Objective:To explore the correlation of excessive daytime sleepiness (EDS)with clinical features as well as inflammatory cytokines in adolescents with major depressive disorder.Methods:From January to December 2021, a total of 164 adolescents with major depressive disorder were included in the psychiatry departments of two hospitals in Anhui province, China, and divided into the EDS group ( n=70) and the non-EDS group ( n=94) according to whether or not they were accompanied by EDS. The center for epidemiological studies depression scale (CES-D) and the positive and negative suicidal ideation scale (PANSI) were used to assess patients' depressive symptoms severity and suicidal ideation levels, respectively. Additionally, plasma levels of inflammatory cytokines, including interleukin (IL)-1β, IL-6, IL-10, IL-17A, and tumour necrosis factor-α (TNF-α) were measured using the MSD ultrasensitive multifactor electrochemiluminescence analyzer. Statistical analysis were performed using SPSS 23.0 software, and independent influences of EDS were analyzed by Logistic stepwise regression. Results:The prevalence of EDS was 42.7%(70/164) in adolescents with major depressive disorder. In univariate analysis, patients in the EDS group had higher body mass index (BMI), CES-D total score, PANSI total score, IL-1β (Log) and IL-6 (Log) compared to the non-EDS group (all P<0.05). Logistic stepwise regression analysis showed that BMI ( OR=1.094, 95% CI=1.007-1.189, P=0.033), CES-D total score ( OR=1.043, 95% CI=1.012-1.075, P=0.007), and IL-1β (Log) ( OR=3.868, 95% CI=1.484-10.079, P=0.006) were independent influencing factors of EDS in adolescents with major depressive disorder. Conclusions:The risk of EDS in adolescents with major depressive disorder is relatively high, and EDS may be closely related to BMI, depression severity, suicidal ideation and IL-1β level.

Objective : To explore the predictive value of depression severity plasma thyroid-stimulating hormone(TSH) and brain-derived neurotrophic factor(BDNF) levels for agitated symptoms in patients with adolescent depressive disorder(MDD). Methods : Ninety-one patients with adolescent depressive disorder were enrolled, and the degree of agitation was assessed according to the modified outward aggressive behavior scale(MOAS); 24-item hamilton depression scale(HAMD24) was used to determine the severity of depression; chemiluminescence immunoassay(CLIA) was used to determine the plasma thyroid-stimulating hormone(TSH) level; and electrochemiluminescence immunoassay(ECL) was used to determine the plasma BDNF. SPSS 26.0 was used for statistical analysis of the data, Spearman correlation analysis was used to analyze the relationship between HAMD24and plasma TSH and BDNF levels and the degree of agitation, multiple linear regression analysis was used to analyze the factors influencing the degree of agitation in adolescents with MDD, and binary Logistic regression analysis and subjects′ work characteristic curves(ROC) were used to establish predictive models. Results: The degree of agitation in adolescent MDD patients was positively correlated with HAMD24total score(P<0.001); both HAMD24total score and plasma BDNF level were identified as risk factors for agitation severity(bothP<0.05); both HAMD24total score and plasma BDNF levels were risk factors for the degree of agitation(allP<0.05); HAMD24total score, plasma TSH, BDNF levels were all risk factors for concomitant agitation symptoms in adolescent MDD patients; ROC curve analysis showed that the three combined prediction models(AUC=0.889,P<0.001) had a higher predictive value than the single prediction model(P<0.01). Conclusion Concomitant agitation symptoms in adolescents with MDD are strongly associated with HAMD24total score and plasma TSH and BDNF levels, and the three combined models have good predictive power.

Objective:To explore the correlation of excessive daytime sleepiness (EDS)with clinical features as well as inflammatory cytokines in adolescents with major depressive disorder.Methods:From January to December 2021, a total of 164 adolescents with major depressive disorder were included in the psychiatry departments of two hospitals in Anhui province, China, and divided into the EDS group ( n=70) and the non-EDS group ( n=94) according to whether or not they were accompanied by EDS. The center for epidemiological studies depression scale (CES-D) and the positive and negative suicidal ideation scale (PANSI) were used to assess patients' depressive symptoms severity and suicidal ideation levels, respectively. Additionally, plasma levels of inflammatory cytokines, including interleukin (IL)-1β, IL-6, IL-10, IL-17A, and tumour necrosis factor-α (TNF-α) were measured using the MSD ultrasensitive multifactor electrochemiluminescence analyzer. Statistical analysis were performed using SPSS 23.0 software, and independent influences of EDS were analyzed by Logistic stepwise regression. Results:The prevalence of EDS was 42.7%(70/164) in adolescents with major depressive disorder. In univariate analysis, patients in the EDS group had higher body mass index (BMI), CES-D total score, PANSI total score, IL-1β (Log) and IL-6 (Log) compared to the non-EDS group (all P<0.05). Logistic stepwise regression analysis showed that BMI ( OR=1.094, 95% CI=1.007-1.189, P=0.033), CES-D total score ( OR=1.043, 95% CI=1.012-1.075, P=0.007), and IL-1β (Log) ( OR=3.868, 95% CI=1.484-10.079, P=0.006) were independent influencing factors of EDS in adolescents with major depressive disorder. Conclusions:The risk of EDS in adolescents with major depressive disorder is relatively high, and EDS may be closely related to BMI, depression severity, suicidal ideation and IL-1β level.

To establish a medical imaging teacher competency model and evaluate its application value in group teaching for undergraduates.

BackgroundPatients demonstrating depressive disorder with psychotic symptoms often have increased risk of death and poor prognosis. A large amount of research has explored the factors influencing psychotic symptoms in adult patients with depressive disorder， but few has focused on adolescent patients. ObjectiveTo explore the influencing factors of psychotic symptoms in adolescent patients with depressive disorder， so as to provide references for early screening and intervention in clinic. MethodsA total of 96 adolescent patients who met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） for depressive disorder and were seen in the psychiatry departments of Chaohu Hospital of Anhui Medical University and The Fourth People's Hospital of Hefei from September 2022 to January 2023 were included. Another 56 healthy individuals from the health examination center of Chaohu Hospital of Anhui Medical University were concurrently recruited as control group. Patients were assigned into psychotic group （n=32） and non-psychotic group （n=64） according to the presence or absence of psychotic symptoms. Hamilton Depression Scale-24 item （HAMD-24）， Positive and Negative Syndrome Scale （PANSS）， Positive and Negative Suicide Ideation （PANSI） and Childhood Trauma Questionnaire-Short Form （CTQ-SF） were used for evaluation. Plasma brain-derived neurotrophic factor （BDNF） concentration was obtained using Meso Scale Discovery electrochemiluminescence assay. Pearson and Spearman correlation analysis were adopted to determine the correlation of PANSS positive symptom subscale score with plasma BDNF concentration and clinical characteristics of adolescent depression patients with psychotic symptoms. Binary Logistic regression analysis was used to identify the factors influencing the presence of psychotic symptoms in adolescent patients with depressive disorder， and multiple linear regression analysis was utilized to screen the factors affecting the severity of psychotic symptoms. ResultsThe plasma BDNF concentration of adolescent patients with depressive disorder was lower than that of control group （t=-3.080， P<0.01）.The plasma BDNF concentration of psychotic group was lower than that of non-psychotic group （t=2.418， P<0.05）， while the body mass index （BMI） PANSI scores， CTQ-SF scores and HAMD-24 total scores were all higher than those of non-psychotic group （t=-2.024， -2.530， -2.187， -4.977， P<0.05 or 0.01）. Correlation analysis showed that PANSS positive symptom subscale scores were negatively correlated with anxiety/somatization factor score and weight factor score in HAMD-24 of psychotic group （r=-0.438， -0.498， P<0.05 or 0.01）. Binary Logistic regression showed that BMI， plasma BDNF concentration， HAMD-24 total scores and cognitive dysfunction factor score were the influencing factors of psychotic symptoms in adolescent patients with depressive disorder. Multiple linear regression analysis demonstrated that weight factor scores （β=-0.349， P<0.05） and anxiety/somatization factor score （β=-0.433， P<0.05） in HAMD-24 were the factors influencing the severity of psychotic symptoms. ConclusionHigh BMI， low plasma BDNF concentration， severe depressive symptoms and cognitive dysfunction may be the risk factors of psychotic symptoms in adolescent patients with depressive disorder， furthermore， BMI and anxiety symptoms are found to be associated with the severity of psychotic symptoms. ［Funded by Scientific Research Fund Project of Anhui Institute of Translational Medicine （number， 2022zhyx-B01）； Central Finance Supported Provincial Key Clinical Specialty Construction Project of Anhui Province in 2019］

The twenty-first century has already recorded more than ten major epidemics or pandemics of viral disease, including the devastating COVID-19. Novel effective antivirals with broad-spectrum coverage are urgently needed. Herein, we reported a novel broad-spectrum antiviral compound PAC5. Oral administration of PAC5 eliminated HBV cccDNA and reduced the large antigen load in distinct mouse models of HBV infection. Strikingly, oral administration of PAC5 in a hamster model of SARS-CoV-2 omicron (BA.1) infection significantly decreases viral loads and attenuates lung inflammation. Mechanistically, PAC5 binds to a pocket near Asp49 in the RNA recognition motif of hnRNPA2B1. PAC5-bound hnRNPA2B1 is extensively activated and translocated to the cytoplasm where it initiates the TBK1-IRF3 pathway, leading to the production of type I IFNs with antiviral activity. Our results indicate that PAC5 is a novel small-molecule agonist of hnRNPA2B1, which may have a role in dealing with emerging infectious diseases now and in the future.
Animals ; Mice ; Antiviral Agents/pharmacology* ; COVID-19 ; Hepatitis B virus ; Interferon Type I/metabolism* ; SARS-CoV-2/drug effects* ; Heterogeneous-Nuclear Ribonucleoprotein Group A-B/antagonists & inhibitors*

Cognitive impairment after infectious meningitis seriously affects the activities of daily living for survivors. There has been lack of systematic researches on the cognitive impact of infectious meningitis so far, it is not clear how to early identify and evaluate the cognitive impairment after meningitis, how to properly carry out early rehabilitative intervention to improve the activities of daily living and to reduce the social and economic burden of patients. This article reviews the characteristics, evaluation methods and rehabilitative interventions of cognitive impairment in patients after infectious meningitis, to provide reference for clinical application.

The low-frequency oscillation of electroencephalography can reflect the process of brain neuron remodeling. This article reviews the basic principles of neurobiology, measurement and analysis methods of delta (0.5-4 Hz) and theta (4-8 Hz) low-frequency oscillatory activities and their clinical applications in post-stroke motor, cognitive and language functions, and discusses the possibility of their clinical research and conversion application in the field of stroke rehabilitation.

Objective:To explore the changes in the diffusion tensor imaging (DTI) parameters of the pontocerebellar tract 3 months and one year after ischemic stroke and analyze the data′s potential for predicting long-term motor outcomes.Methods:Thirty patients with middle cerebral artery infarction were prospectively studied using DTI within 3 months and 1 year after the onset. A region of interest-based analysis was performed for the fractional anisotropy (FA) of the middle cerebellar peduncles (MCP) in the pontocerebellar fibers (PCF). Neurological functioning was evaluated using the National Institutes of Health Stroke Scale and the degree of paresis was assessed at the same time using paresis grading. At one year after the onset, balance function, functional prognosis and self-care ability were evaluated using the Brunel Balance Scale, the modified Rankine Scale and the Functional Independence Scale respectively.Results:The average FA on the healthy side 3 months and 1 year after onset was significantly less than on the affected side at each time point. The ratio of the FA of the affected side to that of the unaffected side (rFA) in the PCF correlated significantly with the average paresis scores of the lower and upper extremity and the total paresis score at each time point. Moreover, the rFA of the PCF was significantly correlated with the average functional independence score, the prognosis for the upper and lower extremities as well as motor functioning. The area ratio under the ROC curve of the PCF for predicting lower extremity motor outcome was 0.84, and the optimal threshold was 0.92 (sensitivity 71.4%, specificity 73.9%). The area ratio under the ROC curve was not a significant predictor of upper extremity motor outcome.Conclusion:The DTI parameter rFA of the PCF in patients with subacute middle cerebral artery infarction can help to predict the long-term recovery of motor ability. It can serve as an important reference index for predicting the long-term motor ability of the lower limbs.

Objective:To explore whether endoscopic surgery can achieve the same effect on thyroid cancer as open surgery.Method:44 cases were selected to endoscopic thyroidectomy with breast areola approach, who were prepared to accept the surgical treatment of thyroid cancer with cT1N0 stages, female, ≤60 years old, no history of neck surgery and beauty desire. Fifty patients with the same conditions undergoing thyroid open surgery were as the control group.Results:Operative time of endoscopic group[ (170.0±28.0) min] was longer than that of the open operation group[ (90.0±21.0) min ( t=15.610, P=0.000) ]. There was no significant difference between the two groups in surgical complications ( P>0.05) . There was no statistical difference between the number of paratracheal and anterior tracheal lymph nodes of endoscopic group (6.0 ±4.2) and open surgery group (5.5 ±3.7) ( t=0.692, P>0.05) . There was no statistical difference between the number of anterior laryngeal lymph nodes of endoscopic group (0.7 ±1.1) and open surgery group (0.5 ±0.9) ( t=1.186, P>0.05) . Conclusion:The breast areola approach endoscopic thyroidectomy is safe and reliable in treatment of thyroid cancer, and the central cervical lymph node dissection is sufficient, which can be used as the choice of operation mode for thyroid cancer patients in cT1N0 stage.