BackgroundAggressive behavior in schizophrenic patients could result in legal disputes and public safety concerns. In patients with illness episodes of different numbers， there may exist differences in the association between levels of novel inflammatory indicators and aggressivity. ObjectiveTo investigate the differences in the correlation between levels of novel inflammatory indicators and aggressivity in patients with first-episode and recurrent schizophrenia， in order to search for inflammatory biomarkers to assess aggression level in schizophrenic patients. MethodsA total of 168 schizophrenic patients were selected as subjects， who were hospitalized for acute disease onset in Chaohu Hospital of Anhui Medical University from October 2022 to April 2024 as well as met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. Patients were divided into first-episode group （n=58） and recurrent group （n=110）. Meanwhile， 110 healthy controls from community who matched in age and gender with the patient group were recruited. All patients were evaluated with Modified Overt Aggression Scale （MOAS） and Positive and Negative Syndrome Scale （PANSS）. All subjects went through examination of the levels of novel inflammatory indicators， including neutrophil/lymphocyte ratio （NLR）， monocyte/lymphocyte ratio （MLR）， platelet/lymphocyte ratio （PLR）， neutrophil/high-density lipoprotein ratio （NHR）， monocyte/high-density lipoprotein ratio （MHR） and platelet/high-density lipoprotein ratio （PHR）. Spearman correlation analysis was adopted to investigate the correlation between levels of novel inflammatory indicators and the total score of MOAS in patients with first-episode and recurrent schizophrenia. ResultsThe levels of NLR， MLR， PLR， NHR， MHR and PHR in first-episode group were higher than those in control group （adjusted P<0.01）. The levels of NLR， MLR， NHR， MHR and PHR in recurrent group were higher than those in control group （adjusted P<0.01）. No significant difference was observed in the comparison in the levels of six novel inflammatory indicators between first-episode group and recurrent group （adjusted P>0.05）. Spearman correlation analysis showed， the MOAS total score of recurrent group was positively correlated with the levels of NLR， MLR and PLR （r=0.234， 0.192， 0.243， P<0.05）. There was no statistical significance in the correlation between MOAS total score and levels of six novel inflammatory indicators in first-episode group （P>0.05）. ConclusionAmong patients with first-episode and recurrent schizophrenia， the correlation between levels of novel inflammatory indicators and aggressivity could differ. NLR， MLR and PLR might be the biomarkers for assessing aggression level in recurrent schizophrenic patients. ［Funded by Anhui Provincial Natural Science Foundation （number， 2108085MH275）］

ObjectiveTo systematically review the effect of high-intensity interval training (HIIT) on executive function for healthy children and adolescents, and delineate the factors related to the intervention outcome. MethodsLiterature about the effect of HIIT on executive functions for healthy children and adolescent was retrieved from Web of Science, PubMed, Cochrane, Embase, Google Scholar, and CNKI, up to July 31st, 2023. The methodological quality was evaluated using the Physiotherapy Evidence Database (PEDro) scale, and relevant data were systematically reviewed. ResultsFifteen researches were included, from nine countries, comprising 13 randomized controlled trials with the scores of PEDro scale from five to eight, involving 17 021 participants aged six to 18 years. They were published mainly from 2016 to 2023. The primary factors related to the intervention outcome were the age of participants, HIIT intervention programs, and work-to-rest ratio. HIIT significantly improved working memory and inhibitory control in healthy children, while it was limited for adolescents. ConclusionHIIT can significantly improve inhibitory control and working memory in healthy children. Key factors related to the intervention outcomes include the age of participants and the specifics of the HIIT program, etc.

Objective: Excessive daytime sleepiness (EDS) and insomnia symptoms are common in patients with major depressive disorder (MDD), which might lead to a poor prognosis and an increased risk of depression relapse. The current study aimed to investigate the prevalence, and sociodemographic and clinical correlates of EDS and insomnia symptoms among adolescents with MDD. Methods: The sample of this cross-sectional study included 297 adolescents (mean age=15.26 years; range=12–18 years; 218 females) with MDD recruited from three general and four psychiatric hospitals in five cities (Hefei, Bengbu, Fuyang, Suzhou, and Ma’anshan) in Anhui Province, China between January and August, 2021. EDS and insomnia symptoms, and clinical severity of depressive symptoms were assessed using Epworth sleepiness scale, Insomnia Severity Index, and Clinical Global Impression-Severity. Results: The prevalence of EDS and insomnia symptoms in adolescents with MDD was 39.7% and 38.0%, respectively. Binary logistic regression analyses showed that EDS symptoms were significantly associated with higher body mass index (odds ratio [OR]=1.097, 95% confidence interval [CI]=1.027–1.172), more severe depressive symptoms (OR=1.313, 95% CI=1.028–1.679), and selective serotonin reuptake inhibitors use (OR=2.078, 95% CI=1.199–3.601). And insomnia symptoms were positively associated with female sex (OR=1.955, 95% CI=1.052–3.633), suicide attempts (OR=1.765, 95% CI=1.037–3.005), more severe depressive symptoms (OR=2.031, 95% CI=1.523–2.709), and negatively associated with antipsychotics use (OR=0.433, 95% CI=0.196–0.952). Conclusion EDS and insomnia symptoms are common among adolescents with MDD. Considering their negative effects on the clinical prognosis, regular screening and clinical managements should be developed for this patient population.

Objective: To investigate the status of insomnia, Internet addiction, and depressive symptoms among medical students and to analyze the effect of Internet addiction on insomnia and the mediating role of depressive symptoms, in order to provide a basis for the development of targeted interventions and measurements for medical students. Methods: A stratified whole group sampling method was used to select full-time college students from three medical universities in Anhui Province. The Chinese version of Insomnia Severity Index (ISI), Internet Addiction Test (IAT) scale and 9-item Patient Health Questionnaire (PHQ-9) were used to evaluate the symptoms of insomnia, Internet addiction and depressive in students. A multivariate Logistic regression analysis was used to explore the factors influencing insomnia among medical students and to analyze the relationship between insomnia with Internet addiction and depressive symptoms, respectively. Results: The overall rate of Internet addiction was 49.5%, depressive symptoms was 39.5%, insomnia was 18.6%. High academic stress, and the presence of surrounding people diagnosed with COVID-19 were associated with a higher risk of insomnia ( P <0.05). The higher the level of Internet addiction (mild, OR =2.60; moderate/severe, OR =4.21) and depression. (mild, OR =6.35; moderate/severe, OR =19.32), the higher the risk of insomnia. Mediated effect analysis showed that Internet addiction had a direct predictive effect ( β =0.02, P <0.05) on insomnia and also indirectly affected insomnia through depression (indirect effect=0.07，95% CI =0.06-0.08). Conclusion The detected rates of insomnia, Internet addiction and depressive symptoms are high among medical students in Anhui Province, and Internet addiction and depressive symptoms are risk factors for insomnia, which should be given more attention and appropriate interventions when necessary to improve their physical and mental health.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has had a serious impact on health all over the world. Cancer patient, whose immunity is often compromised, faces a huge challenge. Currently, some COVID-19 vaccines are being developed and applied on general population; however, whether cancer patients should take COVID-19 vaccine remains unknown. Our study aimed to explore the knowledge, attitude, acceptance, and predictors of intention to receive the COVID-19 vaccine among cancer patients in Eastern China. METHODS: A cross-sectional study was conducted in Eastern China from June 17th to September 3rd, 2021. Patients were selected using a convenience sampling method. A self-report questionnaire was developed to assess knowledge about the COVID-19 vaccine, attitude towards the vaccine and acceptance of the vaccine; following a review of similar studies previously published in the scientific literature, multivariate logistic regression analysis was used to determine the predictors associated with COVID-19 vaccine acceptance. RESULTS: A total of 2158 cancer patients were enrolled in this study. The rate of vaccine hesitancy was 24.05% (519/2158); further, among the participants of vaccine acceptance, 767 had taken COVID-19 vaccine (35.54%), and 872 were willing to get vaccinated (40.01%). A total of 24 variables including demographic characteristics, clinical status of cancer, impact of COVID-19 pandemic on study participants, patients' knowledge about the COVID-19 vaccine, and attitude towards the vaccine, had significant differences between the "vaccine hesitancy" population and "vaccine acceptance" population. Multivariate logistic regression analysis indicated that parameters including alcohol consumption (odds ratio [OR] = 1.849; 95% confidence interval [CI]: 1.375-2.488; P-reference [P-Ref] < 0.001 vs non-drinkers), income impacted by COVID-19 pandemic (OR = 1.930, 2.037 and 2.688 for mild, moderate, and severe impact, respectively; all P-Ref < 0.01 vs no impact), knowledge of how the vaccine was developed (OR = 1.616; 95% CI: 1.126-2.318; P-Ref = 0.009 vs unknown), believing in the safety of the vaccine (OR = 1.502; 95% CI: 1.024-2.203; P-Ref = 0.038 vs denying the safety of vaccine), willingness to pay for the vaccine (OR = 3.042; 95% CI: 2.376-3.894; P-Ref < 0.001 vs unwilling), and willingness to recommend families and friends to get vaccinated (OR = 2.744; 95% CI: 1.759-4.280; P-Ref < 0.001 vs do not recommend) were contributors to vaccine acceptance. While such as being retired (OR = 0.586; 95% CI: 0.438-0.784; P-Ref < 0.001 vs unemployed), undergoing multiple therapies of cancer (OR = 0.408; 95% CI: 0.221-0.753; P-Ref = 0.004 vs no ongoing treatment), and worrying that the vaccine might deteriorate the prognosis of cancer (OR = 0.393; 95% CI: 0.307-0.504; P-Ref < 0.001 vs might not) were contributors to vaccine hesitancy. CONCLUSION This study provided preliminary estimates of the rates of vaccine acceptance and vaccine hesitancy among cancer patients in Eastern China. The intention to receive the COVID-19 vaccine was impacted by factors such as patient occupation, alcohol consumption, and some parts of knowledge about and attitude towards COVID-19 vaccine. It is recommended to develop individualized vaccination plans that meet the healthcare needs of cancer patients.
COVID-19 ; COVID-19 Vaccines ; China ; Cross-Sectional Studies ; Humans ; Intention ; Neoplasms ; Pandemics ; SARS-CoV-2 ; Vaccination Hesitancy

Objective:To investigate the efficacy of additional treatment (chemoradiotherapy or esophagectomy) after endoscopic submucosal dissection (ESD) for superficial esophageal squamous cell carcinoma.Methods:Clinicopathological data of 97 patients of esophageal squamous cell carcinoma with infiltration depth of M3-SM3 who underwent ESD in Zhongda Hospital from July 2014 to April 2019 were reviewed. There were 57 patients in the additional treatment group and 40 patients in the observation group. The rate of relapse-free survival (RFS) was evaluated by Kaplan-Meier method (used log-rank test).Results:In the additional treatment group, 15 underwent esophagectomy after ESD, and no tumor metastases were found, but 1 patient died of upper gastrointestinal bleeding after surgery; 42 underwent chemoradiotherapy, and all patients were alive, but 3 patients experienced distant metastases. In the observation group, 13 patients experienced local recurrence, 2 patients died of tumor recurrence and 1 patient died of cerebrovascular disorder. Kaplan-Meier analysis showed that the RFS rate of the additional treatment group was higher than that of the observation group ( P=0.001). Conclusion:ESD followed by additional chemoradiotherapy or esophagectomy has good clinical efficacy and can improve prognosis for superficial esophageal squamous cell carcinoma (M3-SM3) patients.

To compare the efficacy and safety of rt-PA and UK in the treatment of ischemic stroke （AIS） within 6 hours of onset in routine clinical practice in China. To compare the effects of rt-PA and UK on various parameters of thrombelastogram（TEG），and the relationship between various parameters of thrombelastogram and the safety of intravenous thrombolytic therapy of rt-PA and UK were compared. Methods A total of 102 AIS patients who received intravenous thrombolytic therapy of rt-PA （within 4.5 h） or UK （within 6 h） in chaohu hospital affiliated to anhui medical university from July 2018 to February 2021 were collected. including 59 patients who received rt-PA and 43 patients who received urokinase. NIHSS scores of patients on admission and before thrombolytic therapy，NIHSS scores of patients 14 days after thrombolytic therapy （or at discharge），complications of intracranial hemorrhage and digestive tract hemorrhage，and the number of deaths during hospitalization of patients in the two groups were recorded. At the same time，TEG parameters （including R，MA，K，α Angle and CI） after intravenous thrombolysis were recorded，and the indicators of R，MA，K，α Angle and CI of rt-PA group and UK group were compared and analyzed. Results There were no significant differences in neurological improvement，mortality，incidence of intracranial hemorrhage and digestive tract hemorrhage between rt-PA group and UK group （P> 0.05）. There were statistically significant differences in MA value between rt-PA group and urokinase group. The mean R value of patients with bleeding complications （bleeding group） was higher than that of non-bleeding group，and the difference was statistically significant. Conclusions Rt-PA and UK have similar efficacy and safety in AIS patients. Both rt-PA and UK can improve the prognosis of AIS patients. After intravenous thrombolysis，the hypocoagulant state of the UK group may be more significant than that of the rt-PA group，and the R time of the bleeding group is longer than that of the non-bleeding group，which has a certain predictive effect on the hemorrhage of acute cerebral infarction after intravenous thrombolysis.

Objective: To investigate the risk factors affecting the occurrence of complications in patients with vaginal bleeding after in vitro fertilization/intracytoplasmic sperm injection embryo transfer(IVF/ICSI-ET) and the construction of nomogram prediction model. Methods: A total of 272 patients with threatened abortion after IVF/ICSI-ET were retrospectively analyzed in this study. They were divided into the live birth group and abortion group according to the final outcome of pregnancy. Patient characteristics were evaluated using the chi-square test, independent-samples Student's t-test or Wilcoxon rank sum test. A nomogram was created to predict the pregnancy outcome of women with threatened abortion who received IVF/ICSI using multivariate logistic regression coefficients. Results: There was no significant difference in the basic data, percentage of frozen embryos, treatment method, number of embryos transferred, high-quality embryo rate, and embryo implantation rate of the live birth group and abortion group(P>0.05). There were significant differences in body mass index, the onset of vaginal bleeding time after transplantation, serum levels of hCG and progesterone on 14 th day after embryo-transfer, and the number of gestational sacs between the two groups(P<0.05). After multivariate logistic regression analysis, the onset of vaginal bleeding time after transplantation and serum hCG levels on 14 th day after transfer were statistically significant(P<0.05). The nomogram was established based on the above indicators, with an area under the curve of 0.710 for the nomogram. The area under the ROC curve of our nomogram was better than the area under the ROC curve of a single risk factor(AUC of bleeding time after embryo-transfer: 0.644, AUC of serum hCG14:0.625). Conclusion The nomogram model established based on the onset of vaginal bleeding time after embryo-transfer and serum hCG value on 14 th day after embryo-transfer can better predict pregnancy outcome of patients with threatened abortion after IVF/ICSI-ET.

Objective:To evaluate the efficacy and safety of oral prednisone acetate and oral prednisone acetate combined with local injection of triamcinolone acetonide for the prevention of esophageal stricture after endoscopic submucosal dissection (ESD) for early esophageal cancer and precancerous lesions.Methods:Data of 52 patients with early esophageal cancer or precancerous lesions hospitalized from December 2014 to February 2019 in Zhongda Hospital of Southeast University were analyzed retrospectively. They were divided into the control group (group A, n=20), oral hormone group (group B, n=17) and oral medication combined with local injection group (group C, n=15). The rates of stenosis and refractory stenosis, endoscopic dilatation times after ESD, time interval of first dilation after ESD and adverse events related to the operation and administration of glucocorticoids were compared among the three groups. Results:The differences in stenosis rates [85.0% (17/20) VS 47.1% (8/17) VS 46.7% (7/15), P<0.01], rates of refractory stenosis [75.0% (15/20) VS 23.5% (4/17) VS 20.0% (3/15), P<0.01], and endoscopic dilatation times [3.50 (2.25, 6.00) VS 0.00 (0.00, 2.50) VS 0.00 (0.00, 2.00), P<0.01] were statistically significant among the three groups. In pairwise comparison, the above indicators in group B and group C were significantly lower or less than those in group A ( P<0.05), but there were no statistical differences between group B and group C ( P>0.05). The time intervals of the first dilation after ESD were significantly different among the three groups (27.7±9.4 d VS 110.1±46.0 d VS 147.4±9.4 d, P<0.01). In pairwise comparison, the first dilation intervals in group B and group C were longer than that in group A ( P<0.01), and this indicator in group C was longer than that in group B ( P<0.01). Two patients in the control group developed perforation after ESD but they were treated actively and recovered finally. No severe ESD, steroid, or perforation related adverse events occurred in any other patient of the three groups. Conclusion:Both oral prednisone and oral prednisone combined with local injection of triamcinolone acetonide after ESD can effectively and safely prevent esophageal stricture after ESD. Oral administration combined with local injection of corticosteroids can prolong the time interval of the first dilation after ESD, which is beneficial to the psychological recovery and the improvement of patients’ life quality after the operation.

ObjectiveTo investigate the status of sleep insufficiency in children and adolescents with mental disorders and related influencing factors. MethodsA total of 131 children and adolescents who were admitted to the Third People's Hospital of Fuyang from February to June 2021 and met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for schizophrenia， depression or childhood-onset mood disorders were selected as the research subjects. A self-compiled questionnaire was used to collect the general demographic information， sleep status， lifestyle habits， family and school status of the selected individuals. The demographic information was compared between sleep sufficiency group and sleep insufficiency group. Spearman rank correlation was used to screen the influencing factors. Results① Among 131 children and adolescents with mental disorders， 93 cases （71.0%） had sleep insufficiency. There were significant differences between sleep insufficiency group and sleep sufficiency group in terms of disease types （χ²=8.798， P=0.012）， experience of being beaten in recent 6 months （χ²=3.427， P=0.035）， being scolded in recent 6 months （χ²=4.145， P=0.031）， and cyberbullying over the past year （χ²=4.187， P=0.041）. ② Among patients with sleep insufficiency， 77 cases （82.8%） reported difficulty in falling asleep and 69 cases （74.2%） reported nocturnal awakenings. ③ Sleep insufficiency in children and adolescents with mental disorders was positively correlated with the experience of being scolded （r=0.210， P=0.037） or beaten （r=0.145， P=0.023） over the past 6 months and cyberbullying over the past year （r=0.179， P=0.041）. ConclusionChildren and adolescents with mental disorders suffer a high risk of sleep insufficiency， and is closely associated with depressive disorder， experience of being scolded or beaten over the past 6 months， and cyberbullying over the past year.