Objective:To investigate the interactive effects of loss of the only child and childhood trauma on brain structure, function, and structure-function coupling, and to analyze their association with clinical symptom.Methods:A total of 112 parents who lost their only child and participated in the psychological aid project organized by Local Civil Affairs Department in Sunan aear of Jiangsu Province in China from April 2021 to July 2021 and 36 healthy controls recruited from the community during the same period were selected. Based on childhood trauma questionnaire scores, parents who had lost their only child were divided into those with childhood trauma (group A, n=55) and those without childhood trauma (group B, n=57); similarly, the healthy controls were divided into a group with childhood trauma (group C, n=12) and a group without childhood trauma (group D, n=24). All participants were evaluated by clinical scales such as Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Mini-Mental State Examination (MMSE). MRI 3D-T1 structural images and resting-state functional magnetic resonance imaging data were collected; gray matter volume (GMV) and degree centrality (DC) were calculated by standardized image preprocessing procedure, and ratio of DC to GMV within each voxel was computed to obtain the structure-function coupling map. A two-factor analysis of variance was used to analyze the independent effect and interactive effect of loss of the only child and childhood trauma on GMV, DC, and DC/GMV coupling value. Spearman rank correlation analysis was used to evaluate the associations of above indicators in brain regions with significant difference in independent effect and interactive effect with clinical scale scores. Results:(1) Compared with the participants without childhood trauma (group B+group D), the participants with childhood trauma (group A+group C) showed significantly reduced GMV in the left middle temporal gyrus and right dorsolateral superior frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, Gaussian random field [GRF] corrected). A significant interactive effect of loss of the only child and childhood trauma on GMV in the right precuneus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (2) Compared with the healthy controls, parents who had lost their only child exhibited significantly increased DC in the left middle frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). Compared with participants without childhood trauma, participants with childhood trauma showed significantly increased DC in the right thalamus (voxel-level P<0.01, cluster-level P< 0.05, GRF corrected). A significant interactive effect of loss of the only child and childhood trauma on DC in the left dorsolateral superior frontal gyrus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (3) Compared with the healthy controls, parents who had lost their only child showed significantly decreased DC/GMV coupling value in the left middle frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). Compared with participants without childhood trauma, participants with childhood trauma showed significantly increased DC/GMV coupling value in the right thalamus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). A significant interactive effect of loss of the only child and childhood trauma on DC/GMV coupling value in the left dorsolateral superior frontal gyrus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (4) Correlation analysis revealed that GMV in the right precuneus with significant interactive effect of loss of the only child and childhood trauma was positively correlated with MMSE score ( r s=0.317, P=0.010, Bonferroni corrected). GMV in the left middle temporal gyrus with significant independent effect of childhood trauma was positively correlated with both HAMD score and HAMA score ( r s=0.362, P=0.006; r s= 0.349, P=0.008, Bonferroni corrected). Conclusion:Loss of the only child and childhood trauma can interact to jointly affect the brain structure, function, and structure-function coupling; and some of these brain structure alterations are closely associated with clinical symptoms.

Objective To explore the relationship between serum Interleukin-27(IL-27),Cystatin C(CysC),and Glyceraldehyde-3-phosphate dehydrogenase(GAPDH)antibodies and the severity of disease in children with Neuromyelitis optica spectrum disorder(NMOSD),as well as their impact on prognosis.Methods A total of 102 children with NMOSD admitted to Kunming Children's Hospital from July 2019 to July 2023 were selected,along with 102 healthy during the same period.Serum levels of IL-27,CysC,and GAPDH antibodies were compared between children with NMOSD and healthy children.The levels of serum IL-27,CysC,and GAPDH antibodies were compared among children with varying disease severity.The correlations between serum IL-27,CysC,GAPDH antibodies and disease condition,cerebrospinal fluid markers were analyzed.And 102 children with NMOSD received individualized treatment and were followed up for 1 year.The prognosis was evaluated based on disease relapse,and patients were divided into recurrence group and non-recurrence group.The clinical data,serum IL-27,CysC,and GAPDH antibody levels were compared between the two groups.the impact of serum IL-27,CysC,and GAPDH antibodies on disease recurrence was analyzed,and the predictive value of serum IL-27,CysC,and GAPDH antibodies for disease recurrence was evaluated.Results Children with NMOSD had lower levels of serum IL-27 and CysC and higher levels of GAPDH antibodies than healthy children(P<0.05).Serum IL-27 and CysC levels were negatively correlated with Aquaporin 4(AQP4)-IgG antibody positivity,the number of spinal cord-involved segments,Expanded disability status scale(EDSS)scores,cerebrospinal fluid protein content,and white blood cell count.In contrast GAPDH antibodies were positively correlated with these parameters(P<0.05).After 1-year follow-up,2 cases were lost to follow-up,21 cases relapsed,and 79 cases did not,which were included in the relapse group and non-relapse group,respectively.There were significant differences in the number of spinal cord-involved segments,EDSS scores,and cerebrospinal fluid protein content between the relapse group and non-relapse group(P<0.05).The levels of serum IL-27 and CysC were lower and the levels of GAPDH antibodies were higher in the relapse group than the non-relapse group(P<0.05).Serum IL-27,CysC,and GAPDH antibodies were significantly associated with disease relapse(P<0.05).The Area under the curve(AUC)values for predicting disease recurrence in children with NMOSD based on serum IL-27,CysC,and GAPDH antibodies were 0.748,0.791,and 0.747,respectively,with optimal cutoff values of 38.77 pg/mL,0.79 mg/L,and 55.81 pg/mL,respectively.The combined prediction of disease relapse using these three markers had an AUC of 0.900,which was superior to individual prediction values(Z=2.215,2.137,2.220,P=0.024,0.033,0.023).Conclusion The levels of serum IL-27,CysC,and GAPDH antibodies are significantly correlated with the disease severity and prognosis in children with NMOSD,and can effectively predict the risk of disease recurrence.Combined detection provides more reliable predictive value.

Objective To investigate the impact of intergenerational caregiving on the brain structure and function of grandparents,and to analyze its correlation with caregiving factors.Methods Healthy adults(66 with grandchildren,24 without grandchildren)were recruited as study subjects,and clinical and MRI data were collected.Resting-state brain functional degree centrality(DC)and surface-based morphometry(SBM)methods were used to compare the differences in brain structure and function between the groups with and without grandchildren.The correlation between the differences in brain regions and △ values with grandchild's age,number,and time spent in childcare were assessed,respectively.Results Compared to the group without grandchildren,the group with grandchildren showed reduced surface area and cortical volume in the left middle temporal gyrus,as well as decreased DC values in the left medial superior frontal gyrus,bilateral orbital superior frontal gyrus,and left anterior cingulate and paracingulate gyrus(P＜0.05),respectively.In the grandchildren group,DC values and △ values in the left orbital superior frontal gyrus,left anterior cingulate and paracingulate gyrus were significantly positively correlated with time spent in childcare.Conclusion The brain structures and functions of grandparents related to empathy and motivation are changed in intergenerational caregiving,which may reveal the neuroplasticity after caring for their grandchildren.

Objective:To investigate the predictive value of multimodal magnetic resonance imaging (MRI) techniques in assessing symptom remission of post-traumatic stress disorder (PTSD) of bereaved parents who lost their only child.Methods:In this prospective study, 34 parents with PTSD resulting from the loss of the only child were followed-up for 2 years. Based on the PTSD diagnostic status at the end of the follow-up, participants were divided into the remission group and the persistent group.R 3.6.1 and SPSS 20.0 software were used for statistical analysis.Baseline clinical data and neuroimaging findings were compared between the two groups. Logistic regression and LASSO regression analyses were used to identify independent predictors of PTSD symptom remission. The predictive performance of these factors was evaluated by receiver operating characteristic (ROC) curve analysis.Results:Initial screening with univariate Logistic regression and LASSO regression revealed that regional homogeneity (ReHo) in the left middle temporal gyrus, the combined predictive value based on ReHo, and the integrated predictive value combining gray matter volume (GMV) and ReHo (GMV-ReHo predictor) were significant factors influencing symptom remission (all P<0.05). Multivariate Logistic regression further demonstrated that the GMV-ReHo predictor retained independent predictive significance ( P<0.05), with ROC curve analysis showing an area under the curve (AUC) of 0.979 (95% CI=0.935-0.996, P<0.001) for its ability to predict PTSD remission. Notably, a combined model incorporating both the scores of the clinician administered PTSD scale (CAPS) and the GMV-ReHo predictor achieved an enhanced predictive performance, yielding an AUC of 0.984 (95% CI=0.952-0.998, P<0.001). Conclusion:The GMV-ReHo predictor effectively identifies symptom remission in PTSD resulting from the loss of the only child.

Objective:To investigate the predictive value of multimodal magnetic resonance imaging (MRI) techniques in assessing symptom remission of post-traumatic stress disorder (PTSD) of bereaved parents who lost their only child.Methods:In this prospective study, 34 parents with PTSD resulting from the loss of the only child were followed-up for 2 years. Based on the PTSD diagnostic status at the end of the follow-up, participants were divided into the remission group and the persistent group.R 3.6.1 and SPSS 20.0 software were used for statistical analysis.Baseline clinical data and neuroimaging findings were compared between the two groups. Logistic regression and LASSO regression analyses were used to identify independent predictors of PTSD symptom remission. The predictive performance of these factors was evaluated by receiver operating characteristic (ROC) curve analysis.Results:Initial screening with univariate Logistic regression and LASSO regression revealed that regional homogeneity (ReHo) in the left middle temporal gyrus, the combined predictive value based on ReHo, and the integrated predictive value combining gray matter volume (GMV) and ReHo (GMV-ReHo predictor) were significant factors influencing symptom remission (all P<0.05). Multivariate Logistic regression further demonstrated that the GMV-ReHo predictor retained independent predictive significance ( P<0.05), with ROC curve analysis showing an area under the curve (AUC) of 0.979 (95% CI=0.935-0.996, P<0.001) for its ability to predict PTSD remission. Notably, a combined model incorporating both the scores of the clinician administered PTSD scale (CAPS) and the GMV-ReHo predictor achieved an enhanced predictive performance, yielding an AUC of 0.984 (95% CI=0.952-0.998, P<0.001). Conclusion:The GMV-ReHo predictor effectively identifies symptom remission in PTSD resulting from the loss of the only child.

Objective To investigate the impact of intergenerational caregiving on the brain structure and function of grandparents,and to analyze its correlation with caregiving factors.Methods Healthy adults(66 with grandchildren,24 without grandchildren)were recruited as study subjects,and clinical and MRI data were collected.Resting-state brain functional degree centrality(DC)and surface-based morphometry(SBM)methods were used to compare the differences in brain structure and function between the groups with and without grandchildren.The correlation between the differences in brain regions and △ values with grandchild's age,number,and time spent in childcare were assessed,respectively.Results Compared to the group without grandchildren,the group with grandchildren showed reduced surface area and cortical volume in the left middle temporal gyrus,as well as decreased DC values in the left medial superior frontal gyrus,bilateral orbital superior frontal gyrus,and left anterior cingulate and paracingulate gyrus(P＜0.05),respectively.In the grandchildren group,DC values and △ values in the left orbital superior frontal gyrus,left anterior cingulate and paracingulate gyrus were significantly positively correlated with time spent in childcare.Conclusion The brain structures and functions of grandparents related to empathy and motivation are changed in intergenerational caregiving,which may reveal the neuroplasticity after caring for their grandchildren.

Objective:To investigate the interactive effects of loss of the only child and childhood trauma on brain structure, function, and structure-function coupling, and to analyze their association with clinical symptom.Methods:A total of 112 parents who lost their only child and participated in the psychological aid project organized by Local Civil Affairs Department in Sunan aear of Jiangsu Province in China from April 2021 to July 2021 and 36 healthy controls recruited from the community during the same period were selected. Based on childhood trauma questionnaire scores, parents who had lost their only child were divided into those with childhood trauma (group A, n=55) and those without childhood trauma (group B, n=57); similarly, the healthy controls were divided into a group with childhood trauma (group C, n=12) and a group without childhood trauma (group D, n=24). All participants were evaluated by clinical scales such as Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Mini-Mental State Examination (MMSE). MRI 3D-T1 structural images and resting-state functional magnetic resonance imaging data were collected; gray matter volume (GMV) and degree centrality (DC) were calculated by standardized image preprocessing procedure, and ratio of DC to GMV within each voxel was computed to obtain the structure-function coupling map. A two-factor analysis of variance was used to analyze the independent effect and interactive effect of loss of the only child and childhood trauma on GMV, DC, and DC/GMV coupling value. Spearman rank correlation analysis was used to evaluate the associations of above indicators in brain regions with significant difference in independent effect and interactive effect with clinical scale scores. Results:(1) Compared with the participants without childhood trauma (group B+group D), the participants with childhood trauma (group A+group C) showed significantly reduced GMV in the left middle temporal gyrus and right dorsolateral superior frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, Gaussian random field [GRF] corrected). A significant interactive effect of loss of the only child and childhood trauma on GMV in the right precuneus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (2) Compared with the healthy controls, parents who had lost their only child exhibited significantly increased DC in the left middle frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). Compared with participants without childhood trauma, participants with childhood trauma showed significantly increased DC in the right thalamus (voxel-level P<0.01, cluster-level P< 0.05, GRF corrected). A significant interactive effect of loss of the only child and childhood trauma on DC in the left dorsolateral superior frontal gyrus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (3) Compared with the healthy controls, parents who had lost their only child showed significantly decreased DC/GMV coupling value in the left middle frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). Compared with participants without childhood trauma, participants with childhood trauma showed significantly increased DC/GMV coupling value in the right thalamus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). A significant interactive effect of loss of the only child and childhood trauma on DC/GMV coupling value in the left dorsolateral superior frontal gyrus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (4) Correlation analysis revealed that GMV in the right precuneus with significant interactive effect of loss of the only child and childhood trauma was positively correlated with MMSE score ( r s=0.317, P=0.010, Bonferroni corrected). GMV in the left middle temporal gyrus with significant independent effect of childhood trauma was positively correlated with both HAMD score and HAMA score ( r s=0.362, P=0.006; r s= 0.349, P=0.008, Bonferroni corrected). Conclusion:Loss of the only child and childhood trauma can interact to jointly affect the brain structure, function, and structure-function coupling; and some of these brain structure alterations are closely associated with clinical symptoms.

This article reviews the development models, evaluation tools, participation status, decision-making aids, interventions and influencing factors of chronic obstructive pulmonary disease (COPD) patients participating in treatment decision-making at home and abroad, so as to provide references for my country's research on COPD patients participating in treatment decision-making.

Objective:To investigate the microRNA (miRNA) expression features in ectopic endometrial tissues of endometriosis (EMS) patients.Methods:From April 2018 to October 2019, ectopic endometrial tissues from EMS patients and eutopic endometrial tissues from control women who received treatment in the Department of Obstetrics and Gynecology of The First Affiliated Hospital of Xiamen University were used in subsequent experiments. Differentially expressed miRNAs were screened out in ectopic endometrial tissues by detecting miRNA sequence from Illumina. The potential roles of these differentially expressed miRNAs and their potential targeted genes in pathogenesis of EMS were analyzed by bioinformatics, and the differential expression levels of 6 miRNAs (miR-98-5p, miR-495-3p, let-7c-5p, miR-200b-3p, miR-200c-3p, miR-148b-3p) were validated by quantitative real-time polymerase chain reaction (qRT-PCR) and subsequently used to build the miRNA-gene regulatory network, then we verified its potential target gene.Results:The microarray results showed that 69 miRNAs might be differentially expressed in ectopic endometrial tissues compared with those in eutopic endometrial tissues (fold change>1.5, P<0.05), including 22 up-regulated miRNAs and 47 down-regulated miRNAs. Gene ontology (GO) analysis showed that the target genes of these differentially expressed miRNAs mainly participated in the protein modification, regulation of development, cell metabolism and morphological structure. KEGG pathway analysis showed that these targeted genes were involved in protein function, autophagy, AGE-RAGE and MAPK signaling pathways. The expression levels of miR-98-5p, let-7c-5p, miR-200b-3p and miR-200c-3p were validated to be significantly altered in ectopic endometrial tissues. The miRNA-gene co-expression network revealed the correlation between the 4 miRNAs and their predicted target genes. qRT-PCR validated results showed that the expression of miR-200b-3p and miR-200c-3p were significantly negatively correlated with ZEB2, while miR-98-5p was negatively correlated with PGRMC1, miR-98-5p and let-7c-5p were positively correlated with ADIPOR2. Conclusion:MiR-98-5p, let-7c-5p, miR-200b-3p and miR-200c-3p were significantly differentially expressed in the ectopic endometrial tissues of EMS patients, which may be involved in the development of EMS.

Objective:To investigate the microRNA (miRNA) expression features in ectopic endometrial tissues of endometriosis (EMS) patients.Methods:From April 2018 to October 2019, ectopic endometrial tissues from EMS patients and eutopic endometrial tissues from control women who received treatment in the Department of Obstetrics and Gynecology of The First Affiliated Hospital of Xiamen University were used in subsequent experiments. Differentially expressed miRNAs were screened out in ectopic endometrial tissues by detecting miRNA sequence from Illumina. The potential roles of these differentially expressed miRNAs and their potential targeted genes in pathogenesis of EMS were analyzed by bioinformatics, and the differential expression levels of 6 miRNAs (miR-98-5p, miR-495-3p, let-7c-5p, miR-200b-3p, miR-200c-3p, miR-148b-3p) were validated by quantitative real-time polymerase chain reaction (qRT-PCR) and subsequently used to build the miRNA-gene regulatory network, then we verified its potential target gene.Results:The microarray results showed that 69 miRNAs might be differentially expressed in ectopic endometrial tissues compared with those in eutopic endometrial tissues (fold change>1.5, P<0.05), including 22 up-regulated miRNAs and 47 down-regulated miRNAs. Gene ontology (GO) analysis showed that the target genes of these differentially expressed miRNAs mainly participated in the protein modification, regulation of development, cell metabolism and morphological structure. KEGG pathway analysis showed that these targeted genes were involved in protein function, autophagy, AGE-RAGE and MAPK signaling pathways. The expression levels of miR-98-5p, let-7c-5p, miR-200b-3p and miR-200c-3p were validated to be significantly altered in ectopic endometrial tissues. The miRNA-gene co-expression network revealed the correlation between the 4 miRNAs and their predicted target genes. qRT-PCR validated results showed that the expression of miR-200b-3p and miR-200c-3p were significantly negatively correlated with ZEB2, while miR-98-5p was negatively correlated with PGRMC1, miR-98-5p and let-7c-5p were positively correlated with ADIPOR2. Conclusion:MiR-98-5p, let-7c-5p, miR-200b-3p and miR-200c-3p were significantly differentially expressed in the ectopic endometrial tissues of EMS patients, which may be involved in the development of EMS.