Objective To investigate the serum amino acid levels in patients with acute schizophrenia(SCZ)and their predictive effect on the improvement of cognitive function after treatment,so as to provide new insights into the clinical intervention of cognitive impairment in SCZ patients.Methods A total of 66 patients with acute SCZ were enrolled(case group-baseline period).Among them,36 cases completed the follow-up after 3 months of standardized treatment(case group-follow-up period);52 healthy controls(HCs)were included.The MATRICS Consensus Cognitive Battery(MCCB)was used to assess the cognitive function of all the participants.Liquid chromatography-tandem mass spectrometry(LC-MS)was employed to detect the concentrations of 18 amino acids in fasting serum of the case group-baseline period and the control group.Independent samples t-test was used to compare serum amino acid levels and cognitive function between the case group-baseline period and the control group.Paired t-test was used to compare the differences in cognitive function between the baseline period and the follow-up period of the case group.Spearman correlation analysis and multivariate linear regression model were used to investigate the correlation between serum amino acid levels at baseline in the case group and the improvement of cognitive function after 3 months of treatment.Results Compared with the control group,the cognitive function of SCZ patients in multiple dimensions at baseline was significantly reduced(P＜0.05).After treatment,the scores of Trail Making Test(TMT),Brief Assessment of Cognition in Schizophrenia:Symbol Coding(BACS),Wechsler Memory Scale-Ⅲ(WMS),and Brief Visuospatial Memory Test-Revised(BVMT)in patients were significantly improved(all P＜0.05).In addition,the levels of proline,methionine,histidine,phenylalanine,arginine,tyrosine,aspartic acid,tryptophan,lysine,and glutamic acid were significantly lower in the case group at baseline than in the control group(all P＜0.05).Among them,the baseline tyrosine level had a significant predictive value for the improvement of TMT(R2=0.136,P=0.029),Neuropsychological Assessment Battery(NAB)(R2=0.339,P＜0.001),and Mayer-Salovey-Caruso Emotional Intelligence Test(MSCEIT)test(R2=0.165,P=0.015).The baseline arginine level had a significant predictive value for the improvement rate of Fluency test(R2=0.113,P=0.048).Conclusion There is a decrease in various amino acid levels in patients with SCZ,and some amino acids can effectively predict the improvement of cognitive function after treatment.

Objective:To investigate the effects of Yisui Shengxue Decoction on the regulation of Notch signaling pathway on bone marrow hematopoiesis in mice with aplastic anemia(AA).Methods:A total of 60 CByB6F1 mice were randomly divided into blank group,model group,positive control cyclosporine(CsA)group,low-dose(YSSX-L)group and high-dose(YSSX-H)group of Chinese herbal compound Yisui Shengxue Decoction,with 12 mice in each group.Except for the blank group,the mice in each group were given 5 Gy X-ray irradiation combined with tail vein infusion of lymphocytes to establish the immune-mediated AA mouse model.The low and high dose groups were given 8.6 and 17.2 g/(kg?d)of Yisui Shengxue Decoction by gavage,the model group and the blank group were given equal volume of saline by gavage,and the positive control group was given 25 mg/(kg?d)of cyclosporine by ga-vage for 14 days.The mice were tested for white blood cell count(WBC),red blood cell count(RBC),hemoglobin(Hb),platelet count(PLT)and bone marrow nucleated cell count in peripheral blood,bone marrow pathological changes and the levels of IFN-γ,IL-4 and IL-5 in peripheral serum,and T-lymphocyte transcription factors T-bet,GATA3,RORγt,FOXP3 mRNA and protein in spleen tissues,as well as the expression levels of Notch signaling pathway-related genes and protein in spleen tissues.Results:Compared with the blank group,the peripheral blood WBC,RBC,Hb,PLT,bone marrow nucleated cell count,expressions of serum IL-4,IL-5 and spleen tissue GATA3,FOXP3 mRNA and protein were significantly lower in the model group(P<0.01),and the expressions of serum IFN-γ,spleen tissue T-bet,RORγt mRNA and protein,and Notch1,Jagged1,DLL4 mRNA and protein were significantly in-creased(P<0.05).Compared with the model group,peripheral blood WBC,RBC,Hb,PLT,bone marrow nucleated cell count,ex-pressions of serum IL-4,IL-5 and spleen tissue GATA3,FOXP3 mRNA and protein were significantly higher in each intervention group(P<0.05),and the expression of serum IFN-γ and spleen tissue T-bet,RORγt mRNA and protein as well as Notch1,Jagged1,DLL4 mRNA and protein were significantly reduced(P<0.05).Conclusion:Yisui Shengxue Decoction can improve bone marrow he-matopoietic function and regulate immune disorders in AA mice,and its mechanism of action may be related to the regulation of Notch signaling pathway.

Objective To investigate the serum amino acid levels in patients with acute schizophrenia(SCZ)and their predictive effect on the improvement of cognitive function after treatment,so as to provide new insights into the clinical intervention of cognitive impairment in SCZ patients.Methods A total of 66 patients with acute SCZ were enrolled(case group-baseline period).Among them,36 cases completed the follow-up after 3 months of standardized treatment(case group-follow-up period);52 healthy controls(HCs)were included.The MATRICS Consensus Cognitive Battery(MCCB)was used to assess the cognitive function of all the participants.Liquid chromatography-tandem mass spectrometry(LC-MS)was employed to detect the concentrations of 18 amino acids in fasting serum of the case group-baseline period and the control group.Independent samples t-test was used to compare serum amino acid levels and cognitive function between the case group-baseline period and the control group.Paired t-test was used to compare the differences in cognitive function between the baseline period and the follow-up period of the case group.Spearman correlation analysis and multivariate linear regression model were used to investigate the correlation between serum amino acid levels at baseline in the case group and the improvement of cognitive function after 3 months of treatment.Results Compared with the control group,the cognitive function of SCZ patients in multiple dimensions at baseline was significantly reduced(P＜0.05).After treatment,the scores of Trail Making Test(TMT),Brief Assessment of Cognition in Schizophrenia:Symbol Coding(BACS),Wechsler Memory Scale-Ⅲ(WMS),and Brief Visuospatial Memory Test-Revised(BVMT)in patients were significantly improved(all P＜0.05).In addition,the levels of proline,methionine,histidine,phenylalanine,arginine,tyrosine,aspartic acid,tryptophan,lysine,and glutamic acid were significantly lower in the case group at baseline than in the control group(all P＜0.05).Among them,the baseline tyrosine level had a significant predictive value for the improvement of TMT(R2=0.136,P=0.029),Neuropsychological Assessment Battery(NAB)(R2=0.339,P＜0.001),and Mayer-Salovey-Caruso Emotional Intelligence Test(MSCEIT)test(R2=0.165,P=0.015).The baseline arginine level had a significant predictive value for the improvement rate of Fluency test(R2=0.113,P=0.048).Conclusion There is a decrease in various amino acid levels in patients with SCZ,and some amino acids can effectively predict the improvement of cognitive function after treatment.

Objective:To investigate the effects of Yisui Shengxue Decoction on the regulation of Notch signaling pathway on bone marrow hematopoiesis in mice with aplastic anemia(AA).Methods:A total of 60 CByB6F1 mice were randomly divided into blank group,model group,positive control cyclosporine(CsA)group,low-dose(YSSX-L)group and high-dose(YSSX-H)group of Chinese herbal compound Yisui Shengxue Decoction,with 12 mice in each group.Except for the blank group,the mice in each group were given 5 Gy X-ray irradiation combined with tail vein infusion of lymphocytes to establish the immune-mediated AA mouse model.The low and high dose groups were given 8.6 and 17.2 g/(kg?d)of Yisui Shengxue Decoction by gavage,the model group and the blank group were given equal volume of saline by gavage,and the positive control group was given 25 mg/(kg?d)of cyclosporine by ga-vage for 14 days.The mice were tested for white blood cell count(WBC),red blood cell count(RBC),hemoglobin(Hb),platelet count(PLT)and bone marrow nucleated cell count in peripheral blood,bone marrow pathological changes and the levels of IFN-γ,IL-4 and IL-5 in peripheral serum,and T-lymphocyte transcription factors T-bet,GATA3,RORγt,FOXP3 mRNA and protein in spleen tissues,as well as the expression levels of Notch signaling pathway-related genes and protein in spleen tissues.Results:Compared with the blank group,the peripheral blood WBC,RBC,Hb,PLT,bone marrow nucleated cell count,expressions of serum IL-4,IL-5 and spleen tissue GATA3,FOXP3 mRNA and protein were significantly lower in the model group(P<0.01),and the expressions of serum IFN-γ,spleen tissue T-bet,RORγt mRNA and protein,and Notch1,Jagged1,DLL4 mRNA and protein were significantly in-creased(P<0.05).Compared with the model group,peripheral blood WBC,RBC,Hb,PLT,bone marrow nucleated cell count,ex-pressions of serum IL-4,IL-5 and spleen tissue GATA3,FOXP3 mRNA and protein were significantly higher in each intervention group(P<0.05),and the expression of serum IFN-γ and spleen tissue T-bet,RORγt mRNA and protein as well as Notch1,Jagged1,DLL4 mRNA and protein were significantly reduced(P<0.05).Conclusion:Yisui Shengxue Decoction can improve bone marrow he-matopoietic function and regulate immune disorders in AA mice,and its mechanism of action may be related to the regulation of Notch signaling pathway.

Objective To investigate the effect of peripheral blood bile acids on the cognitive function of schizophrenia patients.Methods Targeted metabolomics was adopted to analyze the total level of primary and secondary serum bile acid metabolites collected from 23 schizophrenia patients and 23 health control individuals.The MATRICS Consensus Cognitive Battery(MCCB)was adopted to evaluate the subjects'cognitive function in five dimensions.Results We found that the schizophrenia patients had impaired cognitive functions in multiple dimensions including speed of processing,working memory,reasoning and problem solving,and visual learning.Compared with the health control group,serum levels of cholic acid(CA)and chenodeoxycholic acid(CDCA)were significantly lower in patients with schizophrenia,while serum level of glycocholic acid(GCA)was significantly higher,and the ratio of deoxycholic acid(DCA)to CA was higher(3.04 vs.1.16).Speed of processing,working memory,reasoning and problem solving,and visual learning abilities were significantly negatively correlated with serum levels of multiple primary bile acids including taurocholic acid(TCA),GCA,glycochenodeoxycholic acid(GCDCA)and taurochenodeoxycholic acid(TCDCA),after adjustments of age,sex,and body mass index.Conclusion The bile acid profile of schizophrenia patients is obvious,and the decrease in neuroprotective bile acids(namely,CA and CDCA)and the up-regulation of cytotoxic bile acid(i.e.,GCA)may impair the cognitive function of schizophrenia patients.

Objective:To explore the clinical value of shear wave elastography in the diagnosis and pathological classification of nephrotic syndrome.Methods:A retrospective analysis was conducted on the clinical data of 43 patients with primary nephrotic syndrome (primary nephrotic syndrome group) diagnosed through renal biopsy at the Yongchuan Hospital Affiliated to Chongqing Medical University from June 2022 to March 2023. They were further divided into three subgroups: mesangial proliferative glomerulonephritis group, membranous nephropathy group, and minimal change nephropathy group. Another 30 healthy individuals were selected as the control group. We applied shear wave elastography to measure the shear wave velocity of the right renal lower pole parenchyma and statistically analyzed the differences in shear wave velocity between each group.Results:There was a statistically significant difference in shear wave velocity between the primary nephrotic syndrome group [(1.76±0.41)m/s] and the control group [(1.55±0.34)m/s] ( P<0.05); The shear wave velocity in the membranous nephropathy group [(1.97±0.36)m/s] was the highest, and there was a statistically significant difference ( P<0.05) compared to the small lesion nephropathy group [(1.54±0.42)m/s]; There was no statistically significant difference in shear wave velocity between the membranous nephropathy group and the mesangial proliferative glomerulonephritis group [(1.74±0.38)m/s], as well as between the mesangial proliferative glomerulonephritis group and the small lesion nephropathy group (all P>0.05). Conclusions:Shear wave elastography is a non-invasive examination that provides valuable clinical clues for the diagnosis and pathological classification of nephrotic syndrome by detecting the shear wave velocity of the kidney.

Objective:To understand the current situation of nurses' willingness to engage in telecare in county-level hospitals in Henan Province and analyze its influencing factors.Methods:Using the convenient sampling method, a total of 1 300 clinical nurses from 6 Class Ⅱ Grade A county-level hospitals in Zhengzhou, Hebi, Zhoukou and other cities in Henan Province were selected as the research objects from August 2022 to January 2023. General Data Questionnaire and Clinical Nurses' Willingness to Engage in Telecare Questionnaire were used to investigate the research objects. Non-parametric test and multiple linear regression were used to analyze the influencing factors of clinical nurses' willingness to engage in telecare.Results:A total of 1 300 questionnaires were sent out in this study, and 1 183 were effectively collected, with an effective recovery rate of 91.00% (1 183/1 300). The total score of Clinical Nurses' Willingness to Engage in Telecare Questionnaire of 1 183 nurses in county-level hospitals was [105.00 (98.00, 112.00) ] points, and all items were scored [3.50 (3.27, 3.73) ]. Multiple linear regression analysis showed that professional title, post, whether they knew about telecare, and the number of times of receiving training on nursing information each year were the influencing factors of nurses' willingness to engage in telecare in county-level hospitals ( P<0.05) . Conclusions:In Henan Province, 1 183 nurses in county-level hospitals have a high willingness to engage in telecare. Relevant departments should further strengthen the publicity of relevant contents of telecare, carry out practical operation training related to nursing information, improve the nursing information ability of nurses in county-level hospitals and strengthen the awareness of health management services, so as to promote the successful implementation of telecare services in rural areas.

Objective:To evaluate the clinical effect of Toric design orthokeratology in myopic teenagers with mild-to-moderate astigmatism.Methods:A non-randomized controlled clinical study was conducted.Eighty juvenile myopia patients (160 eyes) diagnosed with mild to moderate astigmatism with myopia after mydriatic computer optometry and received the treatment of orthokeratology at Zhejiang Rongjun Hospital from January 2016 to June 2017 were enrolled.The patients were divided into regular spherical design orthokeratology group and Toric design orthokeratology group, with 80 eyes (40 cases) in each group.The patients wore orthokeratology for 8 to 10 hours every night and were re-examined at 1 day, 1 week and 1, 3, 6, 12 and 18 months after wearing, respectively.The visual acuity, refraction, corneal health status and central deviation of the treatment area in the corneal topography map were measured and recorded during the 18-month treatment.The complications during treatment were recorded.After 12-month wearing, the uncorrected visual acuity and the center deviation of the treatment area were compared between the two groups.After 18-month wearing, patients in the two groups stopped wearing the orthokeratology lens for 1 month, and then the refraction examination, IOLMaster and corneal topography were performed to compare the spherical equivalent, axial length and degree of astigmatism.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Zhejiang Rongjun Hospital (No.2020-10). Written informed consent was obtained from guardians prior to any medical examination.Results:After 12-month wearing, the center deviation of the shaping treatment area was (0.86±0.23)mm in the Toric design orthokeratology group, which was significantly lower than (1.16±0.44)mm in the regular spherical design orthokeratology group ( t=5.404, P<0.001). After 12-month wearing, the uncorrected visual acuity was (0.03±0.08) LogMAR in the Toric design orthokeratology group, which was significantly higher than (0.09±0.10) LogMAR in the regular spherical design orthokeratology group ( t=2.963, P=0.004). The spherical equivalent and the axial length of Toric design orthokeratology group were significantly smaller than those of the regular spherical design orthokeratology group ( t=2.542, 2.107; both at P<0.05), and there was no statistically significant difference in the degree of astigmatism between the two groups ( t=0.821, P=0.413). During the 18-month follow-up, the adverse reaction, punctate corneal epithelial opacity, occurred in 18 eyes.The incidence of adverse effect was 6.26%(5/80) in the Toric design orthokeratology group, which was significantly lower than the 16.25% (13/80) in the regular spherical design orthokeratology group ( χ2=3.897, P=0.048). Conclusions:The Toric design orthokeratology shows better efficacy in myopia control as well as reducing the adverse reaction rate in juvenile myopia, and it can better solve the deviation in corneal shaping in the use of regular spherical design orthokeratology.

Objective To evaluate the application way and value of autologous succus entericus reinfusion in neonatal enterostomy.Methods Clinical data from 109 neonatal patients receiving enterostomy in Children's Hospital of Nanjing Medical University from January 2010 to December 2017 were retrospectively analyzed.The neonatal patients were divided into two groups according to whether succus entericus reinfusion conducted as succus entericus reinfusion group (63 neonatal patients) and control group (46 neonatal patients).The 90-day weight gain of the neonatal patients,age of the second stage enterostomy closure,cessation of intravenous infusion time after operation and the rate of re-admission before the second stage enterostomy closure were collected.Results The distance between enterostomy mouth and the Treitz ligament was 80-120 cm in all the children patients,and there was no significant difference between the two groups (P=0.42).The succus entericus reinfusion group was superior to the control group in the weight gain of 90 days after birth (single lumen group vs.single lumen control group:[1.97±0.55] vs.[1.50±0.57] kg,P=0.017;double lumens group vs.double lumenscontrol group:[1.82±0.49] vs.[1.48±0.65] kg,P=0.013),age of the second stage enterostomy closure (single lumen group vs.single lumen control group:[115.76± 15.85] vs.[117.40 ± 11.06] d,P =0.025;double lumens group vs.double lumens control group:[115.48± 14.33] vs.[126.03±8.85] d,P=0.001),cessation of intravenous infusion time after operation (single lumen group vs.single lumen control group:[14.24±3.30] vs.[16.40±2.74] d,P=0.046;double lumens group vs.double lumens control group:[15.07±3.65] vs.[18.71±3.63] d,P＜0.01),and the rate of re-admission before the second stage enterostomy closure (single lumen group vs.single lumen control group:9.5％ [2/21] vs.20％ [3/15],P=0.337;double lumens group vs.double lumens control group:7.1％ [3/42] vs.25.8％ [8/31],P =0.028).Conclusion Autologous succus entericus reinfusion can improve the absorption of nutrients after the operation of small intestinal stoma,improve the function of the distal enteral tube,and create conditions for the early recovery of intestinal continuity.

OBJECTIVETo observe the regulatory effects of acupoint electric stimulation on the analgesic substances and the relevant indices of nerve-immunity-endocrine system in the patients undergoing general anesthesia anorectal operation.

METHODSOne hundred and fifty-six patients undergoing hemorrhoids and anal fistula operation were randomized into three groups, 146 cases were included in the analysis. In the No.1 group (48 cases), the conventional intravenous general anesthesia was applied. In the No.2 group (50 cases), besides the conventional intravenous general anesthesia, the acupoint transcutaneous electric stimulation was combined at Neiguan (PC 6), Shenmen (HT 7), Shangliao (BL 31) and Ciliao (BL 32). operation in the No.2 and No.3 groups were lower apparently than that in the No.1 group (<0.05,<0.01).

CONCLUSIONSDuring the general anesthesia anorectal operation, the acupoint transcutaneous electric stimulation achieves analgesic anesthesia through effectively promoting the release of body analgesic substance and reducing the stress level in the operation. With the comprehensive acupoint selection as Neiguan (PC 6) and Shenmen (HT 7) and the local acupoints, the therapeutic effects are better in comparison with the simple selection of local acupoints. In the No.3 group (48 cases), besides the conventional intravenous general anesthesia, the acupoint transcutaneous electric stimulation was combined at Shangliao (BL 31) and Ciliao (BL 32). The electric stimulation was maintained till the end of operation. The patients' saliva was collected 0.5 h before operation and 1 h after operation separately. The indices that reflect the body pain regulation and nerve-immune-endocrine secretion were detected, such as opiophin protein (OPI), secretory immunoglobulin A (SIgA), saliva amylase (sAA), cortisol (Cor) and tumor necrosis factor α (TNF-α). The pain degree was observed 1 h after operation.

RESULTSIn the No.2 group, OPI after operation was higher than that before operation (<0.05). The difference value of OPI in the No.2 group was higher apparently than that in the No.1 group and the No.3 group (both<0.05). SIgA after operation was higher than that before operation in the No.1 group (<0.05). The difference values of SIgA, sAA, Cor in the No.2 group were lower apparently than those in the No.1 group (<0.05,<0.01). TNF-αbefore and after operation and its difference value among the groups were not significant statistically (all>0.05). The pain degrees in 1 h after.