Objective:To analyze the hearing outcomes of high-risk children of diabetic mothers, especially in the subtypes of pre-pregnancy diabetes and gestational diabetes, in order to provide some reference for clinical practice. Methods:The basic characteristics and hearing levels of children whose mothers had a history of diabetes during pregnancy and underwent audiological diagnosis and evaluation at our hospital's Children's Hearing Diagnosis Center from January 2003 to June 2024 were analyzed. T-tests, Wilcoxon rank-sum tests, and chi-square tests were used for inter-group comparisons, with a significance level set at P<0.05. Results:A total of 285 children（570 ears） of diabetic mothers were included. Hearing loss was found in 310 ears, and the incidence of hearing loss was 54.39%（310/570）. The mean ABR threshold in the pregestational diabetes group was（50.01±29.29） dB HL, while that in the gestational diabetes group was（44.13±26.19） dB HL. The degree of hearing loss in the pregestational diabetes group was more severe than that in the gestational diabetes group（χ²=10.000, P=0.019）. Conclusion:Maternal history of diabetes may be one of the risk factors for hearing loss in their offspring, and the risk of hearing loss in children whose mothers had diabetes before pregnancy may be higher than that in the gestational diabetes group. It is suggested that the clinical practice should pay attention to the monitoring and follow-up management of the hearing status of such children, so as to improve the auditory outcomes of children born to diabetic mothers.
Humans ; Female ; Pregnancy ; Diabetes, Gestational ; Hearing Loss/etiology* ; Child ; Pregnancy in Diabetics ; Risk Factors ; Child, Preschool ; Mothers ; Male

Objective:To explore the risk factors for complications of facial autologous fat transplantation.Methods:A total of 51 female patients (case group) with moderate to severe complications following facial autologous fat transplantation at the Fourth Medical Center of Chinese PLA General Hospital from November 2016 to October 2022 were included in this retrospective study. The median age was 31.0 (27.0, 40.0) years. After age and surgical date were matched with ratio of 1∶1, a total of 51 female patients who received autologous fat transplants at several official medical facilities and experienced no complications within a year after the procedure made up the control group. The median age of the control group was 32.0 (26.0, 41.0) years. The clinical characteristics of the two groups were compared, and the factors for complications of facial autologous fat transplantation were examined using a multivariate logistic regression model.Results:In the case group, complications included facial artery embolism (7 cases), ophthalmic artery embolism (19 cases), infection (19 cases), and fat necrosis (6 cases), with 26 severe and 25 moderate cases. No significant differences were found between the two groups in age, body mass index (BMI), marital status, history of hypertension, infectious diseases, allergies, smoking, or alcohol consumption (all P>0.05). However, significant differences were observed in a history of facial surgery, perimenstrual phase, surgical site, and fat donor site (all P<0.05). Multivariate logistic regression analysis revealed that a history of facial surgery ( OR=17.289, 95% CI: 4.851-61.616, P<0.001) and the surgical site being a clinic/outpatient department (compared to a hospital, OR=7.708, 95% CI: 2.482-23.939, P<0.001) were risk factors for postoperative complications after facial autologous fat transplantation. Conclusion:A history of facial surgery and the surgical site being a clinic/outpatient department (compared to a hospital) are risk factors for complications of facial autologous fat transplantation.

Objective To observe the clinical efficacy of thumb-tack needling therapy combined with Oxycodone Hydrochloride Sustained-Release Tablets in treating patients with severe cancer pain caused by malignant tumors.Methods A total of 60 patients diagnosed with severe cancer pain who were admitted to the Traditional Chinese Medicine Department of Qingpu Branch,Zhongshan Hospital Affiliated to Fudan University between November 2023 and December 2024 were selected as study subjects.Patients were randomly divided into an observation group and a control group using a random number table,with 30 cases in each group.The control group received conventional western medicine pain management,while the observation group received additional thumb-tack needling therapy based on the control group's treatment.The treatment duration was 2 weeks.After treatment,clinical efficacy was evaluated by observing changes in European Quality of Life-5 Dimensions(EQ-5D)scores,Numerical Rating Scale(NRS)scores,Cancer Pain Self-Efficacy Scale(CPSS)scores,and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30)scores in both groups before and after treatment.Changes in serum levels of prostaglandin E2,endothelin-1,β-endorphin,and substance P were also compared.Safety and adverse reactions were assessed.Results(1)The total analgesic effective rate was 76.67％(23/30)in the observation group and 46.67％(14/30)in the control group.The total effective rate in the observation group was significantly higher than that in the control group,with a statistically significant difference(P＜0.05).(2)After treatment,serum levels of prostaglandin E2,endothelin-1,β-endorphin,and substance P were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(3)After treatment,EQ-5D scores,NRS scores,and CPSS scores were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(4)After treatment,EORTC QLQ-C30 scores were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(5)The incidence of adverse reactions was 53.33％(16/30)in the observation group and 83.33％(25/30)in the control group.The incidence of adverse reactions in the observation group was significantly lower than that in the control group,with a statistically significant difference(P＜0.05).Conclusion Thumb-tack needling therapy combined with Oxycodone Hydrochloride Sustained-Release Tablets significantly alleviates pain symptoms,improves health status and self-efficacy,and enhances the quality of life in patients with severe cancer pain caused by malignant tumors.

Objective:To explore the risk factors for complications of facial autologous fat transplantation.Methods:A total of 51 female patients (case group) with moderate to severe complications following facial autologous fat transplantation at the Fourth Medical Center of Chinese PLA General Hospital from November 2016 to October 2022 were included in this retrospective study. The median age was 31.0 (27.0, 40.0) years. After age and surgical date were matched with ratio of 1∶1, a total of 51 female patients who received autologous fat transplants at several official medical facilities and experienced no complications within a year after the procedure made up the control group. The median age of the control group was 32.0 (26.0, 41.0) years. The clinical characteristics of the two groups were compared, and the factors for complications of facial autologous fat transplantation were examined using a multivariate logistic regression model.Results:In the case group, complications included facial artery embolism (7 cases), ophthalmic artery embolism (19 cases), infection (19 cases), and fat necrosis (6 cases), with 26 severe and 25 moderate cases. No significant differences were found between the two groups in age, body mass index (BMI), marital status, history of hypertension, infectious diseases, allergies, smoking, or alcohol consumption (all P>0.05). However, significant differences were observed in a history of facial surgery, perimenstrual phase, surgical site, and fat donor site (all P<0.05). Multivariate logistic regression analysis revealed that a history of facial surgery ( OR=17.289, 95% CI: 4.851-61.616, P<0.001) and the surgical site being a clinic/outpatient department (compared to a hospital, OR=7.708, 95% CI: 2.482-23.939, P<0.001) were risk factors for postoperative complications after facial autologous fat transplantation. Conclusion:A history of facial surgery and the surgical site being a clinic/outpatient department (compared to a hospital) are risk factors for complications of facial autologous fat transplantation.

Objective This study is focused on ultrasound multimodality examination,which refers to the combined use of three ultrasound examination modalities,ultrasound(US),acoustic radiation force impulse(ARFI)imaging,and contrast-enhanced ultrasound(CEUS).The purpose of this study is to analyze the value of applying ultrasound multimodality examination in the differential diagnosis of benign and malignant breast non-mass-like lesions(NMLs).Methods Cases of breast NMLs were analyzed retrospectively,and the nature of all the lesions was verified by pathological examination.Based on the gray-scale ultrasound image characteristics,the cases were classified into types Ⅰto Ⅴ,and type Ⅰ and type Ⅱ were further classified into 4 subtypes,Ⅰa,Ⅰ b,Ⅱ a,and Ⅱ b,according to whether there was also calcification,and the proportion of malignant cases in each subtype was statistically analyzed.Logistic regression models of US,US+ARFI,US+CEUS,and US+ARFI+CEUS for the diagnosis of malignant cases were established,ROC curves were drawn,the area under the curve(AUC)was calculated,and comparisons were made accordingly.The detection rate of malignant NMLs without calcification(atypical malignant NMLs)by the combination examination of US,ARFI,and CEUS was analyzed.Results A total of 407 cases were included in the study.All subjects were female,aged 22 to 81 years,with the average age being(47.0±1 1.0)years.There were 220 benign cases and 187 malignant cases.Ranked from the highest to the lowest,the malignancy proportion of the different types wasⅠb＞Ⅱb＞Ⅲ＞V＞Ⅰa＞Ⅱa＞Ⅳ.The malignant proportion of the low echo area with calcification was significantly higher than that of the lesions without calcification.The AUC(95％confidence interval[CI])for diagnosing malignant cases with the logistic regression models of US,US+ARFI,US+CEUS,and US+ARFI+CEUS were 0.895(0.862-0.927),0.908(0.878-0.937),0.921(0.893-0.948),and 0.927(0.902-0.952),respectively.Comparison of the AUC of the 4 regression models showed significant differences(P＜0.001).The detection rate of US for NMLs without calcification was 80.7％.When US was used in combination with ARFI and CEUS,86.4％of the malignant NMLs lesions without calcification could be detected if the lesion CEUS score was 4 or 5 points or if shear-wave velocity(SWV)≥4.28 m/s.Conclusion Breast NMLs with calcification show high risks of malignancy,and a pathological examination is always recommended for a conclusive diagnosis.Ultrasound multimodality examination can improve the diagnostic accuracy of breast NML without calcification.

Background Schizophrenia patients often face high level of stigma and low level of self-esteem,significantly hindering their recovery.Mindfulness-based intervention has proven be effective in reducing stigma and improving self-esteem.However,traditional mindfulness intervention typically involve high costs and require long-term professional involvement.Objective To explore the effects of blended mindfulness interventions on stigma and self-esteem in patients with stable schizophrenia,so as to provide references for reducing stigma,enhancing self-esteem and promoting recovery.Methods Patients receiving outpatient treatment at the Third Hospital of Daqing from June 2022 to January 2023,who met the diagnostic criteria for schizophrenia in the International Classification of Diseases,tenth edition(ICD-10)and were in a stable phase,were recruited for the study(n=84).According to the random number table method,participants were randomly assigned to study group and control group,with 42 cases in each group.Both groups received treatment with the second-generation antipsychotic medications,while the study group additionally received blended mindfulness intervention for 8 weeks,with sessions lasting 45～60 minutes,three times a week.Both groups were evaluated with Five Facet Mindfulness Questionnaire(FFMQ),Internalized Stigma of Mental Illness Inventory(ISMI)and Rosenberg Self-Esteem Scale(RSES)at baseline and after 8-week intervention.Covariance analysis was used to compare the FFMQ,ISMI and SES scores between two groups after 8-week intervention.Results After 8-week intervention,there were statistically significant differences between two groups in total FFMQ scores,as well as in the observation,acting with awareness,non-judgment and non-reactivity subscale scores(F=50.680,12.952,13.567,22.799,14.043,P<0.01).Statistically significant differences were observed in total ISMI scores,and in the alienation,stereotype endorsement,discrimination experience,stigma resistance and social withdrawal subscale scores(F=513.125,148.990,125.055,75.996,154.850,54.125,P<0.01).The difference in RSES scores between two groups was also statistically significant(F=19.478,P<0.01).Conclusion Blended mindfulness intervention may help improve the mindfulness and self-esteem in stable schizophrenia patients while reducing stigma.

This study summarizes the construction background, rules and regulations and institutional settings of the MOOC and Micro-course Club in the Second Hospital of Jilin University, discusses the means of teacher training for clinical teachers, and shows the application effect of the club. At the same time, the related problems encountered in the process of club construction are summarized and reflected. The construction of MOOC and micro-course clubs is conducive to improving the information-based teaching level of clinical teachers, and also provides new inspiration and ideas for the construction of medical clubs.

Objective:To investigate the the dementia management capabilities of general practitioners (GPs) in urban district community health service centers (CHSCs) of Beijing.Methods:A survey on dementia management capabilities of GPs was conducted from July to November 2018, among 479 GPs from 6 urban districts in Beijing randomly selected by two-step sampling method. A self-designed questionnaire was used for survey, which contained demographic information and dementia management capacity of participants. Data were analyzed using multiple linear regression models with SPSS (20.0).Results:The overall score of GPs′ dementia management capacity was 53.9±10.3. The mean score of "detection, assessment and referral of dementia in pre-diagnosis" was 25.5±5.1; the highest score of the item "Can refer the suspected dementia patients to a specialist if necessary" was 4.1±0.8, while the lowest score of the item "Can use NPI-Q for behavioral and psychotic symptoms of dementia assessment" was 3.4±1.0. And the mean score of "treatment and management of dementia in post-diagnosis" was 28.4±6.2; the highest score of the item "Can provide guidance on safety for dementia patients " was 3.7±0.9, while the lowest score of the item "Can provide non-drug guidance on improving cognitive function for dementia patients " was 3.4±1.0. The factors affecting the GPs′ capability of dementia detection, assessment and referral were their attitudes ( t=0.69, P<0.01) toward dementia management in CHSCs and whether they had participated in dementia-related training in the last year ( t=2.18, P<0.05). And the factor affecting the GPs′ capability of dementia treatment and management was their attitudes toward dementia management in CHSCs ( t=9.17, P<0.01). Conclusions:The study shows that generally GPs feel inadequate in dementia management capability; while those with special training and positive attitudes have a higher dementia management capability. Therefore, adequate training and reasonable incentive mechanism may be the countermeasures to improve the capability of dementia management of GPs in CHSCs.

Objective:To explore the effects of video education based on multidisciplinary collaboration combined with popular science atlas in pregnant women with fetal congenital heart disease (CHD) .Methods:Taking the establishment time of multidisciplinary collaborative health education team in December 2019 as the boundary, the 60 cases of pregnant women with fetal CHD in the Outpatient Department of Obstetrics and Gynecology and Cardiac Surgery of Henan Provincial People's Hospital and Fuwai Central China Cardiovascular Hospital from February to November 2019 were included in the control group, and the 60 cases from December 2019 to October 2020 were included in the observation group, by convenience sampling method. The control group was given routine nursing, and the observation group was given video education based on multidisciplinary collaboration combined with popular science atlas. The scores of Exercise of Self-Care Agency Scale (ESCA) , State-Trait Anxiety Inventory-Form Y (STAI-Y) , Trait Anxiety Inventory (T-AI) , Beck Depression Inventory (BID) and Disease-Related Knowledge Mastery Questionnaire were compared between the two groups before and after intervention. Apgar score and mode of delivery were compared between the two groups.Results:After the intervention, the scores of self-care skills, self-care responsibility, health knowledge and self-concept of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . The scores of STAI-Y, T-AI and BID of the observation group were all lower than those of the control group, and the differences were statistically significant ( P<0.01) . After the intervention, the scores of each dimension and total score of the disease-related knowledge mastery questionnaire of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . There was no statistically significant difference in the neonatal Apgar scores at 1 min and 5 min and delivery mode between the two groups ( P>0.05) . Conclusions:Video education based on multidisciplinary collaboration combined with popular science atlas can improve the psychological states of pregnant women with fetal CHD to some extent, and enhance the mastery of disease-related knowledge and self-care ability.

Objective:To explore the effect and involved mechanism of naringenin on acute kidney injury (AKI) induced by ischemia-reperfusion (IR).Methods:The IR-AKI rat model was constructed using the classic bilateral renal pedicle clamping method, then renal function and pathological change were assessed, as well as inflammation-associated genes were detected by quantitative real-time PCR. The hub genes were selected through differential gene analysis and protein-protein interaction network analysis, and their transcription factors were predicted, which constructed a protein library together. The proteins binding to naringenin were selected by reverse molecular docking analysis and further their binding patterns were predicted to explore the mechanism of naringenin. Finally, the results of bioinformatics were verified by experimental methods.Results:Compared with the AKI group, the kidney pathology of the rats in the naringenin pretreatment group was significantly improved, and the renal tubular injury score was reduced ( P<0.01); meanwhile the serum creatinine level and the mRNA expression of the kidney injury molecule 1 (KIM-1) were significantly decreased (both P<0.05). Compared to sham group, IR-AKI increased the level of nuclear factor κB (NF-κB), tumor necrosis factor-α and interleukin-1β (all P<0.05), which reversed by naringenin indicated that naringenin inhibited inflammation in IR-AKI. Differential gene analysis was performed on the GSE98622 data set, and 359 differential genes were obtained. In reverse molecular docking, the proteins with smallest binding energy including NFKBIA, BCL3, NFKB2 and RELA were considered to be related to the preventive effect of naringenin, which were mainly enriched in NF-κB-related inflammation pathways. Domain functional analysis of NF-κB-related genes showed that naringenin could stably bind to its key domain. According to quantitative real-time PCR results, naringenin increased BCL3 level after AKI ( P<0.05), and further decreased the expression level of RELA and NFKB2 (both P<0.05). Conclusion:Naringenin protects IR-AKI by alleviating inflammation, and its mechanism is related to increasing BCL3 and thereby inhibiting the NF-κB pathway.