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 explore the efficacy and safety of interventional embolism in the treatment of hemoptysis from non-bronchial arterial system.Methods We retrospectively analyzed clinical data of 23 cases of non-bronchial artery system derived hemoptysis from February 2017 to November 2024.The hemorrhagic blood vessels were only the non-bronchial artery system in 6 cases,and from the non-bronchial artery system and bronchial arteries in 17 cases.Sources of non-bronchial artery systems included 14 intercostal arteries,5 thyrocervical trunk,5 subscapular arteries,4 internal thoracic arteries,3 external thoracic arteries,5 diaphragmatic arteries,1 renal artery,and 1 left gastric artery.All the patients were treated with interventional embolism.Recurrence rate was followed up and postoperative complications were recorded.Results The immediate hemostasis rate after surgery was 95.7%(22/23).In one case,hemoptysis was relapsed within 24 h after the operation due to omission of diaphragmatic artery,and hemoptysis did not recurred after the secondary embolization.After surgery,there was 1 case of abdominal discomfort,2 cases of fever,and 2 cases of chest pain.The symptoms disappeared after conservative treatment.After the operation,the follow-up was 4-36 months(median,30 months).A total of 20 patients did not re-develop hemoptysis,while 3 had relapsed hemoptysis at 4 months,4 months,and 36 months after operation,respectively,with a recurrence rate of 13.0%(3/23).No serious complications occurred.Conclusion Interventional embolism is effective in the treatment of non-bronchial hemoptysis,which is safe and feasible.

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 explore the efficacy and safety of interventional embolism in the treatment of hemoptysis from non-bronchial arterial system.Methods We retrospectively analyzed clinical data of 23 cases of non-bronchial artery system derived hemoptysis from February 2017 to November 2024.The hemorrhagic blood vessels were only the non-bronchial artery system in 6 cases,and from the non-bronchial artery system and bronchial arteries in 17 cases.Sources of non-bronchial artery systems included 14 intercostal arteries,5 thyrocervical trunk,5 subscapular arteries,4 internal thoracic arteries,3 external thoracic arteries,5 diaphragmatic arteries,1 renal artery,and 1 left gastric artery.All the patients were treated with interventional embolism.Recurrence rate was followed up and postoperative complications were recorded.Results The immediate hemostasis rate after surgery was 95.7%(22/23).In one case,hemoptysis was relapsed within 24 h after the operation due to omission of diaphragmatic artery,and hemoptysis did not recurred after the secondary embolization.After surgery,there was 1 case of abdominal discomfort,2 cases of fever,and 2 cases of chest pain.The symptoms disappeared after conservative treatment.After the operation,the follow-up was 4-36 months(median,30 months).A total of 20 patients did not re-develop hemoptysis,while 3 had relapsed hemoptysis at 4 months,4 months,and 36 months after operation,respectively,with a recurrence rate of 13.0%(3/23).No serious complications occurred.Conclusion Interventional embolism is effective in the treatment of non-bronchial hemoptysis,which is safe and feasible.

Objective:To investigate the effects of learning flow experience on system thinking in medical students under the mixed mode.Methods:Medical students who completed Medical Statistics of the 2022-2023 academic year were enrolled.Then learning attitudes,learning flow experience,and system thinking were investigated using SATS-36 Scale,Adolescent Learning Flow Experience Questionnaire,and Systems Thinking Scale.Linear correlation analysis explored relationships among these variables.Multiple linear regression and restricted cubic spline(RCS)model analyzed linear/non-linear relationships between learning flow experience and system thinking after adjusting for gender,major,and learning attitude.Results:Among the 349 medical students surveyed,the mean score for learning attitudes was(4.31±0.59)and for learning flow experience was(3.33±0.65),both indicating a moderate to high level.The mean score for systems thinking was(59.01±13.57),indicating a moderate level.Positive correlations were found among learning flow experience,learning attitudes,and system thinking.Significant gender and major differences were observed in learning flow experience.After controlling for gender,major,and learning attitudes,multiple linear regression analysis revealed a significant linear trend between learning flow experience and system thinking(P＜0.01).RCS model analysis indicated a significant J-shaped nonlinear relationship between learning folw experience and system thinking(P for non-linearity＜0.01).Using the median score of 3.16 as the inflection point,when the learning flow experience score was＜3.16,it had no significant effect on medical students'system thinking(P=0.51).When the score was≥3.16,system thinking increased significantly with increasing learning flow experience(Beta per SD=0.56,95%CI:0.44-0.68,P＜0.01).Conclusions:The learning flow experience of medical students under the mixed mode can promote their system thinking.When the flow experience score is≥3.16,higher levels of learning flow experience are associated with increased systems thinking.Different dimensions of learning flow experience exhibit varying strengths of correlation with systems thinking.

Objective:To investigate the effects of learning flow experience on system thinking in medical students under the mixed mode.Methods:Medical students who completed Medical Statistics of the 2022-2023 academic year were enrolled.Then learning attitudes,learning flow experience,and system thinking were investigated using SATS-36 Scale,Adolescent Learning Flow Experience Questionnaire,and Systems Thinking Scale.Linear correlation analysis explored relationships among these variables.Multiple linear regression and restricted cubic spline(RCS)model analyzed linear/non-linear relationships between learning flow experience and system thinking after adjusting for gender,major,and learning attitude.Results:Among the 349 medical students surveyed,the mean score for learning attitudes was(4.31±0.59)and for learning flow experience was(3.33±0.65),both indicating a moderate to high level.The mean score for systems thinking was(59.01±13.57),indicating a moderate level.Positive correlations were found among learning flow experience,learning attitudes,and system thinking.Significant gender and major differences were observed in learning flow experience.After controlling for gender,major,and learning attitudes,multiple linear regression analysis revealed a significant linear trend between learning flow experience and system thinking(P＜0.01).RCS model analysis indicated a significant J-shaped nonlinear relationship between learning folw experience and system thinking(P for non-linearity＜0.01).Using the median score of 3.16 as the inflection point,when the learning flow experience score was＜3.16,it had no significant effect on medical students'system thinking(P=0.51).When the score was≥3.16,system thinking increased significantly with increasing learning flow experience(Beta per SD=0.56,95%CI:0.44-0.68,P＜0.01).Conclusions:The learning flow experience of medical students under the mixed mode can promote their system thinking.When the flow experience score is≥3.16,higher levels of learning flow experience are associated with increased systems thinking.Different dimensions of learning flow experience exhibit varying strengths of correlation with systems thinking.

Objective:To understand the epidemiological characteristics and spatiotemporal distribution of viral encephalitis in children and adolescents in Henan Province from 2012 to 2023.Methods:The information about viral encephalitis cases from October 1, 2012 to July 26, 2023 were collected from Zhengzhou Children's Hospital (National Children's Regional Medical Center),Henan Provincial Children's Hospital for the analyses on temporal distribution the cases, the severe illness rate, age distribution, pathogen type and imaging findings of the cases.Results:A total of 6 276 cases of viral encephalitis were included in this study after excluding cases with incomplete information. The cases mainly originated from Zhengzhou (38.96%), followed by Zhoukou (9.93%), Xuchang (8.68%), Zhumadian (7.90%) and Pingdingshan (7.39%). The cases in boys accounted for 62.13% and the cases in girls accounted for 37.87%. Most cases (72.45%) occurred in age group 7-13 years. The overall rate of severe illness cases was 4.51% from 2012 to 2023. There were significant differences in severe illness cases among different areas and years ( χ2=5.33, P=0.021; χ2=48.14, P<0.001). Enteroviruses were mainly detected (31.57%), in which Coxsackie virus was predominant (58.37%). Imaging findings showed that cerebral hemisphere damage was most common in children and adolescents with viral encephalitis (54.93%). Conclusions:From 2012 to 2023, more cases of viral encephalitis occurred in boys in Henan. Children and adolescents aged 7-13 years were the main affected group. The prevention of enteroviruses infection, especially Coxsackie virus, needs to be strengthened. Special attention should be paid to the prevention of cerebral hemisphere damage after viral encephalitis diagnosis.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To survey the nutritional status of elderly hospitalized patients with hyper-tension and frailty,and explore the correlation between nutrition and frailty.Methods A total of 801 elderly hypertensive patients admitted to our hospital from October 2022 to December 2023 were cosecutively enrolled,and according to Fried frailty phenotype criteria,they were divided into frailty group(score:≥3,276 cases),pre-frailty group(score:1-3,362 cases)and non-frailty group(score:0,163 cases).At the same time,MNA was used to evaluate the nutritional risk of the patients,and the scores of ADL and the score of ACCI were recorded.Logistic regression mod-el was used to analyze the influencing factors of frailty in elderly hypertensive patients,Spearman correlation analysis was employed to analyze the relationship between frailty and nutrition-related indicators,and ROC curve was plotted to analyze the predictive performance of these nutritional indicators in the occurrence of frailty.Results There were statistically differences among the three groups in terms of age,mean SBP,complication of other chronic diseases,polypharmacy,mean handgrip strength,calf circumference,MNA score and classification,ADL and ACCI scores,and levels of hemoglobin,HDL-C,LDL-C,TC,albumin,25-hydroxyvitamin D[25(OH)D],bone alkaline phosphatase,VitB12 and Hcy(P＜0.05,P＜0.01).Multivariate logistic regression analysis revealed that polypharmacy(OR=2.361,95％CI:1.332-4.183),MNA score ≥24(OR=0.298,95％CI:0.110-0.808),ADL score(OR=1.094,95％CI:1.028-1.166),albumin(OR=0.963,95％CI:0.934-0.994),and 25(OH)D(OR=0.989,95％CI:0.980-0.998)were independent risk factors for frailty in elderly hypertensive patients(P＜0.05,P＜0.01).Frailty was positively cor-related with age,polypharmacy,other chronic diseases,and ACCI score(P＜0.01),and negatively with MNA score,MNA classification,hemoglobin,albumin,25(OH)D,HDL-C,LDL-C,Hcy,average grip strength,and calf circumference(P＜0.01).ROC curve analysis showed that the AUC values of 25(OH)D,albumin,and MNA score were 0.607,0.588,and 0.700,separately.Con-clusion Elderly patients with hypertension and frailty have poor nutritional status,and identify-ing early frailty relies on nutritional risk assessment.Frail patients have a high risk of malnutri-tion and are influenced by various factors.Among them,albumin,MNA score,and 25(OH)D can effectively predict the occurrence of frailty in elderly hospitalized hypertensive patients,with MNA score having stronger predictive performance.

Postzygotic mutations are acquired in normal tissues throughout an individual's lifetime and hold clues for identifying mutagenic factors.Here,we investigated postzygotic mutation spectra of healthy individuals using optimized ultra-deep exome sequencing of the time-series samples from the same volunteer as well as the samples from different individuals.In blood,sperm,and muscle cells,we resolved three common types of mutational signatures.Signatures A and B represent clock-like mutational processes,and the polymorphisms of epigenetic regulation genes influence the pro-portion of signature B in mutation profiles.Notably,signature C,characterized by C＞T transitions at GpCpN sites,tends to be a feature of diverse normal tissues.Mutations of this type are likely to occur early during embryonic development,supported by their relatively high allelic frequencies,presence in multiple tissues,and decrease in occurrence with age.Almost none of the public datasets for tumors feature this signature,except for 19.6％of samples of clear cell renal cell carcinoma with increased activation of the hypoxia-inducible factor 1(HIF-1)signaling pathway.Moreover,the accumulation of signature C in the mutation profile was accelerated in a human embryonic stem cell line with drug-induced activation of HIF-1α.Thus,embryonic hypoxia may explain this novel signature across multiple normal tissues.Our study suggests that hypoxic condition in an early stage of embryonic development is a crucial factor inducing C＞T transitions at GpCpN sites;and indi-viduals'genetic background may also influence their postzygotic mutation profiles.