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Abstract Background Hepatocellular carcinoma (HCC) is a common type of malignant tumor where the prognosis is dismal. Circular RNA (CircRNA) is a novel RNA that regulates downstream gene transcription and translation to influence the progression of HCC. However, the regulatory relationship that exists between E3 ligases, which is a class of post-translational modifying proteins, and circRNA remains unclear. Methods Based on the E3 ubiquitin ligase in the competitive endogenous RNA (ceRNA) network, a circRNA-regulated E3 ubiquitin ligase signature (CRE3UL) was developed. A CRE3UL signature was created using the least absolute shrinkage and selection operator (Lasso) and Cox regression analysis and merged it with clinicopathologic characteristics to generate a nomogram for prognosis prediction. The pRRophetic algorithm was utilized and immunological checkpoints were analyzed to compare the responses of patients in the high-risk group (HRG) and low-risk group (LRG) to targeted therapy and immunotherapy. Finally, experimental research will further elucidate the relationship between E3 ubiquitin ligase signature and HCC. Results HRG patients were found to have a worse prognosis than LRG patients. Furthermore, significant variations in prognosis were observed among different subgroups based on various clinical characteristics. The CRE3UL signature was identified as being an independent prognostic indicator. The nomogram that combined clinical characteristics and the CRE3UL signature was found to accurately predict the prognosis of HCC patients and demonstrated greater clinical utility than the current TNM staging approach. According to anticancer medication sensitivity predictions, the tumors of HRG patients were more responsive to gefitinib and nilotinib. From immune-checkpoint markers analysis, immunotherapy was identified as being more probable to assist those in the HRG. Conclusions We found a significant correlation between the CRE3UL signature and the tumor microenvironment, enabling precise prognosis prediction for HCC patients. Additionally, a nomogram was developed that performs well in predicting the overall survival (OS) of HCC patients. This provides valuable guidance for clinicians in devising specific personalized treatment strategies. Graphical Abstract

Abstract Induction of tumor vascular normalization is a crucial measure to enhance immunotherapy efficacy. cGAS-STING pathway is vital for anti-tumor immunity, but its role in tumor vasculature is unclear. Herein, using preclinical liver cancer models in Cgas/Sting-deficient male mice, we report that the interdependence between tumor cGAS and host STING mediates vascular normalization and anti-tumor immune response. Mechanistically, TET2 mediated IL-2/STAT5A signaling epigenetically upregulates tumor cGAS expression and produces cGAMP. Subsequently, cGAMP is transported via LRRC8C channels to activate STING in endothelial cells, enhancing recruitment and transendothelial migration of lymphocytes. In vivo studies in male mice also reveal that administration of vitamin C, a promising anti-cancer agent, stimulates TET2 activity, induces tumor vascular normalization and enhances the efficacy of anti-PD-L1 therapy alone or in combination with IL-2. Our findings elucidate a crosstalk between tumor and vascular endothelial cells in the tumor immune microenvironment, providing strategies to enhance the efficacy of combinational immunotherapy for liver cancer.

Summary: Background: The diagnosis of hepatocellular carcinoma (HCC) often experiences latency, ultimately leading to unfavorable patient outcomes due to delayed therapeutic interventions. Our study is designed to develop and validate a model that employs triple-phase computerized tomography (CT)-based deep learning radiomics and clinical variables for early warning of HCC in patients with cirrhosis. Methods: We studied 1858 patients with cirrhosis primarily from the PreCar cohort (NCT03588442) between June 2018 and January 2020 at 11 centres, and collected triple-phase CT images and laboratory results 3–12 months prior to HCC diagnosis or non-HCC final follow-up. Using radiomics and deep learning techniques, early warning model was developed in the discovery cohort (n = 924), and then validated in an internal validation cohort (n = 231), and an external validation cohort from 10 external centres (n = 703). Findings: We developed a hybrid model, named ALARM model, which integrates deep learning radiomics with clinical variables, enabling early warning of the majority of HCC cases. The ALARM model effectively predicted short-term HCC development in cirrhotic patients with area under the curve (AUC) of 0.929 (95% confidence interval 0.918–0.941) in the discovery cohort, 0.902 (0.818–0.987) in the internal validation cohort, and 0.918 (0.898–0.961) in the external validation cohort. By applying optimal thresholds of 0.21 and 0.65, the high-risk (n = 221, 11.9%) and medium-risk (n = 433, 23.3%) groups, which covered 94.4% (84/89) of the patients who developed HCC, had significantly higher rates of HCC occurrence compared to the low-risk group (n = 1204, 64.8%) (24.3% vs 6.4% vs 0.42%, P

Abstract Background The role of the membrane-associated RING-CH (MARCH) family in carcinogenesis has been widely studied, but the member of this family, RNF173, has not yet been thoroughly explored in the context of hepatocellular carcinoma (HCC). Methods With the use of an HCC tissue microarray and IHC staining, we aim to determine the differential expression of RNF173 in HCC patients and its clinical significance. The biological role of RNF173 is investigated through in vitro and in vivo experiments. RNA sequencing, mass spectrometry, and immunoprecipitation are performed to uncover the underlying mechanism of RNF173's impact on the development of HCC. Results The mRNA and protein levels of RNF173 were significantly lower in HCC tissues than in normal tissues. HCC patients with low RNF173 expression had shorter overall survival and recurrence-free survival, and RNF173 was significantly correlated with tumor number, tumor capsule, tumor differentiation, and BCLC stage. In addition, in vitro and in vivo experiments showed that RNF173 downregulation exacerbated tumor progression, including migration, invasion, and proliferation. GRB2 is a key molecule in the RAF/MEK/ERK pathway. RNF173 inhibits the RAF/MEK/ERK signaling by ubiquitinating and degrading GRB2, thereby suppressing HCC cell proliferation, invasion and migration. Combining clinical samples, we found that HCC patients with high RNF173 and low GRB2 expression had the best prognosis. Conclusion RNF173 inhibits the invasion and metastasis of HCC by ubiquitinating and degrading GRB2, thereby suppressing the RAF/MEK/ERK signaling pathway. RNF173 is an independent risk factor for the survival and recurrence of HCC patients. RNF173 may serve as a novel prognostic molecule and potential therapeutic target for HCC. Video Abstract Graphical Abstract Graphical abstract Model of RNF173 on RAF/MEK/ERK signaling. RNF173 knockdown resulted in impaired ubiquitination and degradation of GRB2, leading to the activation of the RAF/MEK/ERK signaling pathway and promotion of invasion and metastasis in HCC cells.

Three-dimensional reconstruction from point clouds is an important research topic in computer vision and computer graphics. However, the discrete nature, sparsity, and noise of the original point cloud contribute to the results of 3D surface generation based on global features often appearing jagged and lacking details, making it difficult to describe shape details accurately. We address the challenge of generating smooth and detailed 3D surfaces from point clouds. We propose an adaptive octree partitioning method to divide the global shape into local regions of different scales. An iterative loop method based on GRU is then used to extract features from local voxels and learn local smoothness and global shape priors. Finally, a moving least-squares approach is employed to generate the 3D surface. Experiments demonstrate that our method outperforms existing methods on benchmark datasets (ShapeNet dataset, ABC dataset, and Famous dataset). Ablation studies confirm the effectiveness of the adaptive octree partitioning and GRU modules.

Aberrant expression of deubiquitinases (DUBs) is significantly associated with tumorigenesis. However, the precise impact of deubiquitination on the tumour microenvironment (TME) and immunotherapy in hepatocellular carcinoma (HCC) remains unclear. In this study, we comprehensively characterized the transcriptional and genetic alterations of 26 overall survival (OS)-related DUBs in HCC. The consensus clustering algorithm was used to identify patients with distinct deubiquitination patterns. We then established a DUBscore model using the principal component analysis (PCA) algorithm to quantify the deubiquitination patterns of individual HCC patients. Finally, we performed weighted gene coexpression network analysis (WGCNA) to identify the key DUBs. Consequently, three distinct deubiquitination patterns were identified, each showing significant differences in the characteristics of the TME, immune response, and clinical prognosis. Further analysis revealed that the DUBscore was an independent prognostic factor and could predict the response to immunotherapy for patients with HCC. Ultimately, BRCC3 was identified as a key DUB based on the DUBscore, which was significantly overexpressed in tumour tissues, as confirmed by qRT‒PCR and immunohistochemistry (IHC). We analysed the distribution and expression of BRCC3 in various types of immune cells using single-cell RNA sequencing (scRNA-seq). In conclusion, our study revealed the crucial role of deubiquitination patterns in shaping TME complexity and diversity. A more personalized and effective antitumour immunotherapy strategy can be developed by utilizing the DUBscore model to identify deubiquitination patterns in individual HCC patients. Our findings also highlight that BRCC3 may serve as a potential therapeutic target in HCC and a predictive marker for immunotherapeutic response.

BackgroundPrevious studies have suggested an association between gut microbiota and primary biliary cholangitis (PBC). Nonetheless, the causal relationship between gut microbiota and PBC risk remains unclear.MethodsA bidirectional two-sample Mendelian Randomization (MR) study was employed using summary statistical data for gut microbiota and PBC from the MiBioGen consortium and Genome-Wide Association Studies (GWAS) database to investigate causal relationships between 211 gut microbiota and PBC risk. Inverse variance weighted (IVW) method was the primary analytical approach to assess causality, and the pleiotropy and heterogeneity tests were employed to verify the robustness of the findings. Additionally, we performed reverse MR analyses to investigate the possibility of the reverse causal association.ResultsThe IVW method identified five gut microbiota that demonstrated associations with the risk of PBC. Order Selenomonadales [odds ratio (OR) 2.13, 95% confidence interval (CI) 1.10–4.14, p = 0.03], Order Bifidobacteriales (OR 1.58, 95% CI 1.07–2.33, p = 0.02), and Genus Lachnospiraceae_UCG_004 (OR 1.64, 95%CI 1.06–2.55, p = 0.03) were correlated with a higher risk of PBC, while Family Peptostreptococcaceae (OR 0.65, 95%CI 0.43–0.98, p = 0.04) and Family Ruminococcaceae (OR 0.33, 95%CI 0.15–0.72, p = 0.01) had a protective effect on PBC. The reverse MR analysis demonstrated no statistically significant relationship between PBC and these five specific gut microbial taxa.ConclusionThis study revealed that there was a causal relationship between specific gut microbiota taxa and PBC, which may provide novel perspectives and a theoretical basis for the clinical prevention, diagnosis, and treatment of PBC.

To provide a theoretical basis for the effects of functional oligosaccharides on the oral microorganisms, the efficacy of several oligosaccharides on the growth, acid production, adherence and biofilm formation of three cariogenic bacteria including Streptococcus mutans, Porphyromonas gingivalis, Fusobacterium nucleatum were investigated. The three cariogenic bacteria were cultured in TSB medium with xylooligosaccharides, galactooligosaccharides, fructooligosaccharide and isomaltooligosaccharide at the different concentrations, and the absorbance, pH, adhesiveness as well as biofilm formation inhibitory activity were measured for 48 h. The effects of different oligosaccharides on bacterial growth, acid production and adhesion were compared and analyzed. The results showed that four oligosaccharides had inhibitory effects on three kinds of cariogenic bacteria, and xylooligosaccharide had the highest inhibitory effect. Xylo-oligosaccharides and galactooligosaccharides at 0.5% concentration could significantly inhibit the acid production of the three cariogenic bacteria. Compared with xylitol and other oligosaccharides, the inhibition rate of xylo-oligosaccharide on the three pathogens was 60% higher when the xylo-oligosaccharide concentration was more than 5%. The adhesion rates of the four oligosaccharides at 7% concentration to the three cariogenic bacteria were all less than 50%. When the concentration of galactooligosaccharides and xylo-oligosaccharide was greater than 5%, the biofilm formation of the three cariogenic bacteria was inhibited well. By comparison with sorbitol, the combination use of xylo-oligosaccharide, xylitol, galactooligosaccharides had more obvious inhibition on the growth of the three pathogenic bacteria.

The demand for high-performance dielectrics has increased due to the rapid development of modern electric power and electronic technology. Composite dielectrics, which can overcome the limitations of traditional single polymers in thermal conductivity, dielectric properties and mechanical performance, have received considerable attention. In this study, we report a multifunctional nanocomposite material fabricated by blending fluorinated graphene (F-graphene) with epoxy resin. The F-graphene/epoxy composite exhibited a high thermal conductivity of 0.3304 W·m−1·K−1 at a low filler loading of 1.0 wt.%, which was 67.63% higher than that of pure epoxy. The composite dielectric also showed high breakdown strength (78.60 kV/mm), high dielectric constant (8.23), low dielectric loss (−11 S·m−1). Moreover, the composite demonstrated high thermal stability and strong mechanical strength. It is believed that the F-graphene/epoxy composite has outstanding performance in various aspects and can enable the development and manufacturing of advanced electric power and electronic equipment devices.

Spirulina (Arthrospira) is the largest microalgal product by tonnage and value. There are roughly 90% of Spirulina powder and tablets is sold as human nutritional supplements. Spirulina is recognized as a superfood growingly among people, and the mechanism beyond the functional phenomena is also ongoing researching. The relationship between recommended daily intake (RDI, 3 g/d) of Spirulina and recommended nutrition intake (RNI) or adequate intake (AI) is analyzed, and the Spirulina is a good supplement for premier protein, iron, vitamin A, vitamin B12, vitamin K1 and K2. Spirulina is also an effective supplement for manganese and iodine elements. This paper also briefly reviews the progress in the medical and pharmaceutical functions to human beings of Spirulina powder. The clinical trials show that Spirulina is a proficient nutraceuticals in controlling hypertension, diabetes, obese, etc. Finally, the progress of the application of Spirulina in food industry is also discussed. For the heat and light sensitivity of phycocyanin and chlorophyll, there is an urgent demand for the solution of stable Spirulina and new derivatives.

The waveguide invariant is classically considered as constant in shallow water and can be utilized to estimate the source range. When the environment is variable, the error between the estimated range and the true range fluctuates and becomes unstable. The fluctuation of the range estimation error is large when we use the polar coordinate transform to obtain the slope of the two-dimensional Fourier transform ridge (2DFT-PT). The lines which are parallel in the ridge are not considered and the ridge information is not utilized sufficiently. For this problem, we propose a passive ranging method by using the Radon transform to obtain the slope (2DFT-RT) and achieve a more robust result. Its capability is investigated and compared with the 2DFT-PT method via numerical simulation and the SWellEx-96 experiment.

In underwater radiated noise measurement using a vertical linear array, a diagonalization-decorrelation-based diagonal denoising method is proposed to improve the denoising effect for spatially correlated noise. Firstly, the ambient noise cross-spectral matrix is measured without the radiated noise source. Subsequently, the eigenvector matrix of the ambient noise cross-spectral matrix is utilized to implement a unitary transformation for the received data, which eliminates the correlation of the received noise and transforms the received noise cross-spectral matrix into a diagonal matrix, then the noise components are removed by diagonal denoising. Finally, the denoised cross-spectral matrix is used to estimate the power of the radiated noise by beamforming. Consequently, the influence of spatially correlated noise on radiated noise measurement is reduced. The effectiveness of the proposed method is validated and compared with the diagonal denoising method and the whitening-decorrelation-based diagonal denoising method via numerical simulations and experimental data. Under the ideal condition, the noise reduction performances of the proposed method and the whitening-decorrelation-based diagonal denoising method are equal and better than that of the diagonal denoising method. In practice, the number of snapshots is limited, so there is an inevitable mismatch between the ambient noise cross-spectral matrix and the received noise cross-spectral matrix due to the randomness of noise. The mismatch results in imperfect whitening and diagonalization, which reduces the denoising effect. However, the simulation results indicate that the proposed method still reduces more correlated noise and has a better performance on underwater radiated noise measurement compared with the diagonal denoising method and the whitening-decorrelation-based diagonal denoising method even if the number of snapshots is finite.

As bistable composite laminated plate and shell structures are often exposed to dynamic environments in practical applications, the global and local dynamics of a bistable asymmetric composite laminated shell subjected to the base excitation is presented in this paper. Temperature difference, base excitation amplitude, and detuning parameters are discussed. With the change of temperature difference, the super-critical pitchfork bifurcation occurs. Three equilibrium solutions corresponding to three equilibrium configurations (two stable configurations and one unstable configuration) can be obtained. With the increase of excitation amplitude, local and global dynamics play a leading role successively. The global dynamics between the two stable configurations behave as the periodic vibration, the quasi-periodic vibration, the chaotic vibration and dynamic snap-through when the excitation amplitude is large enough. The local dynamics that are confined to a single stable configuration behave as 1:2 internal resonance, saturation and permeation when the excitation amplitude is small. Dynamic snap-through and large-amplitude vibrations with two potential wells for the global dynamics will lead to a broad application prospect of the bistable asymmetric composite laminated shell in energy harvesting devices.

The nonlinear behaviors and energy harvesting of an unsymmetric cross-ply square composite laminated plate with a piezoelectric patch is presented. The unsymmetric cross-ply square composite laminated plate has two stable equilibrium positions by applying thermal stress, thus having snap-through with larger amplitude between the two stable equilibrium positions relative to the general laminated plate. Based on the von-Karman large deformation theory, the nonlinear electromechanical coupling equations of motion of the unsymmetric composite laminated plate with a piezoelectric patch are derived by using Hamilton’s principle. The influence of the base excitation amplitude on nonlinear behaviors and energy harvesting are investigated. For different base excitation amplitudes, the motions of the system demonstrate periodic motion, quasi-periodic motion, chaotic motion and snap-through, and two single-well chaotic attractors and a two-well chaos attractor coexist. Moreover, the power generation efficiency is optimal when the excitation amplitude is in a certain range due to its own unique nonlinear characteristics. The unsymmetric cross-ply square composite laminated plate subjected to thermal stress can actually be called a kind of bistable composite shell structure that has a broad application prospect in combination with morphing aircraft, large deployable antenna and solar panel, which are very likely to have nonlinear vibration.

Underground displacement monitoring is an effective method to explore deep into rock and soil masses for execution of subsurface displacement measurements. It is not only an important means of geological hazards prediction and forecasting, but also a forefront, hot and sophisticated subject in current geological disaster monitoring. In previous research, the authors had designed a novel electromagnetic underground horizontal displacement sensor (called the H-type sensor) by combining basic electromagnetic induction principles with modern sensing techniques and established a mutual voltage measurement theoretical model called the Equation-based Equivalent Loop Approach (EELA). Based on that work, this paper presents an underground displacement inversion approach named “EELA forward modeling-approximate inversion method”. Combining the EELA forward simulation approach with the approximate optimization inversion theory, it can deduce the underground horizontal displacement through parameter inversion of the H-type sensor. Comprehensive and comparative studies have been conducted between the experimentally measured and theoretically inversed values of horizontal displacement under counterpart conditions. The results show when the measured horizontal displacements are in the 0–100 mm range, the horizontal displacement inversion discrepancy is generally tested to be less than 3 mm under varied tilt angles and initial axial distances conditions, which indicates that our proposed parameter inversion method can predict underground horizontal displacement measurements effectively and robustly for the H-type sensor and the technique is applicable for practical geo-engineering applications.

Estimating gross primary production (GPP) and net primary production (NPP) are significant important in studying carbon cycles. Using models driven by multi-source and multi-scale data is a promising approach to estimate GPP and NPP at regional and global scales. With a focus on data that are openly accessible, this paper presents a GPP and NPP model driven by remotely sensed data and meteorological data with spatial resolutions varying from 30 m to 0.25 degree and temporal resolutions ranging from 3 hours to 1 month, by integrating remote sensing techniques and eco-physiological process theories. Our model is also designed as part of the Multi-source data Synergized Quantitative (MuSyQ) Remote Sensing Production System. In the presented MuSyQ-NPP algorithm, daily GPP for a 10-day period was calculated as a product of incident photosynthetically active radiation (PAR) and its fraction absorbed by vegetation (FPAR) using a light use efficiency (LUE) model. The autotrophic respiration (Ra) was determined using eco-physiological process theories and the daily NPP was obtained as the balance between GPP and Ra. To test its feasibility at regional scales, our model was performed in an arid and semi-arid region of Heihe River Basin, China to generate daily GPP and NPP during the growing season of 2012. The results indicated that both GPP and NPP exhibit clear spatial and temporal patterns in their distribution over Heihe River Basin during the growing season due to the temperature, water and solar influx conditions. After validated against ground-based measurements, MODIS GPP product (MOD17A2H) and results reported in recent literature, we found the MuSyQ-NPP algorithm could yield an RMSE of 2.973 gC m(-2) d(-1) and an R of 0.842 when compared with ground-based GPP while an RMSE of 8.010 gC m(-2) d(-1) and an R of 0.682 can be achieved for MODIS GPP, the estimated NPP values were also well within the range of previous literature, which proved the reliability of our modelling results. This research suggested that the utilization of multi-source data with various scales would help to the establishment of an appropriate model for calculating GPP and NPP at regional scales with relatively high spatial and temporal resolution.

In this study, in order to find novel biologically active pyrazole oxime derivatives, twenty-eight new pyrazole oxime compounds containing a substituted isoxazole ring were synthesized and evaluated for their acaricidaland insecticidal activities. Bioassays exhibited that some target compounds indicated good acaricidal and insecticidal activities against Tetranychus cinnabarinus, Aphis medicaginis, Mythimna separata, and Nilaparvata lugens. Especially, compounds 9c, 9h, 9u, and 9v showed 100.00%, 90.56%, 90.78%, and 90.62% insecticidal activities against A. medicaginis at the concentration of 20 μg/mL, respectively, compounds 9k and 9u had 70.86% and 100.00% insecticidal activities against M. separata at 20 μg/mL, respectively.

Quantifying carbon dioxide exchange and understanding the response of key environmental factors in various ecosystems are critical to understanding regional carbon budgets and ecosystem behaviors. For this study, CO2 fluxes were measured in a variety of ecosystems with an eddy covariance observation matrix between June 2012 and September 2012 in the Zhangye oasis area of Northwest China. The results show distinct diurnal variations in the CO2 fluxes in vegetable field, orchard, wetland, and maize cropland. Diurnal variations of CO2 fluxes were not obvious, and their values approached zero in the sandy desert, desert steppe, and Gobi ecosystems. Additionally, daily variations in the Gross Primary Production (GPP), Ecosystem Respiration (Reco) and Net Ecosystem Exchange (NEE) were not obvious in the sandy desert, desert steppe, and Gobi ecosystems. In contrast, the distributions of the GPP, Reco, and NEE show significant daily variations, that are closely related to the development of vegetation in the maize, wetland, orchard, and vegetable field ecosystems. All of the ecosystems are characterized by their carbon absorption during the observation period. The ability to absorb CO2 differed significantly among the tested ecosystems. We also used the Michaelis-Menten equation and exponential curve fitting methods to analyze the impact of Photosynthetically Active Radiation (PAR) on the daytime CO2 flux and impact of air temperature on Reco at night. The results show that PAR is the dominant factor in controlling photosynthesis with limited solar radiation, and daytime CO2 assimilation increases rapidly with PAR. Additionally, the carbon assimilation rate was found to increase slowly with high solar radiation. The light response parameters changed with each growth stage for all of the vegetation types, and higher light response values were observed during months or stages when the plants grew quickly. Light saturation points are different for different species. Nighttime Reco increases exponentially with air temperature. High Q10 values were observed when the vegetation coverage was relatively low, and low Q10 values occurred when the vegetables grew vigorously.

BackgroundOur prior study in Han Chinese women has shown that women with a history of childhood sexual abuse (CSA) are at increased risk for developing major depression (MD). Would this relationship be found in our whole data set?MethodThree levels of CSA (non-genital, genital, and intercourse) were assessed by self-report in two groups of Han Chinese women: 6017 clinically ascertained with recurrent MD and 5983 matched controls. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression.ResultsWe confirmed earlier results by replicating prior analyses in 3,950 new recurrent MD cases. There were no significant differences between the two data sets. Any form of CSA was significantly associated with recurrent MD (OR 4.06, 95% confidence interval (CI) [3.19-5.24]). This association strengthened with increasing CSA severity: non-genital (OR 2.21, 95% CI 1.58-3.15), genital (OR 5.24, 95% CI 3.52-8.15) and intercourse (OR 10.65, 95% CI 5.56-23.71). Among the depressed women, those with CSA had an earlier age of onset, longer depressive episodes. Recurrent MD patients those with CSA had an increased risk for dysthymia (OR 1.60, 95%CI 1.11-2.27) and phobia (OR 1.41, 95%CI 1.09-1.80). Any form of CSA was significantly associated with suicidal ideation or attempt (OR 1.50, 95% CI 1.20-1.89) and feelings of worthlessness or guilt (OR 1.41, 95% CI 1.02-2.02). Intercourse (OR 3.47, 95%CI 1.66-8.22), use of force and threats (OR 1.95, 95%CI 1.05-3.82) and how strongly the victims were affected at the time (OR 1.39, 95%CI 1.20-1.64) were significantly associated with recurrent MD.ConclusionsIn Chinese women CSA is strongly associated with recurrent MD and this association increases with greater severity of CSA. Depressed women with CSA have some specific clinical traits. Some features of CSA were associated with greater likelihood of developing recurrent MD.

To investigate the risk factors that contribute to smoking in female patients with major depressive disorder (MDD) and the clinical features in depressed smokers.We examined the smoking status and clinical features in 6120 Han Chinese women with MDD (DSM-IV) between 30 and 60 years of age across China. Logistic regression was used to determine the association between clinical features of MDD and smoking status and between risk factors for MDD and smoking status.Among the recurrent MDD patients there were 216(3.6%) current smokers, 117 (2.0%) former smokers and 333(5.6%) lifetime smokers. Lifetime smokers had a slightly more severe illness, characterized by more episodes, longer duration, more comorbid illness (panic and phobias), with more DSM-IV A criteria and reported more symptoms of fatigue and suicidal ideation or attempts than never smokers. Some known risk factors for MDD were also differentially represented among smokers compared to non-smokers. Smokers reported more stressful life events, were more likely to report childhood sexual abuse, had higher levels of neuroticism and an increased rate of familial MDD. Only neuroticism was significantly related to nicotine dependence.Although depressed women smokers experience more severe illness, smoking rates remain low in MDD patients. Family history of MDD and environmental factors contribute to lifetime smoking in Chinese women, consistent with the hypothesis that the association of smoking and depression may be caused by common underlying factors.

The prevalence of major depressive disorder (MDD) is higher in those with low levels of educational attainment, the unemployed and those with low social status. However the extent to which these factors cause MDD is unclear. Most of the available data comes from studies in developed countries, and these findings may not extrapolate to developing countries. Examining the relationship between MDD and socio economic status in China is likely to add to the debate because of the radical economic and social changes occurring in China over the last 30 years.We report results from 3,639 Chinese women with recurrent MDD and 3,800 controls. Highly significant odds ratios (ORs) were observed between MDD and full time employment (OR = 0.36, 95% CI = 0.25-0.46, logP = 78), social status (OR = 0.83, 95% CI = 0.77-0.87, logP = 13.3) and education attainment (OR = 0.90, 95% CI = 0.86-0.90, logP = 6.8). We found a monotonic relationship between increasing age and increasing levels of educational attainment. Those with only primary school education have significantly more episodes of MDD (mean 6.5, P-value = 0.009) and have a clinically more severe disorder, while those with higher educational attainment are likely to manifest more comorbid anxiety disorders.In China lower socioeconomic position is associated with increased rates of MDD, as it is elsewhere in the world. Significantly more episodes of MDD occur among those with lower educational attainment (rather than longer episodes of disease), consistent with the hypothesis that the lower socioeconomic position increases the likelihood of developing MDD. The phenomenology of MDD varies according to the degree of educational attainment: higher educational attainment not only appears to protect against MDD but alters its presentation, to a more anxious phenotype.

The relationship between suicidality and major depression is complex. Socio- demography, clinical features, comorbidity, clinical symptoms, and stressful life events are important factors influencing suicide in major depression, but these are not well defined. Thus, the aim of the present study was to assess the associations between the above-mentioned factors and suicide ideation, suicide plan, and suicide attempt in 6008 Han Chinese women with recurrent major depression (MD). Patients with any suicidality had significantly more MD symptoms, a significantly greater number of stressful life events, a positive family history of MD, a greater number of episodes, a significant experience of melancholia, and earlier age of onset. Comorbidity with dysthymia, generalized anxiety disorder (GAD), social phobia, and animal phobia was seen in suicidal patients. The present findings indicate that specific factors act to increase the likelihood of suicide in MD. Our results may help improve the clinical assessment of suicide risk in depressed patients, especially for women.

Dysthymia is a form of chronic mild depression that has a complex relationship with major depressive disorder (MDD). Here we investigate the role of environmental risk factors, including stressful life events and parenting style, in patients with both MDD and dysthymia. We ask whether these risk factors act in the same way in MDD with and without dysthymia.We examined the clinical features in 5,950 Han Chinese women with MDD between 30-60 years of age across China. We confirmed earlier results by replicating prior analyses in 3,950 new MDD cases. There were no significant differences between the two data sets. We identified sixteen stressful life events that significantly increase the risk of dysthymia, given the presence of MDD. Low parental warmth, from either mother or father, increases the risk of dysthymia. Highly threatening but short-lived threats (such as rape) are more specific for MDD than dysthymia. While for MDD more severe life events show the largest odds ratio versus controls, this was not seen for cases of MDD with or without dysthymia.There are increased rates of stressful life events in MDD with dysthymia, but the impact of life events on susceptibility to dysthymia with MDD differs from that seen for MDD alone. The pattern does not fit a simple dose-response relationship, suggesting that there are moderating factors involved in the relationship between environmental precipitants and the onset of dysthymia. It is possible that severe life events in childhood events index a general susceptibility to chronic depression, rather than acting specifically as risk factors for dysthymia.