Schizophrenia (SZ) stands as a severe psychiatric disorder. This study applied diffusion tensor imaging (DTI) data in conjunction with graph neural networks to distinguish SZ patients from normal controls (NCs) and showcases the superior performance of a graph neural network integrating combined fractional anisotropy and fiber number brain network features, achieving an accuracy of 73.79% in distinguishing SZ patients from NCs. Beyond mere discrimination, our study delved deeper into the advantages of utilizing white matter brain network features for identifying SZ patients through interpretable model analysis and gene expression analysis. These analyses uncovered intricate interrelationships between brain imaging markers and genetic biomarkers, providing novel insights into the neuropathological basis of SZ. In summary, our findings underscore the potential of graph neural networks applied to multimodal DTI data for enhancing SZ detection through an integrated analysis of neuroimaging and genetic features.
Humans ; Schizophrenia/pathology* ; Diffusion Tensor Imaging/methods* ; Male ; Female ; Adult ; Brain/metabolism* ; Young Adult ; Middle Aged ; White Matter/pathology* ; Gene Expression ; Nerve Net/diagnostic imaging* ; Graph Neural Networks

BACKGROUND:Cannabidiol has anti-inflammatory,antioxidant,and other pharmacological effects,and has no mental activity,so the research in liver disease is increasing day by day,but its effect on transforming growth factor-β1/Smad signal transduction pathway in hepatic stellate cells is not clear.OBJECTIVE:To investigate the effect of cannabidiol on transforming growth factor-β1/Smad signal transduction pathway in hepatic stellate cells and its possible mechanism of anti-hepatic fibrosis.METHODS:(1)In vitro experiment:Rat hepatic stellate cell line(HSC-T6)was selected and cultured in six groups.The control group was routinely cultured for 24 hours.The simple drug group was cultured with cannabidiol for 24 hours.The modeling group was cultured with transforming growth factor β1 for 24 hours.The modeling+low-dose drug group,the modeling+high-dose drug group,and the modeling+positive control group were cultured with transforming growth factor β1 for 24 hours,1,5 μmol/L cannabidiol and silymarin were cultured for 24 hours.After culture,the mRNA expression of α-smooth muscle actin and type Ⅰ collagen,the levels of interleukin 1β and tumor necrosis factor α,and the protein expression of type Ⅰ collagen and transforming growth factor β1/Smad signal transduction pathway were detected in each group.(2)In vivo experiments:C57BL/6J mice were randomly divided into five groups with eight mice in each group.Models were not established in the sham operation group.The liver fibrosis models were established by biliary ligation in the modeling group,the modeling+low-dose drug group,the modeling+high-dose drug group,and the modeling+positive control group.At 3 weeks after the modeling,4,8 mg/kg cannabidiol or silymarin were injected intraperitoneally,once a day,for 7 consecutive days.After administration,the liver function,liver pathological morphology,expression levels of α-smooth muscle actin,type Ⅰ collagen,and transforming growth factor β1/Smad signal transduction pathway related protein were detected in each group.RESULTS AND CONCLUSION:(1)In vitro experiment:Compared with the control group,mRNA expression of α-smooth muscle actin and type Ⅰ collagen,interleukin 1β and tumor necrosis factor α,and protein expression of type Ⅰ collagen,transforming growth factor β1 and p-Smad2/3 in HSC-T6 cells were increased(P<0.05),while Smad7 protein expression was decreased(P<0.05)in the modeling group.Two doses of cannabidiol could improve the above changes in HSC-T6 cells induced by transforming growth factor β1,and the improvement was more obvious in the modeling+high-dose drug group.(2)In vivo experiment:Compared with sham operation group,the activities of serum alanine aminotransferase and aspartate aminotransferase were increased(P<0.05),inflammatory cell infiltration and collagen content in liver tissue were increased(P<0.05),and the transforming growth factor β1/Smad signal transduction pathway was activated;α-smooth muscle actin and type Ⅰ collagen expression levels were increased(P<0.05)in the modeling group.Two doses of cannabidiol could reduce the changes of the above indexes in the modeling mice,and the effect was more obvious in the modeling+high-dose drug group.(3)It is indicated that cannabidiol inhibits hepatic fibrosis by suppressing the activation of transforming growth factor-β1/Smad signal transduction pathway in hepatic stellate cells.

Chronic diseases constitute one of the most significant public health challenges globally.Addressing the coexistence of chronic conditions and fostering the development of positive adaptive behaviors is of utmost importance in enhancing self-management skills and healthcare outcomes.Selecting an appropriate theoretical model can offer valuable research insights and a robust framework for anticipating and intervening in patients' adaptive behaviors. Therefore, this paper summarizes the application of theoretical models pertinent to adaptive behaviors in patients with chronic diseases. It conducts a thorough analysis of the strengths and weaknesses of each theoretical model, considering aspects such as theoretical development, target application population, nursing interventions, and effect evaluation. Additionally, it proposes future prospects for the application of these models.In order to enhance awareness of disease adaptive behaviors and provide valuable insights for promoting the development and implementation of comprehensive health lifecycle care plans for chronic diseases.

BACKGROUND:Cannabidiol has anti-inflammatory,antioxidant,and other pharmacological effects,and has no mental activity,so the research in liver disease is increasing day by day,but its effect on transforming growth factor-β1/Smad signal transduction pathway in hepatic stellate cells is not clear.OBJECTIVE:To investigate the effect of cannabidiol on transforming growth factor-β1/Smad signal transduction pathway in hepatic stellate cells and its possible mechanism of anti-hepatic fibrosis.METHODS:(1)In vitro experiment:Rat hepatic stellate cell line(HSC-T6)was selected and cultured in six groups.The control group was routinely cultured for 24 hours.The simple drug group was cultured with cannabidiol for 24 hours.The modeling group was cultured with transforming growth factor β1 for 24 hours.The modeling+low-dose drug group,the modeling+high-dose drug group,and the modeling+positive control group were cultured with transforming growth factor β1 for 24 hours,1,5 μmol/L cannabidiol and silymarin were cultured for 24 hours.After culture,the mRNA expression of α-smooth muscle actin and type Ⅰ collagen,the levels of interleukin 1β and tumor necrosis factor α,and the protein expression of type Ⅰ collagen and transforming growth factor β1/Smad signal transduction pathway were detected in each group.(2)In vivo experiments:C57BL/6J mice were randomly divided into five groups with eight mice in each group.Models were not established in the sham operation group.The liver fibrosis models were established by biliary ligation in the modeling group,the modeling+low-dose drug group,the modeling+high-dose drug group,and the modeling+positive control group.At 3 weeks after the modeling,4,8 mg/kg cannabidiol or silymarin were injected intraperitoneally,once a day,for 7 consecutive days.After administration,the liver function,liver pathological morphology,expression levels of α-smooth muscle actin,type Ⅰ collagen,and transforming growth factor β1/Smad signal transduction pathway related protein were detected in each group.RESULTS AND CONCLUSION:(1)In vitro experiment:Compared with the control group,mRNA expression of α-smooth muscle actin and type Ⅰ collagen,interleukin 1β and tumor necrosis factor α,and protein expression of type Ⅰ collagen,transforming growth factor β1 and p-Smad2/3 in HSC-T6 cells were increased(P<0.05),while Smad7 protein expression was decreased(P<0.05)in the modeling group.Two doses of cannabidiol could improve the above changes in HSC-T6 cells induced by transforming growth factor β1,and the improvement was more obvious in the modeling+high-dose drug group.(2)In vivo experiment:Compared with sham operation group,the activities of serum alanine aminotransferase and aspartate aminotransferase were increased(P<0.05),inflammatory cell infiltration and collagen content in liver tissue were increased(P<0.05),and the transforming growth factor β1/Smad signal transduction pathway was activated;α-smooth muscle actin and type Ⅰ collagen expression levels were increased(P<0.05)in the modeling group.Two doses of cannabidiol could reduce the changes of the above indexes in the modeling mice,and the effect was more obvious in the modeling+high-dose drug group.(3)It is indicated that cannabidiol inhibits hepatic fibrosis by suppressing the activation of transforming growth factor-β1/Smad signal transduction pathway in hepatic stellate cells.

Chronic diseases constitute one of the most significant public health challenges globally.Addressing the coexistence of chronic conditions and fostering the development of positive adaptive behaviors is of utmost importance in enhancing self-management skills and healthcare outcomes.Selecting an appropriate theoretical model can offer valuable research insights and a robust framework for anticipating and intervening in patients' adaptive behaviors. Therefore, this paper summarizes the application of theoretical models pertinent to adaptive behaviors in patients with chronic diseases. It conducts a thorough analysis of the strengths and weaknesses of each theoretical model, considering aspects such as theoretical development, target application population, nursing interventions, and effect evaluation. Additionally, it proposes future prospects for the application of these models.In order to enhance awareness of disease adaptive behaviors and provide valuable insights for promoting the development and implementation of comprehensive health lifecycle care plans for chronic diseases.

Objective:To analyze the effect of analysis plan, do, check, and action (PDCA) cycle in improving the completion rate of sepsis bundle treatment in sepsis patients and the knowledge-attitude-practice of sepsis bundle treatment in medical staff.Methods:Using the historical control method, sepsis patients admitted to the Emergency Trauma Intensive Care Unit of Shandong Provincial Hospital Affiliated to Shandong First Medical University were selected as the research objects by convenience sampling. The 35 patients admitted from January to December 2021 will be included in the control group; from June 2022 to June 2023, 28 patients were admitted to the observation group. The control group received routine nursing care, while the observation group received intervention based on the PDCA cycle. The completion rate of sepsis bundle treatment before and after PDCA cycle implementation was compared. The 27 nurses and 5 doctors working in trauma care unit were investigated by using a self-designed questionnaire on their knowledge and practice level of sepsis bundle treatment. The completion rate of sepsis bundle treatment before and after the implementation of PDCA cycle was compared.Results:The control group included 19 males and 16 females, aged (61.77 ± 8.64) years. The observation group included 13 males and 15 females, aged (60.61 ± 10.20) years. After the implementation of PDCA cycle, the completion rate of 3h bundle treatment for sepsis in the observation group was 89.29% (25/28), which was higher than 31.42% (10/35) in the control group, with a statistically significant difference ( χ2=23.22, P<0.05). The completion rate of sepsis bundle treatment within 6 hours in the observation group was 11/11, which was higher than 5/9 in the control group, with a statistically significant difference ( χ2=6.11, P<0.05). Moreover, after the implementation of PDCA cycle, the total score and sub-scale scores of the knowledge-attitude-practice among medical staffs increased from 86.60 ± 10.33, 21.00 ± 4.74, 18.00 ± 1.58, and 47.60 ± 4.10 to 100.00 ± 5.20, 27.60 ± 2.51, 19.60 ± 0.55, and 52.80 ± 2.28 respectively, with statistically significant differences ( t values were -5.10 - -3.14, all P<0.05). Conclusions:PDCA cycle can improve the completion rate of sepsis bundle treatment and improve the level of knowledge, attitude and practice of medical staff.

Objective:To explore the chain mediating effect of basic activity of daily living and nutritional status the effects on comorbidity and frailty, so as to provide guidance for preventing and delaying the frailty of elderly patients with cardiovascular disease and abnormal glucose metabolism.Methods:The cross-sectional study method was adopted, 300 elderly patients with cardiovascular disease and abnormal glucose metabolism who were hospitalized in the cardiovascular medicine ward of Shandong Provincial Hospital Affiliated to Shandong First Medical University, were selected as the study objects from January to August 2022, and were surveyed using General Information Questionnaire, Frailty Scale, Charlson Comorbidity Index Scale, Barthel Index Rating Scale and Mini Nutritional Assessment-Short Form were used to investigate them.Results:A total of 300 questionnaires were collected and 291 valid questionnaires were returned. Out of 291 patients, 167 were male and 124 were female, with an age of (69.55 ± 7.01) years. Comorbidities in elderly patients with cardiovascular disease and abnormal glucose metabolism were positively correlated with frailty ( r=0.414, P<0.01), and negatively correlated with basic activity of daily living and nutritional status ( r=-0.399, -0.373, both P<0.01). Basic activity of daily living was positively correlated with nutritional status ( r=0.575, P<0.01) and negatively correlated with frailty ( r=-0.825, P<0.01). Nutritional status was negatively correlated with frailty ( r=-0.695, P<0.01). The chain mediating model showed that comorbidities had a significant direct effect on frailty (effect value of 0.102), basic activity of daily living partially mediated between comorbidity and frailty (effect value of 0.125). Basic activity of daily living and nutritional status partially chained between comorbidity and frailty (effect value of 0.036). Conclusions:The chain mediating roles of basic activity of daily living and nutritional status between comorbidity and frailty was established. Healthcare professionals should pay attention to the improvement of basic activity of daily living in elderly patients with cardiovascular diseases and abnormal glucose metabolism, guide them to have a reasonable diet to achieve balanced nutrition, and delay the onset and development of frailties.

Respiratory syncytial virus (RSV) is an enveloped, negative-sense, single-stranded RNA virus of the Orthopneumovirus  genus of the Pneumoviridae family in the order Mononegavirales. RSV can cause acute upper and lower respiratory tract infections, sometimes with extrapulmonary complications. The disease burden of RSV infection is enormous, mainly affecting infants and older adults aged 75 years or above. Currently, treatment options for RSV are largely supportive. Prevention strategies remain a critical focus, with efforts centered on vaccine development and the use of prophylactic monoclonal antibodies. To date, three RSV vaccines have been approved for active immunization among individuals aged 60 years and above. For children who are not eligible for these vaccines, passive immunization is recommended. A newly approved prophylactic monoclonal antibody, Nirsevimab, which offers enhanced neutralizing activity and an extended half-life, provides exceptional protection for high-risk infants and young children. This review provides a comprehensive and detailed exploration of RSV's virology, immunology, pathogenesis, epidemiology, clinical manifestations, treatment options, and prevention strategies.
Humans ; Respiratory Syncytial Virus Infections/prevention & control* ; Respiratory Syncytial Viruses/pathogenicity* ; Respiratory Syncytial Virus, Human/pathogenicity* ; Antiviral Agents/therapeutic use*

OBJECTIVE: To observe the ferroptosis triggered by in different pathways during cecal ligation and puncture (CLP)-induced liver injury in septic mice, and to investigate whether mitochondrial aldehyde dehydrogenase 2 (ALDH2) can alleviate sepsis-induced liver injury by inhibiting ferroptosis. METHODS: Sixty 8-week-old male C57BL/6J mice were randomly divided into sham operation group (Sham group), CLP group, ferroptosis inhibitor ferrostain-1 (Fer-1) group, ALDH2-specific agonist Alda-1 group, iron chelator deferasirox Fe³⁺ chelate (DXZ) group and dimethyl sulfoxide (DMSO) group, with 10 mice in each group. The septic liver injury was induced by CLP in mice model. In the Sham group, only laparotomy was performed without ligation and puncture of the cecum. 10 mL/kg 5% DMSO, 5 mg/kg Fer-1, 50 mg/kg DXZ and 10 mg/kg Alda-1 were injected intraperitoneally 1 hour before CLP in the DMSO, Fer-1, DXZ and Alda-1 groups respectively. At 24 hours after operation, eyeball blood and liver tissue were collected from anesthetized mice. The hepatic structure and inflammatory infiltration were observed by hematoxylin-eosin (HE) staining. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) in serum, the levels of hepatic malondialdehyde (MDA), superoxide dismutase (SOD) and reactive oxygen species (ROS) were detected. Western blotting was used to detect the protein expressions of ALDH2, ferroptosis-related proteins glutathione peroxidase 4 (GPX4), ferroptosis suppressor protein 1 (FSP1) and transferrin receptor 1 (TFR1) in liver tissue. RESULTS: Compared with Sham group, the mice in CLP group showed varying degrees of congestion, disorganized hepatocyte arrangement, inflammatory cell infiltration at 24 hours after operation. Compared with the CLP group, the mice in the Fer-1 group, DXZ group and Alda-1 group liver morphology, liver injury and inflammatory cell infiltration was improved. Compared with Sham group, the serum levels of ALT and AST, the contents of MDA and ROS, and the expression of TFR1 protein in CLP group were significantly increased, while the activity of SOD and the expressions of ALDH2, GPX4 and FSP1 protein in CLP group were significantly decreased. Compared with CLP group, serum ALT and AST levels in Fer-1, DXZ and Alda-1 groups were significantly decreased [ALT (U/L): 45.76±10.81, 37.30±2.98, 36.40±12.75 vs. 73.06±12.20, AST (U/L): 61.57±2.69, 52.41±6.92, 56.05±8.29 vs. 81.59±5.46, all P < 0.05], and the contents of MDA, ROS and TFR1 protein expression in liver tissue were significantly decreased [MDA (μmol/L): 0.60±0.10, 0.57±0.18, 0.83±0.39 vs. 1.61±0.30, ROS (fluorescence intensity): 270.34±9.64, 276.02±62.33, 262.05±18.55 vs. 455.38±36.07, TFR1/GAPDH: 0.90±0.04, 1.01±0.09, 0.55±0.08 vs. 1.18±0.06, all P < 0.05], and the SOD activity and ALDH2, GPX4 and FSP1 protein expressions in liver tissue were significantly increased [SOD (kU/g): 88.77±8.20, 88.37±4.47, 93.43±7.24 vs. 50.27±3.57, ALDH2/GAPDH: 1.10±0.15, 1.02±0.07, 1.14±0.07 vs. 0.70±0.04, GPX4/GAPDH: 1.02±0.12, 0.99±0.08, 1.05±0.19 vs. 0.71±0.10, FSP1/GAPDH: 1.06±0.24, 1.02±0.08, 0.93±0.09 vs. 0.66±0.03, all P < 0.05]. There was no significant difference in the parameters between DMSO group and CLP group. CONCLUSIONS Both GPX4 and FSP1 mediated ferroptosis are involved in liver injury in septic mice. Activation of ALDH2 and inhibition of ferroptosis can alleviatehepatic injury. ALDH2 may play a protective role by regulating FSP1 and GPX4 mediated ferroptosis.
Mice ; Male ; Animals ; Aldehyde Dehydrogenase, Mitochondrial ; Ferroptosis ; Reactive Oxygen Species ; Chemical and Drug Induced Liver Injury, Chronic ; Dimethyl Sulfoxide ; Mice, Inbred C57BL ; Sepsis ; Disease Models, Animal

Objective:To explore the path relationship among medical narrative competence and profession quality of life on professional identity of nurses, so as to provide reference for improving nurses ′professional identity. Methods:This study was across-sectional survey. From October 2022 to February 2023, totally 619 nurses in Shandong Provincial Hospital Affiliated to Shandong First Medical University were investigated using Self-designed Demographic Questionnaire, Medical Narrative Competence Scale, Professional Quality of Life Scale and Professional Identity Scale.Results:The score of nurses ′s medical narrative competence was (144.13 ± 22.09) points, compassion satisfaction was (34.82 ± 6.96) points, job burnout was (24.03 ± 5.48) points, secondary traumatic stress was (23.91 ± 5.89) points, and the scores of nurses ′ professional identity was (112.68 ± 19.05) points. Nurses ′ medical narrative competence was positively correlated with compassion satisfaction and professional identity ( r=0.585, 0.697, both P<0.01); nurses ′ medical narrative competence was negatively correlated with job burnout and secondary traumatic stress ( r=-0.516, -0.214, both P<0.01). Regression analysis showed that nurses ′ medical narrative ability, compassion satisfaction and job burnout were the influencing factors of nurses ′professional identity ( t=13.26, 10.52, -2.32, all P<0.05). Structural equation model indicated that medical narrative ability of nurses had an intermediary effect on professional identity through the dimension of compassion satisfaction, and the intermediary effect was 0.269, and the intermediary effect accounted for 36.88% of the total effect. Conclusions:Medical narrative ability of nurses can have positive emotional experience on nurses ′ psychology, and thus have an impact on professional identity. Nursing managers should pay attention to the level of nurses ′ medical satisfaction, and give full play to the intermediary effect of compassion satisfaction in nurses ′ medical narrative ability and professional identity.