No abstract

Mood disorders have multiple phenotypes and complex underlying biological mechanisms and, as such, there are no effective therapeutic strategies. A review of recent work on the role of astrocytes in mood disorders is thus warranted, which we embark on here. We argue that there is tremendous potential for novel strategies for therapeutic interventions based on the role of astrocytes. Astrocytes are traditionally considered to have supporting roles within the brain, yet emerging evidence has shown that astrocytes have more direct roles in influencing brain function. Notably, evidence from postmortem human brain tissues has highlighted changes in glial cell morphology, density and astrocyte-related biomarkers and genes following mood disorders, indicating astrocyte involvement in mood disorders. Findings from animal models strongly imply that astrocytes not only change astrocyte morphology and physiological characteristics but also influence neural circuits via synapse structure and formation. This review pays particular attention to interactions between astrocytes and neurons and argues that astrocyte dysfunction affects the monoaminergic system, excitatory–inhibitory balance and neurotrophic states of local networks. Together, these studies provide a foundation of knowledge about the exact role of astrocytes in mood disorders. Importantly, we then change the focus from neurons to glial cells and the interactions between the two, so that we can understand newly proposed mechanisms underlying mood disorders, and to identify more diagnostic indicators or effective targets for treatment of these diseases.

The prevailing view is that parvalbumin (PV) interneurons play modulatory roles in emotional response through local medium spiny projection neurons (MSNs). Here, we show that PV activity within the nucleus accumbens shell (sNAc) is required for producing anxiety-like avoidance when mice are under anxiogenic situations. Firing rates of sNAc PV neurons were negatively correlated to exploration time in open arms (threatening environment). In addition, sNAc PV neurons exhibited high excitability in a chronic stress mouse model, which generated excessive maladaptive avoidance behavior in an anxiogenic context. We also discovered a novel GABAergic pathway from the anterior dorsal bed nuclei of stria terminalis (adBNST) to sNAc PV neurons. Optogenetic activation of these afferent terminals in sNAc produced an anxiolytic effect via GABA transmission. Next, we further demonstrated that chronic stressors attenuated the inhibitory synaptic transmission at adBNST GABA → sNAc PV synapses, which in turn explains the hyperexcitability of sNAc PV neurons on stressed models. Therefore, activation of these GABAergic afferents in sNAc rescued the excessive avoidance behavior related to an anxious state. Finally, we identified that the majority GABAergic input neurons, which innervate sNAc PV cells, were expressing somatostatin (SOM), and also revealed that coordination between SOM-and PV-cells functioning in the BNST → NAc circuit has an inhibitory influence on anxiety-like responses. Our findings provide a potentially neurobiological basis for therapeutic interventions in pathological anxiety.

No abstract

The harmful effects of particulate matter with an aerodynamic diameter of <2.5 µm (PM2.5) and its association with acute coronary syndrome (ACS) has gained increased attention in recent years. Significant associations between PM2.5 and ACS have been found in most studies, although sometimes only observed in specific subgroups. PM2.5-induced detrimental effects and ACS arise through multiple mechanisms, including endothelial injury, an enhanced inflammatory response, oxidative stress, autonomic dysfunction, and mitochondria damage as well as genotoxic effects. These effects can lead to a series of physiopathological changes including coronary artery atherosclerosis, hypertension, an imbalance between energy supply and demand to heart tissue, and a systemic hypercoagulable state. Effective strategies to prevent the harmful effects of PM2.5 include reducing pollution sources of PM2.5 and population exposure to PM2.5, and governments and organizations publicizing the harmful effects of PM2.5 and establishing air quality standards for PM2.5. PM2.5 exposure is a significant risk factor for ACS, and effective strategies with which to prevent both susceptible and healthy populations from an increased risk for ACS have important clinical significance in the prevention and treatment of ACS.

No abstract

Objective To explore critical care clinicians’ knowledge, attitudes and perceptions toward early mobilization of critically ill patients in ICUs. Design A cross-sectional national survey was conducted. From January to August 2020, ICU nurses in 11 hospitals were surveyed by using a questionnaire on the knowledge, attitudes and perceptions of ICU early mobilization. Results Totally 512 nurses completed the questionnaire. The respondents’ mean score for knowledge of early mobilization was 6.89 ± 2.91. The level of knowledge was good in 2.5% (13/512), fair in 52.3% (268/512). The attitudes toward early mobilization were positive in 31.4% (161/512). In terms of perceived implementation of ICU early mobilization, 42.9% (220/512) of nurses did not believe that this should be a top priority in intensive care. The attitudes of nurses from different ICUs were significantly different ( F = 3.58 , P < 0.05). The knowledge (7.34 ± 2.78 vs. 6.49 ± 2.97, t = 3.37, P < 0.001) and attitudes (3.82 ± 0.58 vs. 3.52 ± 0.56, t = 5.63, P < 0.001) of nurses who had early mobilization related training were higher than those of nurses who had no training. Conclusions The importance of early ICU early mobilization is increasingly recognized by critical care providers. However, there is still a gap in the knowledge, attitudes and perceptions of ICU early mobilization among nurses. In future studies, it is necessary to further systematically identify the reasons leading to the gaps in these aspects and implement targeted interventions around these gaps. Meanwhile, more nurses should be encouraged to participate in decision-making to ensure the efficient and quality implementation of ICU early mobilization practices.

Neurological features in patients with TA were variable, and correlated with the number of arteries and the site of artery involvement. Resistant hypertension was one of the most important risk factors for hemorrhagic stroke in patients with TA.