Objective:To investigate the attention deficit/hyperactivity disorder(ADHD) like behavior of offspring mice induced by stress during pregnancy and its mechanism.Methods:Chronic unpredictable stress was applied to ICR pregnant mice in different gestational periods. The offspring mice were randomly selected and the behavior changes of each group were observed in open field experiment (CG: control group; SG1: cums stress stimulation from 8 to 14 days of gestation; SG2: cums stress stimulation from 15 days of gestation to childbirth). The plasma concentrations of GABA, its metabolic enzymes and dopamine were detected by ELISA.Results:The results of open field experiment showed that the total distance, the time of stay in central area, the speed in central area, and the speed in surrounding area in SG1 group, SG2 group and CG group were statistically significant ( F=8.30, 5.01, 8.05, 7.15, all P<0.05). The total distances of SG1 group and SG2 group were significantly longer than that of CG group ((5 221.07±469.95)mm, (4 825.63±545.49)mm, (3 781.17±111.34)mm, both P<0.05).The times of stay in central area of SG1 and SG2 groups were shorter than that in CG group ((5.95±3.32)s, (8.59±3.42)s, (11.10±3.61)s, all P<0.05). The speeds in central area of SG1 and SG2 groups were faster than that of CG group ((30.93±5.79)mm/s, (32.48±9.06)mm/s, (20.57±5.07)mm/s, all P<0.05).The speed in surrounding area in SG1 group was faster than that in CG group ((16.91±1.64)mm/s), (12.42±3.77)mm/s, P<0.05). ELISA results showed that there were significant differences in mice plasma GABA, GAD65, GAD67 and DA among CG group, SG1 group and SG2 group ( F=16.52, 6.42, 11.04, 7.26, all P<0.05).The plasma concentrations of GABA in SG1 group and SG2 group were lower than that in CG group ((3.70±0.80)μmol/L, (4.40±0.80)μmol/L, (6.06±1.01)μmol/L, all P<0.05).The plasma concentrations of GAD65 ((5.36±0.75)μg/L, (6.99±1.01)μg/L, P<0.05)and GAD67((10.52±1.09)μg/L, (9.84±1.35)μg/L, (12.83±1.67)μg/L, P<0.05)in SG1 group were lower than those in CG group. The plasma DA concentration in SG1 group ((82.81±8.59)ng/L) was higher than that in CG group ((69.43±9.42)ng/L, P<0.05) and SG2 group ((66.36±10.77)ng/L, P<0.05). Conclusion:Prenatal stress can induce ADHD-like behavioural phenotypes in offspring mice, which may be related to the influence of plasma GABA metabolism and DA concentration.

Objective To investigate the present situation and analyze the influence factors of self-management ability of schizophrenic patients in community. Methods A total of 122 cases of schizophrenic patients in community that have been discharged from Zhenjiang Mental Health Center were investigated and analyzed by general information questionnaire, Schizophrenia Self-Management Ability Scale, quality of life and Social Support Rating Scale. Results The scores of self-management ability of schizophrenic patients in community were (68.74 ± 10.24) points. Multiple stepwise regression analysis showed that long-term medication (t =2.351, P<0.05), degree of education(t =2.385, P<0.05), community rehabilitation guidance (t =3.813, P<0.01) and social support (t=2.768, P<0.01) were the influence factors of self-management ability of schizophrenic patients in community. Conclusions Schizophrenia patients in community medical staff should be aimed at strengthening the long-term medication in community rehabilitation guidance and social support, improvement, and strengthen the low degree of culture of patient care, to improve the ability of self-management.

Objective:To investigate the pathogenesis, precaution and treatment of neonatal congenital complete heart block (CCHB) in twins.Methods:The clinical data of a case of premature twins with neonatal CCHB from the Department of Neonatology, the First Affiliated Hospital of Xinxiang Medical University were retrospectively analyzed and related literature was reviewed.Results:(1)Case review: the 37-year-old gravida had no symptoms.Fetal ultrasound cardiogram(fUCG)at 23 weeks of gestation indicated bradycardia and CCHB.Then, the mother was diagnosed with undifferentiated connective tissue disease.After treatment with human immunoglobulin, dexamethasone and hydroxychloroquine, fUCG at 31 weeks of gestation still suggested CCHB.An emergency cesarean section was performed on the diagnosis of threatened preterm labor.With weakly positive neonatal antinuclear antibody (ANA), and positive Ro60 and Ro52 autoantibodies, twins were diagnosed with CCHB by 24 hour-Holter monitors.One of the twins was discharged with CCHB (ventricular rate of 80-90 times/min) after systemic therapy, but the weight increased to 2 200 g. The other one of the twins suffered from the sudden decrease of heart rate and blood pressure and finally died of sudden cardiac arrest.(2) Literature search: two cases in Chinese and 9 cases in English were reviewed.Among them, 9 cases were sjogren syndrome type A (SSA)/Ro and sjogren syndrome type B(SSB)/La related CCHB, and 2 cases were idiopathic CCHB.Conclusions:The placental transfer of anti-SSA or anti-SSB is an important mechanism of neonatal CCHB in twins, and other factors may also be involved.Current treatments are unsatisfactory.Most patients need pacemaker implantation.Early diagnosis and prenatal management can improve the prognosis.

Background Occupational pneumoconiosis is the most common occupational disease in Qinghai Province and China. From the perspective of public health, it is important to assess the disease burden using disability-adjusted life years (DALY) and economic losses. Objective To evaluate the disease burden of occupational pneumoconiosis in Qinghai Province, and to provide a basis for the formulation and implementation of relevant prevention and control strategies. Methods Based on the registered data, a database of occupational pneumoconiosis cases confirmed and reported in Qinghai Province was established. The survival status and death dateof occupational pneumoconiosis patients from 2015 to 2019 were confirmed by on-site visit, telephone survey, matching search of Death Information Registration and Management System, and consulting other departments. The life loss due to occupational pneumoconiosis from 2015 to 2019 was assessed using DALY as an indicator and data from the Global Burden of Disease 2019 (GBD 2019) study. Inpatients with officially diagnosed occupational pneumoconiosis from a hospital in Qinghai Province in 2019 were selected as study subjects, the direct economic loss was evaluated with hospitalization expenses, and the indirect economic loss due to occupational pneumoconiosis in Qinghai Province in 2019 was calculated by human capital approach. Results From 2015 to 2019, 505 new cases of occupational pneumoconiosis were reported in Qinghai Province, and there were 348 death cases. Prevalent cases and years lost due to disability (YLD) due to occupational pneumoconiosis were increased, while DALY and years of life lost (YLL) due to occupational pneumoconiosis decreased firstly and then increased. In each year, there were 87% or more of the DALY, YLL, or YLD attributed to silicosis and coal workers' pneumoconiosis. In 2019, the occupational pneumoconiosis-associated DALY was 2173.55 person years. The total hospitalization expense incurred by 42 inpatients with occupational pneumoconiosis was 1256345.19 yuan. The total hospitalization expense and average daily cost of the inpatients with stageⅡand Ⅲ pneumoconiosis were higher than that of the inpatients with stageⅠ (P<0.05), and the hospitalization expense was higher in the ≥60 years age group than in the <60 years age group (P<0.05). In 2019, the indirect economic burden incurred by occupational pneumoconiosis in Qinghai Province was 44108581.65 yuan, and accounted for 0.15‰ of the gross domestic product (GDP) of the province. Conclusion The disease burden associated with occupational pneumoconiosis in Qinghai Province are outstanding. Silicosis and coal workers' pneumoconiosis are the key contributors. Targeted intervention measures including dust hazard control, enterprise management, follow-up and rehabilitation management of pneumoconiosis should be taken to prevent and control the occurrence and progression of pneumoconiosis and alleviate disease burden of pneumoconiosis.