BackgroundCognitive function is closely related to an individual's quality of life and social functioning， with approximately 20%~35% of patients with depressive disorder experiencing some degree of cognitive impairment even after clinical symptom remission. Existing evidence suggests that tACS can improve specific cognitive domains， such as memory function， while its effects on other cognitive dimensions， such as executive functioning， attention， and information processing speed， remain unclear. ObjectiveTo explore the effects of tACS on the multidimensional cognitive functions and emotional problems of patients with depressive disorder， thus to provide references for the treatment of depressive disorder. MethodsForty-nine patients with depressive disorder who were hospitalized in the Fourth People's Hospital of Wuhu from November 2022 to October 2024 and met the diagnostic criteria for depressive disorder outlined in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）， were selected as study participants. Subjects were randomly divided into study group （n=23） and control group （n=26） based on Microsoft Excel. Both groups received sertraline treatment. The initial dose was 50 mg/day， which gradually titrated upward based on individual variability， drug tolerance， and therapeutic response， with a maintenance dose ranging from 100 to 200 mg/day. In addition， the study group underwent tACS therapy for 4 weeks， with 5 sessions per week， each lasting 20 minutes. The control group received sham stimulation， in which the stimulus was interrupted after the first 30 seconds. At baseline， the 4^th week， and the 12^th week of treatment， patients were assessed using the Hamilton Depression Scale-17 item （HAMD-17）， Hamilton Anxiety Scale （HAMA）， and MATRICS Consensus Cognitive Battery （MCCB）. ResultsRepeated measures analysis of variance indicated that both the time effect and the time×group interaction effect for HAMD-17 scores were statistically significant between the two groups （F=260.437， 25.309， P<0.01）. At week 12 of treatment， the HAMD-17 score in the study group was lower than that in the control group （t=4.236， P<0.01）. For HAMA scores， the time effect， group effect， and time×group interaction effect were all statistically significant between the two groups （F=248.082， 4.506， 9.500， P<0.05 or 0.01）. At weeks 4 and 12， study group reported lower HAMA scores compared with control group （t=4.580， 2.608， P<0.05 or 0.01）. Regarding the MCCB scores for attention/vigilance， verbal learning， and overall composite， the time effect， group effect， and time×group interaction effect were all statistically significant between the two groups （F=70.331， 27.882， 51.679， 5.560， 10.948， 7.860， 8.490， 3.874， 5.025， P<0.05 or 0.01）. After intervention， the study group showed significantly higher MCCB scores for attention/vigilance， verbal learning， and overall composite at both week 4 （t=-2.149， -3.530， -2.740， P<0.05） and week 12 （t=-3.534， -3.576， -3.838， P<0.01） when compared to the control group. ConclusionThe combined tACS and sertraline therapy may demonstrate superior efficacy to pharmacotherapy alone in the short term for improving attention/vigilance， verbal learning， overall cognitive function， and anxiety symptoms in patients with depressive disorders. Based on the 12-week outcomes， the combined tACS and sertraline therapy not only sustaine its previously observed advantages in improving cognitive domains and anxiety symptoms， but also demonstrate potentially superior efficacy over monotherapy in alleviating depressive symptoms. ［Fund by Clinical Medical Research Transformation Special Project of Anhui Province （number， 202204295107020065）］

Objective To observe the value of artificial intelligence(AI)knowledge graph and image classification for quality control(QC)of chest posterior-anterior position X-ray radiograph(abbreviated as chest film).Methods Totally 9 236 chest films from 595 medical institutions in Anhui province imaging cloud platform were retrospectively enrolled.QC knowledge graph containing 21 classification labels were constructed.Firstly,QC of chest films based on the above knowledge graph were performed by 10 technicians for 2 rounds of single person and 1 round of multi person,and the results were recorded as A,B and C,respectively.Then AI algorithms were used to classify and evaluate based on knowledge graph,and the result was recorded as D.Finally,a QC expert reviewed results C and D to determine the final QC results and taken those as references to analyze the efficiency of the above 4 QC.Results The area under the curve(AUC)of AI algorithm for QC of chest films were all ≥0.780,with an average value of 0.939.The average precision of QC for chest films of A,B,C and D was 81.15％,85.47％,91.65％and 92.21％,respectively.Conclusion AI knowledge graph and image classification technology could be effectively used for QC of chest posterior-anterior position X-ray radiograph.

Purpose Develop deep learning models to assess the clarity of chest X-ray images and validate the model's effectiveness by comparing it with the subjective evaluations of radiologists.Materials and Methods A retrospective collection of 9 135 chest X-ray images from 590 hospitals in Anhui Province,spanning from June 2015 to August 2022,was organized involving multiple radiologists who repeatedly evaluated the clarity of the images using a five-level scoring system.Individual assessments were designated as A and B,whereas the collective result of multiple assessments was designated as C.By constructing a deep learning model based on ResNet-50,image clarity evaluations of chest X-ray images were performed,we used the result C as the training and testing data for the model.The model's evaluation results were denoted as D.A radiology quality control expert conducted an audit assessment of the model's evaluation results and the multi-person assessments of physicians,serving as the reference standard for image clarity.Their assessment results were labeled as E.Statistical analysis,including Spearman's rank correlation coefficient,root mean square error(RMSE)and accuracy was employed to evaluate the effectiveness of the model.Results Compared with the reference standard E,D achieved an average accuracy of 0.85,exceeding the accuracy of C,which stood at 0.84.The ρ values for A,B,C,D and E were 0.58(0.54,0.62),0.59(0.55,0.63),0.74(0.71,0.77)and 0.80(0.78,0.82),respectively.The model exhibited the highest correlation with E.The ρ between A and B was 0.45(0.41,0.49),indicating a lower correlation between two individual subjective assessments of image clarity.The RMSE values for A,B,C,D and E were 0.99,0.94,0.72,and 0.71,respectively.The model's RMSE was lower than that of manual assessments.Conclusion This research model is capable of accurately assessing the clarity of chest X-ray images,and reducing the subjective interference of manual evaluation through deep learning methods,thereby providing an effective and objective evaluation tool for the assessment of clarity in clinical radiographic images.

Objective:This study aims to explore the expression characteristics of mitochondrial function-related genes in patients with manic episodes of bipolar disorder and the correlation between differentially expressed genes and clinical metabolic indicators.Methods:Twenty patients with manic episodes of bipolar disorder (patient group) and 20 healthy controls (control group) were included. Quantitative real-time PCR was used to detect mitochondrial quality control and oxidative phosphorylation-related gene expression in peripheral blood leukocytes, and several metabolic indicators were collected. Mann-Whitney test or independent sample t-test was used for comparison between groups. Spearman correlation test was used to analyze the correlation between gene expression and metabolic indicators. Results:Mitochondria function-related genes, including NRF2, P62, MFN1, MFN2, YME1L, MFF, MTATP8, and AIF, were significantly lower in patients with bipolar disorder than in healthy controls ( P<0.05, U=86, 90, 97, 93, 106, 89, 93, 105, FDR=0.038). The expression level of MTATP8 was negatively correlated with BMI, total cholesterol, and globulin level in the patient group ( r=-0.49, -0.58, -0.46, P=0.028, 0.009, 0.050). The expression level of MFF was significantly negatively correlated with waist circumference in healthy controls ( r=-0.53, P=0.020) and with globulin level in the patient group ( r=-0.48, P=0.040). The expression level of AIF was significantly and positively correlated with high-density lipoprotein cholesterol in healthy controls ( r=0.53, P=0.036). Conclusion:The expression of several genes involved in mitochondrial quality control and oxidative phosphorylation processes was significantly downregulated, and differentially expressed genes were significantly associated with metabolic index, suggesting that mitochondrial dysfunction may be related to the high risk of metabolic disease in patients with manic episodes of bipolar disorder.

BackgroundThe schizophrenia is majorly treated with drug and through physical therapy. However， both treatments would lead to adverse reactions， which could affect therapy adherence and treatment efficacy. Previous studies have shown that aerobic exercise can help alleviate cognitive function in patients with Alzheimer's disease and depressive disorder. At present， little research has been done on such alleviation in schizophrenia patients. ObjectiveTo explore the effect of aerobic exercise on cognitive function in male patients with chronic schizophrenia， so as to provide references for relevant treatments. MethodsA total of 76 male patients with chronic schizophrenia hospitalized in the Fourth People's Hospital of Wuhu between December 2022 and April 2023 were selected as the study subjects and， in accordance with random number table， divided into study group （n=36） and control group （n=40）. Both groups received conventional drug treatment. On this basis， the study group received a 60-minute aerobic exercise 5 times a week for 8 weeks as intervention. Before and after intervention， assessment of cognitive function was performed by using MATRICS Consensus Cognitive Battery （MCCB） and Stroop Color Word Test （SCWT）. ResultAfter intervention， compared with the control group， the study group spent less time on finishing the Trail Making Test and scored higher in both the spatial span test and maze test （Z=-2.070， -2.306， -2.375， P<0.05）. Repeated measure ANOVA results showed that the time main effect of Hopkins Verbal Learning Test score was statistically significant in the two groups after intervention （F=39.067， P<0.05）. So was the interaction effect between the time and group of the Brief Visuospatial Memory Test and Verbal Fluency Test scores （F=10.092， 9.252， P<0.05）. After intervention， the scores of the Brief Visuospatial Memory Test and Verbal Fluency Test in the study group were higher than those in the control group （t=6.689， 4.249， P<0.05）. As for the study group itself， the scores were higher than those before intervention （t=23.746， 23.842， P<0.05）. After intervention， the numbers of correct reading in color test and word test in the study group were more than those in the control group （Z=-2.358， -2.771， P<0.05）. The interaction effect between the time and group of the reaction time in color test， word test and color word interference test were statistically significant in both groups （F=23.383， 19.888， 19.662， P<0.05）. After intervention， the reaction time in color test and color word interference test of the study group was shorter than those of the control group （t=4.895， 6.163， P<0.05）. As for the study group itself， the reaction time were shorter than before intervention （t=54.318， 42.425， 42.141， P<0.01）. ConclusionAerobic exercise may help alleviate the cognitive problems in male patients with chronic schizophrenia in terms of information processing speed， working memory， reasoning/problem solving ability， word learning and memorizing， visual learning and memorizing， and executive function. ［Funded by Wuhu Science and Technology Plan Project （number， 2021jc2-3）］

Objective:This study aims to explore the expression characteristics of mitochondrial function-related genes in patients with manic episodes of bipolar disorder and the correlation between differentially expressed genes and clinical metabolic indicators.Methods:Twenty patients with manic episodes of bipolar disorder (patient group) and 20 healthy controls (control group) were included. Quantitative real-time PCR was used to detect mitochondrial quality control and oxidative phosphorylation-related gene expression in peripheral blood leukocytes, and several metabolic indicators were collected. Mann-Whitney test or independent sample t-test was used for comparison between groups. Spearman correlation test was used to analyze the correlation between gene expression and metabolic indicators. Results:Mitochondria function-related genes, including NRF2, P62, MFN1, MFN2, YME1L, MFF, MTATP8, and AIF, were significantly lower in patients with bipolar disorder than in healthy controls ( P<0.05, U=86, 90, 97, 93, 106, 89, 93, 105, FDR=0.038). The expression level of MTATP8 was negatively correlated with BMI, total cholesterol, and globulin level in the patient group ( r=-0.49, -0.58, -0.46, P=0.028, 0.009, 0.050). The expression level of MFF was significantly negatively correlated with waist circumference in healthy controls ( r=-0.53, P=0.020) and with globulin level in the patient group ( r=-0.48, P=0.040). The expression level of AIF was significantly and positively correlated with high-density lipoprotein cholesterol in healthy controls ( r=0.53, P=0.036). Conclusion:The expression of several genes involved in mitochondrial quality control and oxidative phosphorylation processes was significantly downregulated, and differentially expressed genes were significantly associated with metabolic index, suggesting that mitochondrial dysfunction may be related to the high risk of metabolic disease in patients with manic episodes of bipolar disorder.

Objective To investigate the changes and clinical significance of thyroid function in patients with depression by detecting serum thyroid hormone levels.Methods Totally 127cases of depression in the Department of Psychiatric of our hospital from January 2016to January 2018were collected as research objects.According to the characteristics of depression, patients with unipolar depression were selected as unipolar group (n=45), while patients with bipolar depression were selected as bipolar group (n=82).Meanwhile, 53cases of healthy volunteers underwent physical examination in the same period in our hospital were collected as control group.The serum samples of three groups were collected and the serum levels of thyroid hormones (T3, T4, FT3, FT4, TSH) were detected by chemiluminescence immunoassay.The changes of thyroid function between the three groups were compared and analyzed.Results The proportion of patients with T3and T4decreased in unipolar group were significantly higher than those in bipolar group, and the proportion of patients with T3increased in unipolar group was significantly lower than that in bipolar group, and the proportion of patients with FT4decreased in unipolar group was significantly higher than that in bipolar group;and the proportion of patients with TSH increased and TSH decreased in unipolar group were significantly higher than those in bipolar group, the differences were statistically significant (P＜0.05).The level of FT3in unipolar group was significantly lower than that in bipolar group (P＜0.05), while the level of FT4in unipolar group was significantly lower than that in control group and bipolar group, and the differences were statistically significant (P＜0.05).Conclusion The level of thyroid hormone in patients with different types of depression was different, so the treatment should be distinguished.Psychological treatment should be focused on the unipolar depression patients with hypothyroidism, while attention should be paid to drug treatment for bipolar depression patients with high levels of free thyroid hormone.

Objective To investigate the mechanism of pulmonary inflammation induced by influenza virus , and provide reference for the development of effective drugs for viral pneumonia .Methods An influenza PR8 infection mouse model was established .The levels of inflammatory cytokines and complement molecules were determined using RT -PCR and ELISA.The pathological changes were examined using biopsy .The complement inhibitor cobra venom factor ( CVF) was injected intraperitoneally at a dose of 50 μg/( kg· 24 h) , and then body mass .The survival rate and inflammatory factors were examined .Results Compared with the control group , the expressions of complement regulatory molecule Crry and CD59 were significantly decreased (P<0.01), while those of complement C9 and complement receptor C3aR and C5aR were significantly increased in the lungs of influenza model mice (P<0.01).Pro-inflammatory cytokines TNF-α, IL-6 and IFN-γwere highly expressed , but anti-inflammatory cytokine IL-2 was lowly expressed in serum .Treatment with CVF caused a sight body mass loss, a survival rate increase and a lung index decrease (P <0.05).Moreover, an IL-2 expression increase and a decrease of IL-6, TNF -αand INF-γexpression were observed in CVF treatment mice ( P< 0.05).Conclusion Inhibition of complement activation can increase the survival rate of mice with influenza pneumonia and decrease pulmonary indexes .thus delaying the pathogenesis of PR 8.

OBJECTIVETo confirm 17 rare HLA alleles detected during routine HLA typing and deduce their haplotypes.

METHODSBi-allelic sequence-based typing and Luminex DNA PCR-SSOP assay were applied for the initial or repeat HLA typing, respectively. The rare HLA alleles were confirmed with mono-allelic sequence-based typing. Predicted haplotypes of the rare alleles were inferred based on the frequencies of HLA alleles and haplotypes in Han population.

RESULTSThe authenticity of the total 17 rare HLA alleles was proven, and 18 predicted haplotypes associated with the rare alleles were recognized. A*11:12 and DRB1*13:19 were detected twice among unrelated individuals.

CONCLUSIONStudy of rare HLA alleles and predicted haplotype can provide useful information for donor searching and transplantation, and enrich polymorphisms of HLA in this population.

Alleles ; Asian Continental Ancestry Group ; ethnology ; genetics ; Gene Frequency ; HLA-A Antigens ; genetics ; HLA-B Antigens ; genetics ; HLA-DRB1 Chains ; genetics ; Haplotypes ; Humans

Objective To analyze the distribution of HLA-C alleles in Shandong Han population of China.Methods One hundred and fifty unrelated potential donors,self-claimed as Han population from Shandong province,were selected from China Marrow Donor Program.Genotypes of HLA-C with the donors were identified by PCR-SBT.The frequencies of allele were calculated with direct counting method and the differences with other populations were analyzed with SPSS16.0 x2 software.Results A total of 25 alleles of HLA-C were observed and the most common alleles were C * 06:02 and C * 07:02 with the frequency of more than 10.00％.Moreover,there were 16 kinds of alleles with the frequency of more than 1.00％ accounting for 95.33％ of the total alleles.The distribution of HLA-C alleles in Shandong Han population was similar to that in northern Han population,but had some differences with that in southern Han population.In addition,the distribution of HLA-C alleles in Shandong Han population significantly differed from that of German/African American.Conclusion This study on the distribution of HLA-C alleles in Shandong Han population provides valuable references for further studies on the genetics of HLA,cross-match for organ transplantation and other genetic-associated diseases in this population.