Introduction: Perimenopausal depression is predominantly caused by hormone shock, but the underlying physical and psychological factors are still unclear.Objectives: To explore the constituent components of perimenopausal depression by dynamically depicting its influencing factors and interactive pathways from the perspective of embodied cognition.Methods: This is a randomized clinical controlled trial. In this study, electroacupuncture was compared with escitalopram. A total of 242 participants with mild to moderate perimenopausal depression were enrolled from 6 hospitals in China. Each participant had a 12-week intervention and a 12-week follow-up period. The primary outcome of this study is the Hamilton Depression Rating Scale (HAMD-17), and the secondary outcome is the menopause-specific quality of life scale (MENQOL), serum Follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estrogen (E2) levels.Results: The structural equation model suggested that hormone levels were not directly associated with HAMD-17 (P = 0.852), while MENQOL was statistically correlated with HAMD-17 as an intermediary variable (P < 0.001). Electroacupuncture gradually showed positive impacts on MENQOL and HAMD-17 during the follow-up period (P < 0.05). Cognitive impairment is the dominant dimension of perimenopausal depression.Conclusions: Hormonal shock may affect clinical symptoms and poor quality of life to induce cognitive impairment leading perimenopausal depression, and this impact on cognition is embodied. Electroacupuncture has positive effect on perimenopausal depression and quality of life.

Background: Because of inadequate psychotherapy resources, antidepressants are the front-line option for Major depressive disorder, but with dissatisfied curative effect. Many patients have an interest in acupuncture and moxibustion treatment as complementary therapies. However, there is no sufficient evidence on effectiveness of the integrated treatment. The aim of this study is to evaluate the efficacy and safety of the integrated acupuncture and moxibustion treatment in treating major depressive disorder and to find out the most suitable implementation protocol.Methods: This study is a multicenter, single-blind, 2 × 2 factorial randomized trial. A total of 592 adult participants with moderate depression will be enrolled and randomized into four groups with a ratio of 2: 2: 2: 1, that is, combined group, integrated acupuncture and moxibustion treatment only group, sertraline only group, or placebo group. Participants will undergo a 12-week intervention with either 50 mg of sertraline or placebo once a day, as well as the active/sham integrated acupuncture and moxibustion treatment for three times per week. The primary outcome is assessed using the 17-item version of Hamilton Depression Scale. The secondary outcomes are anxiety and sleep-related scales that assessed using Hamilton Anxiety Scale and Pittsburgh Sleep Quality Index. Safety will be evaluated using liver and kidney function tests examined before and after treatment, as well as daily adverse events. The primary and secondary outcomes will be measured at weeks 0, 4, 8, 12 and 8-week posttreatment, and an intent-to-treat principle will be followed for outcomes analyses.Discussion: Sertraline is one of antidepressants as the front-line treatment for major depressive disorder, but with a delayed onset, high rate of inadequate response and low rate of adherence. As a traditional Chinese therapy, acupuncture and moxibustion are popular and widely accepted. This trial will provide more sufficient evidence for the efficacy and safety of the integrated treatment for major depressive disorder and the most suitable combination strategy. Thus, these finds will extend our knowledge in treating for major depressive disorder.Trial registration: Chinese Clinical Trial Registry ChiCTR2100042841; Registered on 30 January 2021.

BACKGROUND Non-small-cell lung cancer (NSCLC) has the highest morbidity and mortality rates among all malignant tumor types. Although therapies targeting the mutated genes such as KRAS have been used in the clinic for many years, the prognosis remains poor. Therefore, it is necessary to further study the aberrant expression or mutation of non-target genes affecting the survival and prognosis. AIM To explore the impact of simultaneous abnormalities of multiple genes on the prognosis and survival of patients. METHODS We used R packages to analyze gene expression data and clinical data downloaded from The Cancer Genome Atlas (TCGA) database. We also collected samples from 85 NSCLC patients from the First People’s Hospital of Jingzhou City and retrospectively followed the patients. Multivariate Cox regression analysis and survival analysis were performed. RESULTS Analysis of gene expression data from TCGA revealed that the overexpression of the following single genes affected overall survival: TP53 ( P = 0.79), PTEN ( P = 0.94), RB1 ( P = 0.49), CTNNB1 ( P = 0.24), STK11 ( P = 0.32), and PIK3CA ( P = 0.013). However, the probability of multiple genes ( TP53 , PTEN , RB1 , and STK11 ) affecting survival was 0.025. Retrospective analysis of clinical data revealed that sex (hazard ratio [HR] = 1.29; [95%CI: 0.64-2.62]), age (HR = 1.05; [95%CI: 1.02-1.07]), smoking status (HR = 2.26; [95%CI: 1.16-4.39]), tumor histology (HR = 0.58; [95%CI: 0.30-1.11]), cancer stage (HR = 16.63; [95%CI: 4.8-57.63]), epidermal growth factor receptor ( EGFR ) mutation (HR = 1.82; [95%CI: 1.05-3.16]), abundance (HR = 4.95; [95%CI: 0.78-31.36]), and treatment with tyrosine kinase inhibitors (TKIs) (HR = 0.58; [95%CI: 0.43-0.78]) affected patient survival. Co-occurring mutations of TP53 , PTEN , RB1 , and STK11 did not significantly affect the overall survival of patients receiving chemotherapy ( P = 0.96) but significantly affected the overall survival of patients receiving TKIs ( P = 0.045). CONCLUSION Co-occurring mutation or overexpression of different genes has different effects on the overall survival and prognosis of NSCLC patients. Combined with TKI treatment, the co-occurring mutation of some genes may have a synergistic effect on the survival and prognosis of NSCLC pa...

The incidence of depression is increasing, especially in the young adult population. Impaired cognitive function is one of the characteristics of depression, which may be related to impaired cerebral autoregulation (CA). We investigated the characteristics of CA in young adults with mild depression, as well as its validity for identifying patients with depression. Patients (aged 18-35 years) with Hamilton Depression Rating Scale (HAMD) scores ranging from 8 to 17 and a first episode of mild depression were enrolled in this study. Healthy volunteers were recruited as controls. Noninvasive continuous arterial blood pressure and bilateral middle cerebral artery blood flow velocity were simultaneously recorded from each subject. Transfer function analysis was applied to derive phase difference, gain, coherence and rate of recovery for the assessment of CA. Forty-three patients and 43 healthy controls were enrolled. Phase difference values were significantly compromised in young adults with mild depression and were negatively correlated with HAMD scores. Rate of recovery values estimated from depressed patients was significantly lower. The validity in identifying patients with depression was favorable for the phase difference. The cutoff phase difference value was 29.66. Our findings suggest that dynamic CA was impaired in young patients with mild depression and negatively correlated with HAMD scores. CA represented by phase difference can be used as an objective auxiliary examination of depression, and has clinical diagnostic value for the early identification of patients with depression.

Background: Subthreshold depression is the prodromal stage of a depressive episode, which is characterized by depressive symptoms but fails to meet the diagnostic criteria for depression. At present, there is no recognized therapy for subthreshold depression worldwide. Studies have also shown that acupoint stimulation can significantly decrease depressive symptoms by modulating different executive control systems, such as reward circuits and motivational circuits. In this proposed study, our objective is to evaluate the efficacy of intradermal thumbtack needle therapy, a continuous and effective acupoint stimulation therapy, on subthreshold depression and generate hypotheses on the mechanism by which this therapy resets executive control system function in young patients with subthreshold depression.Method: In this randomized controlled trial, all eligible participants are diagnosed with subthreshold depression. Participants are randomly assigned to two groups at a ratio of 1:1 and receive either intradermal thumbtack needle or sham intradermal thumbtack needle therapy. The primary outcome is self-reported depression severity on the 9-item Patient Health Questionnaire (PHQ-9) from baseline to 6 weeks. The secondary outcomes include the Short Form Survey (SF-12) and the Generalized Anxiety Disorder Assessment (GAD-7) complementarity. Two psychological paradigms, the Attention Network Test (ANT) and the Psychomotor Vigilance Task (PVT), and functional magnetic resonance imaging (fMRI) will be used to evaluate the mechanism. These two psychological paradigms will explain the mechanism from the perspective of executive control in psychology, and fMRI will reflect the change in functional reset of the executive control system from an imaging point of view. The results are obtained at the start of treatment andthe end of treatment. The entire duration of the study will be approximately 12 months. Discussion: This study is designed to evaluate the efficacy of intradermal thumbtack needle on StD patients. Additionally, mechanisms by which this therapy resets executive control system function will be studied Trial registration: NCT04319562. [ClinicalTrials.gov] [registered before start of inclusion; 24 March 2020] {2a and 2b}