1.Effect and Mechanism of Schisandrae Chinensis Fructus Lignans on Behavior of Schizophrenic Mice
Jiaqi LI ; Xi CHEN ; Siwei WANG ; Qi WANG ; Yiting LIU ; Ziyan GUO ; Zilong LUN ; Chengyi ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):65-71
ObjectiveTo investigate the effects of Schisandrae Chinensis Fructus lignans on schizophrenia induced by dizocilpine maleate (MK-801) in mice and to clarify its mechanism. MethodsMale mice of 4-6 weeks old were randomized into blank, model, positive drug, and low-, medium-, and high-dose (40, 80, 160 mg·kg-1, respectively) Schisandrae Chinensis Fructus lignans groups. The blank group was administrated with distilled water, and the other groups were injected with 0.5 mg·kg-1 MK-801 to induce schizophrenia symptoms. Meanwhile, risperidone was injected at 0.2 mg·kg-1 in the positive drug group, and mice in the intervention groups were injected with corresponding drugs for 14 consecutive days. The behavioral changes of mice were observed by autonomous activity test, open field test, forced swimming test, and water maze test. The levels of dopamine (DA) and 5-hydroxytryptamine (5-HT) in the brain and tumor necrosis factor-α (TNF-α) and nuclear factor-κB (NF-κB) in peripheral blood were quantified by enzyme-linked immunosorbent assay (ELISA). The changes in the prefrontal lobe of mice were observed by hematoxylin-eosin staining, and the changes of the hippocampal tissue were observed by Nissl staining. The protein levels of silencing information regulatory factor 1 (SIRT1) and forkhead box protein O3a (FoxO3a) in the hippocampus of mice were determined by Western blot. ResultsCompared with the model group, low, medium, and high doses of Schisandrae Chinensis Fructus lignans reduced the total number of autonomous activities, total distance in the open field test, immobile time in the forced swimming test, and levels of TNF-α and NF-κB in peripheral blood (P<0.05), while increasing the number of platform crossings in the water maze test and DA and 5-HT levels in the brain tissue (P<0.05). Compared with the model group, risperidone and low, medium, and high doses of Schisandrae Chinensis Fructus lignans improve the neural cell morphology in the CA1 region, with full cells in neatly dense arrangement and exhibiting clear membrane boundary. Schisandrae Chinensis Fructus lignans inhibited the expression of SIRT 1 and FoxO3a in the hippocampus (P<0.05). ConclusionTo sum up, Schisandrae Chinensis Fructus lignans may improve the behavior of schizophrenic mice by activating the SIRT1/FoxO3a signaling pathway to exert neuroprotective effects.
2.Empirical study of input, output, outcome and impact of community-based rehabilitation stations
Xiayao CHEN ; Ying DONG ; Xue DONG ; Zhongxiang MI ; Jun CHENG ; Aimin ZHANG ; Didi LU ; Jun WANG ; Jude LIU ; Qianmo AN ; Hui GUO ; Xiaochen LIU ; Zefeng YU
Chinese Journal of Rehabilitation Theory and Practice 2026;32(1):83-89
ObjectiveTo investigate the present situation of input, output, outcome and impact of all registered community-based rehabilitation stations in Inner Mongolia in China, and analyze how the input predict the output, outcome and impact. MethodsFrom March 1st to April 30th, 2025, a questionnaire survey was conducted on all registered community-based rehabilitation stations in Inner Mongolia, covering four dimensions: input, output, outcome and impact. A total of 1 365 questionnaires were distributed. The input included four items: laws and policies, human resources, equipment and facilities, and rehabilitation information management. The output included two items: technical paths and benefits/effectiveness. The outcome included three items: coverage rates, rehabilitation interventions and functional results. The impact included two items: health and sustainability. Each item contained several questions, all of which were described in a positive way. Each question was scored from one to five. A lower score indicated that the situation of the community-based rehabilitation station was more in line with the content described in the question. Regression analysis was performed using the total score of each item of input dimension as independent variables, and the total scores of the output, outcome and impact dimensions as dependent variables. ResultsA total of 1 262 valid questionnaires were collected. The mean values of input, output, outcome and impact of community-based rehabilitation stations were 1.827 to 1.904, with coefficient of variation of 45.892% to 49.239%. The regression analysis showed that, rehabilitation information management, human resources, and laws and policies significantly predicted the output dimension (R² = 0.910, P < 0.001). Meanwhile, all four items in the input dimension predicted both the outcome (R² = 0.850, P < 0.001) and impact dimensions (R² = 0.833, P < 0.001). ConclusionInput, output, outcome and impact of the community-based rehabilitation stations in Inner Mongolia were generally in line with the content of the questions, although some imbalances were observed. Additionally, the input of community-based rehabilitation stations could significantly predict their output, outcome and impact.
3.Expert consensus on neoadjuvant PD-1 inhibitors for locally advanced oral squamous cell carcinoma (2026)
LI Jinsong ; LIAO Guiqing ; LI Longjiang ; ZHANG Chenping ; SHANG Chenping ; ZHANG Jie ; ZHONG Laiping ; LIU Bing ; CHEN Gang ; WEI Jianhua ; JI Tong ; LI Chunjie ; LIN Lisong ; REN Guoxin ; LI Yi ; SHANG Wei ; HAN Bing ; JIANG Canhua ; ZHANG Sheng ; SONG Ming ; LIU Xuekui ; WANG Anxun ; LIU Shuguang ; CHEN Zhanhong ; WANG Youyuan ; LIN Zhaoyu ; LI Haigang ; DUAN Xiaohui ; YE Ling ; ZHENG Jun ; WANG Jun ; LV Xiaozhi ; ZHU Lijun ; CAO Haotian
Journal of Prevention and Treatment for Stomatological Diseases 2026;34(2):105-118
Oral squamous cell carcinoma (OSCC) is a common head and neck malignancy. Approximately 50% to 60% of patients with OSCC are diagnosed at a locally advanced stage (clinical staging III-IVa). Even with comprehensive and sequential treatment primarily based on surgery, the 5-year overall survival rate remains below 50%, and patients often suffer from postoperative functional impairments such as difficulties with speaking and swallowing. Programmed death receptor-1 (PD-1) inhibitors are increasingly used in the neoadjuvant treatment of locally advanced OSCC and have shown encouraging efficacy. However, clinical practice still faces key challenges, including the definition of indications, optimization of combination regimens, and standards for efficacy evaluation. Based on the latest research advances worldwide and the clinical experience of the expert group, this expert consensus systematically evaluates the application of PD-1 inhibitors in the neoadjuvant treatment of locally advanced OSCC, covering combination strategies, treatment cycles and surgical timing, efficacy assessment, use of biomarkers, management of special populations and immune related adverse events, principles for immunotherapy rechallenge, and function preservation strategies. After multiple rounds of panel discussion and through anonymous voting using the Delphi method, the following consensus statements have been formulated: 1) Neoadjuvant therapy with PD-1 inhibitors can be used preoperatively in patients with locally advanced OSCC. The preferred regimen is a PD-1 inhibitor combined with platinum based chemotherapy, administered for 2-3 cycles. 2) During the efficacy evaluation of neoadjuvant therapy, radiographic assessment should follow the dual criteria of Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and immune RECIST (iRECIST). After surgery, systematic pathological evaluation of both the primary lesion and regional lymph nodes is required. For combination chemotherapy regimens, PD-L1 expression and combined positive score need not be used as mandatory inclusion or exclusion criteria. 3) For special populations such as the elderly (≥ 70 years), individuals with stable HIV viral load, and carriers of chronic HBV/HCV, PD-1 inhibitors may be used cautiously under the guidance of a multidisciplinary team (MDT), with close monitoring for adverse events. 4) For patients with a poor response to neoadjuvant therapy, continuation of the original treatment regimen is not recommended; the subsequent treatment plan should be adjusted promptly after MDT assessment. Organ transplant recipients and patients with active autoimmune diseases are not recommended to receive neoadjuvant PD-1 inhibitor therapy due to the high risk of immune related activation. Rechallenge is generally not advised for patients who have experienced high risk immune related adverse events such as immune mediated myocarditis, neurotoxicity, or pneumonitis. 5) For patients with a good pathological response, individualized de escalation surgery and function preservation strategies can be explored. This consensus aims to promote the standardized, safe, and precise application of neoadjuvant PD-1 inhibitor strategies in the management of locally advanced OSCC patients.
4.Progress in the application of poloxamer in new preparation technology
Xue QI ; Yi CHENG ; Nan LIU ; Zengming WANG ; Hui ZHANG ; Aiping ZHENG ; Dongzhou KANG
China Pharmacy 2025;36(5):630-635
Poloxamer, as a non-ionic surfactant, exhibits a unique triblock [polyethylene oxide-poly (propylene oxide)-polyethylene oxide] structure, which endows it with broad application potential in various fields, including solid dispersion technology, nanotechnology, gel technology, biologics, gene engineering and 3D printing. As a carrier, it enhances the solubility and bioavailability of poorly soluble drugs. In the field of nanotechnology, it serves as a stabilizer etc., enriching preparation methods. In gel technology, its self-assembly behavior and thermosensitive properties facilitate controlled drug release. In biologics, it improves targeting efficiency and reduces side effects. In gene engineering, it enhances delivery efficiency and expression levels. In 3D printing, it provides novel strategies for precise drug release control and the production of high-quality biological products. As a versatile material, poloxamer holds promising prospects in the pharmaceutical field.
5.Application of serological methods combined with flow cytometry in the detection of immune hemolytic transfusion reaction
Lei LIU ; Qunjuan ZENG ; Guoqin GONG ; Dong XIANG ; Zhongying WANG
Chinese Journal of Blood Transfusion 2025;38(1):116-121
[Objective] To explore the effects of different methods on antibody detection through investigating the causes of cross-matching incompatible in a patient with gastric malignant tumor, and to establish flow cytometry protocol for confirming hemolytic transfusion reaction (HTR). [Methods] Antibodies in the patient's serum were identified by red blood cells (RBCs) blood grouping, antibody screening and identification, acid elution test and PEG enhancement test. To confirm HTR, patient RBCs, proximal and distal ends RBCs, separated by capillary centrifugation, were tested by direct antiglobulin test (DAT) and Jka antigen single label and double label flow cytometry. [Results] Routine serological technology revealed the presence of anti-C, e (titer:2) and anti-Jka (titer >1) in the patient’s serum. After separation using capillary centrifugation technology, both the proximal and distal DAT and Jka antigen tests were negative. Both DAT and Jka antigen positive red blood cells (0.21%, 6/6 327) were found in the patient's blood samples by flow cytometry. After separation of blood samples by capillary centrifugation, there were significantly more DAT and Jka antigen double-positive RBCs in the distal end (0.43%, 33/7 707) than in the proximal end (0.09%, 15/7 225). Two blood samples were screened from over 100 donor blood samples that are compatible with the patient's cross-matching, and the transfusion effect was favorable. [Conclusion] Serological methods combined with flow cytometry could improve the sensitivity of antibody detection, provide a more accurate basis for the diagnosis of HTRs, and guarantee the safety of blood transfusion.
6.Mechanism of 1,25(OH)2D3 improving liver inflammation in a rat model of nonalcoholic steatohepatitis induced by choline-deficient L-amino acid-defined diet
Haiyang ZHU ; Jingshu CUI ; Liu YANG ; Mengting ZHOU ; Jian TONG ; Hongmei HAN
Journal of Clinical Hepatology 2025;41(2):254-262
ObjectiveTo investigate the effect of 1,25(OH)2D3 on the level of peroxisome proliferator-activated receptor-γ (PPAR-γ) in the liver, the phenotype of hepatic macrophages, and liver inflammation in a rat model of nonalcoholic steatohepatitis (NASH), as well as the mechanism of 1,25(OH)2D3 improving liver inflammation. MethodsAfter 1 week of adaptive feeding, 24 specific pathogen-free Wistar rats were randomly divided into normal group [choline-supplemented L-amino acid-defined (CSAA) diet], normal+1,25(OH)2D3 group [CSAA diet+1,25(OH)2D3], model group [choline-deficient L-amino acid-defined diet (CDAA) diet], and model+1,25(OH)2D3 group [CDAA diet+1,25(OH)2D3], with 6 rats in each group. The dose of 1,25(OH)2D3 was 5 μg/kg for intraperitoneal injection twice a week for 12 weeks. The serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured, liver histopathology was observed, and SAF score was assessed. M1 hepatic macrophages and M2 hepatic macrophages were measured to analyze in the change in the phenotype of hepatic macrophages, and ELISA was used to measure the levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-4 (IL-4), and interleukin-10 (IL-10) in liver tissue, and qPCR was used to measure the mRNA level of PPAR-γ. The two-factor analysis of variance was use for comparison between groups, and the least significant difference t-test was used for further comparison; the Pearson method was used for correlation analysis. ResultsCompared with the normal group, the model rats with CDAA diet-induced NASH had significant increases in the serum levels of AST and ALT (P=0.019 and P<0.001), the SAF score of liver histopathology (P<0.001), the level of M1 hepatic macrophages (P<0.001), and the ratio of M1 and M2 hepatic macrophages (P<0.001), as well as a significant increase in the level of TNF-α (P<0.001) and a significant reduction in the level of IL-4 in liver tissue (P=0.025). The 1,25(OH)2D3 group had significant reductions in the serum levels of ALT (P<0.001), the SAF score of liver histopathology (P<0.001), the level of M1 hepatic macrophages (P<0.001), and the ratio of M1 and M2 hepatic macrophages (P=0.001), the level of IL-1β (P<0.001) and a significant increase in the level of M2 hepatic macrophages (P=0.017), the level of IL-10 (P=0.039), the level of IL-4 (P<0.001), the level of PPAR-γ (P=0.016). There were significant interactions between CDAA diet-induced NASH model and 1,25(OH)2D3 in serum the levels of AST and ALT (P=0.007 and P=0.008), the SAF scores of liver histopathology (P<0.001), the level of M1 hepatic macrophages (P<0.001), the level of M2 hepatic macrophages (P=0.008), the ratio of M1 and M2 of hepatic macrophages (P=0.005), the level of TNF-α (P<0.001), the level of IL-10 (P=0.038), the level of IL-4 (P<0.001) and the level of PPAR-γ (P=0.009). The correlation analysis showed that PPAR-γ was negatively correlated with the ratio of M1 and M2 hepatic macrophages (r=-0.415, P=0.044) and was positively correlated with M2 hepatic macrophages (r=0.435, P=0.033), IL-10 (r=0.433, P=0.035), and IL-4 (r=0.532, P=0.007). ConclusionThis study shows that 1,25(OH)2D3 improves liver inflammation in NASH by activating PPAR-γ to regulate the phenotypic transformation of hepatic macrophages.
7.Effect of gallic acid in increasing the chemosensitivity of hepatocellular carcinoma HepG2 cells to sorafenib
Baikun LIU ; Zhiru WANG ; Wenjing ZHAO
Journal of Clinical Hepatology 2025;41(2):292-299
ObjectiveTo investigate the chemosensitization effect of gallic acid (GA) combined with sorafenib (Sora) on hepatocellular carcinoma HepG2 cells and related mechanisms. MethodsHepG2 cells were randomly divided into control group, GA group, Sora group, and GA+Sora group. CCK8 assay was used to measure cell viability; CompuSyn software was used to analyze combination index (CI); colony formation assay was used to evaluate the colony formation ability of cells; flow cytometry was used to measure cell apoptosis; wound healing assay and Transwell chamber assay were used to observe the migration and invasion abilities of cells; Western Blot was used to measure the expression matrix metalloproteinase 2 (MMP-2), matrix metalloproteinase 9 (MMP-9), and apoptosis-related proteins. HepG2 cells were subcutaneously inoculated into the lower right back of mice, and 6 days later, the mice were divided into control group, GA group, Sora group, and GA+Sora group. Tumor size and body weight were measured once a week, and drug intervention was performed for 21 days. Then the nude mice were sacrificed, and tumor weight was measured. A one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. ResultsThe mean IC50 values of GA and Sora for the treatment of HepG2 cells for 48 hours were 123.47±5.16 μmol/L and 9.87±0.98 μmol/L, respectively, and when Sora was combined with 70 μmol/L GA (IC30), IC50 decreased to 2.06±0.35 μmol/L; the CI value was<1 for Sora at different concentrations combined with 70 μmol/L GA. The number of cell colonies was 234.0±20.4, 147.0±12.1, 129.3±13.3, and 73.0±7.6, respectively, in the four groups, and the GA+Sora group had a significantly lower number of cell colonies than the control group, the GA group, and the Sora group (all P<0.05). After 48 hours of treatment, the cell apoptosis rate was 1.98%±0.29%, 15.17%± 1.56%, 18.65%±1.48%, and 34.60%±5.36%, respectively, in the four groups, and the GA+Sora group had a significantly higher cell apoptosis rate than the control group, the GA group, and the Sora group (all P<0.05). After 24 hours of treatment, the cell migration rate was 55.59%±5.08%, 29.34%±4.36%, 21.80%±5.16%, and 6.47%±2.75%, respectively, in the four groups, and the GA+Sora group had a significantly lower cell migration rate than the control group, the GA group, and the Sora group (all P<0.05). After 48 hours of treatment, the number of transmembrane cells was 223.7±13.0, 168.3±10.9, 155.3±29.1, and 62.7±19.7, respectively, in the four groups, and the GA+Sora group had a significantly lower number of transmembrane cells than the control group, the GA group, and the Sora group (all P<0.05). Compared with the control group, the GA group, the Sora group, and the GA+Sora group had significant reductions in the protein expression levels of MMP-2, MMP-9, and Bcl-2 (all P<0.05) and significant increases in the protein expression levels of Bax and cleaved caspase-3 (all P<0.05). Compared with the control group, the GA, Sora, and GA+Sora groups had significant reductions in tumor volume and weight (all P<0.05), and compared with the Sora group, the GA+Sora group had significant reductions in tumor volume and weight in nude mice (both P<0.05). ConclusionGA can increase the sensitivity of HepG2 cells to Sora chemotherapy, possibly by promoting cell apoptosis and inhibiting cell migration and invasion after combination with Sora.
8.Analysis of unhealthy listening habits and related factors on hearing impairment among primary and middle school students in Jilin Province
YANG Shuo, LIU Bing, ZHANG Yuting, WU Xiaogang, MEI Songli
Chinese Journal of School Health 2025;46(2):215-218
Objective:
To understand the unhealthy listening habits and related factors hearing on impairment among primary and middle school students in Jilin Province, so as to provide a scientific basis for the prevention of hearing impairment in children and adolescents.
Methods:
From September to November 2021, a stratified cluster random sampling method was employed to select 12 847 primary and middle school students in nine cities of Jilin Province who use headphones for more than 0.5 hours daily for a questionnaire survey. Data on unhealthy listening habits, lifestyle habits and hearing impairment were collected. The data were analyzed using the χ 2 test and Logistic regression.
Results:
Totally 1 702 students(13.25%) experienced hearing impairment within the last month. There were statistical differences between the sexes with the average daily headphone use, the times of using headphones ≥1 h every day for one week use in all environment or noisy environment ( χ 2=47.86, 57.60, 66.31, P <0.01). Logistic regression analysis results showed that factors related to the occurrence of hearing impairment among primary and secondary school students included:average daily headphone use of 1-2 h and more than 2 h ( OR=1.74, 95%CI =1.60-1.90; OR=1.73, 95%CI =1.59-1.90), times of using headphones ≥1 h every day for one week were 1-2 times and >2 times ( OR=1.71, 95%CI =1.59- 1.84 ; OR=1.83, 95%CI =1.71-1.97), the times of using headphones≥1 h every day for one week being 1-2 times and >2 times in noisy environment per week ( OR=1.48, 95%CI =1.40-1.56; OR=1.72, 95%CI =1.61-1.86), economic underdevelopment ( OR=1.85, 95%CI =1.76-1.96), boarding (OR=1.78, 95%CI =1.69-1.89), single parent family ( OR=1.72, 95%CI =1.60- 1.87 ), daily activity duration less than 1 h ( OR=1.71, 95%CI =1.63-1.81), sedentary behavior duration more than 6 h per day ( OR=1.88, 95%CI =1.79-1.98) ( P <0.05).
Conclusions
The behavior of ear protection among primary and middle school students in Jilin Province needs to be enhanced, focusing on students in economically underdeveloped areas, boarding schools and single parent families. It is necessary to guide primary and middle school students to improve their bad ear habits, increase outdoor activities and reduce the time of sitting.
9.Current advances of the sausage technique in bone augmentation
ZHOU Yanmin ; LIU Xiuyu ; CHEN Siyu.
Journal of Prevention and Treatment for Stomatological Diseases 2025;33(4):260-267
Sufficient bone tissue is required to ensure the long-term stability of implants. Based on the principles of guided bone regeneration, Dr. Istvan Urban proposed the “sausage technique”. Research indicates that the horizontal bone augmentation observed with the sausage technique averages (5.3 ± 2.3) mm and the vertical bone augmentation averages (4.2 ± 1.9) mm, which is significantly greater than the outcomes achieved with traditional guided bone regeneration techniques. The sausage technique is reliable because the biological membrane has sufficient elasticity and toughness with the application of membrane screws, which stabilizes the mixture of autologous bone and bone graft materials in the bone grafting area and prevents the grafting materials from being displaced. Using substitute materials for autologous bone graft balances the osteogenic activity and the low graft absorption rate. A ball drill is used to prepare nourishing holes in the cortical bone of the recipient area, providing a pathway for mesenchymal stem cells and bone progenitor cells to migrate to the bone regeneration area. Furthermore, this method accelerates the early angiogenesis of wound healing, fully reduces tension during suturing, and ensures that excessive pressure is not applied to the healing area during suturing. Thus, the sausage technique is consistent and reliable. Despite the good outcomes demonstrated by the sausage technique in clinical applications, its potential complications related to soft and hard tissue have attracted widespread attention. These complications negatively affect the patient’s recovery process and influence the final results of the surgery. Therefore, a complete understanding of the complications associated with the sausage technique and their underlying causes is necessary to enhance the clinical safety and effectiveness of the sausage technique. This article summarizes the application principles, clinical effects, barrier membrane applications, selection of bone transplant materials, and related complications of the sausage technique, aiming to provide a reference for clinical application.
10.Relationship between internalized stigma and quality of life in patients with schizophrenia::the chain mediating role of self-esteem and severity of negative symptoms
Guiju AI ; Ming JIN ; Quanming SHAO ; Yanni LIU ; Xianzhen WANG ; Hong LUO
Sichuan Mental Health 2025;38(2):172-177
BackgroundPatients with schizophrenia experience low quality of life, and internalized stigma is considered an important indicator for quality of life, while the mediating role of self-esteem and severity of negative symptoms in the relationship between internalized stigma and quality of life remains underexplored. ObjectiveTo examine the mediating role of self-esteem and severity of negative symptoms in the relationship between internalized stigma and quality of life, so as to provide references for improving their quality of life. MethodsA total of 342 patients with schizophrenia who were hospitalized in 6 hospitals in Xiangyang City, Siping City and Changchun City from April to September 2023 were included, and all of whom met the diagnostic criteria for schizophrenia according to the International Classification of Diseases, tenth edition (ICD-10). Internalized Stigma of Mental Illness Scale (ISMI), Schizophrenia Quality of Life Scale (SQLS), Self-Esteem Scale (SES) and negative symptom subscale of Positive and Negative Symptom Scale (PANSS) were administered to all patients. Spearman correlation analysis was adopted to determine correlations between the different scales. A structural equation modeling was constructed using Amos 28.0, and Bootstrap method was employed to verify the mediating effect of self-esteem and negative symptom severity in the association between internalized stigma and quality of life. ResultsA total of 309 patients (90.35%) completed questionnaires in this study. The ISMI score of schizophrenia patients was positively correlated with both SQLS score and the PANSS negative symptom subscale score (r=0.612, 0.492, P<0.01), while was negatively correlated with SES score (r=-0.513, P<0.01). The SQLS score was negatively associated with the SES score (r=-0.555, P<0.01) and positively associated with PANSS negative symptom subscale score (r=0.672, P<0.01). The SES score was negatively correlated with PANSS negative symptom subscale score (r=-0.433, P<0.01).The total effect value of internalized stigma on quality of life was 0.746 (95% CI: 0.680~0.806). Self-esteem and severity of negative symptoms independently mediated the relationship between internalized stigma and quality of life, and the indirect effect values were 0.151 (95% CI: 0.062~0.254) and 0.126 (95% CI: 0.047~0.205), accounting for 20.24% and 16.89% of the total effect, respectively. In addition, a chained mediation effect of self-esteem and quality of life was also demonstrated, the indirect effect value was 0.102 (95% CI: 0.049~0.165), accounting for 13.67% of the total effect). ConclusionInternalized stigma in patients with schizophrenia patients can not only directly affect the quality of life, but also indirectly affect the quality of life of patients through either separate or chained mediation of self-esteem and the severity of negative symptoms. [Funded by Hubei Provincial Undergraduate Innovation and Entrepreneurship Project (number, S202410519027)]


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