Objective: To investigate the difference in behavioral characteristics among different phenotypes of attention deficit hyperactivity disorder (ADHD) using amplitude of low-frequency fluctuation (ALFF), so as to provide insights into clinical differentiation of behavioral characteristics among different phenotypes of ADHD. Methods: The children with ADHD admitted to The Affiliated Hospital of Hangzhou Normal University were enrolled and classified into the inattentive type (ADHD-I), hyperactive/impulsive type (ADHD-HI) and combined type (ADHD-C). The reaction time (RT) was measured using integrated visual and auditory continuous performance test, and the mean (RT-mean) and standard deviation of RT (RT-SD) were estimated. In addition, the ALFF was calculated at 0.010 to 0.027, 0.027 to 0.073, 0.073 to 0.167 Hz, and the difference of ALFF was compared among children with different types of ADHD. Results: A total of 107 children with ADHD were enrolled, including 95 boys and 12 girls, with a mean age of (8.89±1.93) years. There were 69 children with ADHD-I, 8 children with ADHD-HI and 30 children with ADHD-C. The RT-SD was significantly higher among children with ADHD-C than among children with ADHD-I [(126.003±51.619) ms vs. (97.720±45.302) ms; P=0.007]; however, there was no significant difference in RT-mean among children with various ADHD phenotypes (F=1.386, P=0.255). There was an interaction between frequency and ADHD phenotypes (F=2.754, P=0.032), and the ALFF was significantly higher among children with ADHD-C than among children with ADHD-I at 0.010 to 0.027 [(5 590.567±231.595) ms vs. (4 694.001±154.397) ms; P=0.002] and 0.073 to 0.167 Hz [(4 312.609±174.709) ms vs. (3 690.805±116.473) ms; P=0.005]. Conclusions The ALFF varies in ADHD phenotypes, and there is a frequency-specific difference.

Objective:To explore the mediating effect of resilience between perceived stress and insomnia in medical staff.Methods:A questionnaire survey was conducted among 1 163 medical staff. All subjects were assessed with the insomnia severity index (ISI), simplified Chinese version of Connor-Davidson resilience scale (CD-RISC-10) and perceived stress scale (PSS-10). SPSS 20.0 software was used for common method biases test, descriptive statistics, difference analysis, correlation analysis, hierarchical regression analysis, and SPSS PROCESS V3.4 was used for Bootstrap mediating effect.Results:①The perceived stress (16.28±6.35) was positively correlated with insomnia (6.14±5.80)( r=0.404, P<0.01), and psychological resilience was negatively correlated with insomnia and perceived stress in medical staff ( r=-0.279, P<0.01, r=-0.399, P<0.01). ②Psychological resilience played a partial mediating role between perceived stress and insomnia in medical staff, with the mediating effect as 0.051, accounting of 13.82% of the total effect. Conclusion:Psychological resilience can reduce the negative effects of perceived stress on sleep and is a protective factor for insomnia in medical staff. Clinically, reducing perceived stress and improving psychological resilience can reduce insomnia in medical staff.

We reported two fetal cases diagnosed with Smith-Magenis syndrome.One case was found with bilateral ventriculomegaly,double-outlet right ventricle,pulmonary stenosis and ventricular septal defect when performing fetal echocardiography.Then the fetus was diagnosed with severe tetralogy of Fallot and tortuous ductus arteriosus by autopsy.The other case was suggested to have tetralogy of Fallot,right aortic arch and ectopic ductus arteriosus by fetal echocardiography,which was later confirmed by autopsy.Both of the two pregnancies were terminated.Tissue samples of the two fetuses were analyzed by the low-coverage whole-genome sequencing,and both cases carried a microdeletion of 3.63 Mb and 4.86 Mb in chromosome 17pl 1.2,which overlapped with the missing segments causing Smith-Magenis syndrome.Therefore,the two fetuses were both diagnosed with Smith-Magenis syndrome.