Background Schizophrenia and the use of antipsychotic medications are identified to be the likely contributors to the development of metabolic syndrome(MS)and cardiovascular disease,and jeopardize the prognosis of schizophrenia.Therefore,effectively preventing or reducing the risk of developing MS in patients with schizophrenia is critical.Objective To explore the efficacy of aripiprazole combined with olanzapine for male schizophrenia patients and its effect on MS,so as to provide a certain reference for the selection of antipsychotic drugs for schizophrenia patients.Methods Male patients(n=80)who were hospitalized in The Third People's Hospital of Meizhou from February to June 2023 and fulfilling the International Classification of Diseases,tenth edition(ICD-10)diagnostic criteria for the schizophrenia were enrolled,and grouped using random number table method,each with 40 cases.Study group was treated with aripiprazole combined with olanzapine,while control group was given aripiprazole monotherapy.The treatment lasted for 6 continuous weeks in both groups.At the baseline,Positive and Negative Symptom Scale(PANSS)score,MS-related indices[fasting plasma glucose(FPG),hemoglobin A1c(HbA1c),body mass index(BMI),waist-to-hip ratio(WHR),lipid profile],S100 calcium-binding protein B(S100B)and high sensitivity C-reactive protein(hs-CRP)were recorded.Then the PANSS scores at the end of the 2nd,4th and 6th week of treatment,the Clinical Global Impression(CGI)scores at the end of the 2nd and 6th week of treatment,as well as the MS-related indices,S100B,hs-CRP,Treatment Emergent Symptom Scale(TESS)score and Rating Scale for Extrapyramidal Side Effects(RSESE)score at the end of the 6th week of treatment were recorded in all participants.Results Analysis on PANSS score revealed a significant group effect,time effect and group×time interaction effect(F=18.092,634.780,2.917,P<0.05 or 0.01).Analysis on CGI score revealed a significant group effect and time effect(F=20.492,99.190,P<0.01).At the end of the 6th week of treatment,study group detected lower serum concentrations of HbA1c and triglyceride(TG)compared with control group(t=-3.495,-3.293,P<0.05).The post-treatment hs-CRP level was lower in study group than that in control group(t=-3.916,P<0.05).Study group scored lower on TESS compared with control group(t=-4.684,P<0.01).Conclusion Aripiprazole combined with olanzapine can effectively alleviate psychotic states in male schizophrenia patients,and the combination therapy yields less impact on MS-related indices than olanzapine monotherapy.

Objective To explore the efficacy and safety of remimazolam combined with propofol for gastroscopy in school-age children.Methods A total of 106 children who underwent painless gastroscopy from january to february 2024 were selected,56 males and 50 females,aged 7-12 years,ASA physical status Ⅰ or Ⅱ.Children were randomly divided into two groups:propofol group(group P)and remimazolam combined with propofol group(group RP),53 children in each group.After intravenous injec-tion of alfentanil 8 μg/kg,group P was intravenously injected with propofol 2.5 mg/kg,and group RP was intravenously injected with remimazolam 0.183 mg/kg and propofol 1 mg/kg in turn.Gastroscopy was per-formed when the eyelash reflex disappeared and the modified observer's assessment alertness/sedation scale(MOAA/S)score≤1.The onset time of anesthesia,examination time,and recovery time were recorded.The number of add propofol and successful sedation cases were recorded.Adverse reactions such as respira-tory depression,hypotension,bradycardia,injection pain,hiccups,nausea and vomiting were recorded.Results Compared with group P,the onset time of anesthesia in group RP was significantly prolonged,and the recovery time was significantly shortened(P＜0.05).Compared with group P,the incidence of add propofol,hypotension,respiratory depression and injection pain in group RP were significantly decreased(P＜0.05).Conclusion Remazolam combined with propofol for gastroscopy in children can not only en-sure the sedative effect,but also reduce the incidence of adverse reactions,stabilize hemodynamic changes and shorten the recovery time.

Objective:To determine the median effective dose (ED 50) and 95% effective dose (ED 95) of remimazolam for gastroscopy when combined with propofol in pediatric patients of different ages. Methods:This was a prospective study. American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ pediatric patients, aged 3-12 yr, who underwent painless gastroscopy in Hainan Women and Children′s Medical Center from January to February 2024, were divided into the following groups: preschool group (3-6 yr) and school-age group (7-12 yr). Penehyclidine 0.01 mg/kg, afentanil 8 μg/kg and corresponding doses of remimazolam and propofol 1 mg/kg were intravenously injected, and gastroscopy was performed when the Modified Observer′s Assessment of Alertness/Sedation Scale score)≤1. Up-and-down sequential allocation was used. A positive response was defined as bucking, nausea, vomiting, body movement, and frowning occurred when the gastroscope entered the pharynx. The initial dose of remimazolam was 0.2 mg/kg, and the dose of remimazolam was increased/decreased by 0.02 mg/kg each time in the next patient. Probit regression method was applied to calculate the ED 50, ED 95 and 95% confidence interval ( CI) of remimazolam inhibiting responses to gastroscope placement when combined with propofol. The anesthesia-related adverse events were recorded. Results:A total of 27 pediatric patients completed the trial in preschool group and 26 cases in school-age group. The ED 50 of remimazolam was 0.266 mg/kg (95% CI 0.249-0.285 mg/kg) and the ED 95 was 0.302 mg/kg (95% CI 0.283-0.409 mg/kg) in preschool group. The ED 50 of remimazolam was 0.16 mg/kg (95% CI 0.147-0.170 mg/kg) and ED 95 was 0.183 mg/kg (95% CI 0.172-0.234 mg/kg) in school-age group. The ED 50 and ED 95 were significantly decreased in school-age group as compared with preschool group ( P<0.05). During anesthesia, 3 patients suffered hypotension (11%) in preschool group, and 3 patients suffered hypotension (12%), 2 patients suffered respiratory depression (8%), 2 patients suffered hiccup (8%), 1 patient suffered injection pain (4%) and 1 patient suffered muscle rigidity (4%) in school-age group. There was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05). Conclusions:When combined with propofol, the ED 50 of remimazolam for gastroscopy in preschool and school-age pediatric patients is 0.266 mg/kg and 0.160 mg/kg, respectively, and the ED 95 is 0.302 mg/kg and 0.183 mg/kg, respectively, indicating a stronger anesthetic potency in school-age children. The probability of adverse reactions is low when the two are combined.

Objective: We primarily aimed to investigate the attention network function among parents of children with autism spectrum disorder (ASD) using the Attention Network Test (ANT). The secondary objective was to observe whether the three attention networks of all participants were related to each other. Methods: We included 28 parents of children with ASD and 28 well-matched parents of typically developing children. All participants underwent the neuropsychological assessment and ANT test. The three distinct attention networks, including alerting, orienting, and executive control, were also measured. Results: Compared with controls, parents of children with ASD showed less-efficient alerting and executive control network (all p<0.05), but not orienting network (p=0.74). No significant correlation was found between the alerting, orienting, and executive control network for either group. Conclusion Our findings showed that parents of children with ASD had deficits in alerting and executive control attention functions. The deficits are indications of a broad autism phenotype.

Objective:To learn about the arsenic status of drinking water in Urumqi City and evaluate its health risk, so as to provide scientific basis for the construction of water improvement projects in Urumqi City.Methods:From 2018 to 2020, 687 water samples were collected at monitoring sites in 7 districts and 1 county of Urumqi City for three consecutive years, and arsenic in drinking water was detected according to "Standard Examination Methods for Drinking Water - Nonmetal Parameters" (GB/T 5750.5-2006), and the arsenic in drinking water was evaluated according to "Standards for Drinking Water" (GB/T 5749-2006). The health risk of arsenic in drinking water in Urumqi City was evaluated by using the health risk assessment model recommended by United States Environmental Protection Agency (USEPA).Results:All of 687 water samples were centralized water supply, the arsenic compliance rates in dry season ( n = 342) and wet season ( n = 345), surface water ( n = 414) and underground water ( n = 273) were 100.0%. In dry season, the carcinogenic risk of arsenic via drinking water was 8.24 × 10 -6/a. In wet season, the carcinogenic risk of arsenic via drinking water was 3.30 × 10 -6/a. Conclusions:Remarkable achievements have been made in the construction of water improvement projects in Urumqi City, and the drinking water arsenic condition is good, the health risk of arsenic via drinking water is small. In the future, we should continue to strengthen the monitoring of drinking water quality, promote the construction of water improvement projects, further improve the drinking water sanitation, and put forward targeted prevention and control measures to ensure drinking water safety.

Objective:To investigate the implementation effect of micro-video assisted physiological theory teaching based on functional experiments.Methods:There were 140 clinical undergraduates (control group) from Class 1 and Class 2, and 123 clinical undergraduates (experimental group) from Class3 and Class 4 of Batch 2017 in our university who were involved in this study. The control group adopted traditional teaching method, the experimental group adopted micro-videos to assist traditional teaching in the teaching of selected chapters, and these micro-videos were collected from the recording and editing of functional experiments. After the course, questionnaire survey in terms of course design, implementation and effect, as well as final exanimation performance analysis were conducted to evaluate the teaching effect. SPSS 17.0 was used for t test. Results:The final examination scores of the experimental group were significantly higher than those of the control group [(81.02±9.64) vs. (73.41±11.39)], with significant differences ( t=-5.805, P<0.001). Among them, the scores of Chapter 2 of the two groups were [(8.07±0.94) vs. (6.14±1.05), t=-15.616, P<0.001)], the scores of Chapter 4 were [(16.16±1.79) vs. (10.90±2.23), t=-20.903, P<0.001)], and the scores of Chapter 6 were [(6.04±0.53) vs. (5.82±0.78), t=-2.638, P=0.009)], all with significant differences. 100% of questionnaires were recovered, and more than 90% of students were interested in this teaching method which could strengthen their understanding of the key and difficulties in physiology and was also helpful to cultivate their ability of induction and summarization. Conclusion:Micro-videos based on functional experiments assisted teaching can improve the teaching effect of physiology, and it's worth popularizing.

Objective:To investigate the effect of sodium arsenite (NaAsO 2) on autophagy protein microtubule-associated protein light chain 3 (LC3) and Beclin-1 in human hepatic stellate cells (LX-2 cells). Methods:LX-2 cells were cultured in vitro, and LX-2 cells were stably infected with red fluorescent protein-green fluorescent protein-microtubule-LC3 (RFP-GFP-LC3) lentivirus. Flow cytometry was used for screening and infection rate determination. Using a group design, different concentrations NaAsO 2 [μmol/L: 5.00 (infection + high arsenic dose group), 0.50 (infection + medium arsenic dose group), 0.05 (infection + low arsenic dose group), and 0.00 (infection group)] were incubated to stably infect LX-2 cells, and an in vitro liver fibrosis model was constructed, and a blank group was established. The effect of NaAsO 2 on the activity of LX-2 cells was detected by CCK-8 method. The mRNA and protein expression levels of LC3, Beclin-1 and α-smooth muscle actin (α-SMA) were detected by real-time fluorescent quantitative PCR and Western blotting. Results:After stable infection of LX-2 cells by RFP-GFP-LC3 lentivirus, the fluorescence rate of RFP and GFP was determined by flow cytometry, and the infection rate was about 70%. There was no significant difference in the fluorescence intensity of RFP and GFP observed under fluorescence microscope, and the infected cells were established successfully. After treatment with NaAsO 2 for 24, 48, 72 h, compared with the blank group, the cell viability of the infection group was not significantly different statistically ( P > 0.05), and the cell viability of other dose groups decreased ( P < 0.05). There were significant differences in the expression levels of LC3, Beclin-1, α-SMA mRNA and protein in blank, infection, infection + high arsenic dose, infection + medium arsenic dose, and infection + low arsenic dose groups ( F = 17.450, 11.084, 11.294, 11.745, 31.635, 12.130, P < 0.05). In infection, infection + high arsenic dose, and infection + low arsenic dose groups, the levels of LC3 mRNA (20.09 ± 6.50, 36.57 ± 9.68, 14.19 ± 6.17) were higher than that of the blank group (1.25 ± 0.21, P < 0.05), and the level of LC3 mRNA in infection + high arsenic dose group was higher than that of the infection group ( P < 0.05); in infection, infection + high arsenic dose, infection + medium arsenic dose, and infection + low arsenic dose groups, the levels of Beclin-1 mRNA (22.46 ± 0.66, 13.38 ± 2.27, 20.80 ± 6.95, 24.31 ± 7.09) were higher than that of the blank group (1.10 ± 0.53, P < 0.05); in infection + high arsenic dose, infection + medium arsenic dose, and infection + low arsenic dose groups, the levels of α-SMA mRNA (1.07 ± 0.27, 1.65 ± 0.17, 1.73 ± 0.26) were higher than that of the blank and infection groups (0.60 ± 0.11, 0.31 ± 0.09, P < 0.05). In infection, infection + medium arsenic dose, and infection + low arsenic dose groups, the LC3 protein expressions (0.20 ± 0.06, 0.15 ± 0.00, 0.16 ± 0.01) were significantly increased compared to that of the blank group (0.04 ± 0.01, P < 0.05); in infection + medium arsenic dose, and infection + low arsenic dose groups (0.83 ± 0.03, 1.20 ± 0.02), the Beclin-1 protein expressions were significantly increased compared to that of the blank group (0.25 ± 0.01, P < 0.05), and the Beclin-1 protein expression in infection + low arsenic dose group was increased compared to that of the infection group (0.53 ± 0.03, P < 0.05); in infection + medium arsenic dose, and infection + low arsenic dose groups (0.78 ± 0.10, 0.68 ± 0.06), the α-SMA protein expressions were significantly increased compared to that of the blank and infection groups (0.40 ± 0.07, 0.48 ± 0.04, P < 0.05). Conclusion:NaAsO 2 may affect the process of arsenic-induced liver fibrosis by promoting the autophagy level of LX-2 cells.

Objective To investigate the effectiveness of Microlecture plus PowerPoint (PPT) in physiology experiment teaching.Methods The students of clinical medicine in Grade 2015 of Hubei University of Medicine were selected as the subjects.Among them,61 students in Class 1 were studied as the control group,while 59 students in Class 2 as the experimental group.The control group adopted the traditional teaching method and required students to complete the experimental report with handwriting,while the experimental group adopted teaching method of Microlecture plus PPT.In the experimental group,students watched the microlecture for preview and could also repeat watching at any time to correct the mistakes during the operation.After class,students of the experimental group were required to complete the experiment report in the form of PPT and send it to the teacher through QQ within the prescribed time.The learning outcomes were evaluated by using descriptive analysis and t test based on the class operation,final examination and questionnaire.Results Both the average score of experiment operation and the average scoreof final theory exam in the experimental group were higher than those of the control group [(95.074 ± 3.233) vs.(81.706 ± 2.901) and (92.204 ± 3.074) vs.(77.913 ± 2.611)],and the differences were of statistical significance(P＜0.05).The recovery rate of questionnaire survey was 100％ in the experimental group.Over 80％ students thought Microlecture plus PPT could help enhance autonomous learning ability,deepen the understanding of theory and increase group cooperation ability,et al.Conclusion Microlecture plus PPT teaching can improve the teaching effect of physiology experiment teaching,which is worthy of promotion.However,it is still necessary to combine other teaching methods to achieve better teaching results.

Objective To investigate the prevalence and trend of dental fluorosis of 7-14 years old children in 134 Regiment,8 Division,Xinjiang Production and Construction Corps,and to evaluate the effectiveness of water improvement and fluoride control measures.Methods From 2010 to 2017,using cross-sectional survey,six water allocation places were selected from 134 Regiment,8 Division,Xinjiang Production and Construction Corps,and the fluoride content was determined.Children of 7-14 years old in 2 central primary schools were investigated,and dental fluorosis was examined.Taking 2017 as the benchmark,children born before water improvement were 11-14 years old,children born after water improvement were 7-10 years old.Water fluoride was detected via the ion-selective electrode method.Diagnosis of dental fluorosis was based on the standard of "Dental Fluorosis Diagnosis" (WS/T 208-2011).The detection rate of dental fluorosis was compared by x2 test,and rank sum test was used to compare the severity of the disease.Results A comprehensive water improvement and fluoride reduction project was completed in 134 Regiment,8 Division,Xinjiang Production and Construction Corps in 2007.The detection rate of dental fluorosis in children born before water improvement was 2.65 times higher than that of children born after water improvement [14.43％ (101/700) vs 5.44％ (33/607),X2 =28.567,P ＜ 0.01].The dental fluorosis index of children born before water improvement was also higher than that of children born after water improvement (0.33 vs 0.11).According to age standardization (based on 2017),there was a significant difference in the detection rate of dental fluorosis among children in different years (x2 =351.300,P ＜ 0.01).The detection rate of dental fluorosis in children decreased from 35.26％ in 2010 to 10.25％ in 2017.There was a statistically significant difference in the severity of dental fluorosis in children of different years (H =954.033,P ＜ 0.01).The dental fluorosis index of children decreased from 0.71 in 2010 to 0.23 in 2017,and the disease changed from extremely mild fluorosis epidemic to non-fluorosis epidemic.Conclusion After effective water improvement in 134 Regiment,8 Division,Xinjiang Production and Construction Corps,the prevalence of dental fluorosis in children in the disease affected areas has decreased significantly,the effect of defluoridation project is significant.

Objective To investigate the risk factors for post-ERCP complications. Methods Data of the patients who underwent ERCP in the First Affiliated Hospital of Nanchang University from 1 January 2011 to 31 December 2013 were retrospectively analyzed. Post-ERCP complications were analyzed by univariate and multivariate analyses. Results A total of 277 patients out of 1 951 developed complications, 101(5.18%)pancreatitis, 54(2.77%)hyperamylasemia(not including pancreatitis), 134(6.87%) biliary infection,8(0.41%)hemorrhage,1(0.05%)obstruction and 1(0.05%)perforation.Multivariate analyses showed cholangiocarcinoma(P=0.002,OR=2.39, 95% CI:1.38-4.14), long operation time(>60 min)(P=0.020,OR=3.77,95%CI:1.23-11.53)and endoscopic sphincterotomy(EST)(P=0.008, OR=2.56,95% CI:1.28-5.14)and entrance of guidewire to pancreatic duct(P=0.012,OR=1.43, 95%CI:1.08-1.87)were independent risk factors for PEP. Cholangiocarcinoma(P<0.01, OR=2.93, 95%CI:1.88-4.56),multiple times of ERCP during the period of hospitalization(P<0.01, OR=2.53, 95%CI:1.63-3.93)were independent risk factors for post-cholangitis. However, EST(P=0.03, OR=0.65,95%CI:0.44-0.97)and antibiotics prophylaxis after ERCP(P=0.03, OR=0.64, 95% CI:0.39-0.95)were protective factors for post-cholangitis. ConclusionCholangiocarcinoma, endoscopic sphincterotomy, long operation time(> 60 min)and entrance of guidewire to pancreatic duct were independent risk factors for PEP. Cholangiocarcinoma and multiple ERCP during the period of hospitalization are independent risk factors for post-cholangitis.EST and antibiotics prophylaxis after ERCP might reduce the occurrence of cholangitis.