BackgroundThe violent aggressive behaviors of patients with schizophrenia usually have the characteristics of suddenness， unpredictability， high severity， and great difficulty in prevention. Early identification and accurate assessment of their risk of violent aggression have significant clinical significance. ObjectiveTo construct a predictive model for the violence risk in hospitalized patients with schizophrenia， to identify the key factors influencing the occurrence of violent behavior in these patients， so as to provide references for clinical precise quantitative assessment and early intervention. MethodsA total of 200 patients with schizophrenia who were hospitalized at Taiyuan Psychiatric Hospital from March 2022 to September 2024 and met the diagnostic criteria of the International Classification of Diseases， eleventh edition （ICD-11） were collected to form the modeling cohort. They were randomly divided into a training set （n=140） and a test set （n=60） at a ratio of 7∶3. Based on the least absolute shrinkage and selection operator （LASSO） regression algorithm， the feature variables were screened and dimension-reduced. The support vector machine （SVM） from machine learning was selected for model training and prediction. The discrimination efficacy of the model was evaluated by the area under the receiver operating characteristic （ROC） curve （AUC）， accuracy， precision， sensitivity， specificity， F1 value， and Brier value. ResultsLASSO regression screening identified 16 feature variables. Pearson correlation analysis revealed a positive correlation between prior violent behavior frequency and clinical psychiatric symptom scores （r=0.580， P<0.01）， a positive correlation between hospitalization compliance and current disease status （r=0.550， P=0.003）， and a positive correlation between educational level and family per capita monthly income （r=0.367， P<0.01）. The SVM model achieved an AUC of 0.853， accuracy of 0.800， precision of 0.810， sensitivity of 0.895， specificity of 0.636， F1 value of 0.850， and Brier value of 0.168. ConclusionThe SVM model has a relatively high level of applicability and overall predictive performance in the assessment of violent risk in schizophrenia patients， which is helpful for the early identification of violent risks in such patients. ［Funded by Specialized Research Project for Enhancing the Competence of Health Professionals in Taiyuan City （number， Y2023006）］

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

BackgroundFluvoxamine is increasingly used in the treatment for depressive disorder in adolescents. However， little research has been done on the effect of fluvoxamine on lipid metabolism， and the disordered lipid metabolism would cause severe harm to the health of patients and affect relevant prognosis. ObjectiveTo analyze the effect of fluvoxamine on lipid metabolism in adolescent patients with depressive disorder and to investigate the safety of fluvoxamine treatment. MethodsFrom June 2022 to June 2023， 60 adolescent patients with depressive disorder were involved， who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） and received inpatient treatments in Shanxi Mental Health Center. These cases were randomly divided into study group （receiving fluvoxamine treatment） and control group （receiving sertraline treatment） with 30 cases in each group. The treatment period was 4 weeks. At baseline as well as 2 weeks and 4 weeks after treatment， both groups' indexes of fasting lipid metabolism were measured， including serum total cholesterol （TC）， triglycerides （TG）， high-density lipoprotein （HDL） and low-density lipoprotein （LDL）， and Hamilton Depression Scale-17 item （HAMD-17） was adopted. The levels of lipid metabolism indexes and HAMD-17 score were compared between the two groups at different follow-up time points. ResultsFor HAMD-17 score， the time effect was statistically significant （F=849.687， P<0.01）， while the inter-group effect and interaction effect was not statistically significant （F=0.033， 1.760， P>0.05）. For TC levels， the inter-group effect was not statistically significant （F=1.461， P=0.232）， but the time effect and interaction effect were statistically significant （F=13.129， 5.029， P<0.05 or 0.01）. The time effect and the inter-group effect of TG level were not statistically significant （F=0.825， 0.185， P>0.05）， but the interaction effect was statistically significant （F=7.577， P=0.004）. For HDL levels， the time effect， inter-group effect and interaction effect were not statistically significant （F=1.079， 0.160， 1.877， P>0.05）. For LDL levels， there was no statistical significance in the inter-group effect （F=0.019， P=0.891）， while statistical significance was observed in both time effect and interaction effect （F=6.721， 9.075， P<0.01）. ConclusionFluvoxamine and sertraline have curative effectiveness of same level on adolescent depression disorder， and short-term application of fluvoxamine has little effect on lipid metabolism indexes of patients. ［www.chictr.org.cn number： ChiCTR2300074129］

ObjectiveTo investigate the effects of maltol aluminum exposure on miR-193a-3p, demethylase AlkB homolog 5 (ALKBH5), phosphatase and tensin homolog deleted on chromosome ten (PTEN) and protein kinase B (AKT), and whether miR-193a-3p is involved in aluminum-induced cognitive impairment by regulating ALKBH5/PTEN/AKT signaling pathway. Methods Specific pathogen-free male SD rats were randomly divided into control group and low-, medium- and high- dose groups according to their body weight, with eight rats in each group. Rats in the low-, medium-, and high- dose groups were intraperitoneally injected with maltol aluminum solution at concentrations of 10.00, 20.00, and 40.00 μmol/kg body weight, respectively, while the rats in control group were given an equal volume of 0.9% sodium chloride solution. Rats were injected for five days every week for three months. After injection, the novel object recognized test was used to assess the learning and memory ability of the rats. The relative expression of miR-193a-3p and B-cell lymphocytoma-2 (Bcl-2), Bcl-2 associated X protein (Bax) and cysteine aspartate protease-3 (Caspase-3) mRNA in rat hippocampus was detected using the real-time quantitative polymerase chain reaction. The relative protein expression of ALKBH5, PTEN, and AKT2 in the rat hippocampus was detected using Western blot. Results The discrimination index and the preference index of the new object recognition test of the rats in high-dose group were lower than those in control group and low-dose group (all P<0.05). The relative expression of miR-193a-3p and Bcl-2 mRNA in the hippocampus of the rats in high-dose group was lower than those in control group and low-dose group (all P<0.05). The relative mRNA expression of Bax in the high-dose group was higher than those in the control group and low-dose group (both P<0.05). The relative mRNA expression of Caspase-3 of the rats in the high-dose group was higher than that in the other three groups (both P<0.05). The relative protein expression of ALKBH5 in the hippocampus of the rats in the high-dose group was lower than that in the control group (P<0.05). The relative expression of PTEN protein was higher than those in the control group and low-dose group (both P<0.05). The relative protein expression of AKT2 was lower than those in the control group and low-dose group (both P<0.05). Conclusion Sub-chronic aluminum exposure can inhibit the expression of miR-193a-3p in the hippocampus of rats, which may disrupt the ALKBH5/PTEN/AKT pathway and affect normal neuronal homeostasis and cellular function. This pathway may play an important role in aluminum-induced cognitive impairment.

AIM:To investigate the effects of subchronic aluminum exposure on the expression of silent infor-mation regulator(Sirt1),Kelch-like ECH-associated protein 1(Keap1),nuclear factor E2-related factor 2(Nrf2),and microRNA-128-3p(miR-128-3p)in the hippocampus of rats.Additionally,we aimed to explore the mechanism of miR-128-3p and the Sirt1-Keap1/Nrf2 signaling pathways in aluminum-induced cognitive impairment in rats.METHODS:Thirty-two healthy 6-week-old SPF male SD rats,weighing(190±20)g,were randomly divided into four groups based on body weight:control group,low-dose(10 μmol/kg)group,medium-dose(20 μmol/kg)group,and high-dose(40 μmol/kg)group,with 8 rats in each group.The rat exposure model was established by intraperitoneal injection of maltol alumi-num.The Morris water maze test was used to assess the learning and memory ability of the rats.Western blot analysis was performed to measure the protein expression of Sirt1,Keap1 and Nrf2 in the hippocampus,while RT-qPCR was used to measure the expression of miR-128-3p in the hippocampus.The level of reactive oxygen species(ROS)in the cerebral cor-tex was detected using fluorescence staining in frozen sections.RESULTS:(1)In the positioning cruise experiment,the escape latency of the aluminum exposure group was significantly higher than that of the control group on the 3rd,4th,and 5th days(P＜0.05).On day 6,the number of times the rats crossed the platform and the platform quadrant in the high-dose group was reduced compared to the control and low-dose groups(P＜0.01).(2)The expression levels of Sirt1 and Nrf2 in the hippocampal tissues of all groups decreased gradually with increasing maltol aluminum exposure dose.The ex-pression level of Keap1 increased gradually with increasing maltol aluminum exposure dose.The expression level of miR-128-3p in the high-dose group was significantly higher than that in the control group(P＜0.05).(3)The content of gluta-thione peroxidase in the hippocampus of rats decreased with increasing exposure dose,while ROS levels gradually in-creased.CONCLUSION:Subchronic aluminum exposure can increase the expression of miR-128-3p in the rat hippo-campus and suppress the Sirt1-Keap1/Nrf2 signaling pathway.This inhibition prevents the activation of the Sirt1-Keap1/Nrf2 signaling pathway,leading to a reduced antioxidant capacity.The imbalance in the antioxidant system in rats results in oxidative damage to nerve cells and a subsequent decline in cognitive function.

Objective To investigate the protective effect of mucopolysaccharide polysulfate cream(MPC) and micro needle array drug delivery technologarray(MNADDT) on the blood vessel of arteriovenous fistula.Methods Eighty cases maintenance hemodialysis patients with autogenous arteriovenous fistula were randomly divided into control group(with the treatment of MPC) and study group(with the treatment of MPC plus MNADDT),40 patients in each group.Both groups were studied for the duration of 12 months.The vascular complications of puncture pain sense,puncture failure times,phlebitis,hardening of the arteries,internal fistula stenosis or embolism,pseudoaneurysm,swollen hands comprehensive syndrome of two groups were observed,and the changes of arteriovenous fistula blood flow,blood vessel diameter by Doppler ultrasound were observed in the two groups for 12 months.Results (1)The incidence of puncture pain(2.71±0.11 vs.2.76±0.14,t=2.21,P<0.05),puncture failure times(38 times vs.73 times,χ2=11.425,P<0.05),phlebitis(2 cases vs.8 cases,χ2=4.341,P<0.05) and blood vessel sclerosis(2 cases vs.9 cases,χ2=5.446,P<0.05) of the treatment group were significantly lower than that of the control group during the study(P<0.05).(2)Blood flow of arteriovenous fistulain of control group before and after treatment were (859.7±148.3) ml/min and (946.5±169.2) ml/min respectively,and the difference was significant(t=2.356,P<0.05).While blood flow of arteriovenous fistulain,cephalic vein diameter,head of venous flow velocity of study group before and after treatment were (824.6±171.5) ml/min and (1 218.1±241.9) ml/min,(5.59±0.74) mm and (6.02±0.57) mm,(94.23±27.35) cm/s and (115.85±36.63) cm/s,respectively,and the differences were significant(t=8.212,2.382,2.877,P<0.05),there were no significantly changes in the above indexes in the study group after treatment(t=5.3612,2.152,2.281,P<0.05).Conclusion MPC plus MNADDT can reduce the vascular complications of arteriovenous fistula,improve blood vessel diameter and increase blood flow.