Objective To investigate predictive factors of malignant risk for follicular thyroid neoplasms(FTN)with a maximum diameter≤4 cm,providing evidence for preoperative diagnosis and individualized treatment for FTN patients.Methods We retrospectively analyzed clinical data of FTN patients with a maximum tumor diameter≤4 cm treated at our hospital between January 2018 and December 2023.Based on postoperative pathological diagnosis,the patients were divided into follicular thyroid carcinoma(FTC)group and follicular thyroid adenoma(FTA)group.Univariate and multivariate logistic regression analyses were performed to explore predictive factors of malignant risk of FTN.Results A total of 870 patients were included,comprising of 745 patients(85.6%)in the FTA group and125 patients(14.4%)in the FTC group.The univariate analysis showed thatage,gender,BMI,comorbidity of Hashimoto's thyroiditis,number and location of nodules,the maximum diameter of nodules,internal structure of nodules,and internal blood flow signals had no significant differences(P>0.05),while nodule echogenicity,margins,halo,taller-than-wide shape,and calcification had significant differences(P<0.05).Multivariate logistic regression analysis revealed that irregular margins(OR=3.061,95%CI:1.653-5.667,P=0.000),uneven thickness of the halo(OR=5.868,95%CI:1.258-27.377,P=0.024),and peripheral rim calcification(OR=4.364,95%CI:1.329-14.333,P=0.015)were predictive factors of malignant risk for FTC.Conclusions Ultrasound features have certain value for evaluating benign or malignant nature of FTN.Careful assessment of nodule margins,halo,and calcification can facilitate early diagnosis and treatment of small FTN.

Objective To investigate predictive factors of malignant risk for follicular thyroid neoplasms(FTN)with a maximum diameter≤4 cm,providing evidence for preoperative diagnosis and individualized treatment for FTN patients.Methods We retrospectively analyzed clinical data of FTN patients with a maximum tumor diameter≤4 cm treated at our hospital between January 2018 and December 2023.Based on postoperative pathological diagnosis,the patients were divided into follicular thyroid carcinoma(FTC)group and follicular thyroid adenoma(FTA)group.Univariate and multivariate logistic regression analyses were performed to explore predictive factors of malignant risk of FTN.Results A total of 870 patients were included,comprising of 745 patients(85.6%)in the FTA group and125 patients(14.4%)in the FTC group.The univariate analysis showed thatage,gender,BMI,comorbidity of Hashimoto's thyroiditis,number and location of nodules,the maximum diameter of nodules,internal structure of nodules,and internal blood flow signals had no significant differences(P>0.05),while nodule echogenicity,margins,halo,taller-than-wide shape,and calcification had significant differences(P<0.05).Multivariate logistic regression analysis revealed that irregular margins(OR=3.061,95%CI:1.653-5.667,P=0.000),uneven thickness of the halo(OR=5.868,95%CI:1.258-27.377,P=0.024),and peripheral rim calcification(OR=4.364,95%CI:1.329-14.333,P=0.015)were predictive factors of malignant risk for FTC.Conclusions Ultrasound features have certain value for evaluating benign or malignant nature of FTN.Careful assessment of nodule margins,halo,and calcification can facilitate early diagnosis and treatment of small FTN.

Aim To construct a diabetic atherosclerosis mouse model and study the pathological characteristics of diabetic atherosclerosis.Methods Fifty 8-week-old male LDLR-/-mice were fed with standard diet for 2 weeks and then changed to high-fat diet,they were randomly divided into two groups.The diabetic atherosclerosis group was given intraperitoneal injection of low dose streptozotocin(STZ)for 5 days continuouly to establish the model,and the atheroscle-rosis group was given citrate buffer injection at the same time.The body mass,blood glucose and blood lipids of the mice in the two groups were detected for many times.At the age of 23 weeks,the mice were euthanized after glucose tolerance test.HE staining and oil red O staining were used to detect the gross and aortic root atherosclerosis,immunohistochemical staining was used to detect CD4,α-smooth muscle actin(α-SMA),EGF-like module-containing mucin-like hormone re-ceptor-like 1(EMR1),monocyte chemotactic protein-1(MCP-1),NOD-like receptor protein 3(NLRP3),vascular cell adhesion molecule-1(VCAM-1),matrix metalloproteinase-2(MMP-2)and tissue inhibitor of metalloproteinase-1(TIMP-1),Western blot was used to detect α-SMA,CD4,tumor necrosis factor-α(TNF-α),NLPR3,intercellular adhesion molecule-1(ICAM-1),and type Ⅰ and Ⅲ collagen.Results Compared with the atherosclerosis group,the body mass decreased,the levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDLC)increased,and the levels of high density lipoprotein cholesterol(HDLC)decreased(P＜0.05)in the diabetic atherosclerosis group.Compared with the atherosclerosis group,the distribution of atherosclerotic plaques was diffuse and the area was increased in the diabetic atherosclerosis group,and the contents of lipids,T cells,macrophages,smooth muscle cells,type Ⅰ and Ⅲ colla-gen were increased(P＜0.05);the protein levels of TNF-α,MCP-1,MMP-2,NLRP3,ICAM-1 and VCAM-1 in vascular tissues were increased,while the content of TIMP-1 were decreased and MMP2/TIMP-1 were increased(P＜0.05).Conclusions LDLR-mouse model of diabetic atherosclerosis can be successfully established by STZ induction combined with high-fat diet,which can reflect the plaque composition and inflammatory characteristics of diabetes promoting atheroscle-rosis.It can be used as a relatively ideal pathological model for the study of diabetic macroangiopathy.

Objective:Postdoctoral researchers in Chinese universities commonly face a high risk of mental health issues,such as depression,yet the underlying causes and mechanisms remain unclear.This study aims to explore the influence of childhood socioeconomic status(SES)on depression among postdoctoral researchers and the mediating roles of current subjective SES and perceived stress in this process. Methods:An online survey was conducted among postdoctoral researchers at a university.The survey included a general information questionnaire,the Childhood Socioeconomic Status Scale,the Subjective Socioeconomic Status Scale,the Perceived Stress Scale,and the Patient Health Questionnaire.A total of 505 valid responses were collected.Pearson correlation analysis was used to analyze the data,and the PROCESS macro was employed for chain mediation analysis. Results:Childhood SES was significantly positively correlated with current subjective SES(P<0.05)and significantly negatively correlated with postdoctoral tenure,perceived stress,and depression(all P<0.05).Current subjective SES was significantly negatively correlated with perceived stress and depression(both P<0.05),while perceived stress was significantly positively correlated with depression(P<0.05).The chain mediation effect of childhood SES → current subjective SES → perceived stress → depression was significant(P<0.05). Conclusion:Childhood socioeconomic status can influence depression among postdoctoral researchers through the mediating roles of current subjective socioeconomic status and perceived stress.These findings provide a target for the prevention and intervention of depression in postdoctoral populations and offer a reference for the development of mental health promotion strategies for young university faculty.

ObjectiveTo explore the mechanism of Astragali Radix-Aconiti Lateralis Radix Praeparata in the treatment of heart failure and substance basis based on ultra-performance liquid chromatography-quadrupole-time of flight-mass spectrometer （UPLC-Q-TOF-MS） and network pharmacology. MethodThe chemical components of Astragali Radix-Aconiti Lateralis Radix Praeparata solution was analyzed by UPLC-Q-TOF-MS， and the active components and targets were screened out by the PubChem database. The targets related to heart failure disease were retrieved from Comparative Toxicogenomics Database（CTD）， Online Mendelian Inheritance in Man （OMIM）， and GeneCard databases， and the common targets were obtained by Venn analysis. The target protein-protein interactions （PPI） were analyzed using the STRING database. Gene ontology （GO） functional enrichment analysis and Kyoto encyclopedia of genes and genomes （KEGG） pathway enrichment analysis were performed using the Metascape database， and molecular docking verification of key targets and active components was performed using SYBYL-X 2.1.1. Experimental validation of key targets was carried out using the rat model of heart failure. ResultThere were 202 chemical components identified in Astragali Radix-Aconiti Lateralis Radix Praeparata solution， of which 64 active components were predicted to act on 183 targets for the treatment of heart failure. The important active components were caffeic acid， L-arginine， biochanin A， adenine， nicotinic acid， trans-ferulic acid， p-coumaric acid， riboflavin， calycosin， etc. The main targets were interleukin （IL）-6， cysteine aspartic acid specific protease （Caspase）-3， vascular endothelial growth factor A （VEGFA）， protein kinase B1 （Akt1）， tumor necrosis factor （TNF）， IL-1B， matrix metallopeptidase （MMP）-9， etc. The main signaling pathways involved hypoxia-inducible factor （HIF）-1 signaling pathway， TNF signaling pathway， phosphatidylinositol 3-kinase （PI3K）/Akt signaling pathway， Toll-like receptor signaling pathway， mitogen-activated protein kinase （MAPK） signaling pathway， forkhead box O （FoxO） signaling pathway， etc. The molecular docking results showed that the active components in Astragali Radix-Aconiti Lateralis Radix Praeparata solution had a good binding ability with HIF-1α， VEGFA， Akt1， Caspase-3， and IL-6， which were the key proteins in the HIF-1 signaling pathway. Animal experiments showed that Astragali Radix-Aconiti Lateralis Radix Praeparata solution significantly improved the hemodynamic indexes， reduced the serum atrial natriuretic peptide （ANP）， brain natriuretic peptide （BNP）， and IL-6 levels， improved the myocardial histopathological changes， protected the mitochondrial morphology of cardiomyocytes， down-regulated the expression of HIF-1α， VEGFA and phosphorylation（p）-Akt， and reduced the activation of Caspase-3 in the myocardial tissue of rats with heart failure. ConclusionAstragali Radix-Aconiti Lateralis Radix Praeparata treats heart failure in a multi-component， multi-target， and multi-pathway manner. The experimental validation indicates that it treats heart failure by improving myocardial histopathological changes and regulating HIF-1 signaling pathway， which provides references for the subsequent pharmacodynamic substance research.

Early distinction of bipolar disorder (BD) from major depressive disorder (MDD) is difficult since no tools are available to estimate the risk of BD. In this study, we aimed to develop and validate a model of oxidative stress injury for predicting BD. Data were collected from 1252 BD and 1359 MDD patients, including 64 MDD patients identified as converting to BD from 2009 through 2018. 30 variables from a randomly-selected subsample of 1827 (70%) patients were used to develop the model, including age, sex, oxidative stress markers (uric acid, bilirubin, albumin, and prealbumin), sex hormones, cytokines, thyroid and liver function, and glycolipid metabolism. Univariate analyses and the Least Absolute Shrinkage and Selection Operator were applied for data dimension reduction and variable selection. Multivariable logistic regression was used to construct a model for predicting bipolar disorder by oxidative stress biomarkers (BIOS) on a nomogram. Internal validation was assessed in the remaining 784 patients (30%), and independent external validation was done with data from 3797 matched patients from five other hospitals in China. 10 predictors, mainly oxidative stress markers, were shown on the nomogram. The BIOS model showed good discrimination in the training sample, with an AUC of 75.1% (95% CI: 72.9%-77.3%), sensitivity of 0.66, and specificity of 0.73. The discrimination was good both in internal validation (AUC 72.1%, 68.6%-75.6%) and external validation (AUC 65.7%, 63.9%-67.5%). In this study, we developed a nomogram centered on oxidative stress injury, which could help in the individualized prediction of BD. For better real-world practice, a set of measurements, especially on oxidative stress markers, should be emphasized using big data in psychiatry.
Biomarkers/metabolism* ; Bipolar Disorder/metabolism* ; Depressive Disorder, Major/diagnosis* ; Early Diagnosis ; Humans ; Oxidative Stress

Recently, monkeypox has become a global concern amid the ongoing COVID-19 pandemic. Monkeypox is an acute rash zoonosis caused by the monkeypox virus, which was previously concentrated in Africa. The re-emergence of this pathogen seems unusual on account of outbreaks in multiple nonendemic countries and the incline to spread from person to person. We need to revisit this virus to prevent the epidemic from getting worse. In this review, we comprehensively summarize studies on monkeypox, including its epidemiology, biological characteristics, pathogenesis, and clinical characteristics, as well as therapeutics and vaccines, highlighting its unusual outbreak attributed to the transformation of transmission. We also analyze the present situation and put forward countermeasures from both clinical and scientific research to address it.
COVID-19 ; Disease Outbreaks/prevention & control* ; Humans ; Monkeypox/epidemiology* ; Monkeypox virus ; Pandemics/prevention & control*

Objective: To learn the mutation types and hearing screening results in local newborns of Zhoushan,in order to provide evidence for prevention and early detection of deafness. Methods: The newborns in Zhoushan Maternal and Child Health Hospital from August 2015 to May 2018 were recruited and detected by matrix-assisted laser desorption ionization time of flight mass spectrometry（MALDI-TOF-MS）for twenty-two mutation sites of GJB2,SLC26A,GJB3 and 12SrRNA genes. The results of genotyping and hearing screening were analyzed and the hearing condition of abnormal newborns was followed up. Results: Among 4 029 newborns,180（4.47%）newborns were identified to carry mutations,including 94 males（4.66%）and 86 females （4.28%）. There was no statistically significant difference in the rate of carrying mutations between male and female infants （P>0.05）. Totally 135 （3.35%）newborns failed in primary hearing screening,13（9.63%）of whom carried the deafness genes;3 894（96.65%）newborns passed,167（4.29%）of whom carried the deafness gene. There was statistically significant difference in the the rate of carrying mutations between newborns who passed and failed in primary hearing screening （P<0.05）. Eleven newborns were diagnosed with hearing loss,with a rate of 2.73‰. Among 180 mutations identified,there were 91 GJB2 mutations（2.26%）,57 SLC26A4 mutations（1.41%）,14 GJB3 mutations （0.35%）,15 mtDNA 12SrRNA mutations （0.37%）and 3 with mutations of two genes （0.07%）. Sixteen mutation sites （184 cases）were found,and the detection rate was 4.57%. Conclusion The rate of carrying deafness genes in Zhoushan newborns was 4.47%. The deafness genes found were mainly GJB2 and SLC26A4,the carrying rate of mtDNA 12SrRNA gene mutation was also high.

Objective To investigate the regulatory effect of cognitive behavioral therapy (CBT) on the functional connectivity of cognitive control network in untreated obsessive-compulsive disorder (OCD) patients,so as to provide evidence for understanding the neurobiological mechanism of CBT.Methods A total of 45 OCD patients and 45 matched normal controls were recruited at the outpatient clinic in Beijing Anding Hospital.Four therapists provided 14 times of CBT treatment for OCD patients.All subjects underwent clinical symptom assessment and magnetic resonance imaging at baseline and at the end of 12 weeks.The clinical symptoms were assessed by the psychiatrists using Y-BOCS,HAMD17 and HAMA.The clinical symptoms of OCD patients before and after CBT treatment were compared.The GRETNA software package was used to preprocess the resting-state fMRI data.The whole brain function network was constructed with the template of Power 264 functional brain area as the network node.The function connection intensity outside the cognitive control network was calculated,and the function connection of 2 groups of brain networks at two timepoints were compared by repeated measurement of variance analysis.Results A total of 41 patients completed CBT.The scores of obsessive-compulsive symptoms,anxiety symptoms and depressive symptoms decreased at the end of 12th week,of which 32 patients were improved (Y-BOCS reduction ≥35％).Single factor repeated analysis of variance and post hoc tests were performed between patients with improvement and normal controls.At baseline,the functional connection between the cingulo-opercular network and the salience network of OCD patients was lower than that of the normal control (0.172±0.060 vs.0.215±0.076,t=1.731,P=0.040),it increased after treatment (0.186±0.171 vs.0.172±0.060,t=2.480,P=0.010).At baseline,the functional connection of cingulo-opercular network and subcortical network in OCD patients was lower than that of normal control (0.119±0.081 vs.0.129±0.070,t=1.640,P=0.040),and it increased after treatment (0.130±0.161 vs.0.119±0.081,t=2.421,P=0.020).At baseline,the functional connection between the frontal-parietal network and subcortical network was lower than that of normal controls (-0.004 ± 0.039 vs.0.021 ± 0.054,t=2.280,P=0.020),and it increased after treatment (0.020±0.042 vs.-0.004±0.039,t=-2.300 P=0.020).Conclusions CBT could effectively improve obsessive-compulsive symptoms accompanying with improvement of the external functional connectivity of cognitive control network in OCD patients.

Objective To investigate the regulatory effect of cognitive behavioral therapy (CBT) on the functional connectivity of cognitive control network in untreated obsessive-compulsive disorder (OCD) patients,so as to provide evidence for understanding the neurobiological mechanism of CBT.Methods A total of 45 OCD patients and 45 matched normal controls were recruited at the outpatient clinic in Beijing Anding Hospital.Four therapists provided 14 times of CBT treatment for OCD patients.All subjects underwent clinical symptom assessment and magnetic resonance imaging at baseline and at the end of 12 weeks.The clinical symptoms were assessed by the psychiatrists using Y-BOCS,HAMD17 and HAMA.The clinical symptoms of OCD patients before and after CBT treatment were compared.The GRETNA software package was used to preprocess the resting-state fMRI data.The whole brain function network was constructed with the template of Power 264 functional brain area as the network node.The function connection intensity outside the cognitive control network was calculated,and the function connection of 2 groups of brain networks at two timepoints were compared by repeated measurement of variance analysis.Results A total of 41 patients completed CBT.The scores of obsessive-compulsive symptoms,anxiety symptoms and depressive symptoms decreased at the end of 12th week,of which 32 patients were improved (Y-BOCS reduction ≥35％).Single factor repeated analysis of variance and post hoc tests were performed between patients with improvement and normal controls.At baseline,the functional connection between the cingulo-opercular network and the salience network of OCD patients was lower than that of the normal control (0.172±0.060 vs.0.215±0.076,t=1.731,P=0.040),it increased after treatment (0.186±0.171 vs.0.172±0.060,t=2.480,P=0.010).At baseline,the functional connection of cingulo-opercular network and subcortical network in OCD patients was lower than that of normal control (0.119±0.081 vs.0.129±0.070,t=1.640,P=0.040),and it increased after treatment (0.130±0.161 vs.0.119±0.081,t=2.421,P=0.020).At baseline,the functional connection between the frontal-parietal network and subcortical network was lower than that of normal controls (-0.004 ± 0.039 vs.0.021 ± 0.054,t=2.280,P=0.020),and it increased after treatment (0.020±0.042 vs.-0.004±0.039,t=-2.300 P=0.020).Conclusions CBT could effectively improve obsessive-compulsive symptoms accompanying with improvement of the external functional connectivity of cognitive control network in OCD patients.