Objective To investigate the characteristics and influencing factors of mental health status of permanent residents in Yichang, Hubei Province. Methods A total of 9 576 permanent residents aged 18 years and older from Yichang City were selected by a multistage random sampling method between June and October 2022. The PHQ-9 was used to assess the residents’ depressive symptoms, the GAD-7 was used to assess their anxiety symptoms, the ISI was used to assess their insomnia status, and the PCL-5 was used to assess their stress status. The influence factors of depression and anxiety were analyzed using χ2 test and logistic regression. Results A total of 9 122 valid questionnaires were completed. The detection rate of depression, anxiety, insomnia, and stress symptoms were 29.98%, 19.03%, 11.97% and 1.58%, respectively. Gender, education level, monthly family income, self-rated health status, mental health literacy level, total GAD-7 score, total ISI score, and total PCL-5 score were the main factors that caused residents' anxiety symptoms, while gender, education level, self-rated health status, total PHQ-9 score, total ISI score, and total PCL-5 score were the main factors that caused residents' anxiety symptoms. Conclusion The prevalence of depression and anxiety is high among the permanent residents in Yichang, while the situation of insomnia and stress is relatively good. Measures such as improving the level of mental health literacy can be taken to improve mental health level of residents in Yichang.

Objective:To evaluate the feasibility of abandoning prophylactic abdominal drainage in patients undergoing minimally invasive minor hepatectomy based on a propensity score matching (PSM) study.Methods:Retrospective review of a prospectively collected database of patients undergoing minimally invasive minor hepatectomy from July 2022 to May 2023 at the Department of Hepatopancreatobiliary Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital. A total of 108 patients were enrolled, including 48 males and 60 females, aged (60.8±13.7) years old. According to whether the abdominal drainage tube was prophylactically placed intraoperatively, patients were divided into two groups: the drainage group (with prophylactic placement of abdominal drainage tubes, n=76); the no-drainage group (without prophylactic placement of abdominal drainage tubes, n=32). PSM was used to compare the perioperative data between the groups, including extent of liver resection, intraoperative blood loss, operative time, and postoperative complications. Postoperative survival status within 90 days was followed up through telephone review. Results:Before PSM, the two groups differed significantly on age and the history of hypertension (both P<0.05). After PSM, there were 23 patients in each group. Patients in the two groups showed comparable results regarding the intraoperative parameters including the surgical method, pathological types, the number and maxium diameter of hepatic lesions, the extent and complexity of liver resection, and the duration of hepatic inflow occlusion (all P>0.05). No postoperative intra-abdominal bleeding occurred in either group. The incidences of postoperative complications were comparable between the groups, including fever, bile leakage, incision infection, and abdominal acupuncture for drainage (all P>0.05). After PSM, compared to patients wothout prophylactic abdominal drainage, prophylactic abdominal drainage group showed a decreased white blood cell counts on postoperative day 1 [9.39(6.30, 10.58)×10 12/L vs. 13.19(10.15, 14.90)×10 12 /L, P=0.006] and a shorter length of postoperative hospital stay [4(3, 5) d vs. 5(4, 5) d, P=0.033]. No postoperative death within 90 days occurred in either group. Conclusion:In minimally invasive minor hepatectomy, abandoning prophylactic abdominal drainage could be feasible, which facilitates fast recovery without increasing the incidence of postoperative fever, perihepatic fluid accumulation and postoperative abdominal acupuncture for drainage.

Objective This study aims to explore the associations between threat and deprivation childhood traumas and dysfunctional attitudes among patients with major depressive episode,based on the dimensional model of adversity and psychopathology(DMAP).Methods Data from 970 patients with major depressive episode were collected and categorized based on the childhood trauma questionnaire-short form(CTQ-SF)scores into no trauma(426),threat-only(86),deprivation-only(210),and mixed groups(248).Cognitive distortions were assessed using the dysfunctional attitudes scale(DAS),with scores above the upper quartile indicating significant distortions.Multifactorial logistic regression analysis was employed to examine the association between threat and deprivation and dysfunctional attitudes.Results There were significant differences in the proportion of cognitive distortions among the no trauma,threat-only,deprivation-only,and mixed groups(19.25% vs.30.23% vs.20.00% vs.35.89%,P<0.001),with differences across all dimensions(P≤0.001).Multifactorial logistic regression revealed a positive correlation between threat and overall cognitive distortions(OR=2.031,P<0.001),and specific positive correlations with dimensions such as vulnerability(OR=1.709,P<0.001),appeal and repulsion(OR=2.088,P<0.001),perfectionism(OR=2.321,P<0.001),compulsivity(OR=1.765,P=0.001),approval seeking(OR=1.837,P<0.001),dependency(OR=1.554,P=0.006),and autonomous attitudes(OR=1.864,P<0.001).In contrast,deprivation was only positively correlated with the cognitive philosophy dimension(OR=1.495,P=0.015).Conclusion Childhood trauma is closely associated with dysfunctional attitudes in patients with major depressive episode.Threat correlates positively with cognitive distortions in all dimensions except cognitive philosophy,whereas deprivation correlates only with the cognitive philosophy dimension.

Extracellular vesicles(EV)are a group of membrane-bound structures that originate from the endosomal system or are shed from the plasma membrane of cells.EVs can carry a heterogeneous set of molecules,including proteins,lipids,nucleic acids,and membrane receptors from their cell of origin.EV can cross the blood-brain barrier,allowing brain-derived EV(BDEV)to be specifically extracted from peripheral blood using surface markers on neuronal cells.Due to the presence of signals from the central nervous system,such as proteins,lipids,and nucleic acids,BDEV has emerged as a promising tool for exploring the central nervous system.This article provided an overview of the feasibility of BDEV as biomarkers for neurological and psychiatric disorders,as well as their potential for monitoring therapeutic efficacy in the treatment process.

Objective:To investigate the effects of biologics on psychological status and quality of life in patients with inflammatory bowel disease (IBD).Methods:A cross-sectional survey was conducted in 42 hospitals in 22 provinces (autonomous regions and municipalities directly under the central government) from September 2021 to May 2022. General clinical information and the use of biologics were obtained from adult patients diagnosed with IBD who voluntarily participated in the study. Psychological status was evaluated using the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), and Inflammatory Bowel Disease Questionnaire (IBDQ) assessment tools. Counts were analyzed via the Chi-square test, and datasets that were not normally distributed were analyzed via nonparametric tests. P<0.05 was considered statistically significant. Results:A total of 2 478 valid questionnaires were collected. The GAD-7 score of the biologics group was significantly lower than that of the non-use group [6 (2, 9) vs. 7 (3, 10), Z=-3.49, P<0.001]. IBDQ scores [183 (158, 204) vs. 178 (152, 198), Z=-4.11, P<0.001], intestinal symptom scores [61 (52, 67) vs. 58 (49, 65), Z=-5.41, P<0.001], systemic symptom scores [28 (24, 32) vs. 27 (23, 31), Z=-2.37, P=0.018], emotional ability scores [69 (58, 77) vs. 67 (56, 75), Z=-3.58, P<0.001] and social ability scores [26 (22, 29) vs. 25 (22, 29), Z=-2.52, P=0.012] in the biologics group were significantly higher than in the non-use group. GAD-7 scores [5 (2, 9) vs. 6 (3, 10), Z=-3.50, P<0.001] and PSQI scores [6 (4, 9) vs. 6 (4, 9), Z=-2.55, P=0.011] were significantly lower in the group using infliximab than in the group not using it. IBDQ scores were significantly higher in patients using vedolizumab than in those not using it [186 (159, 205) vs. 181 (155, 201), Z=-2.32, P=0.021] and were also significantly higher in the group treated with adalimumab than in the group not treated with adalimumab [187 (159, 209) vs. 181 (155, 201), Z=-2.16, P=0.030]. However, ustekinumab had no significant effect on any of the scores. Conclusion:The use of biologics is strongly associated with improvements in anxiety status and quality of life in IBD patients.

Nephrotic syndrome (NS) is associated with cerebral venous sinus thrombosis (CVST), which is a rare cerebrovascular disorder in children. Systemic anticoagulation with heparin is the standard therapy for CVST, and mechanical thrombectomy (MT) has been described as a salvage treatment for adult anticoagulant refractory CVST, However, it has never been reported in children. We describe a case of MT for refractory CVST in a child with NS. A 13-year-old boy with newly diagnosed NS presented to an emergency department with acute headache. A head computed tomography showed acute thrombus in the superior sagittal sinus, straight sinus and transverse sinus. The child was started on heparin therapy, but clinically deteriorated and became unresponsive. In view of the rapid deterioration of the condition after anticoagulation treatment, the patient received intravascular treatment. Several endovascular technologies, such as stent retriever and large bore suction catheter have been adopted. After endovascular treatment, the patient’s neurological condition was improved within 24 hours, and magnetic resonance venography of the head demonstrated that the CVST was reduced. The child recovered with normal neurological function at discharge. This case highlights the importance of considering MT for refractory CVST, and we suggest that MT may be considered for refractory CVST with NS in children.

Objective:To study the safety and feasibility of en-bloc lymph node dissection in laparoscopic radical resection for gallbladder cancer(GBC).Methods:The clinical data of 87 patients who underwent laparoscopic radical resection for GBC at Zhejiang Provincial People's Hospital from January 2014 to February 2022 were retrospectively analyzed. There were 26 males and 61 females, aged 67.0 (59.0, 72.0) years old. The patients were divided into the en-bloc dissection group ( n=29) and the non-en-bloc dissection group ( n=58) based on whether en-bloc lymph node dissection was carried out. Differences in general data, tumor characteristics, operation, recurrence and survival were compared between the two groups. Postoperative survival status of these patients was followed-up by telephone. Results:The number of lymph nodes dissected in the en-bloc dissection group was 9.0(8.0, 12.0), which was significantly higher than the 8.0(4.8, 11.0) in the non-en-bloc dissection group ( Z=-2.39, P=0.017). There were no significant differences in age, gender, preoperative blood biochemical indexes, tumor carbohydrate antigen 19-9, tumor stage, nerve and vascular invasion, operation time, intraoperative blood loss, postoperative drainage tube retention time, postoperative hospital stay, and incidences of postoperative complications (biliary fistula, abdominal hemorrhage and abdominal infection) between the two groups (all P>0.05). The median survival was longer in the en-bloc group than in the non-en-bloc group (21 vs. 15 months), and the median relapse-free survival time was 18 months in the en-bloc group compared with 10 months in the non-en-bloc group. However, there were no significant differences in postoperative cumulative survival and recurrence-free survival between the two groups (all P>0.05). Conclusion:En-bloc lymphadenectomy was safe and feasible in laparoscopic radical GBC surgery, with more lymph nodes being removed than the non-en-bloc lymphadenectomy group.

Objective To understand the health-related quality of life (HRQOL) of migrant workers with pneumoconiosis who received basic medical treatment in Hunan Province. Methods A total of 613 migrant workers with pneumoconiosis who received basic medical treatment and assistance in Hunan Province was selected as the study subjects using stratified random sampling method. The European Quality of Life-5 Dimensions (EQ-5D) questionnaire was used to assess their HRQOL. Results The abnormality of the five dimensions of the EQ-5D health description system, from high to low, were as follows： daily activities, mobility, pain/discomfort, anxiety/depression, and self-care, with the abnormal rates of 50.9%, 46.8%, 41.1%, 21.0%, and 14.5%, respectively. The visual analogue scale (VAS) score of EQ-5D was (63.5±18.6) points. Patients with stage Ⅲ pneumoconiosis had high abnormality in mobility, daily activities, and pain/discomfort compared with those with stage Ⅰ and Ⅱ disease (all P<0.02). Patients in stage Ⅱ and Ⅲ of pneumoconiosis had higher incidence of anxiety/depression compared with those with stage I disease (all P<0.02). Patients with complications in addition to pneumoconiosis had higher abnormality in mobility, self-care, and pain/discomfort compared to those with simple pneumoconiosis or those eligible for lung lavage treatment (all P<0.02). Patients with simple pneumoconiosis had a higher incidence of anxiety/depression compared with those eligible for lung lavage treatment (P<0.02). Patients with stage Ⅲ pneumoconiosis had lower average VAS scores compared with stage Ⅰ and Ⅱ patients (all P<0.02). Patients with simple pneumoconiosis or those with complications had lower average VAS scores compared with those eligible for lung lavage treatment (all P<0.05). Conclusion The HRQOL of pneumoconiosis patients among migrant workers needs improvement, especially for patients with stage Ⅲ disease and those with complications. This study indicates the need of optimizing policies, raising the hospitalization expense limit for critically ill patients with stage Ⅲ pneumoconiosis or with complications, and improving their HRQOL.

Objective:To investigate the associations of brain white matter integrity deficits, and to explore the association of fractional anisotropy (FA) abnormality with clinical symptoms and cognitive impairments, as well as the prediction effect of the FA alterations on symptoms and cognitive function outcomes in the acute stage of schizophrenia from the whole brain level based on magnetic resonance diffusion tensor imaging (DTI).Methods:From November 2019 to December 2020, thirty-eight patients with first-episode schizophrenia and 38 healthy controls were recruited in this study. Wisconsin card classification test (WCST), digit span test (DST forward/backward), verbal fluency test, Stroop (A/B/C), trail making test (TMT-A/B), as well as positive and negative syndrome scale (PANSS) were utilized to evaluate patients' cognitive function and clinical symptoms both before and after 8 weeks of risperidone monotherapy. T1-weighted images and DTI data of all the subjects were collected . FSL and SPM8 were used to preprocess MRI data and compare the between-group differences of FA. Support vector machine (SVM) analysis was used to evaluate the accuracy of abnormal FA values in differentiating schizophrenic patients from healthy controls. Finally, stepwise multiple regression analysis or generalized linear models were used to explore the associations between white matter integrity and symptoms or cognition.Results:Before treatment, patients' FA values of right medial temporal lobe (mTL), cuneus, anterior cingulate gyrus (ACG) and inferior parietal lobe (IPL) were significantly lower than those in healthy controls ( P<0.01, GRF corrected), and patients' FA values of bilateral middle cingulate gyrus (mCG) were significantly higher than those in the control group ( P<0.01, GRF corrected). SVM analysis showed that four combinations could distinguish the patients from the control with the most accurate rate of 89.47%. Patients' baseline decreased FA values in the right IPL were positively associated with their increased total response time in WCST ( β=0.489, P=0.003, FDR corrected), correct response time in WCST ( β=0.450, P=0.008, FDR corrected), error response time in WCST ( β=0.435, P=0.008, FDR corrected), TMT-B ( β=0.296, P=0.042, FDR corrected), Stroop-C ( β=0.345, P=0.035, FDR corrected), and PANSS-P ( β=0.321, P=0.042, FDR corrected). Reduced FA values in the right mTL in patient group were significantly negatively related to the total time spent on the TMT-A ( β=-0.425, P=0.009, FDR corrected) and TMT-B ( β=-0.325, P=0.026 with FDR correction). Increased FA values in right mCG in patient group demonstrated positive associations with total response time in the WCST ( β=0.585, P=0.002, FDR corrected), correct response time in WCST ( β=0.524, P=0.003, FDR corrected), error response time in WCST ( β=0.536, P=0.003, FDR corrected) and total time consuming in TMT-B ( β=0.484, P=0.004, FDR corrected), as well as negative associations with DST-forward ( β=-0.319, P=0.042, FDR corrected). After treatment, patients' percentage changes in total response time of WCST ( β=0.715, P<0.001, FDR corrected), correct response time of WCST ( β=0.752, P<0.001, FDR corrected), as well as total time-consuming of TMT-A ( β=1.333, P=0.001, FDR corrected) showed positive correlations with baseline increased FA values in the left mCG. Percentage alteration of Stroop-B was negatively correlated with baseline FA values in the right cuneus ( β=-0.745, P=0.015, FDR corrected). Conclusions:The combination of abnormal FA values in multiple brain regions may be potential biomarkers to distinguish schizophrenic patients from healthy volunteers. There was regional dependence in the associations of the impairment of white matter integrity with the cognitive impairment, the severity of psychopathological symptoms as well as the prognosis of patients in the acute stage.

In recent years, the role of inflammation in depression has received people's attention.Studies have suggested that immune disorder may play an important role in depression, and patients with depression exhibit characteristic immunophenotypes.Inflammation seems to interact with a variety of pathogenesis of depression.Therefore, immunoregulation is becoming an adjuvant therapy for depression.Clinically, not only antidepressants show anti-inflammatory effects, but also anti-inflammatory drugs show antidepressant effects, and they mainly including non-steroidal anti-inflammatory drugs, statins, and cytokine inhibitors.In addition, some non-drug treatment methods are also given immunomodulatory effects, such as electric shock therapy, vagus nerve stimulation, acupuncture and exercise therapy.However, there are still some problems in immunomodulation therapy, such as immunomodulation therapy may be only effective for some subgroups of patients, and its efficacy and safety need to be evaluated.In the future, looking for more effective biomarkers and identifying immune-inflammation-related subtype of depression, will serve to explore new diagnosis and treatment strategies.