Objective To analyze the correlation between cumulative fluid balance volume and increasing plasma volume and aggravated clinical congestion symptoms in patients with heart failure on admission for 1～7 d,and to explore the application value of cumulative fluid balance volume in predicting volume overload.Methods Using the convenience sampling method,235 heart failure patients hospitalized from October 2022 to February 2023 in a total of 3 tertiary hospitals in Nanjing,Lianyungang,Jiangsu Province,and Zhumadian,Henan Province,were selected and classified into an increasing/decreasing plasma volume group and an aggravated/alleviated clinical congestion symptoms group.General information,clinical characteristics,and 1～7 d cumulative fluid balance volume of the study subjects were collected to compare the differences in cumulative fluid balance volume between the 2 groups.Logistic regression was used to analyze the effect of cumulative fluid balance volume on plasma volume and clinical congestion symptoms.Receiver operating characteristic curves were used to analyze the optimal cutoff value of cumulative fluid balance volume for predicting increasing plasma volume and aggravated clinical congestion symptoms.Results Excluding 15 pat ients who were discharged early and 3 patients with inaccurate records of fluid intake and excretion,a total of 217 patients were included.The incidence of positive fluid balance was lowest on day 1,at 65.90%,with the smallest cumulative volume of(0.235±0.983)L;the highest incidence of positive balance occurred on day 6,at 75.58%,with the largest cumulative volume of(2.444±5.445)L.The cumulative fluid balance at 4～7 d in the increasing plasma volume group was higher than that in the decreasing plasma volume group,and the difference was statistically significant(P<0.05);the cumulative fluid balance at 4～7 d was an independent risk factor for plasma volume elevation,and a cumulative fluid balance of 2.308,3.361,3.518,and 3.702 L at 4～7 d was predictive of a plasma volume elevation,and areas under receiver operating characteristic curve were 0.686,0.721,0.647,and 0.766,respectively.The cumulative fluid balance for 4～7 d in the aggravated clinical congestion symptoms group was higher than that in the alleviated clinical congestion symptoms group,and the difference was statistically significant(P<0.05);the cumulative fluid balance for 4～7 d was an independent risk factor for the aggravated clinical congestion symptoms,and a cumulative fluid balance for 4～7 d of 2.574,3.383,4.995,and 4.235 L predicted aggravated clinical congestion symptoms,and area under receiver operating characteristic curve was 0.640,0.693,0.654,and 0.720,respectively.Conclusion The incidence of cumulative positive fluid balance in heart failure patients is high,and the amount of cumulative fluid balance can better predict the occurrence of volume overload,and the increase of plasma volume precedes the appearance of clinical congestion symptoms.It is suggested that heart failure patients with more than 3 d of cumulative positive balance should be closely monitored,and when the cumulative positive balance exceeds 2.308 L,measures should be taken in time to drain excessive fluid,so as to avoid the incidence of volume overload.

Objective:To investigate the value of 18F-FDG PET/CT combined with conventional imaging modalities in the evaluation of the depth of tumor invasion, regional lymph node metastasis, distant organ and lymph node metastasis (TNM staging), and the adjacent structure invasion of rectal cancer. Methods:Fifty-four patients (28 males, 26 females, age (65.8±11.0) years) with pathologically confirmed rectal cancer admitted to the Affiliated Qingdao Central Hospital of Qingdao University between September 2019 and June 2021 were retrospectively analyzed. 18F-FDG PET/CT examination, conventional imaging modalities including high-resolution MRI (HR-MRI), chest CT plain scan, upper abdominal MRI or CT plain scan+ enhanced examination were performed within 2 weeks before or after the rectal cancer being confirmed. The TNM staging and adjacent structural invasions including circumferential resection margin (CRM), extramural vascular invasion (EMVI), anal sphincter complex involvement were evaluated by 18F-FDG PET/CT and conventional imaging modalities separately or in combination, and those results based on imaging were compared with the pathological results or clinical follow-up results. χ2 test was used to compare the differences of diagnostic sensitivity, specificity and accuracy between the 18F-FDG PET/CT or conventional imaging modalities and combined examination. Results:The accuracy for T staging and the sensitivity and accuracy for N staging of the combined examination were 96.30%(52/54), 98.65%(73/74) and 93.91%(185/197), respectively, which were significantly higher than those of 18F-FDG PET/CT (85.19%(46/54), 66.22%(49/74), 81.73%(161/197); χ2 values: 3.97, 26.88, 13.66, all P<0.05). The specificity (91.06%, 112/123) and accuracy of the combined examination for N staging were higher than those of the conventional imaging modalities (77.24%(95/123), 83.76%(165/197); χ2 values: 8.81, 10.23, both P<0.05). The sensitivity and accuracy of the combined examination for M staging were higher than those of the conventional imaging modalities (97.01%(65/67) vs 73.13%(49/67), 95.95%(71/74) vs 68.92%(51/74); χ2 values: 15.05, 18.66, both P<0.001). The sensitivities of the combined examination in evaluating CRM and EMVI were 100%(22/22) and 95.00%(19/20), and the accuracies were 98.15%(53/54) and 96.30%(52/54), all of which were higher than those of 18F-FDG PET/CT (CRM: 54.55%(12/22), 74.07%(40/54); EVMI: 30.00%(6/20), 74.07%(40/54); χ2 values: 12.94, 13.08, 18.03, 10.56, all P<0.01). The accuracy of the combined examination in evaluating EMVI was higher than that of the conventional imaging modalities (85.19%(46/54); χ2=3.97, P=0.046). Conclusion:18F-FDG PET/CT combined with conventional imaging modalities can improve the diagnostic efficacy for TNM staging and assessment of adjacent structural invasion in rectal cancer.

Objective:To explore the effects of aerobic exercise therapy and anaerobic exercise therapy on improving depressive symptoms, sleep quality, and cognitive function in patients with mild and moderate depression.Methods:A prospective study was conducted to collect clinical data from 148 inpatients with mild to moderate depression treated at the Second Affiliated Hospital of Xinxiang Medical College from February 2019 to May 2023 including 74 males and 74 females aged 18 to 60 (40.08±11.03) years. They were randomly assigned the conventional treatment group (group A, 49 cases), the conventional treatment+moderate-intensity aerobic exercise therapy intervention group (group B, 51 cases), and the conventional treatment+moderate intensity anaerobic exercise therapy intervention group (group C, 48 cases). Patients in each group were treated the corresponding intervention for 4 weeks. The 24-item Hamilton Depression Scale (HAMD 24), Pittsburgh Sleep Quality Index (PSQI), and the Montreal Cognitive Assessment (MOCA) were used to score depressive symptoms, sleep quality, and cognitive function, respectively, before and after intervention. Paired sample t-tests were used to compare the changes in scores before and after the intervention. One-way ANOVA was used to analyze and compare the score differences on each scale among the groups. Results:After the intervention, HAMD 24 and PSQI scores in all groups decreased compared with those before the intervention (Group A: HAMD 24 (15.08±4.15) vs (29.33±4.75), PSQI (12.76±2.52) vs (14.88±3.64); Group B: HAMD 24 (12.82±3.83) vs (28.61±5.08), PSQI (11.59±2.26) vs (14.55±4.14); Group C: HAMD 24 (14.44±3.60) vs (29.44±4.98), PSQI (11.40±2.30) vs (15.13±4.62)) (all P<0.001). After the intervention, the MOCA scores in all groups were higher than those before the intervention (Group A: (26.04±2.21) vs (25.92±2.34), t=-2.20, P=0.032; Group B: (26.22±1.59) vs (25.35±1.95), t=-4.45, P<0.001; Group C: (26.10±2.15) vs (25.21±2.13), t=-3.15, P=0.003). After the intervention, the HAMD 24 scores of Group B were lower than those of Group A and Group C ((12.82±3.83) vs (15.08±4.15) vs (14.44±3.60)) (all P<0.05), and the PSQI scores of groups B and C were lower than those of group A ((11.59±2.26) and (11.40±2.30) vs (12.76±2.52)) (all P<0.05). No statistically significant differences in MOCA scores among Group A, Group B, and Group C after the intervention ( P=0.906). Conclusion:Exercise therapy is helpful in improving depressive symptoms and sleep quality in patients with mild to moderate depression, but it does not have a significant advantages in improving cognitive function.

Objective:To explore the effects of aerobic exercise therapy and anaerobic exercise therapy on improving depressive symptoms, sleep quality, and cognitive function in patients with mild and moderate depression.Methods:A prospective study was conducted to collect clinical data from 148 inpatients with mild to moderate depression treated at the Second Affiliated Hospital of Xinxiang Medical College from February 2019 to May 2023 including 74 males and 74 females aged 18 to 60 (40.08±11.03) years. They were randomly assigned the conventional treatment group (group A, 49 cases), the conventional treatment+moderate-intensity aerobic exercise therapy intervention group (group B, 51 cases), and the conventional treatment+moderate intensity anaerobic exercise therapy intervention group (group C, 48 cases). Patients in each group were treated the corresponding intervention for 4 weeks. The 24-item Hamilton Depression Scale (HAMD 24), Pittsburgh Sleep Quality Index (PSQI), and the Montreal Cognitive Assessment (MOCA) were used to score depressive symptoms, sleep quality, and cognitive function, respectively, before and after intervention. Paired sample t-tests were used to compare the changes in scores before and after the intervention. One-way ANOVA was used to analyze and compare the score differences on each scale among the groups. Results:After the intervention, HAMD 24 and PSQI scores in all groups decreased compared with those before the intervention (Group A: HAMD 24 (15.08±4.15) vs (29.33±4.75), PSQI (12.76±2.52) vs (14.88±3.64); Group B: HAMD 24 (12.82±3.83) vs (28.61±5.08), PSQI (11.59±2.26) vs (14.55±4.14); Group C: HAMD 24 (14.44±3.60) vs (29.44±4.98), PSQI (11.40±2.30) vs (15.13±4.62)) (all P<0.001). After the intervention, the MOCA scores in all groups were higher than those before the intervention (Group A: (26.04±2.21) vs (25.92±2.34), t=-2.20, P=0.032; Group B: (26.22±1.59) vs (25.35±1.95), t=-4.45, P<0.001; Group C: (26.10±2.15) vs (25.21±2.13), t=-3.15, P=0.003). After the intervention, the HAMD 24 scores of Group B were lower than those of Group A and Group C ((12.82±3.83) vs (15.08±4.15) vs (14.44±3.60)) (all P<0.05), and the PSQI scores of groups B and C were lower than those of group A ((11.59±2.26) and (11.40±2.30) vs (12.76±2.52)) (all P<0.05). No statistically significant differences in MOCA scores among Group A, Group B, and Group C after the intervention ( P=0.906). Conclusion:Exercise therapy is helpful in improving depressive symptoms and sleep quality in patients with mild to moderate depression, but it does not have a significant advantages in improving cognitive function.

Objective:To investigate the role of mitogen-activated protein kinase phosphatase-1 (MKP-1) on depressive-like behaviors and hippocampal neuron apoptosis in chronic unpredictable mild stress (CUMS) rats.Methods:A total of 36 Sprague-Dawley male rats were randomly divided into 4 groups using a random number table, including the control group( n=8), CUMS group( n=8), virus control group( n=10), and MKP-1 down-regulated group( n=10), with 8 rats in each group. Except for the control group, rats in other groups were stressed by CUMS model of depression. Rats in the virus control group and MKP-1 down-regulated group received adeno-associated virus injections in the hippocampal CA1 and CA3 regions before CUMS modeling. Sucrose preference test, forced swimming test, and open field test were used to observe the behavioral changes of rats. Western blotting was used to detect the protein expression of MKP-1, B-cell lymphoma-2 gene (Bcl-2) and B-cell lymphoma-2 gene-related X protein (Bax), in the hippocampus. TUNEL staining was utilized to observe the morphology of apoptotic cells in the hippocampus CA1 area. Repeated measures variance was used to analyze body weight and behaviors, while an independent sample t-test was used to analyze protein levels. Results:Compared with the control group, the body weight of rats in the CUMS group decreased ( F=44.664); the sucrose preference rate decreased ( F=14.978); the forced swimming immobility time increased ( F=8.436); the number of defecation in the open field test increased ( F=9.572); the relative expression level of MKP-1 and Bax/Bcl-2 also significantly increased ( t=4.415,3.410), P<0.05 for all; Compared with the virus control group, rats in the MKP-1 down-regulation group showed a higher sucrose preference rate ( F=11.922) and a shorter forced swimming immobility time ( F=12.868), furthermore, the activity distance ratio in the central area increased ( F=6.291), the number of uprights in the open field test increased ( F=14.372), and the relative expression levels of MKP-1 and Bax/Bcl-2 ( t=3.775,6.193) decreased, P<0.05 for all. The number of DNA fragments in the nucleus of the hippocampal CA1 region of the CUMS group was significantly more than that of the control group. In comparison, the number of DNA fragments in the nucleus of the MKP-1 down-regulated group was substantially less than that of the virus control group. Conclusion:Down-regulation of MKP-1 gene alleviated depressive-like behavior and hippocampal neuron apoptosis in CUMS rats.

Objective:To investigate the role of mitogen-activated protein kinase phosphatase-1 (MKP-1) on depressive-like behaviors and hippocampal neuron apoptosis in chronic unpredictable mild stress (CUMS) rats.Methods:A total of 36 Sprague-Dawley male rats were randomly divided into 4 groups using a random number table, including the control group( n=8), CUMS group( n=8), virus control group( n=10), and MKP-1 down-regulated group( n=10), with 8 rats in each group. Except for the control group, rats in other groups were stressed by CUMS model of depression. Rats in the virus control group and MKP-1 down-regulated group received adeno-associated virus injections in the hippocampal CA1 and CA3 regions before CUMS modeling. Sucrose preference test, forced swimming test, and open field test were used to observe the behavioral changes of rats. Western blotting was used to detect the protein expression of MKP-1, B-cell lymphoma-2 gene (Bcl-2) and B-cell lymphoma-2 gene-related X protein (Bax), in the hippocampus. TUNEL staining was utilized to observe the morphology of apoptotic cells in the hippocampus CA1 area. Repeated measures variance was used to analyze body weight and behaviors, while an independent sample t-test was used to analyze protein levels. Results:Compared with the control group, the body weight of rats in the CUMS group decreased ( F=44.664); the sucrose preference rate decreased ( F=14.978); the forced swimming immobility time increased ( F=8.436); the number of defecation in the open field test increased ( F=9.572); the relative expression level of MKP-1 and Bax/Bcl-2 also significantly increased ( t=4.415,3.410), P<0.05 for all; Compared with the virus control group, rats in the MKP-1 down-regulation group showed a higher sucrose preference rate ( F=11.922) and a shorter forced swimming immobility time ( F=12.868), furthermore, the activity distance ratio in the central area increased ( F=6.291), the number of uprights in the open field test increased ( F=14.372), and the relative expression levels of MKP-1 and Bax/Bcl-2 ( t=3.775,6.193) decreased, P<0.05 for all. The number of DNA fragments in the nucleus of the hippocampal CA1 region of the CUMS group was significantly more than that of the control group. In comparison, the number of DNA fragments in the nucleus of the MKP-1 down-regulated group was substantially less than that of the virus control group. Conclusion:Down-regulation of MKP-1 gene alleviated depressive-like behavior and hippocampal neuron apoptosis in CUMS rats.

Depressive disorder is a common mental disorder.At present, the diagnosis of depressive disorder mainly relies on patients' self-reported symptoms and clinical interviews which are relatively subjective.As one of the new technologies assisting diagnosis and therapeutic effect evaluation of depressive disorder, near-infrared spectroscopy (NIRS) has received a lot of attention in recent years.This article reviewed studies of using NIRS in the diagnosis and therapeutic effect evaluation of depressive disorder in the past five years.The review showed that NIRS could reflect abnormal hemodynamic activities of the prefrontal cortex and temporal cortex of patients with depressive disorder, especially the dorsolateral prefrontal cortex and inferior frontal gyrus.Changes of concentration of oxygenated hemoglobin in these areas showed higher accuracy in assisting the diagnosis of depression disorder.Until now, only a few longitudinal studies utilized NIRS to compare changes of cerebral hemodynamic activities at different time points of treatment which preliminarily confirmed the potential of NIRS in the evaluation of therapeutic effects of depressive disorder.In future, more large-scale studies will be needed to further determine the specific application standards for NIRS in the diagnosis and therapeutic effect evaluation of depressive disorder.

Objective:To systematically review the effects of limited fluid intake on the prognosis of patients with heart failure.Methods:RCTs about the effects of limited fluid intake on the prognosis of patients with heart failure published up to March 31, 2021 were retrieved from PubMed, The Cochrane Library, CINAHL, Embase, Web of Science, CNKI, Wanfang, VIP, and SinoMed. Two independent researchers were employed to extract data and evaluate the quality of included literature. Rev Man 5.3 was used for Meta-analysis, sequential analysis to evaluate the reliability and authenticity of the research results, and the Egger's test for publication bias.Results:A total of 7 articles were included, with a sample size of 867 cases. Meta-analysis showed that the body weight [ MD=-3.04, 95% CI (-4.70, -1.38) , P<0.001], B-type natriuretic peptide [ MD=-249.32, 95% CI (-305.00, -193.63) , P<0.001], blood creatinine [ MD=-22.03, 95% CI (-24.98, -19.09) , P<0.001], readmission rate [ OR=0.30, 95% CI (0.20, 0.45) , P<0.001] of the limited fluid intake group in the chronic phase of heart failure were lower than those in the control group; the body weight [ MD=1.41, 95% CI (-3.73, 6.55) , P=0.59], B-type natriuretic peptide [ MD=64.52, 95% CI (-50.01, 179.06) , P=0.27], serum creatinine [ MD=3.83, 95% CI (-9.69, 17.36) , P=0.58], readmission rate [ OR=1.21, 95% CI (0.65, 2.27) , P=0.55] of the acute fluid intake group were not statistically different from those in the control group. Conclusions:Limiting fluid intake in the chronic phase of heart failure can effectively improve the patients' heart and kidney function and the prognosis of the disease. In the acute phase of heart failure, it may be necessary to combine multiple treatments to keep the patients at the best volume state.

Objective:To explore the effect of cognitive behavior orientation group psychotherapy on coping style, time management and family function of middle school students with internet addiction, and provide theoretical basis for the internet addiction psychotherapy system.Methods:Based on IAT, 70 internet addiction middle school students were screened and divided into control group and experimental group according to random number table method.The control group was only given conventionally psychological and drug treatments, the experimental group participated in cognitive behavioral orientation group psychotherapy on the basis of the treatment of the control group.Thirty-two people in the control group and thirty-three people in the experimental group completed the treatment.Before and after treatment, the two groups of middle school students were evaluated by the internet IAT, the SCSQ, the ATMD and the FAD.Results:There was no significant difference in the scales between the two groups of internet addiction middle school students before treatment (all P>0.05). After the intervention of the experimental group, the differences in the positive response (1.89±0.51), negative response (1.55±0.51), time monitoring (58.39±12.10), time value (26.64±4.48), time efficacy (30.42±5.18), and roles(18.85±2.40), communication(24.18±3.77), behavior control (18.82±2.57) and general functioning(24.79±3.90) of FAD were statistically significant compared with the control group (1.62±0.44), (1.84±0.55), (52.09±11.72), (19.34±3.96), (21.91±6.13), (21.16±2.63), (26.09±3.75), (20.59±2.54), (28.69±3.68) and the pre-intervention period (1.46±0.48), (1.97±0.56), (48.73±13.46), (18.27±4.84), (20.00±5.79), (21.76±2.72), (26.58±3.86), (19.76±2.96), (29.27±4.76) (all P<0.05). There were significant differences in problem-solving (12.67±2.50) and affective responsiveness (14.03±3.73) scores of the FAD between the experimental group and the pre-intervention group (14.15±2.83), (14.61±3.66) (all P<0.05). There were significant differences in SCSQ and ATMD before and after treatment in the control group (all P<0.05). Conclusion:Cognitive behavior orientation group psychotherapy can optimize the coping style, ameliorate their time management ability and significantly improve the role, communication, behavior control and overall function of family function of middle school students with internet addiction.

Objective:To establish a synthetic cyclic citrullinated peptide induced arthritis model in mice, explore immunogenicity and arthritogenicity of this peptide. Methods: 36 DBA/1 mice were randomly divided into three groups, which were injected the type Ⅱ collagen ( CⅡ, CIA ) emulsion, cyclic citrullinated vimentin peptide ( CCit-Vim, CCV-IA ) emulsion, cyclic citrullinated vimentin peptide conjugated KLH ( CCit-Vim+KLH,CCV+K-IA) emulsion on day 0 and 21,respectively. Using arthritis index( AI) ,paw swelling to evaluate the incidence of arthritis;ELISA tested serum anti-CCit-Vim antibody,anti-CⅡantibody,anti-CCP antibody and TNF-α, IIF detected AKA;Histopathology of the ankle joint was obsearved. Results: There were three mice appeared arthritis in CCV+K-IA,the incidence rate of 25%,but arthritis occurs later time,short duration,and the incidence and extent of arthritis were lower than the CIA. CCV-IA no arthritis performance. CCV+K-IA produce anti-CCit-Vim antibody were significantly higher than those in CIA (1. 32±0. 59 vs 0. 78±0. 27,P=0. 031). While Anti-CCP antibody of CCV+K-IA were significantly lower than CIA (54. 73±7. 33 vs 64. 37±9. 91,P=0. 007). The anti-CⅡ antibody in CCV+K-IA and CCV-IA were lower than the CIA(15. 73±2. 10, 16. 71±3. 03 vs 19. 50±2. 36,P<0. 05). The TNF-α produced by CCV+K-IA and CIA were both significantly higher than the CCV-IA (645. 61±35. 26,618. 98±53. 32 vs 533. 63±79. 49,P<0. 05). The AKA positive rate of CCV+K-IA is 50% (6/12),significantly higher than CCV-IA 25% ( 3/12 ) and CIA 16. 67% ( 2/12 ) . Histopathology of the ankle showed that the CCV-IA and CCV+K-IA have a mild synovial hyperplasia,no obvious synovial pannus formation and inflammatory cell infiltration. Conclusion:The cyclic citrul-linated peptide conjugated KLH not only has stronger immunogenicity but also has arthritogenicity. It induced a higher positive rate of AKA than CⅡ.