Objective To explore the associations among smoking behavior,cognitive function,and personality traits in first-episode male patients with schizophrenia,thereby providing theoretical underpinnings for individualized treatment strategies in clinical settings.Methods A total of 140 first-episode male inpatients with schizophrenia admitted to the hospital from January 2022 to December 2023 were recruited.According to their smoking behavior,they were categorized into a smoking group(n=80)and a non-smoking group(n=60).Moreover,healthy controls were recruited and classified into a healthy smoking group(n=62)and a healthy non-smoking group(n=67)based on their smoking status.The Positive and Negative Syndrome Scale(PANSS)was employed to evaluate psychiatric symptoms in the schizophrenia groups.Nicotine dependence was measured using the Fagerstr?m Test for Nicotine Dependence(FTND)in the two smoking groups.Cognitive function and personality traits were assessed in all participants using the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)and the Eysenck Personality Questionnaire(EPQ),respectively.Results Regarding cognitive function,the smoking group among schizophrenia patients demonstrated significantly higher scores than the non-smoking group in immediate memory,attention,and delayed memory(all P<0.05).Among schizophrenia patients,FTND scores were moderately negatively correlated with attention and delayed memory(r=-0.552 and-0.657 respectively;both P<0.001).Concerning personality traits,smokers had significantly higher scores in neuroticism and psychoticism compared to non-smokers(both P<0.001).Both patient groups had significantly lower lie scale scores when contrasted with healthy controls(P<0.01),while the healthy smoking group showed significantly higher extraversion scores than the other groups.Conclusions The smoking behavior of male patients during their first episode of schizophrenia exhibits specific characteristics in relation to cognitive performance and personality traits.Smokers demonstrate relatively superior performance in cognitive domains including attention,immediate memory,and delayed memory.However,higher degrees of nicotine dependence are associated with poorer cognitive function,especially in the aspects of attention and delayed memory.Regarding personality,smoking patients display elevated levels of neuroticism and psychoticism.These findings indicate that smoking behavior may be closely associated with cognitive functioning and personality traits,thus meriting clinical attention in the management of schizophrenia.

Objective:To evaluate strategies for screening and diagnosing Lynch syndrome associated endom-etrial carcinoma(LS-EC)in clinical practice and analyze clinicopathological characteristics of LS-EC.Methods:A total of 258 patients with endometrial carcinoma who underwent surgery in The Fourth Hospital of Hebei Medical University from January 2019 to January 2022 were included.All enrolled patients underwent postoperative immu-nohistochemical testing for mismatch repair(MMR)proteins.Based on the expression status of the four MMR proteins,the patients were divided into deficient mismatch repair(d-MMR)group(57 cases)and proficient mis-match repair(p-MMR)group(201 cases).Among them,23 patients in the d-MMR group underwent germline gene testing for Lynch syndrome(LS).According to germline gene testing results,these patients were further classified into LS-EC(n=8)and non-LS-EC(n=15)groups.Clinicopathological features of LS-EC patients were analyzed.Results:Among the 258 endometrial carcinoma patients,57cases(22.1%)exhibited d-MMR,with MLH1 and PMS2 co-deletion being the most common(61.4%,35/57).Among the23 d-MMR patients who under-went genetic testing,8 cases(34.8%)were identified as having LS-EC,including 5 cases(62.5%)of MLH1 gene mutation,1 case(12.5%)of MSH2 gene mutation,1 case(12.5%)of PMS2 gene mutation and 1 case(12.5%)of MSH6 gene mutation.Compared with the non-LS-EC group,the LS-EC patients showed significant familial aggregation and higher pathological grade(P<0.05).Conclusions:Immunohistochemical analysis of MMR proteins combined with family history represents an effective screening strategy for LS-EC,however defini-tive diagnosis requires germline genetic testing.Among LS-EC cases,MLH1 is the most frequently mutated gene.LS-EC patients are characterized by familial clustering and high pathological grade.Discrepancies between immu-nohistochistochemistry and genetic testing results present challenges in the definitive diagnosis of LS-EC.

Objective:To explore the values of reticulin fiber staining (RFS) in evaluating bone marrow (BM) involvement of lymphoma and in grading of BM biopsy from adult lymphoma patients.Methods:Retrospectively,354 cases of adult lymphoma were collected from November 2023 to May 2024 at Peking University Cancer Hospital. BM samples were stained with RFS and immunohistochemical staining (IHC), and flow cytometry (FCM) was also performed with the BM aspirations simultaneously. RFS was graded according to the European Consensus, as high grade (grade 2-3) indicating BM involvement in the study. BM involvement was considered as definite if no less than two positive findings among IHC, FCM, and RFS. Statistical analyses were performed via SPSS software (V23.0).Results:In this series, 52.3% (185/354) of the patients were male; 35.0% (124/354) aged >60 years; BM involvements were found in 34.5% (122/354) cases with high grade of RFS, which, in turn, were lymphoblastic leukemia/lymphoma (ALL/LBL) group (4/4), indolent B-cell lymphoma (IndBCL) group (49.1%, 53/108), transformed B-cell lymphoma (TrBCL) group (2/5), invasive B-cell lymphoma (InvBCL) group (26.5%, 41/155), T and NK cell lymphoma (TNKCL) group (27.3%, 12/44) and classical Hodgkin lymphoma (CHL) group (26.3%, 10/38); if classified by specific types, T-ALL/LBL (2/2), B-ALL/LBL (2/2) and CLL/SLL (8/10) ranked top three. In terms of the positive rate of BM involvement evaluated by RFS, no significant difference was seen between either gender or age groups ( χ2=3.416, P=0.332 and χ2=4.200, P=0.241); however, significant differences were observed between different lymphoma groups and types ( χ2=29.961, P=0.012 and χ2=102.546, P<0.001, respectively). BM invasion rates indicated by IHC and FCM were 25.4% (90/354) and 13.8% (49/354), respectively. The overall BM invasion rate was 24.3% (86/354), and the sensitivity of RFS, IHC, and FCM was 90.8%, 97.8%, and 55.8%, and specificity was 84.1%, 99.6%, and 98.9%, respectively. Overall, the concordance rate of RFS with IHC and FCM was 83.6% and 74.0%, respectively, including 85.8% and 74.2% for InvBCL group, 79.6% and 75.0% for IndBCL group, 84.1% and 75.0% for TNKCL group, 81.6% and 73.7% for CHL group, 5/5 and 2/5 for TrBCL group, and 4/4 and 3/4 for ALL/LBL group. Conclusions:In the evaluation of BM involvement status of adult lymphoma, high sensitivity and specificity are observed by RFS, and high concordance is also noted with both IHC and FCM. Thus, the BM infiltrating status of adult lymphoma could be evaluated more accurately by a combined usage of the three methods.

Objective:To evaluate strategies for screening and diagnosing Lynch syndrome associated endom-etrial carcinoma(LS-EC)in clinical practice and analyze clinicopathological characteristics of LS-EC.Methods:A total of 258 patients with endometrial carcinoma who underwent surgery in The Fourth Hospital of Hebei Medical University from January 2019 to January 2022 were included.All enrolled patients underwent postoperative immu-nohistochemical testing for mismatch repair(MMR)proteins.Based on the expression status of the four MMR proteins,the patients were divided into deficient mismatch repair(d-MMR)group(57 cases)and proficient mis-match repair(p-MMR)group(201 cases).Among them,23 patients in the d-MMR group underwent germline gene testing for Lynch syndrome(LS).According to germline gene testing results,these patients were further classified into LS-EC(n=8)and non-LS-EC(n=15)groups.Clinicopathological features of LS-EC patients were analyzed.Results:Among the 258 endometrial carcinoma patients,57cases(22.1%)exhibited d-MMR,with MLH1 and PMS2 co-deletion being the most common(61.4%,35/57).Among the23 d-MMR patients who under-went genetic testing,8 cases(34.8%)were identified as having LS-EC,including 5 cases(62.5%)of MLH1 gene mutation,1 case(12.5%)of MSH2 gene mutation,1 case(12.5%)of PMS2 gene mutation and 1 case(12.5%)of MSH6 gene mutation.Compared with the non-LS-EC group,the LS-EC patients showed significant familial aggregation and higher pathological grade(P<0.05).Conclusions:Immunohistochemical analysis of MMR proteins combined with family history represents an effective screening strategy for LS-EC,however defini-tive diagnosis requires germline genetic testing.Among LS-EC cases,MLH1 is the most frequently mutated gene.LS-EC patients are characterized by familial clustering and high pathological grade.Discrepancies between immu-nohistochistochemistry and genetic testing results present challenges in the definitive diagnosis of LS-EC.

Objective:To explore the values of reticulin fiber staining (RFS) in evaluating bone marrow (BM) involvement of lymphoma and in grading of BM biopsy from adult lymphoma patients.Methods:Retrospectively,354 cases of adult lymphoma were collected from November 2023 to May 2024 at Peking University Cancer Hospital. BM samples were stained with RFS and immunohistochemical staining (IHC), and flow cytometry (FCM) was also performed with the BM aspirations simultaneously. RFS was graded according to the European Consensus, as high grade (grade 2-3) indicating BM involvement in the study. BM involvement was considered as definite if no less than two positive findings among IHC, FCM, and RFS. Statistical analyses were performed via SPSS software (V23.0).Results:In this series, 52.3% (185/354) of the patients were male; 35.0% (124/354) aged >60 years; BM involvements were found in 34.5% (122/354) cases with high grade of RFS, which, in turn, were lymphoblastic leukemia/lymphoma (ALL/LBL) group (4/4), indolent B-cell lymphoma (IndBCL) group (49.1%, 53/108), transformed B-cell lymphoma (TrBCL) group (2/5), invasive B-cell lymphoma (InvBCL) group (26.5%, 41/155), T and NK cell lymphoma (TNKCL) group (27.3%, 12/44) and classical Hodgkin lymphoma (CHL) group (26.3%, 10/38); if classified by specific types, T-ALL/LBL (2/2), B-ALL/LBL (2/2) and CLL/SLL (8/10) ranked top three. In terms of the positive rate of BM involvement evaluated by RFS, no significant difference was seen between either gender or age groups ( χ2=3.416, P=0.332 and χ2=4.200, P=0.241); however, significant differences were observed between different lymphoma groups and types ( χ2=29.961, P=0.012 and χ2=102.546, P<0.001, respectively). BM invasion rates indicated by IHC and FCM were 25.4% (90/354) and 13.8% (49/354), respectively. The overall BM invasion rate was 24.3% (86/354), and the sensitivity of RFS, IHC, and FCM was 90.8%, 97.8%, and 55.8%, and specificity was 84.1%, 99.6%, and 98.9%, respectively. Overall, the concordance rate of RFS with IHC and FCM was 83.6% and 74.0%, respectively, including 85.8% and 74.2% for InvBCL group, 79.6% and 75.0% for IndBCL group, 84.1% and 75.0% for TNKCL group, 81.6% and 73.7% for CHL group, 5/5 and 2/5 for TrBCL group, and 4/4 and 3/4 for ALL/LBL group. Conclusions:In the evaluation of BM involvement status of adult lymphoma, high sensitivity and specificity are observed by RFS, and high concordance is also noted with both IHC and FCM. Thus, the BM infiltrating status of adult lymphoma could be evaluated more accurately by a combined usage of the three methods.

Objective To explore the associations among smoking behavior,cognitive function,and personality traits in first-episode male patients with schizophrenia,thereby providing theoretical underpinnings for individualized treatment strategies in clinical settings.Methods A total of 140 first-episode male inpatients with schizophrenia admitted to the hospital from January 2022 to December 2023 were recruited.According to their smoking behavior,they were categorized into a smoking group(n=80)and a non-smoking group(n=60).Moreover,healthy controls were recruited and classified into a healthy smoking group(n=62)and a healthy non-smoking group(n=67)based on their smoking status.The Positive and Negative Syndrome Scale(PANSS)was employed to evaluate psychiatric symptoms in the schizophrenia groups.Nicotine dependence was measured using the Fagerstr?m Test for Nicotine Dependence(FTND)in the two smoking groups.Cognitive function and personality traits were assessed in all participants using the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)and the Eysenck Personality Questionnaire(EPQ),respectively.Results Regarding cognitive function,the smoking group among schizophrenia patients demonstrated significantly higher scores than the non-smoking group in immediate memory,attention,and delayed memory(all P<0.05).Among schizophrenia patients,FTND scores were moderately negatively correlated with attention and delayed memory(r=-0.552 and-0.657 respectively;both P<0.001).Concerning personality traits,smokers had significantly higher scores in neuroticism and psychoticism compared to non-smokers(both P<0.001).Both patient groups had significantly lower lie scale scores when contrasted with healthy controls(P<0.01),while the healthy smoking group showed significantly higher extraversion scores than the other groups.Conclusions The smoking behavior of male patients during their first episode of schizophrenia exhibits specific characteristics in relation to cognitive performance and personality traits.Smokers demonstrate relatively superior performance in cognitive domains including attention,immediate memory,and delayed memory.However,higher degrees of nicotine dependence are associated with poorer cognitive function,especially in the aspects of attention and delayed memory.Regarding personality,smoking patients display elevated levels of neuroticism and psychoticism.These findings indicate that smoking behavior may be closely associated with cognitive functioning and personality traits,thus meriting clinical attention in the management of schizophrenia.

Objective:To explore the patterns of failure after postoperative intensity-modulated radiotherapy for gastric cancer.Methods:Clinical data of patients diagnosed with gastric cancer or gastroesophageal junction carcinoma with pathological stages T 3-4N 0 or T xN 1-3 admitted to Cancer Hospital of Chinese Academy of Medical Sciences from May 2009 to December 2018 were retrospectively analyzed. All patients received postoperative radiotherapy. During the follow-up, tumor recurrence was confirmed by imaging or endoscopic or pathological data, etc. According to the location of tumor recurrence, recurrence patterns were divided into local, regional and distant recurrence. Differences in recurrence patterns among different groups were compared using t-test and Chi-square test. Patient survival was assessed through Kaplan-Meier method. Results:A total of 76 patients were enrolled, with a median age of 49 years old (27-67 years old), 34 cases (45%) were classified as T 3 stage, 40 cases (53%) of T 4 stage, and 75 cases (99%) of N 1-3 stage, respectively. Seventy-three patients (92%) were classified as stage Ⅲ, and 38 patients (50%) underwent D2 dissection. The median follow-up time was 32.8 months (7.1-138.5 months). The median time of recurrence was 17.6 months (2.9-113.6 months). The median survival time after recurrence was 8.19 months (0.6-91.9 months). There were 13 cases (17%) of local recurrence, 6 cases (8%) of regional recurrence, and 72 cases (95%) of distant metastasis in patients. Peritoneal metastasis (33 cases, 43%) and distant lymph node metastasis (12 cases, 16%) were the main patterns of distant recurrence. Conclusions:By intensity-modulated radiotherapy technology, adjuvant radiotherapy yields favorable local and regional control for gastric cancer. Distant metastasis is still the main pattern of recurrence.

Objective:To analyze clinical efficacy of intensity-modulated chemoradiotherapy for patients with anal squamous cell carcinoma and identify prognostic factors.Methods:Clinical data of patients with anal squamous cell carcinoma who received intensity-modulated chemoradiotherapy in the Cancer Hospital of Chinese Academy of Medical Sciences from January 1, 2010 to January 1, 2022 were retrospectively analyzed. Regular follow-up was carried out. The main indexes included disease-free survival (DFS), locoregional failure-free survival (LRFFS) and overall survival (OS), and adverse reactions were recorded. The survival curve was delineated by Kaplan-Meier method and the influencing factors of survival were analyzed by Cox regression models.Results:A total of 65 patients were enrolled with 19 (29%) males and 46 (71%) females. According to the American Joint Committee on Cancer (AJCC) 7 th edition staging, there were 7 (11%), 28 (43%), 10 (15%), and 20 (31%) patients with stage I, II, IIIa, and IIIb, respectively. Before the chemoradiotherapy, 2 (3%) patients received chemotherapy and 12 (18%) patients received local resection. The median dose of radiotherapy was 54 Gy (range: 45-64 Gy) and the main concurrent chemotherapy regimen was capecitabine combined with cisplatin ( n=34, 52%). The completion rate of radiotherapy during concurrent chemoradiotherapy was 100%, and the chemotherapy completion rate was 88%. During the therapy, 5 patients (8%) were interrupted but completed concurrent chemoradiotherapy in full dose, and 8 patients (12%) reduced the dose of concurrent chemotherapy due to the toxicities. During the chemoradiotherapy, 15 cases (23%) experienced grade 3-4 leukopenia, and 17 cases (26%) experienced grade 3-4 radiation dermatitis. No treatment-related death occurred during the treatment. The median follow-up time was 50.4 months (range: 4.4-142.2 months), local recurrence occurred in 7 cases (11%), distant metastasis occurred in 3 cases (5%), and the 5-year DFS, LRFFS and OS rates were 78.8%, 86.5% and 85.1%, respectively. Cox univariate analysis indicated that T stage was significantly associated with DFS ( P=0.006), and tended to be associated with OS ( P=0.054). Conclusions:Intensity-modulated radiotherapy combined with concurrent chemotherapy is an effective treatment for anal squamous cell carcinoma, with tolerable acute toxicities. T stage is an influencing factor of DFS in anal squamous cell carcinoma patients.

Objective:To investigate the effect of growth hormone (GH) pretreatment on in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) in women with poor ovarian reserve. Methods:A retrospective cohort study was conducted to analyze the clinical data of women who underwent IVF/ICSI-ET with gonadotropin-releasing hormone (GnRH) antagonist protocol in Reproductive Medicine Center of Peking University Third Hospital from October 2018 to October 2019. Patients with poor ovarian reserve belong POSEIDON group 3 or POSEIDON group 4 were included as the research objects and were divided into GH group ( n=103) and control group ( n=197) by pretreated with GH or not. GH group received 2 U/d subcutaneous injection of GH for 4 weeks before ovulation induction, and the dosage was adjusted to 4 U/d until the trigger day during ovulation induction. GH was not used in control group. The clinical outcomes of the two groups were analyzed and compared. Results:There were no significant differences in general condition between GH group and control group including age, infertility duration, body mass index (BMI), anti-Müllerian hormone (AMH), basal follicle-stimulating hormone (FSH) and antral follicle count (AFC, all P>0.05). No significant differences were found in the duration of gonadotropin (Gn) used, total dosage of Gn used, estrogen levels and the endometrial thickness on human chorionic hormone (hCG) injection day between the two groups (all P>0.05). Furthermore, no statistically significant difference was found in the number of oocytes retrieved between GH group and control group ( P>0.05). The number of available embryos in GH group (2.62±2.41) was significantly higher than that in control group (1.51±1.56, P<0.001). There were 56 fresh embyo transfer cycles in GH group and 106 fresh embyo transfer cycles in control group. There were no statistically significant differences in endometrial thickness on fresh embyo transfer day and the number of embryos transferred between GH group and control group (all P>0.05). No statistically significant differences were found in clinical pregnancy rate, miscarriage rate and live delivery rate after fresh embyo transferred between the two groups (all P>0.05). Conclusion:GH pretreatment for 4 weeks before controlled ovarian sitmulation and continued use till the trigger day may improve number of the available embryos in poor ovarian reserve patients with GnRH antagonist.

Practice teaching is an important link in the training of public health talents in colleges and universities. At present, there are still some problems in the education of public health and preventive medicine in the colleges and universities in China, such as attaching greater importance to theory than to practice and weak training of practical skills among students. In view of this situation, a public health practice teaching model of "internal-external interactions" has been constructed in Dalian Medical University with focuses on the following aspects: ①experiments in the university are optimized based on social needs; ②the practice base outside the university is expanded based on the teaching in the university; ③"internal-external interactions" are adopted to enhance practice training and improve post competence. The teaching practice shows that the implementation of the teaching model of "internal-external interactions" can help to improve practice teaching ability, promote the improvement in the training quality of public health talents, and meet the social demand for application-oriented professionals.