Objective:This study aims to explore the changes in brain surface morphology and their association with psychological characteristics in adolescents experiencing their first episode of major depressive disorder.Methods:This study included 48 adolescents with first-episode major depressive disorder (depression group) admitted to the Department of Psychiatry of the First Affiliated Hospital of Chongqing Medical University from October 2021 to July 2022. At the same period,35 healthy controls (control group) were also enrolled,from communities of Chongqing. All participants underwent assessments for depressive symptoms, emotion regulation capacity, impulsiveness, and psychological resilience using the 17-item Hamilton Depression Scale (HAMD 17), the Patient Health Questionnaire-9 (PHQ-9), the Emotion Regulation Questionnaire (ERQ), the Barratt Impulsiveness Scale-11 (BIS-11), and the Connor-Davidson Resilience Scale (CD-RISC). Structure magnetic resonance imaging (sMRI) was utilized to evaluate brain surface morphology. The values of cortical thickness, fractal dimension, sulcus depth, and cortical gyrification index were calculated. The index of brain surface morphology between the two groups was compared using the two-sample t-test, chi-square test, and non-parametric statistical tests with multiple comparisons correction using threshold-free cluster enhancement (TFCE) and false discovery rate (FDR). Pearson correlation analyses were used to analyze the correlation between the scores of each scale (HAMD 17, PHQ-9, ERQ, BIS-11, and CD-RISC) and the cortical thickness values and fractal dimension in the depression group. In addition, multiple linear regression was used to analyze the impact of clinical symptoms on the cortical thickness values in the depression group. Results:Compared with the control group, the depression group exhibited a significant reduction in the cortical thickness of the left occidental (FDR corrected, P<0.05) and an increase of the fractal dimension in the right insula, right superior temporal gyrus, and right transverse temporal gyrus (TFCE uncorrected, P<0.001). Correlation analyses showed that left occipital cortical thickness was positively correlated with the cognitive reappraisal scores of ERQ ( r=0.315, P=0.029), the total score of CD-RISC ( r=0.366, P=0.016), and the unplanned impulsiveness scores of BIS-11 (reverse scoring for this dimension) ( r=0.354, P=0.014). The partial correlation analysis revealed a positive linear correlation between cortical thickness and unplanned impulsiveness scores after controlling for age ( r=0.467, P=0.001). However, after Bonferroni correction, these correlations were not statistically significant. Conclusions:Compared with healthy individuals, adolescents with first-episode depressive disorders demonstrated increased fractal dimension in the right insula, right superior temporal gyrus, and right transverse temporal gyrus and decreased cortical thickness in the left occipital lobe. The decreased cortical thickness in the left occipital lobe was associated with impaired emotion regulation ability and impulse control ability during periods of stress.

Objective:This study aims to explore the changes in brain surface morphology and their association with psychological characteristics in adolescents experiencing their first episode of major depressive disorder.Methods:This study included 48 adolescents with first-episode major depressive disorder (depression group) admitted to the Department of Psychiatry of the First Affiliated Hospital of Chongqing Medical University from October 2021 to July 2022. At the same period,35 healthy controls (control group) were also enrolled,from communities of Chongqing. All participants underwent assessments for depressive symptoms, emotion regulation capacity, impulsiveness, and psychological resilience using the 17-item Hamilton Depression Scale (HAMD 17), the Patient Health Questionnaire-9 (PHQ-9), the Emotion Regulation Questionnaire (ERQ), the Barratt Impulsiveness Scale-11 (BIS-11), and the Connor-Davidson Resilience Scale (CD-RISC). Structure magnetic resonance imaging (sMRI) was utilized to evaluate brain surface morphology. The values of cortical thickness, fractal dimension, sulcus depth, and cortical gyrification index were calculated. The index of brain surface morphology between the two groups was compared using the two-sample t-test, chi-square test, and non-parametric statistical tests with multiple comparisons correction using threshold-free cluster enhancement (TFCE) and false discovery rate (FDR). Pearson correlation analyses were used to analyze the correlation between the scores of each scale (HAMD 17, PHQ-9, ERQ, BIS-11, and CD-RISC) and the cortical thickness values and fractal dimension in the depression group. In addition, multiple linear regression was used to analyze the impact of clinical symptoms on the cortical thickness values in the depression group. Results:Compared with the control group, the depression group exhibited a significant reduction in the cortical thickness of the left occidental (FDR corrected, P<0.05) and an increase of the fractal dimension in the right insula, right superior temporal gyrus, and right transverse temporal gyrus (TFCE uncorrected, P<0.001). Correlation analyses showed that left occipital cortical thickness was positively correlated with the cognitive reappraisal scores of ERQ ( r=0.315, P=0.029), the total score of CD-RISC ( r=0.366, P=0.016), and the unplanned impulsiveness scores of BIS-11 (reverse scoring for this dimension) ( r=0.354, P=0.014). The partial correlation analysis revealed a positive linear correlation between cortical thickness and unplanned impulsiveness scores after controlling for age ( r=0.467, P=0.001). However, after Bonferroni correction, these correlations were not statistically significant. Conclusions:Compared with healthy individuals, adolescents with first-episode depressive disorders demonstrated increased fractal dimension in the right insula, right superior temporal gyrus, and right transverse temporal gyrus and decreased cortical thickness in the left occipital lobe. The decreased cortical thickness in the left occipital lobe was associated with impaired emotion regulation ability and impulse control ability during periods of stress.

Objective:To explore the knowledge of pediatric nurses about intravenous infusion therapy, find the problems, and provide a reference for managers to provide targeted training.Methods:In this multicenter cross-sectional study, the nurses on duty were selected from 43 hospitals under the medical alliance of Beijing Children's Hospital by convenient sampling from July 24th to 31st, 2018. The self-made questionnaires were used in this study, and data were collected online through wjx.cn. The questionnaires were developed by 4 veteran venous infusion therapists according to the Infusion Therapy Standards of Practice (2016 ) as well as the Technical Standards for Intravenous Therapy Nursing Issued by the National Health Commission of the People's Republic of China in 2014. The questionnaire mainly included three parts. Part I was the basic information of the respondent subjects and hospitals; Part II was the knowledge of the subjects about domestic standards for infusion therapy and Infusion Therapy Standards of Practice; and Part III the knowledge of the subjects about infusion therapy operations and maintenance as well as the current status of infusion therapy in their departments. SPSS 17.0 was used for statistical analysis. Results:A total of 8 405 pediatric nurses were investigated in this study. The average knowledge of infusion therapy was (11.72±2.41), and the pass rate was 54.8%. The survey showed that nurses performed well in selecting infusion tools and puncture sites according to the nature of the drug, evaluating the patient and treatment plan before infusion therapy, the sealing method of peripheral vein indwelling needles, and treatment methods when resistance was encountered or no blood was returned in suction. The univariate analysis revealed that the level of the hospital, whether the hospital had a dosing center and an infusion therapy group, the nurse's education, job title, working years, position, and whether to teach young nurses were the main influencing factors to nurses' knowledge about infusion therapy ( P<0.05) . The results of Logistic regression analysis showed that whether the hospital had a dosing center and a infusion therapy group, and the nurse's education background, title, working years, position, and teaching were the main influencing factors for the nurse's knowledge of infusion therapy ( P<0.05) . Conclusions:Pediatric nurses have insufficient knowledge about infusion therapy. They need to be further trained in the basics of infusion therapy, especially in the correct use of infusion tools, the proper selection of puncture sites, and catheter maintenance.