Myocardial ischemia/reperfusion injury(MIRI)occurs after cardiopulmonary bypass open heart surgery,cardiovascular intervention and thrombolytic therapy,which is the most important cause of cardiac insufficiency,heart fail-ure,and even death in patients after treatment.In recent years,studies have found that the release of endogenous active peptides can alleviate the production of MIRI,and regulating the function and action of endogenous peptides may be one of the most effective ways to treat MIRI.Dipeptidyl peptidase 4(DPP4)is an important serine protease in mammals,with enzymatic activity to hydrolyze endogenous peptides.Its primary physiological function is to metabolize short peptides,in-cluding growth factors,hormones,etc.This review aims to better understand and search for effective therapeutic targets by elucidating the impact of DPP4 on the hydrolysis of endogenous peptides in MIRI,and ultimately provide new ideas for the therapeutic effects of MIRI.

Objective:To investigate the topological properties of whole-brain functional networks in first-episode drug-na?ve adolescents with major depressive disorder (MDD).Methods:Seventy-six first-episode drug-na?ve adolescents with MDD admitted to Department of Neurology, Xiangyang No.1 Hospital Affilated to Hubei University of Medicince from January 2022 to January 2023 were selected as study subjects; 66 gender- and age-matched healthy controls (HCs) were recruited via advertisement. All subjects underwent resting-state functional MRI. The whole-brain functional networks were constructed for each subject; and then, the global topological metrics (global efficiency, local efficiency, clustering coefficient, characteristic path length, normalized clustering coefficient, normalized characteristic path length, and small-worldness properties) and local topological metrics (nodal degree centrality, nodal efficiency and nodal betweenness centrality) of the functional brain networks were analyzed between the two groups using graph-theory methods. Network-based statistics were used to examine between-group differences in functional connectivity strength of whole brain networks. Results:Small-worldness properties were demonstrated in both MDD group and HC group. MDD patients showed significantly higher global efficiency (0.129[0.124, 0.132] vs. 0.131[0.128, 0.133]), significantly lower clustering coefficient and characteristic path length (0.143[0.139, 0.146] vs. 0.139[0.135, 0.144]; 0.457[0.446, 0.734] vs. 0.451[0.440, 0.463]), and significantly increased nodal centralities in the right inferior parietal lobule, bilateral caudate nucleus and bilateral thalamus of brain functional networks compared with HCs ( P<0.05, FDR-corrected). Compared with HCs, MDD patients exhibited obviously lower functional connectivity strength in the orbitofrontal-temporal and anterior cingulate-limbic-temporal circuits. Conclusion:Abnormal alterations of topological properties of the brain functional networks are found in adolescents with MDD, which may be the underlying neuropathologic basis for MDD.

Objective    To explore the application value of machine learning models in predicting postoperative survival of patients with thoracic squamous esophageal cancer. Methods    The clinical data of 369 patients with thoracic esophageal squamous carcinoma who underwent radical esophageal cancer surgery at the Department of Thoracic Surgery of Northern Jiangsu People's Hospital from January 2014 to September 2015 were retrospectively analyzed. There were 279 (75.6%) males and 90 (24.4%) females aged 41-78 years. The patients were randomly divided into a training set (259 patients) and a test set (110 patients) with a ratio of 7 : 3. Variable screening was performed by selecting the best subset of features. Six machine learning models were constructed on this basis and validated in an independent test set. The  performance of the models' predictions was evaluated by area under the curve (AUC), accuracy and logarithmic loss, and the fit of the models was reflected by calibration curves. The best model was selected as the final model. Risk stratification was performed using X-tile, and survival analysis was performed using the Kaplan-Meier method with log-rank test. Results    The 5-year postoperative survival rate of the patients was 67.5%. All clinicopathological characteristics of patients between the two groups in the training and test sets were not statistically different (P>0.05). A total of seven variables, including hypertension, history of smoking, history of alcohol consumption, degree of tissue differentiation, pN stage, vascular invasion and nerve invasion, were included for modelling. The AUC values for each model in the independent test set were: decision tree (AUC=0.796), support vector machine (AUC=0.829), random forest (AUC=0.831), logistic regression (AUC=0.838), gradient boosting machine (AUC=0.846), and XGBoost (AUC=0.853). The XGBoost model was finally selected as the best model, and risk stratification was performed on the training and test sets. Patients in the training and test sets were divided into a low risk group, an intermediate risk group and a high risk group, respectively. In both data sets, the differences in surgical prognosis among three groups were statistically significant (P<0.001). Conclusion    Machine learning models have high value in predicting postoperative prognosis of thoracic squamous esophageal cancer. The XGBoost model outperforms common machine learning methods in predicting 5-year survival of patients with thoracic squamous esophageal cancer, and it has high utility and reliability.

Objective: To compare the reliability of Internet Addiction Impairment Index (IAII), Revised Chen Internet Addiction Scale(CIAS-R)-Taiwan Revision, CIAS-R-Mainland Revision, Young Diagnostic Questionnaire (YDQ) and the consistency of Internet addiction using the four scales in college students. Methods: A total of 1 004 undergraduates from 3 universities in Hefei were selected to measure the tendency of internet addiction simultaneously using the four scales, and 122 students were re tested two weeks after the initial assessment. Correlation coefficient, coincidence rate and Kappa value were used to analyze the consistency of the four scales. Analysis of variance, t test and Logistic regression were used to determine the consistency of the factors related to internet addiction scale. Results: The reliability of the four Internet addiction scales were greater than 0.7( P <0.01). The correlation coefficient among all scales was greater than 0.5( P <0.01). The agreement between YDQ and CIAS-R-Mainland Revision was 0.87. The Kappa value of YDQ and CIAS-R-Taiwan Revision in the consistency analysis was 0.51( P <0.01), the Kappa value between the other scales was less than 0.5. Results showed that the four scales were consistent in Internet addiction prevalence by gender, grade and major, while CIAS-R-Taiwan Revision and YDQ were not consistent with the other two scales in sleep disorder. Conclusion The four Internet addiction scales all have good reliability, while low agreement in Internet addiction assessment, suggesting further improvement and revision in Internet addiction scales.

Obsessive-compulsive disorder (OCD), which has the main clinical features of intrusive obsessions and compulsive behaviors, is listed as one of the top ten disabling diseases by the World Health Organization.Error related negativity(ERN) is a neurocognitive alarm signal in the case of errors.The individual differences in the ERN reflect the variability in reactivity to errors and to an internally generated threat.More and more studies have reported that ERN amplitudes in OCD have significantly increased.As a result, overactive error-monitoring is a core dysfunction disorder in OCD, which is closely related to the key symptoms of OCD including worry, doubt, repeating check behaviors.In addition, the increased ERN amplitudes are expected to serve as a diagnostic or predictive marker of OCD as well as a potential intervention target of this disease.Therefore, further understanding about the relationship between ERN and pathophysiology of OCD plays an important role in the effective diagnosis and treatment of OCD.The current paper aims to review the research results of ERN in patients with OCD and explore the following issues: the common experiment paradigms of ERN in OCD, the brain region sources of ERN in OCD, the characteristic manifestations of ERN in OCD, influencing factors of ERN and clinical value and application of ERN in OCD.In a word, it will provide reference for clinical practice and scientific research in the future.

Objective:To explore the incidence and risk factors of preoperative deep vein thrombosis (DVT) of elective total joint arthroplasty (TJA).Methods:Data of 500 patients before TJA from March 2015 to August 2016 who underwent ultrasound surveillance were retrospectively analyzed. All patients were divided into DVT group and non-DVT group according to results of ultrasound. Parameters including demographic data, basic medical history, and surgical information and laboratory indexes were collected. Risk factors were assessed via univariate, multivariate and logistic regression analysis.Results:Preoperative DVT was detected in 23 cases (4.6%, 23/500), all of which occurred in the intermuscular vein with no symptom, and among them there were 16 cases (5.6%, 16/285) before total knee arthroplasty and 7 cases (3.3%, 7/215) before total hip arthroplasty. Univariate analysis showed that age ( t=2.266, P=0.024), female patients ( χ2=4.028, P=0.045), history of hypertension ( χ2=7.907, P=0.005), D-dimer ≥0.5 μg/ml ( χ2=13.171, P < 0.001) were significantly higher than those in non-DVT group, and the differences were statistically significant. Multivariate analysis showed that D-dimer ≥0.5 μg/ml [ OR=6.655, 95% CI (1.929, 22.960), P=0.003] and history of hypertension [ OR=2.715, 95% CI (1.017, 7.250), P=0.046] were independent risk factors for preoperative DVT. Among them, the thrombus of 14 cases located in the operation side, 6 cases in non-operation side, and 3 cases in bilateral sides. Postoperative ultrasound showed that newly DVT occurred in 9 patients of whom 5 cases located in the contralateral muscular veins and 4 cases in the nearby muscular veins. After discharge, 22 patients (95.7%) with preoperative DVT were further evaluated by ultrasound. The average follow-up time was 3.0 months (range from 6 weeks to 9 months). The results showed that thrombus of 7 cases were completely dissolved, 13 cases were partially dissolved, and 2 cases remained unchanged. Thrombus extensions to proximal veins or symptomatic PE were not found. Conclusion:The incidence of preoperative DVT in patients with elective joint replacement was about 4.6%, among which D-dimer ≥0.5 μg/ml and history of hypertension were the risk factors for preoperative thrombosis.

Objective:To test whether the constructed intervention model of advance care planning (ACP) for patients with advanced cancer can be successfully implemented and the preliminary intervention effect, which provides reference for empirical research.Methods:32 cases of advanced cancer patients and 25 cases of their families at the Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai were selected. The patients were subdivided into the experimental group and the control group by random number table method. The control group received routine nursing, while the experimental group adopted the intervention model of "VIP for future care" on the basis of customary nursing. We measured the main outcome indicators: enrollment rate, consent rate, completion rate and loss of follow-up rate and secondary outcome indicators: decision-making certainty, end-of-life care preference and post-intervention satisfaction of patients and their families, within 1 week and 1 month after intervention.Results:The enrollment rate, consent rate and loss of follow-up rate were 74.6% (206/276), 36.9% (76/151)and 15.6% (5/32), respectively. After intervention, the completion rates of the experimental group and the control group were 16/16 and 15/16 within one week, and 14/16 and 13/16 within one month. All of the family members were conducted during the follow-up period. The intervention mode of "VIP for future care" had a statistically significant difference in decision-making certainty between the two groups of patients ( β=0.63, 95% CI 0.08-1.18, P<0.05), no statistically significant difference in end-of-life care preference between the two groups of patients and their families ( P>0.05), and had a statistically significant difference in "whether to recommend this project to others" between the two groups ( χ2 value was 4.167 , P<0.05). Conclusions:On the premise of sufficient preparation, the "VIP for future care" intervention mode can be successfully implemented in advanced cancer patients in mainland China, can improve the decision-making certainty of patients and the satisfaction of patients and their families, and it is recommended. And should be applied to ACP intervention for patients with advanced cancer.

Objective:To compared theclinic effectiveness ofBikini incision with that of traditional incisionbased on a short-term following and provide a suggesting reference for surgeons.Methods:The data of patients who accepted total hip arthroplasty (THA) through direct anterior approach (DAA) from January to November in 2019 were collected, male 13 and female 73, age 67.5±11.8 years (42-90 years). Forty-three patients were recruited to analyzeas one retrospective study in each group. Bikini incision: male 5 and female 38; age 69.7±10.8 years (51-90 years), following up 5.7 months (3.0-8.5 months). Traditional incision: male 8 and female 35; age 66.1±10.6 years (42-90 years), following up 6.5 months (3.0-10.0 months). The length area of incision, duration of operation, intraoperative blood loss, the rate of infection, lateral femoral cutaneous nerve (LFCN) deficits, and the Harris score were analyzed between those two groups. The scars were evaluated according toPatients Scar Assessment Scale and Vancouver Scar Scale.Results:There were no significant difference in age, sex, BMI and diseases distribution between Bikini and traditional incision group. The length of incision, duration of operation, analgesic drugs dosage and hip Harris score wereanalysed no significant difference between those two groups. No patients in those twogroupssuffered from infection of incision. As to LFCN deficits, Bikini group had lower than traditional group (11.6% vs 32.6%, P=0.019). The scar area of Bikini group 1.0±0.4 cm 2 wasmeasured smaller rate than that of traditional group 16.5±28.7 cm 2. As to the Patients Scar Assessment Scale and Vancouver Scar Scale, Bikini group was 8.2±3.2 and 2.4±1.8, which was better than traditional group which was 17.0±5.8 and 4.2±3.0. Conclusion:Compared to traditional incision, Bikini incision was evaluated having significant lower rate of LFCN deficits and smaller scar,good cosmetic appearance and clinical application value.

Objective: To explore the mediating role played by college students social anxiety and social support in the relationship between internet addiction and depression. Methods: A cluster random sampling method was used to conduct a questionnaire survey among 3 536 college students in three higher vocational colleges in Anhui Province. The content included general demographic characteristics, depression, Internet addiction, social support, and social anxiety. The Process program was used to mediate and analysis of regulation. Results: Among the survey subjects, 1 552(43.90%) had depressive symptoms, including 561(45.65%) boys and 991(42.96%) girls.The total score of Internet addiction was significantly positively correlated with depression score(r=0.30, P<0.01); social anxiety(social fear, social avoidance) was positively correlated with depression(r=0.24, 0.27, P<0.01); social support(subjective support, objective support, support utilization) was significantly negatively correlated with depression(r=0.25, -0.23, -0.17, P<0.01). Conditional process analysis shows that social anxiety had a mediating role between internet addiction and depression(c'=0.06, P<0.01), and that Internet addiction and social anxiety were regulated by social support(β=-0.00，P=0.02). Conclusion By increasing the social support of college students to improve social anxiety, it might help to reduce the depression of college students caused by Internet addiction.

Objective To analyze the CT features of cavitation between primary lung adenocarcinoma and squamous cell cancer.Methods The CT findings of cavity of primary lung adenocarcinoma and squamous cell carcinoma were evaluated in 57 patients,including 33 of squamous cell carcinoma and 24 of adenocarcinoma.The clinical data and CT features were analyzed retrospectively using the independent samples t-test,Pearson Chi-square test or Fisher's exact test.Results The mean age of ptients with squamous cell carcinoma was higher than that of patients with adenocarcinoma (65.57-4-9.26 vs 58.75 ± 11.12,P =0.015).Statistical differences were found in distribution of gender and smoking habit between the two kinds of carcinomas (P =0.014 and P =0.029).The T stages were also different between the two carcinomas (P=0.003).In addition,the maximum diameter of tumor (P =0.003),the maximum diameter of cavity (P =0.029) and the maximum thickness of the cavity wall (P=0.001) of squamous cell carcinoma were higher than those of adenocarcinoma.Moreover,the presence of ground-glass opacity (P =0.010),vessel passing through the cavity (P =0.001),septum inside the cavity (P＜0.001) and tumoral bronchogram (P =0.027) in adenocarcinoma were higher than those in squamous cell carcinoma.Conclusion There are significant differences between adenocarcinoma and squamous cell carcinoma in the population distribution and image features,comprehensive analysis helps the differential diagnosis.