Objective To investigate the correlation between lipid accumulation index (LAP),visceral fat index (VFI) and insulin resistance (IR) in healthy check-up population.Methods A total of 9121 subjects who underwent physical examination in the Health Management Center of the First Affiliated Hospital of Ar-my Medical University from October 2016 to June 2023 were selected as the study subjects,including 5988 males and 3133 females.The age,waist circumference (WC),body mass index (BMI),LAP,VFI,blood lipid, blood glucose and homeostasis model assessment of insulin resistance (HOMA-IR) were compared between different genders.Obesity was assessed according to BMI.LAP,VFI and HOMA-IR were compared between obese (BMI≥28 kg/m2) and non-obese patients (BMI<28 kg/m2).Pearson correlation analysis was used to analyze the relationship between LAP,VFI and HOMA-IR in all healthy subjects.Multiple logistic regression analysis was used to analyze the independent influencing factors of HOMA-IR in all healthy subjects. Results The age and high-density lipoprotein cholesterol (HDL-C) of male healthy subjects were significant-ly lower than those of female,while WC,BMI,triglyceride (TG),total cholesterol (TC),low-density lipopro-tein cholesterol (LDL-C),LAP,VFI,fasting blood glucose (FBG),fasting insulin (FINS),glycosylated hemo-globin (HbA1c) and HOMA-IR were significantly higher than those of female (P<0.05).There were 1733 cases of obesity in all healthy subjects,accounting for 19％.The LAP,VFI and HOMA-IR of obese people were significantly higher than those of non-obese people (P<0.05).Pearson correlation analysis showed that HOMA-IR was positively correlated with WC,BMI,TG,TC,LDL-C,LAP and VFI,and negatively correlated with HDL-C (P<0.05).The correlation coefficient r value of LAP was the highest,reaching 0.367,followed by WC,BMI,TG and VFI.Multivariate logistic correlation analysis showed that BMI,LAP and VFI were in-dependent influencing factors of HOMA-IR in all healthy subjects (P<0.05).Conclusion Obesity should not be ignored in health check-up population.LAP and VFI are associated with IR,especially LAP,which can reliably evaluate body fat accumulation and blood glucose metabolism.

Objective:To explore the effect of personalized psychological intervention based upon acceptance and commitment therapy on paternal donors and spouses after pediatric liver transplantation.Methods:From July 2017 to November 2019, a total of 160 parental donors and spouses undergoing pediatric liver transplantation were selected as research objects.Through a random number table, 40 donors and 40 liver donor spouses were assigned into control and experimental groups.The control group received routine psychological intervention while the experimental group had personalized psychological intervention with acceptance and commitment therapy based upon conventional psychological intervention.Symptom checklist-90, numeric rating scale, chronic pain acceptance questionnaire-8, length of stay, hospitalization cost, complication rate, initial postoperative ambulation time and hospital satisfaction were employed as evaluation tools.Results:After interventions, SCL-90 score, pain assessment score and initial ambulation time of donor group were significantly lower than those of control group( P<0.05). Hospitalization satisfaction and chronic pain acceptance were significantly higher than those of control group( P<0.05). SCL-90 score was significantly lower in liver spouse observation group than that in control group and hospitalization satisfaction higher than control group( P<0.05). Conclusions:Personalized psychological intervention based upon acceptance and commitment therapy can help parental donors and spouses to improve their mental health, help donors to recover sooner and boost hospitalization satisfaction.

Objective:To investigate the clinical features of 17q12 microdeletion cases before and after delivery, and provide a reference for prenatal diagnosis and genetic counseling.Methods:A retrospective analysis was conducted on five fetuses diagnosed with 17q12 microdeletion by single nucleotide polymorphism array in Quanzhou Women's and Children's Hospital between April 2020 and June 2023. Clinical data including prenatal ultrasonography findings, genetic causes, parental clinical features, and postnatal outcomes were summarized and analyzed using descriptive statistical analysis.Results:The five fetuses had normal results of karyotype analysis of amniotic fluid, but carried a microdeletion of 1.4 to 1.8 Mb in the 17q12 region of the chromosome, involving 20 genes listed in the Online Mendelian Inheritance in Man database. Pedigree verification was performed on all five cases and the results indicated one maternally inherited case with the mother having polycystic kidneys complicated by left hydronephrosis, one de novo case, and three paternally inherited cases with one father having multiple cysts in both kidneys and two fathers showing no abnormalities. Multiple abnormalities were found in the five fetuses by prenatal ultrasonography, including enhanced renal parenchymal echogenicity in four cases and pyelectasis in one case. Two cases chose to terminate the pregnancies, while the other three continued the pregnancies to full term. Postnatal follow-ups showed that one case was normal in growth and development with no abnormalities by renal ultrasound; one case developed polycystic kidney; one case with normal renal ultrasound findings had a speech disorder and symptoms of suspected autism at the age of three. Conclusions:The main manifestation of 17q12 microdeletion is enhanced renal parenchymal echogenicity in the fetal stage and postnatal polycystic kidney. In prenatally diagnosed cases, pedigree verification is necessary as an objective and scientific genetic counseling is helpful in pregnancy decision-making.

Objective: To understand the psychological experience of the pediatric living donor liver transplantation who is the child`s parent, identify the problems and gains that donors face in the event of donor liver, help donors to solve their difficulties to promote early recovery of donors and children, and help potential donors better understand the surgical. Methods: The phenomenological methodology in qualitative research was used in the study, and the Colaizzi 7-step data analysis method was used for analysis the interview recording. Results: Total of four themes are summarized. Preoperative psychological path: excitement, impatience, anxiety. Postperative growth: grateful, regain hope, hard work and proactive. Postnatal negative emotions: fear and jealousy. Family and social support. Conclusion Medical staff should strengthen psychological care and health education, use narrative care and other methods to mobilize the donor′s positive psychological experience, while providing perioperative quality care, strengthen social and family support, and help donors to restore physical and mental health.