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 investigate the medical narrative competence of pediatric staff, and analyze its influencing factors and correlation with psychological resilience, and to discuss strategies to improve narrative competence.Methods:From January 11 to February 25, 2022, by convenience sampling, we sampled pediatric personnel and those on refresher training at Children's Hospital, Zhejiang University School of Medicine for a questionnaire survey involving general information, the narrative competence scale, and the 14-item resilience scale. With the use of SPSS 26.0, the narrative competence of different populations was compared, and factors affecting narrative competence were determined through Pearson correlation analysis and multiple regression analysis.Results:A total of 361 valid questionnaires were included in this study, and there was significant differences in the narrative competence score between different ages, professional titles, working years, income levels, and whether they wrote parallel charts ( P<0.05). The total score of narrative competence of pediatric staffs was (147.13±18.76), and positively correlated with the total resilience score and the score of each dimension ( P≤0.001). The regression analysis showed that writing parallel charts and resilience could explain 53.10% of the variation in narrative competence ( P<0.001). Conclusions:Pediatric staff's narrative competence is at low or intermediate levels. Parallel chart writing and resilience training can improve narrative competence and promote a harmonious doctor-patient relationship.

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 explore the compatibility and medication law of Cinnamomi Ramulus-Alismatis Rhizoma medicinal pair in ancient and modern prescriptions.Methods:Ancient prescriptions and Chinese patent medicines containing Cinnamomi Ramulus-Alismatis Rhizoma medicinal pair were retrieved from the database of ancient classic famous prescriptions 1.0 and the database of listed Chinese patent medicines 1.0 developed by the Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences. Excel 2019 was used to establish a database. The ancient and modern medical record cloud platform V2.3.5 and SPSS Modeler 18.0 software were used to perform frequency statistics, association rule analysis, clustering analysis, etc. on the data.Results:Totally 79 ancient articles with Cinnamomi Ramulus-Alismatis Rhizoma medicinal pair were obtained, including 76 ancient prescriptions, involving 250 kinds of Chinese materia medica; 25 kinds of Chinese patent medicine were obtained, involving 186 kinds of Chinese materia medica. The drug properties of ancient prescriptions and modern TCM patent medicines were both mainly warm, cold and neutral. The main tastes of ancient prescriptions and modern Chinese patent medicines were pungent, sweet and bitter. And the drugs mainly belong to spleen, lung, liver and kidney meridians. Correlation analysis suggested the same high-frequency association compatibility of ancient and modern prescriptions, Poria-Cinnamomi Ramulus-Alismatis Rhizoma, Atractylodis Rhizoma-Cinnamomi Ramulus-Alismatis Rhizoma, Atractylodis Macrocephalae Rhizoma-Cinnamomi Ramulus-Alismatis Rhizoma. Both clinical symptoms and diseases associated with medicinal compatibility of ancient prescriptions were intestinal flora, edema and vomiting. The syndrome types included bladder impoundment, dampness trapped in the guardian surface, internal retention of phlegm and morbid fluid. The clinical symptoms associated with medicinal compatibility of modern TCM patent medicine were limb joints pain and edema. The diseases included rheumatic arthritis (RA) and kidney disease. The syndrome types included wind-cold-dampness RA, stagnation of collaterals and kidney yang deficiency. High frequency drug clustering yielded 4 clustered squares.Conclusion:The core indications treated by Cinnamomi Ramulus-Alismatis Rhizoma are exogenous diseases with dampness caused by syndrome types including internal storage of water-dampness, cold-dampness obstruction and so on, which can provide reference for further in-depth research and guidance on clinical medication.

Objective: To prepare a composite membrane by chitosan/β-sodium glycerophosphate(CS/β-GP) thermosensitive hydrogel combined with stromal cell derived factor-1(SDF-1) and observe its biological characteristics in vitro. Methods: Different doses of SDF-1 were added into CS/β-GP solution and then the thermosensitive gel time was measured. The SDF-1/CS/β-GP solution was membrane paved and dried to prepare composite membranes. The morphological characteristics were observed by scanning electron microscope(SEM). Composite membranes were placed into cell culture medium, and the supernatant(n=3) was extracted after standing at 6, 12, 24, 36, 48, 60 h, respectively. The concentration of SDF-1 in the solution was measured. Bone mesenchymal stem cells(BMSCs) were cultured in the Transwell room, and the composite membranes containing different concentrations of SDF-1 were placed in the lower chamber. There were four groups(n=3): Group M0 used CS/β-GP membrane(control group), Group M1, M2, M3 used SDF-1/CS/β-GP membrane(SDF-1 was 100, 200, 400 ng/mL respectively). After culture for 6, 12 and 24 h, the cells under the membrane were preserved and Giemsa stained and counted. The absorbance(OD) value was measured by MTT method to calculate the cell proliferation rate. SPSS 19.0 was used for multi-factor analysis of variance. Results : After adding a certain amount of SDF-1 into CS/β-GP solution, the gel time did not change significantly(P>0.05). The SDF-1/CS/β-GP membrane was translucent and porous at 37 ℃. In this experiment, the volumic mass of SDF-1 released by SDF-1/CS/β-GP composite membrane increased gradually with the experimental time(P<0.01). Transwell cell chemotaxis test showed that the number of BMSCs cells with directional migration increased with the prolongation of observation time(P<0.01) and the increase of SDF-1 volumic mass(P<0.01). In MTT test, the OD value of migration cell solution increased with the prolongation of time(P<0.01) and the increase of SDF-1 volumic mass(P<0.01). Conclusion The SDF-1/CS/β-GP composite membrane has a porous structure and biological activity of chemotactic BMSCs directional migration. It is a potential membrane for guided tissue regeneration.

Objective To investigate the distribution differences of cytochrome P4502C19(CYP2C19)gene polymorphisms and its impact on antiplatelet therapy in patients with coronary arter-y disease undergoing percutaneous coronary intervention(PCI)in Yangzhou region.Methods A to-tal of 215 patients diagnosed with coronary heart disease who underwent PCI from January 2021 to De-cember 2022 in Yangzhou region were retrospectively selected as study objects.The age of the pa-tients ranged from 37 to 93 years,with 152 males and 63 females.Polymerase chain reaction-sequen-cing was used to detect the CYP2C19 genotypes in the patients.The relationships of gender and age with distribution of CYP2C19 gene polymorphism were observed.Based on the metabolic types of CYP2C19 and the antiplatelet drugs used post-operatively,the patients were divided into fast-metabo-lizing clopidogrel group,medium-slow metabolizing clopidogrel group,fast-metabolizing ticagrelor group,medium-slow metabolizing ticagrelor group.After 6 months of follow-up,the incidence rates and severity of adverse events of cardiovascular ischemia and bleeding were compared among groups.Results The CYP2C19 genotypes of 215 patients were distributed as follows:81 cases of CYP2C19*1/*1 genotype,93 cases of CYP2C19*1/*2,10 cases of CYP2C19*1/*3,25 cases of CYP2C19*2/*2,6 cases of CYP2C19*2/*3.CYP2C19 metabolite types were fast metabolizers in 81 cases(37.67％),intermediate metabolizers in 103 cases(47.91％)and slow metabolizers in 31 cases(14.42％).The proportion of extensive metabolizers of CYP2C19 in the study patients was 37.67％,intermediate metabolizers accounted for 47.91％,and poor metabolizers accounted for 14.42％.There was no significant difference in the distribution of CYP2C19 genotype between different genders(x2=0.346,P=0.987).There was no significant difference in the distribution of metabolic type between different genders(x2=0.342,P=0.843).There was no significant differ-ence in the distribution frequency of metabolic type among different age groups(x2=1.098,P=0.895).The incidence of cardiovascular ischemia of adverse events in the fast-metabolizing clopi-dogrel group and the fast-metabolizing ticagrelor group was 16.67％and 14.29％,respectively,no significant difference was observed(P＞0.05).The incidence of cardiovascular ischemia of adverse events in the medium-slow metabolized clopidogrel group was higher than that in the medium-slow metabolized ticagrelor group,and the difference was statistically significant(P＜0.05).There was no significant between-group difference in the incidence of bleeding of adverse events among groups(P＞0.05).Conclusion In patients undergoing PCI for coronary heart disease in Yangzhou re-gion,there is a polymorphism in the CYP2C19 gene with no significant differences between genders and age groups.The intermediate and fast metabolizers are more prevalent.It is clinically significant to perform CYP2C19 gene testing and adopt precise antiplatelet therapy for such patients.

Objective To investigate the distribution differences of cytochrome P4502C19(CYP2C19)gene polymorphisms and its impact on antiplatelet therapy in patients with coronary arter-y disease undergoing percutaneous coronary intervention(PCI)in Yangzhou region.Methods A to-tal of 215 patients diagnosed with coronary heart disease who underwent PCI from January 2021 to De-cember 2022 in Yangzhou region were retrospectively selected as study objects.The age of the pa-tients ranged from 37 to 93 years,with 152 males and 63 females.Polymerase chain reaction-sequen-cing was used to detect the CYP2C19 genotypes in the patients.The relationships of gender and age with distribution of CYP2C19 gene polymorphism were observed.Based on the metabolic types of CYP2C19 and the antiplatelet drugs used post-operatively,the patients were divided into fast-metabo-lizing clopidogrel group,medium-slow metabolizing clopidogrel group,fast-metabolizing ticagrelor group,medium-slow metabolizing ticagrelor group.After 6 months of follow-up,the incidence rates and severity of adverse events of cardiovascular ischemia and bleeding were compared among groups.Results The CYP2C19 genotypes of 215 patients were distributed as follows:81 cases of CYP2C19*1/*1 genotype,93 cases of CYP2C19*1/*2,10 cases of CYP2C19*1/*3,25 cases of CYP2C19*2/*2,6 cases of CYP2C19*2/*3.CYP2C19 metabolite types were fast metabolizers in 81 cases(37.67％),intermediate metabolizers in 103 cases(47.91％)and slow metabolizers in 31 cases(14.42％).The proportion of extensive metabolizers of CYP2C19 in the study patients was 37.67％,intermediate metabolizers accounted for 47.91％,and poor metabolizers accounted for 14.42％.There was no significant difference in the distribution of CYP2C19 genotype between different genders(x2=0.346,P=0.987).There was no significant difference in the distribution of metabolic type between different genders(x2=0.342,P=0.843).There was no significant differ-ence in the distribution frequency of metabolic type among different age groups(x2=1.098,P=0.895).The incidence of cardiovascular ischemia of adverse events in the fast-metabolizing clopi-dogrel group and the fast-metabolizing ticagrelor group was 16.67％and 14.29％,respectively,no significant difference was observed(P＞0.05).The incidence of cardiovascular ischemia of adverse events in the medium-slow metabolized clopidogrel group was higher than that in the medium-slow metabolized ticagrelor group,and the difference was statistically significant(P＜0.05).There was no significant between-group difference in the incidence of bleeding of adverse events among groups(P＞0.05).Conclusion In patients undergoing PCI for coronary heart disease in Yangzhou re-gion,there is a polymorphism in the CYP2C19 gene with no significant differences between genders and age groups.The intermediate and fast metabolizers are more prevalent.It is clinically significant to perform CYP2C19 gene testing and adopt precise antiplatelet therapy for such patients.

To explore the clinical efficacy and possible mechanism of Tai Ji Quan for post-stroke depression (PSD), literature related to Tai Ji Quan and PSD were retrieved from China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full- text Database (Wanfang), Chongqing VIP Database (CQVIP), China Biology Medicine Disc (CBM), and PubMed, screened and then summarized. The results showed that Tai Ji Quan could effectively improve the depression and quality of life of stroke patients, and there were differences in the clinical efficacy among different training programs. Tai Ji Quan has the characteristics of "regulating mind", "regulating breath", and "regulating body". It may achieve the effect of "combined physique-spirit treatment" by improving social psychology, increasing the level of neurotrophin, regulating neuroendocrine, reducing inflammatory factors, and regulating neural circuits.

AIM: To evaluate the bioequivalence of two kinds of amlodipine besylate tablets in Chinese healthy subjects under fasting and fed conditions. METHODS: Twenty-four healthy subjects were enrolled, and a random, open, single-dose, two preparations, two sequences and double-crossover design was used to give the test or reference preparations under fasting and postprandial conditions. The concentration of metformin in plasma was detected by LC-MS/MS, and the main pharmacokinetic parameters were calculated to evaluate the bioequivalence. RESULTS: In fasting state, the mean of C