BackgroundAtypical antipsychotics have been widely used in patients with chronic schizophrenia， and aripiprazole and risperidone are the most commonly used drugs. The mechanism of action of the two is different， while previous studies have provided insufficient credible evidence from multiple perspectives to support the comparative efficacy of the two drugs in improving symptoms in patients with chronic schizophrenia. ObjectiveTo compare the efficacy of aripiprazole and risperidone on the improvement of symptoms， prepulse inhibition （PPI）， cognitive functioning and neurotrophic factors in patients with chronic schizophrenia， so as to provide effective treatment regimens for these patients. MethodsA total of 86 patients with chronic schizophrenia attending the psychiatry department of the Third People's Hospital of Fuyang from March 2021 to March 2023 and fulfilling the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） were enrolled and grouped using random number table method， each with 43 cases. Aripiprazole group was given oral aripiprazole once daily at an initial dose of 5 mg for one week and then gradually increased to a maximum dose of 25 mg. Risperidone group received oral risperidone twice daily at an initial dose of 0.5 mg for one week and then gradually increased to a maximum dose of 3 mg. Treatment in both groups lasted 3 months. Before treatment and 3 months after treatment， Patients were required to complete Positive and Negative Symptom Scale （PANSS）， detection of both strong and weak PPIs in a startle modification passive attention paradigm， Wisconsin Card Sorting Test （WCST） and the measurement of neurotrophic factors at baseline and after treatment. The adverse reactions were recorded. Analysis of covariance was used to test the difference between the PANSS score， PPI， WCST and neurotrophic factor levels of the groups， with the pretest used as the covariate. Results3 months after treatment， no statistical difference was found in the scores of PANSS general psychopathology subscale， positive symptom subscale， negative symptom subscale and total score between two groups after treatment （F=0.621， 0.815， 0.743， 0.752， P>0.05）. There were no statistically significant differences between the two groups in PPI inhibition rate， single intense stimulus amplitude， single intense stimulus latency， prepulse inhibition amplitude， or prepulse inhibition latency （F=0.174， 0.001， 0.183， 0.171， 0.001， P>0.05）. There was no statistically significant difference in the total number of WCST tests between two groups （F=0.512， P>0.05）， whereas aripiprazole group reported significantly larger total numbers of categories completed and correct responses as well as smaller total numbers of random errors and perseverative errors compared to risperidone group （F=3.737， 4.621， 4.892， 5.130， P<0.05）. A significant increase in brain-derived neurotrophic factor （BDNF） and nerve growth factor （NGF） along with a reduction in glial fibrillary acidic protein （GFAP） were documented in risperidone group when compared to risperidone group （F=4.414， 3.781， 6.319， P<0.05）. No significant difference was demonstrated in the incidence of adverse reactions between the two groups （χ²=0.261， P>0.05）. ConclusionAripiprazole may be more beneficial than risperidone in improving cognitive functioning and neurotrophic factor levels in patients with chronic schizophrenia. ［Funded by Scientific Research Project of Fuyang Municipal Health Commission in 2021 （number， FY2021-147）］

OBJECTIVE To systematically evaluate the methodological quality of the postoperative chemotherapy guidelines/ consensuses for ovarian epithelial tumor. METHODS A search was conducted across databases including PubMed， Embase， Web of Science， CBM， VIP， Chinese Medical Journal Data， Wanfang Data， and CNKI， as well as the official websites of GIN， NICE， Medlive， AHRQ， CSCO， ASCO， and NCCN. The search period was from the establishment of the databases/websites to March 10， 2025. The quality of the included guidelines/consensus was evaluated by using the AGREE-Ⅱ tool. RESULTS A total of 16 guidelines/consensuses were included. The domain scores of AGREE-Ⅱ evaluation were as follows： scope and purpose of 85.07%， participants of 47.92%， rigor of development of 57.49%， clarity of presentation of 88.02%， applicability of 8.20%， and independence of 53.39%. Among them， 14 were recommended at grade B and 2 were recommended at grade C. The subgroup analysis by different countries/regions and different types of studies showed that the scores for participants， rigor of development， and independence of the guidelines/consensuses in China were significantly lower than foreign countries （P＜0.05）； the scores for participants and rigor of development of the guidelines were significantly higher than consensuses （P＜0.05）. The guideline/ consensus recommendation results indicated that grade B guidelines/consensus recommend platinum-based combination chemotherapy as the preferred adjuvant chemotherapy regimen for stage Ⅰ high-grade serous carcinoma patients；platinum-based combination chemotherapy±bevacizumab was recommended as the preferred adjuvant chemotherapy regimen for stage Ⅱ-Ⅳ high- grade serous carcinoma patients and for platinum-sensitive recurrent high-grade serous carcinoma patients； non-platinum single- agent chemotherapy±bevacizumab was recommended as the preferred chemotherapy regimen for platinum-resistant recurrent high- grade serous carcinoma patients. CONCLUSIONS The overall quality of postoperative chemotherapy guidelines/consensuses for ovarian epithelial tumor is not high. The methodological quality of guidelines/consensuses in China is still lagging behind that of foreign countries. The recommendations differ from those in foreign countries. It is recommended to improve the aspects of participants， rigor of development， and independence， to recommend treatment plans based on the different stages of ovarian cancer， and develop guidelines/consensuses that align with China’s national conditions.

Diterpenoid ferruginol is a key intermediate in biosynthesis of active ingredients such as tanshinone and carnosic acid.However, the traditional process of obtaining ferruginol from plants is often cumbersome and inefficient. In recent years, the increasingly developing gene editing technology has been gradually applied to the heterologous production of natural products, but the production of ferruginol in microbe is still very low, which has become an obstacle to the efficient biosynthesis of downstream chemicals, such as tanshinone. In this study, miltiradiene was produced by integrating the shortened diterpene synthase fusion protein,and the key genes in the MVA pathway were overexpressed to improve the yield of miltiradiene. Under the shake flask fermentation condition, the yield of miltiradiene reached about(113. 12±17. 4)mg·L~(-1). Subsequently, this study integrated the ferruginol synthase Sm CYP76AH1 and Sm CPR1 to reconstruct the ferruginol pathway and thereby realized the heterologous synthesis of ferruginol in Saccharomyces cerevisiae. The study selected the best ferruginol synthase(Il CYP76AH46) from different plants and optimized the expression of pathway genes through redox partner engineering to increase the yield of ferruginol. By increasing the copy number of diterpene synthase, CYP450, and CPR, the yield of ferruginol reached(370. 39± 21. 65) mg·L~(-1) in the shake flask, which was increased by 21. 57-fold compared with that when the initial ferruginol strain JMLT05 was used. Finally, 1 083. 51 mg·L~(-1) ferruginol was obtained by fed-batch fermentation, which is the highest yield of ferruginol from biosynthesis so far. This study provides not only research ideas for other metabolic engineering but also a platform for the construction of cell factories for downstream products.
Saccharomyces cerevisiae/genetics* ; Diterpenes/metabolism* ; Metabolic Engineering ; Fermentation ; Abietanes

Objective To evaluate the molluscicidal effect of spraying 5% niclosamide ethanolamine salt granules with drones against of Oncomelania hupensis snails in snail habitats in marshland areas. Methods From September to October, 2022, marshlands were sampled from Dantu District, Zhenjiang City, Jiangsu Province as study areas, and assigned into four groups, of approximately 3 000 m² per group. In Group A, environmental cleaning was performed, followed by spraying 5% niclosamide ethanolamine salt granules with knapsack sprayers at a dose of 40 g/m², and in Group B, 5% niclosamide ethanolamine salt granules were sprayed with knapsack sprayers at a dose of 40 g/m² without environmental cleaning, while in Group C, environmental cleaning was conducted, followed by spraying 5% niclosamide ethanolamine salt granules with drones at a dose of 40 g/m², and in Group D, 5% niclosamide ethanolamine salt granules were sprayed with drones at a dose of 40 g/m² without environmental cleaning. Then, the study areas in each group were equally divided into six blocks, with Block 1 for baseline surveys and blocks 2 to 6 for snail surveys 1, 3, 5, 7, 14 days following chemical treatment. The mortality of snails and the reduction of the density of living snails were calculated. Results A total of 132 frames were surveyed during the period from September to October 2022, and the occurrence of frames with living snails and means density of living snails were 61.36% (81/132) and 1.58 snails/0.1 m², respectively. The overall mortality rates of snails were 43.02% (77/179), 38.69% (77/199), 47.78% (86/180) and 31.02% (58/187) 14 days following chemical treatment in groups A, B, C and D, respectively (χ² = 11.646, P < 0.05), and there were differences detected in the snail mortality between group A and D, and between groups C and D (both P_adjusted values < 0.05). The adjusted mortality rates of snails were 37.42%, 36.07%, 38.85% and 40.40% in groups A, B, C and D 14 days post-treatment, and the density of living snails decreased by 48.10%, 63.29%, 67.09% and 69.62% 14 days post-treatment relative to pre-treatment, respectively. Conclusions Chemical treatment with drones is feasible for O. hupensis snail control in marshland areas; however, the molluscicidal effect of spraying 5% niclosamide ethanolamine salt granules with drones is comparable to spraying chemicals manually in marshland areas regardless of environmental cleaning.

Objective To explore the preoperative predictive factors influencing microscopic positive proximal margin in upper gastric cancer,and to establish a nomogram prediction model and to validate it internally.Methods Retrospective analysis of 187 patients with upper gastric cancer operated in the Department of Gastrointestinal Surgery of Hengshui People's Hospital from January 2018 to October 2022 were included in this study.Patients were divided into the microscopic positive proximal margin(the R0 group,n=15)and the negative microscopic proximal margin group(the R1 group,n=172)according to histopathological diagnosis.Preoperative factors that may influence positive upper margin of proximal gastric cancer were collected,including patient age,gender,tumor size,tumor location,Borrmann staging,tumor differentiation,Lauren staging,cT stage and cN stage.Receiver operating characteristic(ROC)curve was used to figure out the optimal cut-off value for predicting positive margin of proximal gastric cancer by tumor length.Multivariate Logistic regression was used to analyze the variables with statistical difference between the two groups,and independent risk factors were screened out,and prediction mode was constructed.The prediction accuracy of the model was verified internally using Bootstrap method.Results The best threshold for predicting positive margin of proximal gastric cancer by tumor length was 4.85 cm.Univariate analysis showed that there were significant differences in tumor length,tumor location,Borrmann staging,Lauren staging,cT staging and cN staging between the two groups(all P＜0.05).Multivariate Logistic regression analysis showed that tumor length>4.85 cm(OR=4.000,95%CI:1.039-15.399),tumor located in esophagogastric junction(OR=7.108,95%CI:1.604-31.494),Borrmann staging Ⅲ—Ⅳ(OR=6.991,95%CI:1.538-31.782),Lauren staging as diffuse or mixed(OR=7.583,95%CI:1.814-31.701)and cT staging as cT4(OR=8.249,95%CI:1.890-36.007)were independent predictors of microscopic positive proximal margin of advanced upper gastric cancer before surgery,and a prediction model was established based on results of multivariate analysis.The area under ROC curve(AUC)value for subjects with the model was 0.862 after internal validation.The calibration curve showed that the model predicted the probability of microscopic positive proximal margin occurrence in good agreement with the probability of actual microscopic positive proximal margin occurrence(Hosmer-Lemeshow χ2=6.145,P=0.523).Conclusion The established nomogram prediction model can predict the probability of positive upper incisal margin of proximal gastric cancer before operation,and provide clinical guidance for formulating surgical strategy.

Objective To evaluate the maturity and metabolic status of heterotopic ossification(HO)by single-photon emission computed tomography(SPECT)/CT fusion bone imaging.Methods The clinical and SPECT/CT fusion bone imaging data of 57 patients with HO confirmed by pathology or follow-up were analyzed retrospectively.HO was graded by CT,and the characteristics of radioactive concentration of HO were analyzed.Results Of 57 cases,single lesion in 52 cases,and multiple lesions in 5 cases,with a total of 63 lesions,mostly located in the hip joint(55.6%,35/63)and thigh(19.0%,12/63).There were 41 lesions in the middle stage and 22 lesions in the late stage.In the visual evaluation of SPECT/CT fusion bone imaging,the middle stage lesions were mostly clumps or flakes,with moderate or high radioactive concentration(75.6%,31/41),furthermore,the concentration range was larger than or equal to the total or limited range of CT ossification(21/41,50.1%),with high concentration mainly located in the mixed areas of ossification density.The concentration of the late stage lesions was mostly non-radioactive(72.7%,16/22).Conclusion SPECT/CT fusion bone imaging can show the range,degree and maturity of HO radioactive concentration,and can accurately locate the area with osteoblastic activity,which provides scientific basis for the selection of surgical timing.

BACKGROUND:The study of the lumbar spine and pelvis in patients with Lenke type 5 lordosis is limited to the coronal and sagittal planes,and the three-dimensional relationship between the scoliosis and the pelvis has not yet been clarified. OBJECTIVE:To analyze the effect of lumbar scoliosis on the pelvis in patients with Lenke type 5 lordosis and to study the correlation between the lumbar spine and the three-dimensional spatial position of the pelvis. METHODS:Imaging data of 60 patients with Lenke type 5 lordosis scoliosis admitted to the 3D Printing Reception Center of Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2019 to September 2023 were retrospectively analyzed,including Cobb angle,coronal pelvic tilt,lumbar lordosis,left and right pelvic hip width ratio(sacroiliac-anterior superior iliac spine),spinal rotation angle,pelvic tilt,sacral slope,pelvic incidence,coronal deformity angular ratio,sagittal deformity angular ratio,C7 plumb line-center sacral vertical line,apical vertebral translation,and coronal sacral inclination.The information was summarized as a database.SPSS 22.0 software was used to analyze the data related to the lumbar spine and pelvis of the patients with Lenke type 5 primary lumbar curvature adolescent idiopathic scoliosis using Spearman's correlation analysis and linear regression. RESULTS AND CONCLUSION:(1)Cobb angle was highly positively correlated with coronal deformity angular ratio,apical vertebral translation,and spinal rotation angle(r=0.91,r=0.841,r=0.736).(2)Coronal deformity angular ratio was highly positively correlated with apical vertebral translation(r=0.737),moderately positively correlated with C7 plumb line-center sacral vertical line(r=0.514),and moderately negatively correlated with sagittal deformity angular ratio(r=-0.595).(3)There was a high positive correlation between lumbar lordosis and sagittal deformity angular ratio(r=0.942)and a moderate negative correlation with coronal deformity angular ratio(r=-0.554).(4)There was a moderate positive correlation between Cobb angle with coronal pelvic tilt and coronal sacral inclination(r=0.522,r=0.534)and a moderate positive correlation between C7 plumb line-center sacral vertical line and coronal pelvic tilt(r=0.507).Apical vertebral translation with coronal pelvic tilt and coronal sacral inclination showed a moderate positive correlation(r=0.507,r=0.506).Lumbar lordosis with sacral slope and pelvic incidence showed a moderate positive correlation(r=0.512,r=0.538).Sagittal deformity angular ratio was moderately positively correlated with sacral slope and pelvic incidence(r=0.614,r=0.621).(5)Studies have found that the relative position of the lumbar spine and the pelvis is closely related in the horizontal,sagittal and coronal planes.When the lumbar spine affects scoliosis and is rotated,the relative position of the pelvis will also change to compensate,which indicates that while correcting scoliosis,the correction of the pelvis cannot be ignored.

OBJECTIVE: To investigate the relationship of the expression levels of protein arginine methyltransferase 5 (PRMT5) and Dickkopf-related protein 3 (DKK3) in the PCa tissue with biochemical recurrence (BR) of the malignancy after radical surgery. METHODS: This study included 105 cases of PCa diagnosed in our hospital from January 2016 to December 2020 and, according to BR within 3 years after surgery, we divided them into a BR (n = 22) and a non-BR group (n = 83). We detected the expressions of PRMT5 and DKK3 in the prostate tissues of the patients by immunohistochemistry, analyzed the correlation of the expression levels of PRMT5 and DKK3 using the Spearman method, and conducted a multivariate analysis of postoperative BR of the malignancy using the Cox multivariate regression model. RESULTS: The positive expression of PRMT5 was significantly higher while that of DKK3 remarkably lower in the PCa than in the adjacent tissue (P<0.05). Spearman correlation analysis showed a negative correlation between the expression levels of PRMT5 and DKK3 in the PCa tissue (r = －0.532, P<0.05). The expressions of PRMT5 and DKK3 were significantly associated with tumor-node-metastasis (TNM) stages, positive surgical margins, peripheral nerve invasion, capsular invasion, seminal vesicle invasion and vascular invasion (P<0.05). The percentage of TNM stages III－IV, the positive expression of PRMT5 and the negative expression of DKK3 were remarkably higher in the BR than in the non-BR group (P<0.05). PRMT5 was found to be an independent risk factor for while DKK3 a protective factor against postoperative BR of PCa in the patients (P<0.05). CONCLUSION PRMT5 is highly while DKK3 lowly expressed in PCa tissue, and their expressions are both closely related to the biochemical recurrence of PCa after radical surgery.
Humans ; Male ; Protein-Arginine N-Methyltransferases/metabolism* ; Prostatectomy ; Prostatic Neoplasms/pathology* ; Neoplasm Recurrence, Local ; Adaptor Proteins, Signal Transducing ; Intercellular Signaling Peptides and Proteins/metabolism* ; Middle Aged ; Immunohistochemistry

Objective: To explore the effect of the comprehensive intervention on overweight and obesity among middle school students at the population level (health education lecture and official account push) and individual level (personalized dietary guidance), so as to provide a reference for preventing and controlling their overweight and obesity. Methods: Three junior high schools and three senior high schools were randomly selected in Guangzhou in 2018 by convenience sampling. Through physical examination, 1 457 overweight and obese students aged from 12 to 18 years old were screened. Intervention was administered through "Student Personalized Dietary Guidance" manual, health tweets on the official accounts, and health education lectures from September 2018 to December 2019. The Chi square test was used to compare the difference in overweight and obesity constituent ratio between the two groups before and after the intervention. And intervention effect was evaluated by analyzing the number needed to treated(NTT). Results: The proportion of overweight before the intervention was 66.71% (972/1 457), and decreased to 59.92% (873/1 457) after the intervention; the proportion of obesity before the intervention was 33.29% (485/1 457), which decreased to 26.63% (388/1 457) after the intervention. Among obese students, the smallest NNT was seen in the girl group aged 12-13 years (NNT=2.6, 95% CI =1.9-4.1), while the largest NNT in the boy group aged 14-18 years (NNT=5.9, 95% CI =4.7-8.1). The NNT of the girls aged 12-13 years was the smallest (NNT=2.7, 95% CI =2.2-3.5), and the NNT of the boys aged 14-18 years was the largest (NNT=7.4, 95% CI =6.0-9.7). Conclusion Health education at population level (health education lectures, official account push) with individual level (personalized dietary guidance) can effectively intervene overweight and obesity among middle school students in Guangzhou.

Objective To explore the preoperative predictors of lymphovascular invasion(LVI)in patients with advanced gastric cancer,and establish the corresponding nomogram prediction model and conduct internal validation.Methods A total of 246 cases of advanced gastric cancer who underwent surgical resection in the Department of Gastrointestinal Surgery of Hengshui People's Hospital from January 2018 to December 2021 were selected.Patients were divided into the LVI positive group and the LVI negative group according to postoperative pathological diagnosis.The age,gender,tumor differentiation,tumor size,tumor site,Borrmann classification,Lauren's classification,cT stage,cN stage and systemic immune-inflammation index(SII)of patients were collected and compared between the two groups.The predictors that were statistically different between the two groups were subjected to multivariate Logistic regression and further developed into a visual prediction model.Bootstrap method was applied for internal validation of the prediction efficiency of the model.Results The differences of tumor size,Borrmann classification,tumor differentiation,Lauren classification,cT staging,cN staging and SII were statistically significant between the two groups(P＜0.05).Multivariate Logistic regression analysis showed that tumor size(OR=2.184,95%CI:1.224-3.898),Borrmann classification(OR=2.517,95%CI:1.294-4.896),cT staging(OR=1.860,95%CI:1.045-3.308),cN staging(OR=1.816,95%CI:1.004-3.285)and SII(OR=1.001,95%CI:1.000-1.002)were independent predictors of LVI in advanced gastric cancer.A preoperative nomogram prediction model for advanced gastric cancer LVI was developed based on results of multivariate analysis.By internal validation,the area under curve(AUC)value of the subject operating characteristic(ROC)curve of the nomogram was 0.735,which was higher than that of tumor size(0.599),Borrmann staging(0.564),cT staging(0.604),cN staging(0.582)and SII(0.615),respectively.The calibration curve showed that the probability of predicted LVI by the nomogram was in a good agreement with the probability of actual LVI occurrence.The Hosmer-Lemeshow test showed good model fit(χ2=4.387,P=0.821).Conclusion The established nomogram prediction model can help to predict the probability of LVI in advanced gastric cancer preoperatively,which can provide a guideline for clinical individualized treatment.