Objective To investigate the prevalence of chronic somatic comorbidities in schizophrenic patients in Shanghai communities,and to explore the factors influencing comorbidities.Methods Based on Shanghai community-based severe mental disorders cohort,5 422 patients with schizophrenia(SCZ)were included in the study.12 common chronic somatic diseases,defined by patients'self-report,were selected to analyze the prevalence of comorbidity,and Logistic regression model was used to analyze the factors influencing the number of somatic comorbidities.Results The total prevalence of somatic comorbidity was 37.0%in 5 422 patients with SCZ,with the highest prevalence of hypertension(22.6%)and diabetes mellitus(13.1%)among 12 somatic diseases selected.Older age was the main factor associated with chronic somatic comorbidities in community schizophrenic patients.The risk of 1-2 comorbidities in patients aged≥60 years was 3.34(95%CI:2.74-4.07)times higher than those aged<45 years,while the risk of≥3 comorbidities was 3.27(95%CI:2.11-5.09)times higher,correspondingly.Female gender,marriage,smoking,and longer duration of illness were also risk factors for comorbidity.Women after menopause had higher risk of comorbidity than perimenopausal women.Conclusion Cardiovascular and metabolic diseases were common somatic comorbidities among schizophrenic patients in Shanghai communities.Older age,female gender,marriage,smoking,and longer duration of illness were risk factors for increasing number of comorbidities.

Objective To investigate the learning curve of real-life vaginal delivery,including its difficult steps and influencing factors,to optimize the future training of vaginal delivery for residents in department of obstetrics and gynecology.Methods From 25 Sep 2020 to 12 Mar 2022,OBGYN residents without previous experiences in vaginal delivery were prospectively enrolled in Obstetrics and Gynecology Hospital,Fudan University.Residents performed normal vaginal delivery under the supervision of senior obstetricians and midwives.The performance score(PS)of vaginal delivery and its 9 steps were evaluated via a questionnaire fulfilled by the supervisor once each delivery was finished.Logistic regression models were performed for univariate and multivariate analyses to evaluate the factors that might be correlated with the PS.Results Eventually,233 deliveries performed by 60 residents were analyzed.Results showed that more than 10 deliveries were needed for 70%of residents to obtain minimal competence of vaginal delivery.Perineal protection,delivery of the fetal head,delivery of the fetal shoulders and repair of episiotomy or laceration were found to be the most difficult steps,which required more practices to achieve minimal competence level.Univariate analyses showed the delivery experience,the times of observation/simulation/training,and humanistic care skills might influence the total PS(P<0.05).However,only delivery experience(OR=1.43,95%CI:1.22-1.67)and the times of observation(OR=1.02,95%CI:1.00-1.04)were found to be independently correlated with the total PS in multivariate analyses.Conclusion More than 10 real-life practices were required to achieve the minimal competence of normal vaginal delivery.Enhancing the training on the four difficult steps of vaginal delivery might improve the learning efficiency when delivery opportunities are limited.

Objective To investigate the changes in the concentration of endothelial cell-specific molecule-1(ESM-1)in cerebrospinal fluid during the acute phase of patients with moderate to severe traumatic brain injury(TBI)and its relationship with injury severity and outcomes.Methods Eighty-four patients with moderate to severe TBI who underwent ventriculostomy for intracranial pressure(ICP)monitoring at Department of Neurosurgery,Jinshan Hospital,Fudan University from Jan 2020 to Dec 2023 were selected as the study subjects,and their clinical data were collected.Based on the Glasgow Coma Scale(GCS)upon admission,TBI patients were divided into moderate TBI group(GCS 9-12,n=48)and severe TBI group(GCS 3-8,n=36).According to the Glasgow Outcome Scale(GOS)at three months post-injury,the moderate to severe TBI patients were categorized into poor outcome group(GOS 1-3)and good outcome group(GOS 4-5).Patients were also classified based on ICP monitoring values into a normal ICP group(ICP≤15 mmHg),a mildly elevated ICP group(15 mmHg

Objective To explore the efficacy of"internet+"family doctor contract service model on controlling risk factors related to atherosclerotic cardiovascular disease(ASCVD)such as hypertension,dyslipidemia,and diabetes in young and middle-aged patients in the community.Methods A total of 231 young and middle-aged patients with ASCVD who were contracted and treated regularly in Shanghai Yangpu District Xinjiangwancheng Community Health Service Center from Jan to Dec 2020.According to the different intervention models,they were divided into the traditional group receiving the conventional family doctor contract service and the Internet group taking"internet+"family doctor contract service mode for intervention.The systolic blood pressure,diastolic blood pressure,fasting plasma glucose(FPG),low density lipoprotein(LDL-C),triglyceride(TG)and total cholesterol(TC)were compared within and between the two groups before intervention,three months after intervention,and one year after intervention,to evaluate the control effects of the two intervention modes.Results The 231 patients,of which 113 cases in traditional group and 118 cases in Internet group,were recruited in the study.there were no significant differences in gender,age and proportions of hypertension,diabetes and dyslipidemia between the two groups.Before intervention,there were no significant differences in systolic blood pressure,diastolic blood pressure,FPG,LDL-C,TG and TC between the two groups.Three months after intervention,the systolic blood pressure,diastolic blood pressure,FPG,LDL-C,TG and TC of the two groups were significantly lower than those before the intervention(all P<0.05),and the systolic blood pressure and diastolic blood pressure of the Internet group were significantly lower than those of the traditional group(all P<0.05),but there was no significant difference between the two groups in FPG,LDL-C,TG and TC.One year after the intervention,the systolic blood pressure,diastolic blood pressure,FPG,LDL-C,TG and TC of the patients in the two groups decreased significantly compared with those before intervention(all P<0.05),while the Internet group decreased more significantly(all P<0.05).Conclusion Compared with the traditional contract model,"internet+"family doctor contract service had better management effect on ASCVD-related risk factors in young and middle-aged patients in the community,and benefits the patients to a higher degree.

Objective To observe the efficacy and safety of Baduanjin combined with acupuncture in treating neck-type cervical spondylopathy(NTCS)patients.Methods Eighty patients were randomly divided into an intervention group and a control group in a 1∶1 ratio.The intervention group was treated with a combination of Baduanjin and acupuncture.Patients underwent Baduanjin exercise daily and acupuncture treatment twice a week for a total of 8 consecutive weeks.The control group received routine acupuncture twice a week for a total of 8 consecutive weeks.After the end of the treatment course,the effective rates of the two groups,as well as the visual analogue scale(VAS),neck disability index(NDI),self-rating anxiety scale(SAS),self-rating depression scale(SDS),and general comfort questionnaire(GCQ)assessment before and after treatment were compared,then safety evaluations was assessed.Results After intervention,the total effective rates of the intervention group and the control group were 91.4%and 76.31%,respectively,with a statistically significant difference(P<0.05);Compared within the group,the VAS,NDI,SAS,SDS scores of both groups were significantly lower than before treatment(all P<0.01),and the GCQ scores were higher than before treatment(both P<0.01);After intervention,inter-group comparison showed that the improvement of VAS,NDI,SAS,SDS,and GCQ scores in the intervention group was more significant than that in the control group(all P<0.05).Conclusion The combination of Baduanjin and acupuncture treatment can improve the clinical efficacy of NTCS patients and has good safety,which is worthy of clinical promotion and application.

Objective To investigate the one-year postpartum weight retention for patients with gestational diabetes mellitus(GDM)and analyze its related influencing factors,so as to improve the postpartum weight retention.Methods GDM women who were diagnosed and gave birth at the Obstetrics and Gynecology Hospital,Fudan University from Oct 2022 to May 2023 were selected as the research subjects.The GDM postpartum weight status survey questionnaire was used to conduct a survey of one-year postpartum weight retention status and analyze relevant influencing factors.Results A total of 150 GDM postpartum women were included,with a weight retention rate of 46.7%one year after delivery,including a high weight retention rate of 25.3%.The follow-up rate of postpartum glucose tolerance was 36.0%,and the influencing factors of postpartum weight retention were excessive gestational weight gain(OR=2.883,95%CI:1.226-6.779)and the presence of dietary risk(OR=4.604,95%CI:1.065-19.903).Conclusion The one-year postpartum weight retention after GDM is relatively high.The possible influencing factors are excessive weight gain during pregnancy and dietary risk after delivery.Attention should be paid to the weight and healthy diet management of GDM during pregnancy and postpartum from multiple dimensions.

Transthoracic echocardiography(TTE)is the preferred noninvasive modality for screening and diagnosing pulmonary hypertension(PH).By measuring parameters such as tricuspid regurgitation velocity(TRV),TTE can estimate pulmonary artery systolic pressure(PASP)and evaluate right heart function.TTE plays a critical role in the early screening,risk stratification,and prognostic assessment of PH,particularly in large-scale epidemiological studies.Furthermore,in percutaneous valvular interventions(e.g.,transcatheter aortic valve replacement,mitral valve edge-to-edge repair),TTE provides essential hemodynamic data for patient selection,intraoperative decision-making,and postoperative follow-up.This review summarizes recent advances in TTE for PH evaluation and its application in valvular interventions in order to support clinical practice.

p120-catenin(p120ctn)is one of the crucial members of armadillo family,which is well known as a core stabilizing factor for vascular endothelial cadherin(VE-cadherin).Throughout the entire process of vascular development,p120ctn plays multiple roles.From neovascularization to endothelial barrier,the presence of p120ctn is indispensable.It participates in regulating the normal development of vertebrate embryo vasculature and promoting endothelial cell proliferation.Additionally,p120ctn contributes to the maintenance and remodeling of adherens junctions and can modulate adhesion strength by altering cell morphology.This review summarized the latest research progress on p120ctn from neovascular development and endothelial barrier function.

With the continuous development of perinatal medicine and neonatology,although the survival rate of infants with low gestational age and low birth weight has improved,the incidence of neurodevelopmental morbidities remains high.Breast milk is the preferred source of enteral nutrition for preterm infants,playing an important role in growth,development,immunity,metabolism,and other functions.Of particular note is its effect on the nervous system,not only promoting brain development and maturation in preterm infants,but also effectively reducing the incidence and severity of brain injury,thereby improving long-term neurological outcomes.This review aims to explore the effects of breast milk on brain injury and repair,brain structural maturation,and neurodevelopmental outcomes in preterm infants,in order to further enhance the understanding of the importance of breast milk for the neurodevelopment of preterm infants.

The data from outpatient prescriptions of small-size aspirin enteric-coated tablets(25 mg/tablet)in a community hospital were analyzed to provide reference for rational clinical drug use.Patients'medication information of 1 325 prescriptions was collected and analyzed by defined daily dose system(DDDs)and drug utilization index(DUI),and the rationality of drug use was analyzed according to drug instructions and literature.The mean age of males and females were(73.70±8.33)years old and(72.95±8.34)years old,respectively.The top 3 DDDs age groups were women aged 60-79 years,men aged 60-79 years and women aged 80-99 years.The proportion of prescriptions in female patients was 59.62%.DUI ranges from 0.75 to 0.85.Irrational drug use was found in 123 prescriptions,including 89 prescriptions(72.35%)of inappropriate drug selection,19 prescriptions(15.45%)with low dose,6 prescriptions(4.88%)with contraindication,5 prescriptions(4.06%)with inconsistent frequency of administration,2 prescriptions(1.63%)of out-of-indication drug use,and 2 prescriptions(1.63%)of high dose.For the phenomenon of irrational drug use,it is necessary to conduct real-time intervention to ensure the safety and effectiveness of drug use.