Depression and circadian rhythms exhibit bidirectional interactions,suggesting a close association with the biological clock system.The biological clock in the suprachiasmatic nucleus of the hypothalamus is regulated by circadian genes.Recent clinical and basic research has revealed multifaceted associations between depression and circadian genes.For instance,significant phase abnormalities in BMAL1,PER2,and PER3 were detected in brain tissue from depressed patients,while plasma levels of CRY1,ARNTL,and PER1 proteins showed marked reduction,demonstrating good diagnostic value.Mice with CLOCK and BMAL1 knockouts exhibited depression-like behaviors.Single nucleotide polymorphisms(SNPs)in genes such as PER1 and PER3 directly influence depression susceptibility.Methylation levels of BMAL1,PER3,and CLOCK genes correlate closely with depressive symptoms.Antidepressant mechanisms like ketamine exert their effects by downregulating PER2 and other genes.This review summarizes the differential expression patterns of circadian clock genes in depression and associated therapeutic approaches,aiming to provide new theoretical foundations for precision diagnosis and personalized treatment strategies for depression.

Depression and circadian rhythms exhibit bidirectional interactions,suggesting a close association with the biological clock system.The biological clock in the suprachiasmatic nucleus of the hypothalamus is regulated by circadian genes.Recent clinical and basic research has revealed multifaceted associations between depression and circadian genes.For instance,significant phase abnormalities in BMAL1,PER2,and PER3 were detected in brain tissue from depressed patients,while plasma levels of CRY1,ARNTL,and PER1 proteins showed marked reduction,demonstrating good diagnostic value.Mice with CLOCK and BMAL1 knockouts exhibited depression-like behaviors.Single nucleotide polymorphisms(SNPs)in genes such as PER1 and PER3 directly influence depression susceptibility.Methylation levels of BMAL1,PER3,and CLOCK genes correlate closely with depressive symptoms.Antidepressant mechanisms like ketamine exert their effects by downregulating PER2 and other genes.This review summarizes the differential expression patterns of circadian clock genes in depression and associated therapeutic approaches,aiming to provide new theoretical foundations for precision diagnosis and personalized treatment strategies for depression.

Objective To explore the effect and safety of right unilateral modified electroconvulsive therapy(RUL-MECT)for major depressive disorder patients(MDD).Methods A randomized controlled trial was conducted on 70 patients with MDD who were randomly divided into a study group and a control group.The study group underwent age-based RUL-MECT,while the control group underwent bitemporal MECT.The participants were evaluated using the 17-item Hamilton depression scale(HAMD-17),MATRICS consensus cognitive battery(MCCB)and orientation recovery tests(ORT).Any adverse reactions that occurred during each intervention process were recorded.Results Before treatment,there were no significant differences in the HAMD-17(32.89±5.68 vs.33.54±4.78)between the two groups(P>0.05).The HAMD-17 score of the intervention group was 6.83±4.68,while the control group was 7.20±4.60 after 8 interventions,repeated measures analysis of variance showed the time effect(P<0.001)was significant.The intergroup effect and interaction effect was not significant(P>0.05).In terms of MCCB scores,there were significant main effect(P<0.001)in connectivity tests,symbol coding,language memory,spatial breadth,number sequence,maze test,visual memory,emotional management and the duration of continuous operation.The intergroup effects of language memory,number sequence,visual memory,speech fluency,and continuous operation were significant(P<0.05).The interaction effect of language memory and continuous operation were significant(P<0.05).After the intervention,the recovery of orientation time was significantly shorter in the study group than that in the control group[(508.57±104.48)s vs.(631.66±212.27)s](P<0.05).The incidence of adverse reactions between two groups(28.6% vs.40.0% )has no significance(P>0.05).Conclusions Compared with bitemporal MECT,RUL-MECT has comparable efficacy in treating depressant and better performance in improving cognitive function and recovery of orientation.

Psychotherapy is one of the widely used therapies for depression.Yet there are currently no definitive biological markers as indicators of effectiveness.Using functional magnetic resonance imaging(fMRI)to assess the neuroimaging biomarkers before and after different psychological treatments for depression reveals corresponding changes in brain region activation and functional connectivity.For example,after cognitive-behavioral therapy,the prefrontal cortex of patients may be activated and dynamic functional connectivity variability may change,while mindfulness therapy may show alterations in specific temporal lobe regions.Additionally,studies exploring special populations and internet-based psychological intervention have also found changes in brain region activation and functional connectivity,providing guidance for the efficacy evaluation of corresponding psychotherapies.This article reviews the characteristic brain region or network changes in fMRI activity after different psychotherapies in depressed patients,aiming to discuss future directions for research that integrates neuroimaging with psychological treatment for depression.

This article presents a review on the effect of family environmental factors on adolescent depression patients， in which the domestic and foreign literature on the family environment of adolescent depression patients are thoroughly reviewed with the emphasis of the relevant concepts， assessment tools， impact effects and potential mechanisms， and the research progress， existing limitations and directions for future research are summarized. Additionally， the awareness of the negative family environment associated with depression derives specific reference values for the early identification and prevention of adolescent depression.

Objective:To investigate the epidemiological and clinical characteristics of human parainfluenza viruses (HPIVs) infection among hospitalized children with community-acquired pneumonia (CAP) in China, and provide basic data for diagnosis, treatment and prevention of HPIVs infection.Methods:From November 2014 to February 2020, 5 448 hospitalized children with CAP were enrolled in 14 hospitals in 11 provinces and municipalities directly under the Central Government in southern China and northern China. Nasopharyngeal aspirates or throat swabs were collected, and the nucleic acids of 18 types respiratory viruses including HPIV1-4 were screened by suspension array technology. Demographic data and clinical information were collected for statistical analysis.Results:The total detection rate of HPIVs in 5 448 children with CAP was 8.83% (481/5 448), and the detection rate in males was higher than that in females (62.79% vs. 37.21%; χ2=0.000, P=0.992). The detection rate of HPIVs in 1~< 3 years age group was higher than that in other age groups, and the difference was statistically significant ( χ2=61.893, P<0.001). The detection rate of HPIVs in the northern region was higher than that in the southern region (9.02% vs 8.65%), but the difference was not statistically significant ( χ2=0.239, P=0.625). The prevalence of HPIV1-4 in northern and southern China was not completely same. HPIV1 was mainly prevalent in autumn in both northern and southern regions. HPIV2 was prevalent in summer in northern China, and the detection rate was low in southern China. HPIV3 reached its peak in both spring and summer in both northern and southern China, but its duration was longer in southern China than in northern China. HPIV4 is mainly popular in autumn in both southern China and northern China. Among 481 children infected with HPIVs, 58.42% (281/481) were infected with HPIV alone, and the main clinical manifestations were cough (90.75%) and fever (68.68%). Out of the HPIV-positive cases, 42.62% (205/481) were co-infected with another type of HPIV or a different virus, while 11.43% (55/481) had co-infections with two or more different viruses. HPIV3 was the most common type of co-infection with other viruses. HPIV3 infection accounted for the largest proportion (76.80%) in 47 HPIVs-positive children with severe pneumonia. Conclusions:HPIVs is one of the most important pathogens causing CAP in children in China, and children under 3 years of age are the main populations of HPIVs infection. The prevalence characteristics of all types of HPIVs in children in the north and south are not completely same. HPIV3 is the dominant type of HPIV infections and causes more severe diseases.

ObjectiveTo explore the correlation of sleep quality with negative life events and coping styles in adolescents based on structural equation modeling， and to provide references for improving the adolescents' sleep quality. MethodsFrom December 2021 to May 2022， a total of 767 junior middle school students from three schools in Chongqing were enrolled， and assessed using Pittsburgh Sleep Quality Index （PSQI）， Adolescent Self-rating Life Events Checklist （ASLEC） and Simplified Coping Style Questionnaire （SCSQ）. Then the structural equation model was applied to discuss the correlation of sleep quality with negative life events and coping styles in adolescents. ResultsA total of 222 adolescents （28.94%） were found to have sleep disorders. PSQI score was positively correlated with ASLEC score and negative coping dimension score of SCSQ （r=0.612， 0.590， P<0.01）， and negatively correlated with positive coping dimension score of SCSQ （r=-0.435， P<0.01）. The structural equation model of the relationship between negative life events， coping styles and sleep quality denoted that negative life events exhibited both direct and indirect positive effects on sleep quality （β=0.448， 0.322， P<0.05）， positive coping style had direct negative effects on sleep quality （β=-0.368， P<0.05）， and negative coping style had direct positive effects on sleep quality （β=0.442， P<0.05）. ConclusionNegative life events and negative coping style cause adverse effects on adolescents' sleep quality， while positive coping style exerts positive effects on adolescents' sleep quality.

Combining with the currently applied psychology teaching mode of medical colleges and universities, regarding the core curriculum, abnormal psychology, as the object, we have explored the new teaching mode of graduate students majoring in applied psychology based on massive open online courses (MOOC), and promoted the fusion of classroom theory teaching, hospital practice, and MOOC course, so as to guide teaching reform of applied psychology and improve the quality of personnel training.

Objective:To investigate the effects of metformin on the survival of patients with advanced non-small cell lung cancer (NSCLC).Methods:PubMed, EMbase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang and other databases were searched from the beginning of database construction to February 2020, relevant literatures were screened and included, and the characteristics of the literatures were extracted. RevMan 5.3 software was used to analyze progression-free survival (PFS), overall survival (OS), hazard ratio(HR) and 95% CI; the heterogeneity and publication bias were also evaluated. Results:A total of 11 studies were enrolled, and metformin did not improve PFS in patients with advanced NSCLC ( HR = 0.80, 95% CI 0.58-1.09, P = 0.15). The subgroup analysis results of different treatment strategies showed that metformin combined with tyrosine kinase inhibitor (TKI) ( HR = 0.71, 95% CI 0.32-1.57, P = 0.39), chemoradiotherapy ( HR = 0.97, 95% CI 0.59-1.61, P = 0.92), and immune checkpoint inhibitor (ICI) ( HR = 0.64, 95% CI 0.35-1.16, P = 0.14) did not improve the PFS. Metformin improved OS in patients with advanced NSCLC ( HR = 0.84, 95% CI 0.75-0.93, P = 0.001). Metformin combined with TKI ( HR = 0.68, 95% CI 0.38- 1.22, P = 0.19) and ICI ( HR =0.80, 95% CI 0.39-1.63, P = 0.54) did not improve OS of patients, while metformin combined with chemoradiotherapy could improve OS ( HR = 0.85, 95% CI 0.78-0.93, P < 0.01). No evidence of publication bias was shown in the funnel plot analysis. Conclusions:Metformin can prolong OS time in patients with advanced NSCLC, especially in patients undergoing metformin combined with radiotherapy and chemotherapy, or concurrent chemoradiotherapy.

The ongoing pandemic of Coronavirus disease 19 (COVID-19) is caused by a newly discovered β Coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). How long the adaptive immunity triggered by SARS-CoV-2 can last is of critical clinical relevance in assessing the probability of second infection and efficacy of vaccination. Here we examined, using ELISA, the IgG antibodies in serum specimens collected from 17 COVID-19 patients at 6-7 months after diagnosis and the results were compared to those from cases investigated 2 weeks to 2 months post-infection. All samples were positive for IgGs against the S- and N-proteins of SARS-CoV-2. Notably, 14 samples available at 6-7 months post-infection all showed significant neutralizing activities in a pseudovirus assay, with no difference in blocking the cell-entry of the 614D and 614G variants of SARS-CoV-2. Furthermore, in 10 blood samples from cases at 6-7 months post-infection used for memory T-cell tests, we found that interferon γ-producing CD4
Adaptive Immunity/physiology* ; Adult ; Aged ; Antibodies, Neutralizing/blood* ; COVID-19/immunology* ; Cohort Studies ; Female ; Humans ; Immunoglobulin G/blood* ; Male ; Middle Aged ; SARS-CoV-2/immunology* ; T-Lymphocytes/physiology* ; Time Factors ; Viral Proteins/immunology*