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 Polycyclic aromatic hydrocarbons (PAHs), one of the main components of fine particulate matter (PM_2.5), have a certain impact on ambient air quality, and long-term exposure to PAHs may pose potential health risks to human beings. Objective To identify the distribution characteristics and sources of PAHs in atmospheric PM_2.5 in a district of Taizhou City from 2019 to 2021, and to evaluate the health risks of PAHs to the population in the area through the inhalation pathway. Methods From 2019 to 2021, air PM_2.5 sampling was carried out at a state-controlled surveillance point in a district of Taizhou City for 7 consecutive days on the 10th-16th of each month, the sampling time was 24 h·d⁻¹, and the sampling flow rate was 100 L·min⁻¹. PM_2.5 mass concentration was calculated by gravimetric method. A total of 16 PAHs were determined by ultrasonic extraction-liquid chromatography. Kruskal-Wallis H test was used to compare the distribution charac teristics of PAHs concentrations by years and seasons, characteristic ratio and principal component analysis (PCA) was used to analyze their sources, and a lifetime carcinogenic risk (ILCR) model was used to assess the health risk of PAHs. Results From 2019 to 2021, the annual average concentrations [M (P₂₅, P₇₅)] of ∑PAHs in atmospheric PM_2.5 in the selected district of Taizhou City were 6.52 (2.46, 10.59), 8.52 (4.56, 12.29), and 3.72 (1.51, 7.11) ng·m⁻³, respectively, and the annual benzo[a]pyrene (BaP) excess rates (national limit: 1 ng·m⁻³) were 27.38% (23/84), 47.62% (40/84), and 19.04% (16/84), respectively, both presenting 2020> 2019 > 2021 (P<0.001, P<0.05). The ∑PAHs concentration distribution showed a seasonal variation, with the highest value in winter and the lowest value in summer (P<0.05). Among the atmospheric PM_2.5 samples, the proportion of 5-ring PAHs was the highest, the proportion of 2-3-ring PAHs was the lowest; the proportion of 2-4-ring PAHs showed a yearly upward trend, and the proportion of 5-6-ring PAHs showed yearly downward trend (P<0.05). The characteristic ratio and PCA results suggested that the sources of sampled PAHs were mainly mixed sources such as dust, fossil fuel (natural gas), coal combustion, industrial emissions, and motor vehicle exhaust emissions. The ILCR (R_ILCR) of PAHs by inhalation for men, women, and children were 1.83×10⁻⁶, 2.35×10⁻⁶, and 2.04×10⁻⁶, respectively, and the annual average R_ILCR was 2.07×10⁻⁶, all greater than 1×10⁻⁶. Conclusion For the sampled time period, the main sources of PAHs pollution in atmospheric PM_2.5 in the target district of Taizhou City are dust, fossil fuel (natural gas), coal combustion, industrial emissions, motor vehicle emissions, etc., and PAHs may have a potential carcinogenic risk to local residents.

Objective To discuss the application effects of trinitarian visualization teaching model in endoscopy reprocessing teaching practice. Methods Subjects in the study were divided into the trinitarian visualization teaching group (n=40) and the traditional teaching group (n=43) by random number table method; Compliance and credibility rating of endoscope reprocessing procedures were compared between 2 groups. 2 weeks after training, objectives were examined and assessed by questionnaires separately. Results Compliance of the trinitarian visualization teaching group was higher than the traditional teaching group (χ2=10.501, P=0.033). The trinitarian visualization teaching group had a higher rating in compliance, with 47.47 credibility points, theory test (93.79 ± 3.81) points and 93.02%(40/43) of operation pass. The traditional teaching group had a credibility point of 43.68 credibility points, with theory test (85.25±3.14) points and 77.50%(31/40) of operation pass. Significant difference between the two groups were statistical significant (t=4.84 and 11.097, χ2=4.038,P<0.01 or 0.05). Conclusions The trinitarian visualization teaching model can be used to improve the reprocessing training quality, to save time and human resource and to reach the training demand.

Objective To approach the related factors and emergency endoscopic hemostasis measures for duode-nal papilla hemorrhage after ERCP, then sum up the clinical experience of prevention and treatment. Methods Clin-ical data of 27 patients with duodenal papilla hemorrhage treated by emergency endoscopic hemostasis were retro-spectively analyzed. Results 26 cases treated by emergency endoscopic hemostasis were successful, the success rate was 96.30 %. Conclusions Prevention is very important for duodenal papilla hemorrhage. Once bleeding after ER-CP, emergency endoscopic hemostasis is the most direct, simple and effective measure.

Objective The study aimed to observe the influence of Puritybile capsules combined with different doses of Compound polyethylene glycol (PEG) in bowel preparation.Methods 120 patients were set into three groups (group A,B and C) randomly (40 patients in each).Group A take the routine Compound polyethylene glycol treatment orally.On the basis of the same routine Compound polyethylene glycol treat-ment,group B added regular dose of Puritybile capsules.Group C took half dose of Compound polyethylene glycol and regular dose of Puritybile capsules.The cleaning effect and adverse reaction were compared among three groups.Results According to Ottawa Scale,the cleaning effects as well as the existing of air bubbles showed no significant difference among three groups.Among which group C was 30％lower than that of group A,10％ lower than that of group B.There was no statistical differences in adverse events.Conclusions Half dose of Compound polyethylene glycol and regular dose of Puritybile capsules can guarantee the ef-fect of bowel cleaning and lower medical expense of patients.