Clinical high risk (CHR) is the prodrome stage of schizophrenia and the population with CHR show subtle clinical symptoms and abnormal brain structure and function. Specifically, the pathological changes in the brain were mainly manifested as reduced gray matter volume in the anterior cingulate gyrus and hippocampus, damaged white matter fibers in the corpus callosum, uncinate tract and arcuate tract, cerebellar atrophy, and abnormal resting-state brain network connection.This paper reviews the brain imaging features, their relationship with clinical symptoms, and their role in predicting clinical outcomes in individuals with CHR. In the future, we can combine artificial intelligence and neuroimaging techniques to find specific markers of brain structure and function in the CHR population to guide early clinical detection and intervention.

ObjectiveTraditional Chinese medicine， namely Dahuang Zhechongwan （DHZCW） was used to treat myocardial fibrosis in model rats， observe its effect on myocardial fibrosis in rats， and explore its action mechanism. MethodThirty-six SPF male Kunming rats were divided into blank group， model group， low-， medium-， high-dose groups of DHZCW （0.056， 0.084， 0.168 g·kg^-1）， captopril group （10 mg·kg^-1）， with six rats in each group. Except for the blank group， the other groups were intraperitoneally injected isoproterenol solution of 5 mg·kg^-1 for 15 consecutive days to replicate the myocardial fibrosis model. At the beginning of modeling， the rats in each group took drugs， and they were sacrificed 28 days after administration. Serum and heart tissue were collected for the corresponding detection. Hematoxylin-eosin （HE） staining and Masson staining were used to observe tissue inflammation， cellular degeneration， necrosis， and fibrosis. The contents of hydroxyproline （HYP）， tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， hyaluronic acid （HA）， laminin （LN）， type-Ⅲ procollagen （PC Ⅲ） in serum of rats and rats were determined by enzyme-related immunosorbent assay （ELISA）. The expression levels of key pathway proteins transforming growth factor-β₁ （TGF-β₁）， α-smooth muscle actin （α-SMA）， Smad2， Smad3， and Smad7 were detected by Western blot. The expression levels of key pathway genes TGF-β₁， α-SMA， Smad2， Smad3， Smad7， miR-29a-5p， miR-29b-2-5p， and miR-29c-5p were detected by Real-time quantitative polymerase chain reaction （Real-time PCR）. ResultCompared with the blank group， the pathological changes of fibrosis in the model group were obvious， the contents of serum HYP， TNF-α， IL-1β， IL-6， HA， LN， and PCⅢ were increased （P<0.01）， the protein expression levels of TGF-β₁， α-SMA， Smad2， and Smad3 were increased； the protein expression level of Smad7 was decreased （P<0.01）. The mRNA expression levels of TGF-β₁， α-SMA， Smad2， and Smad3 were increased （P<0.05， P<0.01）， while those of Smad7， miR-29a-5p， miR-29b-2-5p， and miR-29c-5p were decreased （P<0.01）. Compared with the model group， after 28 days of administration， serum HYP， TNF-α， IL-1β， IL-6， HA， LN， and PCⅢ in high-， medium-， and low-dose groups of DHZCW and captopril groups were decreased （P<0.01）. Except for the low-dose group， the protein contents of TGF-β₁， α-SMA， Smad2， and Smad3 were decreased， while the protein content of Smad7 was increased （P<0.01）. The mRNA expression levels of TGF-β₁， Smad2， α-SMA， and Smad3 in high-dose group of DHZCW were decreased （P<0.05，P<0.01）， while those of Smad7， miR-29a-5p， miR-29b-2-5p， and miR-29c-5p were increased （P<0.05）. The mRNA expressions of TGF-β₁， Smad2， and Smad3 in the medium-dose group of DHZCW were decreased （P<0.05， P<0.01）， while mRNA expression of Smad7 was increased （P<0.01）. The mRNA levels of TGF-β₁ and Smad2 in the low-dose group of DHZCW were decreased （P<0.01）. ConclusionDHZCW can improve myocardial fibrosis in rats， and its action mechanism may be related to the regulation of the TGF-β₁/Smads/miR-29 pathway. In addition， there is dose dependence in the range of 0.056-0.168 g·kg^-1， and the effect of the high-dose group is more stable.

Objective: To analyze the association between short term PM 2.5 exposure and high blood pressure in adolescents and its modification effect of overweight and obesity, and to provide a reference for the refined management of students physical health and the scientific prevention and controlling of air pollution. Methods: A total of 148 956 junior high school students and senior high school students who passed the annual physical examination data of middle school students in Beijing from 2017 to 2018 were selected; The inverse distance weighted interpolation method was used to get the meteorological elements and air quality of the research area; Linear mixed effect model was used to estimate the cumulative lag effect of short term PM 2.5 exposure on systolic and diastolic blood pressure within 7 days, and analyze the modification effect of overweight and obesity on the association between short term PM 2.5 exposure and high blood pressure in adolescents. Results: From September 1, 2017 to June 30, 2018, the average concentration of PM 2.5 was (56.53±45.85)μg/m 3; The detection rate of overweight and obesity was 34.22%, and the detection rate of high blood pressure was 8.03%. The cumulative lag effect of PM 2.5 on systolic blood pressure in overweight and obesity group was the largest at lag07, that is, the daily average concentration of PM 2.5 increased by 10 μg/m 3 was significantly correlated with higher systolic blood pressure ( OR =1.05,95% CI =1.03-1.07); the cumulative lag effect of PM 2.5 on systolic blood pressure in non overweight and obese group was the largest at lag05, that is, the daily average concentration of PM 2.5 increased by 10 μg/m 3 was significantly correlated with higher systolic blood pressure ( OR =1.04,95% CI =1.02-1.06). Short term exposure to PM 2.5 did not affect the high diastolic blood pressure in adolescents. Overweight and obese adolescents were more susceptible to high blood pressure caused by short term PM 2.5 exposure within 3 days of cumulative lag (lag01-lag03). Conclusion The short term exposure of PM 2.5 has a significant positive correlation with adolescent blood pressure, and shows a lag effect. Overweight and obese adolescents have higher blood pressure after PM 2.5 short term exposure.

Objective:To explore the effect of WeChat-supported health education based on the information knowledge attitude practice (IKAP) model in patients with ulcerative colitis (UC) .Methods:From June 2017 to September 2021, 347 UC patients admitted to the Gastroenterology Department of Shanxi Provincial People's Hospital were selected by convenience sampling as the research object. The UC patients admitted from June 2017 to August 2019 were set as the control group ( n=173) and received routine health education. The UC patients admitted from September 2019 to September 2021 were set as the observation group ( n=174) , and they were given WeChat-supported health education based on the IKAP model. The self-management level and quality of life of the two groups of patients before and after the intervention were compared. Results:After the intervention, the scores of each dimension of the Self-management Scale and the Short Form 36 Health Survey Questionnaire of the two groups were higher than those before the intervention, and those of the observation group were higher than those of the control group, with statistical differences ( P<0.05) . Conclusions:WeChat-supported health education based on the IKAP model can improve the self-management and quality of life of UC patients, which is worthy of clinical promotion.

Objective: To analyze the relationship between short term exposure of PM 2.5 and the vital capacity of children and adolescents and the modification effect of overweight and obesity, and to provide a scientific reference for appropriate outdoor activities and strengthening prevention of air pollution. Methods: A total of 1 036 273 students who qualified in the annual health examination data of primary and secondary school students in a city from 2017 to 2018 were selected; the meteorological factors and air quality of the study area were obtained by inverse distance weighted interpolation method; the generalized linear mixed model was used to estimate the individual lag effect and average lag effect of PM 2.5 short term exposure on lung capacity with in 7 days, and to analyze the modification effect of overweight and obesity on the relationship between short term PM 2.5 exposure and vital capacity in children and adolescents. Results: From September 1, 2017 to June 30, 2018, the average PM 2.5 concentration in this city was 66.36 μg/m 3, the detection rate of overweight and obesity was 33.38%, and the average lung capacity was (2 286.72±956.77)mL. The single lag effect of PM 2.5 on vital capacity was the biggest when lag6, the average daily PM 2.5 concentration increased by 10 μg/m 3 and the decrease of vital capacity of children and adolescents by 2.81(95% CI =2.60-3.03)mL. The average lag effect of PM 2.5 on lung capacity was the largest when lag07, the average concentration of PM 2.5 sliding was significantly correlated with the decrease of lung capacity of children and adolescents by 5.82(95% CI =5.37-6.27)mL every 10 μg/m 3 increase. The prevalence of PM 2.5 short term exposure to pulmonary capacity decreased in overweight and obese children and adolescents was higher ( P ＜0.01). Conclusion The short term exposure of PM 2.5 has a significant negative correlation with the lung capacity of children and adolescents, and there is a lag effect. The decrease of the vital capacity of overweight and obese children and adolescents after PM 2.5 short term exposure is more significant.

Liver fibrosis is the result of persistent inflammatory response and chronic scar healing response during chronic liver injury and may progress to liver cirrhosis, portal hypertension, and liver failure, which finally requires liver transplantation. Interleukin-22 (IL-22) belongs to the IL-10 family and is the only cytokine that is produced by immune cells but does not act on immune cells. IL-22 plays a role by binding to its receptors IL-22R1 and IL-10R2, which has attracted much attention in the field of liver disease research in recent years. IL-22 not only plays the role of anti-inflammation and promotion of liver regeneration and tissue repair, but also has a pro-inflammatory effect in liver diseases, and it exerts a protective effect on the liver by reducing fibrosis in some pathological conditions, but there are still controversies over its association with liver fibrosis. IL-22 has different effects and mechanisms in liver fibrosis caused by different etiologies. This article reviews the role and possible mechanisms of IL-22 in liver fibrosis caused by viral infection (HBV and HCV), alcohol, high-fat diet, and autoimmunity.

Ulcerative colitis (UC) is one of the main types of inflammatory bowel disease (IBD). It is a chronic, nonspecific, and inflammatory disease of the colon that is prone to repeated attacks and requires long-term maintenance treatment. Its clinical features include: diarrhea, weight loss, abdominal pain, fever, blood in the stool and the risk of cancer. It is currently believed that the pathogenesis of UC is due to environmental factors acting on genetically susceptible individuals, causing abnormal activation of the immune system and destruction of the intestinal mucosal barrier, resulting in inflammatory changes of the colonic mucosa, in which T cells and cytokines secreted by them is the important topics in UC pathogenesis research. Th9 cells are a newly discovered subset of T cells. IL-9 secreted by it has been shown to be involved in a variety of autoimmune disease. Now we will review the differentiation of Th9 cells and the mechanisms involved in the pathogenesis of UC.

Objective: To evaluate the association of short-term fine particulate matters (PM2.5) exposure and blood pressure in children and adolescents. Methods: A total of 144 813 junior and senior middle school students who participated in the physical examination in the 2017-2018 academic year in a northern city of China, with complete record of demographic characteristics, blood pressure and no history of heart and other important organ diseases were selected as the study subjects. Data on PM2.5 and other pollutants and meteorological data were obtained from the nearest air quality and meteorological monitoring stations of each schools. A generalized linear mixed effect model was used to analyze the association between short-term exposure of PM2.5 and blood pressure. Results: The 6 day average concentration of PM2.5 (lag05) increased by 10 μg/m 3 was associated with an increase of 0.177(95%CI=0.148-0.207)mm Hg (1 mm Hg=0.133 kPa) in systolic blood pressure and 4.4%(OR=1.044, 95%CI=1.030-1.058) increase of the prevalence of high systolic blood pressure. And it was also associated with -0.021(95%CI=-0.040--0.002)mm Hg decrease in diastolic blood pressure, but had no significant correlation with the prevalence of high diastolic blood pressure. In general, a 10 μg/m 3 increase of PM2.5 was associated with 3.3% increase in the prevalence of high blood pressure (OR=1.03, 95%CI=1.02-1.05), and difference of boys and girls were found in different lagged days (P<0.05). Conclusion Short-term exposure of PM2.5 is associated with increased systolic blood pressure and prevalence of high blood pressure among children and adolescents. Attention should be paid to the prevention of short-term exposure of PM2.5 to protect the health of children and adolescents.

Objective To investigate the clinical significance of autophagy-related protein 7 (ATG7) in the diagnosis of HBV-related hepatocellular carcinoma (HBV-HCC) by measuring the expression level of serum ATG7 in patients with HBV-HCC. Methods A total of 50 patients with chronic hepatitis B (CHB) and 89 patients with HCC who were hospitalized in Mengchao Hepatobiliary Hospital of Fujian Medical University from June 2018 to December 2020 were enrolled, among whom 67 patients had HBV-HCC (HBV-HCC group) and 22 patients had no HBV-HCC (non-HBV-HCC group), and 20 healthy volunteers who underwent physical examination were enrolled as healthy control (HC) group. Demographic data and laboratory data including alpha-fetoprotein (AFP) were collected from each group, and ELISA was used to measure the serum level of ATG7. The receiver operating curve (ROC) was plotted for ATG7 and AFP used alone or in combination, and the area under the ROC curve (AUC) was compared. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Mann-Whitney U test was used for comparison between two groups; the chi-square test was used for comparison of categorical data between groups; a Spearman correlation analysis was used to investigate correlation. Results The serum level of ATG7 was 22.88(19.79-23.04) ng/mL in the HBV-HCC group, 17.06(14.45-19.40) ng/mL in the non-HBV-HCC group, 19.21(16.65-20.82) ng/mL in the CHB group, and 13.82(8.70-17.82) ng/mL in the HC group, with a significant difference between groups ( χ 2 =65.144, P < 0.001). ATG7 had an AUC of 0.818 (95% confidence interval [ CI ]: 0.743-0.879) and AFP had an AUC of 0.777 (95% CI : 0.698-0.843) in the diagnosis of HBV-HCC, suggesting that ATG7 had a slightly higher AUC than AFP ( Z =0.852, P =0.394). ATG7 combined with AFP had an AUC of 0.859 (95% CI : 0.790-0.913) in the diagnosis of HBV-HCC, which was significantly higher than the AUC of ATG7 alone ( Z =2.192, P =0.028) and AFP alone ( Z =2.076, P =0.038). Conclusion ATG7 is a good marker for the diagnosis of HBV-HCC, and combined measurement of ATG7 and AFP can significantly improve the diagnostic rate for HBV-HCC.

Objective:To explore effects of perioperative application of NNN-linked nursing model on self-perceived burden, postoperative rehabilitation and quality of life in patients undergoing hip-knee replacement.Methods:A total of 100 patients with osteoarthritis who were scheduled to undergo artificial hip-knee replacement in the First People's Hospital of Lianyungang from July 2018 to July 2019 were selected by stratified sampling method and they were randomly divided into the control group and the observation group according to the sealed envelope method, with 50 patients in each group. The control group was given routine perioperative nursing while the observation group was given perioperative nursing based on NNN-linked nursing model. Self-Perceived Burden Scale (SPBS) was used to evaluate self-perceived burden before surgery and at 3 days after surgery, American Knee Society knee score (AKS) was used to measure the active and passive activity of knee joints and the knee visual analogue score (VAS) was used to evaluate the knee rehabilitation in the two groups at 1 day and 2 weeks after surgery. Nursing Outcomes Classification-Patient Satisfaction Survey Scale was used to investigate nursing satisfaction of patients before discharge in two groups. MOS 36-Item Short Form Health Survey (SF-36) was used to assess the quality of life in the two group before surgery and at 3 days after surgery.Results:At 3 days after surgery, SPBS scores in the two groups were significantly decreased compared with those before surgery, and the score in the observation group were significantly lower than that in control group ( P<0.05) . AKS score at 1 day and 2 weeks after surgery in observation group were respectively (27.26±6.81) and (103.26±15.22) , which were significantly higher than (24.28±5.68) and (95.32±10.83) in the control group ( P<0.05) . The active range of knee joint motion and passive range of knee joint motion at 1 day and 2 weeks after surgery in the observation group were respectively (47.66±9.22) °, (81.23±14.22) ° and (64.23±12.22) °, (89.23±14.26) °, which were significantly greater than (42.25±8.59) °, (72.26±12.52) ° and (58.26±10.12) °, (78.26±13.10) ° in the control group ( P<0.05) . VAS scores at 1 day and 2 weeks after surgery in the observation group were respectively (5.29±0.82) and (3.46±0.77) , which were significantly lower than (5.91±0.88) and (4.22±0.98) in the control group ( P<0.05) . The improvements in AKS score, active and passive knee motion range and VAS score at 2 weeks after operation in both groups were greater than 1 day after operation ( P<0.05) . The nursing satisfaction scores of communication, safety, nursing technology, nursing, guidance and physical environment and total score of satisfaction in observation group were significantly higher than those in the control group ( P<0.05) . At 3 days after surgery, scores of physical functioning, physical role, body pain, general health, vitality, social function, emotional function and mental health of SF-36 in the two groups were significantly increased compared with those before surgery ( P<0.05) , and the scores in observation group were higher than those in the control group ( P<0.05) . Conclusions:Application of NNN-linked nursing model in perioperative nursing of patients with hip-knee replacement can reduce the self-perceived burden, improve knee function and active and passive range of motion, relieve knee pain and improve nursing satisfaction and quality of life.