BackgroundAs a high prevalence disorder， schizophrenia has caused significant burden to family and society due to the impairment of occupational and social function. Currently， the dominant vocational training model in China follows a paternalistic， clinician-led decision-making approach. Although it improves patients' social function to some extent， it undermines their autonomy and treatment adherence. Therefore， it is urgently necessary to explore a new intervention method to enhance treatment compliance and social function in patients. ObjectiveTo explore the impact of shared decision-making oriented vocational training on social function in hospitalized schizophrenia patients， so as to provide references for rehabilitation interventions. MethodsA total of 68 patients diagnosed with schizophrenia according to the International Classification of Diseases， tenth edition （ICD-10） criteria were consecutively enrolled from January to June 2024 at The Third People's Hospital of Wenjiang Distric， Chengdu. Participants were randomly allocated into the research group （n=34） and the control group （n=34） using a random number table method. Both groups received routine rehabilitation training， while the research group received shared decision-making oriented vocational training for 12 weeks， 2 times a week for 2 hours each time. Before and at the 4^th and 12^th week of intervention， two groups were evaluated by General Self-Efficacy Scale （GSES）， Stigma Scale for Mental Illness （SSMI）， Scale of Social function of Psychosis Inpatients （SSFPI） and Inpatient Psychiatric Rehabilitation Outcome Scale （IPROS）. ResultsA total of 63 participants completed the study， with 30 cases in the research group and 33 cases in the control group. Repeated measures ANOVA revealed statistically significant time effects and interaction effects in both groups for GSES， SSMI， SSFPI and IPROS scores （F=20.451， 16.022； 26.193， 12.944； 23.957， 5.023； 11.776， 3.985， P<0.05 or 0.01）， while no significant group effects were observed （F=0.188， 0.742， 1.878， 0.474， P>0.05）. At the 12^th week of intervention， there were statistically significant differences in GSES， SSMI， SSFPI and IPROS scores between the two groups. ConclusionShared decision-making oriented vocational training may help to improve social function in patients with schizophrenia. ［Funded by 2023 Chengdu Medical Research Project （number， 2023468）］

Background Prenatal chronic psychological stress may increase the risk of allergic diseases in children, and eczema is the most common allergic disease in children, the pathogenesis of which is not yet fully understood. Objective To preliminarily clarify the changes in offspring intestinal flora after chronic stress exposure during pregnancy in rats that increases offspring immune imbalance and eczema susceptibility. Methods Thirty SPF-grade adult female SD rats were selected and randomly divided into a model group and a control group (n=15). Sixteen male rats were randomly divided into a model mating group and a control mating group (n=8). A 28-day chronic unpredictable mild stress (CUMS) model during pregnancy was established. On the 7th day of stress, male and female rats were caged in a ratio of 3:1. Blood samples were collected from female rats in each group via angular vein on the 1st day before stress, and on the 7th, 14th, 21st, and 28th days after stress. The content of plasma corticosterone during pregnancy was determined by enzyme-linked immunosorbent assay (ELISA). For the offspring rats, an eczema model was constructed using 2,4-dinitrochlorobenzene (DNCB). The number of scratching times of the offspring rats within 5 min was recorded. The offspring rats were divided into 4 groups: DNCB-CUMS group (MM), DNCB-control group (MC), solvent control-CUMS group (CM), and blank control group (CC), with 8 rats in each group. The eczema was induced once every 3 days, and the induction period was 12 d. The expression level of immunoglobulin E (IgE) in the serum of offspring rats after the eczema induction experiment were determined by ELISA. The concentrations of tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-2 (IL-2), interleukin-4 (IL-4), and interleukin-13 (IL-13) in the serum were quantified by multi-parameter flow cytometry. The composition and abundance of intestinal microbiota in the feces of offspring rats were detected by 16S rRNA high-throughput sequencing technology. Results The plasma corticosterone concentrations in the model group were higher than those in the control group on the 7th and 21st days of stress (P<0.05). On the 14th and 21st days of stress, the 1% sucrose preference percentages of female rats in the model group were lower than that in the control group. On the 7th, 14th, and 21st days of stress, the horizontal movement scores of female rats in the model group and the vertical movement scores on the 7th and 14th days were lower than those in the control group (P<0.05). After 6, 9, and 12 d of model building, the scratching frequencies in the MC group and MM group were significantly higher than those in the CC group and CM group (P<0.05). Moreover, there were differences in the contents of cytokines including IFN-γ, IL-2, TNF-α, IL-4, IL-13, and IgE among the offspring rat groups (P<0.05). The CM group and MM group led to an increase in the contents of TNF-α, IL-4, IL-13, and IgE cytokines (P<0.05), while the MM group caused a decrease in the contents of IFN-γ and IL-2 (P<0.05). After the eczema induction experiment, the α-diversity analysis showed that the Simpson index and Shannon index in the CM were higher than those in the CC (P<0.05), indicating that CUMS during the pregnancy of female rats could increase the species abundance of their offspring. The abundances of Prevotella and Lactobacillus in the CM group decreased (P<0.05). Conclusion Intestinal dysbiosis in offspring due to chronic prenatal psychological stress, which may be one of the mechanisms linking maternal stress to immune imbalance and increased susceptibility to eczema in offspring.

Objective: To understand the indoor light at night (LAN) exposure intensity during sleep among children and adolescents in Shanghai, so as to provide a basis for exploring potential health risks and formulating effective interventions. Methods: From April to December in 2024, a total of 628 students in grades 4-7 were recruited from three schools in Shanghai. A portable illuminance meter was used to measure LAN for one week, and participants recorded their sleep time. The Kruskal-Wallis H- test was used for comparison between groups, and the error bar chart was used to show the trend and variation range of average LAN exposure intensity in different sleep periods. Results: The indoor LAN exposure intensity of children and adolescents in Shanghai was [2.4(0.8, 5.9)lx] during sleep, and 28.8% of children and adolescents were exposed to indoor LAN≥5 lx. There was no significant differences in indoor LAN exposure intensity between boys [2.4(1.0, 5.9)lx] and girls [2.3(0.7, 5.9)lx] ( Z=-0.86, P > 0.05 ). The indoor LAN exposure intensity of primary school students [2.9(1.1, 6.6)lx] was higher than that of junior high school students [1.0(0.3, 3.1)lx] ( Z =-5.87), and indoor LAN exposure intensity of students in the main urban area [3.2(1.1, 7.8)lx] was higher than that of rural students [1.6(0.5, 4.3)lx] ( Z =-5.23)(both P <0.05). The indoor LAN exposure intensity showed an overall decreasing trend during sleep of children and adolescents ( tau=-0.81, P =0.02), with a slight increase before waking up. Conclusions Indoor LAN exposure intensity among children and adolescents in Shanghai is generally high, especially among primary school students and students living in the main urban area. Health policy and education should be strengthened to reduce the impact of LAN on children and adolescent health.

Objective:To systematically review the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)on recurrence or metastasis of patients with ovarian cancer whose postoperative serum carbohydrate antigen 125(CA125)occurred abnormal elevation.Methods:A systematic search was conducted in foreign databases,including PubMed,Embase,Cochrane Library(Central)and Web of Science(SCI-Expanded),as well as Chinese databases,such as China National Knowledge Infrastructure(CNKI),VIP Network,Wanfang Database,and China Biology Medicine(CBM),for the studies that were published between January 2010 and January 2023 on the diagnostic value of 18F-FDG PET/CT on recurrence or metastasis of patients with ovarian cancer whose postoperative serum CA125 levels occurred abnormal elevation.The quality of the included studies was assessed by using the QUADAS-2 quality evaluation tool in Review Manager 5.4 software.The effective data were extracted,and effect quantities were merged,and heterogeneity test was conducted through Meta-Disc 1.4 software.Publication bias of the included studies was tested by using Stata 14.0 software.Results:A total of seven literatures were involved in this research,and 290 patients with ovarian cancer were included to conduct heterogeneity test,which revealed I2 values all were greater than 50%.Therefore,the a fixed-effect model was used to merge effect quantity.The results demonstrated that the diagnostic accuracy was higher,and the sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,and diagnostic odds ratio(DOR)of the mergement were respectively 0.95(95%CI:0.91-0.98),0.83(95%CI:0.70-0.92),4.84(95%CI:2.82-8.31),0.07(95%CI:0.04-0.13)and 73.53(95%CI:28.00-187.90).The area under curve(AUC)value of receiver operating characteristic curve(AUC)was 0.9527,and the diagnostic accuracy of 18F-FDG PET/CT for metastasis or recurrence in patients with ovarian cancer,whose postoperative serum CA125 levels occurred elevation,reached to 95.27%.Publication bias testing showed there was no evidence of publication bias.Conclusion:18F-FDG PET/CT exhibits higher accuracy in diagnosing recurrence or metastasis in patients with ovarian cancer whose postoperative serum CA125 levels occurred elevation,which can sensitively and accurately confirmed postoperative recurrence or metastasis of patients with ovarian cancer,and early find the lesions of metastasis or recurrence of ovarian cancer.

OBJECTIVE To study the prevention and control strategies for carbapenem-resistant Acinetobacter bau-mannii(CRAB)infection through inves-tigating an outbreak of CRAB infection in an intensive care unit(ICU),and provide a scientific basis for the prevention and control of such hospital-acquired infections.METHODS Epide-miological investigations were conducted on patients with CRAB infection in the ICU of a hospital from Jul.7 to Jul.29,2023,and microbial sampling,identification and drug sensitivity testing were conducted on suspected con-taminated environments and items.Targeted prevention and control measures were taken to control the outbreak.RESULTS Within a short period,8 patients in this hospital developed CRAB hospital-acquired infection,among whom,the drug resistance profiles of CRAB isolated from the specimens of 7 patients in bed A4,A14,B18,B19,B20,B21 and B22 were consistent.Through environmental hygiene monitoring,CRAB isolated from patient clothing,isolation gowns and medical staff uniforms matched the drug resistance profiles of the seven patient iso-lates.After taking targeted measures,no new CRAB infection cases occurred in Oct.,and CRAB was no longer i-solated from the environment and medical fabrics.CONCLUSIONS The suspected outbreak of CRAB infection may be related to the inadequate management and contamination of medical fabrics.Therefore,in addition to strictly implementing the routine prevention and control measures for multidrug-resistant bacteria,it is also crucial to strengthen the standardized management of medical fabrics for the prevention and control of hospital-acquired in-fections and outbreaks.

Objective:To develop a treatment-related quality of life scale for Chinese patients with multiple myeloma (MM) and to test its reliability and validity.Methods:The initial scale was constructed through a literature search, Delphi expert correspondence, and cognitive testing. This study conducted a preliminary survey of 379 patients with MM and a formal survey of 865 patients from the hematology departments of 155 hospitals nationwide from February 2024 to March 2024. The final scale was obtained after conducting item analysis and reliability and validity tests on the initial scale.Results:The constructed scale contains 36 items covering six domains: physiological, psychological, social, treatment side effects, general health, and others. In the preliminary survey, the Cronbach’s alpha coefficient of each item ranged from 0.597 to 0.939, and the test-retest reliability was 0.747 ( P<0.001). Exploratory factor analysis extracted eight common factors with a cumulative variance contribution of 60.058%. In the formal survey, the Cronbach’s alpha coefficient of each item ranged from 0.484 to 0.930, and the test-retest reliability was 0.835 ( P<0.001). Confirmatory factor analysis revealed a comparative fit index of 0.750, a root-mean-square error of approximation of 0.090, and a root-mean-square residual of 0.067. Conclusion:The treatment-related quality of life scale for Chinese patients with MM designed in this study exhibited good reliability and validity, reflecting the impact of treatment on the quality of life of patients. This scale can provide a reference to clinicians for assessing the disease status of patients.

OBJECTIVE To explore the differences in the clinical laboratory test indexes between the patients with two different TCM syndrome types of eczema(dampness-heat infiltration type and non-dampness-heat infiltration type)and observe the distribution and drug resistance rate of pathogens isolated from the skin lesions so as to pro-vide bases for syndrome differentiation and reasonable use of antibiotics.METHODS A total of 180 patients with eczema who were positive for bacterial culture of skin secretions and were treated in Beijing Hospital of Traditional Chinese Medicine from Jan.2021 to Dec.2023 were enrolled in the study and were divided into the dampness-heat infiltration group with 134 cases and the non-dampness-heat infiltration group with 46 cases.The data of clini-cal laboratory test indexes were collected from the two groups of patients,the secretion specimens were sampled from the skin lesion sites,the isolated pathogens were identified by VITEK 2 Compact automatic microorganism analysis system,and the drug susceptibility testing was performed.RESULTS The direct bilirubin level of the dampness-heat infiltration group was(3.99±1.62)umol/L,higher than(3.46±1.12)umol/L of the non-damp-ness-heat infiltration group(P＜0.05),but both were in the normal range;there were no significant differences in other test indexes between the two groups.Totally 180 strains of pathogens were isolated from the 180 patients with eczema,156(86.67％)of which were gram-positive bacteria;Staphylococcus aureus(98 strains),Staphy-lococcus epidermidis(29 strains)and Staphylococcus haemolyticus(15 strains)were the predominant species of the gram-positive bacteria.The gram-negative bacteria accounted for 12.22％(22 strains).The drug resistance rate of the S.aureus strains to penicillin was up to 82.65％,and the isolation rate of methicillin-resistant Staphy-lococcus aureus(MRSA)was 12.24％(12/98);the drug resistance rates of the S.epidermidis strains to penicil-lin and erythromycin were 75.86％,and the drug resistance rate of the S.haemolyticus strains to erythromycin was 100.00％.CONCLUSIONS The gram-positive bacteria(dominated by the S.aureus)are dominant among the pathogens isolated from the skin lesion specimens of the eczema patients and are highly resistant to penicillin and erythromycin.The isolation rate of MRSA is relatuvely low.There is limited clinical significant difference in the direct bilirubin between the two groups.It is necessary to further explore more reliable indexes for syndrome dif-ferentiation.

Objective:To develop an artificial intelligence (AI)-based platelet review strategy to identify abnormal platelet histograms with no significant difference between initial impedance platelet count (PLT-I) and PLT-F results.Methods:This study included 5 119 routine blood analysis in Nanfang Hospital of Southern Medical University and its Ganzhou branch from July 2023 and March 2024. Specimens exhibiting abnormal platelet histograms and an initial platelet count >40×10?/L underwent review using the fluorescent platelet count (PLT-F) channel. Consistency of the results was defined as a difference between impedance platelet count (PLT-I) and PLT-F less than ±20% of the PLT-F results. A deep learning model was developed using platelet and red blood cell histogram data from a training set of 3 807 specimens. The model′s diagnostic performance was evaluated on an independent external validation set ( n=805) using receiver operating characteristic (ROC) curve analysis. Changes in the number of reviewed samples and sample turnaround time were analyzed to assess its clinical utility. Results:The deep learning model based on platelet and red blood cell histograms achieved an area under the ROC curve (AUC) of 0.854 in the training set. At a cutoff value of 0.1, the sensitivity was 0.954 and specificity was 0.358. The model could reduce review by 16.80% (190/1 131). In the validation set, the AUC was 0.805, with a sensitivity of 0.955 and specificity of 0.307, corresponding to a reduction of 17.41% (47/270) in reviewed specimens.Conclusion:The platelet review prediction model developed based on deep learning technology can efficiently identify samples with consistent results before and after review, reducing unnecessary reviews and shortening specimen testing time, thereby improving the efficiency of platelet test.

OBJECTIVE To explore the APOA5 gene polymorphisms,serum lipase(LPS),soluble programmed death ligand 1(sPD-L1)and procalcitonin(PCT)in the severe acute pancreatitis(SAP)patients with secondary infectious pancreatic necrosis(IPN).METHODS A total of 122 patients with SAP who were treated in the First Affiliated Hospital of Hebei North University from Jan.2020 to Nov.2023 were recruited as the research subjects and were divided into the secondary group with 31 cases and the non-secondary group with 91 cases according to the status of secondary IPN.The APOA5 gene polymorphisms were detected for the two groups of patients by means of polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).The levels of LPS,sPD-L1 and PCT as well as Ranson score were compared between he two groups.The association of the serum LPS,sPD-L1 and PCT with Ranson score was observed by Spearman analysis.The value of the joint detection of LPS,sPD-L1 and PCT in diagnosis of secondary IPN in the SAP patients was analyzed by means of receiver oper-ating characteristic(ROC)curves.RESULTS The frequencies of AA genotype and A allele at rs619054 locus of APOA5 gene were higher in the secondary group than in the non-secondary group(P＜0.05),and the frequency of G allele of the secondary group was lower than that of the non-secondary group(P＜0.05).There were significant differences in the levels of serum LPS,sPD-L1 and PCT as well as Ranson score between the secondary group and the non-secondary group(P＜0.05).Spearman analysis showed that the Ranson score was positively correlated with the levels of serum LPS,sPD-L1 and PCT(r=0.738,0.701,0.721,P＜0.05).ROC curve analysis indicated that the area under the curve(AUC)of the joint detection of the three indexes was higher than that of the single detection in diagnosis of secondary IPN in the SAP patients(P＜0.05),with the sensitivity 90.30％,the specifici-ty 84.60％.CONCLUSIONS The SAP patients with secondary IPN show the high expressions of LPS,sPD-L1 and PCT.The joint detection of the indexes may facilitate the diagnosis of the secondary IPN in the SAP patients.There is association between the levels of LPS,sPD-L1 and PCT and the Ranson score.The rs619054 locus of APOA5 gene may be involved in pathogenesis of secondary IPN in the SAP patients.

Fetal malformation of cortical development(MCD)is a group of structural neurological disorders caused by abnormalities in development of cortical layer during embryogenesis,characterized by significant heterogeneity and diversity,which may lead to adverse clinical outcomes such as epilepsy and intellectual disabilities.The progresses in prenatal evaluation on fetal MCD were reviewed in this article.