Objective To analyze the treatment trajectory and revelant factors of serotonin reuptake inhibitors (SSRIs) in patients with first-episode major depression after single-drug treatment. And to provide ideas for early optimal treatment. Methods This study was a real-world study in which 82 untreated outpa-tients with first-episode depression were enrolled for SSRIs monotherapy. The Eysenck Personality Test (EPQ),the Liebowitz Social Anxiety Scale (LSAS),Yale -Brown Forced Scale (Y-BOCS),Social Function Deficit Scale (SDSS) were used to assess all patients at baseline. Then the patients were treated with SSRIs monotherapy. Patients who did not achieve a HAMD-17 20% reduction rate in the second week switched to receive another SSRIs monotherapy application. Follow-up to the 12th week to analyze treatment trajectory and identify factors associated with treatment trajectory. Results The psychotism personality trait ( B=-0. 287,95%CI=-0. 701~-0. 071,P=0. 009) and age ( B=0. 099,95%CI=0. 014~0. 244,P=0. 017) were related to treatment trajectories. The psychotism personality trait did not directly influence the treatment trajectory but influenced the treatment indirectly through agitation and the effect value was 0. 016,which ac-counted for 10. 76% of the total effect. Social anxiety and avoidance,depression,anxiety,obsessive-compul-sive symptoms and social dysfunction at baseline were not associated with antidepressant efficacy. Conclusion Psychoticism can predict the efficacy of antidepressants treatment as a mediator at the second week of treat-ment.

Objective To explore the effective early identification indicators of refractory mycoplasma pneumoniae pneumonia(RMPP)in children.Methods Thirty children admitted to Department of Pediatrics the First People's Hospital of Huzhou and diagnosed with RMPP from June 2021 to June 2023 were selected as the study group.Forty children with mycoplasma pneumoniae pneumonia(GMPP)were selected as the control group.Blood interferon(IFN)-γ,D-dimer,lactate dehydrogenase(LDH)and C-reactive protein(CRP)were detected in all children after admission.Pharynx samples were collected for detection of Mycoplasma pneumoniae nucleic acid and drug resistance sites.The expression of IFN-γ,D-dimer,LDH and CRP in the early stage of mycoplasma pneumoniae pneumonia was compared between the two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive effect of each index on RMPP.To analyze the correlation between macrolide resistance and RMPP.Results The expression levels of IFN-γ,D-dimer and CRP in the study group were significantly higher than those in the control group.The difference between the two groups was statistically significant(P＜0.05).There was no significant difference in LDH expression between the study group and the control group(P＞0.05).By comparing the area under the ROC curve(AUC).IFN-γ had the highest AUC of 0.908(95% CI:0.840-0.976,P＜0.001).CRP was 0.760(95% CI:0.637-0.883,P＜0.001).D-dimer was 0.698(95% CI:0.573-0.822,P=0.005).LDH was 0.575(95% CI:0.434-0.715,P=0.288).These results indicate that IFN-γ has better diagnostic effect on RMPP than other variables.The proportion of macrolide resistance in RMPP patients was significantly higher than that in GMPP group.Conclusion IFN-γ,CRP,D-dimer,macrolide resistance factors have certain efficacy in the early prediction of RMPP.RMPP had the best prediction effect when IFN-γ＞24pg/ml.Combined with drug resistance factors can be used as a good indicator to predict RMPP.