Objective:To investigate the value of biparametric-MRI (bpMRI) based peritumoral radiomics for preoperative prediction of extraprostatic extension (EPE) in prostate cancer (PCa).Methods:In this cross-sectional study, consecutive bpMRI of patients undergoing prostatectomy for PCa were retrospectively collected from the First Medical Center (center 1) and the Third Medical Center (center 2) of Chinese PLA General Hospital. A total of 274 patients were finally enrolled. Patients at center 1 from January 2020 to December 2022 were randomly divided into a training set (149 cases) and an internal validation set (63 cases) by stratified random sampling. Patients at center 2 from January 2023 to March 2024 were assigned to the external test set (62 cases). Patients were categorized into EPE-positive group and EPE-negative group according to pathological assessment postoperatively. In the training set, there were 49 cases in EPE-positive group and 100 cases in EPE-negative group. In the internal validation set, there were 26 cases in EPE-positive group and 37 cases in EPE-negative group. In the external test set, there were 22 cases in EPE-positive group and 40 cases in EPE-negative group. Axial T 2WI and apparent diffusion coefficient (ADC) images were manually annotated to obtain index lesion regions of interest (ROIs), with the peritumoral ROIs subsequently delineated by semi-automatic segmentation technique. Radiomics features were extracted from intra-tumoral, peri-tumoral, and intra-tumoral plus peri-tumoral ROIs. The training set data was employed to select and optimize features to build the radiomics models. The logistic regression analysis was used to develop radiomics, clinical, and integrated models. The predictive performance was assessed by the area under the receiver operating characteristic curve (AUC) in the external test set, and compared by the DeLong test. The sensitivity and specificity were compared by the exact McNemar test. Results:In the external test set, the peri-tumoral radiomics model based on bpMRI showed the highest performance in evaluating EPE, with an AUC of 0.739 (95% CI 0.611-0.842), which was identified as the optimal radiomics model. EPE grade ( OR=6.151, 95% CI 3.371-11.226, P<0.001) was incorporated into the clinical model, with an AUC of 0.780 (95% CI 0.657-0.875) in the external test set. The integrated model had an AUC of 0.817 (95% CI 0.698-0.904) in the external test set. There was no statistically significant difference in comparisons of AUCs among the three models (all P>0.05). The sensitivity of the integrated model (68.2%) showed no significant difference from those of the clinical model and the optimal radiomics model (77.3% and 86.4%, respectively; P=0.500 and P=0.289). However, the specificity of the integrated model (85.0%) was significantly higher than those of the clinical model (67.5%, P=0.016) and the optimal radiomics model (50.0%, P<0.001). Conclusion:A bpMRI-based peritumoral radiomics integrating clinical model demonstrates high performance for preoperative prediction of EPE in PCa.

Objective:To investigate the impact of traumatic experiences on panic attack,depression and anxi-ety symptoms among community residents.Methods:Totally 11 280 community residents were recruited.The Com-posite International Diagnostic Interview-3.0,Patient Health Questionnaire,7-item Generalized Anxiety Disorder Scale and general information questionnaire were used for face-to-face interview to collect information.Propensity Score Matching was conducted to match 5 184 community residents for analysis.Logistic regression was employed to analyze the impact of traumatic events on panic attack,depressive symptoms,and anxiety symptoms among the study sample.Results:Traumatic events were associated with a higher likelihood of experiencing panic attack(OR=3.26,95％CI:2.26-4.70),depression symptoms(OR=1.92,95％CI:1.56-2.37)and anxiety symptoms(OR=1.57,95％CI:1.24-1.99).Conclusion:Traumatic events extensively impact the mental health of commu-nity residents.Timely psychological support and early intervention are essential to prevent mental health issues in community residents affected by trauma.

Objective:To investigate the impact of traumatic experiences on panic attack,depression and anxi-ety symptoms among community residents.Methods:Totally 11 280 community residents were recruited.The Com-posite International Diagnostic Interview-3.0,Patient Health Questionnaire,7-item Generalized Anxiety Disorder Scale and general information questionnaire were used for face-to-face interview to collect information.Propensity Score Matching was conducted to match 5 184 community residents for analysis.Logistic regression was employed to analyze the impact of traumatic events on panic attack,depressive symptoms,and anxiety symptoms among the study sample.Results:Traumatic events were associated with a higher likelihood of experiencing panic attack(OR=3.26,95％CI:2.26-4.70),depression symptoms(OR=1.92,95％CI:1.56-2.37)and anxiety symptoms(OR=1.57,95％CI:1.24-1.99).Conclusion:Traumatic events extensively impact the mental health of commu-nity residents.Timely psychological support and early intervention are essential to prevent mental health issues in community residents affected by trauma.

Objective:To explore the effects of the deep Theta burst stimulation (dTBS) applied to the bilateral dorsolateral prefrontal cortex on depressive symptoms and executive functions in patients with depression.Methods:The clinical data of a total of 98 patients with depression who were outpatients and inpatients in the Mental Health Center of the First Hospital of Hebei Medical University from June 2023 to October 2024 were prospectively collected, including 37 males and 61 females, aged 18-65 (37.4±13.3) years. Patients were randomly assigned to one of three groups: an active dTBS+drug therapy group (active stimulation group, n=33), a sham dTBS+drug therapy group (sham stimulation group, n=32), and a drug therapy group ( n=33). A shielding cover was added over the sham dTBS coil to increase the distance between the coil and the cortical surface, thereby achieving the sham stimulation effect. During each treatment, both active and sham dTBS were first applied by 1, 200 pulses of intermittent dTBS (diTBS) to the left dorsolateral prefrontal cortex, followed by 600 pulses of continuous dTBS (dcTBS) to the right dorsolateral prefrontal cortex. Before treatment and two weeks after treatment, the Hamilton Anxiety Scale (HAMA) and 17-Item Hamilton Depression Scale (HAMD 17) were used to evaluate patients′ depression and anxiety, and the Symbol Digit Coding Test of the Chinese Brief Cognitive Test (C-BCT) was used to assess the executive functions. The 32-item Hypomania Checklist (HCL-32) as well as the Mood Disorder Questionnaire (MDQ) were used to evaluate the risk of treatment-emergent mania. The primary outcomes included reduction rate in HAMD 17 and HAMA scores, as well as changes in the Symbol Digit Coding Test of the C-BCT. Secondary outcomes encompassed HAMD 17 treatment response rate, adverse events, and the risk of treatment-emergent mania. The differences in efficacy between the three groups were compared using one-way ANOVA and LSD post-hoc analysis (reduction rate in HAMD 17 scores, reduction rate in HAMA scores, and changes in the Symbol Digit Coding Test of the C-BCT). Results:At the end of the 2nd week of the treatment, the HAMD 17 reduction rate in the active stimulation group was higher than the sham stimulation group and the drug therapy group, with a significant difference (59.4 (46.9, 80.2) % vs 47.6 (31.2, 58.3) %, H=18.95, P=0.006; 59.4 (46.9, 80.2) % vs 35.5 (20.0, 50.0) %, H=31.10, P<0.001). The HAMA reduction rate in the active stimulation group and the sham stimulation group were higher than the drug therapy group, with a significant difference (52.6 (43.5, 65.7) % vs 2.1 (21.1, 58.8) %, H=21.31, P=0.002; 52.9 (41.7, 62.5) % vs 32.1 (21.1, 58.8) %, H=14.4, P=0.037). The changes in the symbol digit coding test of the C-BCT in the active stimulation group were significantly higher than the sham stimulation group and the drug therapy group (6.3±2.1 scores vs 2.9±3.2 scores, F=5.02, P=0.011; 6.3±2.1 scores vs 2.8±3.1 scores, F=5.02, P=0.009). The incidence rate of adverse events in the active stimulation group was 12.1% (4/33) and 3.1% (1/32) in the sham stimulation group, and there was no significant difference in the incidence of adverse events between the two groups (χ 2=0.17, P=0.355). Conclusion:Bilateral dTBS stimulation of the dorsolateral prefrontal cortex combined with drug therapy can improve depressive symptoms and executive functions, such as information processing speed, attention and working memory.

Objective:To investigate the value of biparametric-MRI (bpMRI) based peritumoral radiomics for preoperative prediction of extraprostatic extension (EPE) in prostate cancer (PCa).Methods:In this cross-sectional study, consecutive bpMRI of patients undergoing prostatectomy for PCa were retrospectively collected from the First Medical Center (center 1) and the Third Medical Center (center 2) of Chinese PLA General Hospital. A total of 274 patients were finally enrolled. Patients at center 1 from January 2020 to December 2022 were randomly divided into a training set (149 cases) and an internal validation set (63 cases) by stratified random sampling. Patients at center 2 from January 2023 to March 2024 were assigned to the external test set (62 cases). Patients were categorized into EPE-positive group and EPE-negative group according to pathological assessment postoperatively. In the training set, there were 49 cases in EPE-positive group and 100 cases in EPE-negative group. In the internal validation set, there were 26 cases in EPE-positive group and 37 cases in EPE-negative group. In the external test set, there were 22 cases in EPE-positive group and 40 cases in EPE-negative group. Axial T 2WI and apparent diffusion coefficient (ADC) images were manually annotated to obtain index lesion regions of interest (ROIs), with the peritumoral ROIs subsequently delineated by semi-automatic segmentation technique. Radiomics features were extracted from intra-tumoral, peri-tumoral, and intra-tumoral plus peri-tumoral ROIs. The training set data was employed to select and optimize features to build the radiomics models. The logistic regression analysis was used to develop radiomics, clinical, and integrated models. The predictive performance was assessed by the area under the receiver operating characteristic curve (AUC) in the external test set, and compared by the DeLong test. The sensitivity and specificity were compared by the exact McNemar test. Results:In the external test set, the peri-tumoral radiomics model based on bpMRI showed the highest performance in evaluating EPE, with an AUC of 0.739 (95% CI 0.611-0.842), which was identified as the optimal radiomics model. EPE grade ( OR=6.151, 95% CI 3.371-11.226, P<0.001) was incorporated into the clinical model, with an AUC of 0.780 (95% CI 0.657-0.875) in the external test set. The integrated model had an AUC of 0.817 (95% CI 0.698-0.904) in the external test set. There was no statistically significant difference in comparisons of AUCs among the three models (all P>0.05). The sensitivity of the integrated model (68.2%) showed no significant difference from those of the clinical model and the optimal radiomics model (77.3% and 86.4%, respectively; P=0.500 and P=0.289). However, the specificity of the integrated model (85.0%) was significantly higher than those of the clinical model (67.5%, P=0.016) and the optimal radiomics model (50.0%, P<0.001). Conclusion:A bpMRI-based peritumoral radiomics integrating clinical model demonstrates high performance for preoperative prediction of EPE in PCa.

Objective:To establish a prognostic model based on endoplasmic reticulum stress-related genes for evaluating the prognosis of patients with renal cell carcinoma.Methods:This study utilized Non-negative Matrix Factorization to identify molecular subgroups based on endoplasmic reticulum stress-related genes and employed Weighted Correlation Network Analysis to determine co-expressed genes associ-ated with these subgroups.A risk prognostic model was constructed using univariate Cox regression analysis and Lasso regression analysis.Preliminary experimental validations were conducted to elucidate the biological functions of model genes in renal cell carcinoma.Results:Two molecular subgroups with distinct survival prognoses were identified,and an intersection of related genes was used to construct a nov-el endoplasmic reticulum stress-related prognostic model.Patients in the high-risk group exhibited significantly poorer overall survival in both the training and validation cohorts.In vivo experiments demonstrated that PCK1,a model gene,could inhibit the proliferation,migra-tion,and invasion of renal cell carcinoma cells.Conclusions:The risk scoring model developed in this study effectively predicts the survival probability of renal cell carcinoma patients and can serve as an independent prognostic indicator.This model offers a new direction for per-sonalized treatment strategies in renal cell carcinoma patients.

Objective:To establish a prognostic model based on endoplasmic reticulum stress-related genes for evaluating the prognosis of patients with renal cell carcinoma.Methods:This study utilized Non-negative Matrix Factorization to identify molecular subgroups based on endoplasmic reticulum stress-related genes and employed Weighted Correlation Network Analysis to determine co-expressed genes associ-ated with these subgroups.A risk prognostic model was constructed using univariate Cox regression analysis and Lasso regression analysis.Preliminary experimental validations were conducted to elucidate the biological functions of model genes in renal cell carcinoma.Results:Two molecular subgroups with distinct survival prognoses were identified,and an intersection of related genes was used to construct a nov-el endoplasmic reticulum stress-related prognostic model.Patients in the high-risk group exhibited significantly poorer overall survival in both the training and validation cohorts.In vivo experiments demonstrated that PCK1,a model gene,could inhibit the proliferation,migra-tion,and invasion of renal cell carcinoma cells.Conclusions:The risk scoring model developed in this study effectively predicts the survival probability of renal cell carcinoma patients and can serve as an independent prognostic indicator.This model offers a new direction for per-sonalized treatment strategies in renal cell carcinoma patients.

Objective:To explore the effects of the deep Theta burst stimulation (dTBS) applied to the bilateral dorsolateral prefrontal cortex on depressive symptoms and executive functions in patients with depression.Methods:The clinical data of a total of 98 patients with depression who were outpatients and inpatients in the Mental Health Center of the First Hospital of Hebei Medical University from June 2023 to October 2024 were prospectively collected, including 37 males and 61 females, aged 18-65 (37.4±13.3) years. Patients were randomly assigned to one of three groups: an active dTBS+drug therapy group (active stimulation group, n=33), a sham dTBS+drug therapy group (sham stimulation group, n=32), and a drug therapy group ( n=33). A shielding cover was added over the sham dTBS coil to increase the distance between the coil and the cortical surface, thereby achieving the sham stimulation effect. During each treatment, both active and sham dTBS were first applied by 1, 200 pulses of intermittent dTBS (diTBS) to the left dorsolateral prefrontal cortex, followed by 600 pulses of continuous dTBS (dcTBS) to the right dorsolateral prefrontal cortex. Before treatment and two weeks after treatment, the Hamilton Anxiety Scale (HAMA) and 17-Item Hamilton Depression Scale (HAMD 17) were used to evaluate patients′ depression and anxiety, and the Symbol Digit Coding Test of the Chinese Brief Cognitive Test (C-BCT) was used to assess the executive functions. The 32-item Hypomania Checklist (HCL-32) as well as the Mood Disorder Questionnaire (MDQ) were used to evaluate the risk of treatment-emergent mania. The primary outcomes included reduction rate in HAMD 17 and HAMA scores, as well as changes in the Symbol Digit Coding Test of the C-BCT. Secondary outcomes encompassed HAMD 17 treatment response rate, adverse events, and the risk of treatment-emergent mania. The differences in efficacy between the three groups were compared using one-way ANOVA and LSD post-hoc analysis (reduction rate in HAMD 17 scores, reduction rate in HAMA scores, and changes in the Symbol Digit Coding Test of the C-BCT). Results:At the end of the 2nd week of the treatment, the HAMD 17 reduction rate in the active stimulation group was higher than the sham stimulation group and the drug therapy group, with a significant difference (59.4 (46.9, 80.2) % vs 47.6 (31.2, 58.3) %, H=18.95, P=0.006; 59.4 (46.9, 80.2) % vs 35.5 (20.0, 50.0) %, H=31.10, P<0.001). The HAMA reduction rate in the active stimulation group and the sham stimulation group were higher than the drug therapy group, with a significant difference (52.6 (43.5, 65.7) % vs 2.1 (21.1, 58.8) %, H=21.31, P=0.002; 52.9 (41.7, 62.5) % vs 32.1 (21.1, 58.8) %, H=14.4, P=0.037). The changes in the symbol digit coding test of the C-BCT in the active stimulation group were significantly higher than the sham stimulation group and the drug therapy group (6.3±2.1 scores vs 2.9±3.2 scores, F=5.02, P=0.011; 6.3±2.1 scores vs 2.8±3.1 scores, F=5.02, P=0.009). The incidence rate of adverse events in the active stimulation group was 12.1% (4/33) and 3.1% (1/32) in the sham stimulation group, and there was no significant difference in the incidence of adverse events between the two groups (χ 2=0.17, P=0.355). Conclusion:Bilateral dTBS stimulation of the dorsolateral prefrontal cortex combined with drug therapy can improve depressive symptoms and executive functions, such as information processing speed, attention and working memory.

Objective To explore association between childhood trauma,resilience and non-suicidal self-injury in adolescents.Methods One hundred and fifty-eight first-episode adolescent patients with mood disorders were selected and divided into NSSI group(n=94)and non-NSSI group(n=64)based on presence or absence of NSSI.The Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA),childhood trauma questionnaire(CTQ-SF)and Connor-Davidson resilience scale(CD-RISC)were used to evaluate the depression and anxiety symptoms,childhood trauma and resilience.Results There were more cases of younger age(16.17±1.67 vs.16.73±1.37),lower education level(30.9% vs.15.6% ),left behind experience(48.9% vs.29.7% ),school bullying(46.8% vs.25.0% ),suicide ideation(85.1% vs.37.5% )and history of attempted suicide(29.8% vs.6.3% )in the group with NSSI compared to those without NSSI.The HAMD score(27.99±5.94 vs.24.19±5.19),HAMA score(18.02±5.94 vs.15.45±4.99),CTQ total score(48.43±15.40 vs.41.97±9.75),emotional abuse score(12.77±6.06 vs.10.19±4.06),and emotional neglect score(11.40±5.34 vs.9.14±3.55)were higher in the group with NSSI,and the differences between the two groups were significant(P<0.05).The total scores of psychological resilience(39.83±10.27 vs.28.66±12.75),resilience(19.59±4.92 vs.12.28±6.47),strength(12.03±3.98 vs.9.99±4.67),and optimism(8.98±2.97 vs.6.47±3.73)in the group without NSSI were higher than those in the group with NSSI(P<0.05).Logistic regression analysis showed that left behind experience(OR=4.494,95% CI:1.192-16.940),school bullying(OR=5.983,95% CI:1.329-26.945),suicidal ideation(OR=13.225,95% CI:2.908-60.146),history of attempted suicide(OR=16.769,95% CI:1.845-152.379),HAMD(OR=1.264,95% CI:1.046-1.626),emotional abuse(OR=1.327,95% CI:1.093-1.612),and resilience(OR=0.468,95% CI:0.266-0.823)were significantly associated with adolescent mood disorders with NSSI(P<0.05).Conclusion Left behind experience,campus bullying,suicidal ideation and attempted suicide,emotional abuse,degree of depression,and psychological resilience may be associated with NSSI behavior in adolescents with mood disorders.

Objective To compare the effects of ginsenosides Rg1 and Rb1 on depression-and anxiety-like behaviors in chronic unpredictable stress-induced rats.Methods Seventy male SPF grade SD rats were tested for sugar and water preference after 5 days of adaptation and divided into seven groups according to their preference index:a control group,model group,fluoxetine hydrochloride group,ginsenoside Rg1 24 mg/kg group,ginsenoside Rg1 48 mg/kg group,ginsenoside Rb1 33 mg/kg group,and ginsenoside Rb1 67 mg/kg group.All rats,except for the control group,were subjected randomly to one or two different stimulating factors every day for a total of 35 days.On the 36th day,behavioral experiments including sugar and water preference,open field,novel environment feeding inhibition,elevated cross maze,and forced swimming experiments were conducted to investigate the anti-depression and anti-anxiety effects of the treatments.Serum and hippocampal levels of interleukin(IL)-1β,IL-6,tumor necrosis factor(TNF)-α and serum corticosterone were measured by enzyme-linked immunosorbent assay.Results Compared with the model group,ginsenoside Rg1 and Rb1 significantly increased sucrose consumption in the sucrose preference test and decreased immobility in the forced swimming test.Ginsenoside Rg1(48 mg/kg)significantly reduced the latency to eat in the novelty-suppressed feeding test,and ginsenoside Rg1(24 and 48 mg/kg)significantly increased the percentage of open arm entries and time in the elevated cross maze test.Serum corticosterone levels were significantly decreased in the ginsenoside Rg1 and Rb1 groups,serum IL-1β and IL-6 levels were significantly decreased in the ginsenoside Rg1(48 mg/kg)group,serum TNF-α and IL-6 levels were significantly decreased in the ginsenoside Rb1(33 mg/kg)group,and IL-1β,IL-6,and TNF-α levels in the hippocampus were significantly decreased in the ginsenoside Rg1(48 mg/kg)and Rb1(67 mg/kg)groups.Conclusions Both ginsenosides can regulate the hypothalamic-pituitary-adrenal axis and inhibit neuroinflammation,improving depression-and anxiety-like behaviors in rats induced by chronic unpredictable stress.Ginsenoside Rg1 has a significantly better anti-anxiety effect than Rb1.