ObjectiveTo investigate the non-suicidal self-injury （NSSI） behaviors in adolescents with depressive disorder， analyze related influencing factors， and provide theoretical basis and reference for the prevention and treatment of NSSI. MethodsAccording to DSM-5 criteria， 95 depressive adolescents were divided into two groups： one with NSSI （NSSI group） and one without NSSI （nNSSI group）. All patients were assessed with Adolescent Non-suicidal Self-injury Assessment Questionnaire （ANSAQ）， Self-Rating Depression Scale （SDS）， Self-Rating Anxiety Scale （SAS）， Simplified Coping Style Questionnaire （SCSQ）， Experiences in Close Relationships-Relationship Structures Scale （ECR-RS）， and Childhood Trauma Questionnaire-Short Form （CTQ-SF）. The inter-group differences were compared. The influencing factors of NSSI were analyzed by using binary logistic regression. ResultsOf the 95 depressive adolescents， 59 cases of NSSI were identified， with a detection rate of 62.11%. NSSI group had higher scores than nNSSI group on SDS， SAS， negative coping style， paternal attachment anxiety， maternal attachment anxiety and avoidance， CTQ-SF total score， emotional neglect， physical neglect， emotional abuse， and sexual abuse （all P<0.05）. Binary logistic regression analysis showed that anxiety， negative coping style， maternal attachment avoidance and emotional abuse increased the risk of NSSI among adolescents with depressive disorders （all P< 0.05）. ConclusionsAdolescents with depression have a high incidence of NSSI behaviors， which is related to anxiety， negative coping style， maternal attachment avoidance and emotional abuse. In addition to improving patients' depression and anxiety in clinical setting， attention should also be paid to patients' coping styles， parent-child relationship and childhood trauma to reduce the occurrence of NSSI behaviors.

Cognitive dysfunction is the impairment of higher brain functions.Cognitive impairment caused by neuropsychiatric diseases has caused serious impact on patients'quality of life and the outcome of the disease.The transcranial alternating current stimulation(tACS)improves cognitive function by modulating neural oscillations of specific frequencies,affecting the release of neurotransmitters such as serotonin and dopamine,and enhancing local and distal synchronization of brain networks.Specific frequencies of tACS can improve the cognitive impairment caused by Alzheimer disease(AD),schizophrenia,and depression,among which the gamma and theta frequencies of tACS have the most significant effects on cognitive function.tACS has high safety and low operational difficulty,and has great potential to improve cognitive function.

Objective To explore the effect and possible mechanism of aerobic exercise and empagliflozin(EMPA)on isoproterenol(ISO)-induced pathological cardiac remodeling.Methods Mice were divided randomly into control(Con),ISO,exercise(EX)+ISO,EMPA+ISO,and EX+EMPA+ISO groups.Mice in the EX groups were trained continuously for 6 weeks,mice in the EMPA groups were gavaged continuously for 4 weeks,and mice in the ISO groups were injected subcutaneously with ISO for 7 days before dissection.After euthanasia,the whole heart mass index,left heart mass index,heart mass to tibial length ratio,and left heart mass to tibial length ratio were calculated by weighing and measuring.Pathological changes,collagen fiber deposition,and myocardial cell cross-sectional area in the hearts were detected by hematoxylin and eosin,Sirius red,and wheat germ agglutinin staining.The expression levels of genes and proteins related to cardiac fibrosis and hypertrophy,macrophage infiltration,ferroptosis,and the phosphoinositide 3-kinase(PI3K)/AKT pathway were examined by quantitative reverse transcription-polymerase chain reaction,Western Blot,and immunofluorescence staining.Results(1)The whole heart mass index,left heart mass index,heart mass to tibial length ratio,and left heart mass to tibial length ratio showed downward trends in the EX+ISO group compared with the ISO group.The whole heart mass index and left heart mass index were significantly decreased in the EMPA+ISO group(P＜0.01,P＜0.05),and the heart mass to tibial length ratio and left heart mass to tibial length ratio were both down regulated.Mice in the EX+EMPA+ISO group had a significant decrease in whole heart mass index(P＜0.05),and the other three indicators were all down-regulated.(2)Myocardial cells were more orderly in the three intervention groups compared with the ISO group,with significant reductions in inflammatory cell infiltration(P＜0.01),the area of cardiac fibrosis,and the cross-sectional area of myocardial cells(P＜0.001).(3)The mRNA and protein expression levels of Col 1 and Anp were significantly reduced in the three intervention groups compared with the ISO group(P＜0.05,P＜0.01,P＜0.001).Col 3 mRNA expression significantly reduced in the EMPA+ISO and EX+EMPA+ISO groups(P＜0.05),and showed a downward trend in the EX+ISO group.(4)Macrophage infiltration and IL-6 mRNA levels were significantly reduced in the three intervention groups compared with the ISO group(P＜0.05,P＜0.01,P＜0.001).(5)Nrf2 and Gpx4 mRNA levels were upregulated in the three intervention groups compared with the ISO group,with a significant increase in GPX4 protein expression(P＜0.01,P＜0.001)and a significant decrease in HO-1 protein expression(P＜0.01,P＜0.001).(6)Pi3k mRNA levels were significantly increased in the EX+ISO group compared with the ISO group(P＜0.05),and Pi3k mRNA was upregulated in the EMPA+ISO and EX+EMPA+ISO groups.Akt mRNA levels showed an upward trend in the three intervention groups.PI3K and phospho-AKT protein levels were significantly increased in the EX+ISO group(P＜0.01,P＜0.05),and showed an increasing trend in the EMPA+ISO and EX+EMPA+ISO groups.Conclusions Moderate intensity aerobic exercise,the novel hypoglycemic drug EMPA,and their combination can alleviate ISO-induced pathological cardiac remodeling,possibly via a mechanism related to activation of the PI3K/AKT signaling pathway and inhibition of cardiac ferroptosis.

Objective To analyse the effect of baseline serum vascular endothelial growth factor(VEGF)level on clinical factors,pathological features and prognosis of patients with non-triple-negative breast cancer.Methods A total of 120 patients with non-triple-negative breast cancer admitted to the hospital from January 2019 to December 2020 were selected as the study objects.According to the TNM stage of the tumor,the stud-y objects were divided into 80 patients with TNM stage Ⅰ and Ⅱ(group A)and 40 patients with TNM stageⅢ(group B).Serum VEGF levels,clinical factors and pathological features were compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the optimal cut-off value of serum VEGF level in predicting stage Ⅲ breast cancer.Survival curves for overall survival and disease-free survival were plotted using the Kaplan-Meier method,and comparisons were made using the Log-rank test.The effects of baseline serum VEGF levels on overall survival and disease-free survival in non-triple-negative breast cancer were investigated by multivariate Cox regression model.Results Serum VEGF,D-dimer,fibrinogen(FIB),fi-brin degradation products(FDP),cancer antigen 125(CA-125)and cancer antigen 15-3(CA15-3)in group B were significantly different from those in group A(P＜0.05).ROC curve analysis showed that the area under the curve of serum VEGF in TNM stage Ⅲ of non-triple-negative breast cancer was 0.875,95％CI(0.802-0.948),P＜0.001.The levels of D-dimer,FIB,FDP,CA-125 and CA15-3 in serum VEGF≥180.40 pg/mL patients were higher than those in serum VEGF＜180.40pg/mL patients,and the differences were statistically significant(P＜0.05).In patients with serum VEGF＜180.40 pg/mL,the proportion of tumor T1 stage,tumor N0 and N1 stage,TNM stage Ⅰ/Ⅱ,and Luminal type A were higher than those with serum VEGF≥180.40 pg/mL patients,and the differences were statistically significant(P＜0.05).The disease-free survival rate of serum VEGF＜180.40 pg/mL patients was significantly higher than that of serum VEGF≥180.40 pg/mL patients,and the difference was statistically significant(P＜0.001).After correction,VEGF≥180.40 pg/mL was a risk factor for recurrence and metastasis of non-triple-negative breast cancer[HR=2.563,95％CI(1.772-3.708),P＜0.001].Conclusion High baseline VEGF levels are associated with progression of non-triple-negative breast cancer and are an influential factor in its prognosis.

Objective To investigate the characteristics of obese children with asthma and to analyze its influencing factors in Yiling area of Yichang. Methods A stratified random cluster sampling method was used to select 379 obese children with asthma in Yiling area from 2018 to 2019, and 210 healthy children in the same period were selected as the control group. The general information of the children was obtained through questionnaire survey. Univariate and multivariate logistic analyses were conducted for statistical analysis of the data. Results The proportion of male, living in city, family history of asthma, second-hand smoke exposure ≥ 5 days / week, vegetable intake and sweet food intake were higher in the obese children with asthma than those in the control group (P < 0.05). Multivariate logistic analysis revealed that male children, living in city, family history of asthma, second-hand smoke exposure, less vegetable intake and more sweet food intake were risk factors for obesity with asthma in children (P < 0.05); ORs (95% CI) were 1.425 (1.057-1.878), 1.347 (1.124-1.742), 2.014 (1.326-4.222), 1.879 (1.879) 415-3.775）, 2.503（1.550-5.730）, 2.184（1.484-5.371）. Conclusion The incidence rate of childhood obesity and asthma in Yiling was higher in male than in female children. Living in city, family history of asthma, secondhand smoke exposure, less vegetable intake and more sweet food intake were the risk factors for obesity and asthma. Development of effective intervention measures is essential to reduce the incidence rate of childhood obesity and asthma in Yiling.

Objective In observational studies or non-randomized design,the researchers' ability to make causal inferences from data was hampered by confounding factors.This study used this method to analyze a group of observational medical data in order to instruct relevant medical personnel to carry out their own causal inference studies.Methods At present,the four main types of propensity scoring methods:matching,stratification,inverse probability weighting and covariate adjustment have been widely used in the study of causal inference.Propensity score method can theoretically eliminate the bias of the observable confounding factors,so that the treatments variables are close to the result of random assignment design,thus,it is estimated that the treatment factor has a causal effect on the outcome.Results Considering the advantages of the inverse probability weighting method over other methods,this paper summarizes the applicable conditions for the estimate of causal effect,particularly illustrates the use of a modern nonparametric statistical technology--Generalized Boosted Models (GBM) and its advantages and disadvantages.Conclusion When there is a lot of different types of confounding factors,and uncertain functional forms for their associations with treatment selection in linear,non-linear or interaction effect,and other issues,GBM propensity score weighting method can overcome the obstacles in the process of accurately estimating propensity score.

Described in this paper are how to coordinate the acquisition of library holdings for hospital libraries, how to improve their service, and how to effectively train their librarians by The Colleague of Fudan University Medical Libraries in order to provide their effective service for the characteristic innovations in their medical treatment, teaching and research, including top design, joint acquisition, rational allocation of subject library holdings, and improvement of comprehensive service.

Objective To do screening acute lymphoblastic leukemia patients scFv antibody single chain variable region to cre-ate conditions for the expression and obtain further specificity of antibody fragments.Methods In this study,patients with newly diagnosed acute lymphoblastic leukemia serum as coating antigen using phage display technology,screening phage an-tibody specificity from the semi-synthetic human phage antibody libraries,the first to target the immune antigen-coated tab-let,phage library was added,so that with the target antigen-specific binding phage antibody was immobilized on plates immu-nization,could not be specifically bound phages were rinsed.The eluted specific binding phage,E.coli infection.Could get the specific antibody gene containing phagemid.Results After three “adsorption-elution-amplification”screening process,got stronger leukemia patient antigen-specific phage antibody variable region fragment and identification.Conclusion Got better strain affinity antibody fragments,to create the conditions for the next fragment expression,identification and clinical appli-cation.

Objective To investigate the relationship between heart failure with normal ejection fraction and cardiac remodeling.Methods One hundred and eighty-eight cases with chronic heart failure were collected from January 2009 to March 2012 from Department of Cardiology of Longkou People's Hospital.In strictly accordance with the diagnostic criteria,participants were divided into HFNEF(n =109) and HFREF groups (n =79).According to the NYHA classification,HFNEF and HFREF patients were further divided into three subgroups respectively (HFNEF patients:52 cardiac function Ⅱ,36 cardiac function Ⅲ,21 cardiac function Ⅳ ;HFREF patients:13 cardiac function Ⅱ,27 cardiac functionⅢ,39 cardiac functionⅣ).The measurements of the left ventricular ejection fraction (LVEF),left atrial diameter (LAD),interventricular septal thickness (IVST),left ventricular posterior wall thickness (LVPWT),right ventricular diameter (RVD) were conducted in all objects and their clinical data were statistically analyzed.Results Compared with HFREF patients,HFNEF group had older mean age ((64.59 ± 5.34) yrs vs.(58.89 ± 4.23) yrs,t =3.345,P =0.001),more female patients (58.7％ (64/109) vs.41.8％ (33/79),x2 =5.265,P =0.022),higher incidence of hypertension (81.65％ (89/109) vs.63.29％ (50/79),x2 =8.012,P =0.005).LVPWT,IVST,LAD,RVD gradually increased in HFNEF patients with the severity of cardiac function,with significant differences in LVPWT ((9.05 ± 1.89) mm vs.(11.30 ± 2.67) mm vs.(13.90 ± 2.77) mm,F =3.578,P =0.028),IVST ((9.35 ±1.75)mm vs.(11.51 ±2.48)mm vs.(12.98 ±3.01)mm,F =3.081,P =0.048),LAD ((31.23 ±5.98)mm vs.(35.55 ±7.31)mm vs.(44.81 ± 10.72)mm,F =6.711,P ＜0.001),but no difference in RVD ((18.95 ±1.02) mm vs.(19.21 ± 1.11) mm vs.(19.99 ± 0.98) mm,F =2.751,P ＞ 0.05).There was significant difference in LVPWT ((13.90 ±2.77)mm vs.(7.45 ±2.01)mm,t =11.439,P ＜0.001),IVST ((12.98 ±3.01)mm vs.(7.23 ± 1.94)mm,t =10.318,P ＜0.001),RVD ((19.99 ±0.98)mm vs.(23.51 ± 1.10)mm,t =2.838,P ＜ 0.001) between HFNEF and HFREF patients with Ⅳ level of cardiac function,while there was no statistical difference ((44.81 ± 10.72) nn vs.(46.30 ± 11.76) mm),t =1.451,P =0.151) on LAD.Conclusion Senior age,high proportions of women and essential hypertension are found in HFNEF patients.Impaired cardiac function has increasing impact on cardiac remodeling with the increase of severity but it almost has no effect on the right ventricle.Ventricular structural changes exist significantly different from HFNEF to HFREF.Therefore clinicians should have in-depth understanding of the characteristics of the HFNEF and its epidemiology,pathophysiology,diagnostic criteria and treatment principles in order to improve diagnosis and treatment of this class of patients.