Selective serotonin reuptake inhibitors (SSRIs) represent an effective treatment for major depressive disorder (MDD). This study employed glutamate chemical exchange saturation transfer (GluCEST) magnetic resonance imaging (MRI) to compare glutamate-sensitive signals in the prefrontal cortex and hippocampus of MDD patients before and after SSRI treatment.

The study included 35 unmedicated MDD patients and 39 healthy controls (HCs) who underwent baseline GluCEST imaging, using magnetization transfer ratio asymmetry (MTRasym) values to reflect regional glutamate levels. Twenty MDD patients completed follow-up GluCEST imaging after 8 weeks of SSRI treatment. Depressive symptoms were assessed using the Hamilton Rating Depression Scale (HAMD).

At baseline, the MTRasym values in the left hippocampus and bilateral prefrontal cortex were significantly lower in MDD patients compared to the HCs. Following SSRI treatment, the 20 MDD patients who completed follow-up showed significantly increased MTRasym values in the bilateral hippocampus and bilateral prefrontal cortex relative to baseline. Uncorrected correlation analyses showed that treatment-related differences in MTRasym values in the left hippocampus and left prefrontal cortex were associated with changes in HAMD-17 total score, sleep disturbance, and retardation scores.

GluCEST imaging suggested abnormal glutamate-sensitive signals in the prefrontal cortex and hippocampus of patients with MDD. SSRI treatment was associated with increased GluCEST signals across all regions of interest. The observed associations between regional GluCEST signal changes and symptom changes further suggest a potential role of glutamatergic-related modulation in the therapeutic effects of SSRIs.

This real-world study aimed to characterize patients with schizophrenia who achieve sustained good functional outcomes after antipsychotic discontinuation and to develop the Functional Remission in Schizophrenia after Antipsychotic Discontinuation (FURSAD) predictive model.

We retrospectively identified individuals aged 18–65 years with schizophrenia (ICD-10) from the Shanghai Mental Health Center discharge database. Patients who discontinued antipsychotics for ≥1 year were classified as functional remission (FR) or functional non-remission (FNR) based on functioning assessments. Sociodemographic, clinical, and treatment-related data were extracted blindly from hospital records and structured interviews.

Among 4,166 discharged patients screened, 180 met the inclusion criteria (FR: 116; FNR: 64). Six independent predictors were identified: total disease course, Clinical Global Impression-Severity (CGI-S) score, Positive and Negative Syndrome Scale (PANSS) emotional distress subscale score, use of first-generation antipsychotics, discontinuation due to treatment benefits, and discontinuation due to lack of insight. The logistic regression model showed strong predictive performance (AUC = 0.867, 95% CI 0.813–0.921), with 82.8% sensitivity and 81.9% specificity. Internal validation was performed via 10-fold cross-validation.

Discontinuation motives and illness trajectory are relevant in predicting long-term functional outcomes. A limitation is that a substantial number of patients could not be recontacted or declined participation, which may introduce selection bias. The FURSAD nomogram may help clinicians estimate the probability of FR 4.5 years post-antipsychotic discontinuation in patients previously on antipsychotics for ≥3 years.

Because messages are broadcast on social media timelessly and efficiently, it is a critical disaster management survey tool. Taiwan’s Regional Emergency Medical Operation Center (REMOC) has responded to nationwide disaster messages in real time since 2005. To construct an early warning system to reduce the delay between the outbreak of accidents and messages received by REMOC.

Timely data, often from first responders and social media, is critical. A system was developed to collect disaster related posts from social media platforms, focusing on keywords like typhoon, flooding, and traffic accidents. Given the mix of topics, informal language, and frequent errors, text analytics and the SVM-based tool LibShortText were used to classify relevant messages. REMOC’s system identified 3,022 disaster-related messages out of 66,588 total posts. We calculated event frequency in 2019, response speed, and engagement rate (ER) to assess the responsiveness of traditional media and individual users.

Most messages collected were related to earthquakes (23%), followed by traffic accidents (17%), fires (12%), and floods (3%). Of 702 earthquake-related messages (142 episodes), social media users shared 35 messages about 18 earthquakes, while traditional media posted 667 messages about 124 earthquakes. Social media consistently posted 100% of earthquake messages faster than traditional media (“early dissemination efficacy”: 124/124). For 251 fires (367 messages), social media shared 122 messages on 82 fires, with an early dissemination efficacy of 0.57 hours. For 32 flood events (117 messages), social media posted 55 messages on 16 floods, achieving an early dissemination efficacy of 0.65 hours.

Results show that social media users responded faster than traditional media to disaster news, especially for earthquakes, fires, and floods. Earthquakes and floods had the highest response rates from social media. Integrating REMOCs and social media information systems can greatly enhance preparedness and response, particularly for earthquakes and floods.

In Jishishan County, Linxia Prefecture, Gansu Province, China, the altitude ranges from 1,787 meters to 4,308 meters. At 23:59 Beijing time on December 18, 2023, a magnitude 6.2 earthquake struck Jishishan County. The objective is to report the injury characteristics and medical treatments of those injured in the earthquake.

The injury and treatment data were retrospectively collected and analyzed for earthquake-related injuries among patients admitted to the People’s Hospital of Linxia Hui Autonomous Prefecture and the Traditional Chinese Medicine Hospital of Linxia Hui Autonomous Prefecture.

A total of 166 patients were hospitalized: 142 at the People’s Hospital of Linxia Hui Autonomous Prefecture and 24 at the Traditional Chinese Medicine Hospital of Linxia Hui Autonomous Prefecture. Among the injured, 40.3% presented with a single injury. The others had multiple injuries: 28.3% had two injuries, 14.5% had three injuries, 12.1% had four injuries, 4.2% presented with five injuries, while only 0.6% were diagnosed with six injuries. Additionally, 78.9% involved fractures alone, 36.8% involved lung contusions, and 34.9% involved both fractures and lung contusions. Conservative treatment was used slightly more than surgery (54.8% versus 45.2%). Among the 75 surgical cases, internal fixation and sutures were the most common (17.4% each). In total, 53.0% of the injured were treated and discharged and 47.0% were transferred to provincial hospitals. In addition, the outcome of injured patients with differing injury conditions was different.

Fractures and multiple injuries were the primary injury types in this study. Suturing and internal fixation were the most common surgical interventions. The core findings of this study provide an important reference for regionalized prevention and treatment of rural earthquake injuries in high-altitude regions.

The treatment response for the negative symptoms of schizophrenia is not ideal, and the efficacy of antidepressant treatment remains a matter of considerable controversy. This systematic review and meta-analysis aimed to assess the efficacy of adjunctive antidepressant treatment for negative symptoms of schizophrenia under strict inclusion criteria.

A systematic literature search (PubMed/Web of Science) was conducted to identify randomized, double-blind, effect-focused trials comparing adjuvant antidepressants with placebo for the treatment of negative symptoms of schizophrenia from database establishment to April 16, 2025. Negative symptoms were examined as the primary outcome. Data were extracted from published research reports, and the overall effect size was calculated using standardized mean differences (SMD).

A total of 15 articles, involving 655 patients, were included in this review. Mirtazapine (N = 2, n = 48, SMD −1.73, CI −2.60, −0.87) and duloxetine (N = 1, n = 64, SMD −1.19, CI −2.17, −0.21) showed significantly better efficacy for negative symptoms compared to placebo. In direct comparisons between antidepressants, mirtazapine showed significant differences compared to reboxetine, escitalopram, and bupropion, but there were no significant differences between other antidepressants or between antidepressants and placebo. No publication bias for the prevalence of this condition was observed.

These findings suggest that adjunctive use of mirtazapine and duloxetine can effectively improve the negative symptoms of schizophrenia in patients who are stably receiving antipsychotic treatment. Therefore, incorporating antidepressants into future treatment plans for negative symptoms of schizophrenia is a promising strategy that warrants further exploration.

Major depressive disorder (MDD) patients exhibit a mood-congruent emotional processing bias within the amygdala toward negative facial stimuli at both unconscious and conscious levels. Therefore, our study aimed to investigate the temporal and spatial dynamics of amygdala along with its interactions with the whole brain during implicit and explicit conditions in MDD.

Thirty MDD patients and 26 healthy controls (HCs) underwent magnetoencephalography (MEG) recordings and performed implicit and explicit emotional face recognition tasks with happy, sad, and neutral facial expressions. Using the amygdala as a seed region, time frequency representations (TFR) and functional connectivity (FC) were calculated. Pearson correlation analyses measured the relationship between TFR and FC values with clinical symptoms.

During implicit processing, MDD patients exhibited left amygdala activation in the gamma power (60–70 Hz) before 250 ms in response to sad facial stimuli compared to HCs. In the implicit mode, there were increased FC between the right amygdala and several brain regions in the occipitoparietal lobes, as well as higher FC between the left amygdala and putamen in MDD patients. Additionally, the right amygdala was positively correlated with the severity of depression and anxiety during implicit processing.

MDD patients had lateralized amygdala activation in response to sad facial expressions during unconscious emotional recognition of facial stimuli. Our study provided valuable insights into the spatiotemporal dynamics of facial emotional recognition associated with depressive and anxiety-related cognitive bias during implicit and explicit processing.

Euthymic bipolar disorder (euBD) patients exhibit deficits in neurocognitive and social cognitive functioning compared to healthy controls (HCs). Our prior research has shown that the excitatory/inhibitory (E/I) imbalance in the default mode network (DMN) is linked to executive function in euBD. Neurocognitive impairments are associated with social cognition deficits in individuals with mental disorders. Given this connection, this study posits E/I imbalance within the DMN is associated with social cognition, with executive function as a mediator.

Seventy-five HCs and 49 euBD individuals were recruited. Using the emotion recognition task, Diagnostic Analysis of Nonverbal Accuracy 2-Taiwan version (DANVA-2-TW) and cognitive flexibility task, Wisconsin Card Sorting Test (WCST), we assessed emotion recognition and prefrontal function. Proton magnetic resonance spectroscopy (1H-MRS) measured metabolites in the posterior cingulate cortex (PCC) and medial prefrontal cortex/anterior cingulate cortex (mPFC/ACC), quantifying excitatory glutamate+glutamine (Glx) and inhibitory GABA to calculate the E/I ratio.

euBD patients showed poorer emotion recognition (p = 0.020) and poorer cognitive flexibility (fewer WCST categories completed, p = 0.002). A negative association was found between emotion recognition and the E/I ratio in the mPFC/ACC of the BD patients (r = −0.30, p = 0.034), which was significantly mediated by cognitive flexibility (Z = −2.657, p = 0.007).

The BD patients demonstrate deficits in emotion recognition, linked to an altered E/I balance in the prefrontal cortex, and the cognitive flexibility, a key aspect of executive function, mediates the impact of the E/I ratio on emotion recognition accuracy in euBD patients.

Antimicrobial resistance (AMR) is a global health crisis exacerbated by policies like China’s Volume-Based Procurement (VBP), which may inadvertently increase antimicrobial overuse. This study evaluates a clinical pharmacist-led Antimicrobial Stewardship (AMS) program with prospective audit for special-restricted antimicrobials under VBP.

A retrospective quasi-experimental interrupted time-series analysis compared pre-intervention (2022) and post-intervention (2023–2024) data at Tongji Hospital, a tertiary hospital in Wuhan, China. Key metrics included Antimicrobial Use Density (AUD), prescription rationality, antimicrobial costs, and multidrug-resistant infection rates.

The intervention significantly improved prescription appropriateness for special-restricted antimicrobials (80.24% vs. 93.83%, P < 0.005) and reduced AUD (47.87 vs. 34.25, P < 0.001). Total antimicrobial costs decreased by 41.26%, with a reduction in the incidence of multidrug-resistant infections from 0.084% to 0.062% (P < 0.05). Carbapenem use correlated with CRKP isolation rates (R = 0.62, P < 0.05). Clinical pharmacists rejected 10.24% of prescriptions, all accepted by physicians.

Pharmacist-led prospective audits optimize antimicrobial use under VBP, mitigate resistance risks, and reduce costs, while acknowledging that concurrent infection control measures may have contributed to these trends. This model may inform similar interventions in other institutions, particularly those in resource-limited settings.

Danon disease is an X-linked disorder caused by variants in the lysosome-associated membrane protein-2 (LAMP2) gene located on Xq24. Due to its inheritance in an X-chromosome dominant manner, males typically experience more severe manifestations than females.

The whole exome sequencing was conducted on a cohort of 218 children diagnosed with hypertrophic cardiomyopathy; four children with hypertrophic cardiomyopathy carrying the LAMP2 variants were diagnosed at our centre. Variants in the LAMP2 gene were summarised, and their pathogenicity and conservation were analysed using bioinformatics methods. A retrospective analysis of genotype-phenotype associations was also conducted in conjunction with previously reported cases.

Four patients with Danon disease were diagnosed in our single centre by gene sequencing; they all presented with myocardial hypertrophy as the initial manifestation. Both male patients manifested symptoms from infancy, while disease onset in the two female cases occurred below the average age reported for females. Through gene sequencing, a total of four variants were identified in these four patients, including one splicing variant: c.865-1G>C, one loss of heterozygosity variant: loss1 exon:4-9), one frameshift variant: c.973delG(p.(L325Wfs×21)), and one stop codon variant: c.467T>G(p.(L156*)).

This study identified four patients with LAMP2 gene variants, thereby enriching the documented genetic landscape of LAMP2-associated disorders. Bioinformatics analyses corroborated the pathogenicity of these variants. Additionally, we emphasised that women with suspected Danon disease should be thoroughly evaluated, and the possibility of implantable cardioverter defibrillator implantation and heart transplantation should be considered and discussed as early as possible.

Tumour immunotherapy holds great promise as a treatment for cancer, which ranks as the second highest cause of mortality worldwide. This therapeutic approach can be broadly categorized into two main types: active immunotherapy and passive or adoptive immunotherapy. Active immunotherapy, such as cancer vaccines, stimulates the patients’ immune system to target tumour cells. On the other hand, adoptive immunotherapy involves supplying in vitro activated immune cells, such as T cells, natural killer cells and macrophages, to the patient to combat the tumour. Induced pluripotent stem cells are extensively utilized in both active and adoptive tumour immunotherapy due to their pluripotency and ease of gene editing. They can be differentiated into various types of immune cells for direct cancer treatment and can also function as tumour vaccines to elicit an immune response against the tumour. Importantly, iPSCs can be leveraged to develop off-the-shelf allogenic immunotherapy products.

This article provides a comprehensive review of the application of iPSCs in tumor immunotherapy, along with a discussion of the opportunities and challenges in this evolving field.