Esketamine reduces inflammation in microglial cells stimulated with lipopolysaccharide, a bacterial toxin that mimics neuroinflammation. The anti-inflammatory effect involves upregulation of the cannabinoid type 2 (CB2) receptor and activation of protein kinase C (PKC). Blocking either the CB2 receptor with AM630 or PKC with chelerythrine reversed esketamine's ability to lower proinflammatory cytokines, nitrite, iNOS, and NF-κB (p65) expression. These results suggest the microglial CB2-PKC pathway mediates esketamine's anti-inflammatory actions, offering a potential mechanism for its antidepressant effects beyond direct neurotransmitter modulation.
Advanced maternal age, higher education level, pregnancy complications, and a lower newborn Apgar score are independent risk factors for postpartum depression in elderly primiparas. A retrospective analysis of 75 women with postpartum depression found that those who received mindfulness-based psychological intervention, in addition to routine care, showed significantly greater improvements in self-efficacy, reductions in depression and anxiety scores, and better sleep quality compared to those receiving routine care alone. Progesterone levels also decreased more in the intervention group. The findings suggest that mindfulness-based intervention benefits emotional well-being and sleep quality in this population.
A single low dose of esketamine (0.2 mg/kg) given intravenously for 40 minutes right after fetal delivery, combined with standard patient-controlled intravenous analgesia, reduces early postpartum depression symptoms and speeds recovery in women having cesarean sections. In a randomized controlled trial of 136 women, those receiving esketamine had lower Edinburgh Postnatal Depression Scale scores on days 2 and 7 after surgery, higher Obstetric Quality of Recovery-10 scores, shorter times to first walking, passing gas, and breastfeeding, and more frequent breastfeeding within 48 hours, compared with a placebo group. Adverse reactions did not differ significantly between groups.
Psychiatric nursing involves patient agitation, emotional labor, and ethical difficulties that can lead to burnout and stress. This narrative review of qualitative and quantitative research examines how mindfulness-based interventions (MBIs) like mindfulness-based stress reduction (MBSR) and acceptance and commitment therapy (ACT) address stress, burnout, and resilience in psychiatric nurses. Longer, structured programs tailored to local expectations show clearer reductions in burnout dimensions, while shorter programs, single-session workshops, or online-only formats offer limited and short-lived benefits.