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This study applied the Kirkpatrick Training Evaluation Model to examine how training motivation, skill mastery, and environmental support predict cardiopulmonary resuscitation (CPR) performance among police officers serving as first responders.
Methods
A cross-sectional design was employed, involving 233 participants in a pilot phase and 138 in the main study, all recruited from 3 police precincts in New Taipei City, Taiwan. A structured questionnaire was validated using exploratory and confirmatory factor analyses. CPR performance was assessed using QCPR manikins, capturing compression depth, rate, and recoil. Hierarchical regression analyses identified predictors of CPR skill performance.
Results
Training motivation significantly predicted compression depth (β = 0.62, P < 0.001; R2 = 0.188), while real-life resuscitation experience predicted compression rate (β = 0.17, P = 0.039; R2 = 0.054). Chest recoil performance was significantly associated with training motivation (β = 0.31, P = 0.007) and the age group 30-39 (β = 0.22, P = 0.028), within a model explaining 11.4% of the variance (R² = 0.114). The 3 training-related constructs demonstrated varied and domain-specific impacts on CPR skills.
Conclusions
Beyond technical instruction, contextual and motivational factors significantly influence CPR performance among police officers. Training programs should incorporate multi-level strategies—including supportive environments and motivational components—to improve readiness and response effectiveness in prehospital emergency care.
The Chinese pangolin Manis pentadactyla is categorized as Critically Endangered on the IUCN Red List, but the development of effective conservation strategies is hindered by a lack of data on its distribution range and population dynamics. In addition, standardized survey and analysis methods are required to facilitate the sharing of results and maximize conservation effectiveness. To fill these knowledge and methodological gaps, we investigated the occurrence of pangolin burrows in the subtropical forest ecosystem of Fujian, China. We surveyed a total of 70 transects across five land-cover types within the Fujian Junzifeng National Nature Reserve and detected 87 burrows. The majority of burrows (87%) were located in mixed conifer and broadleaf forests. We used six environmental variables in a generalized linear model to examine the relationship between the occurrence of burrows and environmental factors. The average model results from the best model set showed that the distribution of burrows was significantly influenced by forest type. For effective pangolin conservation, we recommend that local conservation authorities prioritize the protection of mixed conifer and broadleaf forests. Our findings support the local conservation of the Chinese pangolin and the standardization of surveys and conservation efforts across the species’ range.
Direct numerical simulations are performed to explore the impact of surface roughness on inter-scale energy transfer and interaction in a turbulent open-channel flow over differently arranged rough walls. With friction Reynolds number approximately 540, six distinct configurations of roughness arrangements are examined. The results show that the clustered roughness arrangements yield notable changes in large-scale secondary-flow structures, which manifest in the profiles of dispersive stresses, predominantly near the roughness elements. They are marked by the presence of spanwise alternating high-momentum pathways and low-momentum pathways. From the outer peak in the spanwise energy spectra, the size and intensity of turbulent secondary flows are shown to be related to the spanwise spacing of the roughness heterogeneity. The emergence of turbulent secondary flows serves to suppress the original large-scale structures in the outer region of smooth-wall turbulence, paving the way for the development of new turbulent structures at the second harmonic scale. Furthermore, the spanwise triadic interaction analysis reveals the mutual energy exchange between the secondary harmonic scale and the secondary-flow scale. These findings elucidate the underlying mechanisms behind the attenuation of large-scale structures in the outer region influenced by roughness, offering new insights into the dynamic interplay of scale interactions in rough-wall turbulence.
CD33 has been implicated in the pathogenesis of Alzheimer’s disease primarily through its role in inhibiting the clearance of beta-amyloid (Aβ). However, genetic studies yield mixed results and it is unclear whether the impact of CD33 is specific to Alzheimer’s disease or related to broader neurodegenerative processes. Interestingly, CD33 has also been shown to interact with the hepatitis B (HBV) and C viruses (HCV).
Aims
This study aims to investigate the effects of CD33 single-nucleotide polymorphisms (SNPs) on cognitive functions across diverse populations, including healthy controls, individuals with chronic HBV or HCV and those diagnosed with Parkinson’s disease.
Method
We genotyped CD33 SNPs in 563 participants using the Affymetrix platform. Participants’ cognitive functions were cross-sectionally assessed using a neuropsychological test battery spanning six domains.
Results
Our analysis revealed that CD33 SNP variations had no significant cognitive impact on healthy individuals or Parkinson’s disease patients. However, chronic HBV and HCV patients exhibited significant cognitive differences, particularly in memory, related to CD33 SNP genotypes. Moderation analysis indicated a heightened influence of CD33 SNPs on cognitive functions in chronic HBV and HCV individuals. Our data also suggest that inflammation severity may modulate the cognitive effects in hepatitis patients with specific CD33 SNPs.
Conclusions
This study highlights the importance of CD33 SNPs in cognitive outcomes, emphasising their role in the context of chronic viral hepatitis. It contributes to understanding the cognitive profiles influenced by CD33 SNPs and posits CD33’s potential contribution to neurodegenerative disease progression, potentially intensified by HBV/HCV-induced inflammation.
Overnutrition during before and pregnancy can cause maternal obesity and raise the risk of maternal metabolic diseases during pregnancy, and in offspring. Lentinus edodes may prevent or reduce obesity. This study aimed to to assess Lentinus edodes fermented products effects on insulin sensitivity, glucose and lipid metabolism in maternal and offspring, and explore its action mechanism. A model of overnutrition during pregnancy and lactation was developed using a 60 % kcal high-fat diet in C57BL6/J female mice. Fermented Lentinus edodes (FLE) was added to the diet at concentrations of 1 %, 3 %, and 5 %. The results demonstrated that FLE to the gestation diet significantly reduced serum insulin levels and homeostatic model assessment for insulin resistance (HOMA-IR) in pregnant mice. FLE can regulate maternal lipid metabolism and reduce fat deposition. Meanwhile, the hepatic phosphoinositide-3-kinase-protein kinase (PI3K/AKT) signaling pathway was significantly activated in the maternal mice. There is a significant negative correlation between maternal FLE supplementation doses and offspring body fat percentage and visceral fat content. Furthermore, FLE supplementation significantly increased offspring weaning litter weight, significantly reduced fasting glucose level, serum insulin level, HOMA-IR and serum glucose level, significantly activated liver PI3K/AKT signaling pathway in offspring, and upregulated the expression of liver lipolytic genes adipose triglyceride lipase, hormone-sensitive lipase and carnitine palmitoyltransferase 1 mRNA. Overall, FLE supplementation can regulate maternal lipid metabolism and reduce fat deposition during pregnancy and lactation, and it may improve insulin sensitivity in pregnant mothers and offspring at weaning through activation of the PI3K/AKT signaling pathway.
The extracellular matrices, such as the haemolymph, in insects are at the centre of most physiological processes and are protected from oxidative stress by the extracellular antioxidant enzymes. In this study, we identified two secreted superoxide dismutase genes (PxSOD3 and PxSOD5) and investigated the oxidative stress induced by chlorpyrifos (CPF) in the aquatic insect Protohermes xanthodes (Megaloptera: Corydalidae). PxSOD3 and PxSOD5 contain the signal peptides at the N-terminus. Structure analysis revealed that PxSOD3 and PxSOD5 contain the conserved CuZn-SOD domain, which is mainly composed of β-sheets and has conserved copper and zinc binding sites. Both PxSOD3 and PxSOD5 are predicted to be soluble proteins located in the extracellular space. After exposure to different concentrations of sublethal CPF, MDA content in P. xanthodes larvae were increased in a dose-dependent manner; SOD and CAT activities were also higher in CPF-treated groups than that in the no CPF control, indicating that sublethal CPF induces oxidative stress in P. xanthodes larvae. Furthermore, PxSOD3 and PxSOD5 expression levels and haemolymph SOD activity in the larvae were downregulated by sublethal CPF at different concentrations. Our results suggest that the PxSOD3 and PxSOD5 are putative extracellular antioxidant enzymes that may play a role in maintaining the oxidative balance in the extracellular space. Sublethal CPF may induce oxidative stress in the extracellular space of P. xanthodes by reducing the gene expression and catalytic activity of extracellular SODs.
Parental psychopathology is a known risk factor for child autistic-like traits. However, symptom-level associations and underlying mechanisms are poorly understood.
Methods
We utilized network analyses and cross-lagged panel models to investigate the specific parental psychopathology related to child autistic-like traits among 8,571 adolescents (mean age, 9.5 years at baseline), using baseline and 2-year follow-up data from the Adolescent Brain Cognitive Development study. Parental psychopathology was measured by the Adult Self Report, and child autistic-like traits were measured by three methods: the Kiddie Schedule for Affective Disorders and Schizophrenia for DSM-5 autism spectrum disorder (ASD) subscale, the Child Behavior Checklist ASD subscale, and the Social Responsiveness Scale. We also examined the mediating roles of family conflict and children’s functional brain connectivity at baseline.
Results
Parental attention-deficit/hyperactivity problems were central symptoms and had a direct and the strongest link with child autistic-like traits in network models using baseline data. In longitudinal analyses, parental attention-deficit/hyperactivity problems at baseline were the only significant symptoms associated with child autistic-like traits at 2-year follow-up (β = 0.014, 95% confidence interval [0.010, 0.018], FDR q = 0.005), even accounting for children’s comorbid behavioral problems. The observed association was significantly mediated by family conflict (proportion mediated = 11.5%, p for indirect effect <0.001) and functional connectivity between the default mode and dorsal attention networks (proportion mediated = 0.7%, p for indirect effect = 0.047).
Conclusions
Parental attention-deficit/hyperactivity problems were associated with elevated autistic-like traits in offspring during adolescence.
Emission line galaxies (ELGs) are crucial for cosmological studies, particularly in understanding the large-scale structure of the Universe and the role of dark energy. ELGs form an essential component of the target catalogue for the Dark Energy Spectroscopic Instrument (DESI), a major astronomical survey. However, the accurate selection of ELGs for such surveys is challenging due to the inherent uncertainties in determining their redshifts with photometric data. In order to improve the accuracy of photometric redshift estimation for ELGs, we propose a novel approach CNN–MLP that combines convolutional neural networks (CNNs) with multilayer perceptrons (MLPs). This approach integrates both images and photometric data derived from the DESI Legacy Imaging Surveys Data Release 10. By leveraging the complementary strengths of CNNs (for image data processing) and MLPs (for photometric feature integration), the CNN–MLP model achieves a $\sigma_{\mathrm{NMAD}}$ (normalised median absolute deviation) of 0.0140 and an outlier fraction of 2.57%. Compared to other models, CNN–MLP demonstrates a significant improvement in the accuracy of ELG photometric redshift estimation, which directly benefits the target selection process for DESI. In addition, we explore the photometric redshifts of different galaxy types (Starforming, Starburst, AGN, and Broadline). Furthermore, this approach will contribute to more reliable photometric redshift estimation in ongoing and future large-scale sky surveys (e.g. LSST, CSST, and Euclid), enhancing the overall efficiency of cosmological research and galaxy surveys.
Rare earth elements (REEs) preserved in speleothems have garnered increasing attention as ideal proxies for the paleoenvironmental reconstruction. However, due to their typically low contents in stalagmites, the availability of stalagmite-based REE records remains limited. Here we present high-resolution REEs alongside oxygen isotope (δ18O) records in stalagmite SX15a from Sanxing Cave, southwestern China (110.1–103.3 ka). This study demonstrates that REE records could provide useful information for the provenance and formation process of the stalagmite, due to consistent distribution pattern across different periods indicating stable provenance. More interestingly, the total REE (ΣREE) record could serve as an effective indicator to reflect local hydrological processes associated with monsoonal precipitation. During Marine Isotopic Stage (MIS) 5d, a relatively low ΣREE content is consistent with the positive SX15a δ18O and negative NGRIP δ18O, reflecting a dry-cold environment; while during MIS 5c, a generally high ΣREE content suggests a humid-warm circumstance. Furthermore, the ΣREE record captured four prominent sub-millennial fluctuations within the Greenland interstadial 24 event, implying a combined influence by the regional climate and local soil redox conditions. Our findings indicate that the stalagmite-based REE records would be a useful proxy for better understanding of past climate and environment changes.
Glyphodes pyloalis Walker (Lepidoptera: Pyralidae) is a destructive monophagous pest of mulberry, Morus Linnaeus (Moraceae), trees. In order to identify mulberry cultivars resistant to G. pyloalis, 12 cultivars were examined using field and in vitro testing. Field observations indicated that cultivars AlbapC, BombyL, LaeviT, and CathaB had less than 10.0% damage, with no observed damage on the CathaB cultivar. The life table parameters showed that CathaB cultivar had the longest larval and pupal duration (23.2 days in total), the shortest adult period (5.3 days), the lowest rates of both pupation (55.0%) and adult emergence (69.7%), the highest adult mortality (61.7%), the lowest average weight of pupae (30.4 mg), and the lowest daily oviposition (5.0 eggs/female/day). The larval performance of G. pyloalis in the field revealed that CathaB had the lowest larval density. Correlation analyses confirmed that significant correlations exist between all the performance parameters of G. pyloalis for both the observed damage and larval performance. Leaf characterisation of selected cultivars indicated CathaB had significantly higher values of leaf wax, trichome density, soluble glucose, and protein contents compared to MultiQ. This study would be a valuable reference for evaluating pest-resistant cultivars and establishing a theoretical foundation for managing G. pyloalis.
Internet addiction (IA) refers to excessive internet use that causes cognitive impairment or distress. Understanding the neurophysiological mechanisms underpinning IA is crucial for enabling an accurate diagnosis and informing treatment and prevention strategies. Despite the recent increase in studies examining the neurophysiological traits of IA, their findings often vary. To enhance the accuracy of identifying key neurophysiological characteristics of IA, this study used the phase lag index (PLI) and weighted PLI (WPLI) methods, which minimize volume conduction effects, to analyze the resting-state electroencephalography (EEG) functional connectivity. We further evaluated the reliability of the identified features for IA classification using various machine learning methods.
Methods
Ninety-two participants (42 with IA and 50 healthy controls (HCs)) were included. PLI and WPLI values for each participant were computed, and values exhibiting significant differences between the two groups were selected as features for the subsequent classification task.
Results
Support vector machine (SVM) achieved an 83% accuracy rate using PLI features and an improved 86% accuracy rate using WPLI features. t-test results showed analogous topographical patterns for both the WPLI and PLI. Numerous connections were identified within the delta and gamma frequency bands that exhibited significant differences between the two groups, with the IA group manifesting an elevated level of phase synchronization.
Conclusions
Functional connectivity analysis and machine learning algorithms can jointly distinguish participants with IA from HCs based on EEG data. PLI and WPLI have substantial potential as biomarkers for identifying the neurophysiological traits of IA.
The interaction of a swimmer with unsteady vortices in complex flows remains a topic of interest and open discussion. The present study, employing the immersed boundary method with a flexible fin model, explores swimming behaviours behind a circular cylinder with vortex-induced vibration (VIV). Five distinct swimming modes are identified on the $U_r$–$G_0$ plane, where $U_r$ denotes the reduced velocity, and $G_0$ represents the fin’s initial position. These modes include drifting upstream I/II (DU-I/II), Karman gait I/II (KG-I/II), and large oscillation (LO), with the DU-II, KG-II and LO modes being newly reported. The fin can either move around or cross through the vortex cores in the KG-I and KG-II modes, respectively, for energy saving and maintaining a stable position. When the upstream cylinder vibrates with its maximum amplitude, a double-row vortex shedding forms in the wake, allowing the DU-II mode to occur with the fin to achieve high-speed locomotion. This is attributed to a significant reduction in the streamwise velocity caused by vortex-induced velocity. Furthermore, a symmetry breaking is observed in the fin’s wake in the DU-II mode, potentially also contributing to high-speed locomotion. Overall, compared to the case without an upstream cylinder, we demonstrate that a self-propelled fin gains hydrodynamic advantages with various swimming modes in different VIV wakes. Interestingly, increased power transferred from flows by the oscillating cylinder leads to a more favourable environment for the downstream fin’s propulsion, indicating that a fin in VIV wakes obtains more advantages compared to the vortex street generated by a stationary cylinder.
Nutraceuticals have been taken as an alternative and add-on treatment for depressive disorders. Direct comparisons between different nutraceuticals and between nutraceuticals and placebo or antidepressants are limited. Thus, it is unclear which nutraceuticals are the most efficacious.
Methods
We conducted a network meta-analysis to estimate the comparative efficacy and tolerability of nutraceuticals for the treatment of depressive disorder in adults. The primary outcome was the change in depressive symptoms, as measured by the standard mean difference (SMD). Secondary outcomes included response rate, remission rate, and anxiety. Tolerability was defined as all-cause discontinuation and adverse events. Frequentist random-effect NMA was conducted.
Results
Hundred and ninety-two trials involving 17,437 patients and 44 nutraceuticals were eligible for inclusion. Adjunctive nutraceuticals consistently showed better efficacy than antidepressants (ADT) alone in outcomes including SMD, remission, and response. Notable combinations were Eicosapentaenoic acid + Docosahexaenoic Acid plus ADT (EPA + DHA + ADT) (SMD 1.04, 95% confidence interval 0.64–1.44), S-Adenosyl Methionine (SAMe) + ADT (0.99, 0.31–1.68), curcumin + ADT (1.03, 0.55–1.51), Zinc + ADT (1.59, 0.63–2.55), tryptophan + ADT (1.24, 0.32–2.16), and folate + ADT (0.64, 0.17–1.10). Additionally, four nutraceutical monotherapies demonstrated superior efficacy compared to ADT: EPA + DHA (0.6, 0.32–0.88), SAMe (0.52, 0.18–0.87), curcumin (0.62, −0.17 to 1.40) and saffron (0.69, 0.34–1.04). It is noted that EPA + DHA, SAMe, and curcumin showed strong performance as either monotherapies or adjuncts to ADT. Most nutraceuticals showed comparable tolerability to placebo.
Conclusions
This extensive systematic review and NMA of nutraceuticals for treating depressive disorders indicated a number of nutraceuticals that could offer benefits, either as adjuncts or monotherapies.
Terminal cancer patients often endure significant distress, impacting their quality of life. Spiritual well-being provides peace and meaning during this challenging period.
Objectives. This study explored the spiritual well-being of terminally ill patients and their next-of-kin caregivers in hospice care, focusing on factors influencing their spiritual experiences.
Methods
This mixed-methods study included 30 terminally ill patients and 17 next-of-kin caregivers in hospice care. Spiritual well-being was assessed using the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being Scale (FACIT-Sp-12), and symptom distress with the Edmonton Symptom Assessment Scale. Qualitative data were collected through semi-structured interviews at baseline, 1 week, and 1 month. Data were analyzed using quantitative methods and thematic analysis.
Results
Patients showed a significant improvement in spiritual well-being over time, with FACIT-Sp-12 scores increasing from 28.6 at baseline to 31.3 at 1 month (p < .01). Symptoms such as shortness of breath (β = –1.19, p < .001), drowsiness (β = –1.27, p = .01), and anxiety (β = –0.60, p = .03) were negatively associated with spiritual well-being. Caregiver spiritual well-being positively influenced patient scores, especially with female caregivers (β = 0.26, p < .001). Qualitative findings supported these results, revealing themes of spiritual adjustment, the impact of physical symptoms on spiritual well-being, and the crucial role of caregivers in providing emotional and spiritual support.
Significance of results
Early palliative care facilitates spiritual adjustment in terminally ill patients. A holistic approach addressing physical symptoms and psychological distress is essential. Supporting caregivers, particularly female ones, positively impacts patient spiritual well-being. Tailored interventions considering the unique needs of patients and caregivers are recommended to enhance palliative care quality.
Hand, foot, and mouth disease (HFMD) shows spatiotemporal heterogeneity in China. A spatiotemporal filtering model was constructed and applied to HFMD data to explore the underlying spatiotemporal structure of the disease and determine the impact of different spatiotemporal weight matrices on the results. HFMD cases and covariate data in East China were collected between 2009 and 2015. The different spatiotemporal weight matrices formed by Rook, K-nearest neighbour (KNN; K = 1), distance, and second-order spatial weight matrices (SO-SWM) with first-order temporal weight matrices in contemporaneous and lagged forms were decomposed, and spatiotemporal filtering model was constructed by selecting eigenvectors according to MC and the AIC. We used MI, standard deviation of the regression coefficients, and five indices (AIC, BIC, DIC, R2, and MSE) to compare the spatiotemporal filtering model with a Bayesian spatiotemporal model. The eigenvectors effectively removed spatial correlation in the model residuals (Moran’s I < 0.2, p > 0.05). The Bayesian spatiotemporal model’s Rook weight matrix outperformed others. The spatiotemporal filtering model with SO-SWM was superior, as shown by lower AIC (92,029.60), BIC (92,681.20), and MSE (418,022.7) values, and higher R2 (0.56) value. All spatiotemporal contemporaneous structures outperformed the lagged structures. Additionally, eigenvector maps from the Rook and SO-SWM closely resembled incidence patterns of HFMD.
The outbreak of major epidemics, such as COVID-19, has had a significant impact on supply chains. This study aimed to explore knowledge innovation in the field of emergency supply chain during pandemics with a systematic quantitative analysis.
Methods
Based on the Web of Science (WOS) Core Collection, proposing a 3-stage systematic analysis framework, and utilizing bibliometrics, Dynamic Topic Models (DTM), and regression analysis to comprehensively examine supply chain innovations triggered by pandemics.
Results
A total of 888 literature were obtained from the WOS database. There was a surge in the number of publications in recent years, indicating a new field of research on Pandemic Triggered Emergency Supply Chain (PTESC) is gradually forming. Through a 3-stage analysis, this study identifies the literature knowledge base and distribution of research hotspots in this field and predicts future research hotspots and trends mainly boil down to 3 aspects: pandemic-triggered emergency supply chain innovations in key industries, management, and technologies.
Conclusions
COVID-19 strengthened academic exchange and cooperation and promoted knowledge output in this field. This study provides an in-depth perspective on emergency supply chain research and helps researchers understand the overall landscape of the field, identifying future research directions.
Dietary intervention is a key strategy for preventing and managing chronic kidney disease (CKD). However, evidence on specific foods’ effects on CKD is limited. This study aims to clarify the impact of various foods on CKD risk. We used two-sample Mendelian randomisation to analyse the causal relationships between the intake of eighteen foods (e.g., cheese, processed meat, poultry, beef and non-oily fish) and CKD risk, as well as estimated glomerular filtration rate (eGFR)cr and eGFRcys levels. The inverse variance weighting method, weighted median method, MR-Egger regression, simple mode and weighted mode were employed. The sensitivity analysis included Cochran’s Q test and the Egger intercept test. According to the main method, the IVM results indicated that frequent alcohol intake was linked to higher CKD risk (P= 0·007, 0·048). Protective factors included cheese (OR = 0·71, (95 % CI: 0·53, 0·94), P= 0·017), tea (OR = 0·66, (95 % CI: 0·43, 1·00), P= 0·048) and dried fruit (OR = 0·78, (95 % CI: 0·63, 0·98), P= 0·033). Oily fish (β = 0·051, (95 % CI: 0·001, 0·102), P= 0·046) and dried fruit (β = 0·082, (95 % CI: 0·016, 0·149), P= 0·014) were associated with elevated eGFRcys. Salad/raw vegetables (β = 0·024, (95 % CI: 0·003, 0·045), P= 0·028) and dried fruit (β = 0·013, (95 % CI: 0·001, 0·031), P= 0·014) were linked to higher eGFRcr, while cereal intake (β = –0·021, (95 % CI: −0·033, −0·010), P < 0·001) was associated with lower eGFRcr. These findings provide insights for optimising dietary strategies for CKD patients.
Major depressive disorder (MDD) and coronary heart disease (CHD) can both cause significant morbidity and mortality. The association of MDD and CHD has long been identified, but the mechanisms still require further investigation. Seven mRNA microarray datasets containing samples from patients with MDD and CHD were downloaded from Gene Expression Omnibus. Combined matrixes of MDD and CAD were constructed for subsequent analysis. Differentially expressed genes (DEGs) were identified. Functional enrichment analyses based on shared DEGs were conducted to identify pivotal pathways. A protein-protein network was also applied to further investigate the functional interaction. Results showed that 24 overlapping genes were identified. Enrichment analysis indicated that the shared genes are mainly associated with immune function and ribosome biogenesis. The functional interactions of shared genes were also demonstrated by PPI network analysis. In addition, three hub genes including MMP9, S100A8, and RETN were identified. Our results indicate that MDD and CHD have a genetic association. Genes relevant to immune function, especially IL-17 signalling pathway may be involved in the pathogenesis of MDD and CHD.