Schizophrenia (SZ) stands as a severe psychiatric disorder. This study applied diffusion tensor imaging (DTI) data in conjunction with graph neural networks to distinguish SZ patients from normal controls (NCs) and showcases the superior performance of a graph neural network integrating combined fractional anisotropy and fiber number brain network features, achieving an accuracy of 73.79% in distinguishing SZ patients from NCs. Beyond mere discrimination, our study delved deeper into the advantages of utilizing white matter brain network features for identifying SZ patients through interpretable model analysis and gene expression analysis. These analyses uncovered intricate interrelationships between brain imaging markers and genetic biomarkers, providing novel insights into the neuropathological basis of SZ. In summary, our findings underscore the potential of graph neural networks applied to multimodal DTI data for enhancing SZ detection through an integrated analysis of neuroimaging and genetic features.
Humans ; Schizophrenia/pathology* ; Diffusion Tensor Imaging/methods* ; Male ; Female ; Adult ; Brain/metabolism* ; Young Adult ; Middle Aged ; White Matter/pathology* ; Gene Expression ; Nerve Net/diagnostic imaging* ; Graph Neural Networks

Objective:To evaluate the clinical efficacy of individualized postural management guided by lung ultrasound (LUS) in neonates with grade Ⅲ bronchopulmonary dysplasia (BPD).Methods:This prospective randomized controlled trial enrolled neonates diagnosed with grade Ⅲ BPD at Guangdong Second People's Hospital Affiliated to Jinan University from July 2022 to December 2024, who were randomly assigned to control or intervention groups. The control group received conventional postural management (head elevation 15°-30°, supine-left lateral-right lateral-prone positioning with 2-hour rotations), while the intervention group underwent additional LUS examinations every 12 hours for dynamic posture adjustment based on pulmonary findings. Outcomes included LUS signs (pleural line abnormalities, A-line disappearance, B-line increases, cystic hyperaeration, alveolar-interstitial syndrome, consolidation) and primary endpoints (post-diagnosis oxygen therapy duration, invasive mechanical ventilation duration, and hospital stay). Secondary outcomes comprised new complications (pulmonary hemorrhage, necrotizing enterocolitis, BPD-associated pulmonary hypertension, grade Ⅲ-Ⅳ intracranial hemorrhage, retinopathy of prematurity). Intergroup comparisons used two independent samples t-tests and Chi square tests. Results:Among 49 eligible neonates, 47 were randomized (intervention group=24; control group=23), with 40 completing the study (20 per group after exclusions). At day 7, the intervention group showed significantly lower rates of pleural line abnormalities [55% (11/20) vs. 90% (18/20), χ2=6.14, P=0.013], A-line disappearance [50% (10/20) vs. 80% (16/20), χ2=3.95, P=0.046], B-line increases [50% (10/20) vs. 85% (17/20), χ2=5.58, P=0.018], alveolar-interstitial syndrome [65% (13/20) vs. 95% (19/20), χ2=5.62, P=0.017], and consolidation [50% (10/20) vs. 80% (16/20), χ2=3.95, P=0.046]. The intervention group also demonstrated shorter invasive ventilation [(9.5±2.3) vs. (11.6±3.5) days, t=2.18, P=0.035] and hospital stay [(58.9±4.9) vs. (63.2±6.4) days, t=2.33, P=0.025] post-diagnosis, with no significant differences in new complication rates (all P>0.05). Conclusion:LUS-guided postural management improves pulmonary pathology, reduces respiratory support duration and hospitalization, without increasing complications in grade Ⅲ BPD neonates.

Objective:To evaluate the clinical efficacy of individualized postural management guided by lung ultrasound (LUS) in neonates with grade Ⅲ bronchopulmonary dysplasia (BPD).Methods:This prospective randomized controlled trial enrolled neonates diagnosed with grade Ⅲ BPD at Guangdong Second People's Hospital Affiliated to Jinan University from July 2022 to December 2024, who were randomly assigned to control or intervention groups. The control group received conventional postural management (head elevation 15°-30°, supine-left lateral-right lateral-prone positioning with 2-hour rotations), while the intervention group underwent additional LUS examinations every 12 hours for dynamic posture adjustment based on pulmonary findings. Outcomes included LUS signs (pleural line abnormalities, A-line disappearance, B-line increases, cystic hyperaeration, alveolar-interstitial syndrome, consolidation) and primary endpoints (post-diagnosis oxygen therapy duration, invasive mechanical ventilation duration, and hospital stay). Secondary outcomes comprised new complications (pulmonary hemorrhage, necrotizing enterocolitis, BPD-associated pulmonary hypertension, grade Ⅲ-Ⅳ intracranial hemorrhage, retinopathy of prematurity). Intergroup comparisons used two independent samples t-tests and Chi square tests. Results:Among 49 eligible neonates, 47 were randomized (intervention group=24; control group=23), with 40 completing the study (20 per group after exclusions). At day 7, the intervention group showed significantly lower rates of pleural line abnormalities [55% (11/20) vs. 90% (18/20), χ2=6.14, P=0.013], A-line disappearance [50% (10/20) vs. 80% (16/20), χ2=3.95, P=0.046], B-line increases [50% (10/20) vs. 85% (17/20), χ2=5.58, P=0.018], alveolar-interstitial syndrome [65% (13/20) vs. 95% (19/20), χ2=5.62, P=0.017], and consolidation [50% (10/20) vs. 80% (16/20), χ2=3.95, P=0.046]. The intervention group also demonstrated shorter invasive ventilation [(9.5±2.3) vs. (11.6±3.5) days, t=2.18, P=0.035] and hospital stay [(58.9±4.9) vs. (63.2±6.4) days, t=2.33, P=0.025] post-diagnosis, with no significant differences in new complication rates (all P>0.05). Conclusion:LUS-guided postural management improves pulmonary pathology, reduces respiratory support duration and hospitalization, without increasing complications in grade Ⅲ BPD neonates.

Objective:To evaluate the efficacy of oliceridine for analgesia in the patients undergoing radical thyroidectomy for thyroid cancer.Methods:In this prospective, randomized, double-blind, single-center, positive-control study, 84 patients of either sex, aged 18-64 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, weighing 50-70 kg, with a body mass index of 18-28 kg/m 2, education years ≥ 6 yr, and expected surgery time>1 h, with thyroid cancer undergoing radical surgery under general anesthesia at the Affiliated Cancer Hospital of Zhengzhou University from August to October 2024, were divided into 2 groups using a random number table method: sufentanil group (S group, n=41) and oliceridine group (O group, n=43). During anesthesia induction: Group S received intravenous injection of sufentanil 15 μg, while group O received intravenous injection of oliceridine 3 mg; If the increase in mean arterial pressure or heart rate exceeded 20% of the baseline value within 3 min after tracheal intubation, an additional 5 μg of sufentanil (S group) or 1 mg of oliceridine (O group) was added. At 2 min before skin incision, sufentanil 15 μg was intravenously injected in group S, and oliceridine 3 mg was intravenously injected in group O. Effectiveness evaluation indicators: The visual analog scale scores were recorded at 5 min after tracheal extubation, immediately upon exiting the post-anesthesia care unit, and at 24 and 48 h postoperatively; Ramsay sedation scores were recorded at 5, 10, 20 and 30 min after tracheal extubation. The safety evaluation indicators: The use of vasoactive drugs during surgery and occurrence of adverse reactions within 48 h after surgery were recorded. Results:Compared with group S, no significant change was found in visual analog scale scores at different time points after surgery and Ramsay sedation scores at different time points after tracheal extubation ( P>0.05), and the usage rate of atropine during surgery and incidence of postoperative nausea and vomiting were significantly decreased in group O ( P<0.05). Conclusions:Oliceridine can produce postoperative analgesic efficacy comparable to sufentanil in the patients undergoing radical thyroidectomy for thyroid cancer, with smoother intraoperative hemodynamics and lower incidence of postoperative nausea and vomiting.

Objective:To evaluate the efficacy of oliceridine for postoperative analgesia in patients undergoing breast-conserving surgery for breast cancer.Methods:In this prospective, randomized, double-blind, single-center, positive-control clinical study, 123 patients with breast cancer, aged 18-64 yr, of American Society of Anesthesiologists Physical Status classification I or Ⅱ, with a body mass index of 18-28 kg/m 2, undergoing breast-conserving surgery under general anesthesia at the Affiliated Cancer Hospital of Zhengzhou University from May to August 2024, were divided into 2 groups using a random number table method: sufentanil group (group S, n=62) and oliceridine group (group O, n=61). During anesthesia induction, sufentanil 15 μg was intravenously injected in group S, and oliceridine 3 mg was intravenously injected in group O. At 2 min before skin incision, sufentanil 10 μg was intravenously injected in group S, and oliceridine 2 mg was intravenously injected in group O. Postoperative patient-controlled intravenous analgesia was performed, with group S receiving sufentanil 50 μg and group O receiving oliceridine 10 mg, each diluted with normal saline to 100 ml. The pain visual analog scale scores at rest and during activity were recorded at 6, 12, 24 and 48 h postoperatively. The time of the first pressing of the postoperative analgesic pump, effective pressing times of patient-controlled analgesia and requirement for rescue analgesia within 24 h after surgery were recorded. The Ramsay sedation scores were recorded at 5, 15 and 30 min after tracheal extubation. The postoperative recovery quality was measured using the 15-item quality of recovery questionnaire at 24 h before surgery and at 24 and 48 h after surgery. The adverse reactions were recorded within 48 h after surgery. Results:Compared with group S, no significant change was found in visual analog scale scores at rest and during activity at different time points, the time of the first pressing of the postoperative analgesic pump, effective pressing times of patient-controlled analgesia and requirement for rescue analgesia within 24 h after operation, or the Ramsay sedation scores at 5, 15 and 30 min after tracheal extubation ( P>0.05), and 15-item quality of recovery scores were significantly increased at 24 and 48 h after surgery, and the incidence of postoperative nausea and vomiting was decreased in group O ( P<0.05). Conclusions:Oliceridine produces postoperative analgesic effects comparable to sufentanil without affecting patient awakening and reduces postoperative nausea and vomiting, which is helpful for early postoperative recovery when used in the patients undergoing breast-conserving surgery for breast cancer.

Objective:To evaluate the efficacy of oliceridine for analgesia in the patients undergoing radical thyroidectomy for thyroid cancer.Methods:In this prospective, randomized, double-blind, single-center, positive-control study, 84 patients of either sex, aged 18-64 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, weighing 50-70 kg, with a body mass index of 18-28 kg/m 2, education years ≥ 6 yr, and expected surgery time>1 h, with thyroid cancer undergoing radical surgery under general anesthesia at the Affiliated Cancer Hospital of Zhengzhou University from August to October 2024, were divided into 2 groups using a random number table method: sufentanil group (S group, n=41) and oliceridine group (O group, n=43). During anesthesia induction: Group S received intravenous injection of sufentanil 15 μg, while group O received intravenous injection of oliceridine 3 mg; If the increase in mean arterial pressure or heart rate exceeded 20% of the baseline value within 3 min after tracheal intubation, an additional 5 μg of sufentanil (S group) or 1 mg of oliceridine (O group) was added. At 2 min before skin incision, sufentanil 15 μg was intravenously injected in group S, and oliceridine 3 mg was intravenously injected in group O. Effectiveness evaluation indicators: The visual analog scale scores were recorded at 5 min after tracheal extubation, immediately upon exiting the post-anesthesia care unit, and at 24 and 48 h postoperatively; Ramsay sedation scores were recorded at 5, 10, 20 and 30 min after tracheal extubation. The safety evaluation indicators: The use of vasoactive drugs during surgery and occurrence of adverse reactions within 48 h after surgery were recorded. Results:Compared with group S, no significant change was found in visual analog scale scores at different time points after surgery and Ramsay sedation scores at different time points after tracheal extubation ( P>0.05), and the usage rate of atropine during surgery and incidence of postoperative nausea and vomiting were significantly decreased in group O ( P<0.05). Conclusions:Oliceridine can produce postoperative analgesic efficacy comparable to sufentanil in the patients undergoing radical thyroidectomy for thyroid cancer, with smoother intraoperative hemodynamics and lower incidence of postoperative nausea and vomiting.

Objective:To evaluate the efficacy of oliceridine for postoperative analgesia in patients undergoing breast-conserving surgery for breast cancer.Methods:In this prospective, randomized, double-blind, single-center, positive-control clinical study, 123 patients with breast cancer, aged 18-64 yr, of American Society of Anesthesiologists Physical Status classification I or Ⅱ, with a body mass index of 18-28 kg/m 2, undergoing breast-conserving surgery under general anesthesia at the Affiliated Cancer Hospital of Zhengzhou University from May to August 2024, were divided into 2 groups using a random number table method: sufentanil group (group S, n=62) and oliceridine group (group O, n=61). During anesthesia induction, sufentanil 15 μg was intravenously injected in group S, and oliceridine 3 mg was intravenously injected in group O. At 2 min before skin incision, sufentanil 10 μg was intravenously injected in group S, and oliceridine 2 mg was intravenously injected in group O. Postoperative patient-controlled intravenous analgesia was performed, with group S receiving sufentanil 50 μg and group O receiving oliceridine 10 mg, each diluted with normal saline to 100 ml. The pain visual analog scale scores at rest and during activity were recorded at 6, 12, 24 and 48 h postoperatively. The time of the first pressing of the postoperative analgesic pump, effective pressing times of patient-controlled analgesia and requirement for rescue analgesia within 24 h after surgery were recorded. The Ramsay sedation scores were recorded at 5, 15 and 30 min after tracheal extubation. The postoperative recovery quality was measured using the 15-item quality of recovery questionnaire at 24 h before surgery and at 24 and 48 h after surgery. The adverse reactions were recorded within 48 h after surgery. Results:Compared with group S, no significant change was found in visual analog scale scores at rest and during activity at different time points, the time of the first pressing of the postoperative analgesic pump, effective pressing times of patient-controlled analgesia and requirement for rescue analgesia within 24 h after operation, or the Ramsay sedation scores at 5, 15 and 30 min after tracheal extubation ( P>0.05), and 15-item quality of recovery scores were significantly increased at 24 and 48 h after surgery, and the incidence of postoperative nausea and vomiting was decreased in group O ( P<0.05). Conclusions:Oliceridine produces postoperative analgesic effects comparable to sufentanil without affecting patient awakening and reduces postoperative nausea and vomiting, which is helpful for early postoperative recovery when used in the patients undergoing breast-conserving surgery for breast cancer.

Single-cell RNA sequencing (scRNA-seq) is used for transcriptome profiling at the individual cell level, which is capable of screening in differentially gene expression that results from genetic mutation. Islet-based developmental atlas and heterogeneity characterization are currently the main applications of scRNA-seq in diabetes. scRNA-seq also can be used to mark and purify the functional β cells from resident adult stem cells in the pancreatic islets, which is expected to improve the outcome of islet β cells transplantation in type 1 diabetic patients. In addition, the technique can aid in learning diabetic β cell dedifferentiation and immunomodulatory functions. Although the study of scRNA-seq in diabetic retinopathy, nephropathy, atherosclerosis, and peripheral neuropathy is still at a nascent stage, scRNA-seq has great potential in a wide range of biomedical and clinical applications.

Objective:To investigate the risk factors of diabetic nephropathy (DN) in primary type 2 diabetes mellitus (T2DM) patients and to quantitatively analyze the risk of DN by nomogram modeling.Methods:A total of 1 588 primary T2DM patients from 17 townships and streets in Zhejiang Province were enrolled from June 2018 to August 2018 in this cross-sectional study, with an average age of (56.8±10.1) years (50.06% male) and a mean disease duration of 9 years. The clinical data, biochemical test results, and fundus photographs of all T2DM patients were collected, and logistic regression analysis was used to screen the risk factors of DN. Then, a nomogram model was used to quantitatively analyze the risk of DN.Results:DN occurred in 27.71% (440/1 588 cases) primary type 2 diabetes patients. Hemoglobin A 1c (HbA 1c) ( OR=1.159, 95% CI 1.039-1.292), systolic blood pressure ( OR=1.041, 95% CI 1.031-1.051), serum creatinine (Scr) ( OR=1.011, 95% CI 1.004-1.017), serum globulin (GLOB) ( OR=1.072, 95% CI 1.039-1.105), diabetic retinopathy (DR) ( OR=1.463, 95% CI 1.073-1.996), education level of more than junior high school ( OR=2.018, 95% CI 1.466-2.777), and moderate-intensity exercise ( OR=0.751, 95% CI 0.586-0.961) were influencing factors of DN. Nomogram model analysis showed that the total score of each factor of DN ranged from 64-138 points, and the corresponding risk rate ranged from 0.1-0.9. The nomogram model also predicted a C-index value of 0.753 (95% CI 0.726-0.781) and an area under the receiver operating characteristic curve of DN of 0.753. Internal verification of the C-index reached 0.738. The model displayed medium predictive power and could be applied in clinical practice. Conclusions:HbA 1c, systolic blood pressure, Scr, GLOB, DR, and more than a junior high school education are independent risk factors of DN. Nomogram modeling can more intuitively evaluate the risk of DN in primary T2DM patients.

Objective:To analysis the correlation of eating speed with obesity.Methods:A total of 644 people aged 40-65 from Caihe Community in Hangzhou were enrolled to collect clinical and demographic data, undergo extensive physical examination and laboratory tests. Participants were divided into two groups according to their eating speed (non-fast and fast). Obesity-related parameters were compared between two groups. Multivariable logistic regression was conducted to explore the relationship between eating speed and obesity after adjusting confounders.Results:Body mass index, waist circumference, and visceral fat area were greater in the fast eating group than non-fast eating group(all P<0.01). After adjusting for age, gender, smoking, alcohol drinking, physical activity level per week, and principal food intake, logistic regression analysis showed that eating fast was correlated with abdominal obesity( OR=1.66, 95% CI 1.11-2.48, P=0.014) and visceral obesity( OR=1.65, 95% CI 1.14-2.39, P=0.007). After stratified by gender, in the group of men, eating fast was correlated with abdominal obesity( OR=2.04, 95% CI 1.07-4.04, P=0.032) and visceral obesity( OR=1.85, 95% CI 1.04-3.31, P=0.037); In the group of women, eating fast was correlated with overweight and obesity( OR=1.59, 95% CI 1.04-2.42, P=0.031). Conclusion:Eating fast is positively associated with obesity. Interventions for reducing eating speed may be effective for weight control.