BackgroundPatients with schizophrenia and depressive disorders exhibit abnormalities in perceptual processing. Previous perceptual studies are mainly based on asking participants to fill in a questionnaire， and little research has been undertaken on objective behavior in patients with schizophrenia and depressive disorders. ObjectiveTo explore the behavioral changes in vibrotactile sense among patients with schizophrenia and depressive disorders， so as to enrich relevant findings in objective behavioral research. MethodsFrom March 2021 to September 2023， 33 patients with schizophrenia and 31 patients with depressive disorders in the outpatient and inpatient departments of Beijing Huilongguan Hospital and met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） diagnostic criteria were enrolled. And another 34 healthy controls were concurrently recruited at Beihang University and Beijing Huilongguan Hospital. Patients with schizophrenia were assessed using Positive and Negative Symptom Scale （PANSS）， and patients with depressive disorders were assessed using Hamilton Depression Scale-17 item （HAMD-17）. The vibrotactile sensitivity of the left hand in all participants was tested in a delay match-to-sample procedure， and the correct rate of vibrotactile delayed discrimination task was compared among the three groups. ResultsCompared with healthy controls， a reduction was found in the correct rates at index finger， middle finger and ring finger in patients with schizophrenia （P<0.01）， the average correct rate at five fingers in patients with schizophrenia （P=0.001）， and the correct rate at thumb in patients with depressive disorders （P=0.026）. No statistical difference was reported in correct rate of vibrotactile delayed discrimination task between patients with depression disorders and schizophrenia （P>0.05）. The average correct rate of vibrotactile sense in schizophrenia group was not significantly correlated with the duration of disease， age of onset， chlorpromazine equivalent doses and PANSS score （r=0.058、0.045、0.114、-0.194， P>0.05）. The average correct rate in depressive group was negatively correlated with age of onset （r=-0.415， P=0.020）， but not significantly correlated with the duration of disease and HAMD-17 score （r=-0.044， 0.142， P>0.05）. ConclusionPatients with schizophrenia and depressive disorders have impaired vibrotactile sense. The vibrotactile sense is impaired in index， middle and ring fingers among patients with schizophrenia， and in thumbs of patients with depressive disorders. Moreover， the impairment in patients with depressive disorders may be related to the age of onset. ［Funded by 2023 Hebei Provincial Graduate Innovation Funding Project （number， CXZZSS2023140）］

Objective:To construct an evaluation the index system of entrustable professional activities for resident training doctors in psychiatric department,and to provide reference for formulating training strategies and assessment standards.Entrustable professional activities refers to the ability of trainees to perform and complete spe-cific clinical tasks independently after they have been trusted.Methods:Through documental analysis and semi-structured interviews,the item database of entrustable professional activities for psychiatric resident training physi-cians was established.Delphi consultation was conducted among 63 experts in the field of psychiatry from 7 national resident training bases and 3 medical colleges in China.Indicators were comprehensively screened and sorted out,and indicators at all levels and their weights were determined by the analytic hierarchy process.Results:A hierarchi-cal evaluation index system of entrustable professional activities for psychiatric resident training doctors was con-structed,including 4 first-level indicators,17 second-level indicators and 68 third-level indicators.The weights of the first-level,second-level and third-level indicators were determined.Conclusion:The evaluation index system of en-trustable professional activities is comprehensive and systematic,which is suitable for clinical work and convenient for practical application.It could provide quantitative standards for the assessment of psychiatric residents and pro-mote the improvement of training quality.

Objective To explore the mediating effect of self-hate between adverse childhood experiences and depression,anxiety,and suicide risk in adolescents.Methods In Juxian county,Rizhao,Shangdong Province,a cross-sectional survey was conducted in 5 junior high schools and high schools using questionnaires.A total of 6838 valid questionnaires were collected.The assessment included a self-designed general information questionnaire,patient health questionnaire-9(PHQ-9),generalized anxiety disorder-7(GAD-7),the mini-international neuropsychiatric interview 5.0 suicide module,revised adverse childhood experience questionnaire(ACEQ-R),and self-hate scale(SHS)to evaluate relevant content.Results The detection rates of depression,anxiety,and suicide risk were significantly higher in girls(P<0.001)and in senior high school students(P<0.001).Adolescents with depression,anxiety,and suicide risk exhibited higher scores for adverse childhood experiences and self-hate compared to those without these conditions(P<0.001).Adverse childhood experiences indirectly predicted depression through self-hate with an indirect effect size of 0.1488,accounting for 60.86% of the total effect(P<0.001).Similarly,adverse childhood experiences indirectly predicted anxiety through self-hate with an indirect effect size of 0.1524,accounting for 62.87% of the total effect(P<0.001).Furthermore,adverse childhood experiences indirectly predicted the risk of suicide through self-hate with an indirect effect size of 0.0485,accounting for 49.44% of the total effect(P<0.001).Conclusions Adverse childhood experiences have predictive effects on depression,anxiety and suicide risk in adolescents,and self-hate plays a mediating role on depression,anxiety and suicide risk in adolescents.

Objective:To explore the mediating role of self-hating in the influence of adverse childhood experiences on adolescents' negative emotions.Methods:A questionnaire method was used to collect demographic variables, and 7 012 valid questionnaires were obtained from adolescents by applying the revised adverse childhood experiences questionnaire, patient health questionnaire-4, and self-hate scale from May 1 to May 30, 2022, in five high schools(90 classes) and five junior high schools(60 classes) in Rizhao city, Shandong province, China. Data entry and analysis were performed by SPSS 22.0 software.Mann-Whitney U test was used for the comparison between demographic variables and other variables, and the correlations between variables were expressed by Spearman correlation coefficient. AMOS 23.0 software was applied for testing the mediating and moderating effects of variables. Results:(1)There were significant positive correlations between adverse childhood experiences(0(2)) and negative emotion(3(10))( r=0.459, P<0.01), self-hating(2(4))( r=0.427, P<0.01). There were significant positive correlations between self-hating and negative emotion( r=0.566, P<0.01). (2) Self-hating played a mediating role between adverse childhood experience and adolescent negative emotion, and the mediating effect was 0.299, accounted for 61.27% of the total effect.(3) The mediating pathway of self-hated was moderated by gender, with girls' adverse childhood experiences( Bsimple=2.428, t=39.585, P<0.05) predicting self-hating more than boys( Bsimple=1.641, t=25.355, P<0.05). Conclusion:Adverse childhood experiences can predict adolescents' negative emotions, and self-disgusting can also affect adolescents' negative emotions.Gender plays a moderating role in the mediating pathway.

BACKGROUND: Pneumonia-like primary pulmonary lymphoma (PPL) was commonly misdiagnosed as infectious pneumonia, leading to delayed treatment. The purpose of this study was to establish a computed tomography (CT)-based radiomics model to differentiate pneumonia-like PPL from infectious pneumonia. METHODS: In this retrospective study, 79 patients with pneumonia-like PPL and 176 patients with infectious pneumonia from 12 medical centers were enrolled. Patients from center 1 to center 7 were assigned to the training or validation cohort, and the remaining patients from other centers were used as the external test cohort. Radiomics features were extracted from CT images. A three-step procedure was applied for radiomics feature selection and radiomics signature building, including the inter- and intra-class correlation coefficients (ICCs), a one-way analysis of variance (ANOVA), and least absolute shrinkage and selection operator (LASSO). Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and construct a clinical factor model. Two radiologists reviewed the CT images for the external test set. Performance of the radiomics model, clinical factor model, and each radiologist were assessed by receiver operating characteristic, and area under the curve (AUC) was compared. RESULTS: A total of 144 patients (44 with pneumonia-like PPL and 100 infectious pneumonia) were in the training cohort, 38 patients (12 with pneumonia-like PPL and 26 infectious pneumonia) were in the validation cohort, and 73 patients (23 with pneumonia-like PPL and 50 infectious pneumonia) were in the external test cohort. Twenty-three radiomics features were selected to build the radiomics model, which yielded AUCs of 0.95 (95% confidence interval [CI]: 0.94-0.99), 0.93 (95% CI: 0.85-0.98), and 0.94 (95% CI: 0.87-0.99) in the training, validation, and external test cohort, respectively. The AUCs for the two readers and clinical factor model were 0.74 (95% CI: 0.63-0.83), 0.72 (95% CI: 0.62-0.82), and 0.73 (95% CI: 0.62-0.84) in the external test cohort, respectively. The radiomics model outperformed both the readers' interpretation and clinical factor model ( P <0.05). CONCLUSIONS The CT-based radiomics model may provide an effective and non-invasive tool to differentiate pneumonia-like PPL from infectious pneumonia, which might provide assistance for clinicians in tailoring precise therapy.
Humans ; Retrospective Studies ; Pneumonia/diagnostic imaging* ; Analysis of Variance ; Tomography, X-Ray Computed ; Lymphoma/diagnostic imaging*

ObjectiveTo discuss the relationship between objective sleep quality and cognitive function in remission depression patients with insomnia. MethodsA total of 47 patients with depression in remission in Beijing Huilongguan Hospital were enrolled. Insomnia Severity Index （ISI） and the sleep efficiency calculated by the first four items of Pittsburgh Sleep Quality Index （PSQI） were defined as insomnia. Among the selected patients， 22 subjects were classified into insomnia group， and 25 subjects in non-insomnia group. The objective sleep status of all subjects was evaluated by polysomnography （PSG）， and the cognitive function was evaluated with the Repeatable Battery for Assessment of Neuropsychological Status （RBANS）. A regression model was established to explore the relationship between objective sleep quality and cognitive function in remission depression patients with insomnia. ResultsThere was statistically significant difference in immediate memory factor scores of RBANS between depression patients in remission with and without insomnia （t=-2.102， P<0.05）. The sleep efficiency （Z=-2.113， P<0.05）， the proportion of N3 sleep stage （Z=-3.175， P<0.01） and the duration of N3 sleep stage （Z=-3.196， P<0.01） in insomnia group were all lower than those in non-insomnia group， and the nocturnal awakening （Z=-2.058， P<0.01）， the proportion of N1 sleep stage （Z=-2.399， P<0.05） and the duration of N1 sleep stage （Z=-2.463， P<0.05） were higher than those of the insomnia group. Within insomnia group， the increased proportion of REM sleep was correlated with the improvement of attention function （β=0.953， 95% CI： 0.123~2.038， P<0.05）， and the increase of nocturnal awakening was correlated with the decline of delayed memory （β=-0.173， 95% CI： -0.325~-0.024， P<0.05）. ConclusionObjective sleep is associated with cognitive impairment in remission depression patients with insomnia， the proportion of REM sleep has a positive impact on attention function， and frequent nocturnal awakening at night has a negative impact on delayed memory.

Objective:To explore the situation of insomnia, fatigue, depression, anxiety and cognitive impairment in adolescents with different characteristics, and the chain mediating effect of fatigue, depression and anxiety on insomnia and cognitive impairment.Methods:The general demographic data of 6 014 adolescents were collected.Insomnia severity index (ISI), the multidimensional fatigue inventory (MFI-20), patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and perceived deficits questionnaire-depression(PDQ-D) were used to compare the insomnia, fatigue, depression, anxiety and cognitive impairment of adolescents with different characteristics.Spearman correlation analysis was conducted by SPSS 20.0 software.The significance of mediating effect was tested by deviation corrected nonparametric percentile Bootstrap method using SPSS macro program PROCESS.Results:The detection rates of insomnia, fatigue, depression, anxiety and cognitive impairment were different in adolescents with different genders, grades and academic achievements.Cognitive impairment was significantly positively correlated with insomnia ( r=0.654, P<0.01), fatigue ( r=0.476, P<0.01), depression ( r=0.677, P<0.01), anxiety ( r=0.655, P<0.01), which was suitable for mediating effect test.Fatigue, depression and anxiety in adolescents had a chain mediating effect between insomnia and cognitive impairment.Insomnia indirectly affects cognition by affecting fatigue and depressive symptoms.The intermediary effect value was 1.253, the effect amount was 55.60%, and the total effect was 2.254.Insomnia indirectly affects cognition by affecting fatigue and anxiety symptoms.The intermediary effect value was 1.161, the effect amount was 51.50%, and the total effect was 2.254. Conclusion:Insomnia can not only directly affect their cognitive impairment, but also indirectly affect their cognitive impairment through the chain mediation of fatigue, depression and anxiety of adolescents.

Objective:To retrieve, evaluate and summarize the clinical practice evidence of nursing care for critically ill patients with naso-intestinal tube feeding, so as provide a basis for correcting feeding intolerance and nutritional substandard.Methods:According to the "6S" evidence model, evidence on nursing care for critically ill patients with naso-intestinal tube feeding was retrieved in Registered Nurses' Association of Ontario, Cochrane Library, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Guidelines International Network, Medive, PubMed, CINAHL, Embase, UpToDate, Joanna Briggs Institute Evidence-based Practice Database, China National Knowledge Infrastructure (CNKI) , WanFang Data, VIP database from January 31, 2015 to September 30, 2019. Evidence included guidelines, expert consensus, best practices, systematic reviews, evidence summary, and original research. Two researchers evaluated the quality of the included literature, extracted and summarized literature that met the quality standards.Results:A total of 24 articles were included, of which 2 guidelines were derived from the American Society of Critical Care Medicine and the American Society of Parenteral Enteral Nutrition, and the European Society of Parenteral Enteral Nutrition, 3 expert consensus, 1 systematic review, 4 evidence summaries, 10 randomized controlled studies, 3 quasi experiments, and 1 diagnostic test. This study summarized 24 evidences of clinical suitability, involving 10 aspects, namely, naso-intestinal tube placement indications, catheter material, placement position, placement method, confirmation method, feeding method, fixation, intolerance, catheter blockage and indwelling time limit.Conclusions:This study provides a management process and evidence-based evidence for critically ill patients with naso-intestinal tube feeding, which is conducive to promoting safe practice and in-depth research for the nursing staff.

Inflammatory response is an effective host defense mechanism to eliminate pathogens at the site of infection. The regression phase of inflammation mainly maintains the stable environment in tissues. Pro-inflammatory regression mediators (SPMs) are endogenous anti-inflammatory molecules, which play an important role in reducing excessive tissue damage and chronic inflammation. This paper reviews the interaction between SPMs and immune cells in inflammatory sites. By reviewing the relevant literature, it was found that SPMs regulate the components of innate and adaptive immune system, including neutrophils, macrophages, innate lymphocytes, natural killer cells and T cells.

Objective:To study the effects of LY294002, a phosphatidylinositol 3 kinase(PI3K) inhibitor, on the AKT/GSK3β/CRMP2 signaling pathway, and the effect of pathway alterations on the depression-like behavior and microtubulin proteins of SD rats.Methods:Sixteen adult male SD rats were randomly divided into LY294002 group and solvent DMSO group by blind method, 8 rats in each group.After anesthesia, the rats were subjected to stereotactic tube placement in the hippocampal CA1 area. After 1 week of the tube placement, stereoscopic injection of LY294002 or DMSO was given, and depression-like behaviors were detected. RT-qPCR technology was used to detect hippocampal AKT, GSK3β, CRMP2, and tubulin mRNA expression levels, and Western blot technology was used to detect the expression levels of hippocampal AKT, p-AKT, GSK3β, p-GSK3β, CRMP2, p-CRMP2, and microtubule dynamic-related proteins markers Acet-tubulin, Tyr-tubulin. Analysis and comparison of behavioral and molecular expression differences between the two groups were conducted.Results:The open field experiment showed that the central movement distance of the rats in the LY294002 group were significantly lower than those in the control group((3.64±2.17) cm, (31.51±12.68) cm; t=2.69, P=0.03), and the duration of the central area in the LY294002 group were also significantly lower than those in the control group((0.73±0.46)s, (4.85±2.10)s; t=2.33, P=0.04). The results of the forced swimming test showed that the immobility time of rats in the LY294002 group had upward trend, but the difference was not statistically significant. The sucrose preference results showed no significant difference in sugar water consumption between the two groups ( P>0.05). The RT-qPCR results showed that the expression level of CRMP2 mRNA in the LY294002 group decreased significantly ( P<0.05). Western blot results showed that compared with solvent DMSO group, the expression levels of p-AKT and p-GSK3β in the LY294002 group decreased ( P<0.05), the expression level of CRMP2 was decreased and the expression level of p-CRMP2 was significantly increased. At the same time, the expression level of Tyr-tubulin decreased, while Acet-tubulin level increased significantly, and the differences were statistically significant ( P<0.05). Conclusion:LY294002 affects AKT/GSK3β/CRMP2 signaling pathway, induces impairment of microtubular dynamic, and results in depression-like behavior in rats.