Prevalence and clinical correlates of suicide attempts in patients with first-episode drug-naïve major depressive disorder and comorbid autoimmune thyroiditis.

BACKGROUND: Autoimmune thyroiditis is closely associated with major depressive disorder (MDD) and suicide attempts. However, few studies have examined this relationship. AIMS: The study aimed to assess the prevalence and correlates of suicide attempts in patients with first-episode drug-naïve (FEDN) MDD and autoimmune thyroiditis. METHOD: We recruited 1718 out-patients with FEDN MDD and assessed depressive, anxiety and psychotic symptoms with the Hamilton Rating Scale for Depression, Hamilton Rating Scale for Anxiety (HRSA) and Positive and Negative Syndrome Subscale positive subscale, respectively. The serum levels of free triiodothyronine, free thyroxine, thyroid stimulating hormone (TSH), antithyroglobulin, thyroid peroxidase antibody (TPOAb) and several other metabolic parameters were assessed. Patients were divided into non-autoimmune thyroiditis, autoimmune thyroiditis only and autoimmune thyroiditis with abnormal TSH groups, based on autoimmune thyroiditis severity. Multiple logistic regression model was applied to identify the correlates of suicide attempts in patients with MDD and autoimmune thyroiditis with abnormal TSH. RESULTS: Compared with the non-autoimmune thyroiditis group, the autoimmune thyroiditis with abnormal TSH group had a nearly fourfold higher likelihood of reporting a suicide attempt, whereas no difference was found between the non-autoimmune thyroiditis and autoimmune thyroiditis only groups. HRSA score, lnTPOAb and lnTSH were independently associated with suicide attempts in patients with autoimmune thyroiditis with abnormal TSH. CONCLUSIONS: Patients with MDD and autoimmune thyroiditis with abnormal TSH are at higher risk for suicide attempt. TPOAb, TSH and anxiety are all independently associated with suicide attempts in this population, and regular thyroid checks are warranted.

Rosacea treatment with mussel adhesive protein delivered via microneedling: In vivo and clinical studies.

BACKGROUND: Rosacea is a prevalent chronic dermatological condition marked by facial inflammation and erythema, significantly compromising the quality of life for affected individuals. Current treatment methods for rosacea are not considered ideal because of the complex etiology of the disease. Mussel adhesive protein (MAP) is a glycoprotein derived from the foot gland of mussels. The protein exhibits anti-inflammatory properties, relieves skin itching, and promotes wound healing. AIMS: We aimed to explore the feasibility of using MAP administered via microneedle delivery for treating rosacea and the potential molecular mechanism involved. MATERIALS AND METHODS: The therapeutic effect and mechanism of MAP microneedle delivery in an LL-37-induced rosacea-like mouse model were observed using morphological and histological methods. Twenty-seven patients with erythematotelangiectatic rosacea (ETR) underwent treatment once every 1 month, with three treatments constituting one treatment course. The therapeutic effect was evaluated by comparing the clinical images taken at baseline, after the first treatment course, and after the second treatment course. The red value, CEA, and GFSS score were also calculated. RESULTS: In response to the microneedle delivery of MAP, innate immunity, inflammatory infiltration, and abnormal neurovascular regulation improved significantly in rosacea-like mice. In the clinical experiments, the microneedle delivery of MAP significantly improved the symptoms of erythema, flushing, and telangiectasia in patients with ETR, and no obvious adverse reactions were observed. CONCLUSIONS: MAP delivered by microneedling is effective and safe for treating ETR.

Suicidal ideation in Chinese patients with chronic schizophrenia: prevalence, clinical correlates, and relationship with alexithymia.

Suicidal ideation (SI) is common among people with schizophrenia. However, it has received less attention than suicide attempts (SA), especially in the Chinese population. Alexithymia is a well-established risk factor for SI across different populations. Nevertheless, very few studies evaluated their relationship in schizophrenia patients. We aimed to determine the prevalence and clinical correlates of SI and its relationship with alexithymia in 812 Chinese chronic schizophrenia inpatients. We assessed SI, clinical symptoms, and alexithymia by the Beck Scale for Suicidal Ideation, the Positive and Negative Syndrome Scale (PANSS), and the Toronto Alexithymia Scale, respectively. A multiple logistic regression model was conducted to identify independent correlates of SI. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were performed to determine the ability of our model to distinguish between patients with and without SI. 10% (n = 84) reported current SI. Lifetime SA (OR, 4.68; 95% CI 2.76-7.94, p < 0.001), PANSS depressive factor (OR, 1.24; 95% CI 1.12-1.38, p < 0.001), PANSS positive subscale (OR, 1.055; 95% CI 1.004-1.108, p = 0.035), and difficulty identifying emotions (OR, 1.07; 95% CI 1.03-1.12, p = 0.002) were associated with SI. The AUC value was 0.80, indicating excellent distinguishing capabilities. Timely assessments of these factors may help identify schizophrenia patients who are at risk for SI.

Correlation between Sonographic Features and Central Neck Lymph Node Metastasis in Solitary Solid Papillary Thyroid Microcarcinoma with a Taller-Than-Wide Shape.

Purpose: This study aimed to investigate the correlation between sonographic features and central neck lymph node metastasis (CNLM) in solitary solid papillary thyroid microcarcinoma (PTMC) with a taller-than-wide shape. Methods: A total of 103 patients with solitary solid PTMC with a taller-than-wide shape on ultrasonography who underwent surgical histopathological examination were retrospectively selected. Based on the presence or absence of CNLM, patients with PTMC were divided into a CNLM (n = 45) or nonmetastatic (n = 58) group, respectively. Clinical findings and ultrasonographic features, including a suspicious thyroid capsule involvement sign (STCS, which is defined as PTMC abutment or a disrupted thyroid capsule), were compared between the two groups. Additionally, postoperative ultrasonography was performed to assess patients during the follow-up period. Results: Significant differences were observed in sex and the presence of STCS between the two groups (p < 0.05). The specificity and accuracy of the male sex for predicting CNLM were 86.21% (50/58 patients) and 64.08% (66/103 patients), respectively. The sensitivity, specificity, positive predictive value (PPV), and accuracy of STCS for predicting CNLM were 82.22% (37/45 patients), 70.69% (41/58 patients), 68.52% (37/54 patients), and 75.73% (78/103 patients), respectively. The specificity, PPV, and accuracy of the combination of sex and STCS for predicting CNLM were 96.55% (56/58 patients), 87.50% (14/16 patients), and 67.96% (70/103 patients), respectively. A total of 89 (86.4%) patients were followed up for a median of 4.6 years, with no patient having recurrence as detected on ultrasonography and pathological examination. Conclusions: STCS is a useful ultrasonographic feature for predicting CNLM in patients with solitary solid PTMC with a taller-than-wide shape, especially in male patients. Solitary solid PTMC with a taller-than-wide shape may have a good prognosis.

Oleanolic acid regulates the proliferation and extracellular matrix of keloid fibroblasts by mediating the TGF-ß1/SMAD signaling pathway.

BACKGROUND: Keloid (KD) is a unique pathological fibroproliferative disease that seriously affects the appearance of patients. This study investigated the effect of oleanolic acid (OA) on the proliferation of keloid fibroblasts (KFs) and the expression of extracellular matrix (ECM)-related proteins. METHODS: The proliferation of KFs was evaluated using an MTT assay. The effects of OA on intra- and extracellular levels of fibronectin (FN), procollagen I, matrix metalloproteinase-1 (MMP-1), and α-smooth muscle actin (α-SMA) were evaluated using Western blotting. To simulate the KD microenvironment, TGF-ß1 was added to the serum-free culture medium, and KFs were incubated with TGF-ß1 and OA for 24 h. The intra- and extracellular levels of the ECM-related proteins and the effect of OA on TGF-ß1-induced phosphorylation of the SMAD2 and SMAD3 proteins were evaluated using Western blotting. RESULTS: OA inhibited the proliferation of KFs in a concentration- and time-dependent manner. Furthermore, OA treatment of KFs reduced the intra- and extracellular levels of FN, procollagen I, and α-SMA and increased those of MMP-1. OA also reduced TGF-ß1-induced increases in the intra- and extracellular levels of FN, procollagen I, and α-SMA and increased the levels of the MMP-1 protein. Additionally, OA significantly reduced TGF-ß1-induced phosphorylation of SMAD2 and SMAD3 in KFs. CONCLUSIONS: OA inhibited KF proliferation and reduced ECM deposition through the TGF-ß1/SMAD pathway, which suggests that OA may be an effective drug for the prevention and treatment of KD.

Mussel adhesive protein treatment delivered by microneedling for sensitive skin: A clinical study.

BACKGROUND: Mussel adhesive protein (MAP) is extracted from the mycelial glands of marine mussels. It has anti-inflammatory properties and may relieve skin itching and other symptoms. AIMS: Based on the anti-inflammatory effect of MAP, this study was designed to treat sensitive skin (SS) using MAP delivered by skin microneedling. PATIENTS/METHODS: Twenty-three Chinese female patients with SS were enrolled. Treatments were delivered three times at one-month intervals. Symptom improvement and recurrence rates, treatment safety, and patient satisfaction levels were evaluated. RESULTS: After one course of treatment, 20 patients had a Symptom Score Reducing Index (SSRI) of >20%, with an effectiveness rate of 87%. At the end of treatment, all patients had an SSRI of >20%, and the effectiveness rate was 100%. Dryness, tightness, desquamation, flushing, burning, itching, and tingling improved. After treatment, the Clinical Erythema Assessment and Lesion Severity Index of Facial Telangiectasia scores were significantly decreased. Clinical photographs following treatment revealed improved erythema reaction and decreased capillary density. During treatment, the patients experienced mild pain and erythema and swelling reaction without exudation. Complications, such as pigmentation changes or scarring, were absent. Additionally, there were no cases of recurrence, and patient satisfaction levels were high. CONCLUSION: MAP combined with microneedling can help treat SS, showing satisfactory safety outcomes and high patient satisfaction.

Prevalence of non-alcoholic fatty liver disease in pediatric mental disorder inpatients: a tertiary mental health referral hospital study.

BACKGROUND AND AIM: Studies have revealed a high prevalence of non-alcoholic fatty liver disease (NAFLD) among adult patients with mental disorders, as well as its associate risk factors, however little is known about these in pediatric population. The aim of the present study is to investigate the prevalence of NAFLD in pediatric inpatients with mental disorder, as well as to explore the risk factors. METHODS: In this retrospective study, we included 1156 pediatric inpatients with mental disorder admitted to our hospital between January 2020 and December 2021, including inpatients with schizophrenia, bipolar disorder, depressive disorder and other mental disorders. Relevant clinical data were obtained from the electronic medical records. We calculated the prevalence rate of NAFLD, and compared NAFLD prevalence between gender, mental disorders types, antipsychotics use, and comorbidities. Multivariable logistic regression was used to examine risk factors associated with NAFLD. RESULTS: The prevalence of NAFLD in pediatric inpatients with mental disorders was 7.35% (85/1156). Patients with NAFLD had senior age than those without NAFLD (15.33±1.75 vs 14.21±1.95 year-old, P<0.001). The NAFLD prevalence in participants with schizophrenia (12.11%) was higher than in participants with bipolar disorder (8.45%), depressive disorder (7.06%) and other mental disorders (2.97%)(p=0.002). The NAFLD prevalence was higher in participants who used antipsychotics (8.70%) than those who didn't (5.45%) (p=0.038). Multivariate analysis revealed that senior age, body weight (overweight/obese) and dyslipidemia were independent risk factors for NAFLD in pediatric inpatients with mental disorders. CONCLUSIONS: The NAFLD prevalence was is higher in those patients with schizophrenia and receiving antipsychotic medication. Metabolic factors and longer evolution may explain these differences.

Prevalence of non-alcoholic fatty liver disease in pediatric mental disorder inpatients: a tertiary mental health referral hospital study

Background and aim: Studies have revealed a high prevalence of non-alcoholic fatty liver disease (NAFLD) among adult patients with mental disorders, as well as its associate risk factors, however little is known about these in pediatric population. The aim of the present study is to investigate the prevalence of NAFLD in pediatric inpatients with mental disorder, as well as to explore the risk factors. Methods: In this retrospective study, we included 1156 pediatric inpatients with mental disorder admitted to our hospital between January 2020 and December 2021, including inpatients with schizophrenia, bipolar disorder, depressive disorder and other mental disorders. Relevant clinical data were obtained from the electronic medical records. We calculated the prevalence rate of NAFLD, and compared NAFLD prevalence between gender, mental disorders types, antipsychotics use, and comorbidities. Multivariable logistic regression was used to examine risk factors associated with NAFLD. Results: The prevalence of NAFLD in pediatric inpatients with mental disorders was 7.35% (85/1156). Patients with NAFLD had senior age than those without NAFLD (15.33±1.75 vs 14.21±1.95 year-old, P<0.001). The NAFLD prevalence in participants with schizophrenia (12.11%) was higher than in participants with bipolar disorder (8.45%), depressive disorder (7.06%) and other mental disorders (2.97%)(p=0.002). The NAFLD prevalence was higher in participants who used antipsychotics (8.70%) than those who didn't (5.45%) (p=0.038). Multivariate analysis revealed that senior age, body weight (overweight/obese) and dyslipidemia were independent risk factors for NAFLD in pediatric inpatients with mental disorders. Conclusions: The NAFLD prevalence was is higher in those patients with schizophrenia and receiving antipsychotic medication. Metabolic factors and longer evolution may explain these differences (AU)

Prevalence and related factors of anxiety in first episode and drug naïve Chinese Han outpatients with psychotic major depression.

BACKGROUND: Anxiety frequently occurs with major depressive disorder (MDD) but to a different extent in the various subtypes. Psychotic major depression (PMD) is a severe subtype of MDD that is under-identified and under-studied. We investigated the prevalence and related risk factors of anxiety in PMD patients. METHODS: A total of 1718 first episode and drug naïve MDD patients were recruited. Measures included the Hamilton Depression Scale (HAMD), Clinical Global Impression-Severity scale (CGI-S), Hamilton Anxiety Scale (HAMA), and positive symptom scale of the Positive and Negative Syndrome Scale (PANSS), thyroid hormone levels, and metabolic parameters. RESULTS: 171 of the entire MDD study sample met the criteria for the PMD subtype. The prevalence of severe anxiety was much higher in PMD patients (22.8 %) than in non-PMD patients (0.4 %) (χ2 = 294.69, P < 0.001, OR = 75.88, 95 % CI = 31.55-182.52). Compared to PMD patients without severe anxiety, PMD patients with severe anxiety had higher HAMD score, CGI-S score, positive symptom subscale score, suicide attempts, blood pressure, thyroid-stimulating hormone (TSH), anti-thyroglobulin (TgAb), and thyroid peroxidases antibody (TPOAb) levels. Furthermore, logistic regression analysis indicated that HAMD score and TSH levels were associated with severe anxiety in PMD patients. LIMITATIONS: Our cross-sectional study cannot explain the causal relationship between anxiety severity and risk factors in PMD patients. CONCLUSIONS: Our results suggest that PMD patients are more likely to experience severe anxiety than non-PMD patients. The severity of depression and TSH levels are independent risk factors for anxiety in PMD patients.

Doctor-patient relationship improved during COVID-19 pandemic, but weakness remains.

OBJECTIVE: To assess the quality of the doctor-patient relationship (DPR) in China and possible influencing factors during the COVID-19 period from the patient's perspective. METHODS: An online survey was carried out nationwide from March 12, 2020 to March 30, 2020 in China via a convenience sampling strategy. Patients who met the inclusion criteria were invited to complete a questionnaire regarding the quality of DPR, including sociodemographic information, the Patient-Doctor Relationship Questionnaire (PDRQ-9), and influencing factors for DPR during the pandemic. RESULTS: A total of 1903 patients were included. Our result showed that participants had a higher PDRQ-9 score during the COVID-19 pandemic (4.18 ± 0.51) than that before the COVID-19 pandemic (3.86 ± 0.67). Importance-performance analysis (IPA) revealed that doctor-patient communication, patient satisfaction, consultation time, doctor's attitude, and medical knowledge were specific aspects that needed to be prioritized to improve the DPR. Multiple linear regression analysis suggested that positive media reports, telemedicine, and national policies had a significantly positive effect on the DPR during the pandemic (P < 0.05). CONCLUSION: In general, the DPR had been improved during the COVID-19 pandemic. Our research found the key points that needed to be prioritized to improve the DPR during the pandemic, which may provide effective suggestions for building a harmonious DPR in the future.

Comparison of Thyroid Hormone Levels Between Patients With Major Depressive Disorder and Healthy Individuals in China.

Abnormal thyroid function in major depressive disorder (MDD) has been studied extensively, but the results still remain inconsistent. In China, few large-scale studies have investigated the differences in the levels of thyroid hormones between patients with MDD and healthy controls (HCs). In this retrospective, cross-sectional study, 535 MDD patients and 998 HCs were included. We compared the levels of thyroid hormones (FT3, FT4, and TSH) between the two groups, as well as investigated the distribution of levels of thyroid hormones within and outside normal ranges. The results showed that all the three hormones were significantly lower in MDD patients than in HCs, which was also true in different gender and age subgroups. The proportion of subjects with levels of all the three hormones outside the normal range in the MDD group was higher than that in the HC group (all p < 0.05). However, no significant difference was found in clinical/subclinical hyperthyroidism or hypothyroidism between the two groups (p > 0.05). Our study showed that the levels of thyroid hormones were lower in MDD patients, suggesting that there was an association between abnormal thyroid function and depression. The higher rate of thyroid dysfunction in MDD patients indicated the importance of regular monitoring of thyroid function.

Integrated bioinformatics analysis of core regulatory elements involved in keloid formation.

BACKGROUND: Keloid is a benign fibro-proliferative dermal tumor formed by an abnormal scarring response to injury and characterized by excessive collagen accumulation and invasive growth. The mechanism of keloid formation has not been fully elucidated, especially during abnormal scarring. Here, we investigated the regulatory genes, micro-RNAs (miRNAs) and transcription factors (TFs) that influence keloid development by comparing keloid and normal scar as well as keloid and normal skin. METHODS: Gene expression profiles (GSE7890, GSE92566, GSE44270 and GSE3189) of 5 normal scar samples, 10 normal skin samples and 18 keloid samples from the Gene Expression Omnibus (GEO) database were interrogated. Differentially expressed genes (DEGs) were identified between keloid and normal skin samples as well as keloid and normal scar samples with R Project for Statistical Computing. Gene Ontology (GO) functional enrichment analysis was also performed with R software. DEG-associated protein-protein interaction (PPI) network was constructed by STRING, followed by module selection from the PPI network based on the MCODE analysis. Regulatory relationships between TF/miRNA and target genes were predicted with miRnet and cytoscape. Core regulatory genes were verified by RT-qPCR. RESULTS: We identified 628 DEGs, of which 626 were up-regulated and 2 were down-regulated. Seven core genes [neuropeptide Y(NPY), 5-hydroxytryptamine receptor 1A(HTR1A), somatostatin (SST), adenylate cyclase 8 (ADCY8), neuromedin U receptor 1 (NMUR1), G protein subunit gamma 3 (GNG3), and G protein subunit gamma 13 (GNG13)] all belong to MCODE1 and were enriched in the "G protein coupled receptor signaling pathway" of the GO biological process category. Furthermore, nine core miRNAs (hsa-mir-124, hsa-let-7, hsa-mir-155, hsa-mir-26a, hsa-mir-941, hsa-mir-10b, hsa-mir-20, hsa-mir-31 and hsa-mir-372), and two core TFs (SP1 and TERT) were identified to play important roles in keloid formation. In the TF/miRNA-target gene network, both hsa-mir-372 and hsa-mir-20 had a regulatory effect on GNG13, ADCY8 was predicted to be target by hsa-mir-10b, and HTR1A and NPY were potentially by SP1. Furthermore, the expression of core regulatory genes (GNG13, ADCY8, HTR1A and NPY) was validated in clinical samples. CONCLUSIONS: GNG13, ADCY8, NPY and HTR1A may act as core genes in keloid formation and these core genes establish relationship with SP1 and miRNA (hsa-mir-372, hsa-mir-20, hsa-mir-10b), which may influence multiple signaling pathways in the pathogenesis of keloid.

Protective effects of ferroptosis inhibition on high fat diet-induced liver and renal injury in mice.

As a complex and highly prevalent global public health problem, obesity is associated with multiple diseases, including liver and renal injury. As an iron-dependent form of cell death, ferroptosis is different from apoptosis and necrosis, which has been reported to participate in pathologic processes of many diseases. However, whether ferroptosis is involved in obesity-induced liver and renal injury remains unclear. Male C57BL/6 mice were fed with high-fat diet (HFD) or control diet for 16 weeks and treated with 5 mg/kg or 10 mg/kg ferroptosis inhibitor, ferrostatin-1 (Fer-1), for the last 8 weeks with results indicating that glutathione peroxidase 4 (GPX4) gene expression decreased in the liver and renal tissue of obese mice. Additionally, Fer-1 pretreatment prevented the obesity-induced decline of GPX4. More importantly, Fer-1 treatment attenuated HFD-induced pathological and functional impairment, fibrosis, inflammatory cell infiltration, and inflammatory cytokine expression in liver and renal tissues. In short, our results indicate that obesity can induce ferroptosis and ferroptosis inhibitor, Fer-1, thereby inhibiting obesity-induced liver and renal injury in mice. The study provides a new therapeutic direction for the complications of obesity.