Background/Aims: Natural killer (NK) cell function is generally considered dampened in chronic hepatitis B virus (HBV) infection; however, the NK cell pool exhibits phenotypic and functional heterogeneity, and the antibody--mediated effect of NK cells remains less characterized. This study evaluated the dynamic changes in antibody-mediated NK cell responses and the involvement of distinct NK subsets across disease stages and during antiviral treatment. Methods: A T-cell receptor-like antibody specific for the HBV core 18–27 peptide (cTCRL-Ab) was used to determine the antibody-mediated effect of NK cells, and an array of NK cell surface markers were analyzed in cross-sectional and longitudinal cohorts of patients with chronic HBV infection. Single-cell RNA sequencing (scRNA-seq) was performed to identify the heterogeneity of NK subsets. Results: The cTCRL-Ab enabled the detection of NK cell cytolytic activity and IFNγ production. Notably, cTCRL-Ab-mediated NK cell responses were compromised in chronically HBV-infected patients, particularly in those receiving pegylated interferon-α (Peg-IFNα), which was associated with the downregulation of CD16 expression. Correspondingly, Peg-IFNα inhibited cTCRL-Ab-mediated NK cell function by reducing CD16 expression in vitro. scRNA-seq revealed that CD16 downregulation occurred mainly within a dysfunctional CD16hi NK subset exhibiting exhaustion properties. In contrast, an activated CD16hiNK subpopulation (CX3CR1⁺KLRC2–CD16hi) with high cytotoxicity was enriched in patients who experienced favorable treatment responses. Furthermore, the intrahepatic CX3CR1+KLRC2–CD16hi subset tended to exhibit functional restoration in HBsAg-loss individuals. Conclusions Our data contribute to the understanding of antibody-mediated responses of NK cells in chronic HBV infection, and highlight a previously unappreciated functional CX3CR1+KLRC2–CD16hiNK subset as a potential therapeutic target.

Objective To observe the value of intravascular ultrasound elastography(IVUSE)for evaluating efficacy of ezetimibe combined with rosuvastatin for treating carotid atherosclerotic plaques.Methods Totally 200 ischemic cerebrovascular disease patients were prospectively enrolled and randomly divided into study group and control group(each n=100).Patients in study group were treated with ezetimibe combined with rosuvastatin,while those in control group were treated with atorvastatin alone for 4 months.The score of National Institutes of Health stroke scale(NIHSS)and related indicators of laboratory examination were recorded before and after treatment.Routine carotid artery ultrasound and IVUSE examination were performed,their efficacy for detecting vulnerable carotid plaque were compared taken the results of digital subtraction angiography(DSA)and CT before treatment as standards.The changes of clinical data,IVUSE parameters and stability of carotid plaque after treatment were observed.Results DSA detected single plaque in 162 cases and multiple plaques in 38 cases,with a total of 232 plaques,including 192 vulnerable plaques and 40 stable plaques.The accuracy of IVUSE for detecting vulnerable carotid plaque was higher than that of conventional ultrasound(x2=16.019,P＜0.001).After treatment,NIHSS score,total cholesterol,triglycerides,low-and high-density lipoprotein cholesterol improved better in study group than those in control group.Eccentric index and strain rate were higher,while the other plaque IVUSE parameters were lower in study group than those in control group(all P＜0.05).The improvement rate of plaque stability in study group after treatment was higher than that in control group(78.00％[78/100]vs.52.00％[52/100],P＜0.001).Conclusion IVUSE could be used to evaluate the efficacy of ezetimibe combined with rosuvastatin for treating carotid atherosclerotic plaque.

Objective To observe the value of intravascular ultrasound elastography(IVUSE)for evaluating efficacy of ezetimibe combined with rosuvastatin for treating carotid atherosclerotic plaques.Methods Totally 200 ischemic cerebrovascular disease patients were prospectively enrolled and randomly divided into study group and control group(each n=100).Patients in study group were treated with ezetimibe combined with rosuvastatin,while those in control group were treated with atorvastatin alone for 4 months.The score of National Institutes of Health stroke scale(NIHSS)and related indicators of laboratory examination were recorded before and after treatment.Routine carotid artery ultrasound and IVUSE examination were performed,their efficacy for detecting vulnerable carotid plaque were compared taken the results of digital subtraction angiography(DSA)and CT before treatment as standards.The changes of clinical data,IVUSE parameters and stability of carotid plaque after treatment were observed.Results DSA detected single plaque in 162 cases and multiple plaques in 38 cases,with a total of 232 plaques,including 192 vulnerable plaques and 40 stable plaques.The accuracy of IVUSE for detecting vulnerable carotid plaque was higher than that of conventional ultrasound(x2=16.019,P＜0.001).After treatment,NIHSS score,total cholesterol,triglycerides,low-and high-density lipoprotein cholesterol improved better in study group than those in control group.Eccentric index and strain rate were higher,while the other plaque IVUSE parameters were lower in study group than those in control group(all P＜0.05).The improvement rate of plaque stability in study group after treatment was higher than that in control group(78.00％[78/100]vs.52.00％[52/100],P＜0.001).Conclusion IVUSE could be used to evaluate the efficacy of ezetimibe combined with rosuvastatin for treating carotid atherosclerotic plaque.

Objective:To explore the application value of guide tube fenestration and drainage technology in intracranial artery stenting surgery.Methods:A total of 120 patients with symptomatic intracranial atherosclerotic stenosis admitted to the Xingtai Third Hospital from January 2021 to December 2022 were selected and randomly divided into an observation group ( n=60) and a control group ( n=60). Both groups were treated with intracranial artery stenting, with the observation group receiving guidance catheterization and window opening technique during the surgery. Two groups of surgeries were observed and compared: the degree of vascular stenosis before and after surgery, the Montreal Cognitive Assessment Scale (MoCA) scores before and one month after surgery, intraoperative complications, and prognosis. Results:The surgical time and catheter placement time in the observation group were (110.20±23.32)minutes and (11.32±2.01)minutes, respectively, which were significantly shorter than those in the control group (all P<0.05). The stent placement rate and operation success rate in the observation group were 95.00% and 96.67%, respectively, significantly higher than those in the control group (all P<0.05). The degree of postoperative vascular stenosis in the observation group was (32.29±7.11)%, significantly milder than that in the control group [(44.43±8.15)%, P<0.05]. One month after surgery, the MoCA scores of both groups improved significantly compared to before surgery (all P<0.05), and there was no statistically significant difference between the groups ( P>0.05). There was no statistically significant difference in the incidence of collateral circulation occlusion and vascular rupture between the two groups (all P>0.05). During the follow-up period, there was no statistically significant difference in the incidence of restenosis, intracranial hemorrhage, and recurrent ischemic stroke between the observation group and the control group (all P>0.05); The good prognosis rate of the observation group was 73.33%, significantly higher than that of the control group (53.33%, P<0.05). Conclusions:The application of guided catheter fenestration technique in intracranial artery stenting has good value, which is beneficial for improving the stent placement rate and operation success rate, and improving the degree of vascular stenosis.

China Medical University was approved to offer psychiatry major for five-year undergraduate in 2016, exploring the cultivating ideas and objectives. The general cultivating target is set to meet the basic requirements of clinician and meanwhile help students acquire the knowledge about psychology, psychiatry and so on. The curriculum system includes a number of characteristic professional courses, such as psychology outlines, clinical psychiatry, clinical psychology, psychiatric foundations, child and adolescent psychiatry. Concerning about the cultivating approach, the university sets up the office of psychiatry department, and establishes the responsibility system of department director, class tutor system, and whole mentor system. Furthermore, the university establishes the evaluation system of students' learning effect, including both the evaluation analysis of teacher and personal growth report. Consequently, the cultivating model has achieved an initial success.

Objective To investigate gender differences of plasma glial cell line-derived neurotro-phic factor (GDNF) levels in patients with major depressive disorder (MDD). Methods MDD subjects (male 20,female 36) and healthy controls (HCs) (male 35,female 45) were divided into four groups by gender. Plasma levels of GDNF were measured and compared in different gender groups. The clinical symp-tom severity of MDD patients was evaluated by 17-item Hamilton Depression Scale (HAMD-17) and Hamil-ton Anxiety Scale (HAMA-17). Results (1)The plasma GDNF level in male patients with major depres-sive disorder (( 1. 55 ± 0. 43 ) pg/ml ) was significantly lower than that in healthy controls (( 1. 86 ± 0. 50)pg/ml,F=4. 64,P=0. 036). There was no significant difference in GDNF level between female de-pression patients((1.62±0.46)pg/ml)) and female healthy control((1. 64±0. 48)pg/ml,F=0. 18,P=0. 672). In HCs,the GDNF level of male was significantly higher than that of female((1. 86±0. 50)pg/ml, (1. 64±0. 48)pg/ml,F=2. 04,P=0. 045). There was no significant difference in GDNF level between male and female patients(P>0. 05). (2) GDNF level in male patients with major depressive disorder was nega-tively correlated with HAMA score(r=-0. 388,P=0. 034). Conclusion The expression of GDNF is affect-ed by sex factors,which may be related to the different pathogenesis of MDD.

Objective To research the changes of regional gray matter volumes in first-episode, medication naive females with major depressive disorder. Methods Magnetic resonance imaging and voxel-based mor-phometry were used to compare regional gray matter volumes between 14 medication-naive female participants with a first episode of major depressive disorder ( MDD) ( age( 29. 5 ±6.8) years, number of education years(11.4 ± 2. 7) years, duration of iIIness(5.4 ±5. 2 ) months, H AMD score(27.6 ±5.5)) and 14 female healthy comparison participants (HC) (age(29.5 ±6.9)years,number of education years( 12. 2 ±3. 3)years,HAMD score(2. 1 ± 1.9)). Results Volumes of bilateral anterior cingulate cortex ( ACC) and right amygdala were significantly smaller in the MDD group than those in the HC group. Conclusion These results suggest that volume reductions in ACC and amygdala in females with MDD are present at illness onset.

Objective To research the effects of tianeptine and lithium on expression of pCREB in hippocampus of chronic stress depression rats. Methods All the experimental rats were divided by random into : Group of depression,Group of tianeptine,Group of lithium and Group of control. The rats of Group of depression, Group of tianeptine and Group of lithium were applied stress for 21 days,and meanwhile Group of control had no stress. The rats of Group of tianeptine were fed with tianeptine (50 mg/kg) , Group of lithium were fed with lithium (60 mg/kg) , while another groups were fed with normal sodium of the same volume. The ethology examination was performed by using method of open-field and experiment of fluid consumption. The expression of pCREB was detected by Western-blotting method. Results After the chronic stress,the horizontal crossing numbers,the erection times,the modification times and the percentage of sacchar-consumption of the rats of Group of depression were 23.2±23.0;8. 1 ±7.2; 3.6 ±3.5 and (55.4 ±11.7)% respectively, which were less than Group of control (46.0±18.9;20.3±11.3;8.4±2.7 and (68.5 ±8.2)% ; P＜0.01). The horizontal crossing numbers(28. 1 ±23.0) ,the erection times(12. 1 ± 9.4) and the modification times(5.5 ±3.2) of Group of tianeptine are less than those of Group of control (P ＜ 0. 05), but no significant difference compared with Group of depression; the percentage of sacchar-consumption(62.7 ± 10.6) % ,Group of tianeptine was more than Group of depression (P＜ 0.05 ) , but no obvious difference with Group of control. The horizontal crossing numbers, the erection times, the modification times and the percentage of sacchar-consumption of Group of lithium were less than those of Group of control (P ＜ 0.05), more than those of Group of depression but no significant difference (P ＞ 0.05). In Westernblotting method,the level of pCREB in the hippocampus of Group of depression was less than that of Group of control (P＜ 0.01); that of Group of tianeptine was more than that of Group of depression (P ＜ 0.01) but no obvious difference with Group of control; that of Group of lithium was less than that of Group of control (P＜0. 01) and more than Group of depression (P＜0.01). Conclusion Tianeptine could reverse the reduction of expression of pCREB in hippocampus of chronic stress depression rats and lithium partly did it.