Attenuated psychosis syndrome(APS)is a clinical disorder associated with a high risk of psychosis.Patients during this period typically exhibit multidimensional neurocognitive and social cognitive impairment.Cognitive impairment in APS patients is associated with structural and functional abnormalities in the frontal,temporal and subcortical brain regions.At present,drug therapy,psychotherapy,nutritional therapy and computer cognitive training are mainly used to improve the cognitive function of APS patients.In the future,we could comprehensively utilize brain imaging,electrophysiology,and molecular imaging to deeply explore the neuropathological mechanism of APS cognitive impairment,and combine computer,virtual reality,and artificial intelligence to develop new cognitive function intervention procedures,in order to achieve APS precise prevention and treatment.

Objective To explore the application value of telmisartan combined with calcium dobesilate in patients with non-dipper hypertension complicated with type 2 diabetes mellitus(T2DM).Methods A total of 260 patients with non-dipper hypertension complicated with T2DM in the endocrinology department of our hospital were selected in this study from January 2021 to December 2022.All the patients were randomly divided into telmisartan group(Tel,n=110)and telmisartan+calcium dobesilate group(Tel+Cal-dob,n=150).The blood pressure level,blood pressure rhythm changes,brachial flow mediated dilatation(FMD),carotid radial pulse wave velocity(crPWV),vasomotor factors[nitric oxide(NO),endothelin-1(ET-1),vascular endothelial growth factor(VEGF)]and the incidence of adverse reactions were compared between the two groups.Results There was no significant difference in general data and biochemical indexes between the two groups(P>0.05).After 3,6 and 12 months of treatment,the FMD and NO were higher,while the dSBP,dDBP,24 hSBP,24 hDBP,nSBP,nDBP,crPWV,ET-1 and VEGF were lower than before treatment in both groups(P<0.05).After 3,6 and 12 months of treatment,the FMD and NO were higher,while dSBP,dDBP,24 hSBP,24 hDBP,nSBP,nDBP,crPWV,ET-1 and VEGF were lower in Tel+Cal-dob group than in Tel group(P<0.05).After 3,6 and 12 months of treatment,the conversion rates of dipper blood pressure were higher in Tel+Cal-dob groupthan in Tel group(P<0.05).There was no significant difference in the incidence of adverse effects between the two groups(P>0.05).Conclusion Telmisartan combined with calcium dobesilate is effective in the treatment of patients with non-dipper hypertension complicated with T2DM.

Depression is one of the most common mental disorders in adolescents, with high recurrence rate and high suicide rate, seriously endangering the physical and mental health development of adolescents. Adolescent depression animal models can mimic the human depression phenotype, which can help to study the disease pathogenesis, find effective therapeutic targets, and develop new antidepressant drugs. Therefore, in order to screen animal models that better meet the experimental requirements, this paper reviews the articles on animal models of adolescent depression, comprehensively summarises and analyses the modelling methods and principles, strengths and weaknesses, and behavioural evaluations of the commonly used animal models of adolescent depression (stress models, genetic models, chemically-induced models, surgical injury models and composite models), and look forward to the development direction of animal models of depression in adolescence. It also looks forward to the development direction of adolescent depression animal models, aiming to better simulate the development of the disease, provide a variety of animal models for adolescent depression animal model related research, and lay the foundation for subsequent research.

The World Health Organization (WHO) classification serves as the internationally recognized standard for diagnosing and classifying hematopoietic and lymphoid tissue tumors(WHO-HEAM). Since 2001, it has undergone multiple upgrades and revisions, updating, clarifying, and refining previous tumor diagnostic and classification standards while incorporating numerous new genetic and molecular biological subtypes. In 2022, two classification proposals emerged due to a wealth of clinical and scientific research results: the fifth edition of the WHO hematopoietic and lymphoid tissue classification (WHO-HAEM5), published in Leukemia journal; and the International Consensus Classification (ICC), published in Blood journal. These two schemes differ in their approach to classifying hematopoietic and lymphoid tissue tumors, posing challenges for clinical laboratory diagnosis and treatment.

English for specific purpose (ESP) courses for the postgraduates in medical schools have both physical and social attributes, with emphasis to improve practical language learning of medical specialties. It's an effective way to develop the English language application ability of high-level medical college students by constructing an ESP teaching and learning ecological system with professional and social contextual characteristics. In this study, through design-based implementation research, scenario simulation class was designed and implemented to accomplish task-based language teaching and learning. Further discussions on how to integrate blended and interrelated classes, on how to define combined and interactive teachers' role were explored. Based on the teaching and learning practices, organically combining the innovative curriculum concept with the construction of ESP ecological system effectively directs the practical application of the ESP class under the perspective of learning science, and verifies the feasibility of the ecological construction of ESP curriculum system.

Objective:To explore the differences in therapeutic effect and prognosis of different molecular subtypes of breast invasive lobular carcinoma treated with nab-paclitaxel, so as to provide a basis for the selection of clinical drugs for breast cancer.Methods:The data of 180 patients with advanced invasive lobular carcinoma of the breast who were treated in Handan Central Hospital and the Fourth Hospital of Hebei Medical University from January 2017 to January 2020 were retrospectively analyzed, including 34 cases of Luminal A type, 92 cases of Luminal B type, 21 cases of human epidermal growth factor receptor 2 (HER2) overexpression type, and 33 cases of triple-negative type. The patients were treated with nab-paclitaxel, and the clinical curative effect was evaluated according to the solid tumor response evaluation criteria version 1.1 after 1 year of treatment, and the objective response rate (ORR) (calculated as complete remission + partial remission) and clinical benefit rate (CBR) (calculated as complete remission + partial remission + stable disease) were calculated; the occurrence of adverse reactions during the treatment was recorded. The Kaplan-Meier method was used to draw the progression-free survival (PFS) and overall survival (OS) curves for each subtype of patients, and the log-rank method was used to test them.Results:The differences in ORR and CBR among patients with the four subtypes of Luminal A, Luminal B, HER2 overexpression, and triple-negative were statistically significant (all P < 0.001), with the triple-negative type having the lowest ORR and CBR [21.2% (7/33) and 63.6% (21/33)] and the Luminal A type having the highest ORR and CBR [70.6% (24/34) and 100.0% (34/34)]. The ORR and CBR of Luminal B type were 45.7% (42/92) and 90.2% (83/92), and the HER2 overexpression type was 38.1% (8/21) and 90.5% (19/21). The differences in the incidence of myelosuppression, numbness of limbs, joint and muscle pain among the four subtypes were statistically significant (all P < 0.05), with the triple-negative type having the highest incidence of all of the above adverse reactions. The PFS and OS of triple-negative subtype were worse than those of Luminal A, Luminal B and HER2 overexpression subtypes, and the differences were statistically significant (all P < 0.05). Conclusions:The clinical response and prognosis of patients with different molecular subtypes of invasive lobular carcinoma is significantly different after nab-paclitaxel intervention, among which the prognosis of patients with triple-negative type is the worst, and the clinical medication can be guided according to the pathological test results.

Human pluripotent stem cells provide an inexhaustible model to study human embryogenesis in vitro. Recent studies have provided diverse models to generate human blastoids by self-organization of different pluripotent stem cells or somatic reprogramming intermediates. However, whether blastoids can be generated from other cell types or whether they can recapitulate postimplantation development in vitro is unknown. Here, we develop a strategy to generate human blastoids from heterogeneous intermediates with epiblast, trophectoderm, and primitive endoderm signatures of the primed-to-naïve conversion process, which resemble natural blastocysts in morphological architecture, composition of cell lineages, transcriptome, and lineage differentiation potential. In addition, these blastoids reflect many features of human peri-implantation and pregastrulation development when further cultured in an in vitro 3D culture system. In summary, our study provides an alternative strategy to generate human blastoids and offers insights into human early embryogenesis by modeling peri- and postimplantation development in vitro.
Humans ; Pluripotent Stem Cells/metabolism* ; Embryo, Mammalian/metabolism* ; Cell Differentiation ; Blastocyst ; Cell Lineage ; Embryonic Development

Objective:To investigate the flow cytometric characteristics of bone marrow in patients with aplastic anemia (AA) and hypoplastic myelodysplastic syndrome (hypoMDS) and its value in differential diagnosis between AA and hypoMDS.Methods:A total of 618 patients were recruited from Shandong Provincial Hospital affiliated to Shandong First Medical University from January 2017 to December 2021, including 441 patients as controls with abnormal peripheral blood counts but confirmed to have no AA, hypoproliferative MDS, or other hematological tumors, 57 patients with AA, 52 patients with hypoMDS and 68 patients with diluted bone marrow. The proportions of bone marrow myeloid progenitor cell, lymphocyte, neutrophil and erythroid cell in bone marrow were analyzed by flow cytometry immunophenotyping. The differences between the four groups were compared by Kruskal-Wallis one-way ANOVA. The diagnostic efficacy was evaluated by the receiver operating characteristic (ROC) curve.Results:The proportion of myeloid progenitor cells in control group was [0.30%(0.20%, 0.46%)]; the proportion of myeloid progenitor cells in AA group was [0.00 (0.00, 0.04)]%, while the proportion of myeloid progenitor cells in hypoMDS group was [3.10%(1.25%, 6.71%)]. The proportion of myeloid progenitor cells in AA group was lower than that in control group( χ2=302.90, P<0.001), while the proportion of myeloid progenitor cells in the bone marrow of patients with hypoMDS was higher than that in the control group ( χ2=203.88, P<0.001). The area under the ROC curve for identifying AA and hypoMDS by the ratio of myeloid progenitor cells in bone marrow is 0.996, with the sensitivity of 96.2% and the specificity of 100% when the cutoff value is 0.21%. The proportion of bone marrow lymphocytes in control group was [10.39%(7.33%, 14.80%)]; the proportion of bone marrow lymphocytes in AA group was [52.67%(42.20%, 67.68%)], and the proportion of bone marrow lymphocytes in hypoMDS group was [24.68%(15.51%, 35.19%)]. The proportion of bone marrow lymphocytes in AA group or hypoMDS group was higher than that in control group( χ2=298.74, P<0.001; χ2=194.33; P<0.001), and the proportion of bone marrow lymphocytes in AA group is higher than that in hypoMDS group, with a statistically significant difference( χ2=104.41, P=0.002). The area under the ROC curve for identifying AA and hypoMDS by the ratio of bone marrow lymphocyte is 0.882, with the sensitivity of 78.9% and the specificity of 92.3% when the cutoff value is 41.6%. Conculsion:Patients with AA and hypoMDS could be differentiated effectively by the proportions of myeloid progenitor cell and lymphocyte in bone marrow by flow cytometry immunophenotyping.

Objective:To explore effects of intervention based on story theory on self-management behavior and emotional state of patients with rectal cancer undergoing anus-preserving surgery.Methods:Using the convenient sampling method, a total of 80 patients with rectal cancer who underwent anus preserving surgery in Henan Provincial People's Hospital from January to September 2019 were selected as the research objects. The patients were randomly divided into 42 cases in the control group and 38 cases in the observation group. The patients in the control group adopted perioperative routine nursing methods for patients with rectal cancer, while patients in the observation group adopted an intervention program based on story theory at basis of the control group. Profile of Mood States-Short Form (POMS-SF) and Bowel Symptoms Self-Management Behaviors Questionnaire For Rectal Cancer Patients After Anus Preservation were used for evaluation.Results:In the end, the control group recovered 40 valid questionnaires and the observation group recovered 38 valid questionnaires. After intervention, scores of all dimensions of POMS-SF of the two groups were compared and the differences were statistically significant ( P<0.05) . In the observation group, scores of dimensions of stress-anxiety, depression-depression, anger-hostility, fatigue-dullness and bewilderment-disorder were lower than those of the control group, and the score of energy-vitality was higher than that of the control group. After intervention, there was no statistically significant difference in the score of treatment management dimension in Bowel Symptoms Self-Management Behaviors Questionnaire For Rectal Cancer Patients After Anus Preservation between the two groups ( P>0.05) . The scores of diet management, perianal skin management, seeking help from others and self-emotional adjustment in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Intervention based on story theory can effectively improve the emotional state of patients with rectal cancer undergoing anus-preserving surgery and improve dietary management, perianal skin management, seeking others' help and self-emotional regulation behaviors in patients' intestinal self-management behaviors, which has good clinical application values.

Early intervention contributes to improving patient experience and doctor-patient relationship in the case of non-psychiatric outpatients with psychological problems.The authors studied the psychological assessment and hierarchical management for non-psychiatric inpatients at a general hospital. Measures taken include establishing multi-disciplinary and inter-department teams, building an intra-hospital joint-action system, and implementing the psychological assessment and hierarchical management for non-psychiatric inpatients.These efforts explored ways for a general hospital in psychological counseling, offering humanistic service, and transformation of medical pattern.