摘要
ObjectiveTo explore the relapse status based on the positive and negative syndrome scale (PANSS Scale) and related factors of schizophrenics in Shanghai communities, and to analyze the association between socio demographic characteristics, lifestyles, clinical characteristics and relapse. MethodsA dynamic cohort prospective study design was used in this study. From March 2018 to February 2019, a total of 189 schizophrenics in Xuhui, Hongkou, Changning, Jiading, Songjiang and Baoshan districts were enrolled successively. Baseline questionnaires were conducted through face-to-face interviews at baseline, which contained social demographic information, lifestyle information and clinical information. A follow-up was conducted every 2 weeks for a measurement of PANSS Scale for a total of 6 months. Relapse was assessed by a PANSS score increase of ≥25% from baseline (or an increase of 10 points or more if the baseline score was ≤40 points). Univariate and multivariate Cox regression models were used to analyze the associations between relapse status (assessed by PANSS Scale) and socio demographic characteristics, lifestyles, and clinical characteristics, respectively. ResultsA total of 165 community schizophrenics completed baseline and follow-up surveys, with a loss to follow-up rate of about 12.7%. After exclusion of sociodemographic and clinical information deficits, 132 patients were included in the analysis totally, with an average age of 48.18±12.67 years, among whom 41.67% were male. Totally 33 patients relapsed during the 6-month follow-up period, with a relapse rate of 25.0%. After adjusting for gender, family history, age, employment, education, marital status, smoking, drinking, exercise frequency, medication compliance, insight, social function, violence history, stress recent events, adverse drug reactions and baseline scores of PANSS Scale, risk factors of relapse included the following four factors: age below 40 years (HR=4.47, 95%CI: 1.15-17.40), primary school or below (HR=7.11, 95%CI: 1.54-32.83), unemployed (HR=8.34, 95%CI: 1.78-38.98), and adverse drug reactions (HR=5.02, 95%CI: 1.75-14.37). ConclusionWe should pay attention to the risk factors such as age, education, employment and adverse drug reactions, in order to identify high-risk patients and to conduct timely interventions during the relapse management of schizophrenics in Shanghai community.
摘要
ObjectiveTo investigate the prevalence of overweight or obesity in community patients with schizophrenia in Shanghai and to explore the related factors. MethodsStratified cluster sampling method was used and the general condition, physical examination and laboratory examination data of patients with schizophrenia who voluntarily participated in 2020 free health examination of National Basic Public Health Service were analyzed. ResultsA total of 3 200 patients were included into the study ,and the prevalence of overweight and obesity was 36.75% and 17.19%, respectively. Multivariate logistic regression analysis indicated that age between 40 and 60 (OR=1.333, 95%CI: 1.030‒1.724), intake of first-generation antipsychotics (OR=1.413, 95%CI: 1.112‒1.796), intake of second-generation antipsychotics (OR=1.573, 95%CI: 1.288‒1.921), high-normal blood pressure (OR=1.549, 95%CI: 1.245‒1.927), high-abnormal blood pressure (OR=2.824, 95%CI: 2.204‒3.619), elevated ALT (OR=1.874, 95%CI: 1.386‒2.535), elevated FBG (OR=1.270, 95%CI: 1.066‒1.513), and elevated TG (OR=1.652, 95%CI: 1.335‒2.044) were the related factors that associated overweight or obesity in patients with schizophrenia. ConclusionOverweight and obesity are highly prevalent among community patients with schizophrenia in Shanghai. Age between 40 and 60, taking first-generation and second-generation antipsychotics, blood pressure higher than 120/80 mmHg, elevated ALT, elevated FBG, and elevated TG are associated with overweight or obesity in patients with schizophrenia. To provide personalized health guidance, medical staff in primary health care institutions should pay more attention to high-risk groups of overweight and obesity in schizophrenia patients at annual physical examination.
摘要
ObjectiveTo explore the effect of paliperidone palmitate treatment on schizophrenic patients in the community. Methods446 schizophrenic patients who used paliperidone palmitate injection were selected in Shanghai. Before and after the treatment, the disease family burden scale, the concise evaluation scale of drug treatment compliance, the VAS100 score of treatment satisfaction, the short form of quality of life measurement scale, and the screening scale of social function defects were used to evaluate the effects of paliperidone palmitate injection. The data were statistically analyzed using SPSS 26.0 software. ResultsAfter using paliperidone palmitate injection, the total score of family burden (13.94±12.17), the score of daily family activities (3.26±2.74), the score of family entertainment activities (2.21±2.30), and the score of family relationship (2.79±2.76) were significantly higher than those before the treatment (14.98±12.64, 3.51±2.88, 2.48±2.38, 3.11±2.87, respectively, all with P<0.05). The scores of the World Health Organization on quality of life brief scale (62.89±11.94) and the medication compliance scale (28.11±5.64) were better than those before treatment (60.67±12.62 and 27.37±6.96, all with P<0.05). Compared with the prior treatment without paliperidone palmitate injection, the number of readmissions after treatment was significantly reduced (P<0.01). ConclusionThe treatment of paliperidone palmitate injection has significant effect, which can effectively reduce the disease family burden of Schizophrenic patients, improve their quality of life, enhance their drug compliance, reduce the readmission rate of patients, ensure long-term treatment effect and promote disease recovery.
摘要
BACKGROUND@#Pancreatic β-cells elevate insulin production and secretion through a compensatory mechanism to override insulin resistance under metabolic stress conditions. Deficits in β-cell compensatory capacity result in hyperglycemia and type 2 diabetes (T2D). However, the mechanism in the regulation of β-cell compensative capacity remains elusive. Nuclear factor-Y (NF-Y) is critical for pancreatic islets' homeostasis under physiological conditions, but its role in β-cell compensatory response to insulin resistance in obesity is unclear.@*METHODS@#In this study, using obese ( ob/ob ) mice with an absence of NF-Y subunit A (NF-YA) in β-cells ( ob , Nf-ya βKO) as well as rat insulinoma cell line (INS1)-based models, we determined whether NF-Y-mediated apoptosis makes an essential contribution to β-cell compensation upon metabolic stress.@*RESULTS@#Obese animals had markedly augmented NF-Y expression in pancreatic islets. Deletion of β-cell Nf-ya in obese mice worsened glucose intolerance and resulted in β-cell dysfunction, which was attributable to augmented β-cell apoptosis and reactive oxygen species (ROS). Furthermore, primary pancreatic islets from Nf-ya βKO mice were sensitive to palmitate-induced β-cell apoptosis due to mitochondrial impairment and the attenuated antioxidant response, which resulted in the aggravation of phosphorylated c-Jun N-terminal kinase (JNK) and cleaved caspase-3. These detrimental effects were completely relieved by ROS scavenger. Ultimately, forced overexpression of NF-Y in INS1 β-cell line could rescue palmitate-induced β-cell apoptosis, dysfunction, and mitochondrial impairment.@*CONCLUSION@#Pancreatic NF-Y might be an essential regulator of β-cell compensation under metabolic stress.
Subject(s)
Rats , Mice , Animals , Reactive Oxygen Species/metabolism , Diabetes Mellitus, Type 2/metabolism , Insulin Resistance , Insulin , Insulin-Secreting Cells/metabolism , Apoptosis , Stress, Physiological , Transcription Factors/metabolism , Palmitates/pharmacology , Obesity/metabolism摘要
ObjectiveTo understand the stress level of people seeking psychological counseling under the coronavirus disease 2019 (COVID⁃19) pandemic and to explore its related factors. MethodsAn online survey was conducted on 1 194 people who sought psychological counseling in Shanghai through the “health cloud” psychological counseling service platform. The questionnaire included demographic information,lifestyle and stress during the COVID-19 pandemic. ResultsParticipants with low,medium,high and very high stress levels accounted for 33.1% (395/1 194),34.6% (413/1 194),25.4% (303/1 194) and 7.0% (83/1 194),respectively. Women and participants aged 18 to 30 years had higher stress levels(Z=-5.368,P<0.001; Z=35.822,P<0.001) compared with other groups. Factors contributing to the rise in stress included reading too much information about COVID-19 (OR=2.057,95%CI:1.012‒4.181),large changes in sleep state (OR=3.496,95%CI:1.669‒7.325),lack of hobbies and interests (OR=2.852,95%CI:1.252‒6.500),and prone to anxiety/irritability/sadness (OR=4.098,95%CI:1.772‒9.480). Conclusionpeople who sought psychological counseling show high levels of psychological stress during the COVID-19 pandemic. We should pay more attention to the vulnerable groups with the following characteristics: women,18‒30 years old, residents who pay too much attention to the pandemic information,sleep less, and almost lose interest in hobbies, and easily become anxious/irritable/sad.
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Osteoporosis is one of the common metabolic diseases, which can easily lead to osteoporotic fractures. Accurate prediction of bone biomechanical properties is of great significance for the early prevention and diagnosis of osteoporosis. Bone mineral density measurement is currently used clinically as the gold standard for assessing bone strength and diagnosing osteoporosis, but studies have shown that bone mineral density can only explain 60% to 70% of bone strength changes, and trabecular bone microstructure is an important factor affecting bone strength. In order to establish the connection between trabecular bone microstructure and bone strength, this paper proposes a prediction method of trabecular bone modulus based on SE-DenseVoxNet. This method takes three-dimensional binary images of trabecular bone as input and predicts its elastic modulus in the z-axis direction. Experiments show that the error and bias between the predicted value of the method and the true value of the sample are small and have good consistency.
Subject(s)
Humans , Biomechanical Phenomena , Bone Density , Cancellous Bone/diagnostic imaging , Elastic Modulus , Osteoporosis/diagnostic imaging摘要
Objective@#To deeply investigate the gene expression profiles of esophageal squamous cell carcinoma (ESCC) and the relationship of gene expression levels with prognosis from The Cancer Genome Atlas (TCGA) database.@*Methods@#RNA-seq V2 data of 11 normal samples and 81 esophageal squamous cell carcinoma patients, and their corresponding clinical data were downloaded from The Cancer Genome Atlas database. Differentially expressed genes between normal and tumor samples were identified by using edgeR package. Gene function enrichment analyses of differentially expressed genes were conducted. A protein-protein interaction network based on differentially expressed genes was constructed by using STRING database and the hub genes were identified based on the created gene co-expression network. In addition, survival analysis was performed.@*Results@#Totally, 2 788 genes were identified as differential expression. Among these, 1 168 genes were up-regulated and 1 620 genes were down-regulated in tumor cases compared with normal samples. Up-regulated genes were enriched in cell cycle, DNA replication and mismatch repair pathways, while down-regulated genes were enriched in metabolic pathways. 707 genes and their 3 428 interactions were identified by protein-protein interaction analysis. Genes with copy number amplifications were considered to interact with other crucial genes. 10 co-expression modules were identified based on the gene co-expression network analysis and the ribosomal protein genes were illustrated to be correlated with tumor locations of ESCC patients (P=0.003). The 3-years survival rates of high and low expression of TNFRSF10B groups were 82.5% and 15.1%, respectively. Similarly, the 3-years survival rates of high and low expression of DDX18 groups were 82.4% and 15.2%, respectively. The survival differences stratified by these two genes were statistically significant (both P<0.1).@*Conclusions@#The analysis results of TCGA database showed that ribosomal protein genes are correlated with tumor locations of ESCC patients. Low expressions of TNFRSF10B and DDX18 are associated with poor prognose of ESCC patients. Consequently, TNFRSF10B and DDX18 may serve as predictive markers for ESCC patients.
摘要
As the research work went further and more detailed, a variety of new treatments compete to come out.However, it remains unclear that how the antigen works to distinguish cancer cells and normal cells.Neoantigen, which is located in the tumor cell surface of a specific antigen, its presence makes human immunotherapy into new areas which may make personalized treatment possible in the near future.Emerging data suggest that the identification of such newantigens is a major factor in clinical immunotherapy.They can form a biomarker in cancer immunotherapy to provide targets for a variety of therapeutic approaches to attack, which allows T cells to selectively enhance the immune response against this class of antigens.