Objective To investigate the number and categories of cognitive subtypes in individuals with First-Episode Schizophrenia(FES)and to explore the potential neurobiological sleep characteristics associated with these distinct cognitive subtypes.Methods The cognitive functions of 45 patients withFES and 40 healthy controls(HCs)were assessed using the MATRICS Consensus Cognitive Battery(MCCB).Latent profile analysis was employed to identify and classify the cognitive subtypes of FES patients.Furthermore,a full-night polysom-nographic recording was conducted to quantify the characteristics of sleep spindle waves.Subsequently,differ-ences in sleep spindle wave features among the identified cognitive subtypes of FES were analyzed and compared.Results Latent Profile Analysis identified two cognitive subtypes among FES patients:a subtype characterized by severe cognitive impairment(SIS,n=32)and another with relatively preserved cognitive function(CRP,n=13).Compared to healthy controls(HCs,n=40),FES patients exhibited increased spindle wave amplitude dur-ing both N2 and N3 sleep stages.Further analysis revealed that the spindle wave duration during the N2 stage was significantly longer in the SIS subtype compared to both CRP and HCs.Similarly,in the N3 stage,the spindle wave duration was longer in SIS than in CRP.Additionally,spindle wave frequency during the N3 stage was higher in both SIS and HCs compared to CRP.Conclusions The results of this study suggest that variations in the fre-quency and duration of spindle waves among different cognitive subtypes may serve as potential neurobiological markers for distinguishing FES cognitive subtypes.

Objective To investigate the number and categories of cognitive subtypes in individuals with First-Episode Schizophrenia(FES)and to explore the potential neurobiological sleep characteristics associated with these distinct cognitive subtypes.Methods The cognitive functions of 45 patients withFES and 40 healthy controls(HCs)were assessed using the MATRICS Consensus Cognitive Battery(MCCB).Latent profile analysis was employed to identify and classify the cognitive subtypes of FES patients.Furthermore,a full-night polysom-nographic recording was conducted to quantify the characteristics of sleep spindle waves.Subsequently,differ-ences in sleep spindle wave features among the identified cognitive subtypes of FES were analyzed and compared.Results Latent Profile Analysis identified two cognitive subtypes among FES patients:a subtype characterized by severe cognitive impairment(SIS,n=32)and another with relatively preserved cognitive function(CRP,n=13).Compared to healthy controls(HCs,n=40),FES patients exhibited increased spindle wave amplitude dur-ing both N2 and N3 sleep stages.Further analysis revealed that the spindle wave duration during the N2 stage was significantly longer in the SIS subtype compared to both CRP and HCs.Similarly,in the N3 stage,the spindle wave duration was longer in SIS than in CRP.Additionally,spindle wave frequency during the N3 stage was higher in both SIS and HCs compared to CRP.Conclusions The results of this study suggest that variations in the fre-quency and duration of spindle waves among different cognitive subtypes may serve as potential neurobiological markers for distinguishing FES cognitive subtypes.

OBJECTIVE To investigate the effects and underlying mechanisms of Yiqi Huoxue Decoction(YQHX)on mitochon-drial midzone division and peripheral fission in myocardial tissue after myocardial infarction(MI).METHODS A total of 48 male SPF-grade C57BL/6N mice were randomly divided into a sham-operated group(Sham,n=12)and a left anterior descending coronary ar-tery ligation MI model(n=36).After MI surgery,mice deemed to have successfully developed the model were randomly divided into a model group(MI,n=12),a YQHX group(n=12),and an empagliflozin group(EMPA,n=12)based on echocardiographic results.Four weeks after infarction,cardiac function and structural changes were comprehensively evaluated using echocardiography imaging,serum myocardial injury biomarkers,and hematoxylin-eosin(HE)staining.Transmission electron microscopy(TEM)was employed to observe mitochondrial ultrastructural,morphological,and quantitative changes at the peri-infarct zone.Myocardial mitochondria and cytoplas-mic fractions were isolated from myocardial tissue using a mitochondrial extraction kit,and the spatial expression changes of mitochon-drial fission-related proteins in both mitochondria and cytoplasm of the peri-infarct myocardium were analyzed by Western blot.These proteins included dynamin-related protein 1(Drp1),its phosphorylated form at serine 616(P-Drp1-Ser616),mitochondrial fission fac-tor(MFF),and mitochondrial fission protein 1(Fis1).RESULTS Compared with the MI group,mice in the YQHX group exhibited sig-nificantly increased left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)(P<0.000 1),as well as decreased left ventricular internal dimension-diastole(LVIDd)and left ventricular end-systolic diameter(LVIDs)(P<0.05,P<0.01),suggesting improved cardiac function.Additionally,serum levels of lactate dehydrogenase(LDH)and creatine kinase-MB(CK-MB)were significantly reduced in the YQHX group(P<0.05,P<0.001),indicating cardio-protective effects of YQHX against ischemic in-jury.HE staining showed that YQHX improved cellular morphology,suggesting structural improvement.TEM showed that YQHX sig-nificantly improved mitochondrial swelling and reduced mitochondrial fragmentation in the marginal zone of myocardial infarction,thereby preserving mitochondrial ultrastructure.Furthermore,Western blot showed that YQHX treatment significantly downregulated P-Drp1-Ser616 expression(P<0.05)in the cytoplasm.Interestingly,YQHX treatment significantly downregulated mitochondrial Fis1 expression(P<0.05),thereby inhibiting peripheral mitochondrial fission.Meanwhile,YQHX treatment significantly increased MFF ex-pression in mitochondria(P<0.01),which may promote mitochondrial midzone fission.CONCLUSION YQHX improves cardiac structure and function after MI,potentially by promoting myocardial mitochondrial midzone fission and inhibiting mitochondrial periph-eral fission in ischemic cardiomyocytes.

Objective To understand phenotype conversion in patients with first-episode depression over a 7-year period,to explore the longitudinal disease characteristics and functional outcomes of transitions and non-transitions,and to further analyse the relevant factors affecting transitions.Methods A total of 346 patients with Hamilton depression scale-17(HAMD-17)score≥18,aged 18-60 years and a single episode of major depressive disorder were included in the study.They were follow-up for 7 years to assess their natural history including demographic data,disease characteristics,whether transitions to manic occurred,treatment status.At the end of the 7-year follow-up,treatment emergent symptom scale(TESS),medication adherence rating scale(MARS),and global assessment function(GAF)were used to evaluate adverse reactions,compliance to medication,and patient's overall functional level.Patients were divided into two groups based on the occurrence of mania or hypomania episodes during the 7-year period:the conversion group(those who developed episodes)and the non-conversion group(those who did not).Results A total of 138 patients were followed up for 7 years,including 54 patients(39.1%)in the conversion group and 84 patients(60.9%)in the non-conversion group.When the first episode was enrolled at baseline,the age of first episode was earlier in the conversion group than in the non-conversion group[(27.63±9.63)years vs.(41.20±11.92)years],and there were differences in marital status(unmarried 40.7%vs.7.1%,first marriage 53.7%vs.85.7%,remarriage 3.7%vs.2.4%,separated/divorced 0.0%vs.2.4%,widowed 1.9%vs.2.4%).The proportion of patients with precipitating factors was lower in the conversion group(29.6%vs.48.8%)and shorter duration of untreated psychosis(DUP)[60(15,90)d vs.90(30,180)d].The treatment method in the conversion group had lower only used antidepressant drugs(61.1%vs.81.0%)and more antidepressant combined with mood stabilizers(31.5%vs.16.7%)(all P<0.05).In the 7 years,total number of episodes in the conversion group was more than in the non-conversion group(4.33±1.21 vs.2.70±1.25,P<0.05).By the end of 7 years,the GAF score was lower in conversion group than in the non-conversion group(66.57±8.22 vs.69.21±7.20,P<0.05).Dichotomous unconditional logistic regression analyses revealed that age at first episode(OR=1.109,95%CI:1.058-1.161,P<0.001),DUP(d)(OR=1.005,95%CI:1.001-1.009,P=0.017),was an independent influencing factor on conversion over a 7-year period in patients with first-episode depressive disorders.Conclusion The rate of conversion over 7 years in patients with first-episode depressive disorder is 39.1%in the present cohort and converted patients had relatively earlier age of onset,more pre-onset without inducement,shorter DUP(d),more recurrence,higher the rate of combined treatment and worse overall functional outcome.

OBJECTIVE To investigate the effects and underlying mechanisms of Yiqi Huoxue Decoction(YQHX)on mitochon-drial midzone division and peripheral fission in myocardial tissue after myocardial infarction(MI).METHODS A total of 48 male SPF-grade C57BL/6N mice were randomly divided into a sham-operated group(Sham,n=12)and a left anterior descending coronary ar-tery ligation MI model(n=36).After MI surgery,mice deemed to have successfully developed the model were randomly divided into a model group(MI,n=12),a YQHX group(n=12),and an empagliflozin group(EMPA,n=12)based on echocardiographic results.Four weeks after infarction,cardiac function and structural changes were comprehensively evaluated using echocardiography imaging,serum myocardial injury biomarkers,and hematoxylin-eosin(HE)staining.Transmission electron microscopy(TEM)was employed to observe mitochondrial ultrastructural,morphological,and quantitative changes at the peri-infarct zone.Myocardial mitochondria and cytoplas-mic fractions were isolated from myocardial tissue using a mitochondrial extraction kit,and the spatial expression changes of mitochon-drial fission-related proteins in both mitochondria and cytoplasm of the peri-infarct myocardium were analyzed by Western blot.These proteins included dynamin-related protein 1(Drp1),its phosphorylated form at serine 616(P-Drp1-Ser616),mitochondrial fission fac-tor(MFF),and mitochondrial fission protein 1(Fis1).RESULTS Compared with the MI group,mice in the YQHX group exhibited sig-nificantly increased left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)(P<0.000 1),as well as decreased left ventricular internal dimension-diastole(LVIDd)and left ventricular end-systolic diameter(LVIDs)(P<0.05,P<0.01),suggesting improved cardiac function.Additionally,serum levels of lactate dehydrogenase(LDH)and creatine kinase-MB(CK-MB)were significantly reduced in the YQHX group(P<0.05,P<0.001),indicating cardio-protective effects of YQHX against ischemic in-jury.HE staining showed that YQHX improved cellular morphology,suggesting structural improvement.TEM showed that YQHX sig-nificantly improved mitochondrial swelling and reduced mitochondrial fragmentation in the marginal zone of myocardial infarction,thereby preserving mitochondrial ultrastructure.Furthermore,Western blot showed that YQHX treatment significantly downregulated P-Drp1-Ser616 expression(P<0.05)in the cytoplasm.Interestingly,YQHX treatment significantly downregulated mitochondrial Fis1 expression(P<0.05),thereby inhibiting peripheral mitochondrial fission.Meanwhile,YQHX treatment significantly increased MFF ex-pression in mitochondria(P<0.01),which may promote mitochondrial midzone fission.CONCLUSION YQHX improves cardiac structure and function after MI,potentially by promoting myocardial mitochondrial midzone fission and inhibiting mitochondrial periph-eral fission in ischemic cardiomyocytes.

Objective To understand phenotype conversion in patients with first-episode depression over a 7-year period,to explore the longitudinal disease characteristics and functional outcomes of transitions and non-transitions,and to further analyse the relevant factors affecting transitions.Methods A total of 346 patients with Hamilton depression scale-17(HAMD-17)score≥18,aged 18-60 years and a single episode of major depressive disorder were included in the study.They were follow-up for 7 years to assess their natural history including demographic data,disease characteristics,whether transitions to manic occurred,treatment status.At the end of the 7-year follow-up,treatment emergent symptom scale(TESS),medication adherence rating scale(MARS),and global assessment function(GAF)were used to evaluate adverse reactions,compliance to medication,and patient's overall functional level.Patients were divided into two groups based on the occurrence of mania or hypomania episodes during the 7-year period:the conversion group(those who developed episodes)and the non-conversion group(those who did not).Results A total of 138 patients were followed up for 7 years,including 54 patients(39.1%)in the conversion group and 84 patients(60.9%)in the non-conversion group.When the first episode was enrolled at baseline,the age of first episode was earlier in the conversion group than in the non-conversion group[(27.63±9.63)years vs.(41.20±11.92)years],and there were differences in marital status(unmarried 40.7%vs.7.1%,first marriage 53.7%vs.85.7%,remarriage 3.7%vs.2.4%,separated/divorced 0.0%vs.2.4%,widowed 1.9%vs.2.4%).The proportion of patients with precipitating factors was lower in the conversion group(29.6%vs.48.8%)and shorter duration of untreated psychosis(DUP)[60(15,90)d vs.90(30,180)d].The treatment method in the conversion group had lower only used antidepressant drugs(61.1%vs.81.0%)and more antidepressant combined with mood stabilizers(31.5%vs.16.7%)(all P<0.05).In the 7 years,total number of episodes in the conversion group was more than in the non-conversion group(4.33±1.21 vs.2.70±1.25,P<0.05).By the end of 7 years,the GAF score was lower in conversion group than in the non-conversion group(66.57±8.22 vs.69.21±7.20,P<0.05).Dichotomous unconditional logistic regression analyses revealed that age at first episode(OR=1.109,95%CI:1.058-1.161,P<0.001),DUP(d)(OR=1.005,95%CI:1.001-1.009,P=0.017),was an independent influencing factor on conversion over a 7-year period in patients with first-episode depressive disorders.Conclusion The rate of conversion over 7 years in patients with first-episode depressive disorder is 39.1%in the present cohort and converted patients had relatively earlier age of onset,more pre-onset without inducement,shorter DUP(d),more recurrence,higher the rate of combined treatment and worse overall functional outcome.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.