The role of ZEB1 in mediating the protective effects of metformin on skeletal muscle atrophy.

Metformin is an important antidiabetic drug that has the potential to reduce skeletal muscle atrophy and promote the differentiation of muscle cells. However, the exact molecular mechanism underlying these functions remains unclear. Previous studies revealed that the transcription factor zinc finger E-box-binding homeobox 1 (ZEB1), which participates in tumor progression, inhibits muscle atrophy. Therefore, we hypothesized that the protective effect of metformin might be related to ZEB1. We investigated the positive effect of metformin on IL-1ß-induced skeletal muscle atrophy by regulating ZEB1 in vitro and in vivo. Compared with the normal cell differentiation group, the metformin-treated group presented increased myotube diameters and reduced expression levels of atrophy-marker proteins. Moreover, muscle cell differentiation was hindered, when we artificially interfered with ZEB1 expression in mouse skeletal myoblast (C2C12) cells via ZEB1-specific small interfering RNA (si-ZEB1). In response to inflammatory stimulation, metformin treatment increased the expression levels of ZEB1 and three differentiation proteins, MHC, MyoD, and myogenin, whereas si-ZEB1 partially counteracted these effects. Moreover, marked atrophy was induced in a mouse model via the administration of lipopolysaccharide (LPS) to the skeletal muscles of the lower limbs. Over a 4-week period of intragastric administration, metformin treatment ameliorated muscle atrophy and increased the expression levels of ZEB1. Metformin treatment partially alleviated muscle atrophy and stimulated differentiation. Overall, our findings may provide a better understanding of the mechanism underlying the effects of metformin treatment on skeletal muscle atrophy and suggest the potential of metformin as a therapeutic drug.

Evaluation of the efficacy of trigger points combined with extracorporeal shock waves in the treatment of plantar fasciitis: heel temperature and plantar pressure.

BACKGROUND: Plantar fasciitis (PF) is the most common cause of heel pain. Among conservative treatments, extracorporeal shock wave therapy (ESWT) is considered effective for refractory PF. Studies have shown that applying ESWT to the trigger points (TrPs) in the triceps surae may play an important role in pain treatment in patients with PF. Therefore, the purpose of this study was to combine the concept of trigger points and ESWT to explore the effect of this combination on plantar temperature and pressure in patients with PF. METHODS: After applying inclusion and exclusion criteria, 86 patients with PF were recruited from the pain clinic of Huadong Hospital, Fudan University and randomly divided into experimental (n = 43) and control groups (n = 43). The experimental group was treated with extracorporeal shock waves to treat the medial heel pain point and the gastrocnemius and soleus TrPs. The control group was only treated with extracorporeal shock waves at the medial heel pain point. The two groups were treated twice with an interval of 1 week. Primary measurements included a numerical rating scale (NRS) score (overall, first step, heel pain during daily activities), and secondary measurements included heel temperature, Roles-Maudsley score (RMS), and plantar pressure. All assessments were performed before treatment (i.e., baseline) and 6 and 12 weeks after treatment. RESULTS: During the trial, 3 patients in the experimental group withdrew from the study, 2 due to interruption of the course of treatment by the COVID-19 epidemic and 1 due to personal reasons. In the control group, 3 patients fell and were removed due to swelling of the heel. Therefore, only 80 patients with PF were finally included. After treatment, the two groups showed good results in NRS score (overall, first step, heel pain during daily activities), RMS, and plantar temperature, especially in the experimental group, who showed a significantly better effect than the control group. CONCLUSION: ESWT of the heel combined with the triceps trigger point of the calf can more effectively improve the pain, function and quality of life of refractory PF than ESWT of the heel alone. In addition, ESWT of the heel combined with the triceps trigger point of the calf can effectively reduce the skin temperature of the heel on the symptomatic side, indicating that the heel temperature as measured by infrared thermal imaging may be used as an independent tool to evaluate the therapeutic effect for patients with chronic PF. Although extracorporeal shock waves combined with TrPs treatment can cause changes in the patients' gait structure, plantar pressure is still difficult to use as an independent tool to evaluate the therapeutic effect for PF. TRIAL REGISTRATION: Registered in the Chinese Clinical Trial Registry ( www.chictr.org.cn ) on 12/17/2021 with the following code: ChiCTR-INR-2,100,054,439.

Thriving arid oasis urban agglomerations: Optimizing ecosystem services pattern under future climate change scenarios using dynamic Bayesian network.

The effects of global climate change and human activities are anticipated to significantly impact ecosystem services (ESs), particularly in urban agglomerations of arid regions. This paper proposes a framework integrating the dynamic Bayesian network (DBN), system dynamics (SD) model, patch generation land use simulation (PLUS) model, and the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model for predicting land use change and optimizing ESs spatial patterns that is built upon the SSP-RCP scenarios from CMIP6. This framework is applied to the oasis urban agglomeration on the northern slope of the Tianshan Mountains in Xinjiang (UANSTM), China. The findings indicate that both the SD model and PLUS model can accurately forecast the distribution of future land use. The SD model shows a relative error of less than 2.32%, while the PLUS model demonstrates a Kappa coefficient of 0.89. The land use pattern displays obvious spatial heterogeneity under different climate scenarios. The expansion of cultivated land and construction land is the main form of land use change in UANSTM in the future. The DBN model proficiently simulates the interactive relationships between ESs and diverse factors. The classification error rates for net primary productivity (NPP), habitat quality (HQ), water yield (WY), and soil retention (SR) are 20.04%, 3.47%, 4.45%, and 13.42%, respectively. The prediction and diagnosis of DBN determine the optimal ESs development scenario and the optimal ESs region in the study area. It is found that the majority of ESs in UANSTM are predominantly influenced by natural factors with the exception of HQ. The socio-economic development plays a minor role in such urban agglomerations. This study offers significant insights that can contribute to the fields of ecological protection and land use planning in arid urban agglomerations worldwide.

Dry needling on latent and active myofascial trigger points versus oral diclofenac in patients with knee osteoarthritis: a randomized controlled trial.

BACKGROUND: Latent and active myofascial trigger points (MTrPs) in knee-associated muscles may play a key role in pain management among patients with knee osteoarthritis (KOA). The aim of this study was to investigate the effect of dry needling treatment on pain intensity, disability, and range of motion (ROM) in patients with KOA. METHODS: This randomized, single-blinded, clinical trial was carried out for 6 weeks of treatment and 6-month follow-up. A total of 98 patients met the entry criteria and were randomly assigned to the dry needling latent and active myofascial trigger point (MTrPs) with the stretching group or the oral diclofenacwith the stretching group. Numeric Pain Rating Scale (NPRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and ROM were statistically analyzed before and after treatment and at the 6-month follow-up. RESULTS: A total of 42 patients in the dry needling group (DNG) and 35 patients in the diclofenac group (DG), respectively, completed the study, and there was no significant difference in the general data between the two groups. After treatments, both the groups showed a good effect in knee pain, function, and ROM, However, the DNG showed a significantly better result than the DG. Especially in the results of the 6-month follow-up, the DNG showed much better results than the DG. CONCLUSIONS: Dry needling on latent and active MTrPs combined with stretching and oral diclofenac combined with stretching can effectively relieve pain, improve function, and restore knee ROM affected by KOA. However, the effects of dry needling and stretching are better and longer lasting than those of oral diclofenac and stretching for at least 6 months. TRIAL REGISTRATION: Registered in the Chinese Clinical Trial Registry ( www.chictr.org.cn ) in 17/11/2017 with the following code: ChiCTR-INR-17013432.

Hub-connected functional connectivity within social brain network weakens the association with real-life social network in schizophrenia patients.

Hubs in the brain network are the regions with high centrality and are crucial in the network communication and information integration. Patients with schizophrenia (SCZ) exhibit wide range of abnormality in the hub regions and their connected functional connectivity (FC) at the whole-brain network level. Study of the hubs in the brain networks supporting complex social behavior (social brain network, SBN) would contribute to understand the social dysfunction in patients with SCZ. Forty-nine patients with SCZ and 27 healthy controls (HC) were recruited to undertake the resting-state magnetic resonance imaging scanning and completed a social network (SN) questionnaire. The resting-state SBN was constructed based on the automatic analysis results from the NeuroSynth. Our results showed that the left temporal lobe was the only hub of SBN, and its connected FCs strength was higher than the remaining FCs in both two groups. SCZ patients showed the lower association between the hub-connected FCs (compared to the FCs not connected to the hub regions) with the real-life SN characteristics. These results were replicated in another independent sample (30 SCZ and 28 HC). These preliminary findings suggested that the hub-connected FCs of SBN in SCZ patients exhibit the abnormality in predicting real-life SN characteristics.

Altered empathy-related resting-state functional connectivity in patients with bipolar disorder.

Empathy is the ability to generate emotional responses (i.e., cognitive empathy) and to make cognitive inferences (i.e., affective empathy) to other people's emotions. Empirical evidence suggests that patients with bipolar disorder (BD) exhibit impairment in cognitive empathy, but findings on affective empathy are inconsistent. Few studies have examined the neural mechanisms of cognitive and affective empathy in patients with BD. In this study, we examined the empathy-related resting-state functional connectivity (rsFC) in BD patients. Thirty-seven patients with BD and 42 healthy controls completed the self-report Questionnaires of Cognitive and Affective Empathy (QCAE), the Yoni behavioural task, and resting-sate fMRI brain scans. Group comparison of empathic ability was conducted. The interactions between group and empathic ability on seed-based whole brain rsFC were examined. BD patients scored lower on the Online Simulation subscale of the QCAE and showed positive correlations between cognitive empathy and the rsFC of the dorsal Medial Prefrontal Cortex (dmPFC) with the lingual gyrus. The correlations between cognitive empathy and the rsFC of the temporal-parietal junction (TPJ) with the fusiform gyrus, the cerebellum and the parahippocampus were weaker in BD patients than that in healthy controls. These findings highlight the underlying neural mechanisms of empathy impairments in BD patients.

A Randomized Controlled Pilot Study Comparing the Efficacy of Pulsed Radiofrequency Combined With Exercise Versus Exercise Alone in Pain Relief and Functional Improvement for Chronic Knee Osteoarthritis.

OBJECTIVES: To compare the long-term efficacy between pulsed radiofrequency (PRF) combined with passive stretching (PRF-PS) exercise and PS exercise alone in reducing pain and improving quadriceps muscle strength and knee function. METHODS: Sixty-two participants were randomly assigned with a 1:1 allocation to the PRF-PS exercise group or the PS exercise group. Level of pain, muscle strength, and knee function were assessed from baseline to the first, third, and sixth months after treatment using the VAS, peak torque (PT), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively. RESULTS: There were no significant differences at baseline between the 2 groups. Compared to exercise alone, participants achieved superior efficacy with PRF-PS in pain relief, improvement of muscle strength, and knee function. Moreover, the improvement of all variables was maintained for a longer period of time in the PRF-PS group. The reduction in participants' VAS pain intensity scores was superior for PRF-PS vs. PS with overall estimation (adjusted mean difference: -1.85 cm; 95% confidence interval [CI] -2.25, -1.45 cm; P = 0.000). The increase in participants' PT scores was superior for PRF-PS vs. PS with overall estimation (adjusted mean difference: 15.53 N. m; 95% CI 7.07, 23.98 N. m; P = 0.000; and 12.62 N. m; 95% CI 0.96, 24.28 N. m; P = 0.000 for PT 60 degrees/s and PT 180 degrees/s, respectively). The reduction in participants' WOMAC scores was superior for PRF-PS vs. PS with overall estimation (adjusted mean difference: -16.43; 95% CI -22.22, -10.64; P = 0.000). DISCUSSION: The improvement in pain relief and knee function might be associated with restoration of muscle strength after PRF-PS exercise by overcoming muscle inhibition.

Synthesis and cytotoxicity of (-)-homo-renieramycin G and its derivatives.

(-)-Homo-renieramycin G and its twenty derivatives were prepared from l-tyrosine methyl ester via a multi-step route. Their cytotoxicities were tested against four human cancer cell lines (A549, HeLa, KB and BGC-823). (-)-Renieramycin G and (-)-homo-renieramycin G showed comparable cytotoxicity against these four cancer cell lines, which indicated that the expansion of ring C from the six-membered 1,4-piperazinone to the seven-membered 1,4-diazepanone had no obvious impact on the cytotoxicity. Compound 42 with methyl side chain and compounds 38-41 with heterocyclic aromatic side chains at C-23 exhibited the most potent cytotoxicity with the IC50 values at the level of 10-6 M.

Validation of the Questionnaire of Cognitive and Affective Empathy in patients with schizophrenia, major depressive disorder and bipolar disorder.

INTRODUCTION: Alteration of empathy is common in patients with psychiatric disorders. Reliable and valid assessment tools for measuring empathy of clinical samples is needed. The Questionnaire of Cognitive and Affective Empathy (QCAE) is a newly-developed instrument to capture cognitive and affective components of empathy. This study aimed to validate the QCAE and compared self-reported empathy between clinical groups with varied psychiatric diagnoses and healthy sample. METHODS: The present study performed factor analysis for the QCAE on clinical samples in the Chinese setting (n = 534), including patients with schizophrenia (n = 158), bipolar disorder (n = 213) and major depressive disorder (n = 163). Internal consistency, internal correlation and convergent validity was examined in the subsample (n = 361). Group comparison among patients with schizophrenia, bipolar disorder, major depressive disorder and healthy controls (n = 107) was conducted to assess the discriminant validity. RESULTS: Our results indicated acceptable factor model, good reliability and validity of the QCAE. Impaired cognitive empathy was found in clinical samples, especially in patients with schizophrenia, while higher affective empathy was found in patients with bipolar disorder and major depressive disorder. CONCLUSION: The QCAE is a useful tool in assessing empathy in patients with varied psychiatric diagnoses.

A concise synthesis of (E)-3-aryl-2,3,4,5-tetrahydro-1H-3-benzazonines by aryne induced [2,3] Stevens rearrangement of 1,2,3,4-tetrahydroisoquinolines.

A mild and transition-metal-free approach for the synthesis of (E)-3-aryl-2,3,4,5-tetrahydro-1H-3-benzazonines via [2,3] Stevens rearrangement of 1,2,3,4-tetrahydroisoquinolines with arynes is described. This protocol provides straightforward access to (E)-3-aryl-2,3,4,5-tetrahydro-1H-3-benzazonines in moderate to good yields with excellent diastereoselectivity. A broad range of functional groups, involving nitrile, esters, ketone and aryl halide, were well tolerated in this reaction.

Evidence for Dry Needling in the Management of Myofascial Trigger Points Associated With Low Back Pain: A Systematic Review and Meta-Analysis.

OBJECTIVE: To evaluate the current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with low back pain (LBP). DATA SOURCES: PubMed, Ovid, EBSCO, ScienceDirect, Web of Science, Cochrane Library, CINAHL, and China National Knowledge Infrastructure databases were searched until January 2017. STUDY SELECTION: Randomized controlled trials (RCTs) that used dry needling as the main treatment and included participants diagnosed with LBP with the presence of MTrPs were included. DATA EXTRACTION: Two reviewers independently screened articles, scored methodologic quality, and extracted data. The primary outcomes were pain intensity and functional disability at postintervention and follow-up. DATA SYNTHESIS: A total of 11 RCTs involving 802 patients were included in the meta-analysis. Results suggested that compared with other treatments, dry needling of MTrPs was more effective in alleviating the intensity of LBP (standardized mean difference [SMD], -1.06; 95% confidence interval [CI], -1.77 to -0.36; P=.003) and functional disability (SMD, -0.76; 95% CI, -1.46 to -0.06; P=.03); however, the significant effects of dry needling plus other treatments on pain intensity could be superior to dry needling alone for LBP at postintervention (SMD, 0.83; 95% CI, 0.55-1.11; P<.00001). CONCLUSIONS: Moderate evidence showed that dry needling of MTrPs, especially if associated with other therapies, could be recommended to relieve the intensity of LBP at postintervention; however, the clinical superiority of dry needling in improving functional disability and its follow-up effects still remains unclear.

Functional rescue of Kallmann syndrome-associated prokineticin receptor 2 (PKR2) mutants deficient in trafficking.

Mutations in the G protein-coupled prokineticin receptor 2 (PKR2) are known to cause Kallmann syndrome and idiopathic hypogonadotropic hypogonadism manifesting with delayed puberty and infertility. Some of the mutant receptors are not routed to the cell surface; instead, they are trapped in the cellular secretory pathway. The cell-permeant agonists/antagonists have been used to rescue some membrane receptors that are not targeted onto the cell membrane. Here, we chose three disease-associated mutations (W178S, G234D, and P290S), which all resulted in retention of PKR2 intracellularly. We show that a small molecule PKR2 antagonist (A457) dramatically increased cell surface expression and rescued the function of P290S PKR2, but had no effect on W178S and G234D PKR2. Furthermore, we also tested chemical chaperone glycerol on the cell surface expression and function of PKR2 mutants. Treatment with 10% glycerol significantly increased the cell surface expression and signaling of P290S and W178S PKR2. These data demonstrate that some Kallmann syndrome-associated, intracellularly retained mutant PKR2 receptors can be functionally rescued, suggesting a potential treatment strategy for patients bearing such mutations.

Distinguishing bipolar and major depressive disorders by brain structural morphometry: a pilot study.

BACKGROUND: The clinical presentation of common symptoms during depressive episodes in bipolar disorder (BD) and major depressive disorder (MDD) poses challenges for accurate diagnosis. Disorder-specific neuroanatomical features may aid the development of reliable discrimination between these two clinical conditions. METHODS: For our sample of 16 BD patients, 19 MDD patients and 29 healthy volunteers, we adopted vertex-wise cortical based brain imaging techniques to examine cortical thickness and surface area, two components of cortical volume with distinct genetic determinants. Based on specific characteristics of neuroanatomical features, we then used support vector machine (SVM) algorithm to discriminate between patients with BD and MDD. RESULTS: Compared to MDD patients, BD patients showed significantly larger cortical surface area in the left bankssts, precuneus, precentral, inferior parietal, superior parietal and the right middle temporal gyri. In addition, larger volumes of subcortical regions were found in BD patients. In SVM discriminative analyses, the overall accuracy was 74.3 %, with a sensitivity of 62.5 % and a specificity of 84.2 % (p = 0.028). Compared to controls, larger surface area in the temporo-parietal regions were observed in BD patients, and thinner cortices in fronto-temporal regions were observed in MDD patients, especially in the medial orbito-frontal area. CONCLUSIONS: These findings have demonstrated distinct spatially distributed variations in cortical thickness and surface area in patients with BD and MDD, suggesting potentially varying etiological and neuropathological processes in these two conditions. The employment of multimodal classification on disorder-specific biological features has shed light to the development of potential classification tools that could aid diagnostic decisions.

Research on Utilizable Calcium from Calcium Carbide Slag with Different Extractors and Its Effect on CO2 Mineralization.

With the increasing accumulation of alkaline industrial solid waste, the mineralization of CO2 using alkaline industrial solid waste has broad application prospects. Carbide slag is highly alkaline and contains a large amount of calcium elements, making it an excellent material for CO2 mineralization. Our idea was to acquire qualified products and fast kinetics by integrating carbide slag utilization and carbon reduction. The reaction route was divided into two steps: calcium extraction and carbonization. In order to achieve efficient extraction of utilizable calcium, we selected NH4Ac as the extraction agent, which has the advantage of buffer protection and environmental friendliness due to being an acetate radical. The extraction efficiency of utilizable calcium exceeded 90% under the conditions of L/S 20:1 and NH4+/Ca2+ 2:1. In the carbonization process, the crystal forms of CaCO3 synthesized by direct carbonation, acid extraction, and ammonium salt were characterized. The formation mechanism of vaterite in ammonium solution and the influence of impurities (Al3+, Mg2+) on the crystal transformation were revealed. This study provides technical support for using alkaline industrial waste to prepare high-purity vaterite. Therefore, alkaline industrial waste can be efficiently and sustainably utilized through CO2 mineralization.

Preparation of Cementitious Materials from Mechanochemically Modified Copper Smelting Slag Compounded with High-Aluminum Fly Ash.

Copper smelting slag discharged from mining and high-aluminum fly ash generated during the combustion of coal for energy production are two typical bulk solid wastes, which are necessary to carry out harmless and resourceful treatment. This research proposed an eco-friendly and economical method for the co-consumption of copper smelting slag and high-aluminum fly ash. Cementitious materials were compounded with copper smelting slag and high-aluminum fly ash as the main materials were successfully prepared, with a 28-d compressive strength up to 31.22 MPa, and the heavy metal leaching toxicity was below the limits of the relevant standards. The optimum mechanical properties of the cementitious materials were obtained by altering the material proportion, ball mill rotation speed, and CaO dosage. Under the combined effect of mechanical ball milling at a suitable speed and chemical activation with a certain alkali concentration, the prepared cementitious materials had an initial activation. The pastes of the cementitious materials generated a gel system during the subsequent hydration process. The two steps together improved the mechanical strength of the cured products. The preparation was simple to operate and offered a high stability of heavy metals. The heavy metal contaminants were kept at a low content throughout the process from raw materials to the prepared cured specimens, which was suitable for application in practical environmental remediation projects and could provide effective solutions for ecological environment construction.

Putative Risk Biomarkers of Bipolar Disorder in At-risk Youth.

Bipolar disorder is a highly heritable and functionally impairing disease. The recognition and intervention of BD especially that characterized by early onset remains challenging. Risk biomarkers for predicting BD transition among at-risk youth may improve disease prognosis. We reviewed the more recent clinical studies to find possible pre-diagnostic biomarkers in youth at familial or (and) clinical risk of BD. Here we found that putative biomarkers for predicting conversion to BD include findings from multiple sample sources based on different hypotheses. Putative risk biomarkers shown by perspective studies are higher bipolar polygenetic risk scores, epigenetic alterations, elevated immune parameters, front-limbic system deficits, and brain circuit dysfunction associated with emotion and reward processing. Future studies need to enhance machine learning integration, make clinical detection methods more objective, and improve the quality of cohort studies.

Depressive and mania mood state detection through voice as a biomarker using machine learning.

Introduction: Depressive and manic states contribute significantly to the global social burden, but objective detection tools are still lacking. This study investigates the feasibility of utilizing voice as a biomarker to detect these mood states. Methods:From real-world emotional journal voice recordings, 22 features were retrieved in this study, 21 of which showed significant differences among mood states. Additionally, we applied leave-one-subject-out strategy to train and validate four classification models: Chinese-speech-pretrain-GRU, Gate Recurrent Unit (GRU), Bi-directional Long Short-Term Memory (BiLSTM), and Linear Discriminant Analysis (LDA). Results: Our results indicated that the Chinese-speech-pretrain-GRU model performed the best, achieving sensitivities of 77.5% and 54.8% and specificities of 86.1% and 90.3% for detecting depressive and manic states, respectively, with an overall accuracy of 80.2%. Discussion: These findings show that machine learning can reliably differentiate between depressive and manic mood states via voice analysis, allowing for a more objective and precise approach to mood disorder assessment.

Crop water productivity assessment and planting structure optimization in typical arid irrigation district using dynamic Bayesian network.

Enhancing crop water productivity is crucial for regional water resource management and agricultural sustainability, particularly in arid regions. However, evaluating the spatial heterogeneity and temporal dynamics of crop water productivity in face of data limitations poses a challenge. In this study, we propose a framework that integrates remote sensing data, time series generative adversarial network (TimeGAN), dynamic Bayesian network (DBN), and optimization model to assess crop water productivity and optimize crop planting structure under limited water resources allocation in the Qira oasis. The results demonstrate that the combination of TimeGAN and DBN better improves the accuracy of the model for the dynamic prediction, particularly for short-term predictions with 4 years as the optimal timescale (R2 > 0.8). Based on the spatial distribution of crop suitability analysis, wheat and corn are most suitable for cultivation in the central and eastern parts of Qira oasis while cotton is unsuitable for planting in the western region. The walnuts and Chinese dates are mainly unsuitable in the southeastern part of the oasis. Maximizing crop water productivity while ensuring food security has led to increased acreage for cotton, Chinese dates and walnuts. Under the combined action of the five optimization objectives, the average increase of crop water productivity is 14.97%, and the average increase of ecological benefit is 3.61%, which is much higher than the growth rate of irrigation water consumption of cultivated land. It will produce a planting structure that relatively reduced irrigation water requirement of cultivated land and improved crop water productivity. This proposed framework can serve as an effective reference tool for decision-makers when determining future cropping plans.

Prevalence and correlates of non-suicidal self-injury among patients with bipolar disorder: A multicenter study across China.

BACKGROUND: Non-suicidal self-injury (NSSI) is increasingly prevalent among patients with bipolar disorder (BD), raising concerns in psychology and mental health. Investigating the incidence and factors associated with NSSI is crucial for developing prevention and intervention strategies. METHODS: NSSI behaviors were identified using the Ottawa Self-injury Inventory. The Clinically Useful Depression Outcome Scale supplemented with questions for the DSM-5 specifier of mixed features (CUDOS-M) and the Mini International Neuropsychiatric Interview (Hypo-)Manic Episode with Mixed Features-DSM-5 Module (MINI-M) were used to evaluate clinical symptoms. Non-parametric tests, chi-square tests, point-biserial correlation and logistic regression analyses were employed for the purposes of data analysis. RESULTS: The enrolled sample comprised 1044 patients with BD from 20 research centers across China. Out of 1044 individuals, 446 exhibited NSSI behaviors, with 101 of them being adolescents, leading to a prevalence of 78.3 % among adolescent patients. The most common methods for females and males were "cutting" (41.2 %) and "hitting" (34.7 %), respectively. By binary logistic regression analysis, young age, female, bipolar type II disorder, with suicidal ideation and mixed states, depressive symptoms and without family history of mental disorder were correlates of NSSI in patients with BD (P < 0.05). LIMITATIONS: As a cross-sectional study, causality between NSSI behaviors and associated factors cannot be established. Reporting and recall biases may occur due to self-rating scales and retrospective reports. CONCLUSION: Our study indicates a concerning prevalence of NSSI, particularly among young patients with BD in China. Future research should focus on understanding NSSI behaviors in this population and developing effective interventions.