ObjectiveTo investigate somatization symptoms in adolescents during frequent earthquakes in Hefei， and to explore their correlation with earthquake experiences. MethodsA cross-sectional survey was used to select 324 adolescents in Hefei as the survey objects. The self-rating scale of somatization symptoms （SSS） and the fatigue intensity scale （FIS） were used to evaluate the somatization symptoms and fatigue degree of middle school students， and multivariate Logistic regression analysis was used to explore the related factors of somatization symptoms and fatigue among middle school students. ResultsA total of 324 adolescents were included， and the overall detection rate of somatization symptoms was 6.5%， and the detection rate of moderate or above fatigue was 20.1%. The results of regression analysis showed that adolescents who were concerned about the earthquake for a longer time （≥1 h） had a higher risk of somatization symptoms （OR=5.430， 95%CI： 1.547-19.058）， and adolescents who received pre-earthquake training had a lower degree of fatigue （OR=0.535， 95%CI： 0.292-0.981） （P<0.05）. ConclusionDuring the frequent earthquakes， adolescents have more somatization symptoms and fatigue. Therefore， it is crucial to enhance health education， reduce the emphasis on event-related reports， and implement earthquake prevention and disaster reduction training to improve the physical and mental health of adolescents.

BackgroundAggressive behavior in schizophrenic patients could result in legal disputes and public safety concerns. In patients with illness episodes of different numbers， there may exist differences in the association between levels of novel inflammatory indicators and aggressivity. ObjectiveTo investigate the differences in the correlation between levels of novel inflammatory indicators and aggressivity in patients with first-episode and recurrent schizophrenia， in order to search for inflammatory biomarkers to assess aggression level in schizophrenic patients. MethodsA total of 168 schizophrenic patients were selected as subjects， who were hospitalized for acute disease onset in Chaohu Hospital of Anhui Medical University from October 2022 to April 2024 as well as met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. Patients were divided into first-episode group （n=58） and recurrent group （n=110）. Meanwhile， 110 healthy controls from community who matched in age and gender with the patient group were recruited. All patients were evaluated with Modified Overt Aggression Scale （MOAS） and Positive and Negative Syndrome Scale （PANSS）. All subjects went through examination of the levels of novel inflammatory indicators， including neutrophil/lymphocyte ratio （NLR）， monocyte/lymphocyte ratio （MLR）， platelet/lymphocyte ratio （PLR）， neutrophil/high-density lipoprotein ratio （NHR）， monocyte/high-density lipoprotein ratio （MHR） and platelet/high-density lipoprotein ratio （PHR）. Spearman correlation analysis was adopted to investigate the correlation between levels of novel inflammatory indicators and the total score of MOAS in patients with first-episode and recurrent schizophrenia. ResultsThe levels of NLR， MLR， PLR， NHR， MHR and PHR in first-episode group were higher than those in control group （adjusted P<0.01）. The levels of NLR， MLR， NHR， MHR and PHR in recurrent group were higher than those in control group （adjusted P<0.01）. No significant difference was observed in the comparison in the levels of six novel inflammatory indicators between first-episode group and recurrent group （adjusted P>0.05）. Spearman correlation analysis showed， the MOAS total score of recurrent group was positively correlated with the levels of NLR， MLR and PLR （r=0.234， 0.192， 0.243， P<0.05）. There was no statistical significance in the correlation between MOAS total score and levels of six novel inflammatory indicators in first-episode group （P>0.05）. ConclusionAmong patients with first-episode and recurrent schizophrenia， the correlation between levels of novel inflammatory indicators and aggressivity could differ. NLR， MLR and PLR might be the biomarkers for assessing aggression level in recurrent schizophrenic patients. ［Funded by Anhui Provincial Natural Science Foundation （number， 2108085MH275）］

Objective: To investigate associations of suicidal ideation with clinical features, inflammatory markers, and thyroid hormones in patients with schizophrenia. Methods: The subjects of this study were 203 schizophrenic patients, grouped on the basis of suicidal ideation. Clinical characteristics were assessed using multiple scales. Neutrophil to lymphocyte ratio(NLR), platelet to lymphocyte ratio(PLR), monocyte to lymphocyte ratio(MLR) and thyroid hormones were also detected. SPSS 23.0 was used for statistical analyses. Results : The prevalence of suicidal ideation was 21.7% in patients with schizophrenia. Logistic stepwise regression analyses showed that Calgary depression scale(CDSS) total score(OR=1.490, 95%CI=1.287-1.724,P<0.001), insomnia severity index scale(ISI) total score(OR=1.096, 95%CI=1.011-1.187,P=0.025), modified overt aggression scale(MOAS) total score(OR=1.111, 95%CI=1.016-1.215,P=0.021), MLR(Ln)(OR=15.123, 95%CI=3.868-59.125,P<0.001), and triiodothyronine(T3)(OR=0.037, 95%CI=0.003-0.388,P=0.006) were the independent influences of suicidal ideation. Additionally, receiver operating characteristic(ROC) curve analyses revealed that the five-item combination of CDSS total score, ISI total score, MOAS total score, MLR(Ln), and T3(AUC=0.908, 95%CI=0.867-0.949,P<0.001) had better ability to identify suicidal ideation. Conclusion The risk of suicidal ideation is relatively high in patients with schizophrenia, and there may be stronger associations between suicidal ideation and depression, insomnia, aggression, MLR, and T3.

Major depressive disorder (MDD) is one of the most common mental health problems in children and adolescents and constitutes a significant risk factor for disability and mortality in this population. Depressive symptoms often present as early manifestations of various childhood psychiatric conditions and may be misdiagnosed as MDD. However, early symptoms of depressive disorder in children and adolescents are frequently atypical, manifesting as personality changes, somatic complaints, or anxiety symptoms, leading to a high rate of misdiagnosis and inapproprate treatment. Familiarity with the clinical features and intervention strategies of MDD in children and adolescents is essential for improving clinicians′ ability to achieve early recognition and initiate appropriate treatment. This review summarizes current research from three perspectives: an overview of MDD in children and adolescents, pre-treatment assessment, and therapeutic strategies, to provide a reference for the clinical diagnosis and treatment.

Major depressive disorder (MDD) is one of the most common mental health problems in children and adolescents and constitutes a significant risk factor for disability and mortality in this population. Depressive symptoms often present as early manifestations of various childhood psychiatric conditions and may be misdiagnosed as MDD. However, early symptoms of depressive disorder in children and adolescents are frequently atypical, manifesting as personality changes, somatic complaints, or anxiety symptoms, leading to a high rate of misdiagnosis and inapproprate treatment. Familiarity with the clinical features and intervention strategies of MDD in children and adolescents is essential for improving clinicians′ ability to achieve early recognition and initiate appropriate treatment. This review summarizes current research from three perspectives: an overview of MDD in children and adolescents, pre-treatment assessment, and therapeutic strategies, to provide a reference for the clinical diagnosis and treatment.

Objective:To explore the correlation between peripheral plasma cytokine levels and disease severity in adolescents with first-episode and recurrent depression.Methods:Clinical data were prospectively collected on a total of 134 adolescents with depression, including 36 males and 98 females, aged 12-18 (15.3±1.5) years, who were either the outpatients or the inpatients in the Department of Psychiatry of Chaohu Hospital of Anhui Medical University and the Hefei Fourth People′s Hospital from October 2020 to March 2022. Patients were classified into 76 first-episode depression (first-episode group) and 58 recurrent depression (recurrent group) according to whether the depressive symptoms were in their first episode or not. During the same period, 76 age-matched healthy controls (health controls group) were recruited, including 45 males and 31 females, aged 12-18 (15.1±1.8) years. The 24-item Hamilton Depression Scale (HAMD 24) was used to assess the severity of depression in the patients, and a total HAMD 24 score of 35 was used as the cutoff point to classify the depressive patients into mild-to-moderate (52 patients) and severe depression (24 patients). Plasma interleukin (IL)-10, IL-17A, IL-1β, IL-6, IL-8, and tumor necrosis factor-α (TNF-α) levels of patients were measured using meso scale discovery. Spearman correlation analysis was used to analyze the relationship between cytokine levels and disease severity in patients with depression; multiple linear regression was used to analyze the factors influencing disease severity in the first-episode group, and binary logistic regression was used to analyze the risk factors in severely ill patients in the first-episode group. Results:Comparison of plasma IL-1β, IL-6 and TNF-α ( H=6.46, 6.75, 6.41, all P<0.05) levels between the 3 groups of subjects showed statistically significant differences; posthoc analysis showed no statistically significant differences in plasma cytokine levels between the first-episode group and the recurrent group(all P>0.05); the plasma IL-6 levels in the first-episode group were significantly higher compared with the healthy controls [ M( Q1, Q3)] [1.69 (1.17, 2.45) ng/L vs 1.34 (1.05, 2.06) ng/L, Z=-2.67, PBonferroni correction=0.030]. Spearman correlation analysis showed a positive correlation between the HAMD-24 total score and the levels of IL-17A, IL-1β, IL-6, and TNF-α ( r=0.275, 0.260, 0.300, 0.331, all P<0.05) in the first-episode group, and no correlation was found between the HAMD 24 total score and any cytokine in the recurrent group. In the first-episode group, plasma IL-10, IL-17A, IL-1β, IL-6, and TNF-α levels were significantly higher in severely ill patients compared to mildly/moderately ill patients[0.48 (0.33, 0.72) ng/L vs 0.63 (0.46, 1.10) ng/L, 1.89 (1.22, 3.04) ng/L vs 3.01 (1.94, 5.18) ng/L, 0.17 (0.12, 0.36) ng/L vs 0.42 (0.22, 0.65) ng/L, 1.55 (1.12, 2.05) ng/L vs 2.30 (1.68, 3.75) ng/L, 0.92 (0.77, 1.38) ng/L vs 1.42 (0.95, 2.15) ng/L respectively, all P<0.05]. Both multiple linear regression and binary logistic regression analyses showed that LgIL-6 level was independently associated with the severity of disease (multiple linear regression: β=2.550,95 %CI:1.258-10.724, P<0.05; binary logistic regression: OR=12.499,95 %CI:2.061-75.806, P<0.05). Conclusion:Higher levels of plasma IL-6 correlate with more severe depressive symptoms in adolescents with first-episode depressive disorder and are a risk factor for severely ill patients with depression.

Objective:To explore the correlation between attempted suicide and childhood trauma as well as inflammatory cytokines levels in adolescents with depressive disorder.Methods:From January to December 2021, a total of 164 adolescents with depressive disorder were included and categorized into attempted suicide group ( n=108) and non-attempted suicide group ( n=56) according to whether they accompanied attempted suicide or not. The Chinese version of the suicide module of MINI 5.0, the childhood trauma questionnaire(CTQ), and the center for epidemiological studies depression scale (CES-D) were used to assess suicidal behavior, childhood trauma and depressive symptoms, while the plasma inflammatory cytokines levels were measured by electrochemiluminescence technology. The data were statistically analyzed by SPSS 23.0 software. Logistic regression was applied to analyze the independent influencing factors of attempted suicide and the predictive value of each independent risk factor for attempted suicide was assessed by receiver operating characteristic curve(ROC) curves. Results:The prevalence of attempted suicide was 65.9%(108/164) in adolescents with depressive disorder.The univariate analyses showed that the total CTQ score ((55.19±12.44), (45.50±12.11)) ( t=-4.771, P<0.001), CES-D total score ((40.75±10.26), (32.98±13.39)) ( t=-4.131, P<0.001), IL-6 level(1.87 (1.32, 2.69) pg/mL, 1.56 (1.05, 1.87) pg/mL)( Z=-3.102, P=0.002), IL-10 level (0.53 (0.38, 0.83) pg/mL, 0.47 (0.31, 0.69) pg/mL) ( Z=-2.100, P=0.036) and IL-17A level (2.20 (1.52, 3.65) pg/mL, 1.67 (1.25, 2.97) pg/mL) ( Z=-2.254, P=0.024) in plasma of patients in the attempted suicide group were significantly higher than those in non-attempted suicide group. Logistic stepwise regression analyses showed that CTQ total score, IL-6, IL-10, and IL-17A were risk factors for attempted suicide in adolescents with depressive disorder.The ROC showed that the total score of CTQ combined with IL-6 (AUC=0.782, 95% CI=0.709-0.855, P<0.001), the total score of CTQ combined with IL-10 (AUC=0.765, 95% CI=0.688-0.841, P<0.001), and the total score of CTQ combined with IL-17A (AUC=0.762, 95% CI=0.684-0.840, P<0.001) had a larger area under the curve, indicating better recognition and prediction ability for attempted suicide, with high sensitivity and specificity. Conclusion:The incidence of attempted suicide in adolescents with depressive disorder is high, and which is closely related to childhood trauma and the levels of inflammatory cytokines.

Objective:To explore the correlation between peripheral plasma cytokine levels and disease severity in adolescents with first-episode and recurrent depression.Methods:Clinical data were prospectively collected on a total of 134 adolescents with depression, including 36 males and 98 females, aged 12-18 (15.3±1.5) years, who were either the outpatients or the inpatients in the Department of Psychiatry of Chaohu Hospital of Anhui Medical University and the Hefei Fourth People′s Hospital from October 2020 to March 2022. Patients were classified into 76 first-episode depression (first-episode group) and 58 recurrent depression (recurrent group) according to whether the depressive symptoms were in their first episode or not. During the same period, 76 age-matched healthy controls (health controls group) were recruited, including 45 males and 31 females, aged 12-18 (15.1±1.8) years. The 24-item Hamilton Depression Scale (HAMD 24) was used to assess the severity of depression in the patients, and a total HAMD 24 score of 35 was used as the cutoff point to classify the depressive patients into mild-to-moderate (52 patients) and severe depression (24 patients). Plasma interleukin (IL)-10, IL-17A, IL-1β, IL-6, IL-8, and tumor necrosis factor-α (TNF-α) levels of patients were measured using meso scale discovery. Spearman correlation analysis was used to analyze the relationship between cytokine levels and disease severity in patients with depression; multiple linear regression was used to analyze the factors influencing disease severity in the first-episode group, and binary logistic regression was used to analyze the risk factors in severely ill patients in the first-episode group. Results:Comparison of plasma IL-1β, IL-6 and TNF-α ( H=6.46, 6.75, 6.41, all P<0.05) levels between the 3 groups of subjects showed statistically significant differences; posthoc analysis showed no statistically significant differences in plasma cytokine levels between the first-episode group and the recurrent group(all P>0.05); the plasma IL-6 levels in the first-episode group were significantly higher compared with the healthy controls [ M( Q1, Q3)] [1.69 (1.17, 2.45) ng/L vs 1.34 (1.05, 2.06) ng/L, Z=-2.67, PBonferroni correction=0.030]. Spearman correlation analysis showed a positive correlation between the HAMD-24 total score and the levels of IL-17A, IL-1β, IL-6, and TNF-α ( r=0.275, 0.260, 0.300, 0.331, all P<0.05) in the first-episode group, and no correlation was found between the HAMD 24 total score and any cytokine in the recurrent group. In the first-episode group, plasma IL-10, IL-17A, IL-1β, IL-6, and TNF-α levels were significantly higher in severely ill patients compared to mildly/moderately ill patients[0.48 (0.33, 0.72) ng/L vs 0.63 (0.46, 1.10) ng/L, 1.89 (1.22, 3.04) ng/L vs 3.01 (1.94, 5.18) ng/L, 0.17 (0.12, 0.36) ng/L vs 0.42 (0.22, 0.65) ng/L, 1.55 (1.12, 2.05) ng/L vs 2.30 (1.68, 3.75) ng/L, 0.92 (0.77, 1.38) ng/L vs 1.42 (0.95, 2.15) ng/L respectively, all P<0.05]. Both multiple linear regression and binary logistic regression analyses showed that LgIL-6 level was independently associated with the severity of disease (multiple linear regression: β=2.550,95 %CI:1.258-10.724, P<0.05; binary logistic regression: OR=12.499,95 %CI:2.061-75.806, P<0.05). Conclusion:Higher levels of plasma IL-6 correlate with more severe depressive symptoms in adolescents with first-episode depressive disorder and are a risk factor for severely ill patients with depression.

Autism Spectrum Disorder (ASD) is a severe neurodevelopmental disorder. Its pathophysiological mechanism remains unclear. To date, the common therapeutic interventions for ASD are symptomatic drug treatment and rehabilitation training. More effective therapeutic methods are urgently in need. In recent years, accumulated studies have been conducted on stem cell therapy for ASD, especially mesenchymal stem cells (MSCs), which may play an important role in the therapeutic effect of MSCs through their secreted exosomes. This article reviews the progress of MSCs and MSC-sourced exosomes (MSC-Exos) in treatment of ASD.

Objective: To investigate the status of insomnia, Internet addiction, and depressive symptoms among medical students and to analyze the effect of Internet addiction on insomnia and the mediating role of depressive symptoms, in order to provide a basis for the development of targeted interventions and measurements for medical students. Methods: A stratified whole group sampling method was used to select full-time college students from three medical universities in Anhui Province. The Chinese version of Insomnia Severity Index (ISI), Internet Addiction Test (IAT) scale and 9-item Patient Health Questionnaire (PHQ-9) were used to evaluate the symptoms of insomnia, Internet addiction and depressive in students. A multivariate Logistic regression analysis was used to explore the factors influencing insomnia among medical students and to analyze the relationship between insomnia with Internet addiction and depressive symptoms, respectively. Results: The overall rate of Internet addiction was 49.5%, depressive symptoms was 39.5%, insomnia was 18.6%. High academic stress, and the presence of surrounding people diagnosed with COVID-19 were associated with a higher risk of insomnia ( P <0.05). The higher the level of Internet addiction (mild, OR =2.60; moderate/severe, OR =4.21) and depression. (mild, OR =6.35; moderate/severe, OR =19.32), the higher the risk of insomnia. Mediated effect analysis showed that Internet addiction had a direct predictive effect ( β =0.02, P <0.05) on insomnia and also indirectly affected insomnia through depression (indirect effect=0.07，95% CI =0.06-0.08). Conclusion The detected rates of insomnia, Internet addiction and depressive symptoms are high among medical students in Anhui Province, and Internet addiction and depressive symptoms are risk factors for insomnia, which should be given more attention and appropriate interventions when necessary to improve their physical and mental health.