Objective:To investigate the trend and related factors of suicidal ideation in college students over a nine-year period.Methods:A multi-stage stratified sampling method was employed to select mental health survey data from college students in Beijing between 2007 and 2015(n=9 716).The survey utilized the items of suicidal ideation and behavior from the National Comorbidity Survey Replication(NCS-R),Center for Epidemiologic Stud-ies-Depression Scale(CESD),and Multidimensional Scale of Perceived Social Support(MSPSS).Linear decompo-sition regression analysis was conducted to examine the factors contributing to the decline in suicidal ideation.Results:The average suicidal ideation score decreased from 0.24 in 2007 to 0.13 in 2015.There was a positive correlation between suicidal ideation score and CESD score(r=0.30,P＜0.001),while a negative correla-tion existed between suicidal ideation scores and MSPSS scores(r=-011,P＜0.001).The results of the regres-sion analysis revealed that the decline in suicidal ideation was more significant in female students than in male students(β=-0.030,-0.017,Ps＜0.05),and urban college students exhibited a faster reduction in suicidal idea-tion than their rural counterparts(β=-0.026,-0.016,Ps＜0.05).Individuals born in later cohorts had higher suicidal ideation scores than earlier cohorts(β=0.012,P＜0.05).Conclusion:It suggests that suicidal ideation has shown adecreasing trend during the survey period,while it is more prevalent in younger cohorts.In addition,depres-sion and social support are found to be associated with suicidal ideation.

Objective To explore the influencing factors of patients with post-stroke depression (PSD) and study their impact on the quality of life.Methods Fifty-two stroke patients admitted to the First ospital of China Medical University from February 2015 to May 2015 were randomly selected for the study,and these patients did not suffer depression as evaluated by the depression rating scale.Their age,history of diseases,types of diseases,cause of illness,disease area and treatments were collected in detail.These patients were followed up for six month.The mental state was assessed by Hamilton depressive scale (HAMD) and self-rating depressive scale (SDS).The life quality was evaluated by stroke specific quality of life score (SS-QOL) and modified Rankin scale(mRS).These data were selected by stratified sampling method and analyzed by SPSS 17.0 software.Results The incidence of PSD in elder patients (≥ years) was significantly higher than in the younger patients (P ＜ 0.05).Patients with cardiogenic cerebral embolism are more likely to suffer from PSD (P ＜ 0.05).The patients with infarction in different regions have different probability to suffer from PSD.Those patients with cerebral infarction in basal ganglia exhibited more possibility on PSD than others (P ＜ 0.01).Previous disease,including hypertension,diabetes and coronary disease,had no effects on PSD.There were no significant effects of stroke types and thrombolytic therapy on PSD.PSD had an unfavorable effect on the life quality of the patients.Conclusion The patients with cerebral infarction in basal ganglia,aged over sixty and cardiogenic cerebral embolism are prone to PSD,and we should pay more attention to them.PSD has a negative impact on the quality of life of patients.

Objective:To explore the correlation between middle cerebral artery (MCA) pulsatility index (PI) and total magnetic resonance imaging (MRI) burden in elderly patients with cerebral small vessel diseases (CSVD).Methods:A total of 203 CSVD inpatients aged 60 years and above who were hospitalized in the Department of Neurology of Hebei General Hospital from March 2017 to December 2020 were enrolled. The clinical data, transcranial Doppler ultrasound parameters and brain MRI data were collected. According to the total burden score, the patients were divided into low burden group (0-1 point) and high burden group (2-4 points). Univariate and multivariate Logistic regression analysis was used to analyze the correlation between MCA PI and total MRI burden in the elderly patients with CSVD. Subsequently, the receiver operating characteristic curve was used to evaluate the value of MCA PI for predicting the high MRI burden of CSVD in the elderly.Results:Hypertension ( OR=2.569, 95% CI 1.068-6.182, P=0.035), systolic blood pressure ( OR=1.033, 95% CI 1.006-1.061, P=0.016), creatinine ( OR=1.044, 95% CI 1.009-1.079, P=0.013) and MCA PI ( OR=1.125, 95% CI 1.087-1.166, P<0.001) were independently correlated with the increasing total MRI burden in the elderly patients with CSVD. Spearman rank correlation analysis revealed that there was strong and positive correlation between MCA PI and high MRI burden in the elderly patients with CSVD ( r=0.65, P<0.001). The analysis showed that when the cut-off for MCA PI was 1.11, it could identify high MRI burden of CSVD in the elderly. The area under the curve was 0.908 (95% CI 0.864-0.953, P<0.001). The sensitivity and specificity were 0.852 and 0.880, respectively. The positive predictive value was 92.38%, and the negative predictive value was 77.70%. Conclusion:The MCA PI is positively correlated with total MRI burden in the elderly patients with CSVD, and has a higher value in predicting the total MRI burden in the elderly CSVD patients, which probably bring brighter prospects for its clinical application.

Objective To investigate the correlations of risk factors of age,delirium-inducing factors,dementia,delirium severity,and disease severity with the prognosis of elderly patients with delirium.Methods A total of 112 patients aged 70 years and older with initial onset of delirium during hospital stay were enrolled in this study.They were hospitalized in Dalian Municipal Central Hospital from Jan.2013 to Dec.2015.The severity of delirium was evaluated by delirium rating scalerevised-98(DRS-R-98).The acute physiology and chronic health enquiry(APACHE-Ⅱ)score and the sequential organ failure assessment(SOFA)score were recorded within 48 h after delirium onset.After periods of hospitalization of Jan.2013 to Dec.2015,patients were followed up until 31 Dec 2017.Correlations of age,delirium-inducing factors and dementia with survival time and long-term viability after delirium onset were statistically analyzed.Results Age,delirium-inducing factors,cognitive impairment,duration of cognitive impairment,type of dementia,and delirium severity had no correlations with the lifetime and long-term viability in patients with delirium.While,APACHE Ⅱ score for assessment of severity degree of delirium(P ＜0.001,r =-0.390) and SOFA score(P ＜0.001,r=-0.638)were negatively correlated with the lifetime in patients with delirium.SOFA score (P =0.004) and delirium recurrence (P ＜ 0.001) were significantly correlated with the long-term viability in patients with delirium.Conclusions The severity and recurrence of delirium are strongly correlated with the lifetime and quality of life in patients with delirium.Compared with APACHE Ⅱ score,SOFA score may have a more important clinical application value in predicting the prognosis of patients with delirium.

Objective To analyze the predictive value of serum levels of procalcitonin(PCT)and cytokines on the prognosis of patients with COVID-19 at admission.Methods From November 2022 to February 2023,patients diagnosed with COVID-19 who were admitted to Beijing Chest Hospital were enrolled.Chemiluminescence was used to detect serum PCT levels,and flow microsphere array was used to detect serum cytokines IL-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-17A,IL-17F,IL-22,TNF-α,TNF-β,IFN-γ level.ICU admission,mechanical ventilation and in-hospital death were defined as poor prognosis.After excluding patients with bacterial infection,the relationship between serum PCT and cytokine levels at admission and the prognosis of COVID-19 patients was analyzed.After excluding patients with bacterial infection,the relationship between serum PCT and cytokine levels at admission and the prognosis of COVID-19 patients was analyzed.Results A total of 176 patients with complete data were included,including 134 in the PCT-normal group and 42 in the PCT-elevated group,with a median age of 71.50 years and 71.59%males.Patients in the PCT elevated-group had significantly higher rates of ICU admission(38.41%vs.13.11%,P<0.05),mechanical ventilation(76.92%vs.24.59%,P<0.001)and in-hospital mortality(38.46%vs.6.56%,P<0.001)were significantly higher than those in the PCT-normal group.Serum levels of cytokines IL-6(7.40 pg/mL vs.4.78 pg/mL,P = 0.033 4)and IL-8(10.97 pg/mL vs.5.92 pg/mL,P<0.001)were significantly higher in patients with poor prognosis than in those with good prognosis.The area under the curve for PCT,IL-6,and IL-8 to predict poor prognosis in COVID-19 patients was 0.687,0.660,and 0.746,respectively;sensitivity was 52.78%,55.17%,and 72.41%,respectively;and specificity was 81.58%,74.19%,and 74.19%,respectively,as calculated from the ROC curve.When PCT,IL-6 and IL-8 jointly predict the prognosis of COVID-19 patients,the area under the curve is 0.764,the sensitivity is 70.00%,and the specificity is 80.00%.Conclusion Serum PCT and cytokines IL-6 and IL-8 could be used as predictive markers for poor prognosis in patients with COVID-19.

Remodeling the tumor microenvironment through reprogramming tumor-associated macrophages (TAMs) and increasing the immunogenicity of tumors via immunogenic cell death (ICD) have been emerging as promising anticancer immunotherapy strategies. However, the heterogeneous distribution of TAMs in tumor tissues and the heterogeneity of the tumor cells make the immune activation challenging. To overcome these dilemmas, a hybrid bacterium with tumor targeting and penetration, TAM polarization, and photothermal conversion capabilities is developed for improving antitumor immunotherapy in vivo. The hybrid bacteria (B.b@QDs) are prepared by loading Ag₂S quantum dots (QDs) on the Bifidobacterium bifidum (B.b) through electrostatic interactions. The hybrid bacteria with hypoxia targeting ability can effectively accumulate and penetrate the tumor tissues, enabling the B.b to fully contact with the TAMs and mediate their polarization toward M1 phenotype to reverse the immunosuppressive tumor microenvironment. It also enables to overcome the intratumoral heterogeneity and obtain abundant tumor-associated antigens by coupling tumor penetration of the B.b with photothermal effect of the QDs, resulting in an enhanced immune effect. This strategy that combines B.b-triggered TAM polarization and QD-induced ICD achieved a remarkable inhibition of tumor growth in orthotopic breast cancer.