Objective:To study the effect of the psychological counseling on the delivery mode of single birth elderly primiparas with anxiety and depression, and to seek a new and effective intervention way to improve the vaginal delivery rate.Methods:A preliminary screening was carried out for 486 single birth elderly primiparas received in the birth cohort research center of China Medical University from April 2018 to September 2019. Among them, 274 cases had mild, moderate or severe anxiety and depression. They were randomly divided into the observation group and the control group (n=137). The control group was given routine nursing measures and simple psychological education and the intervention group was given extra psychological counseling. Psychological counseling adopted the mode of combination of online and offline. The degree of anxiety and depression and the delivery mode were compared between two groups.Results:Before intervention, the degree of anxiety and depression between the observation group and the control group showed no significant difference. After intervention, the degree of anxiety and depression in the observation group was lighter than that of the control group ( χ2 value was 12.782, 6.647, P<0.05). The proportion of cesarean section, vaginal delivery, forceps delivery accounted for 32.1% (44/137), 67.2%(92/137), 0.7%(1/137) in the observation group, and 45.3% (62/137), 54.7%(75/137), 0 in the control group. The difference between the two groups showed statistical significance ( χ2 value was 5.787, P<0.05). Conclusion:The psychological counseling for the single birth elderly primiparas with anxiety and depression can effectively improve the psychological situation and increase the vaginal delivery rate.

Objective:To assess the value of 18F-fluorodeoxyglucose (FDG) PET/MR parameters and their changes in predicting and evaluating the curative effect in patients with locally advanced rectal cancer before and after neoadjuvant chemoradiotherapy (NCRT). Methods:From June 2017 to June 2020, 13 patients (9 males, 4 females; age (52.2±13.2) years) with locally advanced rectal cancer confirmed pathologically and underwent NCRT in Chinese PLA General Hospital were retrospectively enrolled. All patients performed the first PET/MR within one month before NCRT and the second PET/MR within one month before operation. PET/MR parameters including maximum standardized uptake value (SUV max), mean standardized uptake value (SUV mean), metabolic tumor volume (MTV) 2.5, total lesion glycolysis (TLG), minimum apparent diffusion coefficient (ADC min), and their changing percentage (Δ) before and after NCRT were collected. Patients were divided into pathologically complete remission (pCR) group and non-pCR group or response group and non-response group according to the postoperative pathological results as the gold standard. Mann-Whitney U test and logistic regression analysis were used for data analysis. The cut-off values of related parameters and their diagnostic efficiencies were determined by receiver operating characteristic (ROC) curve analysis. Results:Of 13 patients, 5 reached pCR and 8 had histological reaction (response). There were no significant differences in parameters (SUV max, SUV mean, MTV 2.5, TLG, ADC min) between different groups before treatment ( U values: 8.00-19.00, all P>0.05). There were significant differences in SUV max, SUV mean, MTV 2.5, TLG and ΔADC min between pCR group and non-pCR group after treatment ( U values: 0.00-6.00, all P<0.05), but only SUV max was correlated with pCR after treatment (odds ratio ( OR)=0.335, 95% CI: 0.123-0.917, P=0.033). The area under curve (AUC) was 0.95 and the cut-off value of SUV max was 3.055, with the sensitivity of 100%, the specificity of 80.0% and the accuracy of 92.3%. There were significant differences in SUV max, SUV mean, TLG, ADC min, ΔSUV max and ΔADC min between the response group and non-response group after treatment ( U values: 0.00-6.00, all P<0.05), but only ΔSUV max was correlated with the response results ( OR=2.022, 95% CI: 1.100-4.130, P=0.048). The AUC was 0.90 and the cut-off value of ΔSUV max was 69.0%, with the sensitivity of 87.5%, the specificity of 80.0% and the accuracy of 84.6%. Conclusions:PET/MR has high accuracy in evaluating NCRT for locally advanced rectal cancer. SUV max is an independent predictor of pCR after treatment, while ΔSUV max is an independent predictor of histological reaction (response).

Background Maternal atmospheric pollution during pregnancy may alter fetal intrauterine development programming, thereby increasing the risk of childhood obesity in the future. Objective To investigate the effects of atmospheric pollution exposure during pregnancy on the incidence of childhood obesity in offspring. Methods English databases (PubMed, Web of Science, and Medline) and Chinese databases (Wanfang Data Knowledge Service Platform, China National Knowledge Infrastructure, and VIP Information Chinese Journal Service Platform) were searched for literature reporting exposure to atmospheric pollution during pregnancy and childhood obesity published from 1 January 2000 to 31 August 2023. The quality of the included literature was evaluated using the quality assessment tools for observational cohort and cross-sectional studies recommended by the US National Institutes of Health. Results Twenty-four studies meeting the inclusion criteria were identified and the associated atmospheric pollutants included particulate matter, ozone, nitrogen oxide, carbon oxide, and sulfur oxide. In comparison to the non-exposed group, prenatal exposure to various common atmospheric pollutants were significantly associated with an elevated risk of childhood obesity in offspring. Conclusion Maternal exposure to atmospheric pollution during pregnancy is associated with an elevated risk of childhood obesity in subsequent years. Future studies should pay more attention to the effects of atmospheric pollution on the distribution of children's body fat and metabolic development, and further identify potential mechanisms of atmospheric pollutant exposure leading to childhood obesity.