Digital therapy shows promise in providing precise assessments and enhancing the efficacy of treatments for mental illness,offering advantages such as convenience,flexibility,and the potential to reduce costs by shifting towards preventive care.This article reviews the development and benefits of digital therapy in mental health care and discusses the challenges it faces,including concerns over privacy,ethics,security,acces-sibility issues,digital divides,and the lack of sufficient clinical validation and standardization.It also highlights specific risks to mental health patients and explores potential future developments such as integration with brain-computer interfaces and neurofeedback,the use of robot therapists based on large language models,applications of virtual reality or the metaverse,and combinations with traditional physical treatments and medications.The author calls for urgent policy recommendations to refine regulations,establish unified evidence standards,enhance train-ing and education for healthcare providers and patients,and to build multidisciplinary collaborative mechanisms to advance personalized and effective digital therapy in mental health.

The prevention and treatment of adolescent depression and suicide represent a current focal point. Therefore, it is crucial to understand the risk factors for suicide in adolescents with depression, scientifically monitor suicide risk, and conduct a multidisciplinary collaboration. There is still a lack of authoritative, evidence-based guidelines in China on how to assess suicide risk early time and how to take targeted prevention. This paper introduces the bio-psycho-social joint intervention model, aiming to help clinicians comprehensively assess the suicide risk in adolescents with depression. The author discussed comprehensive assessment methods and a collaborative system involving family, school, medical, and community entities working together as more effective interventions.

The prevention and treatment of adolescent depression and suicide represent a current focal point. Therefore, it is crucial to understand the risk factors for suicide in adolescents with depression, scientifically monitor suicide risk, and conduct a multidisciplinary collaboration. There is still a lack of authoritative, evidence-based guidelines in China on how to assess suicide risk early time and how to take targeted prevention. This paper introduces the bio-psycho-social joint intervention model, aiming to help clinicians comprehensively assess the suicide risk in adolescents with depression. The author discussed comprehensive assessment methods and a collaborative system involving family, school, medical, and community entities working together as more effective interventions.

Schizophrenia is a complex mental disorder influenced by many common genetic variants. Studying the genetic characteristics of schizophrenia is helpful for early prevention and individualized treatment. Previous studies on single or several gene variants in mental disorders achieved limited explanatory power. The polygenic risk score (PRS) recently promised to quantify the genetic risk of polygenic diseases by integrating the risk of all identified genetic variation loci, which has already been used to investigate on clinical features, neuroimaging and drug therapy for schizophrenia. Besides, the combination of PRS and exposome score (ES) could capture the joint effect of gene-environment interaction. Therefore, this current study systematically reviewed these applications of PRS in schizophrenia-related investigations, aiming to provide new ideas for the prevention and treatment of schizophrenia.

Schizophrenia is a complex mental disorder influenced by many common genetic variants. Studying the genetic characteristics of schizophrenia is helpful for early prevention and individualized treatment. Previous studies on single or several gene variants in mental disorders achieved limited explanatory power. The polygenic risk score (PRS) recently promised to quantify the genetic risk of polygenic diseases by integrating the risk of all identified genetic variation loci, which has already been used to investigate on clinical features, neuroimaging and drug therapy for schizophrenia. Besides, the combination of PRS and exposome score (ES) could capture the joint effect of gene-environment interaction. Therefore, this current study systematically reviewed these applications of PRS in schizophrenia-related investigations, aiming to provide new ideas for the prevention and treatment of schizophrenia.

Objective To investigate the incidence and relation to primary diseases of the nonbronchial systemic arteries (NBSA) supply to the pulmonary lesions, and to evaluate the clinical value of transcatheter arterial embolization (TAE) of the responsible NBSA for hemoptysis. Methods The aortography and subclavian artery angiography were performed in 139 patients with hemoptysis, including pulmonary tuberculosis in 66 cases (2 cases with post-thoracoplasty, 1 case with post-lobectomy, and 1 case with ventricular septal defect), bronchiectnsis in 41 ( 1 ease with post-lobectomy and 1 case with post- ligation of patent ductus arteriosus), bronchiogenic carcinoma in 15, unknown hemoptysis in 7, silicosis in 3, broncholithiasis in 3, bronchial cysts in 1, empyema in 1, postoperative lung cancer in 1, and chronic pulmonary embolism in 1, respectively. TAE was performed in patients with the discoverable responsible NBSA. The frequency, distribution and relation to primary diseases of the responsible NBSA were evaluated and the clinical results and complications were observed. Follow-up time ranged from 6 months to 5 years. Results Seventy-three patients (52. 5% ) had nonbronchial systemic contributions, including 5 cases of post-thoracotomy with pulmonary lesions, 1 case complicating with ventricular septal defect, 1 ease with post-ligation of patent ductus arterinsns, and 1 case of chronic pulmonary embolism. The total number of NBSA were 181 including posterior intercostal arteries (n = 88), internal thoracic arteries (n = 27 ), inferior phrenic arteries ( n = 21 ), proper esophageal arteries ( n = 20 ), lateral thoracic arteries ( n = 9 ), subscapular arteries ( n = 7 ), eostocervical trunks ( n = 5 ) and thyrocervical trunks ( n = 4 ) . Main responsible NBSA were posterior intercostal arteries (n = 75 ) and branches of subclavian and axillary artery (n =44) in patients with pulmonary tuberculosis, and proper esophageal arteries (n = 16 ) and inferior phrenic arteries (n = 17 ) in bronchiectasis. The clinical result was satisfactory and the bleeding ceased immediately in 69 eases including 19 cases of failed or repeated bronchial artery embolization (the arteries had been obstructive) and 4 cases of the normal bronchial arteries. No severe complications occurred except ipsilateral cerebellar infarction after subclavian artery angiography in 1 case and respiratory failure after internal thoracic artery embolization in another case. Sixty patients were followed up for more than 6 months. The result demonstrated episodic bloody sputum in 16 patients, re-bleeding in 11 and non-bleeding in another after TAE. Eight patients had non-bleeding and 2 patients had episodic bloody sputum who were re- bleeding and underwent repeated TAE. Conclusions The stimulation of adjacent lesions and the cardiovascular diseases with weakened or defected pulmonary perfusion can lead to the responsible NBSA supply to the lung in hemoptysis. During TAE for hemoptysis, the integrity angiograpby and TAE can improve the curative effect.

Objective To investigate the angiographic manifestation of the proper esophageal artery (PEA),the hish risk factom for the presence of the anomalous PEA in hemoptysis and to evaluate the safety of transcatheter aaefial embolization(TAE) of the PEA using gelatin sponge(GS).Methods Selective esophageal arteriography WSS performed in forty-three patients with hemoptysis,including 15 cases of pulmonary tuberculosis,18 cases of bmnchiectasis,7 cases of posttuberculous bronchiectasis and three cases of lung cancer. One case experienced failure of bronchial arterial embolization. The angiographic manifestation of the PEAs Was studied.The complications of the procedure and clinical results were observed in the patients who underwent TAE using GS.Results Thirty-nine PEAs were catheterized selectively in 37 patients(86.0%).Eighteen anomalous PEAs(46.2%)were catheterized selectively in 17 patients (45.9%).The anomalous PEAs showed tortuosity,dilatation,hyperplasia,shunting with pulmonary artery and anastomosis with the bronchial artery.All lesions involved basal segment of inferior pulmonary lobar. Bronchiectasis Was the most frequent disease for PEA abnormality. No complications occurred and satisfactory curative effect Was achieved with TAE of the anomalous PEAs.Conclusions It is necessary to perform selective proper esophageal arteriography when the lesion involves basal segment of inferior pulmonary lobar in hemoptysis.Supplemental TAE of the anomalous PEA using GS is safe and valuable in the management of hemoptysis.

BACKGROUNDTo explore the possibility of the staging of pulmonary angiography with multi slice spiral CT (MSCT) and to evaluate its value in making surgical plan for patients with lung cancer.

METHODSMSCT with two-segment injection and three-protocol scan was performed in 73 patients with central type lung cancer. According to the site and degree, the involvement of pulmonary artery was divided into three grades and blindly compared with the surgery and pathology.

RESULTSMSCT in 68 cases (93.15%, 68/73) was successfully performed. The involvement of central pulmonary artery was grade I in 4 cases (5.88%, 4/68), grade II in 9 (13.23%, 9/68), and grade III in 55 (80.88%, 55/68). All patients with grade I underwent lobectomy. There was remarkable difference of lobectomy ratio between grade II and III (Chi-square=64.03, P < 0.005) and also between IIIa and IIIb (Chi-square=68.69, P < 0.005). All patients with grade IIIc were ruled out from surgery.

CONCLUSIONSThe staging of pulmonary angiography by MSCT is useful to demonstrate the site and degree of involvement of central pulmonary artery and provides more precise evidence of images for making surgical plan.

Objective To explore the diagnostic value of multi-slice spiral CT with big field of view,thin slice thickness,and postprocessing in endobronchial tuberculosis Methods Ninety-eight clinically diagnosed and tuberculosis bacillus positive patients were included The multi-slice spiral CT was performed using 3 mm thickness scan,MiIP,CVR,and CTVE management The CT diagnosis was made by the single-blind method and was compared with fiberoptic bronchoscope and pathology Results Main CT features were as follows: obstruction of bronchia in 13 cases (9 6%),uniform stricture of bronchia in 27 cases (19 8%),and non-uniform stricture of bronchia in 96 cases (70 6%) The lesions located in the main bronchia in 31 (22 8%),pulmonary lobar bronchia in 81 (59 6%),and pulmonary segmental bronchia in 24 (17 7%),respectively Multiple lesions were found in 56 cases (51 7%) The sensitivity,specificity,and accuracy of multi-slice spiral CT in the diagnosis of endobronchial tuberculosis were 89 8%,63 2%,and 84 6%,respectively Conclusion The exertion of multiple functions of multi-slice spiral CT can increase the diagnostic level for endobrochial tuberculosis,and spiral CT is a good supplementary to fiberoptic bronchoscope

Objective To analyze the CT appearance of pulmonary cryptococcosis (PC) in order to improve the identification of this disease. Methods Twenty-one cases with PC confirmed by pathology or bacteriology in our hospital during 1980. 1 to 2003.2 were retrospectively analyzed. Nine cases had underlying diseases. Results CT appearances were various, including solitary lesion in 11 cases, multiple lesions of single lobe in 5 cases,and bilateral lesions in 5 cases. Nodules or masses measuring 1-10 cm in diameter were found in 16 cases (32 lesions). Cavitation was found in 1 case. Lobar consolidations were found in 2 cases. Diffuse mixed pattern were found in two cases. Pleural effusion was evident in 1 patient. Lymphadenopathy was showed in 4 patients. Conclusion The CT appearance of PC has various modes and forms. The examination of pathogen and pathology at the beginning is the key point in improving the diagnostic accuracy.