Objective: To explore the relationship of self-injurious behavior with peer discrimination and depression among AIDS orphans, so as to provide the basis for promoting the mental health of AIDS orphans. Methods: From March 2021 to March 2022, 626 AIDS orphans from 5 counties in Henan Province were selected by stratified cluster random sampling methods. Non suicidal Self-injury assessment Tool, Discrimination Experience Scale, and Zung Self-rating Depression Scale were used to investigate AIDS orphans self-injurious behavior, peer discrimination and depression. Multivariate Logistic regression model was used to analyze the relationship between self-injurious behavior and peer discrimination of AIDS orphans. Multivariate linear regression analysis was used to explore the moderating effect of depression between self-injurious behavior and peer discrimination of AIDS orphans. Results: The detection rates of self-injurious behavior, peer discrimination and depression of AIDS orphans were 80.0%, 73.3% and 67.6 % respectively. The detection rates of the three items mentioned above were 86.9%, 81.5%, and 77.5% for double orphaned children, respectively, which were higher than 74.6%, 67.0%, and 59.8% for single orphaned children, and the differences were statistically significant ( χ 2=21.29, 23.78, 14.23, P <0.01). The score of self-injurious behavior of AIDS orphans was positively correlated with peer discrimination and depression ( r=0.55, 0.40, P <0.01). Depression played a moderating role in the relationship between self-injurious behavior and peer discrimination of AIDS orphans ( β= 0.03, P <0.05). Conclusions AIDS orphans are more likely to engage in self-injurious behaviors after experiencing peer discrimination and psychological depression. The society and schools should adopt targeted intervention strategies to promote the mental health among AIDS orphans.

OBJECTIVETo explore the genetic cause for a child featuring developmental delay and mental retardation.

METHODSThe child was analyzed with G-banded karyotyping and an Illumina Human CytoSNP-12 Beadchip.

RESULTSThe father of the patient had a normal karyotype. The mother had a karyotype of 46, XX, t(12;15)(p13.3;q13). The child had a karyotype of 45, XY, der(12)t(12;15)(p13.3;q13)mat, -15. SNP array analysis showed that the child has deletions in 12p13.31-p13.33 and 15q11.2-q13.2. But no deletion or duplication was detected in his mother.

CONCLUSIONThe unbalanced translocation involving chromosomes 12 and 15 probably accounts for the mental retardation in the child. SNP array is useful for the detection of chromosomal rearrangements and genetic counseling.

Adult ; Child, Preschool ; Chromosome Aberrations ; Chromosome Banding ; Chromosomes, Human, Pair 12 ; genetics ; Chromosomes, Human, Pair 15 ; genetics ; Developmental Disabilities ; genetics ; Female ; Humans ; Intellectual Disability ; genetics ; Karyotyping ; Male ; Translocation, Genetic

Objective:To establish the reference values and neurological intervention cutoffs for cerebral ventricular size in neonates born at 33 +0-41 +6 weeks of gestation and to investigate the influential factors and reliability of the related indices. Methods:This study prospectively recruited 1 370 1-to 7-day neonates born or hospitalized at the Hunan Provincial Maternal and Child Health Care Hospital from February to August 2021. All the neonates, who were born between 33 +0 and 41 +6 weeks of gestation, were subjected to ultrasound scanning to obtain the indices, including ventricular index (VI), anterior horn width (AHW), thalamo-occipital distance (TOD), and ventricular height (VH). The reference value and neurological intervention cutoff for each index were set. Quantile regression was used to estimate the correlation between each index and continuous covariates [gestational age at birth (GA) and birth weight (BW)]. Mann-Whitney U test was used to analyze the differences in the medians of indices in different categorical covariates groups (males/females, left/right lateral ventricles, vaginal delivery/cesarean section, and singleton/multiple births). Intraclass correlation coefficient (ICC) calculated by a two-way mixed effect model and absolute agreement was used to access intra-rater reliability; ICC via a two-way random effect model and absolute agreement was utilized to rate inter-rater reliability (pool reliability: ICC below 0.50; moderate reliability: ICC between 0.50 and 0.75; good reliability: ICC between 0.75 and 0.90; excellent reliability: ICC exceeding 0.90). Results:The upper limits of reference values for AHW, TOD, VI, and VH in 555 (40.5%) preterm neonates were 2.7-3.5 mm, 20.9-22.5 mm, 12.6-13.7 mm, and 3.8-4.9 mm, and in 815 (59.5%) term newborns were 3.4-4.3 mm, 18.6-21.3 mm, 14.2-14.7 mm, and 3.4-3.8 mm, respectively. The cutoff of neurosurgical intervention for each index was the upper limit of reference value plus 4 mm. AHW median was positively correlated with GA [partial regression coefficient (PRC): 0.12, P<0.05], while TOD and VH medians were negatively correlated with GA (PRC:－0.31 and－0.06, both P<0.05). VI, AHW, and TOD medians were positively associated with BW (PRC: 0.46, 0.23, and 0.97, all P<0.05). The medians of VH, AHW, and TOD in the left cerebral ventricular exceeded those in the right cerebral ventricular, respectively (VH: 2.0 vs 1.8 mm, U=836 071.50; AHW: 1.8 vs 1.7 mm, U=874 141.50; TOD: 13.6 vs 12.5 mm, U=738 409.00, all P<0.05). The medians of AHW and VI in male neonates were greater than those in female newborns, respectively (AHW: 1.8 vs 1.7 mm, U=834 124.00; VI: 11.1 vs 10.8 mm, U=884 156.50, both P<0.05). The neonates delivered vaginally had greater AHW median, but smaller TOD median than those delivered by cesarean section (AHW: 2.0 vs 1.6 mm, U=685 546.00, P<0.001; TOD: 13.1 vs 12.9 mm, U=850 797.00, P=0.010). The AHW median in singleton newborns exceeded that in multiple births (1.9 vs 1.4 mm, U=356 999.00, P<0.001). The lower limits of 95% confidence intervals for intra-rater and inter-rater ICCs exceeded 0.75 and 0.50, respectively. Conclusion:Reference values and surgical intervention thresholds for VI, AHW, TOD, VH of newborns with a gestational age of 33 +0-41 +6 weeks were preliminarily established, and the reliability of these indicators were verified.

Objective:To determine possible risk factors of developing HBS after parathyroidectomy for PHPT.Methods:The clinical data of 104 patients with PHPT who were hospitalized in the First Affiliated Hospital of Chongqing Medical University and underwent PTX surgery from Apr. 2014 to Apr. 2022 were retrospectively analyzed.There were 36 males and 68 females. 105 patient were divided into two groups: HBS group ( n=29) and non-HBS group ( n=75) according to whether HBS occurred after PTX. The clinical related data of the two groups were collected and analyzed with SPSS 22.0 software to determine the risk factors of HBS. Results:Serum albumin, blood magnesium, blood phosphorus, 25 (OH) D and hip bone mineral density in HBS group were lower than those in non HBS group; Preoperative blood calcium, blood PTH, bone turnover markers (BALP, OC, PINP β- CTX) were higher than those in non HBS group ( P<0.05). The preoperative serum calcium, BALP, and PINP levels in the HBS group and non HBS group were: (3.37±0.58) vs (2.91±0.28) mmol/L; 38.37 (15.59, 58.79) vs 18.21 (11.28, 25.57) μg/L; 256.25 (139.95, 527.95) vs 79.72 (50.64, 120.33) ng/ml. Preoperative serum calcium ( OR=15.006, P<0.001), PTH ( OR=1.002, P<0.001), BALP ( OR=1.055, P<0.001), OC ( OR=1.019, P<0.001), PINP ( OR=1.008, P<0.001), β-CTX ( OR=1.816, P=0.006) were positively correlated with HBS, while serum albumin ( OR=0.850, P=0.011), magnesium ( OR=0.012, P=0.002), 25 (OH) D ( OR=0.844, P=0.001) and hip BMD ( OR=0.00, P=0.019) were negatively correlated with HBS. Preoperative serum calcium ( OR=36.689, P=0.009), PINP ( OR=1.019, P=0.022) and BALP ( OR=1.049, P=0.031) were independent risk factors for HBS. The ROC curves showed that the AUC values were 0.7368, 0.8326, and 0.7605, respectively, with sensitivities of 55.2%, 75.9%, and 72.4%; the specificities were 88.0%, 81.3% and 78.7%. The amount of intravenous calcium supplement in HBS patients was related to preoperative blood BALP and PINP ( P=0.035) . Conclusions:Patients with PHPT have a significantly increased risk of postoperative HBS when preoperative blood calcium>3.22 mmol/L, P1N P>138.80 ng/ml, or BAL P>26.08 (μg/L). For patients with significantly elevated preoperative blood P1NP, postoperative calcium supplementation can be appropriately increased.

Objective:To summarize the evidence related to the guidance and management of breastfeeding in pregnant women with gestational diabetes mellitus.Methods:UpToDate, BMJ Best Practice, CINAHL, PubMed, Cochrane Library, Embase, Wanfang database, China National Knowledge Infrastructure, and other databases and professional websites were searched by computer for evidence on breastfeeding guidance and management for pregnant women with gestational diabetes mellitus, including clinical decisions, guidelines, evidence summaries, systematic reviews, expert consensus and randomized controlled trials. The search period was from database establishment to April 1, 2023. Two researchers independently conducted literature quality evaluation, evidence extraction, and integration.Results:A total of 23 articles were included, including 4 clinical decision-making articles, 4 guidelines, 4 evidence summaries, 6 systematic reviews, 1 expert consensus and 4 randomized controlled trials. A total of 21 best pieces of evidence were summarized from six aspects of support and education, knowledge and skills, safety issues, feeding issues, dietary care, and blood glucose monitoring.Conclusions:This study summarizes the best evidence on breastfeeding guidance and management for pregnant women with gestational diabetes and suggests that the medical staff should apply the proof according to the clinical situation and the patient's wish.

To explore the way of prenatal echocardiography in the diagnosis of fetal double aortic arch . Methods T he data of fetuses diagnosed as double aortic arch in 6 prenatal centers in Hunan in echocardiograms performed at 20－36 weeks of gestation from 2013 to 2018 were reviewed . T he characteristics of echocardiographic with double aortic arch , and the associated malformations were observed ,the clinical outcome were analyzed . Results T he main echocardiographic features of the double aortic arch were three‐vessel‐tracheal view s ,which showed a bifurcation of the ascending aorta and a ring consisted of aortic right and left arch . From this retrospective analysis , 29 double aortic arches were identified ,which 8 cases ( 28% ) combined with cardiac defect and extracardiac abnormalities , 1 case with 22q11 deletion . Among them ,5 cases were confirmed by autopsy ,24 cases were diagnosed by computed tomography angiography ( 8 cases were confirmed by operation ) . Conclusions Systematic prenatal echocardiography in the diagnosis of fetal double aortic arch has significant clinical value in the cliagnose of double aortic arch ,w hether it is associated with other malformations and is important for assessing fetal prognosis .

Hepatocellular carcinoma is one of the most common malignant tumors in the world, which is a serious threat to human health. HBV infection is one of the most common causes of hepatocellular carcinoma.The diagnosis of most hepatocellular carcinoma has progressed to the middle and late stage, and the prognosis is poor. Early detection, diagnosis and treatment are important supports to improve the clinical outcome of hepatocellular carcinoma. In recent years, scholars at home and abroad have established various hepatocellular carcinoma risk prediction models, which are conducive to improving the early diagnosis rate of hepatocellular carcinoma and reducing the mortality rate. This article reviews the risk factors and risk prediction models of chronic hepatitis B associated hepatocellular carcinoma, in order to provide reference for HBV-associated liver cancer risk monitoring and management decision.

Objective To observe the value of tissue motion mitral annular displacement(TMAD)technique to assess left ventricular function in patients with cardiac amyloidosis.Methods A total of 34 adult patients with cardiac amyloidosis diagnosed by pathology were retrospectively included as the observation group,and 32 healthy adults were collected as the control group for the same period.Basic data of the subjects were collected,and data of routine ultrasonic parameters of left ventricular function and TMAD parameters were obtained,and then compared between groups.The correlation of TMAD parameters with left ventricular ejection fraction(LVEF)or mitral annular plane systolic excursion(MAPSE)were assessed.Results Compared with the control group,the observation group had higher levels of body surface area(BSA),systolic blood pressure,N-terminal pro-B-type natriuretic peptide(NT-proBNP),creatinine and urea(all P＜0.05).The observation group had increased values of ascending aorta(AO),left atrium(LA),interventricular septum(IVS),left ventricular posterior wall thickness in diastole(LVPWD),pulmonary artery(PA),and early diastolic peark velocity of mitral inflow(peak E),while smaller values of left ventricular end-diastolic dimension(LVEDD),LVEF,fractional shortening(FS),early diastolic tissue Doppler velocity E'septal(IVS E')and lateral(LW E')and MAPSE(all P＜0.05),and the LVEF in observation group was(58.18±7.09)％.For TMAD patameters,the observation group had smaller values of the following parameters on apical four chamber(A4C)view as medial displacement of mitral valve annulus(A4C MV1),displacement of lateral mitral valve annulus(A4C MV2),displacement of the midpoint of the mitral valve annulus(A4C Midpt)and the corresponding percentage(A4C Midpt％),as well as smaller values of the following paramets on apical two chamber(A2C)view as A2C MV1,A2C MV2,A2C Midpt and A2C Midpt％(all P＜0.05).In the observation group,A4C Midpt％showed a moderate positive correlation with LVEF(r=0.488,P＜0.05),and A2C Midpt showed a high positive correlation with M APSE(r=0.712,P＜0.05),and A4C MV2,A4C Midpt,A4C Midpt％,A2C MV1,A2C MV2,A2C Midpt％all showed a moderate positive correlation with MAPSE(r=0.420 to 0.691,all P＜0.05).Conclusion Compared with LVEF,the TMAD parameters might reflect the changes in left ventricular systolic function more sensitively in patients with cardiac amyloidosis.

Stress urinary incontinence (SUI) and underactive bladder (UAB) are common types of lower urinary tract dysfunction in women.As the treatment mechanisms of the two conditions are contradictory, the treatment of SUI patients complicated with UAB remains a difficult clinical problem.In order to improve the treatment rate of such patients and promote research, this paper reviews the latest domestic and overseas diagnostic criteria of UAB, summarizes the treatment experience of conventional midurethral sling (tension-free vaginal tape or outside-in transobturator tape) and adjustable sling procedures (transobturator adjustable tape or Remeex system) combined with medication or intermittent catheterization, and the application prospects of cutting-edge technologies such as stem cell injection, cytokine therapy and gene therapy, so as to provide reference for clinicians and researchers.