BackgroundFamily factors are known to play a critical role in the development， progression and prognosis of adolescent patients with depressive disorder. Psychodrama group therapy has the potential for bringing about positive change in individual growth and relationship repair， but there is currently insufficient research evidence for the effectiveness of psychodrama group therapy in promoting the recovery in depressive disorder in adolescents through improving the family parenting skills of their parents. ObjectiveTo explore the influence of psychodrama group therapy based on family parenting intervention on parents of adolescent patients with depressive disorder， so as to provide references for promoting the recovery for adolescent patients with depressive disorder. MethodsPurposive sampling was used to recruit adolescent patients who met the diagnostic criteria for depressive disorder of the International Classification of Diseases， tenth edition （ICD-10） and hospitalized in the psychiatric outpatient department of the First Affiliated Hospital of Chongqing Medical University from October 2023 to March 2024， and their parents （either mother or father） were taken as the study subjects. Psychodrama group therapy based on family parenting intervention was performed once a week for 6 consecutive weeks. After intervention， semi-structured interviews were conducted with parents who participated in the group， and the interviews were recorded. Content analysis method was employed to perform qualitative analysis on the interview recordings and verbatim transcripts. ResultsAfter receiving psychodrama group intervention based on family parenting， parents of adolescent patients with depressive disorder demonstrated improvement in emotional state， enhanced reflective ability and altered coping style， which were specifically manifested as reducing negative emotions， increasing positive emotions， reflecting on themselves， empathizing with others， adjusting cognition， changing the way of stress regulation， improving communication styles and actively seeking resources. ConclusionApplication of psychodrama group therapy based on family parenting intervention may improve emotional state， reflective ability and coping style of the parents of adolescent patients with depressive disorder. ［Funded by Chongqing Education Commission Humanities and Social Science Research Project （number， 19SKGH018）； Chongqing Social Science Planning Project （number， 2021WT29）］

Objective To noninvasively predict isocitrate dehydrogenase(IDH)status of glioma via combining imaging and clini-cal features before surgery,so as to provide basis for individualized clinical treatment decision.Methods A total of 47 patients with glioma confirmed by pathological and molecular genetic tests were included,including 20 with IDH mutant type and 27 with IDH wild type.After diffusion tensor imaging(DTI)scanning,fractional anisotropy(FA)and mean diffusivity(MD)values of tumor paren-chyma were calculated.Combining DTI parameters with MRI morphological features of tumor,blood neutrophil/lymphocyte ratio(NLR)and patient's age,binary logistic regression model was established to effectively predict IDH status of glioma patients before surgery.Results There were significant differences in FAmean/FANAWM,MDmin,NLR,tumor location and age between IDH mutant type and IDH wild type groups(P<0.05).The binary logistic regression model concluding,FAmean/FANAWM,MDmin,cystic degeneration,NLR and age,predicted IDH status of glioma with area under the curve(AUC)of 0.961 and 95%confidence interval(CI)of 0.914-1.00.Conclusion The regression model established via combining DTI,MRI morphological features and blood NLR has great performance in classifying IDH status of glioma,and can help predict IDH status noninvasively before surgery,so as to assist clinical individualized treatment.

Objective:To investigate the regulatory effect of transient receptor potential cation channel subfamily C member 3 (TRPC3) on the retina in oxygen-induced retinopathy (OIR) mice and biological behavior of human retinal vascular endothelial cells (HREC).Methods:A total of 32 healthy SPF grade 7-day-old C57BL/6 mice were selected and randomly divided into a control group and an OIR group by the random number table method, with 16 mice in each group.The control group received no special treatment, and the OIR model was established in the OIR group.On postnatal day 17 (PN17), the success of the model establishment was verified by immunofluorescence staining of the retinal patch.The in vitro cultured HREC were divided into a normal control group, a transfection reagent group, and a si-TRPC3 group.The normal control group received no special treatment, while the transfection reagent group and the si-TRPC3 group were transfected with transfection reagent or transfection reagent + si-TRPC3.The relative expression of TRPC3 mRNA was detected by real-time quantitative fluorescence PCR.The relative expressions of TRPC3, transcription factor NF-E2 related factor (Nrf2), and superoxide dismutase (SOD) proteins were determined by Western blot.HREC were further divided into a normal control group, a vascular endothelial growth factor (VEGF) group, a si-TRPC3 group, and a Pyr3 (TRPC3 channel inhibitor) group, which were cultured in complete medium, medium containing 20 ng/ml VEGF recombinant protein, medium containing 20 ng/ml VEGF recombinant protein (si-TRPC3 transfection for 72 hours), and medium containing 20 ng/ml VEGF recombinant protein+ 1 μmol/L Pyr3 for 48 hours, respectively.The proliferation ability of HREC was detected using cell counting kit 8 (CCK-8). The horizontal and vertical migration ability of cells were detected by cell scratch assay and transwell assay, respectively.This study followed the 3R principles of animal welfare and was approved by the Ethics Committee of Hebei Eye Hospital (No.2023LW04). Results:Pathological neovascular clusters with strong fluorescent staining appeared in the retina of OIR mice on PN17.The relative expressions of TRPC3 mRNA and protein in the retina of OIR mice were 2.057±0.244 and 1.517±0.290, respectively, significantly higher than 0.983±0.033 and 0.874±0.052 of control group ( t=6.165, 3.094; both at P<0.05). The relative expression levels of TRPC3 mRNA and protein were significantly lower, and the relative expression levels of Nrf2 and SOD proteins were higher in the si-TRPC3 group than in the normal control and transfection reagent groups, and the differences were statistically significant (all at P<0.05). The CCK-8 experiment results showed that the cell absorbance value was higher in the VEGF group than in the normal control group, and lower in the si-TRPC3 and Pyr3 groups than in the VEGF group, with statistically significant differences (all at P<0.05). The results of the cell scratch experiment showed that the lateral migration rate of VEGF group cells was higher than that of normal control group, while the lateral migration rate of si-TRPC3 group and Pyr3 group cells was lower than that of VEGF group, and the differences were statistically significant (all at P<0.05). The transwell experiment results showed that the number of stained cells in the VEGF group was higher than that in the normal control group, and the number of stained cells in the si-TRPC3 group and Pyr3 group was lower than that in the VEGF group, with statistically significant differences (all at P<0.05). Conclusions:Hypoxia induces increased TRPC3 expression in OIR mouse retina, and downregulation of TRPC3 inhibits HREC proliferation and migration.The mechanism is related to the activation of the Nrf2-related oxidative stress pathway.

The occurrence of benign prostate hyperplasia(BPH)was related to disrupted sex steroid hormones,and metformin(Met)had a clinical response to sex steroid hormone-related gynaecological disease.How-ever,whether Met exerts an antiproliferative effect on BPH via sex steroid hormones remains unclear.Here,our clinical study showed that along with prostatic epithelial cell(PEC)proliferation,sex steroid hormones were dysregulated in the serum and prostate of BPH patients.As the major contributor to dysregulated sex steroid hormones,elevated dihydrotestosterone(DHT)had a significant positive rela-tionship with the clinical characteristics of BPH patients.Activation of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)by Met restored dysregulated sex steroid hormone homeostasis and exerted antiproliferative effects against DHT-induced proliferation by inhibiting the formation of androgen receptor(AR)-mediated Yes-associated protein(YAP1)-TEA domain transcription factor(TEAD4)heterodimers.Met's anti-proliferative effects were blocked by AMPK inhibitor or YAP1 over-expression in DHT-cultured BPH-1 cells.Our findings indicated that Met would be a promising clinical therapeutic approach for BPH by inhibiting dysregulated steroid hormone-induced PEC proliferation.

Health technology assessment(HTA)is an important tool to inform health decision-making.Although highly related to ethical issues in the context of HTA,equity has attracted much attention from the academia,a consensus has not yet been reached on how to define and evaluate equity in China and abroad.It introduces the concept of equity,pointes out the necessity to realize health equity and the reflection of equity in healthcare sector,and further elaborates four ways to consider equity,and described the official practice of equity in HTA at home and abroad.It proposes several suggestions for China's HTA:considering equity in HTA and the discussion of equity should depend on specific decision-making scenarios;clarifying what health measurement perspective should be adopted before measuring health equity;paying attention to the value judgment of equity adopted by various stakeholders;conducting basic researches on the general population's preference for health measurement perspectives and value judgments of equity in China in a gesture to improve the evaluation system of equity in HTA.

Objective To describe and analyze the current situation of the four same type of departments in an hospital in order to provide a reference for the construction of"the most cost-effective medical care".Methods The CN-DRG were used to automatically group and compare the medical capacity and inpatient service efficiency of the hospital department groups,and in the refined analysis,one DRG disease group of in situ cancer and non-malignant disease loss uterine surgery and single species uterine fibroid was included,and the Kruskal-Wallis H test was used to further compare the differences in length of stay and various costs.Results It included a total of 22630 patients,whose weights varied from a maximum of 3948.62 in diagnostic group 1 to a minimum of 133.55 in diagnostic group 11.The cost consumption indexes ranged from a minimum of 0.89 in diagnostic group 5 to a maximum of 1.04 in diagnostic group 2,while the time consumption indexes ranged from a minimum of 0.48 in diagnostic group 11 to a maximum of 0.81 in diagnostic group 5.When comparing the diagnostic groups,there were statistically significant differences(P＜0.05)in hospitalization days,total cost,diagnostic cost,therapeutic cost,and cost of supplies.Specifically,when comparing the diagnostic and treatment groups within departments,the differences in hospitalization days and all costs were statistically significant(P＜0.05)in departments 1 and 2,the differences in diagnostic cost,therapeutic cost,and cost of supplies were statistically significant(P＜0.05)in department 3.Conclusion There exists a notable disparity in the extent to which each diagnostic and treatment group contributes to the hospital's service capacity and cost variability.Consequently,it is necessary to reasonably evaluate the length of hospital stay and medical cost of patients to achieve the highest cost-effective medical treatment.

Objective:To explore the value of predicting new-onset heart failure events in patients with hypertrophic cardiomyopathy (HCM) using clinical and cardiac magnetic resonance (CMR) features based on machine learning algorithms.Methods:The study was a retrospective cohort study. Patients with a confirmed diagnosis of HCM who underwent CMR examinations at Beijing Anzhen Hospital from May 2017 to March 2021 were selected and randomly divided into the training set and the validation set in a ratio of 7∶3. Clinical data and CMR parameters (including conventional parameters and radiomics features) were collected. The endpoint events were heart failure hospitalization and heart failure death, with follow-up ending in January 2023. Features with high stability and P value<0.05 in univariate Cox regression analysis were selected. Subsequently, three machine learning algorithms—random forest, decision tree, and XGBoost—were used to build heart failure event prediction models in the training set. The model performance was then evaluated using the independent validation set, with the performance assessed based on the concordance index. Results:A total of 462 patients were included, with a median age of 51 (39, 62) years, of whom 332 (71.9%) were male. There were 323 patients in the training set and 139 in the validation set. The median follow-up time was 42 (28, 52) months. A total of 44 patients (9.5% (44/462)) experienced endpoint events (8 cases of heart failure death and 36 cases of heart failure hospitalization), with 31 events in the training set and 13 in the validation set. Univariate Cox regression analysis identified 39 radiomic features, 4 conventional CMR parameters (left ventricular end-diastolic volume index, left ventricular end-systolic volume index, left ventricular ejection fraction, and late gadolinium enhancement ratio), and 1 clinical feature (history of non-sustained ventricular tachycardia) that could be included in the machine learning model. In the prediction models built with the training set, the concordance indices for the random forest, decision tree, and XGBoost models were 0.966 (95% CI 0.813-0.995), 0.956 (95% CI 0.796-0.992), and 0.973 (95% CI 0.823-0.996), respectively. In the validation set, the concordance indices for the random forest, decision tree, and XGBoost models were 0.854 (95% CI 0.557-0.964), 0.706 (95% CI 0.399-0.896), and 0.703 (95%CI 0.408-0.890), respectively. Conclusion:Integrating clinical and CMR features of HCM patients through machine learning aids in predicting heart failure events, with the random forest model showing superior performance.

Objective:To establish the QAMS method for content determination of eight chemical compositions (chlorogenic acid, neochlorogenic acid, cryptochlorogenin acid, isochlorogenic acid A, isochlorogenic acid C, rutin, morroniside and luteolin-7-O-glucoside) from Lonicera alberti Regel. leaves; To verify the feasibility and applicability of this method in quality control for Lonicera alberti Regel. leaves. Methods:The HPLC analysis was performed on a Agilent Eclipse XDB-C18 (250 mm×4.6 mm,5 μm) with a mobile phase consisted of acetonitrile and 0.1% formic acid solution in gradient elution manner at a flow rate of 1 ml/min. The column temperature was maintained at 30 ℃ and the detection wavelength was set at 258 nm. The injection volume was 10 μl.Results:Chlorogenic acid, neochlorogenic acid, cryptochlorogenin acid, isochlorogenic acid A, isochlorogenic acid C, rutin, morroniside and luteolin-7-O-glucoside had a good linear relationship in the corresponding concentration range ( r≥0.999 6). The average sample recovery rates were 103.16%, 103.98%, 99.49%, 103.78%, 102.74%, 101.12%, 104.62%, and 100.94%, respectively. The RSD values were 1.30%, 1.63%, 2.92%, 2.10%, 1.27%, 2.40%, 1.15%, and 2.76%, respectively. Chlorogenic acid was set as internal reference substance, the relative correction factors of isochlorogenic acid A, isochlorogenic acid C, neochlorogenic acid, cryptochlorogenin acid, morroniside, luteolin-7-O-glucoside, rutin were 0.785 5, 0.693 9, 1.001 5, 1.087 2, 1.233 9, 0.369 1, 0.507 5, respectively. The content determination results of QAMS method and external standard method showed that there was no statistical significance in the comparison of the other six components except for morroniside. Conclusions:The established HPLC method can be used for the quality control of Lonicera alberti Regel. leaves. QAMS can be used to determine the contents of neochlorogenic acid, cryptochlorogenic acid, isochlorogenic acid A, isochlorogenic acid C, rutin and luteolin-7-O-glucoside in Lonicera alberti Regel. leaves.

In the treatment of diabetic gastroparesis(DGP),traditional Chinese medicine has conventionally focused on therapies such as ascending clear and descending turbid,pungent-opening and bitter-descending methods,aiming to regulate the ascending and descending of the spleen and stomach's Qi mechanism and to restore the middle-jiao's transformation as the ultimate goal.By explo-ring the physiological relationship between gallbladder and spleen-stomach and its pathological relationship with DGP,this article sug-gests that the gallbladder also participates in the regulation of blood sugar and digestive activities in the body,which is closely related to the onset of the disease.As the Shao Yang pivot,the gallbladder stores essential fluid,harbors ministerial fire,primarily governs the upward movement and dispersion,and is responsible for decision-making and emotions.The normal flow of Qi,blood,and body flu-ids,as well as the functional activities of the channels and collateral vessels,are closely associated with the gallbladder.When the gallbladder's function becomes abnormal,the body may also exhibit imbalances in the intestinal microbiota,disarray of gastrointestinal hormones,delayed gastric emptying,and elevated blood sugar levels,which aligns with the modern medical understanding of the onset of gastroparesis diabeticorum.Therefore,this article proposes the treatment principle of"venting the wood constraint"and the treatment of DGP according to symptoms,offering a reference for clinical treatment.

Based on the view of the correspondence between nature and man in traditional Chinese medicine TCM),TCM master Professor Xia Guicheng attaches importance to the transformation of yin and yang in the female reproductive rhythm and created the"menstrual cycle rhythm regulation method".Women's special physiological phenomena are manifested in the periodic rhythm.The bi-ological clock is the internal mechanism for producing and regulating the physiological behavior and laws of organisms.The biological clock gene is widely expressed in ovarian granulosa cells,theca cells and corpus luteum cells,and is involved in the synthesis of ster-oid hormones,differentiation of follicular somatic cells,follicle development and ovulation and other physiological processes,playing an important role in female reproductive endocrine.Circadian rhythm disorders can lead to reproductive diseases such as menstrual disor-ders,ovarian dysfunction,and endocrine metabolic disorders.There are similarities between TCM time medicine and the biological clock rhythm system.Fully understanding the impact of the biological clock on female ovarian function,revealing its scientific connota-tion,and clarifying the regulatory method and mechanism will have a positive role in resisting reproductive disorders and optimizing fer-tility.