention rate of 99 % after 100 cycles at 60 °C. This system provides a feasible strategy for the development of efficient all‐solid‐state lithium‐ion batteries.
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