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      Association of Chinese herbal medicine use with the depression risk among the long-term breast cancer survivors: A longitudinal follow-up study

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          Abstract

          Background

          Breast cancer patients are at elevated risk of depression during treatment, thus provoking the chance of poor clinical outcomes. This retrospective cohort study aimed to investigate whether integrating Chinese herbal medicines citation(CHM) into conventional cancer therapy could decrease the risk of depression in the long-term breast cancer survivors.

          Methods

          A cohort of patients aged 20–70 years and with newly diagnosed breast cancer during 2000–2008 was identified from a nationwide claims database. In this study, we focused solely on survivors of breast cancer at least1 year after diagnosis. After one-to-one matching for age, sex, and baseline comorbidities, breast cancer patients who received ( n = 1,450) and did not receive ( n = 1,450) CHM treatment were enrolled. The incidence rate and hazard ratio citation(HR) for depression between the two groups was estimated at the end of 2012. A Cox proportional hazard model was constructed to examine the impact of the CHM use on the risk of depression.

          Results

          During the study period, the incidence rate of depression was significantly lower in the treated cohort than in the untreated cohort [8.57 compared with 11.01 per 1,000 person-years citation(PYs)], and the adjusted HR remained significant at 0.74 (95% CI 0.58–0.94) in a Cox proportional hazards regression model. The corresponding risk further decreasing to 43% among those using CHM for more than 1 year.

          Conclusion

          Finding from this investigation indicated that the lower risk of depression observed in breast cancer patients treated with CHM, suggesting that CHM treatment should be considered for disease management toward breast cancer. Yet, the optimal administered dose should be determined in further clinical trials.

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          Most cited references34

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          NF-κB signaling in inflammation

          The transcription factor NF-κB regulates multiple aspects of innate and adaptive immune functions and serves as a pivotal mediator of inflammatory responses. NF-κB induces the expression of various pro-inflammatory genes, including those encoding cytokines and chemokines, and also participates in inflammasome regulation. In addition, NF-κB plays a critical role in regulating the survival, activation and differentiation of innate immune cells and inflammatory T cells. Consequently, deregulated NF-κB activation contributes to the pathogenic processes of various inflammatory diseases. In this review, we will discuss the activation and function of NF-κB in association with inflammatory diseases and highlight the development of therapeutic strategies based on NF-κB inhibition.
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            Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases

            R Deyo (1992)
            Administrative databases are increasingly used for studying outcomes of medical care. Valid inferences from such data require the ability to account for disease severity and comorbid conditions. We adapted a clinical comorbidity index, designed for use with medical records, for research relying on International Classification of Diseases (ICD-9-CM) diagnosis and procedure codes. The association of this adapted index with health outcomes and resource use was then examined with a sample of Medicare beneficiaries who underwent lumbar spine surgery in 1985 (n = 27,111). The index was associated in the expected direction with postoperative complications, mortality, blood transfusion, discharge to nursing home, length of hospital stay, and hospital charges. These associations were observed whether the index incorporated data from multiple hospitalizations over a year's time, or just from the index surgical admission. They also persisted after controlling for patient age. We conclude that the adapted comorbidity index will be useful in studies of disease outcome and resource use employing administrative databases.
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              A meta-analysis of cytokines in major depression.

              Major depression occurs in 4.4% to 20% of the general population. Studies suggest that major depression is accompanied by immune dysregulation and activation of the inflammatory response system (IRS). Our objective was to quantitatively summarize the data on concentrations of specific cytokines in patients diagnosed with a major depressive episode and controls. We performed a meta-analysis of studies measuring cytokine concentration in patients with major depression, with a database search of the English literature (to August 2009) and a manual search of references. Twenty-four studies involving unstimulated measurements of cytokines in patients meeting DSM criteria for major depression were included in the meta-analysis; 13 for tumor necrosis factor (TNF)-alpha, 9 for interleukin (IL)-1beta, 16 for IL-6, 5 for IL-4, 5 for IL-2, 4 for IL-8, 6 for IL-10, and 4 for interferon (IFN)-gamma. There were significantly higher concentrations of TNF-alpha (p < .00001), weighted mean difference (WMD) (95% confidence interval) 3.97 pg/mL (2.24 to 5.71), in depressed subjects compared with control subjects (438 depressed/350 nondepressed). Also, IL-6 concentrations were significantly higher (p < .00001) in depressed subjects compared with control subjects (492 depressed/400 nondepressed) with an overall WMD of 1.78 pg/mL (1.23 to 2.33). There were no significant differences among depressed and nondepressed subjects for the other cytokines studied. This meta-analysis reports significantly higher concentrations of the proinflammatory cytokines TNF-alpha and IL-6 in depressed subjects compared with control subjects. While both positive and negative results have been reported in individual studies, this meta-analytic result strengthens evidence that depression is accompanied by activation of the IRS. Copyright 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                18 August 2022
                2022
                : 13
                : 884337
                Affiliations
                [1] 1Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation , Chiayi, Taiwan
                [2] 2Department of Biomedical Sciences, National Chung Cheng University , Chiayi, Taiwan
                [3] 3Rehabilitation Counseling Program, Portland State University , Portland, OR, United States
                [4] 4Department of Rehabilitation, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation , Chiayi, Taiwan
                [5] 5Epigenomics and Human Diseases Research Center, National Chung Cheng University , Chiayi, Taiwan
                [6] 6Division of Allergy, Immunology and Rheumatology, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation , Chiayi, Taiwan
                [7] 7School of Medicine, Tzu Chi University , Hualien, Taiwan
                [8] 8School of Post-Baccalaureate Chinese Medicine, Tzu Chi University , Hualien, Taiwan
                [9] 9Department of General Surgery, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation , Chiayi, Taiwan
                [10] 10Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University , Tainan, Taiwan
                [11] 11Department of Nursing, Tzu Chi University of Science and Technology , Hualien, Taiwan
                [12] 12Department of Medical Research, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation , Chiayi, Taiwan
                Author notes

                Edited by: Xinfeng Guo, Guangzhou University of Chinese Medicine, China

                Reviewed by: Jiaying LI, The University of Hong Kong, Hong Kong SAR, China; Meaghan Coyle, RMIT University, Australia; Jian-Ping Liu, Beijing University of Chinese Medicine, China

                *Correspondence: Chia-Chou Yeh, yehcc0530@ 123456gmail.com

                These authors have contributed equally to this work

                This article was submitted to Psycho-Oncology, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2022.884337
                9434377
                36059752
                ef5f246e-1ee8-4244-84fa-c79e54e4e768
                Copyright © 2022 Yang, Livneh, Jhang, Yen, Huang, Chan, Lu, Yeh, Wei and Tsai.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 09 March 2022
                : 15 July 2022
                Page count
                Figures: 3, Tables: 3, Equations: 0, References: 35, Pages: 10, Words: 6219
                Categories
                Psychology
                Original Research

                Clinical Psychology & Psychiatry
                breast cancer,chinese herbal medicines,depression,cohort study,risk

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