Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

Objective: A longitudinal mediating model was designed to explore the relationship between sleep chronotype and depressive mood with stressful life events as the mediating variable, so as to provide reference basis for preventing depression in adolescents. Methods: From March (T1) to October (T2) 2022, the Munich Chronotype Questionnaire, and Adolescent Self-rating Life Events Checklist and Center for Epidemiologic Studies Depression Scale were administered in 1 251 middle school students in the first and second grades of a middle school in Meishan, Sichuan Province for a follow up study. Two wave of date on sleep time type, stressful life events, and depressive moods were collected. Results: At T1, the detection rate of depressive mood was 22.5% in adolescents but 27.0% at T2.At the same time point, there were significant positive correlations between chronotype, stressful life events and depressive mood ( r=0.06-0.69, P <0.05). Cross lagged model results showed that early sleep chronotype could significantly predict later depressive mood ( β=0.53, P <0.05), and early depressive mood could significantly predict later sleep chronotype ( β=0.01, P <0.01). Longitudinal mediation model analysis showed that T1 sleep chronotype not only directly affected T2 depressive mood (direct effect value=1.421, 95% CI =0.985- 1.858 , P <0.01), but also affect T2 depressive mood through the partial mediating effects of T2 stressful life events (indirect effect value=1.268, 95% CI =0.810-1.726, P <0.05). Although T1 depressive mood was a direct predictor of T2 sleep chronotype (direct effect value=0.025, 95% CI =0.017-0.032), it was not a direct predictor of T2 sleep chronotype by partial intermediate action of T2 stressful life events (indirect effect value=-0.001, 95% CI = -0.006- 0.004, P >0.05). Conclusions Sleep chronotype can not only directly predict depressive mood of adolescents, but also indirectly affect depressive mood of adolescents through the longitudinal mediating effect of stressful life events. To prevent depression and improve mental health in this population, adolescents should develop the habit of early sleep schedule, and improve their ability to cope with stressful life events.

Objective To explore the effect of Naikan cognitive-music reminiscence therapy on coping style in female patients with chronic schizophrenia.Methods In May, 2020, 72 female patients with chronic schizophrenia from Beijing Huilongguan Hospital were assigned into control group (n = 48) and music group (n = 24) after trait matching. Both groups accepted routine medicine, while the control group accepted Naikan cognitive therapy, and the music group accepted Naikan cognitive therapy combined music reminiscence, for twelve weeks. They were blind assessed with Simplified Coping Style Questionnaire, Self-rating Depression Scale and Self-rating Anxiety Scale before and after intervention.Results There were five cases in the control group removed for erroneous response. The main effects of group were not significant for all the assessments (F < 0.567, P > 0.05). The main effect of time was significant for negative coping style score (F = 6.968, P = 0.01), and the interaction effects were significant for positive coping style score and Self-rating Depression Scale score (F > 4.227, P < 0.05).Conclusion Combining with music reminiscence, Naikan cognitive therapy may be advantageous for the coping style of female patients with chronic schizophrenia.

【Objective】 To analyze and mine the prescription rules of traditional Chinese medicine enema treatment of chronic kidney disease （CKD） in CNKI platform journals based on data mining and network pharmacology so as to find high-frequency core Chinese medicines and predict the potential targets of core Chinese medicines and explore the mechanism of action of core Chinese medicines in the treatment of CKD. 【Methods】 Taking CNKI as the data source， we retrieved the clinical literature of traditional Chinese medicine enema in the treatment of CKD. SPSS modeler 18.0 statistical software was used for statistical processing and association rule analysis. IBM SPSS statistics 21 statistical software was used for cluster analysis. BATMAN-TCM and TCMSP were used to retrieve the effective components and related targets of drugs. Genecards， OMIN， Drugbank， DisGenet， TTD， and PharmGkb databases were used to retrieve disease-related targets， and Venny platform was used to screen disease and drug intersection targets. We used STRING database to obtain relevant documents， Cytoscape 3.8.2 software for visual analysis， Metascape database for enrichment analysis， Wechat website to draw bubble diagram， and AutoDockTools-1.5.6 software for molecular docking prediction. 【Results】 We selected 276 effective prescriptions involving 120 traditional Chinese medicines. The frequency of 19 traditional Chinese medicines was more than 10. Totally 18 core drug combinations were obtained. Cluster analysis could be divided into four categories. The visual net-work analysis shows that “rhubarb， dandelion， oyster， Salvia miltiorrhiza and aconite” are highly correlated and occupy the core position. Through the prediction of the potential targets of five core drugs， 659 “drug disease” intersection targets and 173 core targets were obtained， of which “MAPK1， AKT1 and STAT3” are the key targets， “progesterone， neocryptotanshinone Ⅱ and emodin”. It is predicted that it may play a role in “PI3K Akt signal pathway， MAPK signal pathway， JAK-STAT signal pathway”. Molecular docking showed that the key components have good binding activity with key targets. 【Conclusion】 Based on data mining and network pharmacology， traditional Chinese medicine enema treatment of CKD mainly uses rhubarb as the main drug， assisting warming yang to remove blood stasis and turbidity relief drugs. The key components of its core drug can act on PI3K-Akt by regulating key targets such as PIK3R1. Signal pathways and other pathways play a role in providing new ideas for the treatment of this disease with traditional Chinese medicine enema， medication strategies for clinical prescriptions， and a basis for follow-up further research.

【Objective】 To investigate the unqualified rate of anti-HIV detection of blood screening laboratories in Beijing-Tianjin-Hebei region, and explore the differences in anti-HIV detection ability and influencing factors in each laboratory. 【Methods】 Through filling questionnaires via e-mail, the anti-HIV ELISA unqualified rate and confirmed (WB) positive results (data) from January to December 2018 from 15 blood screening laboratories in Beijing-Tianjin-Hebei region were collected. Our laboratory was responsible for data collection and confirmation, and statistics software SPSS22.0 was used for analysis. 【Results】 1) There was a statistically significant difference among the unqualified rate of anti-HIV ELISA(6.77‱~35.71‱) and confirmed positive rate(0.60‱~3.56‱) in 15 blood screening laboratories in Beijing-Tianjin-Hebei region (P<0.05); 2) There were significant differencse among the ELISA unqualified rate and the confirmed positive rate of 8 reagents for anti-HIV detection(P<0.01), and the sensitivity of the 4th generation detection reagent and the imported reagent was higher than that of the 3rd generation reagent and the domestic reagent. The anti-HIV ELISA unqualified rate of R5 was the highest (19.08‱). 3)There were significant differences in the anti-HIV ELISA unqualified rate of R1, R2, R3, R5 and R7 reagents among different blood station laboratories(P<0.05), and there were no significant differences in the anti-HIV ELISA unqualified rate of R4, R6 and R8 reagents among different blood station laboratories(P>0.05). 4)The unqualified rate of anti-HIV ELISA of laboratories using different regents showed significant differences(P<0.05), except H, J, M. The unqualified rate of imported reagent was significantly higher than that of domestic reagents of laboratories using imported and domestic reagents combinations(P<0.05), except O. 62.5% (5/8) laboratories using domestic 3^rd and 4^th generation reagent combination showed significant differences in the unqualified rates among different reagents(P<0.05); 5) The positive rate of single-reagent(62.02%~95.45%)in 15 blood screening laboratories showed significant difference(P<0.001), and A was the lowest (62.02%). 【Conclusion】 The anti-HIV detection ability among 15 blood screening laboratories in Beijing-Tianjin-Hebei region is quite different. The application of different reagents is the main factor for the difference, and other factors such as personnel, instruments and test strategies also has a great impact on the detection of anti-HIV. It is still necessary to promote the process of homogenization of blood testing quality among blood screening laboratories in Beijing-Tianjin-Hebei region.

Objective:To explore the effect of physical-medical integration training on the rehabilitation of inpatients with schizophrenia and metabolic syndrome.Methods:From January 2019 to January 2020, convenience sampling was used to select 105 patients with schizophrenia and metabolic syndrome who received treatment in Beijing Huilongguan Hospital as the research object. Patients were divided into research group ( n=53) and control group ( n=52) . Control group conducted psychiatric routine nursing, and research group implemented physical-medical integration training model (doctor-nurse-technician participation) on the basis of routine nursing. We compared the body mass index (BMI) , blood glucose, blood pressure and social function score of the two groups of patients after three months of training. Results:Finally, 50 patients in each group completed the study. After three months of training, the BMI, fasting blood glucose, systolic blood pressure and diastolic blood pressure of research group were lower than those of control group, and the total score and all dimension scores of social function were higher than those of control group with statistical differences ( P<0.05) . Conclusions:Physical-medical integration training can directly affect the BMI, blood pressure, and blood glucose of patients with schizophrenia and metabolic syndrome, and can improve the social function of the patient and increase the patient's sense of satisfaction.

Objective:To explore the differential diagnosis methods between nonclassical 21-hydroxylase deficiency(NC21-OHD) and polycystic ovary syndrome(PCOS).Methods:The clinical data of 31 women with NC21-OHD were compared with those of 29 women with PCOS.Results:Women with NC21-OHD showed a higher prevalence of adrenal hyperplasia and lower likelihood of polycystic ovary(PCO) than those with PCOS( P<0.05), with lower height( P<0.05). The levels of adrenocorticotropic hormone (ACTH), 17-hydroxyprogesterone(17-OHP), androstenedione(AD), total testosterone(TT), and progesterone were higher in women with NC21-OHD compared with those with PCOS( P<0.05). Women with PCOS had higher levels of luteinizing hormone(LH) and higher ratio of LH to follicle stimulating hormone(FSH) than those with NC21-OHD( P<0.05). The best two identification indexes for the two diseases were 17-OHP and progesterone, with the optimal cut-off points 3.34 ng/ml(sensitivity 89.7%, specificity 93.1%) and 0.64 ng/ml(sensitivity 90.0%, specificity 75.9%), respectively. During the 1-day mid-dose dexamethasone suppression test(DST), women with NC21-OHD had higher inhibition rates of 17-OHP, progesterone, AD, and TT( P<0.01) than those with PCOS. Their optimal cut-off values of suppression rates were 73.5%(sensitivity 95.2%, specificity 100.0%), 55.5%(sensitivity 100%, specificity 88.9%), 61.4%(sensitivity 84.2%, specificity 100.0%), 68.3%(sensitivity 65.0%, specificity 100.0%), respectively. Conclusion:The clinical manifestations of women with NC21-OHD are similar to those with PCOS. 17-OHP is the best differential indicator and the 1-day mid-dose DST plays an important role in the identification of the two diseases. Genetic analysis is the gold standard for distinguishing the two diseases.

Objective: To improve the understanding of 17α-hydroxylase/17, 20-lyase deficiency(17OHD)disease. Methods: The clinical data of six patients suffering from 17OHD were analyzed retrospectively. Results: Two patients with complete combined defect had typical clinical presentations, including absence of secondary sexual characteristics, primary amenorrhea, hypertension, hypokalamia, lower gonadal hormone levels, as well as elevated corticotropin and progesterone levels. TAC329AA homozygous mutation, IVS1+ 2T>C, and c. 775_776delAT complex heterozygous mutation were found in 2 cases. Four cases of partial combined defect showed high progesterone, lower gonadal hormones and dehydroepiandrosterone-sulfate levels. Three females(46, XX)showed spontaneous menstrual and primary infertility, and two of them got successful pregnancy with assisted reproductive technology. TAC329AA heterozygous mutation was found in those 4 cases. Conclusions TAC329AA mutation is common in 17OHD, and heterozygous or homozygous mutation of TAC329AA may be the genetic and molecular basis for determining whether these patients present as partial or complete defect. The elevated plasma progesterone in non-pregnancy combined with lower gonadal hormones and dehydroepiandrosterone-sulfate is the main character of patients with partial 17OHD. Less severe patients may be able to get successful pregnancy with assisted reproductive technology.

Objective To investigate the MRI findings of perihip heterotopic ossification (HO) in the early, mid and late stages. Meth-ods The MRI of 44 inpatients with HO from February, 2011 to September, 2013 were reviewed, in which 20 cases (28 joints) were in early stage, 18 cases (24 joints) in mid stage and 6 cases (8 joints) in late stage. For the enhanced T1WI, 9 cases (11 joints) were in early stage, 6 cases (7 joints) in mid stage, and 3 cases (4 joints) in late stage. Theχ2 trend test was used to evaluate the MRI signal change with the HO maturity. Results With the maturity of hip HO, the signal intensity of T2WI reduced (χ2=16.773, P<0.001), fat signal on T1WI increased, the enhancement reduced (χ2=16.048, P=0.007). Conclusion The MRI findings of perihip HO are characteristic in MRI in all the stages. MRI is useful for the diagnosis of perihip HO, especially for the early HO.