Abstract:Depressive disorder of adolescents is a mental health problem that has attracted much attention at present. Its incidence is increasing year by year， which has seriously affected the physical and mental health and social adaptability of adolescents. However， there are still significant challenges in identification， diagnosis and treatment. This article systematically reviews the diagnosis and treatment of depressive disorder among adolescents in recent years， providing support for further exploring the effective treatment strategies.

Abstract:Objective To evaluate the efficacy and clinical safety of berberine hydrochloride （BBR） adjunctive therapy for anxiety and insomnia in patients with depressive disorder. Methods From September 2022 to October 2023， 78 patients with depressive disorder in the outpatient or ward of the Zhumadian Second People's Hospital of Henan Province were selected as the research subject. Using a double-blind randomized placebo-controlled clinical trial method， the enrolled patients were randomly divided into a BBR group （n=39） and a placebo group （n=39） by a 1∶1 ratio， were given BBR and placebo， respectively， and were treated with a combination of selective serotonin reuptake inhibitors （SSRIs） for 8 weeks. At baseline and weeks 2， 4， 6， and 8， the patient's anxiety symptoms were evaluated using the Hamilton Anxiety Scale （HAMA）. Pittsburgh Sleep Quality Index （PSQI） was used to evaluate the sleep quality of patients at baseline and 4 and 8 weeks， and the Patient Assessment of Constipation Symptom （PAC-SYM） was used to evaluate the clinical safety of BBR. Repeated measures analysis of variance was used to compare the effects of inter group （BBR group and placebo group）， intra group （at various time points）， and interaction （group * time）. Covariance analysis and Wilcoxon rank sum test were used to explore the differences between two groups of patients at different time points relative to baseline. Binary Logistic regression was used to analyze the anxiety response rate and relief rate of two groups of patients. Kaplan-Meier survival curve was used to evaluate the time required for anxiety response and relief in two groups of patients. Results A total of 68 patients with depressive disorder were included， with 34 cases in BBR group and 34 cases in placebo group， and the dropout rates in both groups were 12.8%（5/39）. Repeated measures analysis of variance showed that compared with placebo group， the HAMA score of BBR group decreased at 6 and 8 weeks， and the difference was statistically significant （P ＜ 0.05）. Covariance analysis showed that there were statistically significant differences in HAMA score changes between BBR group and placebo group at 6 weeks ［（11.44±6.15） vs （6.53±8.50）， P＜ 0.001）］ and 8 weeks ［（11.29±5.94） vs （7.91±8.10）， P=0.005］. Logistic regression showed that the anxiety response rate of BBR group increased at 6 weeks ［OR=8.99， 95%CI （2.22， 36.44）， P=0.002］ and the relief rate increased at 8 weeks ［OR=3.45， 95%CI （1.00， 11.86）， P=0.049］. Survival analysis showed that there was no statistically significant difference in the time required for the response and relief to anxiety between the two groups of patients （all P＞ 0.05）. Repeated measures analysis of variance， covariance analysis， and Logistic regression analysis showed that there was no statistically significant difference in PSQI scores， sleep relief rates， and response rates at different time points between BBR group and placebo group at 4 weeks and 8 weeks （all P＞ 0.05）. Covariance analysis showed that there was no statistically significant difference in the changes in PAC-SYM scores relative to baseline scores between BBR group and placebo group at weeks 4 and 8 （P＞ 0.05）. Conclusions BBR adjunctive therapy may be an effective and safe method to improve anxiety symptoms in patients with depressive disorder.

Abstract:Objective To explore the association between non-suicidal self-injury （NSSI） behavior and lipid metabolism in children and adolescents with depressive disorder. Methods A retrospective study was conducted on 681 children and adolescents with depressive disorder who were hospitalized at the Fuyang Third People's Hospital from April 2020 to December 2021. The patients were divided into a group with NSSI （n=254） and a group without NSSI （n=427）. The general information and lipid metabolism of two groups of patients were compared， and binomial Logistic regression was used to analyze the related factors of NSSI behavior in children and adolescents with depressive disorder. Results The differences in gender， age of onset， total course of disease， educational level， body mass index （BMI）， and high-density lipoprotein cholesterol （HDL-C） between the two groups of patients were statistically significant （all P＜ 0.05）. Binomial Logistic regression analysis showed that women， high BMI， and high HDL-C were risk factors for NSSI behavior in children and adolescents with depressive disorder （OR＞1， P＜0.05）， while older onset age was a protective factor for NSSI behavior （OR＜1， P ＜ 0.01）， and the differences were statistically significant. Conclusions NSSI behavior in children and adolescents with depressive disorder is associated with gender， age of onset， HDL-C， and BMI.

Abstract:Objective To explore the chain mediating effect of anxiety and sleep disorders in adolescents with depressive disorder between depressive symptoms and cognitive deficits. Methods From January to October 2023， 141 adolescents with depressive disorder were recruited from Beijing Huilongguan Hospital as research subjects using the Mini International Neuropsychiatric Interview for Children and Adolescents （MINI-KID）. The Patient Health Questionnaire-9 items （PHQ-9）， Perceived Deficits Questionnaire for Depression （PDQ-D）， Generalized Anxiety Disorder-7 （GAD-7）， and Pittsburgh Sleep Quality Index （PSQI） were used to investigate the depression， cognition， anxiety， and sleep of adolescents with depressive disorder. Pearson correlation was used to analyze the correlation between depressive symptoms， cognitive deficits， anxiety， and sleep disorders in adolescents with depressive disorder. Model 6 of the SPSS PROCESS macro program was used for mediating effect analysis. Results Among adolescents with depressive disorder， the PHQ-9， GAD-7， PSQI， and PDQ-D scores were （20.61±4.99）， （17.06±4.95）， （11.27±3.66）， and （67.32±14.77）. There were positive correlations between cognitive deficits and depressive symptoms， anxiety， and sleep disorders， and the differences were statistically significant （r=0.525 to 0.625， all P ＜ 0.001）. Anxiety and sleep disorders played a chain mediating effect in the relationship between depressive symptoms and cognitive deficits， with a mediating effect value of 0.109， accounting for 19.68% of the total effect. Conclusions Depressive symptoms in adolescents with depressive disorder can directly lead to cognitive deficits， and can also be mediated through the chain mediation of anxiety and sleep disorders.

Abstract:Adolescent depression is mainly caused by social， genetic and other factors， manifested as a clinical syndrome of negative emotions such as self-denial and pain in adolescents， while non-suicidal self-injury （NSSI） behavior is a common accompanying symptom. NSSI refers to a type of behavior in which an individual intentionally and repeatedly harms their body without a clear suicidal intention. This kind of self-injury behavior is not out of suicidal intention， but a way to deal with inner pain and negative emotions. NSSI behavior is common in adolescents， which has a serious impact on their physical and mental health. Clinical studies have shown that adolescents depression patients with NSSI behavior often exhibit neurological imaging differences， which may be related to changes in brain structure and function. Based on this， this paper analyzes and summarizes the research progress of behavioral magnetic resonance imaging （MRI） technology of NSSI in recent years， to provide reference for the pathogenesis research of NSSI behavior and clinical research.

Abstract:The incidence of depressive symptoms among adolescents is relatively high both domestically and internationally， but the intervention effect of mainstream psychotherapy mediated by language on adolescents is not as effective as art therapy. Art therapy is a non-verbal psychotherapy method that mainly includes painting therapy， music therapy， and dance therapy， corresponding to visual， auditory， and tactile artistic expressions. It is beneficial for improving emotional trauma and conflict， emotional fluctuations and stress， as well as self-understanding and identification in adolescents， and alleviating their depressive symptoms. Various artistic activities can also be combined with cognitive-behavioral therapy to promote the perception and expression of emotions among adolescents， which is conducive to personality development and interpersonal interaction. This paper reviews the research progress on the impact of art therapy on adolescent depressive symptoms in recent years， based on the main forms of art therapy activities， with the aim of promoting intervention research and therapeutic effects of art therapy.

Abstract:Objective To explore the clinical characteristics and treatment decisions of depressive disorder patients with suicidal ideation or behavior based on real-world evidence. Methods The clinical data of patients were extracted utilizing the electronic health record （EHR） based on the hospital information system and analyzed by descriptive research method. A total of 7 985 depression patients who were hospitalized and treated with emergency observation at Beijing Anding Hospital affiliated with Capital Medical University from January 1， 2013 to December 31， 2020 were selected as the study subjects. They were divided into three groups based on the presence of suicidal ideation or behavior： major depressive disorder with nonsuicide （MDNS）， major depressive disorder with suicidal ideation （MDSI）， and major depressive disorder with suicidal behavior （MDSB）. The differences were compared among the three groups in demographics， clinical characteristic， and treatment decisions. The risk factors for suicidal ideation or behavior in patients with depression were analyzed by multivariate logistic regression. Results Among the 7 985 patients with depression， 3 297 （41.3%） were in the MDSI group， 840 （10.5%） were in the MDSB group， and 3 848 （48.2%） were in the MDNS group. The age and onset age of patients in the MDSI and MDSB groups were lower than those in the MDNS group， and the proportion of working/studying patients was higher than that in the MDNS group， with statistical significance （all P ＜ 0.05）. The proportion of patients with psychiatric symptoms in the MDSB group was higher than that in the MDSI group， and the difference was statistically significant （P＜ 0.05）. The proportion of patients with pathogenic factors in the MDSI group was higher than that in the MDNS group， and the difference was statistically significant （P＜0.05）. Multivariate logistic regression analysis showed that working/studying （OR=1.230， 95%CI=1.022-1.480， P＜ 0.05） and having underlying causes （OR=1.186， 95%CI=1.021-1.378， P＜ 0.05） were risk factors for suicidal ideation in patients with depression. The gender of female was a risk factor for suicidal behavior in patients with depression （OR=1.487， 95%CI=1.147-1.929， P＜ 0.05）. The proportion of patients in the MDSI and MDSB groups who received complex treatment regimens such as antidepressants combined with mood stabilizers， antidepressants combined with mood stabilizers， and antipsychotic drugs was higher than that in the MDNS group， and the difference was statistically significant （P＜ 0.05）. Conclusions Gender of female， current working/studying， pre-existing triggers are independent risk factors for suicidal ideation or behavior in patients with depressive disorder， and more treatment plans should be used with antidepressants combined with mood stabilizers or combined with mood stabilizers and antipsychotics.

Abstract:Objective To explore the mechanisms of negative life events on non-suicidal self-injury （NSSI） behavior in adolescents. Methods A total of 1 800 adolescents from the first year of junior high school to second year of senior high school in several cities in Heilongjiang Province were selected as the research subjects from January 2021 to January 2022. Adolescent Non-Suicidal Self-Injury Questionnaire and Adolescent Self-rating Life Events Checklist were applied in the investigation. Spearman correlation analysis was used to investigate the correlation between NSSI behavior， NSSI motivation， emotion regulation， self reinforcement， interpersonal influence， and negative life events in adolescents. Process models 4 and 5 in SPSS 25.0 were used for mediation effect analysis. Results A total of 1 666 valid questionnaires were ultimately collected， with an effective response rate of 92.6%. The overall detection rate of NSSI behavior among adolescents was 25.0% （416/ 1 666）. Negative life events in adolescents were positively correlated with NSSI motivation and NSSI behavior， and NSSI behavior was positively correlated with NSSI motivation（r=0.32、0.26、0.22，all P ＜ 0.01）. The mediation model analysis showed that the three types of NSSI motivations （emotion regulation， self reinforcement， and interpersonal influence） had a mediating effect between negative life events and NSSI behavior， with an effect value of 0.012， accounting for 26.67% of the total effect value. The moderation effect analysis found that gender could regulate the direct effect of negative life events on NSSI behavior， that is， compared to the male population， negative life events had a stronger positive predictive effect on NSSI behavior in female adolescents. Conclusions It is crucial to acknowledge the role of adverse life events and the mediating function of NSSI motivation in adolescent NSSI behaviors， particularly among female adolescents， to formulate effective prevention strategies.

Abstract:18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography （18F-FDG PET/CT） is a brain functional imaging technique used to display increased neuronal glycolytic metabolic activity during brain inflammation. It can display metabolic changes in autoimmune encephalitis at different stages and locations， and some certain subtypes of encephalitis have formed specific imaging patterns. The paper summarized the metabolic patterns of different subtypes of autoimmune encephalitis and their metabolic characteristics at different stages of onset， aiming to provide important evidence and opportunities for their early diagnosis and treatment. It is expected to improve the diagnostic criteria and treatment framework of autoimmune encephalitis， and may become an important prognostic evaluation technology for autoimmune encephalitis in the future.

Abstract:Skeletal muscle fibrosis changes muscle structure and interferes with the regeneration of muscle fibers and the recovery of contraction function， ultimately damaging muscle fiber function， promoting the occurrence and development of diseases， and affecting the quality of life of patients. During this process， Toll-like receptor 4 （TLR4） and its downstream effector， nuclear factor kappa B （NF-κB） have been shown to promote collagen production and tissue fibrosis. This article reviews the regulation of skeletal muscle fibrosis by the TLR4/NF-κB signaling pathway.

Abstract:Spinal cord injury is the most severe complication of spinal injury， which can lead to sensory and motor control dysfunction below the level of injury， especially complete spinal cord injury， which can result in complete loss of motor， sensory， and sphincter function below the injury plane. Surface electromyography， as an objective and quantitative assessment tool， has been applied in the evaluation of neuromuscular dysfunction in patients with spinal cord injury. This paper reviews the application of surface electromyography in analyzing commonly used parameters of neuromuscular function in spinal cord injury and clinical evaluation of muscle dysfunction caused by spinal cord injury， aiming to provide reference for future clinical evaluation and treatment of spinal cord injury patients

Abstract: