Objective To explore the influencing factors of self injury or suicide in adolescent patients with depression.Methods A total of 96 adolescents who were diagnosed with depressive disorder at Yunnan Psychiatirc Hospital and Kunming Psychiatirc Hospital from January 2023 to May 2024 were selected for the study.The case group consisted of 61 adolescents who had self-injury or suicidal behaviors within 30 days,while the control group consisted of 35 adolescents who had no self-injury or suicidal behaviors within at least 30 days.Assessments were performed using the Patient Health Questionnaire-9(PHQ-9),Millon Screening Inventory for Borderline Personality Disorder(MSI-BPD),House-Tree-Person Drawing Test(HTP),and the Columbia Suicide Severity Rating Scale(C-SSRS).Among these,72 subjects underwent skin pressure pain threshold testing using the Algometer HP-50,with 12 in the self-harm or suicide group within 2 days and 60 in the group beyond 2 days.Results(1)Analysis of gender and age between the two groups showed statistically significant differences(P<0.05),with a higher proportion of females and younger ages in the 30-day group;(2)The PHQ-9 score for the 30-day group was(19.59±5.99),with a score of(2.41±0.97)for item 9("Thoughts that it would be better to be dead or to hurt oneself in some way"),and an MSI-BPD score of(7.43±1.61).The scores for the group over 30 days were(10.89±7.99),(1.00±1.11)for item 9,and(5.40±3.13)for MSI-BPD.Independent samples t-test analysis showed significant differences(P<0.01);(3)In the 30-day group,five drawing characteristics from the 47 HTP characteristics(shift of center of gravity,hair not disheveled or no hair,no mountains,no sun,and no flowers or grass)were found to occur at a higher rate,with statistical significance(P<0.05);(4)In the binary logistic regression analysis of 96 patients with the 30-day suicide or self-injury behavior as the dependent variable,the absence of flowers and PHQ-9 question 9 score are the risk factors for adolescent depression patients to have self-injury or suicide behavior within 30 days(OR no flowers=7.934,OR score on PHQ-9 question 9=3.554).(5)Among the 72 subjects the skin pressure pain threshold for adolescents who exhibited self-injure or suicide behaviors within 2 days(8.83±4.27 N)was significantly higher than that for patients beyond 2 days(6.48±3.00 N),with statistical significance(t=-2.201,P<0.05).Additionally,the score for item 9 of the PHQ-9 was higher(2.50±0.67 vs 1.87±0.95),also showing statistical significance(t=-2.201,P<0.05).Conclusion The absence of flowers or grass in HTP painting,and stronger suicidal ideation or suicide attempt are risk factors for self-injury or suicidal behavior in adolescents with depression.Furthermore,those who self-injure or commit suicide within 2 days have a higher pain threshold compared to those beyond 2 days.

ObjectiveTo observe the effect of Guben Jiedu prescription （GBJ） on the epithelial-mesenchymal transition （EMT） of lung cancer A549 cells and to explore the mechanism based on phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway. MethodThe GBJ-medicated serum was prepared. Cell viability was detected by methyl thiazolyl tetrazolium （MTT） assay to screen the optimal doses of GBJ-medicated serum for further experiment. A549 cells were classified into normal serum group， low-， medium-， and high-dose GBJ-medicated serum groups （2.5%， 5%， and 10% GBJ-medicated serum）， PI3K/Akt pathway activator SC79 group， and high-dose GBJ-medicated serum + SC79 group. Cell migration ability was measured by wound-healing assay. The protein expression of E-cadherin， N-cadherin， vimentin， Akt， phosphorylated Akt （p-Akt）， glycogen synthase kinase-3β （GSK-3β）， and phosphorylated GSK-3β （p-GSK-3β） was detected by Western blotting， and the mRNA expression of N-cadherin and vimentin by Real-time PCR. ResultCompared with the normal serum， GBJ-medicated serum （2.5%， 5%， 10%， 20%， 40%） decreased the viability of A549 cells （P<0.05）， and 10%， 5%， 2.5% GBJ-medicated serum was respectively selected for the follow-up experiment. The migration ability of cells in the high-， medium-， and low-dose GBJ-medicated serum groups was lower than that in the normal serum group. The expression of N-cadherin mRNA and Vimentin mRNA in A549 cells in the three GBJ-medicated serum groups was significantly lower than that in the normal serum group （P<0.01）. The protein expression of E-cadherin was higher in the high- and medium-dose GBJ-medicated serum groups than in the normal serum group （P<0.01）. The three GBJ-medicated serum groups showed lower protein expression of N-cadherin， vimentin， p-Akt， and p-GSK-3β （P<0.01） and lower expression of p-Akt/Akt， p-GSK-3β/GSK-3β （P<0.05， P<0.01） than normal serum group. Compared with the SC79 group， the high-dose GBJ-medicated serum group demonstrated high protein expression of E-cadherin （P<0.01） and low expression of N-cadherin， vimentin， p-Akt， p-GSK-3β， and p-Akt/Akt， p-GSK-3β/GSK-3β （P<0.01）. Compared with the high-dose GBJ-medicated serum group， high-dose GBJ-medicated serum + SC79 group showed low protein expression of E-cadherin （P<0.01） and high protein expression of N-cadherin， vimentin， p-Akt， p-GSK-3β， p-Akt/Akt， and p-GSK-3β/GSK-3β （P<0.01）. ConclusionGBJ can inhibit the migration and EMT of lung cancer A549 cells by regulating the PI3K/Akt signaling pathway.