Schizophrenia,a severe mental illness characterized by high disability and chronicity,imposes a heavy disease burden on society and patients in China.Community-based management plays a crucial role in the long-term and comprehensive management of patients with schizophrenia.Through years of exploration,community-based management models—primarily focused on case management,assertive community treatment(ACT),and crisis intervention—have proven beneficial to the overall recovery of patients.However,notable differences exist in the implementation of these models between domestic and international practices.Given this context,we systematically analyze domestic and international research to examine the characteristics of different management models and the causes of the differences.Based on this analysis,we propose targeted recommendations for improving community-based management of schizophrenia in China.Regarding case management,a tiered approach should be adopted according to regional economic conditions and resource availability to optimize the efficiency of resource allocation.For ACT,we suggest developing a family-centered integrated intervention framework adapted to China's specific context.Finally,regarding crisis intervention,a collaborative family-community-police response mechanism should be established,complemented by enhanced professional training and streamlined referral procedures.We advocate enhancing resource allocation and theoretical research,along with broader involvement of all sectors of society,to jointly optimize the community-based management model for schizophrenia in China.

Objective To explore the economic toxicity perceptions and experiences of caregivers of colorectal cancer patients from the perspective of social ecological systems theory.Methods Using purposive sampling,18 caregivers of colorectal cancer patients hospitalized in the gastrointestinal sur-gery and oncology departments of a tertiary grade A hospital in Yangzhou were selected for semi-struc-tured interviews.The Colaizzi 7-step analysis method was employed to organize and analyze the data.Results Three main themes and nine sub-themes were extracted regarding the economic toxicity expe-riences and needs of caregivers of colorectal cancer patients.Microsystem included multiple negative experiences,impacted individual health,and difficulties in surrogate decision-making;mesosystem in-cluded heavy family financial burden,altered family lifestyle,and tense family atmosphere;macrosys-tem included needs for the scope and intensity of medical insurance reimbursement,needs for medical resources and services,and a desire for social support.Conclusion The ecological system of caregiv-ers of colorectal cancer patients is not optimistic,and is generally affected by economic toxicity.Inter-vention strategies can be sought from multiple aspects,including alleviating the negative experiences of caregivers,strengthening social support,and paying attention to the needs of caregivers,aiming to re-duce the level of economic toxicity among caregivers of colorectal cancer patients.

Objective:To report a SPTLC2 gene mutation in a family with a phenotype of Charcot-Marie-Tooth disease.Methods:To screen the family of patients with pathogenic mutations of SPTLC2 gene from the database of hereditary peripheral neuropathy in the Department of Neurology, Peking University First Hospital, and to collect their clinical data, peripheral nerve conduction examination, nerve ultrasound examination, pathological examination of the peroneal nerve and whole exome sequencing results of prohand.Results:One family was screened, the proband was a 16-year-old female with 4 years of sensory loss and anhidrosis of both lower limbs and 16 months of walking difficulty who admitted to Peking University First Hospital in January 2022. Physical examination showed sensory loss, dry skin and weakness in distal limbs. Her father had numbness and dry skin in the distal lower limbs from childhood,weakness and atrophy of his lower limbs in adulthood. He died at age of 52 years old. The nerve conduction study revealed no action potentials of the sensory and motor nerves of the lower limbs in the proband. The amplitude of the compound muscle action potential of the motor conduction of the bilateral ulnar nerve and median nerve decreased, and the nerve conduction velocity of the bilateral median nerve were 32 m/s and 24 m/s. Neurosonography showed thickening of peripheral nerves. Sural biopsy revealed severe loss of myelinated and unmyelinated nerve fibers with onion bulbs formation. SPTLC2 gene showed a known heterozygous p.G435V mutation. The lower limb weakness was improved after oral L-serine.Conclusions:SPTLC2 gene mutation can lead to an intermediate Charcot-Marie-Tooth disease phenotype. L-serine can improve the limb weakness.

Objective:To discusses the medication rules of Professor Yuan-Shaoying in the treatment of chronic prostatitis (CP), and to explore the relationship between TCM Syndrome Types and UPOINT system classification. Methods:The TCM syndrome type frequency, UPOINT system classification frequency, drug frequency, four Qi and five flavor meridian tropism frequency were counted by using TCM inheritance auxiliary platform (v2.5). The TCM Syndrome Types and TCM of each type in UPOINT system were obtained according to complex system entropy clustering.Results:A total of 123 prescriptions were included, involving 9 TCM syndrome types, of which the top five were dampness heat stasis syndrome, qi stagnation and blood stasis syndrome, kidney deficiency and blood stasis syndrome, dampness heat downpour syndrome, liver depression and kidney deficiency syndrome. The majority of patients with damp heat stasis syndrome were U-type (urination symptoms) and I-type (infection symptoms), liver depression and kidney deficiency syndrome were mainly p-type (psychological symptoms) and N-type (neural symptoms), most of qi stagnation and blood stasis syndrome were O-type (organ-specific symptoms) and T-type (pelvic floor muscle pain). There were 123 kinds of herbs, and the top five are Shixiaosan ( Wulingzhi + Puhuang), Yanhusuo, licorice, wild grape root and Salvia miltiorrhiza. The drugs mainly include promoting blood circulation and removing blood stasis, clearing heat and tonifying deficiency. The channels of meridian are mainly liver, spleen and kidney. Cold and flat properties are common, while bitter, sweet and pungent are common. According to the U-type classification, the Chinese medicines for clearing heat and detoxification, promoting blood circulation and removing blood stasis were the main drugs, and the top three Chinese medicines were wild grape root, snake berry and licorice root; the P-type was mainly composed of soothing the liver and relieving depression, promoting blood circulation and tonifying the kidney; the top three used frequency were bupleurum, licorice and Paeonia Alba; the O-type was mainly used for promoting Qi, promoting blood circulation, dredging collaterals and relieving pain, and the top three were used frequently. According to the I-type, the main TCMs were clearing heat and activating blood circulation, removing dampness and removing dampness. The top three kinds of TCM were wild grape root, Shixiaosan and liquorice. The N-type was mainly composed of soothing the liver and dredging collaterals, promoting blood circulation and tonifying the kidney, and the top three were bupleurum, Sparganium and Salvia miltiorrhiza; the T-type was mainly the TCM of promoting blood circulation and relieving pain, tonifying liver and kidney; and Yanhusuo, Shixiaosan and Salvia miltiorrhiza were the top three Chinese medicines used frequently. Conclusions:Professor Yuan-Shaoying often takes "promoting Qi, activating blood circulation and removing blood stasis "as the main treatment principle of CP, focusing on regulating the three meridians of liver,spleen and kidney. The relationship between UPOINT system and TCM syndrome types were warranted in further.

Objective:To observe the therapeutic effects of auricular point sticking in managing functional dyspepsia.Methods:Seventy patients with functional dyspepsia were randomly divided into two groups,with 35 patients in the treatment group receiving auricular point sticking therapy,and the other 35 patients in the control group managed by taking Domperidone orally.The therapeutic effects were evaluated 4 weeks later.Result:The total effective rate was 85.7% in the treatment group and82.9% in the control group.Although the difference of the total effective rate between the two groups was not significant,the treatment group was superior to the control group in the improvement of several symptoms(P<0.05).Conclusion:Auricular point sticking therapy is effective in treatment of functional dyspepsia,and compared to Domperidone,it is better in managing gastric pain,abdominal bloating,and belching.

Objective To investigate the correlation between genetic polymorphisms of glutathione S-transferases (GSTs) and ulcerative colitis (UC) in Hubei Han population. Methods Genetic polymorphisms of GSTM1 and GSTT1 of 270 patients with UC (UC group) who were admitted to the Zhongnan Hospital, People's Hospital of Wuhan University, Tongji Hospital and Union Hospital of Huazhong University of Science and Technology from August 2002 to December 2009 and 623 healthy people ( control group) were detected by restriction fragment length polymorphism-polymerase chain reaction. All UC patients were allocated to distal UC group (n= 229) and extensive UC group (n =41 ) according to the location of the lesions; and all UC patients were also allocated to mild-moderate group (n = 237) and severe group (n = 33 ). The genetic polymorphisms of GSTP1 of these patients and healthy people were detected by polymerase chain reaction. The genotypes of GSTM1, GSTT1 and GSTP1 were also detected. GSTM1 and GSTT1 containing small DNA segments ( 157 bp and 480 bp) were defined as GSTM1 (+) and GSTT1 (+), otherwise, GSTM(-) and GSTT1 (-), respectively. All data were analyzed by chisquare test. Results The frequencies of GSTM1(-), GSTT1(-) and GSTP1 (Val/Val) were 70.7% (191/270),64.8% (175/270) and 48.9% (132/270) in the UC group, and 41.7% (260/623), 47.2% ( 294/623 ) and 34.3% (214/623) in the control group, with a significant difference between the two groups (x2 = 63. 404,22. 320, 25. 384, P ＜0.05 ). The frequencies of GSTT1 (-) and GSTP1 (Val/Val) were 71.6% (164/229) and 57.6% (132/229) in the distal UC group, which were significantly higher than 31.7% (13/41) and 29.3%( 12/41 ) in the extensive UC group ( x2 = 24.528, 9.609, P ＜ 0.05 ). The frequencies of GSTM1 (-) were 65.1%(149/229) in the distal UC group and 56.1% (23/41) in the extensive UC group, with no significant difference between the two groups ( x2 = 1. 210, P ＞ 0.05 ). The frequencies of GSTT1 (-) and GSTP1 ( Val/Val ) were 71.6%(164/229), 31.7% ( 13/41 ) in the distal UC group and 57.6% ( 132/229), 29.3% ( 12/41 ) in the extensive UC group, with a significant difference between the two groups ( x2 = 24. 528, 9. 609, P ＜ 0. 05 ). There was no significant difference in the frequencies of GSTM1 (-), GSTT1 (-), GSTP1 (Val/Val) in the mild-moderate group and the severe group( x2 = 0. 623, 1. 884, 3. 403, P ＞ 0. 05 ). Conclusions Variant genotypes of GSTs are significantly correlated with UC in Hubei Han population. The severity of UC may not be correlated with variant genotypes of GSTs.