ObjectiveTo explore the coercive experience of involuntarily hospitalized adolescents with mental disorders during the admission process and hospitalization， providing references for formulating targeted nursing interventions. MethodsSemi-structured interviews were conducted with 15 involuntarily hospitalized adolescents with mental disorders selected from October to December 2023， and the themes were summarized and extracted by content analysis. ResultsA total of 3 themes and 10 sub-themes were extracted， which were used to elaborate the essential contents， causes， and improvement methods of coercive experience. These encompassed the multi-dimensional content of coercive experience （complex emotional experience， different physical sensations， and contradictory cognitive evaluation）， the multi-faceted causes of coercive experience （insufficient personal preparation， inadequate parental communication， and strict medical management system）， as well as the phased improvement of coercive experience （adequate communication before hospitalization， patient notification before coercive intervention， respecting for demands during coercive intervention， and comforting explanation after coercive intervention）. ConclusionThe essential content of the coercive experience of involuntarily hospitalized adolescents with mental disorders is complex and has various causes， which require cooperation from multiple parties to improve. Therefore， parents should respect the expression of their children’s self-will， and medical staff should respect patients’ autonomy， establishing a protection-constrained doctor-patient relationship model and collaborating to reduce the use of coercive interventions， to improve the overall medical satisfaction of adolescents with mental disorders.

In recent years, artificial intelligence (AI) technology has advanced rapidly and has been widely applied in various fields such as medicine and pharmacy, accelerating the drug development process. Focusing on the application of AI in the discovery and optimization of lead compounds, this review provides a detailed introduction to AI-assisted virtual screening and molecular generation methods for discovering lead compounds, while particularly highlighting the cases of AI-drived drugs into clinical trials. Additionally, we briefly outline the application of AI basic algorithm models in quantitative structure-activity relationship (QSAR) and drug repurposing, offering insights for AI-based drug discovery.

Schisandra chinensis, a traditional Chinese medicinal herb, is rich in chemical constituents, including lignans, triterpenes, polysaccharides, and volatile oils. Clinically, it is commonly used to treat cardiovascular, cerebrovascular, liver, gastrointestinal, and respiratory diseases. Modern pharmacological studies have shown that S. chinensis extract and monomers have multiple pharmacological activities in lowering liver fat, alleviating insulin resistance, and resisting oxidative stress, and have good application prospects in alleviating nonalcoholic fatty liver disease(NAFLD). Therefore, this study reviewed the research progress on chemical constituents of S. chinensis and its effect on NAFLD in recent years to provide references for the research on S. chinensis in the treatment of NAFLD.
Non-alcoholic Fatty Liver Disease ; Schisandra ; Insulin Resistance ; Lignans

Objective To evaluate the effectiveness of the integrated schistosomiasis control measures in Changzhou City from 2015 to 2020, so as to provide insights into the formulation of the strategy used to consolidate the schistosomiasis elimination achievements. Methods The annual schistosomiasis control working report and integrated schistosomiasis control data were collected in Changzhou City from 2015 to 2020, and the prevalence of Schistosoma japonicum infections in humans and livestock and snail status were analyzed to evaluate the effectiveness of the integrated schistosomiasis control measures. Results During the period from 2015 to 2020, a total of 112 061 person-time individuals received serological tests for S. japonicum infections in Changzhou City, and the sero-prevalence was 0.15% to 1.09% during the 6-year period, with a significant difference seen among years (χ² = 288.11, P < 0.05). From 2015 to 2020, a total of 13 435 person-time individuals received stool examinations, with no egg-positives identified; among 5 840 herd-time livestock receiving schistosomiasis examinations, no positives were detected, while a 100% coverage of fencing livestock was seen each year. During the 6-year period, a total of 38.40 hm² snail habitats were found, including 8.97 hm² emerging snail habitats, and among the 2 344 snails dissected, no S. japonicum infection was found. Chemical treatment covered an area of 385.71 hm², and environmental improvements covered an area of 200.39 hm². The mean density of living snails was less than 0.1 snails/0.1 m² in snail habitats found in Changzhou City each year from 2015 to 2020, and the coverage of harmless toilets was 100% in 2020. During the 6-year period, a total of 3.740 6 million person-time individuals were given schistosomiasis health education in Changzhou City. Conclusions Changzhou City is now at the post-elimination surveillance stage; however, there are still factors affecting schistosomiasis transmission. The schistosomiasis surveillance system remains to be improved to consolidate the schistosomiasis elimination achievements in Changzhou City.

Zinner syndrome is a congenital genitourinary embryo malformation, which is clinically rare, difficult to diagnose, and usually found in the sexually active stage. MRI is the preferred method for diagnosis. Conservative treatment was usually conducted for most asymptomatic patients. Symptomatic patients can be treated by laparoscopic or robotic surgery. For patients with infertility complicated with ejaculatory duct obstruction, transurethral resection of the ejaculatory duct is feasible, which contributes to improving sperm vitality and quantity and increasing semen volume. However, some patients still have azoospermia after surgery. The etiology is needed further studied. A case of infertility with Zinner syndrome and ectopic ureteral opening in seminal vesicle cyst is reported.

Objective:To investigate the relationship between embryo implantation site and adenomyotic lesions in pregnant patients with adenomyosis and its effects on pregnancy outcomes.Methods:Between January 2018 and December 2020, the clinical data of 95 pregnant patients with adenomyosis who were hospitalized in the Women′s Hospital, School of Medicine, Zhejiang University, which could identify the implantation site of embryo or placenta (≥11 weeks of pregnancy) through the nuchal translucency test under ultrasonography were analyzed retrospectively. According to the relationship between embryo implantation site and adenomyotic lesions, 95 patients were divided into two groups:short-distance group ( n=59, the embryo or placenta implantation was very close to or over the adenomyotic lesion), and long-distance group ( n=36, the implantation site of embryo or placenta was far away from the lesion, or the implantation site and the adenomyotic lesion were on different sides of the uterus). Next, taking 28 weeks of pregnancy as cut-off value, 95 patients were divided into <28 weeks of pregnancy group (pregnancy was terminated because of adverse pregnancy outcome before 28 weeks) and ≥28 weeks of pregnancy group (pregnancy lasted to 28 weeks and later), the differences of pregnancy outcomes between the two groups in different gestation times were analyzed. Results:(1) The age of 95 pregnant patients with adenomyosis was (34.8±3.5) years. There were no significant differences with regard to age, uterine size before pregnancy, the proportions of primipara, assisted reproductive technology conception, endometriosis, history of estrogen and progesterone treatment, diffuse adenomyotic lesions between the short-distance group and the long-distance group (all P>0.05). (2) Among the 95 patients, 12 patients (13%, 12/95) had adverse pregnancy outcomes before 28 weeks of pregnancy (i.e. pregnancy <28 weeks), including 11 cases (19%, 11/59) in the short-distance group and 1 case (3%, 1/36) in the long-distance group, there was significant difference between the two groups ( χ2=5.100, P=0.027). Among the 11 patients with adverse pregnancy outcomes at <28 weeks of gestation in the short-distance group, 1 case had threatened rupture of uterus before delivery of twin pregnancy at 26 weeks of gestation, 5 cases had intra uterine fetal death in the second trimester of pregnancy, 4 cases had late inevitable abortion, and 1 case had live birth of singleton at 26 weeks of gestation. In the long-distance group, one patient with adverse pregnancy outcome less than 28 weeks of pregnancy was late inevitable abortion. (3) Of the 95 patients, 83 cases were pregnant for ≥28 weeks (48 cases in the short-distance group and 35 cases in the long-distance group), and their final pregnancy outcome was all live birth. Compared with the long-distance group, the incidence of placental abnormalities (60% vs 14%), fetal distress (27% vs 6%), preterm delivery (67% vs 23%) and intrapartum bleeding [median 350 ml (range: 100-1 500 ml) vs 300 ml (range: 100-800 ml)] in the short-distance group were significantly higher (all P<0.05). While the gestational weeks in the short-distance group [median 37 weeks (range: 30-41 weeks) vs 38 weeks (range: 28-41 weeks)] and neonatal birth weight [median 2 790 g (range: 1 170-4 040 g) vs 3 010 g (range: 980-4 320 g)] decreased significantly (all P<0.05), compared with those in the long-distance group. Conclusion:Patients with pregnancy complicated with adenomyosis are prone to adverse pregnancy outcomes if the embryo implantation is located on or very close to adenomyotic lesions, so close monitoring and early intervention should be carried out to improve pregnancy outcomes.

Objective To understand the clinical characteristics and changes in laboratory indicators of patients died of visceral leishmaniasis (VL).Methods Clinical data of 4 patients died of VL in Beijing Friendship Hospital from January 2013 to June 2018 were analyzed, differences in laboratory indicators were compared.Results Disease course of 4 cases of VL ranged from3 to 12 months, all patients had multiple organ damage, including 3 cases with hepatomegaly and splenomegaly, 2 cases with central nervous system damage.IgG antibodies of leishmania were positive in 4 patients, Leishman-Donovan body was found in bone marrow smears.Routine peripheral blood test results in 4 patients decreased significantly, albumin decreased significantly and globulin increased;level of serum sodium ion in 4 patients was lower than 135 mmol/L.Conclusion Long disease course, multiple organ damage, involvement of central nervous system, significant reducing in peripheral blood routine test results, hypoproteinemia, and hyponatremia in patients with VL all indicate poor prognosis and high mortality.

Objective To assess the state of schistosomiasis elimination in 6 districts of Changzhou City, Jiangsu Province, so as to provide the evidence for the formulation of consolidation measures. Methods Three towns (streets) were selected according to the schistosomiasis epidemic degree in each district, and one village was sampled from each town. The on-site assessment was carried out between 2016 and 2017, including Oncomelania hupensis snail survey, population investigation and domestic animal investigation. In addition, the related data and materials were evaluated and the monitoring ability was assessed. Results In the history, there were 54 endemic towns, 368 endemic villages in Changzhou City, with a total area of 3 934.79 hm² of historic snail spots, and 114 990 schistosomiasis cases so far. In the field assessment in 6 districts, a total of 26 environments were surveyed, with the surveyed area of 36.23 hm², and there were no living snails captured in each village. A total of 18 199 people were examined for schistosome infection, 255 were blood test positive, and the sero-positive rate was 1.40%. The stool examination was done in 255 sero-positive cases, and no cases were stool-positive. A total of 779 domestic animals were investigated, including 200 cattle, 179 sheep and 400 pigs, and no infections were detected. The files regarding the snail status and schistosomiasis epidemic situation, and the monitoring data were complete and accurate in 6 districts. The annual investment funds for schistosomiasis prevention were 3 120 000 Yuan in Changzhou City, and the number of staff working for schistosomiasis prevention was 86 totally, which could meet the requirements of high quality monitoring. Conclusions All 6 districts of Changzhou City have met the requirements of schistosomiasis elimination.

Objective To investigate the prevalence of major parasitic diseases and related knowledge,attitude and practice among rural residents in Liyang City,so as to provide the evidence for formulating appropriate preventive strategies and mea-sures.Methods Three villages were selected from three towns as survey sites,and the residents who were above three years old and had been in the village for over six months were investigated.The Kato-Katz technique was applied to detect intestinal para-site eggs in residents'feces,and the cellophane anal swab was used to detect Enterobius vermicularis eggs among children aged 3-6 years. The iodine liquid smear and saline smear methods were used to examine intestinal protozoa cysts or trophozoites. Hookworm species were identified by the tube filter paper culture method.A structured questionnaire was used to collect the in-formation on residents'knowledge,attitude and practice of the prevention and control of major parasitic diseases.Results To-tally 759 residents were investigated and tested at the three rural survey sites,and only 2 cases were detected of parasitic infec-tion and the total infection rate was 0.26%.Both cases were mild infections without mixed infection.The total awareness rate of knowledge on ascariasis,trichuriasis and ancylostomiasis was 37.9%,while the awareness rate of knowledge on clonorchiasis was 13.8%.The age and educational level were important factors of the knowledge on prevention and control of parasitic diseases among the residents.The formation rates of washing hands before meal and after using the toilet,and never drinking unboiled wa-ter were 83.8% and 92.1%,respectively. Totally 11.6% of the residents usually ate raw or half-cooked freshwater fishes and shrimps,and 53.0% had not the behavior to prepare raw and cooked food using the different chopping boards.The proportions of residents using fresh feces as manure and working in the field with bare feet were 13.8% and 22.8% respectively.The proportions of residents who thought they could,could not,or were not sure to change the risk behaviors and habits of parasitic infections were 40.2%,28.5% and 31.4%,respectively.Conclusions The infection rate of major parasitic diseases among the rural resi-dents in Liyang City is low,and the awareness rate of knowledge on preventing parasitic diseases is also low. Therefore,the health education on the prevention and control of parasitic diseases should be strengthened to guide them to develop good hy-giene,diet and farming habits.The environmental sanitation should be continuously improved to block the endemic of parasitic infection.

OBJECTIVETo investigate clinical effect of vacuum sealing drainage(VSD) with anterolateral thigh perforator flap for repair foot soft tissue defect.

METHODSFrom September 2014 to September 2016, 45 patients with foot soft tissue defect repaired by VSD with anterolateral thigh perforator flap, including 31 males and 14 females aged from 17 to 55 years with an average of 36 years old. Thirty patients were dorsal soft tissue defects, and 15 patients were plantar soft tissue defects. Sizes of soft tissue defect ranged from 7 cm×10 cm to 11 cm×18 cm, the wound was contaminated seriously and assisted with deep soft tissue exposure. Emergency surgical wound debridement with VSD treatment were performed, and wound surface was cleaned after 5 to 7 days, free anterolateral thigh flap were repaired. Sizes of flap ranged from 9 cm×12 cm to 13 cm×21 cm. Appropriate method was used to repair flap donor area.

RESULTSAll 45 free propeller flap were survived without skin edge necrosis, ulcerative infection. Forty patients were followed up from 3 to 24 months with an average of 13 months. Flap showed good color, beautiful appearance, good elasticity, soft texture, but without obvious bloated, the wood of leg healed well.

CONCLUSIONSVSD with anterolateral thigh perforator flap for repair foot soft tissue defect could effective control wound soft tissue infection, receive reliable flap blood supply and skin flap could repaired at stage I. It is an effective method for repairing foot soft tissue defects.