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To determine the effectiveness of a simple, self-administrable moxibustion-cum-massage intervention for relieving chronic pain and improving psychological well-being for older adults in the community.A randomized controlled trial.Seventy-eight participants with chronic pain were randomly assigned to the intervention and waitlist control groups.Participants received two moxa sticks a day to use the moxibustion-cum-massage procedure with the help of trained volunteers or caregivers for five consecutive days.Participates' pain level, sleep quality, depression and subjective well-being were measured before the intervention (T0), immediately after the intervention (T1), and one week after the intervention (T2).Repeated measures ANOVA revealed a significant group × time interaction effect in subjective well-being with a medium effect size. Regarding within-group effects in the intervention group at post-intervention (T1), the subjective pain level was significantly reduced with a small effect size, while sleep quality and depression significantly improved with large effect sizes. The control group showed no significant within-group effects in these variables. Maintenance effects at follow-up (T2) were not significant.Despite the short intervention timeframe of five days, the study revealed preliminary evidence that the moxibustion-cum-massage intervention can be an effective, self-administrable pain relief regime for older adults. A longer period of intervention time is suggested for future studies.

Purpose Although high expressed emotions (EE) is one of the most significant predictors for schizophrenic relapse, the assessment of EE is often impeded by the demanding Camberwell Family Interview (CFI) that is required to be conducted by specifically trained staff. To enable a more efficient assessment of EE, we developed the 12-item Concise Chinese Level of Expressed Emotion Scale (CCLEES) and reported its predictive and concurrent validity in this study. Methods A one-year prospective study design was adopted. Totally 101 participants diagnosed with schizophrenia were recruited from the department of psychiatry of a major acute hospital in Hong Kong. CCLEES was administered and subsequent relapse information was collected from all participants. At baseline, 10 family members of the participants were also administered CFI. Results Participants who scored above the optimal cut-off point (Score 13 on Criticism, and/or 13 on Hostility, and/or 15 on Emotional Over-involvement) showed a 6.3 times elevated 12-month schizophrenic relapse rate compared to those who scored below cut-off. The CCLEES also demonstrated excellent correspondence with CFI, the widely-recognized golden benchmark of EE assessment. Conclusions The results support the CCLEES as a brief and psychometrically sound self-report measurement for EE in Chinese people with schizophrenia.

The chronic and prevalent natures of schizophrenia result in long-term institutionalization for the patients. Conventional treatment of anti-psychotic medication on management of psychotic symptoms often brings on severe side effects and reduces patients' well-being. Tai-chi is a mind-body exercise that underscores motor coordination and relaxation. This 3-arm randomized controlled trial investigated the psychophysiological benefits of Tai-chi on 153 chronic schizophrenia patients, who were recruited from a mental health rehab complex and randomized into Tai-chi, exercise, or waitlist control groups. Both intervention groups received 12weeks of specific intervention plus standard medication received by the controls. All participants completed psychiatric interviews, self-report questionnaires, performance tasks, and salivary cortisol measures at baseline, 3-month, and 6-month follow-up on psychotic symptoms, motor coordination, memory, daily living function, and stress. Multigroup latent growth modeling was used to evaluate the intervention effects on the outcomes. Compared to controls, the Tai-chi group showed significant decreases in motor deficits and increases in backward digit span and mean cortisol, while the exercise group displayed significant decreases in motor deficits, negative and depression symptoms and increases in forward digit span, daily living function, and mean cortisol. The two interventions did not show significantly different therapeutic effects, except for fewer symptom manifestations in the exercise group. These results suggest psychophysiological benefits for Tai-chi on chronic schizophrenia patients in terms of motor coordination and memory. Though both Tai-chi and exercise groups tended to manifest fewer symptoms than the control group, the exercise group showed better symptoms management than the Tai-chi group.

Previous studies have identified different, but highly correlated variables explaining the effects of mindfulness training. Many of them are limited by tautological explanation. Under the framework of the mind-body connection, mindfulness training cultivates body awareness and promotes self-management of illness. Stagnation, a concept from Chinese medicine, may help explain the mechanism of change in mindfulness training.Individuals with depressive and anxiety symptoms (n=82) were randomized to either a Compassion-Mindfulness Therapy (C-MT) program or a waitlist control condition. The effect of stagnation as a mediator was investigated for dependent variables including depression, anxiety, and other physical and mental health variables.Depression, anxiety, stagnation, physical distress, daily functioning, positive affect, negative affect.Compared with the participants in the control group, those who completed C-MT demonstrated significant decreases in depression, F(1, 78)=15.67, p.001, anxiety, F(1, 78)=7.72, p.001, stagnation, F(1, 78)=4.96, p.001, and other body-mind-spirit well-being measures. After entering the change in stagnation as the mediator, the effect of treatment reduced: depression (.35-.22), anxiety (.33-.05), and same patterns in other three secondary measures. The Sobel test was administered and significant reductions between group and depression (z=2.18, p=.029), anxiety (z=2.21, p=.027), and three secondary other measures (p.05) were indicated.The study provides initial support for the role of stagnation in mediating changes in mindfulness training. It adds evidence to body-mind nondualism and offers new possibilities in studying treatment process and change mechanism.

The expression of bone morphogenic protein 4 (BMP4), a new pro-inflammatory marker, is increased by disturbed flow in endothelial cells (ECs). BMP4 stimulates production of reactive oxygen species (ROS) and causes endothelial cell dysfunction. The present study examined BMP4-induced apoptosis in ECs and isolated arteries from rat, mouse, and human, and the signaling pathways mediating BMP4-induced apoptosis. Apoptosis was assessed by flow cytometry to detect Annexin-V positive cells, and terminal deoxynucleotidyl transferase dUTP nick end (TUNEL) labeling. The superoxide production was measured by dihydroethidium fluorescence. BMP4 induced EC apoptosis in human mesenteric arteries, mouse aortic endothelium, rat primary ECs, and human ECs. BMP4-induced EC apoptosis was mediated through ROS production by activation of NADPH oxidase, which led to cleaved caspase-3 expression. BMP4 also induced sequential activation of p38 MAPK and JNK which was upstream of caspase 3 activation. Knockdown of BMP receptor 1A by lentiviral shRNA or NOX4 siRNA transfection inhibited BMP4-induced ROS production, p38 and JNK phosphorylation, and caspase-3 activation in ECs. JNK siRNA inhibited BMP4-induced JNK phosphorylation and caspase-3 activation. The present study delineates that BMP4 causes EC apoptosis through activation of caspase-3 in a ROS/p38MAPK/JNK-dependent signaling cascade.

The transfer of the hydrogen atoms from the η 2 -H 2 ligand to the cis -disposed olefin ligand in a ruthenium olefin–dihydrogen complex is discussed. It is realized that H 2 O and NEt 3 exhibit promoting effects in the catalytic hydrogenation of olefins with a couple of hydro(trispyrazolyl)borate (Tp)-supported ruthenium complexes. A reaction mechanism that accounts for the promoting effect has been proposed. A Tp-supported ruthenium solvento hydride complex TpRu(PPh 3 )(CH 3 CN)H was found to react with H 2 and R 3 SiH to form the fluxional dihydrogen–hydride, and η 2 -silane–hydride complexes, respectively. Although no stable and isolable σ-complex was formed with CH 4 , the solvento hydride complex was found to be active in catalyzing H/D reactions of CH 4 with some deuterated common organic solvents. In the catalytic CO 2 hydrogenation reactions in THF/H 2 O or alcohol, the complex TpRu(PPh 3 )(CH 3 CN)H generates the metal-ligand bifunctional catalyst TpRu(PPh 3 )(ROH)H (R = H or alkyl) which transfers the hydride and a proton from ROH to the CO 2 molecule in a concerted manner, without coordination of the latter to the metal center. Aminocyclopentadienyl ruthenium complexes, which exhibit intramolecular Ru–H⋯H–N dihydrogen-bonding interactions were synthesized and characterized. These complexes provide good models for the study of heterolytic cleavage of η 2 -H 2 ligand and its reverse-protonation of metal hydride to form dihydrogen complex. An indenyl ruthenium hydride complex was synthesized and found to be good catalyst for nitrile hydration reactions to give amides; these reactions nicely demonstrate the principle of utilizing dihydrogen bond to promote catalytic reactions.

Background Treatment of symptomatic hepatic cysts varies from simple aspiration to liver resection. Each form of treatment has its own merits and associated complications. Given the benign nature of this condition, a minimally invasive form of therapy is increasingly in favour. This case illustrates the successful treatment of a symptomatic hepatic cyst by laparoscopic fenestration. Case outline A 61-year-old woman presented with epigastric pain for several years. Physical examination revealed a 10-cm nontender epigastric mass, and a CT scan raised the suspicion of a pancreatic pseudocyst. Therapeutic ultrasound-guided aspiration was performed twice for alleviation of her symptoms. However, both the symptoms and the cyst recurred. Therefore, diagnostic laparoscopy was performed with the intention to treat. Results The mass was found to be a hepatic cyst located on the undersurface of the left lobe of the liver. Laparoscopic fenestration was performed, and the patient remained symptom-free one year later. Discussion This case illustrates the value of laparoscopic fenestration. Effective decompression of the cyst contents can be achieved with maximal preservation of functional hepatic parenchyma and a smooth postoperative course.