Backgrounds Insomnia is frequent in schizophrenia and is found to be negatively affected by stressful life events,psychotic symptoms and depressive disorder,while the relationship among the four remains understudied in community-dwelling patients with schizophrenia.Objective To analyze the effect of stressful life events on insomnia in community-dwelling patients with schizophrenia,and to explore the mediation effect of psychotic symptoms and depression,so as to provide references for the intervention of insomnia in community-dwelling patients with schizophrenia.Methods From April to June 2023,a sample of 1 105 patients with schizophrenia attending 48 community health centers in Chengdu,Sichuan province and fulfilling the International Classification of Diseases,tenth edition(ICD-10)diagnostic criteria were included.All subjects were assessed using Stressful Life Event Scale(SLEs),Athens Insomnia Scale(AIS),Psychosis Screening Questionnaire(PSQ),and Patient Health Questionnaire Depression Scale(PHQ-9).Spearman correlation analysis was used to determine the correlation among the scales.Then the mediation model was constructed using Smart PLS 4.0,and tested with partial least squares algorithm and Bootstrap techniques.Results 332 patients(30.05%)with community schizophrenia were found to have insomnia.AIS scores in patients with schizophrenia were positively correlated with the scores on SLEs,PSQ and PHQ-9(r=0.165,0.322,0.554,P<0.01).Stressful life events indirectly contributed to insomnia through both separate mediation path and chained mediation path of psychotic symptoms and depressive disorder,and the indirect effect size of 0.102,0.372 and 0.190 was obtained,accounting for 10.46%,38.15%and 19.49%,respectively.Conclusion The stressful life events not only directly exert an impact on insomnia,but also indirectly contribute to insomnia through both the separate and chained mediation effect of psychotic symptoms and depressive disorder.

OBJECTIVE: To explore the influences of andrographolide (Andro) on bladder cancer cell lines and a tumor xenograft mouse model bearing 5637 cells. METHODS: For in vitro experiments, T24 cells were stimulated with Andro (0-40 µmol/L) and 5637 cells were stimulated with Andro (0 to 80 µmol/L). Cell growth, migration, and infiltration were assessed using cell counting kit-8, colony formation, wound healing, and transwell assays. Apoptosis rate was examined using flow cytometry. In in vivo study, the antitumor effect of Andro (10 mg/kg) was evaluated by 5637 tumor-bearing mice, and levels of nuclear factor κ B (NF- κ B) and phosphoinositide 3-kinase/AKT related-proteins were determined by immunoblotting. RESULTS: Andro suppressed growth, migration, and infiltraion of bladder cancer cells (P⩽0.05 or P⩽0.01). Additionally, Andro induced intrinsic mitochondria-dependent apoptosis in bladder cancer cell lines. Furthermore, Andro inhibited bladder cancer growth in mice (P⩽0.01). The expression of p65, p-AKT were suppressed by Andro treatment in vitro and in vivo (P⩽0.05 or P⩽0.01). CONCLUSIONS Andrographolide inhibits proliferation and promotes apoptosis in bladder cancer cells by interfering with NF- κ B and PI3K/AKT signaling in vitro and in vivo.
Animals ; Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Diterpenes/therapeutic use* ; Humans ; Mice ; NF-kappa B/metabolism* ; Phosphatidylinositol 3-Kinases/metabolism* ; Proto-Oncogene Proteins c-akt/metabolism* ; Urinary Bladder Neoplasms/drug therapy*

Objective:To examine the correlations of C-reactive protein (CRP)/albumin ratio (CAR) with the postoperative complications of patients with colorectal cancer.Methods:The clinic data of 312 patients undergoing elective surgery for colorectal cancer in Hainan Hospital of People′s Liberation Army General Hospital between January 2013 and July 2018 was analyzed retrospectively. There were 188 males and 124 females, aged (61.0±12.9) years (range: 21 to 86 years). Logistic analysis was used to identify relative factors for postoperative complications. Receiver operating characteristic curves were developed to examine the cutoff values and compare diagnostic accuracy of the CAR and CRP levels.Results:Postoperative complications occured in 28.5% (89/312) cases. Hemoglobin on postoperative day(POD) 3 ( OR=0.977, 95% CI: 0.957 to 0.998, P=0.034), preoperative CRP ( OR=1.209, 95% CI: 1.055 to 1.386, P=0.006) and CAR on POD 3 ( OR=0.033, 95% CI: 0.016 to 0.067, P<0.01) were found to be significant independent relative factors for postoperative complications. The cutoff point of CAR on POD 3 was 0.325, patients with CAR≥0.325 were found to have more postoperative complications than those with CAR<0.325. The area under the curve of CAR on POD 3 and preoperative CRP were 0.872, 0.626, respectively. The positive predictive value of CAR on POD 3 was higher than that of preoperative CRP (79.9% vs. 55.1%). Conclusions:CAR is closely related to the occurrence of postoperative complications in colorectal surgery. Patients with CAR≥0.325 on POD 3 has higher incidence of postoperative complications.

Objective:To examine the correlations of C-reactive protein (CRP)/albumin ratio (CAR) with the postoperative complications of patients with colorectal cancer.Methods:The clinic data of 312 patients undergoing elective surgery for colorectal cancer in Hainan Hospital of People′s Liberation Army General Hospital between January 2013 and July 2018 was analyzed retrospectively. There were 188 males and 124 females, aged (61.0±12.9) years (range: 21 to 86 years). Logistic analysis was used to identify relative factors for postoperative complications. Receiver operating characteristic curves were developed to examine the cutoff values and compare diagnostic accuracy of the CAR and CRP levels.Results:Postoperative complications occured in 28.5% (89/312) cases. Hemoglobin on postoperative day(POD) 3 ( OR=0.977, 95% CI: 0.957 to 0.998, P=0.034), preoperative CRP ( OR=1.209, 95% CI: 1.055 to 1.386, P=0.006) and CAR on POD 3 ( OR=0.033, 95% CI: 0.016 to 0.067, P<0.01) were found to be significant independent relative factors for postoperative complications. The cutoff point of CAR on POD 3 was 0.325, patients with CAR≥0.325 were found to have more postoperative complications than those with CAR<0.325. The area under the curve of CAR on POD 3 and preoperative CRP were 0.872, 0.626, respectively. The positive predictive value of CAR on POD 3 was higher than that of preoperative CRP (79.9% vs. 55.1%). Conclusions:CAR is closely related to the occurrence of postoperative complications in colorectal surgery. Patients with CAR≥0.325 on POD 3 has higher incidence of postoperative complications.

Patients with chronic hepatitis B virus (HBV) infection with immune control generally have no or little liver damage, with a low incidence rate of adverse events, and spontaneous HBsAg seroclearance may occur in some patients. Most scholars do not recommend antiviral therapy for such patients in China and foreign countries. However, with the gradual aging of chronic HBV infection, patients with immune control are also faced with disease progression and the development of liver cirrhosis or liver cancer. This article introduces the clinical significance of appropriate timing of antiviral therapy for the prognosis of patients with chronic HBV infection with immune control.

Objective:To establish autoverification rules for coagulation tests in multicenter cooperative units, in order to reduce workload for manual review of suspected results and shorten turnaround time (TAT) of test reports, while ensure the accuracy of results.Methods:A total of 14 394 blood samples were collected from fourteen hospitals during December 2019 to March 2020. These samples included: Rules Establishment Group 11 230 cases, including 1 182 cases for Delta check rules; Rules Validation Group 3 164 cases, including 487cases for Delta check; Clinical Application Trial Group 77 269 cases. Samples were analyzed for coagulation tests using Sysmex CS series automatic coagulation analyzers, and the clinical information, instrument parameters, test results, clinical diagnosis, medication history of anticoagulant and other relative results such as HCT, TG, TBIL, DBIL were summarized; on the basis of historical data, the 2.5 and 97.5 percentile of all data arranged from low to high were initially accumulated; on the basis of clinical suggestions, critical values and specific drug use as well as relative guidelines, autoverification rules and limits were established.The rules were then input into middleware, in which Stage I/Stage II validation was done. Positive coincidence, negative coincidence, false negative, false positive, autoverification pass rate, passing accuracy (coincidence of autoverification and manual verification) were calculated. Autoverification rules underwent trial application in coagulation results reports.Results:(1) The autoverification algorisms involve 33 rules regarding PT/INR, APTT, FBG, D-dimer, FDP,Delta check, reaction curve and sample abnormalities; (2)Autoverification Establishment Group showed autoverification pass rate was 68.42% (7 684/11 230), the false negative rate was 0%(0/11230), coincidence of autoverification and manual verification was 98.51%(11 063/11 230), in which positive coincidence and negative coincidence were respectively 30.09% (3 379/11 230) and 68.42%(7 684/11 230); Autoverification Validation Group showed autoverification pass rate was 60.37%(1 910/3 164), the false negative rate was 0%(0/11 230), coincidence of autoverification and manual verification was 97.79%(3 094/3 164), in which positive coincidence and negative coincidence were respectively 37.42%(1 184/3 164) and 60.37%(1 910/3 164); (3) Trialed implementation of these autoverification rules on 77 269 coagulation samples showed that the average TAT shortened by 8.5 min-83.1 min.Conclusions:This study established 33 autoverification rules in coagulation tests. Validation showedthese rules could ensure test quality while shortening TAT and lighten manual workload.

Objective To assess the efficacy and side effects of intravesical instillation of BCG after transurethral resection of the bladder tumor (TURBT) in non-muscle invasive bladder cancer (NMIBC) patients.Methods The clinical data of patients treated with BCG 120 mg per course induced perfusion or more after TURBT from December 2013 to October 2016 in 18 hospitals of northeast China region,were analyzed retrospectively.The first part,data of 106 patients with moderate,high-risk NMIBC were collected.A total of 83 patients were male,while the other 23 patients were female.The average age was 66.7 years old.The clinical staging were T1 in 86(81.1％) cases,Ta in 20(18.9％) cases and carcinoma in situ in 6 (5.7％) patients.Intravesical instillation of BCG was executed after transurethral resection of the bladder tumor.The incidence rate of recurrence and progression during more than 6 months' follow-up time were observed.Multivariate analyses were done by using logistic analysis and Cox proportional hazards regression model with Kaplan-Meier method.The second part,treatment compliance of 276 patients with bladder cancer,including moderate/high-risk NMIBC in 263 cases,moderate/high-risk NMIBC followed with renal pelvis/ureteral carcinoma in 8 cases were and moderate/high-risk NMIBC with renal pelvis/ureteral carcinoma in 5 cases who treated with BCG after the surgeries,were observed.Patients consisted of 211 males and 65 females with average age of 68.3 years.Results With a median follow-up of 12 months,9 (8.5％) patients experienced tumor recurrence and 2 (1.9％) patients were found progression in the first part.The one-year cancer free recurrence rate of the patients was 91.5％.Statistically significant prognostic factors for recurrence identified by multivariable analyses were prior recurrence of the tumors (OR =3.214,95％CI0.804-12.845,P =0.099).In the second port,an incidence rate of adverse effects was 64.1％ (177/276).The Ⅲ/Ⅳ degree complications were occurred in 11 patients and satisfactory outcomes achieved with active treatment.A total of 36 patients withdrawal with the major causes were recurrence and progression of bladder tumor in 12 cases (4.4 ％),9 cases (3.3 ％) with economic reasons and 11 cases (4.0％) with serious complications.Conclusions NMIBC patients treated with intravesical BCG therapy have approving cancer free recurrence rates and acceptable adverse effects.Prior recurrence may be prognostic factor of recurrence after intravesical BCG therapy.

Objective: To apply DNA barcoding to identifying the rodents in Zhejiang Province. Methods : Rodents were captured from Jiashan,Longyou,Yunhe and Ninghai counties in Zhejiang Province. The DNA was extracted from ears of rodent samples,and was amplified and sequenced with mitochondrial cytochrome C oxidase subunit I（COI）genes. The obtained sequences were compared with the related sequences in GenBank,and neighbour-joining evolutionary tree was constructed. Then the results by DNA barcoding and by morphological identification were compared. Results : A total of 22 COI gene samples were amplified. The evolutionary tree constructed by 18 samples was consistent with the morphological identification results and 4 samples were different：Suncus murinus should be Crocidura lasiura,infant rats of Rattus losea and Rattus tanezumi was re-identified as Rattus rattus,infant rats of Microtus fortis（sample number：NH-1）needs further identification. Conclusion DNA barcoding can effectively correct the errors of morphological identification,thus combining the two methods could improve the accuracy of rodent identification.

Patients in the immune tolerance stage of chronic hepatitis B virus (HBV) infection are in a state of high viral replication and low inflammation in the liver, and they often have no disease progression. Therefore, antiviral therapy is not recommended in related guidelines. Recent studies have found that the patients in the immune tolerance stage have immune response and liver injury, which is a risk factor for liver cancer, and therefore, antiviral therapy should be actively initiated to prevent disease progression. This article summarizes the research advances in the diagnosis and treatment of patients in the immune tolerance stage of chronic HBV infection and points out that there are still controversies over the application of antiviral therapy in such patients. Appropriate timing of antiviral therapy has a great significance in improving patients’ prognosis and reducing their economic burden.

Objective To investigate the level of anxiety and depression and its influencing factors in patients with intravesical perfusion chemotherapy. Methods Totally 148 patients with intravesical perfusion chemotherapy were investigated using the Hospital Anxiety and Depression Scale, Self-Perceived Burden Scale and Social Support Rating Scale. Results Among the patients,14.2%(21/148) and 20.3% (30/148) of them expressed respectively their anxiety and depression, and the incidence of anxiety and depression was significantly correlated with the self-perceived burden,social support and its dimensions(P<0.05),in addition to the influence of the course time(P=0.002),religion(P=0.040),and the functional status of the caregiver(P=0.009). Conclusions The incidence rate of anxiety and depression in patients with intravesical perfusion chemotherapy is still to be further controlled.Nursing staff should pay attention to patients' self-perceived burden, and play an important role in social support in order to reduce the incidence of anxiety and depression.