Objective:To investigate the relationship between macrophage activation related factors and clini-cal symptoms of schizophrenia(SCZ).Methods:Outpatient or inpatient SCZ patients(n=166)and normal con-trols(n=71)meeting the diagnostic criteria of DSM 4th edition were selected as subjects.The psychopathological symptoms were assessed by the Positive and Negative Syndrome Scale(PANSS),and the concentrations of α-Na-Galases,MAF and IL-18 were determined by enzyme-linked immunosorbent assay(ELISA).The correlation be-tween biological indicators and clinical symptoms was analyzed and the mediation effect was tested.Results:The concentrations of α-NaGalases(P＜0.001)and MAF(P＜0.01)in SCZ group were lower than those in normal control group.In SCZ group,IL-18 was negatively correlated with α-NaGalases concentration(r=-0.24,P＜0.01).α-NaGalases was positively correlated with MAF concentration(r=0.67,P＜0.001),and the total score of PANSS positive symptom scale was positively correlated with IL-18(r=0.21,P＜0.05)and MAF concentration(r=0.22,P＜0.01).The mediating effect of α-NaGalases and MAF was statistically significant,and the relative mediating effect accounted for 25.47％.Conclusion:The increase of IL-18 level may indicate the occurrence of positive symptoms of schizophrenia,and α-NaGalases and MAF may negatively regulate the inflammatory damage effect of IL-18 on SCZ,thereby reducing the positive symptoms.

Objective:To investigate the relationship between macrophage activation related factors and clini-cal symptoms of schizophrenia(SCZ).Methods:Outpatient or inpatient SCZ patients(n=166)and normal con-trols(n=71)meeting the diagnostic criteria of DSM 4th edition were selected as subjects.The psychopathological symptoms were assessed by the Positive and Negative Syndrome Scale(PANSS),and the concentrations of α-Na-Galases,MAF and IL-18 were determined by enzyme-linked immunosorbent assay(ELISA).The correlation be-tween biological indicators and clinical symptoms was analyzed and the mediation effect was tested.Results:The concentrations of α-NaGalases(P＜0.001)and MAF(P＜0.01)in SCZ group were lower than those in normal control group.In SCZ group,IL-18 was negatively correlated with α-NaGalases concentration(r=-0.24,P＜0.01).α-NaGalases was positively correlated with MAF concentration(r=0.67,P＜0.001),and the total score of PANSS positive symptom scale was positively correlated with IL-18(r=0.21,P＜0.05)and MAF concentration(r=0.22,P＜0.01).The mediating effect of α-NaGalases and MAF was statistically significant,and the relative mediating effect accounted for 25.47％.Conclusion:The increase of IL-18 level may indicate the occurrence of positive symptoms of schizophrenia,and α-NaGalases and MAF may negatively regulate the inflammatory damage effect of IL-18 on SCZ,thereby reducing the positive symptoms.

Objective:To determine the detection rate of myopia among primary and secondary school students in Hunan Province in 2022 and to analyze the influencing factors at both the school and individual levels, thereby providing a scientific basis for developing myopia prevention and control strategies.Methods:From October to November 2022, a multi-stage stratified cluster random sampling method was employed to select students from Year 4 of primary school to Year 3 of senior high school across 14 prefecture-level (autonomous prefecture) cities in Hunan Province for vision screening and questionnaire surveys. A multilevel regression model was utilized to analyze the influencing factors of myopia at both the school and individual levels.Results:A total of 189 343 primary and secondary school students were included in this study. The overall myopia detection rate was 55.56%, with a significantly higher prevalence observed in female students (60.49%) compared to males (51.03%) and in urban students (59.12%) versus those from rural areas (53.50%). A marked upward trend in myopia prevalence was identified with advancing grade levels (trend test χ2=16 246.13, P<0.001). Multilevel regression analysis revealed that at the individual level, female gender, higher grade level, parental myopia history, daily homework duration ≥2 hours after school, improper reading/writing postures, and taking breaks only after more than 15 minutes of near work were associated with an increased risk of myopia. Conversely, adequate sleep duration, outdoor activity ≥2 hours, and outdoor breaks during recess demonstrated protective effects. At the school level, non-compliant blackboard illumination uniformity emerged as a significant risk factor for myopia development. Conclusions:The detection rate of myopia among primary and secondary school students in Hunan Province remains relatively high and is associated with multiple factors at both the school and individual levels. Targeted interventions should be implemented at different levels to mitigate the risk of myopia.

OBJECTIVES: The detection rate of scoliosis among school-aged children has been rising annually, varying by region, and has become a major public health concern affecting both physical and mental health. Its onset is multifactorial, and early screening combined with targeted interventions can alter disease progression. This study aims to investigate the prevalence and influencing factors of scoliosis among primary and secondary school students in Hunan Province, providing scientific evidence for targeted prevention strategies. METHODS: A stratified, randomized cluster sampling method was used to select 281 401 students from 14 prefecture-level cities in Hunan Province for scoliosis screening, physical examination, and questionnaire survey. The chi-square test was used for group comparisons, and trend chi-square test analyzed differences in screening positive rate by age. A multilevel regression model was applied to identify influencing factors, and ArcGIS was used to visualize spatial distribution patterns of scoliosis. RESULTS: The overall screening positive rate for scoliosis among Hunan students was 1.61%. Urban areas had a significantly higher rate than rural counties (2.81% vs 0.98%; P<0.01). The rate was equal between boys and girls (1.61% each). Underweight students had a higher rate than those with normal weight, overweight, or obesity (P<0.01). Stratified by age, urban students aged 6-18 years consistently showed higher positive rates than rural peers (P<0.001). No significant gender differences were observed at most ages (all P>0.05), except at age 11, where the females had a higher rate (1.28% vs 1.02%; P=0.048). After age 11, underweight students exhibited significantly higher positive rates than those with normal or higher BMI(all P<0.05). Across all groups, urban/rural, male/female, underweight/normal/overweight/obese, the scoliosis rate increased with age. By region, the screening positive rate ranged from 0.38% to 3.36%, with the top three being Chenzhou (3.36%), Xiangtan (2.78%), and Hengyang (2.71%), while the lowest was Xiangxi Tujia and Miao Autonomous Prefecture (0.38%). Multilevel regression analysis revealed that age (OR=1.160, 95% CI 1.135 to 1.186) and urban residence (OR=2.497, 95% CI 1.946 to 3.205) were positively associated with scoliosis risk (both P<0.01). Conversely, female gender (OR=0.931, 95% CI 0.874 to 0.993), normal nutritional status (OR=0.751, 95% CI 0.671 to 0.840), overweight (OR=0.513, 95% CI 0.447 to 0.590), obesity (OR=0.418, 95% CI 0.358 to 0.489), and engaging in ≥ 60 minutes of moderate-to-vigorous physical activity 2 to 4 days (OR=0.928, 95% CI 0.865 to 0.996) or 5 to 7 days per week (OR=0.912, 95% CI 0.833 to 0.998) were negatively associated with scoliosis risk (all P<0.05). CONCLUSIONS The prevalence of scoliosis among primary and secondary school students in Hunan Province is relatively high and is significantly associated with age, gender, urban-rural status, nutritional condition, and physical activity frequency. Targeted interventions and enhanced monitoring in high-risk regions and populations are essential to prevent and control scoliosis.
Humans ; Scoliosis/epidemiology* ; Male ; Female ; Adolescent ; China/epidemiology* ; Prevalence ; Child ; Students/statistics & numerical data* ; Rural Population/statistics & numerical data* ; Urban Population/statistics & numerical data* ; Surveys and Questionnaires ; Risk Factors ; Thinness/epidemiology*

Objective:To determine the detection rate of myopia among primary and secondary school students in Hunan Province in 2022 and to analyze the influencing factors at both the school and individual levels, thereby providing a scientific basis for developing myopia prevention and control strategies.Methods:From October to November 2022, a multi-stage stratified cluster random sampling method was employed to select students from Year 4 of primary school to Year 3 of senior high school across 14 prefecture-level (autonomous prefecture) cities in Hunan Province for vision screening and questionnaire surveys. A multilevel regression model was utilized to analyze the influencing factors of myopia at both the school and individual levels.Results:A total of 189 343 primary and secondary school students were included in this study. The overall myopia detection rate was 55.56%, with a significantly higher prevalence observed in female students (60.49%) compared to males (51.03%) and in urban students (59.12%) versus those from rural areas (53.50%). A marked upward trend in myopia prevalence was identified with advancing grade levels (trend test χ2=16 246.13, P<0.001). Multilevel regression analysis revealed that at the individual level, female gender, higher grade level, parental myopia history, daily homework duration ≥2 hours after school, improper reading/writing postures, and taking breaks only after more than 15 minutes of near work were associated with an increased risk of myopia. Conversely, adequate sleep duration, outdoor activity ≥2 hours, and outdoor breaks during recess demonstrated protective effects. At the school level, non-compliant blackboard illumination uniformity emerged as a significant risk factor for myopia development. Conclusions:The detection rate of myopia among primary and secondary school students in Hunan Province remains relatively high and is associated with multiple factors at both the school and individual levels. Targeted interventions should be implemented at different levels to mitigate the risk of myopia.

Objective:To evaluate the long-term efficacy of radiotherapy for elderly patients with esophageal squamous cell carcinoma.Methods:Clinical data of 118 elderly patients aged ≥65 years with esophageal squamous cell carcinoma treated with radiotherapy alone or concurrent chemoradiotherapy in Cancer Hospital affiliated to Xinjiang Medical University from January 2013 to January 2016 were retrospectively analyzed. All patients were randomly divided into the radiotherapy alone ( n=57) and concurrent chemoradiotherapy groups ( n=61). The effective rate, survival rate, adverse reactions and causes of death were compared between two groups. Rate and constituent ratio were used to describe the categorical variables, and Pearson Chi-square test was used for univariate analysis. Results:The effective rate (68.4% vs. 86.9%, P=0.016) and incidence of adverse reactions (21.1% vs. 50.9%, P<0.001) between radiotherapy alone and concurrent chemoradiotherapy groups were significantly differed. The 1-year overall survival rate significantly differed between two groups (75.4% vs. 91.8%, P=0.016), while no significant differences were observed in the 3-year overall survival rate (36.8% vs. 42.7%, P=0.088) and 5-year overall survival rate (10.7% vs. 18.0%, P=0.746). The main cause of death in two groups was recurrence combined with distant metastasis. Conclusion:Compared with the radiotherapy alone, concurrent chemoradiotherapy can significantly improve the effective rate and survival rate for elderly patients with esophageal squamous cell carcinoma, whereas it may increase the incidence of adverse reactions.

Objective:To investigate the effects of free triiodothyronine/free thyroxine(FT3/FT4) and one carbon metabolites on metabolic syndrome(MetS) in patients with severe mental illness(SMI).Methods:Retrospective case-control study was conducted to select 328 patients with SMI who were hospitalized in Beijing Huilongguan Hospital from January 2022 to August 2023 as the study subjects, including 180 patients with schizophrenia (SZ), 74 patients with bipolar disorder (BD), and 74 patients with major depression (MDD). Another 74 healthy subjects in the same period were selected as the control group. The levels of thyroid hormones and one-carbon metabolites [ folic acid, vitamin B12 (VitB12) and homocysteine (HCY) ] were compared between the two groups. At the same time, clinical data and MetS related information of SMI patients were collected. Partial correlation analysis and Logistic regression analysis were used to study the relationship between FT3/FT4 and one-carbon metabolites and MetS risk factors and insulin resistance in SMI patients, respectively.Results:There were statistically significant differences in gender, age, course of disease, smoking rate, body mass index (BMI), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG)/HDL-C, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), antipsychotic drug use rate, mood stabilizer use rate, antidepressant drug use rate and hypoglycemic treatment among SZ, BD and MDD groups in SMI patients (all P<0.05).Compared with the control group, FT3/FT4, folic acid and VitB12 in patients with SMI were significantly lower ( Z=-4.315, P<0.001; Z=-8.216, P<0.001; Z=-6.021, P<0.001), HCY increased significantly ( Z=-8.789, P<0.001);Partial correlation analysis showed that FT3/FT4 in patients with SMI was positively correlated with TG( r=0.303, P<0.001), TG/HDL-C( r=0.228, P<0.001), insulin resistance index(HOMA-IR)( r=0.204, P<0.001), triglyceride glucose index(TyG)( r=0.284, P<0.001), triglyceride glucose body mass index(TyG-BMI)( r=0.211, P<0.001) and body mass index(BMI)( r=0.154, P=0.005), and negatively correlated with insulin sensitivity index(QUICKI)( r=-0.205, P<0.001). VitB12 was positively correlated with HDL-C( r=0.144, P=0.009) and QUICKI( r=0.115, P=0.038), and negatively correlated with TyG-BMI ( r=-0.122, P=0.028) and BMI ( r=-0.127, P=0.022). HCY was positively correlated with TyG ( r=0.114, P=0.039) and TyG-BMI ( r=0.188, P=0.001). Multivariate ordinal logistic regression analysis showed that smoking( OR=1.602,95% CI=1.004-2.558), female( OR=1.736,95% CI=1.041-2.895), FT3/FT4( OR=17.811,95% CI=1.596-198.764), HCY ( OR=1.026,95% CI=1.009-1.043) and BD ( OR=2.150,95% CI=1.092-4.232) were the influencing factors of the number of risk factors for MetS in patients with SMI, while VitB12 ( OR=0.997,95% CI=0.995-0.998) was a protective factor; binary Logistic regression analysis showed that patients with SMI with long course of disease( OR=1.024,95% CI=1.008-1.041) and high level of HCY ( OR=1.033,95% CI=1.014-1.052) were more likely to have MetS. Conclusion:Dynamic monitoring of FT3/FT4 and one-carbon metabolites levels is helpful to identify the risk of MetS in patients with SMI and provide reference for prevention and treatment.

Objective To explore the causal relationship between family resilience and mental health in military personnel population.Methods A total of 204 military personnel were recruited from an army unit stationed in Western China with cluster convenience sampling.Family Resilience Scale(FRS)and Symptom Checklist 90(SCL-90)were used to survey them twice,in an interval of 4 months.Amos 26.0 was applied to construct a cross-lag model and analyze the data.Results After controlling mental symptoms from the first survey,family resilience in the first measure significantly predicted mental symptoms in the second measure(β=-0.14,P＜0.05).After controlling for family resilience from the first survey,mental symptoms in the first measure significantly predicted family resilience in the second measure(β=-0.13,P＜0.05).Conclusion The relationship between family resilience and mental health is mutually causal in military personnel,and one predicts the other one.Our findings highlight the key dimensions of the relationship between the two.

Objective:To investigate the clinicopathological features of colorectal adenocarcinoma with enteroblastic differentiation (CAED).Methods:Eight cases of CAED diagnosed at the Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China from January 2017 to August 2023 were collected. The histopathological, immunohistochemical, molecular and prognostic features of 8 CAED cases were analyzed. The relevant studies were also reviewed.Results:Among the eight patients, there were six males and two females, with an average age of 58 years (range: 29-77 years, median age: 61.5 years). Preoperative serum alpha-fetoprotein levels were elevated in five patients (14.0-286.6 μg/L). Four tumors were located in the colon, and four tumors in the rectum. Two patients were clinically staged as advanced stage (stage Ⅳ), and distant metastasis occurred at the initial diagnosis (one case had liver metastasis, and the other had lung, bone and multiple lymph nodes metastases). Six patients were clinically staged as locally-advanced stage (Stage Ⅱ-Ⅲ). Three of them developed distant metastases after surgery (one case had liver metastasis, one case had lung metastasis, and one case had peritoneal metastasis). Additionally, two patients died at 9 months and 24 months after surgery, respectively. The tumors were composed of various proportions of adenocarcinoma components with enteroblastic differentiation (30%-100%) and classical tubular adenocarcinoma components. The component with enteroblastic differentiation exhibited morphology similar to embryonic intestinal epithelium: cuboidal or columnar tumor cells arranged in tubular, papillary, cribriform, or solid nest patterns, with clear cytoplasm. Immunohistochemical studies showed that tumor cells expressed at least one oncofetal protein (SALL4, Glypican-3, and AFP). In addition, focal squamous differentiation was observed in 3 cases (3/8). Compared to the primary tumor, both CAED and squamous differentiation components were increased in the metastatic tumors. Based on the sequencing results of KRAS, NRAS and BRAF of the primary and/or metastatic tumors, 5 cases were wild-type, while KRAS exon 2 (G13D) mutations were identified in 2 cases.Conclusions:CAED is a rare colorectal malignancy with a dismal prognosis. Accurate pathological diagnosis is prognostically valuable. The histological features of enteroblastic differentiation, elevated serum AFP levels, and the expression of oncofetal proteins play an important role in the tumor diagnosis.

Objective:To investigate the effects of free triiodothyronine/free thyroxine(FT3/FT4) and one carbon metabolites on metabolic syndrome(MetS) in patients with severe mental illness(SMI).Methods:Retrospective case-control study was conducted to select 328 patients with SMI who were hospitalized in Beijing Huilongguan Hospital from January 2022 to August 2023 as the study subjects, including 180 patients with schizophrenia (SZ), 74 patients with bipolar disorder (BD), and 74 patients with major depression (MDD). Another 74 healthy subjects in the same period were selected as the control group. The levels of thyroid hormones and one-carbon metabolites [ folic acid, vitamin B12 (VitB12) and homocysteine (HCY) ] were compared between the two groups. At the same time, clinical data and MetS related information of SMI patients were collected. Partial correlation analysis and Logistic regression analysis were used to study the relationship between FT3/FT4 and one-carbon metabolites and MetS risk factors and insulin resistance in SMI patients, respectively.Results:There were statistically significant differences in gender, age, course of disease, smoking rate, body mass index (BMI), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG)/HDL-C, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), antipsychotic drug use rate, mood stabilizer use rate, antidepressant drug use rate and hypoglycemic treatment among SZ, BD and MDD groups in SMI patients (all P<0.05).Compared with the control group, FT3/FT4, folic acid and VitB12 in patients with SMI were significantly lower ( Z=-4.315, P<0.001; Z=-8.216, P<0.001; Z=-6.021, P<0.001), HCY increased significantly ( Z=-8.789, P<0.001);Partial correlation analysis showed that FT3/FT4 in patients with SMI was positively correlated with TG( r=0.303, P<0.001), TG/HDL-C( r=0.228, P<0.001), insulin resistance index(HOMA-IR)( r=0.204, P<0.001), triglyceride glucose index(TyG)( r=0.284, P<0.001), triglyceride glucose body mass index(TyG-BMI)( r=0.211, P<0.001) and body mass index(BMI)( r=0.154, P=0.005), and negatively correlated with insulin sensitivity index(QUICKI)( r=-0.205, P<0.001). VitB12 was positively correlated with HDL-C( r=0.144, P=0.009) and QUICKI( r=0.115, P=0.038), and negatively correlated with TyG-BMI ( r=-0.122, P=0.028) and BMI ( r=-0.127, P=0.022). HCY was positively correlated with TyG ( r=0.114, P=0.039) and TyG-BMI ( r=0.188, P=0.001). Multivariate ordinal logistic regression analysis showed that smoking( OR=1.602,95% CI=1.004-2.558), female( OR=1.736,95% CI=1.041-2.895), FT3/FT4( OR=17.811,95% CI=1.596-198.764), HCY ( OR=1.026,95% CI=1.009-1.043) and BD ( OR=2.150,95% CI=1.092-4.232) were the influencing factors of the number of risk factors for MetS in patients with SMI, while VitB12 ( OR=0.997,95% CI=0.995-0.998) was a protective factor; binary Logistic regression analysis showed that patients with SMI with long course of disease( OR=1.024,95% CI=1.008-1.041) and high level of HCY ( OR=1.033,95% CI=1.014-1.052) were more likely to have MetS. Conclusion:Dynamic monitoring of FT3/FT4 and one-carbon metabolites levels is helpful to identify the risk of MetS in patients with SMI and provide reference for prevention and treatment.