BackgroundNon-suicidal self-injury （NSSI） behaviors are common among adolescents with depressive disorders， and school bullying is recognized as a major risk factor. Previous research has shown that self-esteem and alexithymia are closely associated with both school bullying and NSSI. However， the mediating roles of self-esteem and alexithymia in the link between school bullying and NSSI are unclear. ObjectiveTo explore the mediating roles of alexithymia and self-esteem in the relationship between school bullying and NSSI behaviors in adolescents with depressive disorders， in order to inform intervention strategies targeting NSSI in this population. MethodsA total of 335 adolescents diagnosed with depressive disorders and treated at the First Psychiatric Hospital of Harbin from July 2023 to October 2024 were enrolled. Assessments included a self-developed demographic questionnaire， Adolescent Non-suicidal Self-injury Assessment Questionnaire-Behavior （ANSAQ-B）， Delaware Bullying Victimization Scale-Student （DBVS-S）， Rosenberg Self-Esteem Scale （RSES）， and 26-item Toronto Alexithymia Scale （TAS-26）. Pearson correlation analysis was used to examine the relationship among variables. Controlling for gender and age at onset of depressive symptoms， mediation analysis was performed using the “mediation” package in R 4.4.2. ResultsScores on DBVS-S and TAS-26 were positively correlated with ANSAQ-B score （r=0.408， 0.417， P<0.01）， while RSES scores were negatively correlated（r=-0.300， P<0.01）. Regression analysis showed that school bullying and alexithymia significantly positively predicted NSSI behaviors （B=0.212， 0.333， P<0.01）， while self-esteem negatively predicted NSSI behaviors （B=-0.368， P<0.01）. Alexithymia was found to mediate the relationship between school bullying and NSSI behaviors， with an indirect effect of 0.040 （95% CI： 0.018~0.069） ，account for 17.17% of the total effect. The indirect effect through self-esteem was not statistically significant （95% CI： -0.004~0.069）. ConclusionExposure to school bullying and high levels of alexithymia are important predictors of NSSI behavior in adolescents with depressive disorders， and school bullying may indirectly influence NSSI behavior through alexithymia. ［Funded by Scientific Research Project of Health Commition of Heilongjiang Province，（number， 20230303090154］

Depression (Dep) is one of the most common concomitant symptoms of Parkinson's disease (PD), but there is a lack of detailed pathologic evidence for the occurrence of PD-Dep. Currently, the management of symptoms from both conditions using conventional pharmacological interventions remains a formidable task. In this study, we found impaired activation of extracellular signal-related kinase (ERK), reduced levels of transcription and translation, and decreased expression of brain-derived neurotrophic factor (BDNF) in the medial prefrontal cortex (mPFC) of PD-Dep rats. We demonstrated that the abnormal phosphorylation of α-synuclein (pS129) induced tropomyosin-related kinase receptor type B (TrkB) retention at the neuronal cell membrane, leading to BDNF/TrkB signaling dysfunction. We chose SEW2871 as an ameliorator to upregulate ERK phosphorylation. The results showed that PD-Dep rats exhibited improvement in behavioral manifestations of PD and depression. In addition, a reduction in pS129 was accompanied by a restoration of the function of the BDNF/ERK signaling loop in the mPFC of PD-Dep rats.
Animals ; Brain-Derived Neurotrophic Factor/metabolism* ; alpha-Synuclein/metabolism* ; Male ; Prefrontal Cortex/drug effects* ; Rats, Sprague-Dawley ; Depression/metabolism* ; MAP Kinase Signaling System/drug effects* ; Rats ; Parkinson Disease/metabolism* ; Receptor, trkB/metabolism* ; Phosphorylation ; Disease Models, Animal ; Signal Transduction

Objective To observe the clinical efficacy of acupuncture combined with western medicine in the treatment of lumbar disc herniation(LDH)of qistagnation and blood stasis type.Methods A total of 62 cases of patients with LDH of qistagnation and blood stasis type were randomly divided into observation group and control group,with 31 cases in each group.The control group was given conventional western medicine for treatment,and the observation group was treated by acupuncture on the basis of the control group,the course of treatment covered three consecutive weeks.After three weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the Japanese Orthopedic Association(JOA)scores and Oswestry Disability Index(ODI)scores,as well as the Visual Analogue Scale(VAS)scores of pain,were observed before and after the treatment of the patients in the two groups.The changes in muscle tension,muscle hardness,and muscle elasticity of the multifidus muscle(MM)and lumbar multifidus muscle(LMM)before and after treatment were compared between the two groups.And the safety and the occurrence of adverse reactions in the two groups were evaluated.Results(1)The total effective rate was 96.77%(30/31)in the observation group and 74.19%(23/31)in the control group.The efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(2)After treatment,the VAS,JOA,and ODI scores of the patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,with a statistically significant difference(P<0.01).(3)After treatment,the muscle tension,muscle hardness,and muscle elasticity of LMM and MM of patients in the two groups were significantly improved(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(4)The incidence rate of adverse reactions was 9.68%(3/31)in the observation group and 9.68%(3/31)in the control group;the intergroup comparison showed that there being no statistically significant difference(P>0.05).Conclusion Acupuncture combined with western medicine in the treatment of LDH of qistagnation and blood stasis type can significantly improve the lumbar function and clinical symptoms of the patients,and improve the muscular performance of the patients'LMM and MM,so as to enhance their quality of life.

Catheter-based percutaneous coronary intervention has become a crucial approach for treating obstructive coronary artery disease and is widely applied in clinical practice.Although the new generation of drug-eluting stents(DES)has significantly reduced the incidence of post-procedur-al restenosis and improved long-term clinical outcomes,in-stent restenosis(ISR)remains one of the key challenges affecting the long-term efficacy of percutaneous coronary intervention.Recent studies have demonstrated that DES still have certain inherent limitations.From the metallic stent platform,drug coating to the polymer carrier,each component may exert varying degrees of biological effects on the vascular intima.Optical coherence tomography(OCT),as a high-resolution intravascular imaging technique,has shown significant value in the mechanism research,etiological diagnosis,and clinical classification of ISR.It can clearly identify the tissue composition and morphological characteristics of ISR,providing a precise basis for the formulation of individualized treatment strategies.This review aimed to systematically search the existing literature,comprehensively review the clinical and patho-logical features of ISR after DES implantation,focus on the OCT-based ISR classification system,and summarize the current treatment strategies and latest advances for ISR.

Objective:To analyze the hepatic tissue inflammatory activity and influencing factors in HBeAg-positive patients during normal alanine aminotransferase (ALT) and indeterminate phases so as to provide a basis for evaluating the disease condition.Methods:Patients with HBeAg-positive with normal ALT and HBV DNA levels below 2 × 10 7 IU/ml from January 2017 to December 2021 were selected as the study subjects. A histopathologic liver test was performed on these patients. Age, gender, time of HBV infection, liver function, HBsAg level, HBV DNA load, genotype, portal vein inner diameter, splenic vein inner diameter, splenic thickness, and others of the patients were collected. Significant influencing factors of inflammation were analyzed in patients using logistic regression analysis, and its effectiveness was evaluated using receiver operating characteristic (ROC) curves. Results:Of the 178 cases, there were 0 cases of inflammation in G0, 52 cases in G1, 101 cases in G2, 24 cases in G3, and one case in G4. 126 cases (70.8%) had inflammatory activity ≥ G2. Infection time ( Z=-7.138, P<0.001), γ-glutamyltransferase ( t ?=-2.940, P=0.004), aspartate aminotransferase ( t ?=-2.749, P=0.007), ALT ( t ?=-2.153, P=0.033), HBV DNA level ( t ?=-4.771, P=0.010) and portal vein inner diameter ( t ?=-4.771, P<0.001) between the ≥G2 group and < G2 group were statistically significantly different. A logistic regression analysis showed that significant inflammation in liver tissue was independently correlated with infection time [odds ratio (OR)=1.437, 95% confidence interval ( CI): 1.267-1.630; P<0.001)] and portal vein inner diameter ( OR=2.738, 95% CI: 1.641, 4.570; P<0.001). The area under the curve (AUROC), specificity, and sensitivity for infection time and portal vein inner diameter were 0.84, 0.71, 0.87, 0.72, 0.40, and 0.95, respectively. Conclusion:A considerable proportion of HBeAg-positive patients have inflammation grade ≥G2 during normal ALT and indeterminate phases, pointing to the need for antiviral therapy. Additionally, inflammatory activity has a close association with the time of infection and portal vein inner diameter.

Objective:To study the related factors of pressure ulcer in liver transplantation patients, to understand the occurrence of postoperative pressure sores in liver transplantation patients, and to propose corresponding nursing strategies to provide theoretical basis for clinical nursing work.Methods:A total of 93 patients with liver transplantation were investigated for postoperative pressure ulcers using a general data sheet and a Braden risk assessment form.Results:The Braden risk score of liver transplantation patients was significantly positively correlated with pressure ulcers ( t value was -3.512, P<0.01). Among the risk factors affecting patients with surgical pressure sores, low pressure ulcer score, postoperative hypotension and low serum albumin were pressure ulcers. The risk factors, OR value were 1.185 (1.037-1.354), 9.443 (2.273-39.237), 1.325 (1.119-1.570), and the short operation time was the protective factor of pressure ulcer. The OR value was 0.729 (0.542-0.981). Conclusions:Clinical medical staff should take comprehensive measures to treat patients with liver transplantation in different situations, reduce the incidence of pressure ulcers and improve the quality of life of patients.

Objective To assess the performance of pediatric clinical illness score (PCIS), pediatric risk of mortality scoreⅢ(PRISMⅢ), pediatric logistic organ dysfunction score 2 (PELOD-2), and pediatric multiple organ dysfunction score (P-MODS) in predicting mortality in critically ill pediatric patients. Methods The data of critically ill pediatric patients admitted to Pediatric Intensive Care Unit (PICU) of First Affiliated Hospital of Sun Yat-Sen University from August 2012 to May 2017 were retrospectively analyzed. The gender, age, basic diseases, the length of PICU stay were collected. The children were divided into survival group and non-survival group according to the clinical outcome during hospitalization. The variables of PCIS, PRISMⅢ, PELOD-2, and P-MODS were collected and scored. Receiver operating characteristic (ROC) curve was plotted, the efficiency of PCIS, PRISMⅢ, PELOD-2, and P-MODS for predicting death were evaluated by the area under ROC curve (AUC). Hosmer-Lemeshow goodness of fit test was used to evaluate the fitting degree of each scoring system to predict the mortality and the actual mortality. Results Of 461 critically ill children, 35 children were excluded because of serious data loss, hospital stay not exceeding 24 hours, and death within 8 hours after admission. Finally, a total of 426 pediatric patients were enrolled in this study. 355 pediatric patients were survived, while 71 were not survived during hospitalization, with the mortality of 16.7%. There was no significant difference in gender, age, underlying diseases or length of PICU stay between the two groups. PCIS score in non-survival group was significantly lower than that of survival group [80 (76, 88) vs. 86 (80, 92)], and PRISMⅢ, PELOD-2 and P-MODS scores were significantly increased [PRISMⅢ: 16 (13, 22) vs. 12 (10, 15), PELOD-2: 6 (5, 9) vs. 4 (2, 5), P-MODS: 6 (4, 9) vs. 3 (2, 6), all P < 0.01]. ROC curve analysis showed that the AUCs of PCIS, PRISMⅢ, PELOD-2, and P-MODS for predicting death of critical ill children were 0.649, 0.731, 0.773, and 0.747, respectively. Hosmer-Lemeshow test showed that PCIS predicted the mortality and the actual mortality in the best fitting effect (χ2= 7.573, P = 0.476), followed by PELOD-2 and P-MODS (χ12 = 9.551, P1= 0.145; χ22 = 10.343, P2= 0.111), while PRISMⅢ had poor fitting effect (χ2= 43.549, P < 0.001). Conclusions PRISMⅢ, PELOD-2 and P-MODS can discriminate between survivors and moribund patients well, and assessing the condition of critically ill pediatric patients with relatively accuracy. PCIS was the best fitting effect in predicting mortality and actual mortality, followed by PELOD-2 and P-MODS, while PRISMⅢ had poor fitting effect.

Objective To analyze the initial response rate of radiotherapy and chemotherapy,and the influence of different treatment modalities on pmgnnsis of primary non-Hodgkin lymphoma(NHL)of the nascl cavity.Methods From January 1993 to December 2002,70 patients were confirmed by histopathology as NHL,including 52 T cell origin,2 B cell and 16 NK cell.The main radiotherapy portal was set in front of the nose with a spade like protrusion,supplement with a portal next to the ear on one side or both sides.Combined portal in facial cervical area was first used when there was invasion of the oropharynx.The median dose to the nasal cavity wag 54.0 Gy with a range of 336 to 66 Gy,given before or during after radiotherapy or alone,consisted of 2-6 cycles chemotherapy of COP,CHOP or COBDP.Prognostic factors were analyzed with Cox model. Results The local control rates was 12.5%, 66.7% and 74.0% in chemotherapy alone,radiotherapy alone,and chemotherapy plus radiotherapy.The 5-year survival rate Wag 12.5%,50.0% and 62.0%,respectively(P＜0.05).Multifaetor analysis showed that tumor extension and treatment methods were the most important prognostic factors besides Ann-Arbor stage,but gender,pathology,age and symptoms had little effect on prognosis.Conclusion Chemotherapy plus radiotherapy group achieved a better survival rate than radiotherapy alone.For some NHL patients with good financial condition,APBSCT is a good choice.

Objective: To detect the expression of basic fibroblast growth factor(bFGF), type Ⅲ collagen(Ⅲ-col)and fibronectin(FN) in human dental pulp at different root development stages of permanent teeth. Methods: 10 teeth at stage Ri～R 1/4 ,15 at R 1/3 ～R 3/ 4 and 12 at Rc～Ac were sectioned for following examination.bFGF, Ⅲ-col and F N were qualitatively and quantitatively analyzed by the use of immunohistologica l SP method and image analysis technique. Results: The ex pression of bFGF became gradually weaker and weaker with the development of too th root (P