Objective:To describe demographic,clinical and physiological characteristics,treatment between first-episode major depressive disorder(MDD)and relapse MDD,and to explore characteristics of relapse MDD.Methods:Totally 858 patients who met the diagnostic criteria for depression of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5),were included by using the Mini International Neuropsychiatric Interview(MINI),Clinician-Rated Dimensions of Psychosis Symptom Severity,and Hamilton Depression Scale etc.Among them,529(58.6％)were first-episode depression and 329(36.0％)were relapsed.The differences of demographic characteristics,clinical and physiological characteristics,treatment were compared byx2test and Kruskal-Wallis rank sum test.Multivariate logistic regression was used to explore the characteristics of MDD recur-rence.Results:Compared to first-episode MDD,relapse MDD had more comorbidity(OR=2.11,95％CI:1.00-4.44),more days out of role(OR=1.26,95％CI:1.01-1.56),more history of using psychiatric drug more than one month(OR=1.41,95％CI:1.02-1.97)and electroconvulsive therapy(OR=3.23,95％CI:1.42-7.36),and higher waist-hip ratio(OR=33.88,95％CI:2.88-399.32).Conclusion:Relapse MDD has positive as-sociation with comorbidity of mental disorders,out of role,and higher waist-hip ratio.

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.

Objective:To explore the effect of grid management combined with guided and driven teaching mode in operation teaching of nursing interns.Methods:From February 2020 to January 2022, 300 nursing interns from the 2020 and 2021 sessions of the Wuxi Second People's Hospital were selected as the research subject by convenience sampling. According to the method of random number table, the nursing interns from February 2020 to January 2021 were set as the control group, and the nursing interns from February 2021 to January 2022 were set as the experimental group, with 150 in each group. The control group adopted the traditional teaching, while the experimental group carried out the grid management combined with guided and driven teaching mode on the basis of the control group. The results, self-study ability, learning enthusiasm, teaching satisfaction, practice satisfaction, and the incidence of sharp tool puncture during the practice were compared between the two groups before and after the practice.Results:After the experiment, the scores of theoretical and operational skills, learning enthusiasm and self-study ability, practice satisfaction of nursing interns in the experimental group were higher than those in the control group, and the incidence of sharp tool puncture was lower than that in the control group, with statistical differences ( P<0.05) . Conclusions:Grid management combined with guided and driven teaching mode can improve the interns' theoretical mastery and clinical operation proficiency, enhance their self-study ability, fully stimulate their learning enthusiasm, and reduce the incidence of clinical accidental injuries, which is worthy of promotion and application.

Streptolysin S (SLS),one of the important virulence factors of Streptococcus,exist in several kinds of human and animal pathogenic bacterial,including Streptococcus pyogenes,Strepstococcus iniae and Streptococcus anginosus.SLS is a peptide toxin encoded by nine consecutive genes (sagA-sagⅠ).The functions of SLS include contributing pathogenic bacterium to pass through epithelial barrier,causing tissue damage,resisting to phagocytic clearance of host immune cells and interacting with other virulence factors.In addition,SLS as a signaling molecule of cell quorum sensing is involved in regulating the expression with other virulence factors.This paper summarized the structures and the biological functions of SLS in Streptococcus infection.

Objective To investigate the effects of glycogen synthase kinase-3β (GSK-3β) and β-catenin signaling on the human renal proximal tubular epithelial HK-2 cell injury induced by depleted uranium(DU),and provide a new enlightenment for the development of DU antidotes.Methods H K-2 cells were exposed to different concentrations of DU for 3-24 h,then the protein expressions of kidney injury molecule 1 (KIM-1),neutrophil gelatinase-associated lipocalin (NGAL) and nuclear β-catenin were detected by immunofluorescence staining.The protein expressions of p-GSK-3 β(S9),GSK-3β and cmyc were detected by Western blot assay.HK-2 cells were transiently transfected by GSK-3β (KD) plasmid or treated by TDZD-8 to inhibit the activity of GSK-3β specifically.Other HK-2 cells were transiently transfected by β-catenin plasmid to overexpress the β-catenin protein.Results The percentages of KIM-1 and NGAL-positive cells increased with DU exposure time and concentrations from 300 and 600 μmol/L,and they were significantly higher than those of the blank control at 6-24 h of DU exposure (KIM-1-positive cells:t =11.06,18.97,30.49,P ＜0.05;t =6.79,16.02,85.45,P ＜ 0.05;NGAL-positive cells:t =11.78,11.37,34.29,P ＜0.05;t =7.34,21.63,36.84,P ＜0.05).In contrast,the ratio of p-GSK-3β (S9) to GSK-3β and percentage of nuclear β-catenin-positive cells were significantly higher than that of the blank control at 3-24 h of DU exposure (p-GSK-3β(S9)/GSK-3β:t =3.95,4.69,5.40,3.34,P ＜ 0.05;nuclear β-catenin-positive cells:t =4.61,6.52,36.64,14.93,P ＜ 0.05) with a maximum response at 9 h of DU exposure accompanied with corresponding increase of protein level of c-myc,a downstream target gene of β-catenin.Transient transfection of HK-2 cells with GSK-3β (KD) plasmid significantly inhibited the activity of GSK-3β (t =8.07,P ＜ 0.05) and reduced the DU-increased percentage of KIM-1-positive cells (t =24.77,P ＜ 0.05).Treatment cells with TDZD-8 inhibited the activity of GSK-3β and enhanced the percentage of nuclear β-catenin-positive cells,and it also significantly reduced the percentage of KIM-1-positive cells in HK-2 cells exposed to DU (t =6.25,6.73,P ＜ 0.05).Moreover,overexpression of β-catenin significantly reduced DU-induced cell injury (t =7.48,P ＜ 0.05).Conclusions GSK-3β/β-catenin signaling plays a key role in regulating the DU-induced cytotoxicity of HK-2 cells.Inhibition of GSK-3β activity and overexpression of β-catenin can protect the HK-2 cells from DU-induced damage.

Cyclin D is the most closely relationship with tumor ,and it is currently known one of the sub-types of cyclins.CyclinD1,as a positive regulatory factor ,has an important role in the process of cell cycle ,espe-cially in cell proliferation and division .CyclinD1 is unusually up-regulated in lots of human cancers .CyclinD1 is a recently discovered protein which is highly expressed in the urinary tumors ,and its expression in tumors is asso-ciated with a more aggressive phenotype ,prognosis and recurrence .Therefore,the research of the target point to CyclinD1 in the urinary tumors may provide a new method for the therapy to urinary tumors .

Objective To evaluate the potential feasibility of γ-H2AX foci as a biodosimetry after exposure to ionizing radiation by comparing DNA double-strand break repair kinetics in rat blood lymphocytes with that in human lymphocytes.Methods Peripheral blood lymphocytes separated from Sprague-Dawley(SD) male rats and healthy adults were exposed to γ-rays,and some rats were also subjected to total body irradiation.The inductions of DNA repair-related foci of γ-H2AX,pATM (S1981) and pDNA-PKcs (T2609) were detected with immunofluorescence staining technique at different time points post-irradiation,and the status of their co-localization was analyzed.Results The induction kinetics of γ-H2AX foci in rat lymphocytes was similar to that observed in human lymphocytes.The frequencies of γ-H2AX foci peaked at 30 min after γ-ray irradiation (trst =62.64,th =28.52,P ＜ 0.05),then decreased rapidly after 6 h post-irradiation (trat =45.96,th =14.80,P ＜0.05),and the residual foci number remained only about 3％-8％ of its maximal value at 24 h post-irradiation.At 30 min after γ-ray irradiation,the frequencies of pATM (S1981) and pDNA-PKcs (T2609) foci in rat and human lymphocytes significantly higher than those of nonirradiated control (trat =21.05,25.80,th =11.07,29.52,P ＜ 0.05),and the frequencies of co-localization of pATM (S1981) or pDNA-PKcs (T2609) foci with γ-H2AX foci also markedly increased by 26％-32％ in irradiated lymphocytes of rat and human (trat =5.34,9.14,thuman =18.32,51.28,P ＜0.05).Moreover,γ-H2AX foci incidence in rat lymphocytes in vitro was consistent with that induced by total body irradiation of rat.The number of γ-H2AX foci in irradiated rat lymphocytes increased with irradiation dose in a linear dose-dependent manner,its slope was similar to that of irradiated human lymphocytes reported by other laboratory.Conclusions Rat is a useful animal model to evaluate radiation biodosimetry with γ-H2AX foci in lymphocytes.The co-activation of ATM and DNA-PK plays an important role in DSB repair in the irradiated lymphocytes of rat and human.

BACKGROUND:Static cold storage is the main storage method of liver transplantation in the past 40 years. There are success cases in foreign countries about the use of mechanical reperfusion in liver transplantation, but there is no large-scale development in China. OBJECTIVE:To investigate and compare the inflammatory cytokines and apoptotic factors in isolated liver between static cold storage and hypothermic machine perfusion before and after liver transplantation. METHODS:There were donor group, static cold storage group and hypothermic machine perfusion group in the study, and 30 dogs were in each group. Liver specimens from donor dogs were subjected to static cold storage and then transplanted into dogs in the static cold storage group. Liver specimens from dogs in the static cold storage group were subjected to hypothermic machine perfusion and then transplanted into dogs in the hypothermic machine perfusion group. Liver specimens from dogs in the hypothermic machine perfusion were used in other experiments. Dogs in the donor group were euthanatized. After liver transplantation, 20 dogs from static cold storage group and hypothermic machine perfusion group were selected respectively for further study. RESULTS AND CONCLUSION: When the liver was separated from the dogs, inflammatory cytokines and apoptosis factors had no significant difference in the static cold storage group and hypothermic machine perfusion group (P > 0.05). P53 expression in these two groups had no significant difference before and after transplantation (P > 0.05). Interleukin-1βand interleukin-8 in these two groups had no significant difference before transplantation (P > 0.05). Compared with the static cold storage group, expressions of tumor necrosis factor-α, macrophage inflammatory protein-1α, macrophage inflammatory protein-1β, CC chemokine ligand 20 and FASR were significantly lower in the hypothermic machine perfusion group before transplantation (P< 0.01). Compared with the static cold storage, interleukin-1β, tumor necrosis factor-α, interleukin-8, macrophage inflammatory protein-1α, macrophage inflammatory protein-1β, CC chemokine ligand 20, FASR and nuclear factor-κB were reduced significantly in the hypothermic machine perfusion group at 60 minutes after transplantation (P < 0.01). Taken together, hypothermic machine perfusion can significantly reduce inflammatory cytokines and apoptosis factor, which is conducive for liver transplantation.

Objective:To define the range and classification of adjuvant drugs. Methods:In order to explore the definition meth-od for the range and classification of adjuvant drugs, the information of definition and classification of adjuvant drugs was obtained by searching PubMed, CNKI, Wanfang database and medicine monographs such as Clinical Medication Notice, New Pharmacology and Martindale:The Complete Drug Reference. Results:The preliminary conclusion on definition, range and classification method for ad-juvant drugs was achieved. Adjuvant drugs were classified into ten categories, so that the adjuvant drugs in our hospital were super-vised. Conclusion:In order to promote the standardized management of clinical application of adjuvant drugs, the range and classifica-tion of adjuvant drugs still need further discussion and standardization.

Objective To explore the expressions of CK20, S100A7 and substance P (SP) in different stages of psoriatic lesions and their relationship. Methods A total of 19 patients, who had received irregular treatment for psoriasis and had both progressive and healed psoriatic lesions, were enrolled in this study. Skin tissue specimens were obtained from perilesional normal skin, progressive lesions and healed lesions of these patients and subjected to immunohistochemical analysis of expressions of CK20, S100A7 and SP. Results The relative expression level (absorbance value obtained from immunohistochemical analysis) was 7683.80 ± 6134.55,18305.04 ± 13171.30, 7257.53 ± 4417.75 for CK20, 8789.05 ± 6240.91, 18058.01 ± 16537.18, 9295.65 ±9310.02 for S100A7, 3242.51 ± 3775.41, 9364.98 ± 7596.64, 2910.85 ± 3349.46 for SP, respectively, in normal skin, progressive lesions and healed psoriatic lesions. A significant increase was observed in the expressions of CK20, S100A7 and SP in progressive lesions compared with normal skin and healed lesions, whereas no statistical difference was noted in those between normal skin and healed lesions (P ＞ 0.05 ). The expression of CK20 was positively correlated with that of S100A7 and SP (r = 0.779, 0.876, both P ＜ 0.05 ). Conclusion The pathogenesis of psoriasis seems to be associated with the changes in the number of Merkel cells.