Objectives: This study aimed to explore the influence of depression severity, disease course, treatment status, and other factors on cognitive function in adolescents with depressive disorders. Methods: Participants who met the inclusion criteria were enrolled in the study. Sociodemographic data of each participant were recorded, including age, sex, and family history of mental disorders. Zung’s Self-Rating Depression Scale was used to assess depression status in adolescents. Moreover, P300 and mismatch negativity (MMN) were used to objectively evaluate the participants’ cognitive function. Results: Only 26.8% of the adolescents with depression received standard antidepressant treatment. The latencies of N2 (267.80±23.34 ms), P3 (357.71±32.09 ms), and MMN (212.10±15.61 ms) in the adolescent depression group were longer than those in the healthy control group (p<0.01). Further analysis revealed that the latency of MMN was extended with increased levels of depression in adolescents.The MMN latency was short in participants with depression receiving standardized treatment. Furthermore, the latency of MMN was positively correlated with the severity and duration of depression (correlation coefficients were 0.465 and 0.479, respectively) (p<0.01). Conclusion Receiving standardized treatment and shortening the course of depression can reduce cognitive impairment in adolescents with depression.

This article reports the pharmacotherapy process of a clinical pharmacist participating in the treatment of acute liver injury caused by nintedanib in a patient with lung cancer complicated with interstitial pneumonia.Clinical pharmacist analyzed the rapid increase of liver enzymes in patients by excluding their past drug use history,stopping suspicious drugs and searching domestic and foreign literature,and determined that the association with nidanib was very likely according to RUCAM scale.The clinical pharmacies suggesteded stopping nintedanib and taking liver protection treatment actively.The clinician adopted the suggestion,and finally the patient's liver function improved after 20 days of treatment.Clinical pharmacists demonstrate their value by analyzing the causes and characteristics of liver injury in patients,assisting physicians in the timely identification and management of adverse reactions,and participating in clinical practice.This article can provide a reference for the diagnosis and treatment of similar cases of acute liver injury.

Objective:To explore the alterations in functional connectivity density (FCD) resulted from mild cognitive impairment (MCI) and their correlations with cognitive scores in various cognitive domains in patients with Parkinson's disease (PD).Methods:Forty-three PD patients admitted to Department of Neurology, Sixth Affiliated Hospital of Nantong University from January 2022 to April 2024 were selected and divided into PD-MCI group (MoCA scores<26) and PD with normal cognition (PD-NC) group (MoCA scores≥26) according to Montreal Cognitive Assessment (MoCA). Another 23 middle-aged and elderly healthy volunteers (HC group) matched with PD patients in age, gender and education level were recruited at the same period. Resting-state functional MRI (rs-fMRI) data were collected and whole brain FCD was calculated. Differences of clinical data, whole brain FCD, and FCD in brain regions with significantly different FCD among the 3 groups were compared. Efficiency of FCD in brain regions with significantly different FCD between PD-MCI group and PD-NC group in differentially diagnosing PD-MCI and PD-NC was analyzed by receiver operating characteristic (ROC) curve. Pearson correlation was used to the analyze the correlations of FCD in brain regions with significantly different FCD with MoCA score and cognitive scores in various cognitive domains.Results:Among the 43 patients, 23 were into the PD-MCI group and 20 into the PD-NC group. PD-MCI group had significantly lower scores in the visuospatial and executive function, abstraction, and delayed memory cognitive domains than PD-NC group ( P<0.05). Brain regions with significantly different FCD among the 3 groups were the right parahippocampal gyrus, left gyrus rectus, right rolandic operculum, left middle occipital gyrus, right precentral gyrus, left middle frontal gyrus, and left medial superior frontal gyrus. Compared with the HC group, the PD-MCI group and PD-NC group had significantly increased FCD at the right parahippocampal gyrus, left gyrus rectus and right rolandic operculum, statistically decreased FCD at the right precentral gyrus, left middle frontal gyrus, and left medial superior frontal gyrus ( P<0.05). Compared with the HC group, the PD-MCI group had significantly increased FCD at the left middle occipital gyrus ( P<0.05). Compared with the PD-NC group, the PD-MCI group had significantly decreased FCD at the right parahippocampal gyrus, and statistically increased FCD at the left middle occipital gyrus and left middle frontal gyrus ( P<0.05). Area under ROC curve (AUC) of FCD in brain regions with significantly different FCD in discriminating PD-MCI and PD-NC was 0.878, with sensitivity of 90.0% and specificity of 91.3%. FCD at right parahippocampal gyrus, left middle occipital gyrus and left middle frontal gyrus was negatively correlated with MoCA score ( P<0.05); FCD at right parahippocampal gyrus was positively correlated with cognitive scores in the visuospatial and executive function, and delayed memory domains ( P<0.05); FCD at left middle occipital gyrus was negatively correlated with cognitive scores in the executive function and visual-spatial skills, and abstraction domains ( P<0.05); FCD at the left medial frontal gyrus was negatively correlated with cognitive scores in the visuospatial and executive function, abstraction and delayed memory domains ( P<0.05). Conclusions:Abnormal FCD can be noted in some brain regions of PD patients, enjoying differences between PD-MCI patients and PD-NC patients. Combined FCD in brain regions with significantly different FCD has high value in differentially diagnosing PD-MCI and PD-NC, and FCD in brain regions with significantly different FCD is correlated with cognitive function changes in PD patients.

Lipotoxicity,caused by intracellular lipid accumulation,accelerates the degenerative process of cellular senescence,which has implications in cancer development and therapy.Previously,camitine palmi-toyltransferase 1C (CPT1C),a mitochondrial enzyme that catalyzes carnitinylation of fatty acids,was found to be a critical regulator of cancer cell senescence.However,whether loss of CPT1C could induce senescence as a result of lipotoxicity remains unknown.An LC/MS-based lipidomic analysis of PANC-1,MDA-MB-231,HCT-116 and A549 cancer cells was conducted after siRNA depletion of CPT1C.Cellular lipotoxicity was further confirmed by lipotoxicity assays.Significant changes were found in the lipidome of CPT1 C-depleted cells,including major alterations in fatty acid,diacylglycerol,triacylglycerol,oxidative lipids,cardiolipin,phosphatidylglycerol,phosphatidylcholine/phosphatidylethanolamine ratio and sphingomyelin.This was coincident with changes in expressions of mRNAs involved in lipogenesis.Histological and biochemical analyses revealed higher lipid accumulation and increased malondialde-hyde and reactive oxygen species,signatures of lipid peroxidation and oxidative stress.Reduction of ATP synthesis,loss of mitochondrial transmembrane potential and down-regulation of expression of mito-chondriogenesis gene mRNAs indicated mitochondrial dysfunction induced by lipotoxicity,which could further result in cellular senescence.Taken together,this study demonstrated CPT1C plays a critical role in the regulation of cancer cell lipotoxicity and cell senescence,suggesting that inhibition of CPT1C may serve as a new therapeutic strategy through induction of tumor lipotoxicity and senescence.

Objective To investigate the status quo of the cerebral injury in patients with acute stress disorder (ASD) and the impact of family function,mental toughness,and the characteristics of brain lesions on it.Methods A total of 349 patients were enrolled from North China University of Science and Technology affiliated hospital neurology department and neurosurgery department from May 2016 to November 2016 and they were tested with Stanford Acute Stress Reaction Questionnaire (SASRQ),the family function assessment scale (APGAR),Chinese version of mental toughness scale (CD-RISC).Results 349 cases of patients with SASRQ score (57.21±44.97),8 to 39 160 people (45.8％),40 to 56 85 people (24.4％),57 to 150 104 people (29.8％).The results showed that whether the hemiplegia (β=-0.030),family function (β=-0.032),mental toughness (β=0.886),disturbing degree (β=0.052),bad days (β=0.060)were picked in the regression equation (P＜0.05).Conclusion There were obvious acute stress symptoms in patients with brain injury.The individuals who have family dysfunction,the worse the psychological resilience and the higher the disturbance degree of the patients with hemiplegia,may be likely to get acute stress disorder.

Objective To explore the effect of mindfulness-based music therapy (MBMT) on sleep-wakefulness behavior in patients with acute stress disorder (ASD) coexisting sleep disorder with cerebral hemorrhage. Methods A total of 70 patients with cerebral hemorrhage and ASD coexisting sleep disorders were randomly divided into two groups (n=35 each group). The study group was treated with mindfulness and soothing music training on the basis of routine treatment for 28 consecutive days. The control group only received routine treatment. Polysomnography (PSG) was used to compare sleep-wake behavior before and after intervention. Results After the intervention, the numbers of awakenings, awakenings greater than 5 min, micro awakenings, NREM micro awakenings, micro awakenings in phase 1, micro awakenings in phase 2, and REM awakenings were decreased in both groups (P<0.05). The degree of reduction of those parameters were greater and the proportion of total sleep time to recording time was longer in the study group than in the control group (P<0.05). Conclusion Music therapy based on mindfulness can effectively improve the sleep-wakeful behavior of ASD patients with cerebral hemorrhage, change the sleep process, and improve their sleep quality.

Objective To explore the correlation between the reliability and validity of Brunel balance assessment(BBA)with the activities of daily living(ADL).Methods The BBA,ADL and walking ability test were performed on 215 patients conforming to the inclusion standard by two professionals.The Pearson correlation analysis,factor analysis and descriptive statistical analysis were adopted.Results The BBA total score and Cronbach's α coefficient in 3 dimensions was 0.852～0.941(P＜0.01),moreover the relative coefficient of each item with its dimension was higher that that of other dimensions;3 common factors were extracted by the factor analysis,the contribution rate was 83.916％;but BBA had the ceiling effect,the relative coefficient of BBA with ADL and walking ability was 0.284-0.709(P＜0.05).Conclusion BBA has a good reliability and validity and can better reflect the functions of ADL and walk.

Objective To investigate the clinical and pathological features and prognostic factors for thymoma with myasthenia gravis (MG).Methods The clinical and pathological data of 126 patients with thymoma and MG confirmed by postoperative pathological examination from 2008 to 2014 were analyzed retrospectively.The Kaplan-Meier method was used to calculate survival rates;the log-rank test was applied for univariate prognostic analysis;the Cox regression model was applied for multivariate prognostic analysis.Results The numbers of patients who received the follow-up visits at 3 and 5 years were 88 and 45,respectively (the patients who were admitted before the end of October 2011 and the end of October 2009).The 3-and 5-year survival rates were 97.9％ and 91.8％,respectively.The 3-and 5-year survival rates for patients with WHO types A+AB+B1 +B2 and B3 were 98.6％/95.2％ and 90.6％/92.9％,respectively (P=0.764),and those for patients with Masaoka stages Ⅰ-Ⅱ and Ⅲ-Ⅳ were 98.6％/95.2％ and 97.4％/72.7％,respectively (P=0.791).The 3-and 5-year survival rates for patients with complete and partial resection were 97.8％/91.7％ and 100.0％/50.0％,respectively (P=0.964),and those for patients with complete resection alone and complete resection+postoperative radiotherapy were 96.8％/93.1％ and 100.0％/94.7％,respectively (P=1.000).Conclusions The major treatment modality for thymoma with MG is complete resection followed by radiotherapy according to the specific circumstances after surgery.Complete resection,postoperative radiotherapy,WHO type,and Masaoka stage may be associated with prognosis.

Objective To investigate whether correlation exists between quantitative perfusion parameters obtained from dynamic contrast?enhanced magnetic resonance imaging (DCE?MRI) and different prognostic factors or immunohistochemical subtypes of breast cancers. Methods A retrospective analysis of DCE?MRI was performed in 87 breast cancer patients with 91 pathology confirmed breast lesions. All the patients underwent the immunohistochemistry after the operation, 80 breast cancer patients with 84 breast lesions were divided into different subtypes based on the immunohistochemical profiles. All the patients underwent plain MRI and DCE?MRI. The volume transfer constant (Ktrans), rate constant (kep) and volume of EES per unit volume of tissue (Ve) value were calculated. Results of the immunohistochemistry and observation results of the the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor?2 (HER?2) were recorded. Subtypes were also categorized. The degree of the expression of Ki?67 was observed simultaneously. Among the 87 breast cancer patients (with 91 breast lesions), 68 were ER?positive,18 were ER?negative, 60 were PR?positive, 26 were PR?negative;30 were HER?2 positive and 58 were HER?2 negative. Eighty breast cancer patients (with 84 breast lesions) were divided into different subtypes:19 were Luminal A, 49 were Luminal B, 7 were HER?2 positive subtype and 9 were triple negative breast cancer (TNBC). The quantitative perfusion parameters with diffierent expression of the receptors were analyzed through Mann?Whitney U test, the correlation between the degree of the expression of Ki?67 and quantitative perfusion parameters was obtained with Spearman test. Furthermore, the distributions of the perfusion parameters between groups according to immunohistochemical subtype were compared using the Kruskal?Wallis test. Results Ktrans and kep value were higher in tumors with ER?negative and PR?negative than with ER?positive and PR?positive and difference was statistically different ( P<0.05). There was no statistically significance in the quantitative perfusion parameters between HER?2 positive and HER?2 negative (P>0.05). The degree of the expression of Ki?67 was 5%to 90%the mean value was 33%, the median and interquartile range of Ktrans, kep and Ve value was 1.33/min (0.88/min), 2.63/min (2.34/min) and 0.51 (0.22) respectively. There was no significant correlations between the degree of the expression of Ki?67 and Ktrans and kep value (r value was 0.24 and 0.22 respectively, P value was 0.03 and 0.04 respectively), and the degree of the expression of Ki?67 was not associated with Ve (r=0.00, P=0.97). Ktrans value was lower in Luminal A and Luminal B than that in HER?2 positive subtype and TNBC, kep value was lower in Luminal A and Luminal B than that in TNBC, and Ve value in Luminal A, Luminal B and HER?2 positive subtype were higher than that in TNBC, kep value was lower in Luminal B than that in HER?2 positive subtype, statistically significance was seen among them (P<0.05).Triple?negative breast cancer showed the highest kep value (3.99/min) and the lowest Ve value (0.41) than the other subtypes. Conclusion The different subtypes of breast cancer may be predicted to some extent with quantitative perfusion parameters, and there is no correlation between quantitative perfusion parameters and the prognostic factors.

Objective: To study subclinical hypothyroidism (SCH) with its treatment in patients after coronary artery bypass grafting (CABG). Methods: A total of 1500 patients received CABG by the same surgical team in our hospital from 2010-06 to 2014-03 were retrospectively studied. According to thyroid function, the patients were divided into 2 groups: SCH group,n=107 and Normal group, n=1393. With 1:4 propensity score matching, there were 104 patients in SCH group and 416 patients in Normal group enrolled in our research. The rates of intra-aortic balloom pumping (IABP) implantation and peri-operational blood transfusion, mechanical ventilation time, new onsets of stroke, myocardial infarction and atrial ifbrillation, malignant arrhythmia, acute kidney injury and in-hospital mortality were observed. The outcome of treatment was assessed by single- and multi-factor analysis. Results: Compared with Normal group, SCH group showed increased mechanical ventilation time (23.3±47.9) h vs (15.0±5.5) h, P<0.05; more patients had mechanical ventilation time>12 h (89.4% vs 78.8%),P<0.05 and more patients had IABP implantation (3.8% vs 0.72%),P<0.05. SCH was related to mechanical ventilation time>12 h (OR=2.363, 95% CI 1.183-4.516) and IABP implantation (OR=6.126, 95% CI 1.190-31.537). The in-hospital death and other events were similar between 2 groups,P>0.05. Conclusion: Our research indicated that SCH was related to mechanical ventilation time and IABP implantation in patients after CABG.