Objective: To investigate the prevalence of depression and anxiety among transgender populations and the correlation with defense mechanism, so as to provide the evidence for improving mental health among transgender populations. Methods: Transgender populations that visited Psychosexual Outpatient Department of Beijing Huilongguan Hospital for the first time from December 2020 to December 2021 were enrolled. Participants' demographics, depression, anxiety and type of defense mechanisms were collected using self-designed questionnaires, Self-rating Depression Scale, Self-rating Anxiety Scale and Defense Style Questionnaire (DSQ). Factors affecting depression and anxiety were identified using a multivariable logistic regression model. Results: Totally 126 transgender individuals were enrolled, including 95 men (75.40%) with a mean age of (21.53±4.55) years and 31 women (24.60%) with a mean age of (23.58±5.55) years. The prevalence of depression was 46.83% among participants, including 44.07% of participants with mild depression, 30.51% with moderate depression and 25.42% with severe depression, and the prevalence of anxiety was 26.19% among participants, including 60.61% of participants with mild anxiety, 21.21% with moderate anxiety and 18.18% with severe anxiety. The detection of depression was 54.74% among men and 22.58% among women (P<0.05), and the detection of both depression (62.79% vs. 38.55%, P<0.05) and anxiety (41.86% vs. 18.07%, P<0.05) was significantly higher among transgender populations with self-injury or suicide behaviors than among those without. Multivariable logistic regression analysis showed that immature defense mechanisms increased the risk of depression (OR=1.034, 95%CI: 1.018-1.051) and anxiety (OR=1.031, 95%CI: 1.014-1.049) among transgender populations, while mature defense mechanisms reduced the risk of depression (OR=0.887, 95%CI: 0.832-0.946) and anxiety (OR=0.878, 95%CI: 0.821-0.938) among transgender populations. Conclusions The prevalence of depression and anxiety was 46.83% and 26.19% among transgender populations included in this study. Mature defense mechanisms are beneficial to reduce the risk of depression and anxiety among transgender populations. Key words： transgender population depression anxiety defense mechanism

Objective:To explore the causes of the maintenance of smoking behaviors in male patient with chronic schizophrenia.Methods:Totally 188 male,smoking patients with chronic schizophrenia,meeting with the criteria of Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-IV),above 5-year course of disease,taken a steady dosage of antipsychotics for 3 months,and 61 healthy smoking men were collected according to the voluntary principles.The psychopathologic symptoms and the dependence of cigarette of all patients were as-
sessed with the Positive and Negative Syndrome Scale (PANSS)and the Fagerstrom Test for Nicotine Dependence (FTND),the Russell's Smoking Motivation Questionnaire (SMQ)was used to investigate the causes for maintai-ning behaviors of smoking in patients and healthy controls respectively.Results:The sedative item scores of SMQ were lower in patient group than in the controls [3 (0,9)vs.6 (0,9),P <0.001],and other scores of subscales had no significant difference compared with control.Heavy dependence happened in patient group slightly less than health controls (2.7%vs.8.2%,P <0.05).The total scores of FTND were positively correlated with the doses of antipsychotics (chlorpromazine equivalent)(r =0.22,P <0.01).The scores of total (β=0.22),automatic (β=0.27)and sedative (β=0.37)items in patient group were less than controls (Ps <0.001)by multi-factors step-wise Linear regression analysis.Conclusion:Compared with general smokers,lower need for sedation,less heavy dependence and motivation in smoking patients might be correlated with the strict management for inpatients smok-ing,social-psychological factors and culture background in China.

Objective:To explore the relation of cognitive function correlates to P50 sensory gating in patients with schizophrenia.Methods:Totally 106 patients with drug-na¨ive first-episode schizophrenia and 86 healthy con-trol subjects matched for age,sex and education were recruited.All patients met the Diagnostic and Statistical Man-ual of Mental Disorders,Fourth Edition (DSM-IV)criteria for schizophrenia.Their cognitive function were assessed with the MATRICS Consensus Cognitive Battery (MCCB).The P50 auditory gating potential were recorded in all subjects using conditioning-testing stimulus paradigm and stimulus train paradigm.The P50 components were meas-ured in S1 S2 latency,S1 S2 amplitude and P50 suppression ratios.Results:Compared with the controls subjects, the patients with schizophrenia had significantly longer S1[60.8 ±7.8)ms vs.(56.3 ±7.0)ms,P <0.05]S2 la-tency [(59.1 ±10.2)ms vs.(55.7 ±10.7)ms,P <0.05],lower S1 amplitude [(2.8 ±1.8)μV vs.(3.5 ±1.6)μV,P <0.05],less amplitude difference (S1-S2)[(1.5 ±1.8)μV vs.(2.2 ±1.4)μV,P <0.05]and higher P50 suppression ratios (S2 /S1 )[(59.7 ±65.6)vs.(37.6 ±30.0),P <0.05].Schizophrenia patients had lower score than control subjects in all cognitive domains of MCCB (Ps <0.05).No differences in neurocognitive performance were found between subjects in the normal P50 ratio and the abnormal in healthy controls or patients with schizo-phrenia (Ps >0.05).No significant correlation was found between P50 gating measures (P50 ratio and P50 ampli-tude difference)and neuropsychological measures in MCCB scores (Ps >0.05).Conclusion:There may be no as-sociation between P50 deficits and cognitive measures in patients with drug-na¨ive first-episode schizophrenia.

Objective To evaluate cognitive impairment and performance-based skills and to explore their rela?tionships with clinical phenotypes in drug-na?ve first-episode patients with schizophrenia. Methods One hundred and forty-five inpatients and 65 healthy controls matched for age, gender and education were recruited. The MATRICS Con?sensus Cognitive Battery (MCCB), Stroop, digit span test, emotional recognition test, University of California, San Diego, Performance-based Skill Assessment (UPSA) and Positive Negative Syndrome Scale scale (PANSS) were used to evaluate cognitive function, life skill and symptoms, respectively. Results Compared with the controls, total score of MCCB and scores of 10 subscales, scores of digit span, emotional recognition and Stroop were significantly lower in patients (all P<0.05). The UPSA total score and scores of financial skill and communication skill were lower in patients than in controls (all P<0.05). Verbal memory, visual memory , Stroop, communication skill scores and total UPSA standard score were sig?nificantly higher in patients with paranoid subtype of schizophrenia than in patients with non-paranoid subtype of schizo? phrenia (all P<0.05). The score of MCCB associated with education years (OR=1.29, 95%CI: 1.13~1.47) and PANSS (OR=0.95, 95%CI:0.92~0.97). Conclusions First-episode, drug-naive patients with schizophrenia have markedly cog?nitive and performance-based skills deficits, which are associated with clinical symptoms. These deficits are differences between paranoid subtype and non-paranoid subtype of schizophrenia.

Objective To explore the risk factors for retreatment of spinal tuberculosis and to provide a theoretical basis for the formulation of clinical prevention and treatment measures. Methods the clinical data of 114 patients who received spinal tuberculosis operation from January 2011 to June 2014 were retrospectively analyzed. Among them, 13 cases were divided into group A after operation, and 101 cases without recurrence after operation were divided into B group. The clinical data of the two groups were compared and the multiple factor Logistic regression was used to analyze the risk factors for retreatment of spinal tuberculosis. Results In group A, preoperative albumin level, after standard anti-tuberculosis treatment, the proportion of complete removal of the lesion was significantly lower than that in group B, and tuberculosis in other parts of the proportion, the emergence of resistant strains, proportion of adverse conditions were significantly higher than those in group B (P＜0. 05). Multivariate Logistic regression analysis showed that preoperative albumin < 35g/L, without fusion, patients who did not receive regular anti-tuberculosis treatment, debridement is not complete, with other parts of tuberculosis, drug resistant strain and adverse conditions were risk factors of postoperative spinal tuberculosis retreatment (P＜0. 05). Conclusion Many factors can affect the incidence of relapse after spinal tuberculosis surgery, and clinical intervention should be carried out to reduce the risk of relapse after spinal tuberculosis operation.

Objective:To explore the effect of attentional bias training on the attentional bias, psychological craving and relapse rate of alcohol dependent patients during rehabilitation.Methods:A randomized controlled trial was used to select 90 alcohol-dependent patients and randomly divide them into an intervention group and a control group. The alcohol cue pictures and neutral pictures were imported into E-Prime software at a ratio of 1∶1.The patients in the two groups were trained for eight times with attentional bias and without attentional bias by point delection paradigm. After each training, the software automatically records the response time and correct rate of the cue pictures and neutral pictures, and before intervention(T0), after 4 interventions(T4), and after 8 interventions(T8), the alcohol craving score was assessed by visual analogue scale and the relapse situation was followed up 1 month after the intervention. SPSS 24.0 software was used for statistical analysis.Repeat measure ANOVA, χ2 test and t-test were used to compare the response time, accuracy and psychological craving of the two groups. Results:Repeated measurement analysis of variance showed that there were interaction between group and time in cue-map response time, line chart accuracy and psychological craving score of the two groups ( F=5.218, 6.939, 147.14, all P<0.01). Simple effect analysis showed that there was no significant difference in cue pictures response time, cue pictures accuracy and psychological craving score between the intervention group and the control group at T0(all P>0.05), but there was significant difference at T4 and T8 (all P<0.05), and there was significant difference in neutral pictures reaction only at T8 ( P<0.05). The comparison between two groups showed that the intervention group showed a downward trend in cue pictures response, T4 and T8 were lower than T0, with statistical difference (both P<0.001), while there was no difference in the control group. In the intervention group, the correct rate of cue pictures increased, T4 and T8 were higher than T0, and there were statistical differences (both P<0.001), while there was no difference in the control group( P>0.05). The psychological craving scores of both the intervention group and the control group showed a downward trend, T4 and T8 were lower than T0, there were statistical differences (both P<0.001), but the difference between T4 and T8 in the control group remained unchanged. One month after the end of the intervention, the difference in the rate of relapse between the intervention group and the control group was marginal (11.10%, 26.70%, P=0.059). The total number of days of abstinence in the intervention group was longer than that in the control group ((28.33±4.99)d, (26.47±6.66)d, P=0.010). Conclusion:Attentional bias training can improve the mental craving and attentional bias of alcohol-dependent patients during the rehabilitation period, and the relapse rate decreased one month after the intervention.

ObjectiveTo investigate the effect and significance of cyclooxygenase-2 (COX-2) inhibitors on the expression of the Acsl gene family in the ileum of rats with nonalcoholic fatty liver disease (NAFLD). MethodsA total of 45 Sprague-Dawley rats were randomly divided into normal control group (15 rats given normal diet), NAFLD model group (15 rats given high-fat diet), and nimesulide group (15 rats given high-fat diet and nimesulide). All rats were sacrificed after 12 weeks of feeding, and then blood samples were collected from the inferior vena cava to measure total cholesterol (TC) and triglyceride (TG). HE staining and oil red O staining were performed for the liver to evaluate the degree of hepatic steatosis in each group, and quantitative real-time PCR was used to measure the mRNA expression of the Acsl family genes in the ileum. An analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the normal control group, the NAFLD model group had significant increases in serum TC and TG and marked hepatic steatosis (all P＜0.05); compared with the NAFLD model group, the nimesulide group had significant reductions in serum TC and TG and degree of hepatic steatosis (all P＜0.05). Compared with the normal control group, the NAFLD model group had a significant increase in the expression of COX-2 in the ileum (P＜0.05), and compared with the NAFLD model group, the nimesulide group had a significant reduction in the expression of COX-2 in the ileum (P＜005). Compared with the normal control group, the NAFLD model group had significant increases in the mRNA expression of Acsl3 and Acsl5 in the ileum (both P＜0.05), and compared with the NAFLD model group, the nimesulide group had significant reductions in the mRNA expression of Acsl3 and Acsl5 (both P＜0.05). ConclusionThe COX-2 inhibitor nimesulide can regulate the expression of the Acsl gene family in the ileum of rats with NAFLD, suggesting that COX-2 inhibitors may inhibit the progression of NAFLD through the Acsl gene.

ObjectiveTo obtain HSC-T6 cells with stable expression of Cas9 protein and HSC-T6-COX-2-/- cells with COX-2 gene defect by transfecting HSC-T6 cells with CRISPR/Cas9 lentiviral vector, and to provide a good method for further functional research and new strategies for the clinical treatment of liver fibrosis. MethodsThe COX-2 gene-specific sgRNAs (COX-2-sgRNA-1, COX-2-sgRNA-2, COX-2-sgRNA-3) were designed, synthesized, and connected to the GV371 vector, and the recombinant plasmid and the packaging plasmid were transfected into 293T cells to form lentivirus particles; the fluorescence method was used to measure virus titer. The most appropriate amount of the virus was calculated based on MOI. Lenti-Cas9-puro was transfected into HSC-T6 cells, and HSC-T6-Cas9 cells were screened out by puromycin; Lenti-COX-2-sgRNA-EGFP was transfected into HSC-T6-Cas9 cells to obtain HSC-T6-COX-2-/- cells. Cruiser enzyme digestion and Western blot were used to verify gene knockout at the gene and protein levels. An analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups. ResultsSequencing verified that the COX-2-sgRNA expression vector was constructed successfully. Recombinant expression plasmids and packaging plasmids were transfected into 293T cells to form lentivirus particles, and the fluorescence method showed a virus titer of ＞1×108. HSC-T6 cells with stable expression of Cas9 protein and HSC-T6-COX-2-/- cells with COX-2 gene defect were successfully constructed. The HSC-T6-Cas9 group had significantly higher relative mRNA expression of LV-Cas9-Puro than the CON group (541.93±105.76 vs 1.00±0.02, t=12.995, P＜0.01). Cruiser enzyme digestion and Western blot showed that the CRISPR/Cas9 lentivirus expression vectors played a role in the target, among which COX-2-sgRNA-2 knockout had the most significant effect, and this group had a significant reduction in the protein expression level of COX-2 compared with the CON group and the NC group (both P＜0.05), suggesting that COX-2-sgRNA was active. ConclusionA CRISPR/Cas9 lentivirus vector is successfully constructed for COX-2 target gene, and HSC-T6-COX-2-/- cells with stable COX-2 gene knockout are obtained.

Objective:To explore the differences in clinical characteristics and treatment outcomes between patients with type A and type B alcohol dependence, and to find the independent risk factors of relapse.Methods:Alcohol-dependent male patients attending the Addiction Medicine Center of Beijing Huilongguan Hospital from January 2018 to December 2020 were selected for the study and divided into type A alcohol-dependent group ( n=77) and type B alcohol-dependent group ( n=87). All patients were given acute detoxification treatment and were followed up after treatment on relapse to drinking. Differences in demographic and clinical data were compared between the two groups, and differences in treatment outcomes between the two groups at different time points over 3 months were compared. Patients were divided into relapse group and non-relapse group according to whether they drank again after 3 months. Logistic regression model was established to screen the risk factors of relapse of alcohol-dependent patients by SPSS 25.0 software. Results:There was no significant difference between the two types of patients in years of education, marital status, smoking status and working status(all P>0.05), but the proportion of co-residents( χ2=5.69, P=0.017) and the proportion of positive family history of alcoholism were significant difference between the two type of patients( χ2=13.32, P<0.001). There were statistically significant differences between the two types of patients in the onset time( t=-7.28, P<0.001), the first drinking age( t=-2.36, P=0.020), the proportion of drinking in the morning( χ2=7.83, P=0.005), psychotic symptoms( χ2=4.31, P=0.038), convulsions after withdrawal( χ2=5.30, P=0.021), and alcohol use disorder identification test(AUDIT) score( t=4.30, P<0.001). At the 4th and 8th weekend of the follow-up, there were statistically significant differences in drinking frequency(0(0, 3), 0(0, 0), Z=-4.13, P<0.001; 3(0, 3), 0(0, 3), Z=-4.42, P<0.001) and relapse rate (40(45.98%), 9(11.69%), χ2=22.92, P<0.001; 61(70.11%), 24(31.17%), χ2=24.82, P<0.001) between the two types of alcohol dependence patients after drinking again. After 12-week follow-up, there were statistically significant differences between the two types of alcohol-dependent patients in the interval of first drinking(20(7, 30)d, 88(38, 90)d, Z=-7.83, P<0.001), the cumulative duration of abstinence(4(0, 8)weeks, 12(4, 12)weeks, Z=-5.13, P<0.001), the cumulative rate of abstinence(71(81.60%), 25(32.47%), χ2=40.62, P<0.001), the frequency of drinking after abstinence(3(3, 3), 0(0, 3), Z=-5.54, P<0.001), and the reduction of daily average alcohol consumption( t=3.36, P<0.001). Logistic regression model showed that type B alcohol dependence ( OR=3.121, P=0.03, 95% CI: 1.12-8.72) and AUDIT score ( OR=1.498, P<0.01, 95% CI: 1.29-1.74) were the risk factors for relapse of alcohol-dependent patients. Conclusions:Patients with type A and type B alcohol dependence have obvious differences in clinical characteristics and treatment outcomes, and type B alcohol dependence is independent risk factor for relapse to drinking in alcohol-dependent patients, which validate the rationality and necessity of alcohol dependence subtypes.

Objective: To analyze the influence of cognition on suicidal ideation in patients with major depressive disorder. Methods: A total of 108 inpatients with major depressive disorder from January 2017 to September 2018 in Beijing Huilongguan Hospital were enrolled.They were divided into suicidal ideation group (n=42) and non-suicidal ideation group (n=66) by the self-rating idea of suicide scale (SIOSS). Cognition was assessed by Repeatable Battery for the Assessment of Neuropsychological Status(RBANS). The general situation was assessed by self-made general situation questionnaire.The related factors were analyzed by Logistic regression. Results: (1) The rate of suicidal ideation was 44.4% in patients with major depressive disorder.(2) The total score of RBANS and five-factor scores of RBANS in suicidal ideation group were lower than those in non-suicidal ideation group(total RBANS score(63.0±7.9) vs (73.8±7.7); immediate memory: (62.7±8.8) vs (70.8±7.6); visual span: (67.2±10.0) vs (72.7±9.8); speech function: (83.3±13.8) vs (91.5±4.5); attention: (85.3±11.9) vs (99.9±8.5); delayed memory: (53.5±7.7) vs (62.3±9.7), F=6.335-46.660, P<0.05). (3)Logistic regression showed, years of education were risk factors for suicidal ideation(β=0.289, P=0.013, OR=1.335, 95%CI=1.063-1.676), RBANS attention factor(β=-0.161, P=0.000, OR=0.851, 95%CI=0.778-0.931)and RBANS delayed memory factor score(β=-0.151, P=0.006, OR=0.860, 95%CI=0.772-0.957)were protective factors for suicidal ideation. Conclusion Cognitive function has an impact on suicide ideation of depressive patients, mainly attention and delayed memory are protective factors for suicide ideation.