Major depressive disorder is a common mental disorder with high rate of disability and suicide rate, but its pathogenesis remains unclear. Numerous studies indicate that energy metabolism is impaired in patients with depression, with the changes in the expression of critical genes that regulate mitochondrial homeostasis (mitochondrial biogenesis, fusion and fission, and mitophagy). Mitochondrial dysfunction, leading to reduced ATP production, oxidative stress, and inflammation, plays a significant role in the onset and development of depression, but the mechanism is still uncertain, and conflicting research findings exist. This paper reviews the intrinsic connections and potential mechanism between mitochondrial homeostasis imbalance, dysfunction, and depression, from two aspects: mitochondrial imbalance and dysfunction. It also discusses the limitations of current research, providing insight into understanding the pathogenesis of depression and developing novel mitochondrial-targeted therapeutic strategies.

Major depressive disorder is a common mental disorder with high rate of disability and suicide rate, but its pathogenesis remains unclear. Numerous studies indicate that energy metabolism is impaired in patients with depression, with the changes in the expression of critical genes that regulate mitochondrial homeostasis (mitochondrial biogenesis, fusion and fission, and mitophagy). Mitochondrial dysfunction, leading to reduced ATP production, oxidative stress, and inflammation, plays a significant role in the onset and development of depression, but the mechanism is still uncertain, and conflicting research findings exist. This paper reviews the intrinsic connections and potential mechanism between mitochondrial homeostasis imbalance, dysfunction, and depression, from two aspects: mitochondrial imbalance and dysfunction. It also discusses the limitations of current research, providing insight into understanding the pathogenesis of depression and developing novel mitochondrial-targeted therapeutic strategies.

Objective To study the time extended for getting emergency intervention in different modes of transportation and factors influencing the modes of transportation of patients with ST elevation myocardial infarction (STEMI).Methods A total of 564 consecutive patients with STEMI admitted from September 2013 to June 2016 were enrolled in the study.The clinical data about time consumed for getting emergency intervention and modes of transportation were collected.Results According to the mode of transportation,patients were divided into three groups:emergency care system (EMS) transportation group (n =96),self-transportation group (n =206) and referral group in which the patients were sent in from other hospitals (n =262).EMS transportation group had significantly shorter total ischemic time before emergency treatment than self-transportation group (229 rin vs.418 min,P ＜ 0.05) and referral group (229 min vs.512 rin,P ＜ 0.05),and significantly shorter length of pre-hospital time than self-arrival group (55 min vs.110 min;P＜0.05) and referral group (55 min vs.372 min;P＜0,05).The referral group had longer pre-hospital time and the self-transportation group had longer door-to-balloon time,but there was no difference in total ischemic time between the self-arrival and referral group (Z =-1.882,P =0.068).Multivariate logistic regression was used to analyze influence factors in mode of transportation:(1) patients characterized with high school or university education,profession of civil service,and their transportation distance more than 30 km were greater in number than referral group (P ＜ 0.05);(2) patients identified with senior middle school education,staff member of public sectors or company,their transportation distance less than 30 km,and with killip grade above Ⅱ were more likely to have EMS transport (P ＜ 0.05);(3) patients defined as businessmen without taking out new rural cooperative medical insurance,taking up transportation distance less than 80 km,and subjecting to killip grade Ⅰ had a higher proportion of individuals of this kind taking self-transportation (P ＜ 0.05).Conclusion Mode of transportation is an important factor that affects the time extended to get emergency intervention.Education level,occupation,medical insurance type,transportation distance,killip grade are associated with modes of transport.