Objective To evaluate the transition rules of normal body mass index(BMI),overweight and metabolic syndrome(MetS)in patients with major depressive disorder(MDD).Methods Patients with MDD who had multiple admission records between Jan 2016 and Nov 2021 in Beijing Anding Hospital,Capital Medical University were included.Based on the overweight and metabolic syndrome status assessed at each admission,the patients were categorized into three states:normal BMI,overweight and metabolic syndrome.A multi-state Markov model was used to analyze the transition intensity and transition frequency between three states and the influence of covariates on transitions.Results A total of 892 records of 398 subjects were included,with a median age of 56 years old and 31.4% males.The median follow-up period was 40 months.The multi-state model showed that there were 494 transitions between the three states,of which 5.1% moved from normal BMI to overweight and 5.5% moved from overweight to MetS.The intensity of transition was the highest from overweight to MetS,9.52 times greater than overweight to normal BMI.After 48.53 months,MDD patients with normal BMI began to transition to MetS.For overweight MDD patients,the transition to MetS started after 8.77 months.MDD patients with normal BMI or overweight had 31.4% and 50.4% probabilities of developing Mets after 36 months.For MDD patients comorbid with MetS,the probability of staying at MetS was 51.2% after 36 months.Multivariate analysis showed that being unmarried was a risk factor against developing overweight in normal BMI MDD patients,while a higher level of education was a protective factor against developing MetS in overweight MDD patients.Conclusion MDD patients exhibited a higher intensity and risk of developing MetS,and it is not easy to reverse MetS,suggesting that BMI management and MetS intervention should be strengthened in MDD patients.

Objective To investigate the impact of serine/threonine-protein kinase 1(AKT1)-mediated autophagy in hepatocellular carcinoma(HCC)cells on their sensitivity to 125I seed irradiation.Methods ① iProX database and STRING12.0 website were utilized to analyze the proteomic data of HCC before and after 125I seed irradiation to explore the differentially expressed proteins and associated functional connections.Meanwhile,The Cancer Genomics Atlas(TCGA)database was employed to analyze the relationship between AKT1 expression level and the survival of HCC patients.② Human HCC cell lines HUH7 and Hep3B were exposed to continuous irradiation from 125I radioactive seeds with an initial apparent activity of 0.8 mCi per seed for approximately 120 h,accumulating a total dose of 8 Gy,while the control cells were cultured under normal condition for 120 h.③ Autophagy inhibitor,chloroquine(CQ)and inducer,rapamycin(RAPA)were used to treat the HCC cells respectively to establish the CQ group and the RAPA group.The lentiviral transfection technique was employed to construct the HCC cells with overexpressed AKT1,namely the AKT1 group.The HCC cells treated in the same way were continuously irradiated with 125I seeds for 120 h to construct the CQ+125I group,the RAPA+125I group,and the AKT1+125I group.④The changes in microtubule-associated protein light chain 3(LC3),p62,AKT1 and p-AKT1 were detected by Western blotting.Cell immunofluorescence assay was employed to observe the expression of autophagy related proteins,such as LC3.The colony forming ability and apoptotic rate were detected with plate cloning assay and flow cytometry.Results ① Continuous irradiation with 125I seeds resulted in decreased expression of p62 and increased ratio of LC3Ⅱ/LC3Ⅰ(P＜0.05)when compared with the negative control(NC)group.Immunofluorescence assay revealed more green fluorescence spots of LC3.When compared with the 125I group,the CQ+125I group had significantly increased expression of p62(P＜0.01),decreased ratio of LC3Ⅱ/LC3Ⅰ(P＜0.01),lower apoptotic rate(P＜0.01),and more colony formations(P＜0.01).In contrast,the results in the RAPA+125I group were opposite to those of the CQ+125I group.② Analysis on the iProX database showed that the expression of AKT1 was decreased in the irradiated group,and analysis on the TCGA database indicated that high expression of AKT1 predicted a poor prognosis for HCC patients(P＜0.01).③After irradiation with 125I seeds,the expression of AKT1 at both the RNA and protein levels was decreased in the 125I group(P＜0.01).After overexpression of AKT1,the level of autophagy was decreased(P＜0.05).Irradiation of HCC cells with overexpressed AKT1 using 125I seeds could partially restore the level of autophagy.In the AKT1+125I group,the expression of AKT1,pAKT1 and p62 were all decreased,and the ratio of LC3Ⅱ/LC3Ⅰwas increased than the AKT1 group(P＜0.05).④ The apoptotic rate of the AKT1+125I group was lower than that of the 125I group(P＜0.05)and higher than that in the AKT1 group(P＜0.05).In HUH7 cells,the clonogenic ability of the AKT1+125I group was higher than that of the 125I group(P＜0.05).In Hep3B cells,the clonogenic ability of the AKT1+125I group was higher than that of the 125I group,and the clonogenic ability of the AKT1 group was higher than that of the NC group(P＜0.05).Conclusion 125I seed irradiation induce lethal autophagy in HCC cells by reducing the expression of AKT1,providing a new theoretical basis for the implantation of 125I radioactive seeds in the treatment of HCC.

Medical technology proficiency is a key indicator of a municipal-level hospital′s core competitiveness. To continuously enhance its medical capabilities, a tertiary prefecture-level hospital in Zhejiang province launched the " 100 high-tech projects" in 2010, designating it as a priority technical development program. The hospital established a hospital-level knowledge management team in 2020 to build a knowledge management system for high-tech projects. This system fostered a virtuous cycle of synergistic advancement in medical technology innovation, knowledge management, and talent development by extracting both explicit and tacit knowledge from the hospital′s high-tech projects, absorbing tacit knowledge from benchmark hospitals′ relevant technologies, and establishing a knowledge-sharing platform. From January 2021 to October 2024, the hospital secured approval for 9 national and provincial-level clinical key specialties, established 7 municipal key technological innovation teams, and enrolled 46 provincial/municipal-level talents. A the same time, talent attrition remained low. The implementation of the knowledge management system to empower high-tech development had achieved phased results. This practice could provide references for other hospitals to enhance their medical technology capabilities.

Objective:To explore the association between big five personality traits, emotional coping information acquisition ability, and depressive symptoms among Chinese adults, providing theoretical support for behavioral intervention strategies targeting individuals with different personality traits and depressive symptoms.Methods:Data were obtained from the Psychology and Behavior Investigation of Chinese Residents (PBICR), a cross-sectional survey conducted from July to September 2021 across 120 cities in China, with 9 966 adults involved. The big five inventory-10 (BFI-10) and patient health questionnaire-9 (PHQ-9) were used to assess personality traits and depressive symptoms, respectively. Emotional coping information acquisition ability was evaluated using a four-point Likert scale. Multivariable binary Logistic regression analysis was performed using R 4.3.1 software to examine associations among big five personality, emotion-coping information acquisition ability, and depressive symptoms.Results:Among the 9 966 surveyed adults, 1 213 individuals(12.2%) who met the PHQ-9 criteria were assessed to have positive depressive symptoms. Difficulties in acquiring emotional coping information were reported by 1 934 individuals(19.4%). The scores of extraversion, agreeableness, neuroticism, openness and conscientiousness in big five personality traits were 6.26±1.58, 7.00±1.49, 6.26±1.49, 6.41±1.52 and 6.91±1.60, respectively. Inter-group comparisons reported statistically significant differences in the five major personality traits between the negative and positive group of depressive symptoms ( χ2=215.39, P<0.05). Logistic regression analysis showed that poor emotional coping information acquisition ability ( B=0.304, OR(95% CI)=1.36(1.15-1.59)) and dominant traits of extraversion ( B=0.597, OR(95% CI)=1.82(1.55-2.13)) or openness ( B=0.321, OR(95% CI)=1.38(1.10-1.72)) were significant risk factors for depression. Conclusions:Chinese adults with big five personality mainly presented as extroversion and openness traits, and with poor emotional coping and information acquisition abilities might be associated with depressive symptoms.

Objective:To explore the association between big five personality traits, emotional coping information acquisition ability, and depressive symptoms among Chinese adults, providing theoretical support for behavioral intervention strategies targeting individuals with different personality traits and depressive symptoms.Methods:Data were obtained from the Psychology and Behavior Investigation of Chinese Residents (PBICR), a cross-sectional survey conducted from July to September 2021 across 120 cities in China, with 9 966 adults involved. The big five inventory-10 (BFI-10) and patient health questionnaire-9 (PHQ-9) were used to assess personality traits and depressive symptoms, respectively. Emotional coping information acquisition ability was evaluated using a four-point Likert scale. Multivariable binary Logistic regression analysis was performed using R 4.3.1 software to examine associations among big five personality, emotion-coping information acquisition ability, and depressive symptoms.Results:Among the 9 966 surveyed adults, 1 213 individuals(12.2%) who met the PHQ-9 criteria were assessed to have positive depressive symptoms. Difficulties in acquiring emotional coping information were reported by 1 934 individuals(19.4%). The scores of extraversion, agreeableness, neuroticism, openness and conscientiousness in big five personality traits were 6.26±1.58, 7.00±1.49, 6.26±1.49, 6.41±1.52 and 6.91±1.60, respectively. Inter-group comparisons reported statistically significant differences in the five major personality traits between the negative and positive group of depressive symptoms ( χ2=215.39, P<0.05). Logistic regression analysis showed that poor emotional coping information acquisition ability ( B=0.304, OR(95% CI)=1.36(1.15-1.59)) and dominant traits of extraversion ( B=0.597, OR(95% CI)=1.82(1.55-2.13)) or openness ( B=0.321, OR(95% CI)=1.38(1.10-1.72)) were significant risk factors for depression. Conclusions:Chinese adults with big five personality mainly presented as extroversion and openness traits, and with poor emotional coping and information acquisition abilities might be associated with depressive symptoms.

Objective To evaluate the transition rules of normal body mass index(BMI),overweight and metabolic syndrome(MetS)in patients with major depressive disorder(MDD).Methods Patients with MDD who had multiple admission records between Jan 2016 and Nov 2021 in Beijing Anding Hospital,Capital Medical University were included.Based on the overweight and metabolic syndrome status assessed at each admission,the patients were categorized into three states:normal BMI,overweight and metabolic syndrome.A multi-state Markov model was used to analyze the transition intensity and transition frequency between three states and the influence of covariates on transitions.Results A total of 892 records of 398 subjects were included,with a median age of 56 years old and 31.4% males.The median follow-up period was 40 months.The multi-state model showed that there were 494 transitions between the three states,of which 5.1% moved from normal BMI to overweight and 5.5% moved from overweight to MetS.The intensity of transition was the highest from overweight to MetS,9.52 times greater than overweight to normal BMI.After 48.53 months,MDD patients with normal BMI began to transition to MetS.For overweight MDD patients,the transition to MetS started after 8.77 months.MDD patients with normal BMI or overweight had 31.4% and 50.4% probabilities of developing Mets after 36 months.For MDD patients comorbid with MetS,the probability of staying at MetS was 51.2% after 36 months.Multivariate analysis showed that being unmarried was a risk factor against developing overweight in normal BMI MDD patients,while a higher level of education was a protective factor against developing MetS in overweight MDD patients.Conclusion MDD patients exhibited a higher intensity and risk of developing MetS,and it is not easy to reverse MetS,suggesting that BMI management and MetS intervention should be strengthened in MDD patients.

Medical technology proficiency is a key indicator of a municipal-level hospital′s core competitiveness. To continuously enhance its medical capabilities, a tertiary prefecture-level hospital in Zhejiang province launched the " 100 high-tech projects" in 2010, designating it as a priority technical development program. The hospital established a hospital-level knowledge management team in 2020 to build a knowledge management system for high-tech projects. This system fostered a virtuous cycle of synergistic advancement in medical technology innovation, knowledge management, and talent development by extracting both explicit and tacit knowledge from the hospital′s high-tech projects, absorbing tacit knowledge from benchmark hospitals′ relevant technologies, and establishing a knowledge-sharing platform. From January 2021 to October 2024, the hospital secured approval for 9 national and provincial-level clinical key specialties, established 7 municipal key technological innovation teams, and enrolled 46 provincial/municipal-level talents. A the same time, talent attrition remained low. The implementation of the knowledge management system to empower high-tech development had achieved phased results. This practice could provide references for other hospitals to enhance their medical technology capabilities.

Objective:To explore the influencing factors of loss of follow-up in a cohort study of participants with acute phase depressive disorders.Methods:A multicenter prospective cohort of patients with depressive disorders conducted from 2017 to 2021 was followed up at baseline, week 4, and week 8.The general information, disease characteristics, life satisfaction, functional status and other information of the subjects were collected.Loss of follow-up was determined by whether the patients followed the follow-up plan for on-site visits.SAS 9.4 software was used for data description and statistical analysis, and multiple Logistic regression analysis was used to explore the influencing factors of subjects loss to follow-up.Results:A total of 1 023 patients with acute phase depressive disorders were included in the study.The scores of the 17-item Hamilton depression rating scale, the quality of life enjoyment and satisfaction questionnaire-short form, and Sheehan disability scale were 18.3±6.6, 37.7±9.6, and 13.8±7.5, respectively.The loss of follow-up ratios at week 4, week 8 and complete visits were 28.6% (293/1 023), 19.5% (199/1 023), and 13.9% (142/1 023), respectively.Multivariate analysis showed that higher depression severity at baseline ( OR=0.81, 95% CI=0.79-0.84) and higher life satisfaction at baseline ( OR=0.96, 95% CI=0.95-0.97) were associated with lower loss of follow-up ratio at week 4.Compared with the < 30-year group, the loss of follow-up ratio at week 4 in the 40-49 -year group was lower ( OR=0.36, 95% CI=0.19-0.65).Patients with high anxiety factor scores ( OR=1.41, 95% CI=1.30-1.54) and the first depressive episode ( OR=1.52, 95% CI=1.10-2.12) had higher loss of follow-up ratio at week 4.The lower loss of follow-up ratio was associated with education level at week 8 ( OR=0.42, 95% CI=0.21-0.85) and life satisfaction at week 4 ( OR=0.97, 95% CI=0.94-0.99).A higher baseline anxiety levels ( OR=1.38, 95% CI=1.27-1.50), lower severity of baseline depressive symptoms ( OR=0.83, 95% CI=0.80-0.86), younger age ( OR=0.44, 95% CI=0.25-0.75), and lower baseline life satisfaction ( OR=0.96, 95% CI=0.95-0.97) were associated with a higher risk of complete loss of follow-up.There was a significant association between the research center and the loss of follow-up rate at week 4, 8, and complete visits. Conclusions:Patients with first episode depression in the acute phase, younger onset age, lower depression severity, comorbid anxiety symptom, and poor or no improvement in disease-related quality of life/satisfaction were associated with a higher risk of loss of follow-up in the prospective cohort study.

Objective To investigate the effect of progesterone receptor membrane component 1(PGRMC1)mediated autophagy on the sensitivity of liver cancer cells to 125I particles irradiation.Methods Hepatoma cell lines Huh7 and LM3 were exposed to different doses(0,2,4,6 and 8 Gy)of 125I particles,and cell autophagy was observed by transmission electron microscopy(TEM).Then,autophagy inhibitor chloroquine(CQ),agonist rapamycin(Rapa),and PGRMC1 inhibitor AG-205 were used respectively to verify that PGRMC1-mediated autophagy plays a key role in the sensitivity of hepatocellular carcinoma cells to 125I particle irradiation.Cell proliferation,colony formation and apoptosis were detected by CCK-8 assay,clonal formation test and flow cytometry,respectively.The expression levels of PGRMC1,microtubule-associated protein light chain 3-Ⅰ(LC3-Ⅰ),LC3-Ⅱ and p62 were detected by Western blotting.Results Different doses of 125I particles irradiation significantly decreased the proliferation and clonogenesis of Huh7 and LM3 cells(P＜0.05),and increased the apoptotic cells(P＜0.01),in a dose-dependent manner.Compared with the 0 Gy group,the ratio of LC3-Ⅱ/LC3-Ⅰ in Huh7 and LM3 cells was obviously increased,and the expression of p62 was significantly down-regulated in the 6 Gy group.The proliferation capacity and clonal formation ability of Huh7 and LM3 cells were decreased significantly,and their apoptotic cells were increased notably in the 6 Gy+CQ group than the 6 Gy group,while the above results were on the contrary in the 6 Gy+Rapa group.The 6 Gy+AG205 group had notably decreased LC3-Ⅱ/LC3-Ⅰ ratio in the Huh7 and LM3 cells,up-regulated p62 expression,reduced cell proliferation capacity and clone formation ability,and enhanced cell apoptosis when compared with the 6 Gy group,and the above results of the 6 Gy+PGRMC1 group were opposite.Conclusion Increment of PGRMC1 induced by 125I irradiation can promote autophagy,increase the proliferation and clonogenesis,and reduce the apoptosis in hepatocellular carcinoma cells.

The medical big data platform for mental illness was constructed by analyzing the clinical characteris-tics and application needs of mental disorders,which was built on the Hadoop ecological construction and used com-mon data model and standard data element dictionary.The construction of the medical big data platform distributes computing framework which provides real-time and full-scale computing,machine learning,and map computing ca-pabilities of medical data,provides efficient inquiries,multi-dimensional statistics and analysis,and supports for scientific research,medical service quality management and operation management.