BackgroundThe violent aggressive behaviors of patients with schizophrenia usually have the characteristics of suddenness， unpredictability， high severity， and great difficulty in prevention. Early identification and accurate assessment of their risk of violent aggression have significant clinical significance. ObjectiveTo construct a predictive model for the violence risk in hospitalized patients with schizophrenia， to identify the key factors influencing the occurrence of violent behavior in these patients， so as to provide references for clinical precise quantitative assessment and early intervention. MethodsA total of 200 patients with schizophrenia who were hospitalized at Taiyuan Psychiatric Hospital from March 2022 to September 2024 and met the diagnostic criteria of the International Classification of Diseases， eleventh edition （ICD-11） were collected to form the modeling cohort. They were randomly divided into a training set （n=140） and a test set （n=60） at a ratio of 7∶3. Based on the least absolute shrinkage and selection operator （LASSO） regression algorithm， the feature variables were screened and dimension-reduced. The support vector machine （SVM） from machine learning was selected for model training and prediction. The discrimination efficacy of the model was evaluated by the area under the receiver operating characteristic （ROC） curve （AUC）， accuracy， precision， sensitivity， specificity， F1 value， and Brier value. ResultsLASSO regression screening identified 16 feature variables. Pearson correlation analysis revealed a positive correlation between prior violent behavior frequency and clinical psychiatric symptom scores （r=0.580， P<0.01）， a positive correlation between hospitalization compliance and current disease status （r=0.550， P=0.003）， and a positive correlation between educational level and family per capita monthly income （r=0.367， P<0.01）. The SVM model achieved an AUC of 0.853， accuracy of 0.800， precision of 0.810， sensitivity of 0.895， specificity of 0.636， F1 value of 0.850， and Brier value of 0.168. ConclusionThe SVM model has a relatively high level of applicability and overall predictive performance in the assessment of violent risk in schizophrenia patients， which is helpful for the early identification of violent risks in such patients. ［Funded by Specialized Research Project for Enhancing the Competence of Health Professionals in Taiyuan City （number， Y2023006）］

To explore the role of the "Clinical Practice Guidelines" column and others in the Medical Joumnal of Peking Union Medical College Hospital (Med J PUMCH) in promoting diseiplinary development.

Objective:To investigate the effect of immune cells in blood and PD-L1 expression in tissues on prognosis of patients with post-surgery of advanced adenocarcinoma of esophagogastric junction(AEGJ)and hyperthermic intraperitoneal chemotherapy(HIPEC)treatment,and to explore the relationship between immune cells and PD-L1 level in patients with post-surgery and HIPEC treatments.Methods:A total of 46 patients with advanced AEGJ surgery and adjuvant HIPEC in the First Affiliated Hospital of Hebei North University from January 2018 to June 2019 were enrolled.Transcriptome sequencing technology was used to examine levels of blood immune cells in patients with AEGJ postoperative adjuvant HIPEC.Immunohistochemistry was applied to detect expression of PD-L1 in tissues of AEGJ,and corresponding statistical methods were used to observe the prediction of immune cells and PD-L1 levels on prognosis of patients with AEGJ,and correlation with each other.Results:As of June 30,2022,the cancer-specific survival rate(CSS),relapse free survival rate(RFS),median CSS and median RFS were 28.26％,45.65％,31 months and 24 months,respective-ly.Positive expression of PD-L1 was 52.17％,ratios of RFS and CSS between positive and negative level of PD-L1 were 16.67％,77.27％and 54.17％,90.91％,respectively;the median time of RFS(12 months vs 37 months)and CSS(24 months vs 37 months)in PD-L1 positive expression was less than those in PD-L1 negative expression separately.A total of 22 kinds of immune cells were exam-ined in this study,compared with CPS<1 group,levels of CD8+T cells,dendritic cells activated and resting NK cells were significantly decreased in CPS≥1 group(all P<0.05),while M2 macrophages in the former group were lower than those in the latter group(0.013±0.012 vs 0.033±0.003,P<0.001).Results of ROC curve showed that CD8+T cells and M2 macrophages were predictor of patients with AEGJ treatments prognosis(AUC=0.690 and 0.698,respectively).COX multivariate regression analysis revealed that CD8+T cell was an independent protective factor for CSS of AEGJ and HIPEC[HR=0.590,95％CI(0.248～0.7080],while M2 macrophage was the risk factors for AEGJ and HIPEC[HR=6.448,95％CI(1.440～9.165)].Positive expression of PD-L1 was positively correlated with level of M2 macrophages(R=0.44,P<0.01),while negatively associated with level of CD8+T cells(R=-0.47,P<0.05).Conclusion:Adjuvant HIPEC therapy maybe regulate the function of M2 macrophage and CD8+T cells,among which the level of M2 macrophage is positively related to PD-L1 expression.The increasing of M2 macrophage cells may be the risk factor for the prognosis of AEGJ patients with surgery and HIPEC-treatment.

Objective:To analyze the risk factors for symptomatic cerebral infarction (SCI) in patients with spontaneous intracerebral hemorrhage (ICH).Methods:A total of 337 patients with spontaneous ICH admitted to the stroke center of Zhengzhou People’s Hospital were consecutively collected from May 2019 to March 2023. Patients were divided into the SCI group and without SCI group according to whether the presence of new neurological deficits consistent with diffusion-weighted imaging hyperintense lesions distant from the hematoma. Magnetic resonance was used to quantify cerebral small vessel disease imaging markers and the degree of cerebral artery stenosis (CAS). SPSS 25.0 software was used for data analysis. Univariate and multivariable Logistic regression models were adopted to assess risk factors associated with concomitant SCI. Subgroup analysis stratified by mean arterial pressure (MAP) tertiles was performed.Results:Compared with patients without SCI, patients with SCI have more histories of ischemic stroke, higher rates of complication of pneumonia and deep venous thrombosis, higher baseline systolic blood pressure, greater MAP change, higher periventricular white matter hyperintensities score and deep white matter hyperintensities (DWMHs) score, and more severe CAS (all P<0.05). Multivariable regression analysis showed that, the degree of CAS ( B=1.095, OR=2.989, 95% CI=1.645-5.432, P<0.001) and DWMHs score ( B=0.789, OR=2.201, 95% CI=1.163-4.166, P=0.015) were risk factors for ICH patients with SCI. Compared with patients with mild CAS, the proportion of SCI significantly increased in patients with moderate and severe CAS in the maximum MAP change group (both P<0.05). Compared with patients with mild DWMHs, the proportion of SCI in patients with severe DWMHs in the maximum MAP change group significantly increased ( P=0.002). Conclusion:Severe CAS and DWMHs are independent risk factors for SCI after ICH, especially with greater fluctuations in MAP change.

Objective:To investigate the effect of immune cells in blood and PD-L1 expression in tissues on prognosis of patients with post-surgery of advanced adenocarcinoma of esophagogastric junction(AEGJ)and hyperthermic intraperitoneal chemotherapy(HIPEC)treatment,and to explore the relationship between immune cells and PD-L1 level in patients with post-surgery and HIPEC treatments.Methods:A total of 46 patients with advanced AEGJ surgery and adjuvant HIPEC in the First Affiliated Hospital of Hebei North University from January 2018 to June 2019 were enrolled.Transcriptome sequencing technology was used to examine levels of blood immune cells in patients with AEGJ postoperative adjuvant HIPEC.Immunohistochemistry was applied to detect expression of PD-L1 in tissues of AEGJ,and corresponding statistical methods were used to observe the prediction of immune cells and PD-L1 levels on prognosis of patients with AEGJ,and correlation with each other.Results:As of June 30,2022,the cancer-specific survival rate(CSS),relapse free survival rate(RFS),median CSS and median RFS were 28.26％,45.65％,31 months and 24 months,respective-ly.Positive expression of PD-L1 was 52.17％,ratios of RFS and CSS between positive and negative level of PD-L1 were 16.67％,77.27％and 54.17％,90.91％,respectively;the median time of RFS(12 months vs 37 months)and CSS(24 months vs 37 months)in PD-L1 positive expression was less than those in PD-L1 negative expression separately.A total of 22 kinds of immune cells were exam-ined in this study,compared with CPS<1 group,levels of CD8+T cells,dendritic cells activated and resting NK cells were significantly decreased in CPS≥1 group(all P<0.05),while M2 macrophages in the former group were lower than those in the latter group(0.013±0.012 vs 0.033±0.003,P<0.001).Results of ROC curve showed that CD8+T cells and M2 macrophages were predictor of patients with AEGJ treatments prognosis(AUC=0.690 and 0.698,respectively).COX multivariate regression analysis revealed that CD8+T cell was an independent protective factor for CSS of AEGJ and HIPEC[HR=0.590,95％CI(0.248～0.7080],while M2 macrophage was the risk factors for AEGJ and HIPEC[HR=6.448,95％CI(1.440～9.165)].Positive expression of PD-L1 was positively correlated with level of M2 macrophages(R=0.44,P<0.01),while negatively associated with level of CD8+T cells(R=-0.47,P<0.05).Conclusion:Adjuvant HIPEC therapy maybe regulate the function of M2 macrophage and CD8+T cells,among which the level of M2 macrophage is positively related to PD-L1 expression.The increasing of M2 macrophage cells may be the risk factor for the prognosis of AEGJ patients with surgery and HIPEC-treatment.

Objective:To explore the effect of Bian-stone warming and ironing therapy on gastrointestinal blood flow in patients with severe cerebrovascular disease undergoing therapeutic hypothermia.Methods:From January 2023 to October 2024, 92 patients with severe cerebrovascular disease in the Neurosurgical Intensive Care Unit of Xuanwu Hospital of Capital Medical University were selected for the study using convenience sampling method. The patients were divided into a control group and an experimental group of 46 cases each according to the randomized numerical table method. Control group was given routine nursing, and experimental group carried out Bian-stone warming and ironing therapy on the basis of control group. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and time-averaged mean velocity (TAMV) of the superior mesenteric artery of the two groups of patients were monitored before and after five days of intervention, respectively, and the situation of gastric retention and bowel sounds were recorded and compared between the groups.Results:PSV was higher in experimental group than in control group after intervention, and the difference was statistically significant ( P<0.05). The difference in EDV between the two groups was not statistically significant ( P>0.05). TAMV of experimental group was higher than that of control group after intervention, and the difference in TAVM before and after intervention of experimental group was smaller than that of control group, and the differences were all statistically significant ( P<0.05). The number of cases of gastric retention and weakened or disappeared bowel sounds in experimental group was less than that in control group after intervention, and the differences were all statistically significant ( P<0.05) . Conclusions:Bian-stone warming and ironing therapy improves gastrointestinal blood flow rate and reduces feeding intolerance in patients with severe cerebrovascular disease undergoing therapeutic hypothermia.

Objective To rescue a strain of Chikungunya virus(CHIKV)using reverse genetics system.Methods Molecular cloning experiments,including PCR,agarose gel electrophoresis and homologous recombination were employed to generate an infectious cDNA clone(pFK-CHIKV-LN)derived from the isolated Caribbean Chikungunya strain(Caribbean strain,isolate M100,Genbank LN898083.1).The mRNA obtained from vitro transcription were transfected into BHK-21 to rescue the CHIKV.The viral titer was determined by 50%tissue culture infection dose(TCID50),with calculations performed using the Reed-Muench method.Western blot(WB)and real time quantitative polymerase chain reaction(RT-qPCR)were employed to assess the levels of viral protein and mRNA at various time points during infection.Results The full-length cDNA clone of CHIKV was successfully constructed,enabling the rescue of CHIKV progeny.RT-qPCR and WB confirmed the significant increasing expression levels of NS1 mRNA and proteins(NS3,E1)of BHK-21 during the infection process.Conclusion The full-length infectious clone of CHIKV has been constructed successfully,which provides a good tool for subsequent studies on the gene structure,protein function and pathogenic mechanism of CHIKV.

OBJECTIVE: To explore the relationship between the geriatric nutritional risk index (GNRI) and cognitive function. METHODS: A cross-sectional study method was conducted. People aged ≥ 60 years from the National Health and Nutrition Examination Survey (NHANES) databases from 1999 to 2002 and 2011 to 2014 were included as study subjects. The participants were divided into three groups based on their GNRI scores: a medium-high risk group (82 ≤ GNRI < 92), a low risk group (92 ≤ GNRI < 98), and a no-risk group (GNRI ≥ 98). Demographic characteristics (gender, age, race, education), chronic diseases [chronic bronchitis, emphysema, thyroid problems, coronary heart disease, angina pectoris, stroke, hypertension, diabetes mellitus, and depression score on the patient health questionnaire (PHQ-9)], lifestyle habits (history of smoking, hours of sleep), etc., were collected. Cognitive function was assessed using the consortium to establish a registry for Alzheimer's disease word learning subtest (CERAD-WL), animal fluency test (AFT), and digit symbol substitution test (DSST) for the 2011-2014 data, while only the DSST was used for the 1999-2002 data. Differences in the above information among the GNRI cohorts were compared. Factors affecting cognitive function in the population were analyzed using multifactorial Logistic regression. RESULTS: 2 653 participants from 2011 to 2014 and 2 380 participants from 1999 to 2002 were enrolled, with a total of 5 033 participants in the study. There were statistically significant differences in age, stroke, diabetes mellitus, DSST score, AFT score, CERAD score test 1 recall (Cst1), and CERAD score test 2 recall (Cst2) among the GNRI groups. Multifactorial Logistic regression analysis of data from 2011 to 2014 showed that in model 3 (DSST score, age, gender, race, marriage, education, hours of sleep, history of smoking, emphysema, thyroid problems, chronic bronchitis, coronary heart disease, angina pectoris, hypertension, diabetes mellitus, depression score on the PHQ-9, and stroke) adjusted for all covariates, GNRI was a protective factor for DSST [odds ratio (OR) = 1.03, 95% confidence interval (95%CI) was 1.00 to 1.05, P = 0.03]; Logistic regression analyse for 1999 to 2002 and 2011 to 2014 showed a significant association even after adjustment for covariates (OR = 1.02, 95%CI was 1.00 to 1.03, P = 0.02). Subgroup Logistic regression analyses of the total population from 2011 to 2014 showed a significant association between GNRI and DSST scores (OR = 1.02, 95%CI was 1.01 to 1.03, P < 0.001), with significant associations in the age subgroups of 60 to 64 years old, across gender, non-Hispanic Whites and Blacks, by education, and by marital status associations were significant (all P < 0.05). Subgroup Logistic regression analyse of the total populations from 1999 to 2002 and 2011 to 2014 showed a significant association between the GNRI and DSST score (OR = 1.01, 95%CI was 1.01 to 1.02, P < 0.001), but did not show a significant year difference (interaction P = 0.503), and the newly found in the smoking population the association was also more significant (P < 0.01). CONCLUSION The GNRI correlates with the presence of cognitive functions related to processing speed, sustained attention, and executive function, and may be able to serve as an indicator for the assessment or prediction of related cognitive functions.
Humans ; Cross-Sectional Studies ; Aged ; Middle Aged ; Nutrition Surveys ; Cognition ; Female ; Male ; Nutritional Status ; Risk Factors ; Geriatric Assessment

Oxidative stress due to aberrant metabolism is considered as a crucial contributor to diabetes and its complications. Hyperglycemia and hyperlipemia boost excessive reactive oxygen species generation by elevated mitochondrial respiration, increased nicotinamide adenine dinucleotide phosphate oxidase activity, and enhanced pro-oxidative processes, including protein kinase C pathways, hexosamine, polyol, and advanced glycation endproducts, which exacerbate oxidative stress. Oxidative stress plays a significant role in the onset of diabetes and its associated complications by impairing insulin production, increasing insulin resistance, maintaining hyperglycemic memory, and inducing systemic inflammation. A more profound comprehension of the molecular processes that link oxidative stress to diabetes is crucial to new preventive and therapeutic strategies. Therefore, this review discusses the mechanisms underlying how oxidative stress contributes to diabetes mellitus and its complications. We also summarize the current approaches for prevention and treatment by targeting the oxidative stress pathways in diabetes.
Oxidative Stress/physiology* ; Humans ; Diabetes Mellitus/physiopathology* ; Diabetes Complications/metabolism* ; Reactive Oxygen Species/metabolism* ; Glycation End Products, Advanced/metabolism* ; Animals

Alzheimer's disease (AD), a prototypical neurodegenerative disorder, encompasses multifaceted pathological processes. As pivotal cellular structures within the central nervous system, ion channels play critical roles in regulating neuronal excitability, synaptic transmission, and neurotransmitter release. Extensive research has revealed significant alterations in the expression and function of ion channels in AD, implicating an important role of ion channels in the pathogenesis of abnormal Aβ deposition, neuroinflammation, oxidative stress, and disruptions in calcium homeostasis and neural network functionality. This review systematically summarizes the crucial roles and underlying mechanisms of ion channels in the onset and progression of AD, highlighting how these channel abnormalities contribute to AD pathophysiology. We also discuss the therapeutic potential of ion channel modulation in AD treatment, emphasizing the importance of addressing multifactorial nature and heterogeneity of AD. The development of multi-target drugs and precision therapies is proposed as a future direction of scientific research.
Alzheimer Disease/therapy* ; Humans ; Ion Channels/physiology* ; Oxidative Stress ; Animals ; Amyloid beta-Peptides/metabolism* ; Synaptic Transmission ; Calcium/metabolism*