Effectiveness of Cognitive Behavioral Therapy on Health Outcomes in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

"The incidence of psychological distress (such as anxiety and depression) is high in COPD patients. CBT has been proved to reduce depression and anxiety and enhance quality of life. This meta-analysis evaluated the effectiveness of cognitive behavioral therapy(CBT) on patients with chronic obstructive pulmonary disease(COPD). The following electronic databases were searched from inception to March 2020: PubMed, EMBase, Cochrane Library, Web of Science, Medline, OVID, CINAHL, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wangfang Database (WF), PsycARTICLES, VIP database. The Scopus and Google scholar database that we did not use. Randomized controlled trials (RCTs) that compared CBT with routine methods of care in COPD were retrieved in electronic databases. The Cochrane Risk of Bias Tool and Review Manager version 5.3 were used for risk of bias assessment and meta-analysis, respectively. Both data synthesis and descriptive analysis were used for outcome assessment. A total of 10 RCTs involving 1173 patients were included. Data synthesis showed that CBT was statistically significant in improving short- and medium-term depression and treatment compliance. Mediumterm anxiety and quality of life were improved among COPD patients receiving CBT, although no significant effect was found for short-term quality of life and anxiety. Descriptive analysis showed that CBT could reduce dyspnea. No clear evidence supports the effectiveness on improving self-efficacy in COPD patients with the use of CBT (P > 0.05). CBT can be a useful strategy to improve the symptoms of depression, dyspnea and treatment compliance in patients with COPD. It can also improve patients’ quality of life and anxiety to some extent, but there is still lack of strong evidence in improving patients’ self-efficacy."

Tumor Necrosis Factor-α-Induced Protein 8-Like 2 Gene Overexpression Prolongs the Survival of Rat Allogeneic Heart Allografts

BACKGROUND

The objective of the study was to examine whether overexpression of the tumor necrosis factor-α-induced protein 8-like 2 (TNFAIP8L2; TP8L2) gene might prolong the survival of a rat heart allograft and to explore the possibility of gene-induced immune tolerance and its specific mechanisms of action in rats.

METHODS

A gene vector (AdC68) was constructed of a rat's TP8L2 gene to overexpress the TP8L2 gene in the models. The Wistar-to-Dawley rat allogeneic heart allograft models were created and randomly separated into 5 groups: control, no treatment after surgery; Fk506, treated with immune inhibitor FK506 0.5 mg/kg/d after surgery; TP8L2, treated with 0.25 × 10(9) Pfu recombinant TP8L2 adenovirus after surgery; FK506+TP8L2, treated with FK506 0.25 mg/kg/d and 0.25 × 10(9) Pfu recombinant TP8L2 adenovirus after surgery; and no-TP8L2, treated with 0.25 × 10(9) Pfu recombinant adenovirus without TP8L2 gene overexpression after surgery. We also examined whether the overexpressed TP8L2 gene can prolong the donor heart's mean survival time and detect the changes of various related indicators.

RESULTS

The survival time of the donor heart in the TP8L2 and FK506+TP8L2 groups was significantly longer than that in the remaining groups; the difference was statistically significant (P < .05). The percentage of CD4(+)CD25(+) regulatory T cells in the TP8L2 and FK506+TP8L2 groups was significantly higher than that in the remaining groups; the difference was statistically significant (P < .05). The expression of interleukin (IL)-2, tumor necrosis factor-α, and interferon-γ in the FK506+TP8L2 group was significantly lower and the expression of IL-4 and IL-10 was significantly higher than those in other groups; the differences in cytokine levels were significant (P < .05).

CONCLUSIONS

TP8L2 plays an important role in the induction of immune tolerance in heart allografts.

Characterization of Erysipelothrix rhusiopathiae strains isolated from acute swine erysipelas outbreaks in Eastern China

Recently, a series of acute swine erysipelas outbreaks occurred in Eastern China. Eight strains isolated from cases of septicemia were determined as serotype 1a, and 4 of the isolates were resistant to acriflavine. One isolate strain named HX130709 was attenuated on agar media containing acriflavine dye. The 432-bp hypervariable region in spaA gene of the field and attenuated strains were amplified and sequenced. It was further compared with the vaccine strain G4T10, and thus, the eight field strains can be divided into four spaA-types. The partial spaA gene analysis also showed that no point mutations occurred among different archived passages of HX130709 during the attenuation. Results of pulsed-field gel electrophoresis showed that eight distinct patterns with 22 to 30 DNA fragment bands were produced from field strains, and twelve distinct patterns with 23 to 27 DNA fragment bands were produced from different passages of the attenuated strains. Mouse pathogenicity test showed that the mortality of the mice infected with 10(4) CFU field strains was 100% and the attenuation of strain HX130709 occurred between 46 and 50 passages. All the field and attenuated strains were highly sensitive to β-lactam antibiotics, tetracyclines and macrolides. So, we can make conclusions that the acute swine erysipelas outbreaks in Eastern China were caused by serotype 1a E. rhusiopathiae strains with different biochemical characteristics, and the virulence of serotype 1a E. rhusiopathiae strains is unrelated with some point mutations in 432-bp hypervariable region of the spaA gene.