In different stages of schizophrenia (SZ), alterations in gray matter volume (GMV) of patients are normally regulated by various pathological mechanisms. Instead of analyzing stage-specific changes, this study employed a multivariate structural covariance model and sliding-window approach to investigate the illness duration-related developmental trajectory of GMV in SZ. The trajectory is defined as a sequence of brain regions activated by illness duration, represented as a sparsely directed matrix. By applying this approach to structural magnetic resonance imaging data from 145 patients with SZ, we observed a continuous developmental trajectory of GMV from cortical to subcortical regions, with an average change occurring every 0.208 years, covering a time window of 20.176 years. The starting points were widely distributed across all networks, except for the ventral attention network. These findings provide insights into the neuropathological mechanism of SZ with a neuroprogressive model and facilitate the development of process for aided diagnosis and intervention with the starting points.
Humans ; Schizophrenia/pathology* ; Gray Matter/pathology* ; Magnetic Resonance Imaging ; Disease Progression ; Male ; Female ; Brain/pathology* ; Cerebral Cortex/pathology* ; Adult

This paper reviews the influencing factors and intervention of post-traumatic growth of breast cancer patients. The influencing factors include demographic factors, disease treatment related factors, intimate relationships, psychological resilience, rumination, cognitive evaluation and so on. Intervention measures involve conducting group psychotherapy, enhancing positive motivational effects between partners, carrying out emotional cognitive training and exercise therapy. In summary, this paper aims to provide ideas for actively implementing interventions for post-traumatic growth in clinical nursing.

Objective:To screen high-risk population of chronic obstructive pulmonary disease (COPD) and to analyze the risk factors in Haicang District of Xiamen City.Methods:A questionnaire survey was conducted from February 2023 to May 2023 among residents who visited or underwent physical examinations at five community health service centers in Haicang District of Xiamen City selected by cluster sampling method. The self-designed general information questionnaire, COPD population screening questionnaire (COPD-PS) and COPD screening questionnaires (COPD-SQ) were applied in the survey. Individuals with COPD-PS scale>5 or COPD-SQ scale>16 were defined as COPD high-risk group. The association of COPD risk with gender, age, smoking, family history of COPD, history of tuberculosis, history of COVID-19 infection, and using coal/woodstove for cooking or heating was analyzed with chi-square test and binary logistic regression analysis.Results:A total of 4 260 questionnaires were distributed and 4 221 valid questionnaires were collected with a recovery rate of 99.6%. Among all respondents there were 1 904 males (45.11%) and 2 317 females (54.89%); and 217 individuals aged 40-<50 (5.14%), 434 aged 50-<60 (10.28%), 2 194 aged 60-<70 (51.98%), 1 302 aged 70-<80 (30.85%) and 74 aged≥80 (1.76%). The results showed that there were 269 respondents (6.4%) scored≥5 on the COPD-PS scale, 534 residents (12.7%) scored≥16 on the COPD-SQ scale, 646 (15.3%) scored≥5 on the COPD-PS scale or≥16 on the COPD-SQ scale. Male gender ( OR=2.592, 95% CI:2.135-3.146), second-hand smoke exposure ( OR=3.763, 95% CI:2.944-4.810), frequently catching cold before the age of 14 ( OR=3.804, 95% CI:2.927-4.944), history of tuberculosis ( OR=2.575, 95% CI:1.224-5.418), hypertension ( OR=1.547, 95% CI:1.277-1.875), and diabetes ( OR=1.791, 95% CI:1.027-3.121) were independently associated with the high-risk of COPD, while the history of COVID-19 ( OR=0.583, 95% CI:0.476-0.714) was a protective factor for COPD risk. Conclusion:Males, exposure to second-hand smoke, frequently catching cold before the age of 14, history of tuberculosis, hypertension, and diabetes will increase the risk of COPD, while the history of COVID-19 is a protective factor.

Objective Apply modified bilateral carotid artery ligation to establish a VD rat model to observe changes in cerebral blood flow and expression of angiogenic proteins.Methods Thirty-six SD male rats were randomly divided into a sham group(n = 18)and model group(n = 18).In the sham group,only the bilateral carotid artery was isolated without ligation,whereas in the model group,the bilateral carotid artery was ligated to establish the VD model.The Morris water maze behavior test was applied before and 14 days after modeling.Variation in cerebral blood flow was detected by laser speckle contrast imaging.Protein expression of HIF-1α,VEGF,and HO-1 was detected by Western Blot.IL-4 and IL-10 contents were measured by ELISA.Results At 14 days after modeling,escape latency was significantly prolonged and the frequency of crossing the platform had significantly decreased in the model group compared with the sham group(P<0.05).At 2 hours,3 days,and 7 days after modeling,cerebral blood flow in the model group was significantly lower than that in the sham group(P<0.05).At 14 and 21 days after modeling,no significant difference was found in cerebral blood flow between sham and model groups(P>0.05).In the model group,cerebral blood flow was decreased to a minimum at 2 hours after modeling(P<0.05)and then began to recover.The peak of recovery occurred at 3～7 days after modeling and returned to the level before modeling on day 14 after modeling.At postoperative day 21,expression of HIF-1α,VEGF,and HO-1 proteins in the hippocampus of the model group was increased remarkably(P<0.05)and the serum contents of IL-4 and IL-10 in the model group were significantly increased compared with those in the sham group(P<0.05).Conclusions The variation in cerebral blood flow in the VD rat model established by the modified bilateral carotid artery ligation was dependent on time.At postoperative day 21,HIF-1α,VEGF,and HO-1 in the hippocampus were increased significantly,which was accompanied by increased levels of IL-4 and IL-10.

Objective:To observe the effect of project-based learning (PBL) in the clinical teaching of radiation physics.Methods:Thirty-two residents specializing in radiotherapy were included in the study. In the experimental group ( n=16), PBL was adopted, while traditional clinical teaching method was employed in the control group ( n=16). After the rotation, the assessment was conducted, as well as a questionnaire survey was performed, including five aspects: overall satisfaction, understanding of radiation physics knowledge, learning motivation, learning burden, and learning efficiency. Results:The assessment score in the experimental group was 86.31±5.41, which was higher than 75.28±5.91 in the control group, and the difference was statistically significant. Residents in the experimental group were satisfied with the effect of PBL.Conclusion:Compared with the traditional teaching method, PBL can improve the learning motivation, efficiency, and performance of radiotherapy residents, which is highly recognized by the residents.

Objective: To evaluate the effectiveness of the SHARP intervention model for increasing students’ moderate to vigorous physical activity (MVPA) levels,and to provide a reference for physical activity enriching intervention among middle schools students’. Methods: One-year interventional teaching was carried out in 6 schools selected in the terms of scale and demographics from Nanjing City, Jiangsu Province. Data were collected during physical education (intervention group 105, control group 113; pre-intervention 119, post-intervention 99) data for 218 students. MVPA was assessed at baseline and post-intervention using the Observed Health and Coaching Time System(SOFIT). Interviews with 19 teachers were conducted with intervention schools to explore teachers’ views on interventions. Results: The two-way analysis of variance showed that the intervention of the SHARP model had a significant impact on MVPA, VPA, and motor skills of middle school students. Proportion of the average MVPA class time of the intervention school students(62.80±9.11), and the average proportion of the VPA class time of the intervention school(24.33±12.55), the average class time for intervention in the school’s mastery of skills(32.34±11.78)(t=-7.46, -4.82, -12.08, P<0.01). The MVPA of students in control school remained relatively constant while the VPA decreased. Classroom teaching capability improved significantly in intervention schools, which was further confirmed by teacher interviews. Conclusion The SHARP intervention model can effectively increase the MVPA level of middle school students.

Objective To investigate the epidemiological characteristics of a family clustering of COVID-19. Methods Field epidemiological survey was conducted. Result Case 1 of the long-term residents from Hubei province was the source of infection of this family clustering. There were 6 cases (from case 2 to case 7) infected in the whole incubation period. The incubation period was more than 14 days for 3 of the second-generation cases. Routes of transmission include respiratory droplets (from case 1 transmitted to case 6, from case 1 to her family members) and closecontact (from case 1 to other cases in her family). All the age groups were generally susceptible, while elderly were easier to progress to critically ill. Besides respiratory symptoms, there were also gastrointestinal symptoms, of which diarrhea was the most common one. Conclusion Family clustering had been an important part for COVID-19 cases.

Objective To evaluate the effect of orthopedic clinical practice teaching design based on WeChat platform.Methods From September 2015 to August 2017,62 undergraduate students majoring in clinical medicine in the department of orthopedics of our hospital were selected as the study subjects,and randomly divided into the experimental group and the control group.With 31 interns in each group,the control group implemented the traditional teaching method according to the requirements of the syllabus.The experimental group was attached to WeChat production,push notification and communication of related courses on the basis of the traditional teaching methods.At the end of the teaching,the theoretical and operational tests,the comprehensive quality assessment,the evaluation for teachers' teaching work and the questionnaire survey of the two groups were administrated to evaluate the teaching effect.SAS 9.0 was used to do t-test and CMH-chi-square test.Results The score of the experimental group in the theoretical test [(87.52 ± 5.45) vs.(82.61 ± 7.70)],operational test [(94.36 ± 2.60) vs.(92.26 ± 3.01)],comprehensive quality assessment [(95.94 ± 1.61) vs.(93.42 ± 2.81)] and the evaluation for teachers' teaching work [(94.58 ± 2.06) vs.(92.55 ± 1.69)] were better than those of control group,and there were statistically significant differences.P values were 0.005,0.005,0.000 and 0.000 respectively.The questionnaire survey results show that the experimental group was better than the control group in learning motivation (P=0.035),literature study (P=0.013),curriculum arrangement (P=0.007),teaching satisfaction (P=0.029) and professional recognition (P=0.040).Conclusions The clinical practice teaching method based on WeChat platform is effective and feasible to the orthopedic medical students,which is helpful to improve students' learning initiative and master effective learning strategies.The application is worth promoting.

Objective To explore the current status and the correlation between learning burnout and family function among undergraduate nursing students in a non-governmental school.Methods A total of 460 undergraduate nursing students in a non-governmental medical school in Changsha were selected as study subjects by convenience sampling from September to October 2016. They were investigated with the learning burnout scale (LBS) and the McMaster family assessment device (FAD).Results The total scores of LBS and FAD of undergraduate nursing students in a non-governmental school were (56.94±9.60) and (137.11±15.80) respectively. The total score of LBS was positively correlated with the total score and the scores of all dimensions of FAD among undergraduate nursing students in a non-governmental school (P<0.01). The influencing factors of learning burnout included grades, whether they acted as a student cadre, attitudes towards nursing speciality, academic record and family function (P<0.05).Conclusions The level of learning burnout has a close correlation with family function in undergraduate nursing students in a non-governmental school. The better the family function is, the less the learning burnout will be. School should strengthen the affective education of students and improve the mental state so as to reduce the learning burnout.