Objective To investigate the effect of attributional retraining group therapy ( ARGT) combined with closabine on the negative symptoms and quality of life in refractory schizophrenia patients. Methods The refractory schizophrenia patients were divided into ARGT combined with clozapine therapy group(study group,n=56) and clozapine alone group(control group,n=54). The positive and negative syn-drome scale( PANSS) was used to assess the symptoms of all patients at baseline and 8 weeks later. The quality of life(QOL) of the patients was assessed by GQOLI-74 at baseline and 8 weeks after treatment. The side effects were evaluated by treatment emergent symptom scale(TESS) before and after treatment. SPSS18. 0 was used for statistical analysis. Results At baseline,there was no significant difference in PANSS score between the two groups. After 8 weeks,the total score of PANSS (79. 41±11. 64) and the score of negative symptoms (28. 68 ±2. 74) in the study group were lower that those of control group(83. 06±11. 58,30. 61± 2. 12),and the differences were statistically significant(t=7. 68,7. 10,both P<0. 05). The scores of positive symptoms,cognitive symptoms,emotional symptoms and aggression symptoms in the study group had no sta- tistical differences compared with the control group (all P>0. 05). There were no significant differences in the scores of material life,mental health,physical health and social function between the two groups at base-line (P>0. 05). After 8 weeks,the total score of GQOLI- 74 (206. 37±14. 37),material life score (48. 69± 6. 35),body health score ( 52. 83± 7. 32),mental health score ( 51. 66 ± 4. 63) and social function score (53. 62± 6. 17) of the study group were higher than those of control group((182. 00± 12. 56),( 44. 62± 6. 11),(48. 52±5. 52),(45. 26±4. 66),(46. 18±5. 32))(t=4. 67,5. 26,3. 26,4. 92,3. 25,all P<0. 05). There was no significant difference in TESS score between the two groups(P<0. 05). Conclusion ARGT combined with clozapine can improve the negative symptoms and the quality of life of patients with refractory schizophrenia.

Self-injury has become a significant public health problem, especially happens in adolescents. Previous studies have suggested that self-injury is related to numerous factors. At present, the occurrence mechanism of self-injury is still unclear, and there is a lack of reliable biological markers in its diagnosis and therapeutic target so far. Previous studies have suggested that self-injury may be related to hypothalamic pituitary adrenal(HPA) axis, β-endorphins, opioids and other hormones. Hypothalamic pituitary thyroid(HPT) axis and hypothalamic pituitary gonadal(HPG) axis are endocrine systems connecting nerves and hormones. Many studies suggested that various hormones in HPT axis and HPG axis of self-injury patients with other mental disorders (such as major depression and bipolar disorder) were abnormal. At present, there are few studies on the relationship between self-injury and HPT axis and HPG axis. There are differences in results even among studies on the same hormones, and some studies involve suicide attempts and even behaviors. Some studies have confirmed that self-injury is related to suicide, expanding the possibility of exploring the correlation between self-injury and hormones. This study will review the relationship between self-injury and hormonal changes.

BackgroundThe incidence of cognitive impairment in patients with depressive disorder is high， and the causes and mechanisms of which deserve more attention. It is usual that the thyroid hormone levels in patients with depressive disorder alter. Further research is needed to explore whether the cognitive function changes in patients with depressive disorder are related to thyroid hormone levels. ObjectiveTo explore the improvement of cognitive function in patients with first-episode depressive disorder after escitalopram and paroxetine treatment， and to analyse its correlation with thyroid hormone levels， so as to look for potential biomarkers of cognitive function change in patients with depressive disorder. MethodsFrom March 2021 to March 2022， 120 patients who met the diagnostic criteria of the International Classification of Diseases， tenth edition （ICD-10） for depression and were hospitalized at Shandong Mental Health Center were selected as the research objects. They were randomly divided into two groups by random number table method with 60 patients in each group. The two groups were treated with escitalopram （starting dose 5 mg/d） and paroxetine （starting dose 20 mg/d） for 6 weeks. Before and 6 weeks after the treatment， levels of thyroid stimulating hormone （TSH）， free thyroxine （FT4） and free triiodothyronine （FT3） were tested respectively. Depression degree and cognitive function level were assessed using the Hamilton Depression Scale-17 item （HAMD-17） and Montreal Cognitive Assessment （MoCA）， respectively. Pearson or Spearman correlation analysis was used to examine the correlation between the MoCA score difference before and after the treatment and the post-treatment level of thyroid hormone. ResultsBefore and 6 weeks after the treatment， the time effect of HAMD-17 total score in both groups was statistically significant （F=1 236.568， P<0.01）. Also， the time effect， group effect as well as interaction effect of time and group of MoCA total score in both groups were statistically significant （F=79.186， 6.026， 20.417， P<0.05 or 0.01）. The time effect， group effect as well as the interaction effect of time and group for FT3 level and FT4 level were statistically significant in both groups （F=75.973， 20.287， 0.961， 84.194， 0.142， 8.299， P<0.05 or 0.01）. According to the simple effect analysis. After the treatment， the MoCA total score in both groups was higher than that before treatment， while FT3 and FT4 levels were lower than those before treatment （F=15.864， 5.421， 8.524， 6.443， 7.628， 3.639， P<0.01）. After the 6-week treatment， the MoCA total score as well as FT3 and FT4 level differences in escitalopram and paroxetine groups were of statistical significance （t=5.841， -0.705， -2.349， P<0.05 or 0.01）. The MoCA score difference before and after treatment in paroxetine group was positively correlated with FT3 and FT4 levels after treatment （r=0.276， 0.382， P<0.05 or 0.01）. ConclusionBoth escitalopram and paroxetine can improve cognitive function in patients with first-episode depressive disorder. The improvement may be related to the changes in serum FT3 and FT4 levels.

Tumor stroma plays key roles in promoting tumor recurrence and treatment resistance. Cancer-associated fibroblasts (CAFs) are one of the most abundant and key components in the stroma of lung cancer. CAFs secrete a variety of inflammatory cytokines and extracellular matrix to form a desmoplastic tumor niche, which play important roles in the occurrence and development of lung cancer. CAFs are mainly derived from normal lung fibroblasts, which are transformed by tumor-derived cytokines. The diverse sources of CAFs lead to great heterogeneity in different CAFs subgroups. Although many studies support that CAFs promote tumor growth, but evolving data also argue for their antitumor actions. The putative bimodal function in oncogenesis of CAFs bring great challenges to the clinical application of CAFs-targeted therapies. This review focuses on the characteristics and functional research of CAFs, and emphasizes the roles and specificity of CAFs in the development of lung cancer.