Objective:This study aims to explore the independent and interactive effects of childhood trauma (CT) and major depressive disorder (MDD) on amygdala subregion volumes and to examine whether volumetric changes in these subregions mediate the relationship between CT and depressive severity.Methods:A total of 129 MDD patients and 127 age- and sex-matched healthy controls were recruited from Nanjing Brain Hospital between October 2022 and November 2024. All participants underwent 3D-T 1 weighted MRI scans,and amygdala subregions were segmented using the FreeSurfer software. Depressive and anxiety symptoms were assessed with the 17-item Hamilton Depression Rating Scale (HAMD 17) and the Hamilton Anxiety Scale (HAMA),respectively. Childhood trauma exposure was evaluated via the Childhood Trauma Questionnaire (CTQ). Generalized linear models (GLM) were applied to analyze the main and interactive effects of MDD diagnosis (depression/healthy controls) and CT (presence/absence),adjusting for age,estimated intracranial volume,sex,medication history,and education years. Partial correlation and mediation analyses were conducted to explore associations between amygdala subregion volumes and clinical measures in MDD patients. Results:MDD diagnosis was independently associated with increased volumes in the right central nucleus ( Wald χ2=9.09, P=0.026) and medial nucleus ( Wald χ2=10.08, P=0.026). CT exposure was independently associated with reduced volumes in the right central nucleus ( Wald χ2=7.99, P=0.047) and medial nucleus ( Wald χ2=9.20, P=0.047). No significant interaction effects between MDD and CT were observed in any amygdala subregion. Mediation analysis revealed that reduced right medial nucleus volume partially mediated the relationship between total CTQ scores and depressive severity (proportion mediated: 26.69%,95% CI=0.002-0.060) and mediated the association between emotional neglect and depressive severity (proportion mediated: 26.75%,95% CI=0.006-0.150). Such mediating effects were not found for the right central nucleus. Conclusion:CT and MDD exhibit divergent patterns of influence on amygdala subregions. CT is linked to volumetric reductions,whereas MDD is associated with volumetric enlargement. Reduced volume of the right medial nucleus mediates the relationship between CT and depression severity.

Objective:This study aims to explore the independent and interactive effects of childhood trauma (CT) and major depressive disorder (MDD) on amygdala subregion volumes and to examine whether volumetric changes in these subregions mediate the relationship between CT and depressive severity.Methods:A total of 129 MDD patients and 127 age- and sex-matched healthy controls were recruited from Nanjing Brain Hospital between October 2022 and November 2024. All participants underwent 3D-T 1 weighted MRI scans,and amygdala subregions were segmented using the FreeSurfer software. Depressive and anxiety symptoms were assessed with the 17-item Hamilton Depression Rating Scale (HAMD 17) and the Hamilton Anxiety Scale (HAMA),respectively. Childhood trauma exposure was evaluated via the Childhood Trauma Questionnaire (CTQ). Generalized linear models (GLM) were applied to analyze the main and interactive effects of MDD diagnosis (depression/healthy controls) and CT (presence/absence),adjusting for age,estimated intracranial volume,sex,medication history,and education years. Partial correlation and mediation analyses were conducted to explore associations between amygdala subregion volumes and clinical measures in MDD patients. Results:MDD diagnosis was independently associated with increased volumes in the right central nucleus ( Wald χ2=9.09, P=0.026) and medial nucleus ( Wald χ2=10.08, P=0.026). CT exposure was independently associated with reduced volumes in the right central nucleus ( Wald χ2=7.99, P=0.047) and medial nucleus ( Wald χ2=9.20, P=0.047). No significant interaction effects between MDD and CT were observed in any amygdala subregion. Mediation analysis revealed that reduced right medial nucleus volume partially mediated the relationship between total CTQ scores and depressive severity (proportion mediated: 26.69%,95% CI=0.002-0.060) and mediated the association between emotional neglect and depressive severity (proportion mediated: 26.75%,95% CI=0.006-0.150). Such mediating effects were not found for the right central nucleus. Conclusion:CT and MDD exhibit divergent patterns of influence on amygdala subregions. CT is linked to volumetric reductions,whereas MDD is associated with volumetric enlargement. Reduced volume of the right medial nucleus mediates the relationship between CT and depression severity.

Objective:To explore the characteristics of hippocampal subfield volume changes in bipolar disorder (BD) patients with childhood trauma and investigate the correlation between these volume changes and the severity of depressive symptoms.Methods:A total of 112 BD patients in the depressive phase and 62 healthy controls (HC) were recruited from April 2019 to April 2024. All participants were assessed using 17-item Hamilton depression scale (HAMD-17), Hamilton anxiety scale (HAMA), and the childhood trauma questionnaire (CTQ). Based on CTQ scores, BD patients were divided into two groups: the BD with childhood trauma group (BD-CT group, n=51) and the BD without childhood trauma group (BD-nCT group, n=61). T1-weighted magnetic resonance imaging (MRI) scans of the brain were collected for all participants, and hippocampal subfield volumes were segmented using FreeSurfer software.SPSS 26.0 software and Rv 4.1.1 software were used for data analysis.Generalized linear models were used to compare volume differences among three groups. Partial correlation analysis was performed to examine the relationship between the hippocampal subfield volumes showing significant differences and HAMD scores. Results:Significant differences were observed among the three groups in the left CA3(221.49(185.83, 243.02), 194.02(163.53, 226.19), 227.39(200.65, 247.47)), left CA4(261.68(240.89, 285.45), 236.86(210.76, 264.78), 269.75(244.90, 286.03)), left granule cell layer of the dentate gyrus (GC-ML-DG)(307.84(283.35, 328.85), 277.92(249.51, 308.25), 315.39(285.18, 330.25)), and left molecular layer(586.72(549.38, 635.25), 548.16(500.34, 605.24), 602.15(557.63, 637.13)) (Wald χ2=12.81-17.60, all P<0.05). The BD-CT group had significantly smaller volumes in the left CA3, left CA4, left GC-ML-DG, and left molecular layer compared to the BD-nCT group (all P<0.05). The BD-CT group also showed significantly smaller volumes in the left CA3, left CA4, and left GC-ML-DG compared to the HC group (all P<0.05). The volumes of left CA3 ( r=-0.33), left CA4 ( r=-0.31), left GC-ML-DG ( r=-0.31), and left molecular layer ( r=-0.28) regions were negatively correlated with HAMD scores (all P<0.05, Bonferroni correction). Conclusion:BD patients with childhood trauma exhibit reduced volumes in the left hippocampus subfields, including left CA3, left CA4, left GC-ML-DG and left molecular layer.These volume reductions are negatively correlated with the severity of depression.

Objective:To explore the characteristics of hippocampal subfield volume changes in bipolar disorder (BD) patients with childhood trauma and investigate the correlation between these volume changes and the severity of depressive symptoms.Methods:A total of 112 BD patients in the depressive phase and 62 healthy controls (HC) were recruited from April 2019 to April 2024. All participants were assessed using 17-item Hamilton depression scale (HAMD-17), Hamilton anxiety scale (HAMA), and the childhood trauma questionnaire (CTQ). Based on CTQ scores, BD patients were divided into two groups: the BD with childhood trauma group (BD-CT group, n=51) and the BD without childhood trauma group (BD-nCT group, n=61). T1-weighted magnetic resonance imaging (MRI) scans of the brain were collected for all participants, and hippocampal subfield volumes were segmented using FreeSurfer software.SPSS 26.0 software and Rv 4.1.1 software were used for data analysis.Generalized linear models were used to compare volume differences among three groups. Partial correlation analysis was performed to examine the relationship between the hippocampal subfield volumes showing significant differences and HAMD scores. Results:Significant differences were observed among the three groups in the left CA3(221.49(185.83, 243.02), 194.02(163.53, 226.19), 227.39(200.65, 247.47)), left CA4(261.68(240.89, 285.45), 236.86(210.76, 264.78), 269.75(244.90, 286.03)), left granule cell layer of the dentate gyrus (GC-ML-DG)(307.84(283.35, 328.85), 277.92(249.51, 308.25), 315.39(285.18, 330.25)), and left molecular layer(586.72(549.38, 635.25), 548.16(500.34, 605.24), 602.15(557.63, 637.13)) (Wald χ2=12.81-17.60, all P<0.05). The BD-CT group had significantly smaller volumes in the left CA3, left CA4, left GC-ML-DG, and left molecular layer compared to the BD-nCT group (all P<0.05). The BD-CT group also showed significantly smaller volumes in the left CA3, left CA4, and left GC-ML-DG compared to the HC group (all P<0.05). The volumes of left CA3 ( r=-0.33), left CA4 ( r=-0.31), left GC-ML-DG ( r=-0.31), and left molecular layer ( r=-0.28) regions were negatively correlated with HAMD scores (all P<0.05, Bonferroni correction). Conclusion:BD patients with childhood trauma exhibit reduced volumes in the left hippocampus subfields, including left CA3, left CA4, left GC-ML-DG and left molecular layer.These volume reductions are negatively correlated with the severity of depression.

Background/Aims: To evaluate temporal trends of atrial fibrillation (AF) prevalence in critically ill patients who received prolonged mechanical ventilation (MV) in the United States. Methods: We used the 2008 to 2014 National Inpatient Sample to compute the weighted prevalence of AF among hospitalized adult patients on prolonged MV. We used multivariable-adjusted models to evaluate the association of AF with clinical factors, in-hospital mortality, hospitalization cost, and length of stay (LOS). Results: We identified 2,578,165 patients who received prolonged MV (21.27% of AF patients). The prevalence of AF increased from 14.63% in 2008 to 24.43% in 2014 (p for trend < 0.0001). Amongst different phenotypes of critically ill patients, the prevalence of AF increased in patients with severe sepsis, asthma exacerbation, congestive heart failure exacerbation, acute stroke, and cardiac arrest. Older age, male sex, white race, medicare access, higher income, urban teaching hospital setting, and Western region were associated with a higher prevalence of AF. AF in critical illness was a risk factor for in-hospital death (odds ratio, 1.13; 95% confidence interval, 1.11 to 1.15), but in-hospital mortality in critically ill patients with AF decreased from 11.6% to 8.3%. AF was linked to prolonged LOS (2%, p < 0.0001) and high hospitalization cost (4%, p < 0.0001). LOS (–1%, p < 0.0001) and hospitalization cost (–4%, p < 0.0001) decreased yearly. Conclusions The prevalence of comorbid AF is increasing, particularly in older patients. AF may lead to poorer prognosis, and high-quality intensive care is imperative for this population.

Background and purpose:miRNA plays important roles in tumorigenesis. It has been reported that many kinds of serum miRNA serve as markers for tumor diagnosis and screening. This study aimed to detect the expression of serum miRNA-31 (miR-31) in colorectal cancer patients and to explore the effect of miR-31 on cell proliferation, apoptosis and cell cycle distribution. Methods: The expressions of miR-31 in 40 cases of colorectal cancer serum and 35 cases of the healthy control were examined by real-time lfuorescent quantitative polymerase chain reaction (RTFQ-PCR). The correlation between miR-31 expression and clinicopathological features of colorectal cancer (including age, gender, depth of inifltration, lymph node metastasis, clinical stage) were further analyzed. The miR-31 mimics, inhibitor and miR-control (negative control) were transfected into HCT116 cells. The effect of miR-31 on cell proliferation was evaluated by CCK-8 method. Flow cytometry was used to examine the change of cell apoptosis and cell cycle. Results:Relative expression of serum miR-31 was signiifcantly increased in cancer patients compared with healthy controls (P<0.01). Expression of serum miR-31 was higher in poorly differentiated carcinoma than that in well or moderately differentiated carcinoma (P<0.05). No correlation was found between serum miR-31 expression and other clinicopathological variables. CCK-8 assay showed that after transfection with miR-31 mimics, the cell proliferation was increased, compared with miR-31 inhibitor and negative control group. Meantime, the apoptotic cell number was signiifcantly decreased, particularly in late apoptosis. The cell number of G1 stage was remarkably increased in miR-31 inhibitor group, compared with miR-31mimics and negative control group. Conclusion:The expression of serum miR-31 is higher in colorectal cancer. miR-31 can promote cell proliferation and inhibit the apoptosis of HCT116 cells. It might be a potential biomarker for colorectal cancer.

OBJECTIVETo examine the proportion and reasons of drop-out from antiretroviral therapy (ART) among 8 367 adult HIV-infected individuals in Dehong prefecture, Yunnan province.

METHODSAll adult HIV-infected patients receiving ART before September 30 of 2014 were examined for the situation of drop-out from ART.

RESULTSThe proportion of drop-out from ART among adult HIV-infected patients in Dehong prefecture was 14.4% (1 202/8 367). Results from the univariate logistic regression analyses indicated that drop-out from ART was significantly correlated with factors as: living area, gender, age, marital status, HIV transmission route, baseline CD4⁺ T cell counts and initial treatment regimen of the patients. After adjusted for potential confounding variables by multiple logistic regression model, drop-out from ART was significantly correlated with residential area, marital status, HIV transmission route, baseline CD4⁺ T cell count and initial treatment regimen of the patients. HIV-infected patients who were living in Mangshi city, Lianghe county or Yingjiang County, being married or living with partner, HIV infection through sexual contact, with baseline CD4⁺ T cell counts ≤ 200 cells/mm³, and ART included in the initial treatment regimen etc., were less likely to drop out from ART. The proportion of drop out from ART was significantly decreasing along with the increasing time of ART. Data from specific investigation revealed that among the 1 202 patients who dropped out from ART, 704 (58.6%) were lost to follow-up, 303 (25.2%) did not adhere to treatment, 74 (6.2%) moved out the region, 64 (5.3%) were Burmese that had returned to Burma, 29 (2.4%) stopped the treatment according to doctors' advice, 18 (1.5%) were incarcerated and 10 (0.8%) were under other reasons. Reasons for the drop-out varied, according to the situation of patients.

CONCLUSIONThe proportion of drop-out from ART varied significantly according to the characteristics of HIV-infected patients in Dehong prefecture that underscoring the needs for tailored responses to reduce drop-out of ART. Focus should be targeted on reducing the loss to follow-up and improving the treatment adherence.

Objective To examine the proportion and reasons of drop-out from antiretroviral therapy(ART)among 8 367 adult HIV-infected individuals in Dehong prefecture,Yunnan province. Methods All adult HIV-infected patients receiving ART before September 30 of 2014 were examined for the situation of drop-out from ART. Results The proportion of drop-out from ART among adult HIV-infected patients in Dehong prefecture was 14.4%(1 202/8 367). Results from the univariate logistic regression analyses indicated that drop-out from ART was significantly correlated with factors as:living area,gender,age,marital status,HIV transmission route,baseline CD4+T cell counts and initial treatment regimen of the patients. After adjusted for potential confounding variables by multiple logistic regression model,drop-out from ART was significantly correlated with residential area,marital status,HIV transmission route,baseline CD4+T cell count and initial treatment regimen of the patients. HIV-infected patients who were living in Mangshi city,Lianghe county or Yingjiang county,being married or living with partner,HIV infection through sexual contact,with baseline CD4+T cell counts≤200 cells/mm3,and ART included in the initial treatment regimen etc.,were less likely to drop out from ART. The proportion of drop out from ART was significantly decreasing along with the increasing time of ART. Data from specific investigation revealed that among the 1 202 patients who dropped out from ART,704(58.6%)were lost to follow-up,303(25.2%) did not adhere to treatment,74(6.2%)moved out the region,64(5.3%)were Burmese that had returned to Burma,29 (2.4%) stopped the treatment according to doctors’advice,18(1.5%)were incarcerated and 10 (0.8%) were under other reasons. Reasons for the drop-out varied,according to the situation of patients. Conclusion The proportion of drop-out from ART varied significantly according to the characteristics of HIV-infected patients in Dehong prefecture that underscoring the needs for tailored responses to reduce drop-out of ART. Focus should be targeted on reducing the loss to follow-up and improving the treatment adherence.

Objective To examine the proportion and reasons of drop-out from antiretroviral therapy(ART)among 8 367 adult HIV-infected individuals in Dehong prefecture,Yunnan province. Methods All adult HIV-infected patients receiving ART before September 30 of 2014 were examined for the situation of drop-out from ART. Results The proportion of drop-out from ART among adult HIV-infected patients in Dehong prefecture was 14.4%(1 202/8 367). Results from the univariate logistic regression analyses indicated that drop-out from ART was significantly correlated with factors as:living area,gender,age,marital status,HIV transmission route,baseline CD4+T cell counts and initial treatment regimen of the patients. After adjusted for potential confounding variables by multiple logistic regression model,drop-out from ART was significantly correlated with residential area,marital status,HIV transmission route,baseline CD4+T cell count and initial treatment regimen of the patients. HIV-infected patients who were living in Mangshi city,Lianghe county or Yingjiang county,being married or living with partner,HIV infection through sexual contact,with baseline CD4+T cell counts≤200 cells/mm3,and ART included in the initial treatment regimen etc.,were less likely to drop out from ART. The proportion of drop out from ART was significantly decreasing along with the increasing time of ART. Data from specific investigation revealed that among the 1 202 patients who dropped out from ART,704(58.6%)were lost to follow-up,303(25.2%) did not adhere to treatment,74(6.2%)moved out the region,64(5.3%)were Burmese that had returned to Burma,29 (2.4%) stopped the treatment according to doctors’advice,18(1.5%)were incarcerated and 10 (0.8%) were under other reasons. Reasons for the drop-out varied,according to the situation of patients. Conclusion The proportion of drop-out from ART varied significantly according to the characteristics of HIV-infected patients in Dehong prefecture that underscoring the needs for tailored responses to reduce drop-out of ART. Focus should be targeted on reducing the loss to follow-up and improving the treatment adherence.

Purpose:To evaluate the efficacy of treating malignant pleural effusion with S 311 anticancer vaccine by intrapleural injection.Methods:62 cases with malignant pleural effusion,after drainage, S 311 anticancer vaccine 0.16 mg was injected into the pleural cavity in therapy group (T),and cisplatine 40 mg/m 2 in control group (C).The treatment was repeated after a week , then the efficacy, quality of life, survival rate and toxicities was evaluated.Results:The response rate was 90.6% in T group and 60.0% in C group. There was statistical difference between the two groups ( P