BACKGROUND Knee osteoarthritis(KOA),a common disabling pathology characterized by knee joint pain,swelling,and functional impairment,primarily affects middle-aged and older adults.In addition to physical limitations,c...BACKGROUND Knee osteoarthritis(KOA),a common disabling pathology characterized by knee joint pain,swelling,and functional impairment,primarily affects middle-aged and older adults.In addition to physical limitations,chronic pain often leads to psychological problems,including anxiety and depression,which further impact patients’quality of life.AIM To examine the efficacy and safety of celecoxib plus duloxetine in managing chronic pain,anxiety,and depression in patients with KOA.METHODS A retrospective analysis was conducted on 123 patients with KOA treated at our center between February 2020 and February 2023.Of these,66 received celecoxib plus duloxetine,and 57 received celecoxib alone.Outcomes were assessed using the Visual Analog Scale(VAS),the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),and the Self-Rating Anxiety Scales(SAS)/Self-Rating Depression Scales(SDS).Safety was evaluated by monitoring changes in liver function enzymes(alanine aminotransferase,aspartate aminotransferase),creatinine,and blood urea nitrogen.RESULTS Patients receiving celecoxib plus duloxetine showed significantly greater reductions in VAS and WOMAC and greater improvements in SAS and SDS scores compared with those receiving celecoxib alone.Hepatorenal function did not differ significantly between the treatment groups.Logistic regression analysis identified patient age,educational background,and treatment regimen as independent predictors of inadequate improvement in negative emotional symptoms.CONCLUSION In patients with KOA,celecoxib plus duloxetine effectively mitigates chronic pain and improves anxiety and depressive symptoms without increasing adverse hepatic or renal effects.These findings support its use as a safe and effective treatment option.展开更多
BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental...BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental suicidal ideation among children with CHD and the associated factors.METHODS This was a cross-sectional study among 50 parents of children with CHD who attended the Cardiac Clinic of University of Nigeria Teaching Hospital Ituku-Ozalla.Information was obtained using the Columbia Suicide Severity Rating Scale and the Hospital Anxiety and Depression Scale.RESULTS A greater percentage of parents whose child had a heart defect had anxiety symptoms(50.0%)than did those whose child had no heart defect(24.0%),and the difference in proportions was statistically significant(χ^(2)=7.250,P=0.007).A greater percentage of parents whose child had a heart defect had suicidal ideation(28.0%)than did those whose child had no heart defect(8.0%),and the difference in proportions was statistically significant(χ^(2)=6.775 P=0.009).A positive correlation was elicited between anxiety and suicide ideation,and this correlation was statistically significant(r=0.748,P<0.001).A positive correlation was elicited between depression and suicidal ideation scores,and this was statistically significant(r=0.617,P<0.001).CONCLUSION There is strong interconnectivity between anxiety and depression with suicidal ideation.There is an urgent need to start screening for the mental health of parents of children with CHD to avert the high propensity of complete suicide.In addition,policy makers may introduce a national clinical practice guideline on the importance of psychotherapy and mental health screening and targeted interventions for parents of children with CHD.展开更多
Objective To develop a depression recognition model by integrating the spirit-expression diagnostic framework of traditional Chinese medicine(TCM)with machine learning algorithms.The proposed model seeks to establish ...Objective To develop a depression recognition model by integrating the spirit-expression diagnostic framework of traditional Chinese medicine(TCM)with machine learning algorithms.The proposed model seeks to establish a TCM-informed tool for early depression screening,thereby bridging traditional diagnostic principles with modern computational approaches.Methods The study included patients with depression who visited the Shanghai Pudong New Area Mental Health Center from October 1,2022 to October 1,2023,as well as students and teachers from Shanghai University of Traditional Chinese Medicine during the same period as the healthy control group.Videos of 3–10 s were captured using a Xiaomi Pad 5,and the TCM spirit and expressions were determined by TCM experts(at least 3 out of 5 experts agreed to determine the category of TCM spirit and expressions).Basic information,facial images,and interview information were collected through a portable TCM intelligent analysis and diagnosis device,and facial diagnosis features were extracted using the Open CV computer vision library technology.Statistical analysis methods such as parametric and non-parametric tests were used to analyze the baseline data,TCM spirit and expression features,and facial diagnosis feature parameters of the two groups,to compare the differences in TCM spirit and expression and facial features.Five machine learning algorithms,including extreme gradient boosting(XGBoost),decision tree(DT),Bernoulli naive Bayes(BernoulliNB),support vector machine(SVM),and k-nearest neighbor(KNN)classification,were used to construct a depression recognition model based on the fusion of TCM spirit and expression features.The performance of the model was evaluated using metrics such as accuracy,precision,and the area under the receiver operating characteristic(ROC)curve(AUC).The model results were explained using the Shapley Additive exPlanations(SHAP).Results A total of 93 depression patients and 87 healthy individuals were ultimately included in this study.There was no statistically significant difference in the baseline characteristics between the two groups(P>0.05).The differences in the characteristics of the spirit and expressions in TCM and facial features between the two groups were shown as follows.(i)Quantispirit facial analysis revealed that depression patients exhibited significantly reduced facial spirit and luminance compared with healthy controls(P<0.05),with characteristic features such as sad expressions,facial erythema,and changes in the lip color ranging from erythematous to cyanotic.(ii)Depressed patients exhibited significantly lower values in facial complexion L,lip L,and a values,and gloss index,but higher values in facial complexion a and b,lip b,low gloss index,and matte index(all P<0.05).(iii)The results of multiple models show that the XGBoost-based depression recognition model,integrating the TCM“spirit-expression”diagnostic framework,achieved an accuracy of 98.61%and significantly outperformed four benchmark algorithms—DT,BernoulliNB,SVM,and KNN(P<0.01).(iv)The SHAP visualization results show that in the recognition model constructed by the XGBoost algorithm,the complexion b value,categories of facial spirit,high gloss index,low gloss index,categories of facial expression and texture features have significant contribution to the model.Conclusion This study demonstrates that integrating TCM spirit-expression diagnostic features with machine learning enables the construction of a high-precision depression detection model,offering a novel paradigm for objective depression diagnosis.展开更多
Background:Depression is prevalent among female college students,with eating behavior potentially related to this issue.This study examines the relationship between eating behavior and depression,focusing on the role ...Background:Depression is prevalent among female college students,with eating behavior potentially related to this issue.This study examines the relationship between eating behavior and depression,focusing on the role of social appearance anxiety and physical activity.Methods:We recruited 2161 female college students from nine universities in China via convenience sampling.Data was collected via an online questionnaire.Eating behavior was assessed via the Eating Behavior Scale short form(EBS-SF),depression was measured via the Center for Epidemiological Studies Depression Scale(CES-D),social appearance anxiety was evaluated via the Social Appearance Anxiety Scale,and physical activity was assessed via a single-item question.Descriptive statistics were analyzed via SPSS 26.0,and moderated mediation analysis was conducted via PROCESS version 3.5.Results:Unhealthy eating behavior was significantly associated with higher levels of depression(β=0.285,p<0.001).Social appearance anxiety mediated this relationship,accounting for 46%of the total effect(β=0.132,95%CI=[0.108,0.158]).The interaction effect between eating behavior and physical activity was significantly and negatively correlated with depression(β=−0.052,p<0.01).The association between eating behavior and depression was stronger under conditions of low physical activity(β=0.210,p<0.001)than under conditions of high physical activity(β=0.105,p<0.001).Conclusions:Integrating nutritional guidance,body image acceptance training,and exercise promotion into campus mental health programs is crucial for addressing depression in female college students.Future research should use longitudinal designs and broader participant ranges to increase the general applicability of the findings.展开更多
AIM:To investigate the impact of depression-like behavior on ocular surface homeostasis in a mouse model,with a focus on dry eye-like alterations.METHODS:Male C57BL/6J mice(10-12 weeks old)were randomly assigned to co...AIM:To investigate the impact of depression-like behavior on ocular surface homeostasis in a mouse model,with a focus on dry eye-like alterations.METHODS:Male C57BL/6J mice(10-12 weeks old)were randomly assigned to control or restraint stress(RS)groups.The RS group underwent three intermittent 24-hour restraint sessions to induce depressive-like behavior.Behavioral testing,tear secretion measurement,and corneal Oregon Green Dextran(OGD)staining were performed.Postmortem analyses included histological evaluation of lacrimal glands,goblet cell quantification using periodic acid-Schiff staining,and assessment of key inflammatory and apoptotic markers:interleukin(IL)-17,matrix metalloproteinases(MMP)-3,MMP-9,IL-13,interferon(IFN)-γ,and cleaved caspase-3 and-8.RESULTS:Repeated RS induced depression-like behavior and significant ocular surface changes.RStreated mice showed increased corneal OGD uptake and upregulation of gene/protein expression of IL-17,MMP-3,and MMP-9(P<0.05).Goblet cell density and IL-13 protein expression were reduced,while IFN-γprotein expression was elevated(P<0.05).Cleaved caspase-3 and-8 levels were significantly increased in both cornea and conjunctiva.Tear volume and lacrimal gland size were unchanged;however,mild inflammatory infiltration was observed in lacrimal glands.CONCLUSION:Repeated RS leads to ocular surface inflammation and dry eye-like pathology,including corneal barrier disruption,goblet cell loss,and epithelial apoptosis.These findings suggest that depression contributes to the pathogenesis of dry eye disease via immune-mediated mechanisms.展开更多
BACKGROUND Parkinson’s disease(PD)is a common neurodegenerative disorder in the elderly population.Non-motor symptoms such as anxiety and depression are often subtle,hindering early detection and intervention,yet the...BACKGROUND Parkinson’s disease(PD)is a common neurodegenerative disorder in the elderly population.Non-motor symptoms such as anxiety and depression are often subtle,hindering early detection and intervention,yet they markedly affect quality of life and clinical outcomes.AIM To investigate the prevalence of anxiety and depression in elderly PD patients,identify associated risk factors,and assess their relationship with fatigue severity.METHODS A cross-sectional analysis was conducted in 123 elderly PD patients treated at The Second Rehabilitation Hospital of Shanghai between January 2023 and December 2024.Demographic and clinical data were obtained using standardized questionnaires.Anxiety,depression,and fatigue were assessed using the Beck Anxiety Inventory(BAI),Geriatric Depression Scale(GDS),and Fatigue Scale-14(FS-14),respectively.Binary logistic regression identified risk factors for anxiety and depression,whereas Spearman’s correlation assessed associations with fatigue.RESULTS Anxiety and depression prevalence rates were 64.2%(mean BAI score:19.59±10.92)and 56.1%(mean GDS score:12.82±6.37),respectively.The mean FS-14 total score was 9.46±1.89,comprising physical(5.77±1.51)and mental(3.69±1.20)fatigue components.Significant positive correlations were observed between fatigue scores(total,physical,and mental)and both anxiety and depression(all P<0.05).Univariate analysis revealed statistically significant associations between anxiety/depression and monthly income,disease duration,and disease severity(all P<0.05).Multivariate logistic regression indicated higher anxiety risk in patients with lower monthly income,prolonged disease duration,advanced disease severity,or multimorbidity.Depression risk was elevated in patients with lower monthly income and severe disease,whereas longer disease duration unexpectedly served as a protective factor.CONCLUSION Elderly PD patients show high rates of anxiety and depression,both of which are significantly correlated with fatigue severity.These findings highlight the importance of psychological monitoring and targeted mental health interventions in PD management among the elderly.展开更多
In this editorial,we comment on the study of the Yu et al on psychological distress in patients with hepatobiliary and pancreatic malignancies.Hepatobiliary and pancreatic malignancies include hepatocellular carcinoma...In this editorial,we comment on the study of the Yu et al on psychological distress in patients with hepatobiliary and pancreatic malignancies.Hepatobiliary and pancreatic malignancies include hepatocellular carcinoma,cholangiocarcinoma,gallbladder cancer and pancreatic cancer.These cancers are among the most aggressive and difficult to treat.Although improvements in surgery,drug treatments and palliative care have led to better survival rates and quality of life,the significant psychological impact on patients remains underrecognized.Anxiety and depression are prevalent at every stage of the disease,from the initial diagnosis to treatment,recurrence and end-of-life care.However,these issues often take a backseat to the urgent need to manage physical symptoms.Mental health challenges can greatly affect how well patients follow treatment plans,recover and their overall outlook.Yu et al explore the causes of psychological distress in hepatobiliary and pancreatic cancers,including disease severity,symptom burden,financial stress and fears about life and death.We highlight the importance of regular mental health screenings,psychological support and teamwork in oncology care.By focusing on emotional health alongside physical treatment,doctors can build resilience,improve outcomes and address a frequently ignored aspect of cancer care.展开更多
Background:Depression is a growing public health concern among Chinese children and adolescents,with substantial healthcare costs.Physical activity(PA)and organized sport are modifiable behaviours protective against d...Background:Depression is a growing public health concern among Chinese children and adolescents,with substantial healthcare costs.Physical activity(PA)and organized sport are modifiable behaviours protective against depression.This study,therefore,estimated the healthcare costs of depression attributable to insufficient PA and organized sport participation.Methods:A cost-of-illness approach with population attributable fraction(PAF)was applied.Relative risks were derived from longitudinal evidence,prevalence estimates from national Chinese surveys,and depression case numbers from the Global Burden of Disease 2021.Direct healthcare costs were extrapolated from European Union estimates,adjusted to 2024 US dollars(USD),and Chinese expenditure.Sex-stratified analyses were conducted.Results:Estimated depression-related healthcare costs attributable to insufficient PA were approximately 81 million USD,compared with around 84 million USD attributable to insufficient organized sport participation.At the population level,the economic burden attributable to insufficient PA and organized sport was of a similar order of magnitude.Among boys,costs attributable to insufficient organized sport participation(approximately 57 million USD)exceeded those attributable to insufficient PA(around 39 million USD),whereas among girls,costs attributable to insufficient PA(approximately 42 million USD)were higher than those related to organized sport(around 27 million USD).These sex-specific patterns were consistent across sensitivity analyses examining uncertainty in key model parameters.Conclusions:Both insufficient PA and organized sport contribute substantially to depression-related healthcare costs,with sex-specific differences.Policies should prioritise promoting overall PA in girls and organized sport in boys to reduce depression burden and associated expenditures.The magnitude of these attributable costs indicates an economically meaningful burden that is potentially modifiable through behavioural interventions.展开更多
Summary Pain is not pain because people interpret symptoms differently.Neck pain is one of the most common pains and should not be missing from a study on the effects of pain.Depression does not arise solely from pain...Summary Pain is not pain because people interpret symptoms differently.Neck pain is one of the most common pains and should not be missing from a study on the effects of pain.Depression does not arise solely from pain but is multicausal and often caused by this cumulative effect.展开更多
Stroke is the second leading cause of death worldwide and a major cause of disability among adults.With the advancement of medical technology,the survival period of stroke patients has been significantly prolonged,but...Stroke is the second leading cause of death worldwide and a major cause of disability among adults.With the advancement of medical technology,the survival period of stroke patients has been significantly prolonged,but the neuropsychiatric sequelae in the chronic stage have become increasingly prominent.Post-stroke depression is one of the very important manifestations.This article conducts a further discussion on this issue.展开更多
Tight sandstone reservoirs represent a pivotal unconventional oil and gas production target.The upper section of the deeply buried Huagang Formation in the Xihu Depression is abundant in hydrocarbons and forms a tight...Tight sandstone reservoirs represent a pivotal unconventional oil and gas production target.The upper section of the deeply buried Huagang Formation in the Xihu Depression is abundant in hydrocarbons and forms a tight reservoir.It exhibits substantial diagenetic variability and strong heterogeneity in sand bodies,which is reflected in variations in physical properties and grain size.Through integrated geological analysis,including rock thin sections,scanning electron microscopy,X-ray diffraction,well logging and production test data,we investigated the diagenesis,reservoir formation mechanisms,and controlling factors of high-quality reservoirs within the superposed sandstone bodies exceeding 100 m thick in the deeper Huagang Formation.We also studied the formation characteristics of these ultrathick sandstones,clarifying that diagenesis and post-depositional modification are crucial for developing high-quality reservoirs in this formation.Our findings indicate that the sandstone underwent compaction,cementation(by chlorite,calcite and quartz),dissolution(of K-feldspar and carbonate cement),and authigenic clay mineral cementation(such as illite,chlorite,kaolinite).Multiple dissolution zones are present within the thick sandstone units.The distribution of these dissolution zones is mainly controlled by temperature and sandstone composition.With increasing temperature,acidic fluids derived from coal-bearing strata and early hydrocarbon source rocks promoted feldspar dissolution.The thick sandstone units in different intervals of varying depths are at various diagenetic stages.The petrophysical zoning of the reservoir is collectively controlled by diagenetic facies dominated by sedimentation,compaction,and dissolution processes.These findings provide valuable guidance and reference for oil and gas exploration and development in this area,particularly within the ultra-thick sandstone layers.展开更多
BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery...BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.展开更多
Selective depression of pyrite remains a major bottleneck in copper flotation,particularly when high-pyrite ores are processed and saline water is used.In such environments,conventional approaches using lime and inert...Selective depression of pyrite remains a major bottleneck in copper flotation,particularly when high-pyrite ores are processed and saline water is used.In such environments,conventional approaches using lime and inert grinding media often fail to discriminate ef-fectively between pyrite and valuable copper minerals due to strong copper activation on pyrite surfaces.This study introduced a novel approach using inorganic radicals generated from peroxymonosulfate(PMS)to selectively oxidize and depress pyrite.Flotation tests with synthetic high-pyrite ore blends showed that PMS significantly reduced pyrite recovery while maintaining or improving chalcopyrite flot-ation.Ethylenediaminetetraacetic acid(EDTA)extraction confirmed selective oxidation of pyrite,and electron paramagnetic resonance(EPR)spectroscopy identified hydroxyl(·OH)and sulfate(SO_(4)^(·-))radicals as the dominant reactive species.Iron ions from grinding me-dia and mineral surfaces were identified as key activators of PMS.A major insight was pyrite’s dual role,acting both as a radical scav-enger and an activator,which made it highly reactive and susceptible to radical-induced oxidation.This process converted surface copper-sulfur species into copper hydroxides,effectively suppressing pyrite flotation.While previous studies have applied EPR to detect radicals in simplified activator/precursor systems,this study provides the first direct mechanistic evidence of radical-driven selectivity in flotation by detecting inorganic radicals in a complex flotation slurry,thereby demonstrating their persistence under industrially relevant conditions and establishing a foundation for more effective and targeted flotation strategies.展开更多
BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly...BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.展开更多
Centering on the critical bottlenecks in the development of shale oil in the Jiyang Depression of Shengli Oilfield,key scientific and engineering issues are proposed in aspects such as the storage space and occurrence...Centering on the critical bottlenecks in the development of shale oil in the Jiyang Depression of Shengli Oilfield,key scientific and engineering issues are proposed in aspects such as the storage space and occurrence state of shale oil,the formation mechanisms of multi-scale flow spaces,the mobilization mechanisms of crude oil in pores and fractures,and the enhanced oil recovery(EOR)mechanisms during the late stage of elastic development.The research progress and mechanistic insights in recent years are reviewed with respect to experimental techniques,characteristics of pore-fracture structure and fluid occurrence,fracture evolution mechanisms,shale oil flow mechanisms and EOR techniques.Through improving the experimental methods,optimizing the testing conditions,and developing new technologies,we deeply understand the occurrence state,storage space and flow pattern of shale oil,and reveal the distribution pattern of“oil-bearing in all pore sizes and oil-rich in large pores”and the differences in fluid phase states under the confinement effect of nano-scale pores in the shales of the Jiyang Depression;depict the characteristics of“restricted vertical expansion and complex fracture networks”of induced fractures and the dynamic evolution of fracture networks during the fracturing-soaking-production process;establish a“easy flow-slow flow-stagnant flow”three-zone model and the elastic drive+imbibition drive synergistic energy replenishment mechanism;and carry out high-pressure injection to further enhance the mass transfer and diffusion capacity of CO_(2)within the shale pore-fracture system,and compete for the desorption of alkanes to improve the mobilization degree of shale oil.The research achievements provide crucial support for the formation of the theory of continental shale oil development and the construction of the technical system.The future research efforts will focus on mine-scale multi-field coupling physical simulation equipment,microscopic to macroscopic multi-scale experimental methods,pore/fracture fine characterization and post-fracturing core fracture description technologies,multi-media fluid-structure coupling numerical simulation algorithms,and low-cost EOR and low-quality shale oil in-situ upgrading technologies,in order to promote the large-scale and profitable development of shale oil in the Jiyang Depression.展开更多
Background:The phenomenon of multimorbidity in chronic diseases among the elderly is prevalent,and its significant association with depression poses a serious threat to the physical and mental health of older adults.C...Background:The phenomenon of multimorbidity in chronic diseases among the elderly is prevalent,and its significant association with depression poses a serious threat to the physical and mental health of older adults.Current research on the associations between 24-hour movement behaviors(including physical activity,sedentary behavior,and sleep)and depression has largely been confined to examining the effects of single behaviors,overlooking the intrinsic compositional nature and interrelationships among these behaviors.Therefore,it is necessary to investigate the integrated effects of 24-hour movement behaviors on depression in older adults with multimorbidity from a holistic,compositional perspective.Methods:From November 2024 to April 2025,a total of 226 older adult patients with multimorbidity were recruited from a tertiary hospital in Changzhou City.Data were collected using a general information questionnaire,the International Physical Activity Questionnaire–Short Form(IPAQ-SF),the Pittsburgh Sleep Quality Index(PSQI),and the Patient Health Questionnaire-9(PHQ-9).Compositional data analysis and isotemporal substitution models were employed for statistical analysis.Results:The mean daily durations of Light-Intensity Physical Activity(LPA),Moderate-to-Vigorous Physical Activity(MVPA),Sedentary Behavior(SB),and Sleep(SLP)in older adults with multimorbidity were 402.48 min,12.04 min,511.52 min,and 458.68 min,respectively.The prevalence of depressive symptoms was 37.6%.Compositional data analysis revealed that SB was positively associated with depression(βSB=1.005,P=0.006),while SLP was negatively associated with depression(βSLP=−1.736,P<0.001).No statistically significant associations were found between MVPA or LPA and depression(P>0.05).In the 10-minute isotemporal substitution model,replacing SB with any other behavioral component was associated with a decrease in depression scores.Conversely,substituting SLP with either LPA or SB resulted in an increase in depression scores,while substituting SLP with MVPA led to a decrease in depression scores.The dose-response analysis revealed that,among the isotemporal substitution effects,replacing SB with SLP and replacing SLP with MVPA were the substitution pathways associated with the most rapid decline in depression scores,representing the greatest beneficial health effects.Conclusion:The prevalence of depression is notably high among older adults with multimorbidity.Reducing daily sedentary behavior(SB),maintaining adequate sleep(SLP),and increasing moderate-to-vigorous physical activity(MVPA)can improve depressive symptoms and enhance overall health in this population.展开更多
Objectives:Although standardized residency trainees are at high risk for depression,anxiety,and suicidal ideation,the psychological pathways connecting depression and anxiety to suicidal ideation,especially the modera...Objectives:Although standardized residency trainees are at high risk for depression,anxiety,and suicidal ideation,the psychological pathways connecting depression and anxiety to suicidal ideation,especially the moderating role of resilience,remain elusive.This study aimed to examine the associations between depression,anxiety,and suicidal ideation among physicians undergoing standardized residency training,and to investigate the moderating roles of different dimensions of individual resilience,namely tenacity,strength,and optimism.Methods:A convenience sampling method was adopted to recruit 133 resident physicians.Validated instruments assessing individual resilience,depressive symptoms,anxiety levels,and suicidal ideation were administered.Spearman correlation analysis was used to evaluate the relationships among the variables.Hierarchical regression analysis was conducted to assess the moderating roles of tenacity,strength,and optimism in the associations between depression,anxiety,and suicidal ideation.Results:Depressive symptoms and anxiety levels were both positively associated with suicidal ideation(p<0.001).All three resilience dimensions were negatively correlated with suicidal ideation(tenacity:r=−0.504,strength:r=−0.477,optimism:r=−0.440,all p<0.001).Tenacity,strength,and optimism significantly moderated the associations between depression and suicidal ideation(all p<0.05).When resilience levels in these dimensions were high,the associations between depression and suicidal ideation were weaker.Strength and optimism also moderated the associations between anxiety and suicidal ideation(strength:p=0.028,optimism:p=0.028).When the resiliences(strength and optimism)were high,the associations between anxiety and suicidal ideation were weaker.Conclusion:Individual resilience,particularly in the dimensions of tenacity,strength,and optimism,may serve as protective correlates for physicians in training,being associated with weaker relationships between depression,anxiety,and suicidal ideation.These findings highlight the potential value of resilience-enhancing strategies in clinical training settings,although causal inferences cannot be drawn due to the cross-sectional design.展开更多
BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and dep...BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and depression(PSD)do not receive sufficient attention.AIM To systematically evaluate risk factors and early identification markers for PSD for more precise screening and intervention strategies in clinical practice.METHODS This retrospective study analyzed clinical data from 112 patients with ischemic stroke admitted between January 2022 and December 2024.Based on assessments using the Hamilton Rating Scale for Anxiety(HAMA)and Hamilton Rating Scale for Depression(HAMD)at 2 weeks(±3 days)post-stroke,patients were classified into the PSD group(HAMA≥7 and/or HAMD≥7)and the non-PSD group(HAMA<7 and HAMD<7).Observation indicators included psychological assessment,demographic and clinical characteristics,stroke-related clinical indicators,neuroimaging assessments,and laboratory biomarkers.Multivariate logistic regression analysis was used to identify independent risk factors for PSD,and receiver operating characteristic curve analysis was used to evaluate the diagnostic value of potential biomarkers.RESULTS Of the 112 patients,46(41.1%)were diagnosed with PSD.Multivariate analysis identified five independent risk factors:Female gender[Odds ratio(OR)=2.32,95%confidence interval(CI):1.56-3.45],history of mental disorders prior to stroke(OR=3.17,95%CI:1.89-5.32),infarct location in the frontal lobe or limbic system(OR=2.86,95%CI:1.73-4.71),stroke severity with National Institutes of Health Stroke Scale≥8 at admission(OR=2.54,95%CI:1.62-3.99),and low social support(Social Support Rating Scale<35,OR=2.18,95%CI:1.42-3.36).Subgroup analysis showed that depression patients more commonly had left hemisphere lesions(68.4%vs 45.2%),while anxiety patients more frequently presented with right hemisphere lesions(59.5%vs 39.5%).The PSD group exhibited larger infarct volumes(8.7 cm^(3) vs 5.3 cm^(3)),more severe white matter hyperintensities,and more pronounced frontal lobe atrophy.Analysis of inflammatory markers showed significantly elevated levels of interleukin-6(7.8 pg/mL vs 4.5 pg/mL)and tumor necrosis factor-alpha(15.6 pg/mL vs 9.8 pg/mL)in the PSD group,while hypothalamicpituitary-adrenal axis function assessment revealed higher cortisol levels(386.5±92.3 nmol/L vs 328.7±75.6 nmol/L)and flattened diurnal rhythm in the PSD group.CONCLUSION PSD is a complex neuropsychiatric consequence of stroke involving disruption of the frontal-limbic circuitry,neuroinflammatory responses,and dysfunction of the hypothalamic-pituitary-adrenal axis.展开更多
BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their effi...BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their efficacy is limited.This study investigated whether combining SSRIs with traditional Chinese medicine(TCM)Free San could enhance their therapeutic effects.AIM To evaluate the clinical efficacy and safety of combining SSRIs with Free San in treating PSD,and to assess its impact on HPA axis function.METHODS Ninety-two patients with PSD were enrolled and randomly divided into control groups(n=46)and study groups(n=46).The control group received the SSRI paroxetine alone,whereas the study group received paroxetine combined with Free San for 4 weeks.Hamilton Depression Scale and TCM syndrome scores were assessed before and after treatment.Serum serotonin,norepinephrine,cortisol,cor-ticotropin-releasing hormone,and adrenocorticotropic hormone were measured.The treatment responses and adverse reactions were recorded.RESULTS After treatment,the Hamilton Depression Scale and TCM syndrome scores were significantly lower in the study group than in the control group(P<0.05).Serum serotonin and norepinephrine levels were significantly higher in the study group than in the control group,whereas cortisol,corticotropin-releasing hormone,and adrenocorticotropic hormone levels were significantly lower(P<0.05).The total efficacy rates were 84.78%and 65.22%in the study and control groups,respectively(P<0.05).No significant differences in adverse reactions were observed between the two groups(P>0.05).CONCLUSION Combining SSRIs with Free San can enhance therapeutic efficacy,improve depressive symptoms,and regulate HPA axis function in patients with PSD with good safety and clinical application value.展开更多
OBJECTIVE:To compare the efficacy of Tongxie Yaofang(痛泻要方,TXYF)versus pinaverium bromide for the treatment of diarrheal irritable bowel syndrome(IBSD)with liver depression and spleen deficiency.METHODS:A search of...OBJECTIVE:To compare the efficacy of Tongxie Yaofang(痛泻要方,TXYF)versus pinaverium bromide for the treatment of diarrheal irritable bowel syndrome(IBSD)with liver depression and spleen deficiency.METHODS:A search of the China National Knowledge Infrastructure Database,China Science and Technology Journal Database,Wanfang Database,Pub Med,EMBASE,Cochrane Library and Web of Science databases was conducted from database creation to the 28th of September 2022.Meta-analysis was performed using Revman 5.4 software.RESULTS:Twelve randomized controlled trials comprising 1058 patients were included in the analysis.TXYF was more efficacious in improving the clinical symptoms of patients.Comparison of the efficacy rate,Traditional Chinese Medicine Evidence Score(TCMPES),self-rating anxiety scale anxiety score,self-rating depression scale depression score,adverse reaction rate and calcitonin gene-related peptide(CGRP)levels showed that TXYF was significantly superior to pinaverium bromide treatment(P<0.05);there was no statistically significant difference in the plasma vasoactive peptide level between the two groups(P>0.05).Funnel plots of the total efficacy rate and TCM-PES were asymmetrically distributed,suggesting publication bias.The GRADEpro Guideline Development Tool was also used to evaluate the studies,and the evidence rating of the included studies was not high.CONCLUSIONS:Although the results of this study suggest that TXYF may be superior for the treatment of IBS-D with liver depression and spleen deficiency,as compared to pinaverium bromide,definitive conclusions are unable to be drawn at this time due to flaws in the overall design of the included trials.Therefore,more rigorous trials are needed to determine the benefit and safety of TXYF.展开更多
文摘BACKGROUND Knee osteoarthritis(KOA),a common disabling pathology characterized by knee joint pain,swelling,and functional impairment,primarily affects middle-aged and older adults.In addition to physical limitations,chronic pain often leads to psychological problems,including anxiety and depression,which further impact patients’quality of life.AIM To examine the efficacy and safety of celecoxib plus duloxetine in managing chronic pain,anxiety,and depression in patients with KOA.METHODS A retrospective analysis was conducted on 123 patients with KOA treated at our center between February 2020 and February 2023.Of these,66 received celecoxib plus duloxetine,and 57 received celecoxib alone.Outcomes were assessed using the Visual Analog Scale(VAS),the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),and the Self-Rating Anxiety Scales(SAS)/Self-Rating Depression Scales(SDS).Safety was evaluated by monitoring changes in liver function enzymes(alanine aminotransferase,aspartate aminotransferase),creatinine,and blood urea nitrogen.RESULTS Patients receiving celecoxib plus duloxetine showed significantly greater reductions in VAS and WOMAC and greater improvements in SAS and SDS scores compared with those receiving celecoxib alone.Hepatorenal function did not differ significantly between the treatment groups.Logistic regression analysis identified patient age,educational background,and treatment regimen as independent predictors of inadequate improvement in negative emotional symptoms.CONCLUSION In patients with KOA,celecoxib plus duloxetine effectively mitigates chronic pain and improves anxiety and depressive symptoms without increasing adverse hepatic or renal effects.These findings support its use as a safe and effective treatment option.
文摘BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental suicidal ideation among children with CHD and the associated factors.METHODS This was a cross-sectional study among 50 parents of children with CHD who attended the Cardiac Clinic of University of Nigeria Teaching Hospital Ituku-Ozalla.Information was obtained using the Columbia Suicide Severity Rating Scale and the Hospital Anxiety and Depression Scale.RESULTS A greater percentage of parents whose child had a heart defect had anxiety symptoms(50.0%)than did those whose child had no heart defect(24.0%),and the difference in proportions was statistically significant(χ^(2)=7.250,P=0.007).A greater percentage of parents whose child had a heart defect had suicidal ideation(28.0%)than did those whose child had no heart defect(8.0%),and the difference in proportions was statistically significant(χ^(2)=6.775 P=0.009).A positive correlation was elicited between anxiety and suicide ideation,and this correlation was statistically significant(r=0.748,P<0.001).A positive correlation was elicited between depression and suicidal ideation scores,and this was statistically significant(r=0.617,P<0.001).CONCLUSION There is strong interconnectivity between anxiety and depression with suicidal ideation.There is an urgent need to start screening for the mental health of parents of children with CHD to avert the high propensity of complete suicide.In addition,policy makers may introduce a national clinical practice guideline on the importance of psychotherapy and mental health screening and targeted interventions for parents of children with CHD.
基金General Program of National Natural Science Foundation of China(82474390)Construction Project of Pudong New Area Famous TCM Studios(National Pilot Zone for TCM Development,Shanghai)(PDZY-2025-0716)Shanghai Municipal Science and Technology Program Project Shanghai Key Laboratory of Health Identification and Assessment(21DZ2271000).
文摘Objective To develop a depression recognition model by integrating the spirit-expression diagnostic framework of traditional Chinese medicine(TCM)with machine learning algorithms.The proposed model seeks to establish a TCM-informed tool for early depression screening,thereby bridging traditional diagnostic principles with modern computational approaches.Methods The study included patients with depression who visited the Shanghai Pudong New Area Mental Health Center from October 1,2022 to October 1,2023,as well as students and teachers from Shanghai University of Traditional Chinese Medicine during the same period as the healthy control group.Videos of 3–10 s were captured using a Xiaomi Pad 5,and the TCM spirit and expressions were determined by TCM experts(at least 3 out of 5 experts agreed to determine the category of TCM spirit and expressions).Basic information,facial images,and interview information were collected through a portable TCM intelligent analysis and diagnosis device,and facial diagnosis features were extracted using the Open CV computer vision library technology.Statistical analysis methods such as parametric and non-parametric tests were used to analyze the baseline data,TCM spirit and expression features,and facial diagnosis feature parameters of the two groups,to compare the differences in TCM spirit and expression and facial features.Five machine learning algorithms,including extreme gradient boosting(XGBoost),decision tree(DT),Bernoulli naive Bayes(BernoulliNB),support vector machine(SVM),and k-nearest neighbor(KNN)classification,were used to construct a depression recognition model based on the fusion of TCM spirit and expression features.The performance of the model was evaluated using metrics such as accuracy,precision,and the area under the receiver operating characteristic(ROC)curve(AUC).The model results were explained using the Shapley Additive exPlanations(SHAP).Results A total of 93 depression patients and 87 healthy individuals were ultimately included in this study.There was no statistically significant difference in the baseline characteristics between the two groups(P>0.05).The differences in the characteristics of the spirit and expressions in TCM and facial features between the two groups were shown as follows.(i)Quantispirit facial analysis revealed that depression patients exhibited significantly reduced facial spirit and luminance compared with healthy controls(P<0.05),with characteristic features such as sad expressions,facial erythema,and changes in the lip color ranging from erythematous to cyanotic.(ii)Depressed patients exhibited significantly lower values in facial complexion L,lip L,and a values,and gloss index,but higher values in facial complexion a and b,lip b,low gloss index,and matte index(all P<0.05).(iii)The results of multiple models show that the XGBoost-based depression recognition model,integrating the TCM“spirit-expression”diagnostic framework,achieved an accuracy of 98.61%and significantly outperformed four benchmark algorithms—DT,BernoulliNB,SVM,and KNN(P<0.01).(iv)The SHAP visualization results show that in the recognition model constructed by the XGBoost algorithm,the complexion b value,categories of facial spirit,high gloss index,low gloss index,categories of facial expression and texture features have significant contribution to the model.Conclusion This study demonstrates that integrating TCM spirit-expression diagnostic features with machine learning enables the construction of a high-precision depression detection model,offering a novel paradigm for objective depression diagnosis.
文摘Background:Depression is prevalent among female college students,with eating behavior potentially related to this issue.This study examines the relationship between eating behavior and depression,focusing on the role of social appearance anxiety and physical activity.Methods:We recruited 2161 female college students from nine universities in China via convenience sampling.Data was collected via an online questionnaire.Eating behavior was assessed via the Eating Behavior Scale short form(EBS-SF),depression was measured via the Center for Epidemiological Studies Depression Scale(CES-D),social appearance anxiety was evaluated via the Social Appearance Anxiety Scale,and physical activity was assessed via a single-item question.Descriptive statistics were analyzed via SPSS 26.0,and moderated mediation analysis was conducted via PROCESS version 3.5.Results:Unhealthy eating behavior was significantly associated with higher levels of depression(β=0.285,p<0.001).Social appearance anxiety mediated this relationship,accounting for 46%of the total effect(β=0.132,95%CI=[0.108,0.158]).The interaction effect between eating behavior and physical activity was significantly and negatively correlated with depression(β=−0.052,p<0.01).The association between eating behavior and depression was stronger under conditions of low physical activity(β=0.210,p<0.001)than under conditions of high physical activity(β=0.105,p<0.001).Conclusions:Integrating nutritional guidance,body image acceptance training,and exercise promotion into campus mental health programs is crucial for addressing depression in female college students.Future research should use longitudinal designs and broader participant ranges to increase the general applicability of the findings.
基金Supported by the Key Program of the National Natural Science Foundation of China(No.82530034)the National Natural Science Foundation of China(No.82271054)the Nature Science Foundation of Xiamen,China(No.3502Z20227121).
文摘AIM:To investigate the impact of depression-like behavior on ocular surface homeostasis in a mouse model,with a focus on dry eye-like alterations.METHODS:Male C57BL/6J mice(10-12 weeks old)were randomly assigned to control or restraint stress(RS)groups.The RS group underwent three intermittent 24-hour restraint sessions to induce depressive-like behavior.Behavioral testing,tear secretion measurement,and corneal Oregon Green Dextran(OGD)staining were performed.Postmortem analyses included histological evaluation of lacrimal glands,goblet cell quantification using periodic acid-Schiff staining,and assessment of key inflammatory and apoptotic markers:interleukin(IL)-17,matrix metalloproteinases(MMP)-3,MMP-9,IL-13,interferon(IFN)-γ,and cleaved caspase-3 and-8.RESULTS:Repeated RS induced depression-like behavior and significant ocular surface changes.RStreated mice showed increased corneal OGD uptake and upregulation of gene/protein expression of IL-17,MMP-3,and MMP-9(P<0.05).Goblet cell density and IL-13 protein expression were reduced,while IFN-γprotein expression was elevated(P<0.05).Cleaved caspase-3 and-8 levels were significantly increased in both cornea and conjunctiva.Tear volume and lacrimal gland size were unchanged;however,mild inflammatory infiltration was observed in lacrimal glands.CONCLUSION:Repeated RS leads to ocular surface inflammation and dry eye-like pathology,including corneal barrier disruption,goblet cell loss,and epithelial apoptosis.These findings suggest that depression contributes to the pathogenesis of dry eye disease via immune-mediated mechanisms.
基金Supported by Foundation of Shanghai Baoshan Science and Technology Commission,No.2024-E-66Shanghai Nursing Association Scientific Research Project,No.2024MS-B02.
文摘BACKGROUND Parkinson’s disease(PD)is a common neurodegenerative disorder in the elderly population.Non-motor symptoms such as anxiety and depression are often subtle,hindering early detection and intervention,yet they markedly affect quality of life and clinical outcomes.AIM To investigate the prevalence of anxiety and depression in elderly PD patients,identify associated risk factors,and assess their relationship with fatigue severity.METHODS A cross-sectional analysis was conducted in 123 elderly PD patients treated at The Second Rehabilitation Hospital of Shanghai between January 2023 and December 2024.Demographic and clinical data were obtained using standardized questionnaires.Anxiety,depression,and fatigue were assessed using the Beck Anxiety Inventory(BAI),Geriatric Depression Scale(GDS),and Fatigue Scale-14(FS-14),respectively.Binary logistic regression identified risk factors for anxiety and depression,whereas Spearman’s correlation assessed associations with fatigue.RESULTS Anxiety and depression prevalence rates were 64.2%(mean BAI score:19.59±10.92)and 56.1%(mean GDS score:12.82±6.37),respectively.The mean FS-14 total score was 9.46±1.89,comprising physical(5.77±1.51)and mental(3.69±1.20)fatigue components.Significant positive correlations were observed between fatigue scores(total,physical,and mental)and both anxiety and depression(all P<0.05).Univariate analysis revealed statistically significant associations between anxiety/depression and monthly income,disease duration,and disease severity(all P<0.05).Multivariate logistic regression indicated higher anxiety risk in patients with lower monthly income,prolonged disease duration,advanced disease severity,or multimorbidity.Depression risk was elevated in patients with lower monthly income and severe disease,whereas longer disease duration unexpectedly served as a protective factor.CONCLUSION Elderly PD patients show high rates of anxiety and depression,both of which are significantly correlated with fatigue severity.These findings highlight the importance of psychological monitoring and targeted mental health interventions in PD management among the elderly.
文摘In this editorial,we comment on the study of the Yu et al on psychological distress in patients with hepatobiliary and pancreatic malignancies.Hepatobiliary and pancreatic malignancies include hepatocellular carcinoma,cholangiocarcinoma,gallbladder cancer and pancreatic cancer.These cancers are among the most aggressive and difficult to treat.Although improvements in surgery,drug treatments and palliative care have led to better survival rates and quality of life,the significant psychological impact on patients remains underrecognized.Anxiety and depression are prevalent at every stage of the disease,from the initial diagnosis to treatment,recurrence and end-of-life care.However,these issues often take a backseat to the urgent need to manage physical symptoms.Mental health challenges can greatly affect how well patients follow treatment plans,recover and their overall outlook.Yu et al explore the causes of psychological distress in hepatobiliary and pancreatic cancers,including disease severity,symptom burden,financial stress and fears about life and death.We highlight the importance of regular mental health screenings,psychological support and teamwork in oncology care.By focusing on emotional health alongside physical treatment,doctors can build resilience,improve outcomes and address a frequently ignored aspect of cancer care.
文摘Background:Depression is a growing public health concern among Chinese children and adolescents,with substantial healthcare costs.Physical activity(PA)and organized sport are modifiable behaviours protective against depression.This study,therefore,estimated the healthcare costs of depression attributable to insufficient PA and organized sport participation.Methods:A cost-of-illness approach with population attributable fraction(PAF)was applied.Relative risks were derived from longitudinal evidence,prevalence estimates from national Chinese surveys,and depression case numbers from the Global Burden of Disease 2021.Direct healthcare costs were extrapolated from European Union estimates,adjusted to 2024 US dollars(USD),and Chinese expenditure.Sex-stratified analyses were conducted.Results:Estimated depression-related healthcare costs attributable to insufficient PA were approximately 81 million USD,compared with around 84 million USD attributable to insufficient organized sport participation.At the population level,the economic burden attributable to insufficient PA and organized sport was of a similar order of magnitude.Among boys,costs attributable to insufficient organized sport participation(approximately 57 million USD)exceeded those attributable to insufficient PA(around 39 million USD),whereas among girls,costs attributable to insufficient PA(approximately 42 million USD)were higher than those related to organized sport(around 27 million USD).These sex-specific patterns were consistent across sensitivity analyses examining uncertainty in key model parameters.Conclusions:Both insufficient PA and organized sport contribute substantially to depression-related healthcare costs,with sex-specific differences.Policies should prioritise promoting overall PA in girls and organized sport in boys to reduce depression burden and associated expenditures.The magnitude of these attributable costs indicates an economically meaningful burden that is potentially modifiable through behavioural interventions.
文摘Summary Pain is not pain because people interpret symptoms differently.Neck pain is one of the most common pains and should not be missing from a study on the effects of pain.Depression does not arise solely from pain but is multicausal and often caused by this cumulative effect.
基金Supported by Science and Technology Program of Nantong City,No.Key003 and No.JCZ2022040Nantong Young Medical Expert,No.46+2 种基金Science and Technology Program of Nantong Health Committee,No.MA2019003,No.MA2021017,and No.MSZ2024038Kangda College of Nanjing Medical University,No.KD2021JYYJYB025,No.KD2022KYJJZD022,and No.KD2024KYJJZD289Nantong Municipal Health Commission Project,No.MSZ2023020.
文摘Stroke is the second leading cause of death worldwide and a major cause of disability among adults.With the advancement of medical technology,the survival period of stroke patients has been significantly prolonged,but the neuropsychiatric sequelae in the chronic stage have become increasingly prominent.Post-stroke depression is one of the very important manifestations.This article conducts a further discussion on this issue.
基金funded by the National Science and Technology Major Project(No.2016ZX05027-004)General Department Project of Shanghai Branch of CNOOC(China)Limited(No.KJ2022-JYZJ-SH01)。
文摘Tight sandstone reservoirs represent a pivotal unconventional oil and gas production target.The upper section of the deeply buried Huagang Formation in the Xihu Depression is abundant in hydrocarbons and forms a tight reservoir.It exhibits substantial diagenetic variability and strong heterogeneity in sand bodies,which is reflected in variations in physical properties and grain size.Through integrated geological analysis,including rock thin sections,scanning electron microscopy,X-ray diffraction,well logging and production test data,we investigated the diagenesis,reservoir formation mechanisms,and controlling factors of high-quality reservoirs within the superposed sandstone bodies exceeding 100 m thick in the deeper Huagang Formation.We also studied the formation characteristics of these ultrathick sandstones,clarifying that diagenesis and post-depositional modification are crucial for developing high-quality reservoirs in this formation.Our findings indicate that the sandstone underwent compaction,cementation(by chlorite,calcite and quartz),dissolution(of K-feldspar and carbonate cement),and authigenic clay mineral cementation(such as illite,chlorite,kaolinite).Multiple dissolution zones are present within the thick sandstone units.The distribution of these dissolution zones is mainly controlled by temperature and sandstone composition.With increasing temperature,acidic fluids derived from coal-bearing strata and early hydrocarbon source rocks promoted feldspar dissolution.The thick sandstone units in different intervals of varying depths are at various diagenetic stages.The petrophysical zoning of the reservoir is collectively controlled by diagenetic facies dominated by sedimentation,compaction,and dissolution processes.These findings provide valuable guidance and reference for oil and gas exploration and development in this area,particularly within the ultra-thick sandstone layers.
基金Supported by the Scientific Research Projects of the Health System in Pingshan District,No.2023122.
文摘BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.
基金support from the Australian Research Council(ARC)Linkage Project(No.LP230100166).
文摘Selective depression of pyrite remains a major bottleneck in copper flotation,particularly when high-pyrite ores are processed and saline water is used.In such environments,conventional approaches using lime and inert grinding media often fail to discriminate ef-fectively between pyrite and valuable copper minerals due to strong copper activation on pyrite surfaces.This study introduced a novel approach using inorganic radicals generated from peroxymonosulfate(PMS)to selectively oxidize and depress pyrite.Flotation tests with synthetic high-pyrite ore blends showed that PMS significantly reduced pyrite recovery while maintaining or improving chalcopyrite flot-ation.Ethylenediaminetetraacetic acid(EDTA)extraction confirmed selective oxidation of pyrite,and electron paramagnetic resonance(EPR)spectroscopy identified hydroxyl(·OH)and sulfate(SO_(4)^(·-))radicals as the dominant reactive species.Iron ions from grinding me-dia and mineral surfaces were identified as key activators of PMS.A major insight was pyrite’s dual role,acting both as a radical scav-enger and an activator,which made it highly reactive and susceptible to radical-induced oxidation.This process converted surface copper-sulfur species into copper hydroxides,effectively suppressing pyrite flotation.While previous studies have applied EPR to detect radicals in simplified activator/precursor systems,this study provides the first direct mechanistic evidence of radical-driven selectivity in flotation by detecting inorganic radicals in a complex flotation slurry,thereby demonstrating their persistence under industrially relevant conditions and establishing a foundation for more effective and targeted flotation strategies.
文摘BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.
基金Supported by the China National Science and Technology Major Project(2024ZD1405103)SINOPEC Science and Technology Major Project(P25184)。
文摘Centering on the critical bottlenecks in the development of shale oil in the Jiyang Depression of Shengli Oilfield,key scientific and engineering issues are proposed in aspects such as the storage space and occurrence state of shale oil,the formation mechanisms of multi-scale flow spaces,the mobilization mechanisms of crude oil in pores and fractures,and the enhanced oil recovery(EOR)mechanisms during the late stage of elastic development.The research progress and mechanistic insights in recent years are reviewed with respect to experimental techniques,characteristics of pore-fracture structure and fluid occurrence,fracture evolution mechanisms,shale oil flow mechanisms and EOR techniques.Through improving the experimental methods,optimizing the testing conditions,and developing new technologies,we deeply understand the occurrence state,storage space and flow pattern of shale oil,and reveal the distribution pattern of“oil-bearing in all pore sizes and oil-rich in large pores”and the differences in fluid phase states under the confinement effect of nano-scale pores in the shales of the Jiyang Depression;depict the characteristics of“restricted vertical expansion and complex fracture networks”of induced fractures and the dynamic evolution of fracture networks during the fracturing-soaking-production process;establish a“easy flow-slow flow-stagnant flow”three-zone model and the elastic drive+imbibition drive synergistic energy replenishment mechanism;and carry out high-pressure injection to further enhance the mass transfer and diffusion capacity of CO_(2)within the shale pore-fracture system,and compete for the desorption of alkanes to improve the mobilization degree of shale oil.The research achievements provide crucial support for the formation of the theory of continental shale oil development and the construction of the technical system.The future research efforts will focus on mine-scale multi-field coupling physical simulation equipment,microscopic to macroscopic multi-scale experimental methods,pore/fracture fine characterization and post-fracturing core fracture description technologies,multi-media fluid-structure coupling numerical simulation algorithms,and low-cost EOR and low-quality shale oil in-situ upgrading technologies,in order to promote the large-scale and profitable development of shale oil in the Jiyang Depression.
基金supported by the 2025 Jiangsu Province Graduate Student Practice Innovation Program(No.SJCX25_1696)the 2024 Changzhou University Educational Research Project(No.GJY2024009).
文摘Background:The phenomenon of multimorbidity in chronic diseases among the elderly is prevalent,and its significant association with depression poses a serious threat to the physical and mental health of older adults.Current research on the associations between 24-hour movement behaviors(including physical activity,sedentary behavior,and sleep)and depression has largely been confined to examining the effects of single behaviors,overlooking the intrinsic compositional nature and interrelationships among these behaviors.Therefore,it is necessary to investigate the integrated effects of 24-hour movement behaviors on depression in older adults with multimorbidity from a holistic,compositional perspective.Methods:From November 2024 to April 2025,a total of 226 older adult patients with multimorbidity were recruited from a tertiary hospital in Changzhou City.Data were collected using a general information questionnaire,the International Physical Activity Questionnaire–Short Form(IPAQ-SF),the Pittsburgh Sleep Quality Index(PSQI),and the Patient Health Questionnaire-9(PHQ-9).Compositional data analysis and isotemporal substitution models were employed for statistical analysis.Results:The mean daily durations of Light-Intensity Physical Activity(LPA),Moderate-to-Vigorous Physical Activity(MVPA),Sedentary Behavior(SB),and Sleep(SLP)in older adults with multimorbidity were 402.48 min,12.04 min,511.52 min,and 458.68 min,respectively.The prevalence of depressive symptoms was 37.6%.Compositional data analysis revealed that SB was positively associated with depression(βSB=1.005,P=0.006),while SLP was negatively associated with depression(βSLP=−1.736,P<0.001).No statistically significant associations were found between MVPA or LPA and depression(P>0.05).In the 10-minute isotemporal substitution model,replacing SB with any other behavioral component was associated with a decrease in depression scores.Conversely,substituting SLP with either LPA or SB resulted in an increase in depression scores,while substituting SLP with MVPA led to a decrease in depression scores.The dose-response analysis revealed that,among the isotemporal substitution effects,replacing SB with SLP and replacing SLP with MVPA were the substitution pathways associated with the most rapid decline in depression scores,representing the greatest beneficial health effects.Conclusion:The prevalence of depression is notably high among older adults with multimorbidity.Reducing daily sedentary behavior(SB),maintaining adequate sleep(SLP),and increasing moderate-to-vigorous physical activity(MVPA)can improve depressive symptoms and enhance overall health in this population.
基金supported by Jiangsu Cancer Hospital Science and Technology Development Fund Project(NO.XHMS202404)Nanjing Medical Science and Technology Development Fund Project(GBX22289).
文摘Objectives:Although standardized residency trainees are at high risk for depression,anxiety,and suicidal ideation,the psychological pathways connecting depression and anxiety to suicidal ideation,especially the moderating role of resilience,remain elusive.This study aimed to examine the associations between depression,anxiety,and suicidal ideation among physicians undergoing standardized residency training,and to investigate the moderating roles of different dimensions of individual resilience,namely tenacity,strength,and optimism.Methods:A convenience sampling method was adopted to recruit 133 resident physicians.Validated instruments assessing individual resilience,depressive symptoms,anxiety levels,and suicidal ideation were administered.Spearman correlation analysis was used to evaluate the relationships among the variables.Hierarchical regression analysis was conducted to assess the moderating roles of tenacity,strength,and optimism in the associations between depression,anxiety,and suicidal ideation.Results:Depressive symptoms and anxiety levels were both positively associated with suicidal ideation(p<0.001).All three resilience dimensions were negatively correlated with suicidal ideation(tenacity:r=−0.504,strength:r=−0.477,optimism:r=−0.440,all p<0.001).Tenacity,strength,and optimism significantly moderated the associations between depression and suicidal ideation(all p<0.05).When resilience levels in these dimensions were high,the associations between depression and suicidal ideation were weaker.Strength and optimism also moderated the associations between anxiety and suicidal ideation(strength:p=0.028,optimism:p=0.028).When the resiliences(strength and optimism)were high,the associations between anxiety and suicidal ideation were weaker.Conclusion:Individual resilience,particularly in the dimensions of tenacity,strength,and optimism,may serve as protective correlates for physicians in training,being associated with weaker relationships between depression,anxiety,and suicidal ideation.These findings highlight the potential value of resilience-enhancing strategies in clinical training settings,although causal inferences cannot be drawn due to the cross-sectional design.
文摘BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and depression(PSD)do not receive sufficient attention.AIM To systematically evaluate risk factors and early identification markers for PSD for more precise screening and intervention strategies in clinical practice.METHODS This retrospective study analyzed clinical data from 112 patients with ischemic stroke admitted between January 2022 and December 2024.Based on assessments using the Hamilton Rating Scale for Anxiety(HAMA)and Hamilton Rating Scale for Depression(HAMD)at 2 weeks(±3 days)post-stroke,patients were classified into the PSD group(HAMA≥7 and/or HAMD≥7)and the non-PSD group(HAMA<7 and HAMD<7).Observation indicators included psychological assessment,demographic and clinical characteristics,stroke-related clinical indicators,neuroimaging assessments,and laboratory biomarkers.Multivariate logistic regression analysis was used to identify independent risk factors for PSD,and receiver operating characteristic curve analysis was used to evaluate the diagnostic value of potential biomarkers.RESULTS Of the 112 patients,46(41.1%)were diagnosed with PSD.Multivariate analysis identified five independent risk factors:Female gender[Odds ratio(OR)=2.32,95%confidence interval(CI):1.56-3.45],history of mental disorders prior to stroke(OR=3.17,95%CI:1.89-5.32),infarct location in the frontal lobe or limbic system(OR=2.86,95%CI:1.73-4.71),stroke severity with National Institutes of Health Stroke Scale≥8 at admission(OR=2.54,95%CI:1.62-3.99),and low social support(Social Support Rating Scale<35,OR=2.18,95%CI:1.42-3.36).Subgroup analysis showed that depression patients more commonly had left hemisphere lesions(68.4%vs 45.2%),while anxiety patients more frequently presented with right hemisphere lesions(59.5%vs 39.5%).The PSD group exhibited larger infarct volumes(8.7 cm^(3) vs 5.3 cm^(3)),more severe white matter hyperintensities,and more pronounced frontal lobe atrophy.Analysis of inflammatory markers showed significantly elevated levels of interleukin-6(7.8 pg/mL vs 4.5 pg/mL)and tumor necrosis factor-alpha(15.6 pg/mL vs 9.8 pg/mL)in the PSD group,while hypothalamicpituitary-adrenal axis function assessment revealed higher cortisol levels(386.5±92.3 nmol/L vs 328.7±75.6 nmol/L)and flattened diurnal rhythm in the PSD group.CONCLUSION PSD is a complex neuropsychiatric consequence of stroke involving disruption of the frontal-limbic circuitry,neuroinflammatory responses,and dysfunction of the hypothalamic-pituitary-adrenal axis.
基金Supported by Open Project of Jiangsu Province Key Laboratory of Integrated Traditional Chinese and Western Medicine for the Prevention and Treatment of Geriatric Diseases,No.202232.
文摘BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their efficacy is limited.This study investigated whether combining SSRIs with traditional Chinese medicine(TCM)Free San could enhance their therapeutic effects.AIM To evaluate the clinical efficacy and safety of combining SSRIs with Free San in treating PSD,and to assess its impact on HPA axis function.METHODS Ninety-two patients with PSD were enrolled and randomly divided into control groups(n=46)and study groups(n=46).The control group received the SSRI paroxetine alone,whereas the study group received paroxetine combined with Free San for 4 weeks.Hamilton Depression Scale and TCM syndrome scores were assessed before and after treatment.Serum serotonin,norepinephrine,cortisol,cor-ticotropin-releasing hormone,and adrenocorticotropic hormone were measured.The treatment responses and adverse reactions were recorded.RESULTS After treatment,the Hamilton Depression Scale and TCM syndrome scores were significantly lower in the study group than in the control group(P<0.05).Serum serotonin and norepinephrine levels were significantly higher in the study group than in the control group,whereas cortisol,corticotropin-releasing hormone,and adrenocorticotropic hormone levels were significantly lower(P<0.05).The total efficacy rates were 84.78%and 65.22%in the study and control groups,respectively(P<0.05).No significant differences in adverse reactions were observed between the two groups(P>0.05).CONCLUSION Combining SSRIs with Free San can enhance therapeutic efficacy,improve depressive symptoms,and regulate HPA axis function in patients with PSD with good safety and clinical application value.
基金Supported by the National Key Basic Research and Development Plan(973 Plan):Research on Traditional Chinese Medicine Original Thinking and Health State Identification Method System(2011CB505406)。
文摘OBJECTIVE:To compare the efficacy of Tongxie Yaofang(痛泻要方,TXYF)versus pinaverium bromide for the treatment of diarrheal irritable bowel syndrome(IBSD)with liver depression and spleen deficiency.METHODS:A search of the China National Knowledge Infrastructure Database,China Science and Technology Journal Database,Wanfang Database,Pub Med,EMBASE,Cochrane Library and Web of Science databases was conducted from database creation to the 28th of September 2022.Meta-analysis was performed using Revman 5.4 software.RESULTS:Twelve randomized controlled trials comprising 1058 patients were included in the analysis.TXYF was more efficacious in improving the clinical symptoms of patients.Comparison of the efficacy rate,Traditional Chinese Medicine Evidence Score(TCMPES),self-rating anxiety scale anxiety score,self-rating depression scale depression score,adverse reaction rate and calcitonin gene-related peptide(CGRP)levels showed that TXYF was significantly superior to pinaverium bromide treatment(P<0.05);there was no statistically significant difference in the plasma vasoactive peptide level between the two groups(P>0.05).Funnel plots of the total efficacy rate and TCM-PES were asymmetrically distributed,suggesting publication bias.The GRADEpro Guideline Development Tool was also used to evaluate the studies,and the evidence rating of the included studies was not high.CONCLUSIONS:Although the results of this study suggest that TXYF may be superior for the treatment of IBS-D with liver depression and spleen deficiency,as compared to pinaverium bromide,definitive conclusions are unable to be drawn at this time due to flaws in the overall design of the included trials.Therefore,more rigorous trials are needed to determine the benefit and safety of TXYF.
