Objective To establish and validate an individualized risk prediction nomogram model for the occurrence of gestational diabetes mellitus in pregnant women with hypothyroidism. Methods A total of 160 pregnant women with hypothyroidism were selected as the study subjects, including 85 patients with gestational diabetes mellitus (observation group) and 75 patients with normal blood glucose levels (control group). The age, gravidity, parity as well as pre-pregnancy body mass index, thyroid peroxidase antibody (TPOAb), homeostatic model assessment of insulin resistance (HOMA-IR), homeostatic model assessment of beta-cell function (HOMA-β), free thyroxine (FT4), free triiodothyronine (FT3) and thyroid stimulating hormone (TSH) were compared between the two groups. Multivariable analysis was used to analyze the risk factors for gestational diabetes mellitusin pregnant women with hypothyroidism. The nomogram model was used to predict the risk of gestational diabetes mellitus in pregnant women with hypothyroidism. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the nomogram model for gestational diabetes mellitus in pregnant women with hypothyroidism. Results The age, gravidity, parity as well as pre-pregnancy body mass index, TPOAb, HOMA-IR and HOMA-β were higher in the observation group than in the control group, while pre-pregnancy FT4, FT3 and TSH were lower (P < 0.05). Multivariable analysis showed that older age, gravidity, parity as well as pre-pregnancy body mass index, TPOAb, HOMA-IR and HOMA-β, and lower pre-pregnancy FT4, FT3 and TSH were risk factors for gestational diabetes mellitusin pregnant women with hypothyroidism. The nomogram model prediction showed that older age (28 to 31 years), gravidity (more than 2 times), parity (more than 1 time) as well as pre-pregnancy body mass index (above 24.00 kg/m²), TPOAb (> 421.33 IU/mL), HOMA-IR (> 2.21) and HOMA-β (> 115.66), and lower pre-pregnancy FT4 (< 0.33 ng/dL), FT3 (< 1.65 pg/mL) and TSH (< 0.26 mIU/mL) were risk factors for gestational diabetes mellitus in pregnant women with hypothyroidism. ROC curve analysis showed that the area under the curve of the nomogram model for predicting gestational diabetes mellitus in pregnant women with hypothyroidism was 0.785, indicating good predictive performance. Conclusion The risk prediction nomogram model has high value in individualized prediction of gestational diabetes mellitus in pregnant women with hypothyroidism.

【Objective】 To explore and evaluate infection control measures of preventing cross-contamination of novel coronavirus during gastrointestinal endoscopy treatment. 【Methods】 According to the hospital’s infection control requirements and related documents, infection control measures were formulated and implemented by combining with our actual clinical situation, including the management of the endoscope room, management and protection of patients and endoscopists. Then, we evaluated the effect of these measures. 【Results】 From January 25 to March 10, 2020, a total of 71 patients (53 males and 18 females) completed gastrointestinal endoscopy treatment, with an average age of 54 years (28-81 years). There were 36 (50.7%) cases of emergency treatment. All patients had been kept in quarantine for about 14 days (24±13), and no cross-contamination of novel coronavirus occurred. 【Conclusion】 During the novel coronavirus infection epidemic period, reasonable and effective measures should be taken to minimize the risk of infection in doctors and patients. The endoscope center should strengthen preoperative screening and management of patients, master indications of endoscopic procedures, complete endoscopists’ management and protection work, strictly follow the specifications of sterilizing gastrointestinal endoscopes, and construct the layout of "three zones and two passages".

Objective:To investigate the characteristics of event-related potentials(ERPs)P300 in the development of attention cognitive function of school-age children.Methods:A total of 180 school-age children were divided into 3 groups according to their ages (7-8 years old group with 48 cases, 9-10 years old group with 44 cases and 11-12 years old group with 48 cases). All of the participants completed an Oddball task, and their behavioral data, P3a and P3b components of ERPs were analyzed by SPSS 21.0.Results:(1)The differences of hit numbers(49(47.25, 50), 50(49, 50), 50(50, 50) ), correct reaction time((533.37±56.94) ms, (486.91±61.12) ms, (411.55±51.97) ms), and Omission errors (2(1, 4), 2(1, 3), 1(0, 2) ) among the three groups were statistically significant( F/χ 2=20.635, 54.477, 13.169, all P<0.01). (2)There was a main effect of age( F=3.884, P=0.023) and an interaction effect between age and condition( F=3.314, P=0.038) on the amplitude of P3a, while the main effect of condition was not significant( F=0.111, P=0.740). The amplitude of P3a component in 11-12 years old group ((11.02±6.00)μV) was significantly larger than that of 7-8 years old group ((7.36±4.48)μV) and 9-10 years old group ((7.76±5.17)μV, both P<0.05). However, there was no significant interaction effect between age and condition on P3a latency, P3b amplitude and latency ( P>0.05). Conclusion:P3a may be a sensitive indicator of cognitive function in school-age children, and the age of 11-12 years old is a sensitive period for the development of children's attention orientation and selection ability, which may be related to the development of brain network.

Objective To explore the changes of attention cognitive function by studying Oddball task behavior and event-related potentials(ERPs) in children with first-episode tic disorder(TD). Methods Oddball task was tested in 30 children with TD and 30 normal children,and their behavioral data and P3a/P3b components of ERPs were analyzed. Results Children with TD had a lower hitting number (49(48, 50)) than control group (50(49,50),P<0. 05). The main effect of group ( F=6. 047,P=0. 015) and the interaction effect between group and condition (F=4. 619,P=0. 034) on the amplitude of P3a were signifi-cant(P<0. 05). The amplitude of P3a component ((5. 91±4. 51)μV ) in TD group were smaller than that in the control group((9. 57±5. 80)μV)(P<0. 05). However,there was no significant interaction effect be-tween group and condition on P3a latency,P3b amplitude and latency (P>0. 05). Conclusion Attentional orienting is impaired in children with TD.

Objective To investigate the epidemiological characteristics of outpatients exposed to rabies and to analyze the post-exposure prophylaxis in Weinan City in 2017 in order to provide a scientific basis for the prevention of rabies. Methods Clinical data of all outpatients with exposure to rabies in Wei-nan were collected. Ecxcel 2007 was used for data entry and SPSS13. 0 for Chi-square test. Results A total of 32 094 cases were reported with an annual exposure rate of 625. 64/100 000 in Weinan in 2017. Animal bites mainly occurred in spring and summer,accounting for 47. 47% of the total cases in 2017. There were statistically differences in exposure rate among different age groups (χ2=15. 858,P=0. 003). Farmers ac-counted for the largest proportion of the outpatients exposed to rabies (52. 34% ). Among 31 435 outpatients, 28 181(89. 65% ) received wound care and rabies vaccination. The vaccination rate of rabies immunoglobu-lin for patients with gradeⅢ exposure was 46. 93%. Conclusion Comprehensive measures with focuses on compulsory vaccination for domestic dogs and adoption of stray dogs should be implemented to prevent human rabies. Meanwhile,health education rabieson prevention and control should also be strengthened.

Objective: To investigate the features of absolute electroencephalogram (EEG) power spectra in children with borderline intellectual functioning (BIF) as well as their correlation with cognitive function and behavioral problems. Methods: 30 children with borderline intellectual functioning and 42 typical developing children (TDC) were recruited in this study. All of them underwent the Chinese Revised Wechsler Intelligence Scale for Children (C-WISC) and their behavioral problems were assessed according to the Conners’ Parent Symptom Questionnaire (PSQ). Resting EEG of 128 electrodes were recorded when the participants closed their eyes and analyzed using wavelet transform to assess the absolute power of alpha, beta, theta, gamma and theta/beta ratio (TBR). Results: (1)PSQ scores of BIF (conduct problems(0.78±0.16), learning problems(1.53±0.14), psychosomatic disorder(0.17±0.04), impulsivity-hyperactivit(1.13±0.14), anxious(0.52±0.08), hyperactivity inde(1.04±0.10))were higher than TDC(conduct problems(0.21±0.03), learning problems(0.35±0.05), psychosomatic disorder(0.07±0.02), impulsivity-hyperactivit(0.27±0.05), anxious(0.26±0.03), hyperactivity index(0.25±0.04)), and the difference was statistically significant(P<0.05). (2)alpha band: the main effects of the two groups on the left and right hemisphere (F=14.44, P<0.01)and the anterior and posterior hemispheres (F=29.54, P<0.01) were significant.The interaction effect between the left and right hemisphere and the anterior and posteriorm hemispheres was significant(F=8.55, P<0.01). The activity of the alpha wave was significant in the right posterior hemisphere.(3)The main effects of the two groups on the left and right hemispheres (F=6.49, P=0.01)and the anterior and posterior hemispheres(F=8.01, P=0.01) were significant.The two groups had significant interaction effects between the left and right hemisphere and the type(F=5.84, P=0.02). The interaction between the left and right hemisphere and anterior and posterior hemispheres was significant(F=10.51, P<0.01). The activity of the right anterior and right posterior parts was more significant.(4)delta band: the main effects of the two groups were significant in the anterior and posterior hemispheres(F=11.15, P<0.01), and the activities in the anterior hemisphere were larger than those in the posterior hemisphere.(5)TBR: the main effects of the two groups were significant in the anterior and posterior hemispheres(F=4.80, P=0.03). The TBR of the two groups was statistically significant in the right hemisphere(t=2.61, P=0.01). Conclusion The TBR activity of BIF on the right was higher than TDC.The increased TBR activity in the right hemisphere of BIF may be a neurobiological basis for cognitive impairment such as adaptive behavior disorder and executive function.

Objective To investigate the behavioral problems and intelligence in children with attention deficit hyperactivity disorder (ADHD) with different degree of sensory integrative dysfunction (SID).Methods Ninety-eight children with ADHD and fifty typical developing children (TD) whose intelligence were assessed with Chinese revised wechsler intelligence scale for children(C-WISC) in this study.Parental report measures of sensory integrative dysfunction and behavioral problems were administrated using the sensory integrative rating scale of children,conners' parent symptom questionnaire (PSQ) and achenbach children behavior checklist scale (CBCL) respectively.Relationship between behavioral problems,cognitive profiles and SID were examined in in children with ADHD with different degree of SID (33 without SID,33 mild SID and 32 severe SID).Results (1) Behavioral problems:the children with ADHD with severe SID (SS) had higher scores in Conduct problem,Learinng problem,Impulsivity-hyperactivity,Hyperactivity index of the PSQ and Depression,Somatic complaint of the CBCL than the children with ADHD without SID (NS),the children with ADHD with mild SID (MS),and TD.SS group had higher scores in Withdrawn behavior,Hyperactivity index,Aggressive and Delinquent behavior in CBCL than the TD and NS groups(P＜0.05).(2) Intelligence:the SS group(98.53±l0.80) had lower Verbal Intelligence Quotient (VIQ) than the TD group(107.40± 12.03) and lower Performance Intelligence Quotient (PIQ) (94.59± 10.56) than the other groups(TD:108.96± 10.20; NS:101.88±8.15 ; MS:100.73 ± 9.52).Additionally,the SS group had lower full scale intelligence quotient (FIQ) (96.22± 10.12) than the NS(102.70±7.52) and TD group (109.18±9.95)(P＜0.05).(3) The scores of SID were negatively correlated with behavior problems (PSQ and CBCL) and positively correlated with PIQ and FIQ.Conclusion SID have negative impact on behavioral problems and cognitive function in children with ADHD.The relationship between sensory integration and cognitive function may provide a new way for the clinical intervention of children with ADHD.

Objective To investigate the intelligence structure and attention properties,and to explore the relationship between them in children with attention deficit hyperactivity disorder of the predominantly inattention type (ADHD-Ⅰ),predominantly hyperactive-impulsive type (ADHD-HI) and combined type (ADHD-C).Methods Children with ADHD-Ⅰ (n=24),ADHD-HI(n=12) and ADHD-C (n=54) aged between 7-10 years were tested with Chinese Revised Wechsler Intelligence Scale for Children (C-WISC) and integrated visual and auditory continuous performance test (IVA-CPT).Comparisons of cognitive profiles of C-WISC scores between subtypes of ADHD were performed.Additionally,the relationship between attention/response control quotients and cognitive profiles was investigated.Results (1) Intelligence structure:verbal intelligence (VIQ) of ADHD-HI (110.08± 10.64) was higher than that of ADHD-C (101.13± 13.20) and ADHD-Ⅰ (94.71± 11.11).Full scale intelligence quotient (FIQ) of ADHD-HI (104.33±9.63) was higher than that of ADHD-Ⅰ (94.38± 10.48).Factor A of ADHD-HI (45.75±7.14) and ADHD-C (41.41±8.57) were higher than that of ADHD-Ⅰ (36.67±6.72).Factor C of ADHD-HI (33.42±5.42) was higher than that of ADHD-C (29.24±5.26) and ADHD-Ⅰ (29.13±5.39).(2) Attention properties:Full scale attention quotient of ADHD-C (90.26± 11.67) was lower than that of ADHD-Ⅰ (98.17 ± 18.03) and ADHD-HI (99.25± 15.58).Auditory attention quotient of ADHD-C (89.94± 14.16) was lower than that of ADHD-Ⅰ (99.00± 18.66).(3) Relationship between intelligence and attention:the Pearson correlations of the auditory attention quotient and auditory control quotient with the PIQ were 0.24 and 0.29 respectively.The correlations of the visual attention quotient with the PIQ and FIQ were 0.21 and 0.25 respectively.The correlations of the full scale attention quotient with PIQ and FIQ were 0.27 and 0.24 respectively.Each of these correlations reached the level of significance at the 5％ level.Conclusion Cognitive profile and attention properties analysis reveal that children with different subtypes of ADHD have distinct weakness in intelligence structure.The understanding of relationship between intelligence structure and attention properties in children with subtypes of ADHD is useful for ADHD diagnosis and treatment.

Objective To investigate the effect of neurofeedback training for tics symptoms and electroencephalogram (EEG) spectrum change in children with tic disorder.Methods 19 patients with transient tic disorder (TTD),20 with chronic motor or vocal tic disorder (CTD) and 15 with Tourette' s disorder (TS) received 40 sessions of neurofeedback training.The clinical effect was evaluated with Yale Global Tic Severity Scale,and brain activity improvement with EEG theta/beta,theta / sensorimotor rhythm (SMR) power ratio.Results The patients with three types of tic disorder all showed a reduction of tics symptoms (TTD:10.32 ± 0.82 vs.5.91 ± 5.74;CTD:12.35 ±1.50 vs.4.00 ±2.22; TS:25.33 ±2.80 vs.13.73 ±4.22; P＜0.01).Additionally,the patients showed theta decreasing and SMR enhancing after the sessions.The ratio of theta/beta (TTD:2.52 ±0.38 vs.2.33 ±0.32;CTD:2.43 ±0.39 vs.2.21 ±0.30; TS:2.64 ±0.35 vs.2.39 ±0.26) and theta/SMR was significantly lower than before treatment (P ＜ 0.01).Conclusion Neurofeedback training is an effective and valuable treatment in tic disorder especially in the patients with transient tic disorder and mild chronic motor or vocal tic disorder.

Objective To investigate the cognitive impairment and time-on-task characteristics of combined type(C type) and predominantly inattentive type (Ⅰ type) of children with attention deficit hyperactivity disorder(ADHD).Methods 24 cases with C type ADHD,20 cases with Ⅰ type ADHD and 24 normal children were completed 2 Block period of continuous performance test task,with conducting a comparative analysis of the behavior results of three groups and block1 and block2.Results 1.three groups comparison:hit numbers of C type (64.37 ±5.29) and Ⅰ type (63.55 ±5.28) were lower than that of the normal control group(67.04 ±2.03) ; reaction time of Ⅰ type (540.33 ± 90.33) ms was longer than that of the normal control group (470.56 ± 95.39)ms; intra-individual variability(ⅡⅤ) of C type (174.24 ± 56.3)ms and Ⅰ type (201.12 ± 50.79)ms were higher than that of the normal control group(144.72 ± 37.17) ms.Commission errors of other figures after 1 of C type was higher than that of Ⅰ type; reaction time of commission errors of Ⅰ type[(701.34 ±311.54) ms] was longer than that of C type((512.57 ± 279.22)ms),and all the differences were statistically significant (P ＜ 0.05).2.Timeon-task comparison:hit numbers,omission errors and ⅡⅤ had the significantly main effect of the type of subjects (P ＜ 0.05) ; hit numbers,omission errors,reaction time and ⅡⅤ had the significantly main effect of time-on-task (P＜0.01) ; Block2 the reaction time of C type and Ⅰ type((501.82 ± 112.47)ms,559.33 ± 90.73)ms) were significantly longer than that of Block1 ((473.19 ± 106.43) ms,(523.45 ± 99.86) ms) (P ＜ 0.05),while no significant difference (P＞0.05) in the normal control group.Conclusions C type ADHD has attention deficit and impulsivity and response inhibition defects.Ⅰ type ADHD has attention deficit and information processing capacity backward.Reaction rate of ADHD is more vulnerable to the impact of time-on-task.Two subtypes of ADHD children has different modes of cognitive impairment.