Objective To explore the predictive value of methylenetetrahydrofolate reductase(MTHFR)gene C677T polymorphism and serum homocysteine(Hcy)level for adverse pregnancy outcomes.Methods The clinical data of 698 pregnant women who received antenatal care and deliv-ered at Ji'an Central People's Hospital were retrospectively collected.According to the research pur-pose,the pregnant women were divided into internal study cohort(n=483)or external validation co-hort(n=215).Each cohort was further divided into adverse pregnancy group and normal pregnancy group based on whether adverse pregnancy outcomes occurred.The MTHFR gene C677T polymor-phism and serum Hcy level of all pregnant women were detected.Binary Logistic regression analysis was used to investigate the relationships of MTHFR gene C677T polymorphism,Hcy level,and other indicators with adverse pregnancy outcomes.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive efficacy of different indicators when used alone and their combina-tion.Results In the internal study cohort,compared with the normal pregnancy group,the detection frequency of the CC genotype at the MTHFR gene C677T locus was lower,while the detection frequencies of the CT and TT genotypes were higher in the adverse pregnancy group(P＜0.001).The proportion of pregnant women with high Hcy levels was higher in the adverse pregnancy group than that in the normal pregnancy group(P＜0.001).Binary Logistic regression analysis showed that age,folic acid level during pregnancy,MTHFR gene C677T polymorphism,and Hcy level were all independ-ent influencing factors for adverse pregnancy outcomes(P＜0.05).The ROC curve indicated that the area under the curve(AUC)of the combined prediction model was 0.938,which was greater than that of each indicator.In the external validation cohort,the AUC of the combined prediction model was 0.917,validating the stability and clinical applicability of the model.Conclusion The TT and CT genotypes at the MTHFR gene C677T locus and high Hcy level are all independent risk factors for adverse pregnancy outcomes.The prediction model constructed by combining these factors with age and folic acid level during pregnancy has a high predictive efficacy for adverse pregnancy outcomes.

Objective To explore the epidemic characteristics of common pneumonia pathogens in preschool children in Xining area and analyze the influencing factors of progression to severe pneumonia. Methods A total of 522 preschool children with pneumonia who were treated in our hospital from May 2021 to March 2024 were retrospectively selected as the research subjects. Sputum samples from children were taken to identify the pathogens and analyze their pathogenic epidemic characteristics.According to the diagnostic criteria in the 2019 version of ^“Standards for the Diagnosis and Treatment of Community-Acquired Pneumonia in Children^”, determine whether it is severe pneumonia, and collect the clinical data of the children.Logistic regression was used to analyze the influencing factors of the progression of common pneumonia to severe pneumonia. Results Among the 522 children with pneumonia, 522 cases were infected with pathogens, of which 447 cases were single infection (85.63%), 75 cases were mixed infection (14.36%). A total of 597 pathogens were detected, including 257 viruses (43.05%), 240 bacteria (40.20%), 68 mycoplasma pneumoniae (11.39%) and 32 chlamydia pneumoniae (5.36) . The detection rates of Streptococcus pneumoniae (149, 24.96%) and respiratory syncytial virus (118, 19.77%) were higher. Logistic regression results showed that length of hospital stay (OR=2.235, 95% CI: 1.552-3.439), ICU admission (OR=2.426, 95% CI: 1.769-3.881), intestinal microbiota disorder (OR=1.626, 95% CI: 1.335-2.842), multi-drug resistance (OR=2.086, 95%CI 1.417-2.905), mixed infection (OR=3.134, 95% CI : 2.217-8.857), nutritional risk (OR=2.783, 95% CI: 2.038-4.764), CRP (OR=2.589, 95% CI: 1.805-4.117), PCT (OR=1.486, 95%CI: 1.077-1.649), and white blood cells (OR=1.329, 95% CI: 1.021-1.536) were all associated with the risk of severe pneumonia (P<0.05). Conclusion The main pathogens of pneumonia in preschool children in Xining are Streptococcus pneumoniae and respiratory syncytial virus. Paying attention to the treatment of children with intestinal disorders, multiple infections, and malnutrition is of great significance to improve the progression of pneumonia.

Abstract: Objective　To investigate the effects and mechanisms of resveratrol on in vitro growth and biofilm formation of hypermucinous Klebsiella pneumoniae(HMKP), so as to provide a preliminary theoretical basis for the development of new antimicrobial drugs. Methods Clinical isolates of Klebsiella pneumoniae, non-repetitive, collected from March to October 2023, were identified for species and sensitivity to common antimicrobials using the VITEK-2 compact automatic microbial identification system. The mucous characteristics of the strains were assessed via a string test, and the broth microdilution method determined the minimum inhibitory concentration (MIC) of resveratrol. The effects of different concentrations of resveratrol on the growth of hypermucinous Klebsiella pneumoniae were observed by the bacterial growth curve method, and the effects of different concentrations of resveratrol on HMKP biofilm were determined by the crystal violet staining method. Real-time quantitative reverse transcription PCR (RT-qPCR) was used to detect the expression levels of virulence-related genes (aerobactin, rmpA, and mrkD) in HMKP. Data plotting and analysis were performed using GraphPad Prism 9.0. Results　A total of 122 strains of Klebsiella pneumoniae were collected, with 29 strains testing positive in the string test (HMKP). Among these, 26 strains were allergic to commonly antimicrobial drugs, such as cephalosporins and their enzyme inhibitors, quinolones, and aminoglycosides, while 3 strains were identified as carbapenem-resistant hypermucinous Klebsiella pneumoniae (HM-CRKP). The minimum inhibitory concentration (MIC) of resveratrol for all HMKP strains exceeded 512 μg/mL. Resveratrol concentrations of 256 μg/mL and 128 μg/mL significantly reduced the growth capacity and biofilm formation capacity of HMKP (P<0.05) and decreased the expression levels of virulence-related genes rmpA and mrkD. Conclusions　Resveratrol can inhibit the growth and biofilm formation of HMKP. The mechanism may be related to the downregulation of virulence-related genes expression, specifically rmpA and mrkD.

Objective:To investigate the effectiveness of suicide prevention cognitive behavioral therapy for depression patients with suicide attempt.Methods:Eligible participants were recruited from the inpatient department of Beijing Huilongguan Hospital from September 2021 to August 2022. A total of 112 patients were randomly allocated into the intervention group (56 cases) and the control group (56 cases) by a random number table. Patients in the intervention group received 12 sessions of cognitive behavioral therapy for suicide prevention over 8 weeks,while participants in the control group received supportive psychotherapy. Patient Health Questionnaire Depression Scale (PHQ-9) and the Beck Scale for Suicide Ideation-Chinese Version (BSI-CV) were used to assess changes in depressive symptoms,suicidal ideation,and suicidal tendencies in both groups at baseline,4-week of treatment,the end of treatment,and at follow-up (weekends 4,8,12). General data and scale scores between the two groups were analyzed by t test,Mann-Whitney rank sum test,and χ 2 test; repeated measure ANOVA were used to assess the baseline and intervention effects. Results:The change of PHQ-9 at each time point of the 2 groups showed a downward trend,and the group x time interaction was significant ( F=2.75, P=0.047). Since the 8th week,the PHQ score in the intervention group was significantly lower than that in the control group ( t=7.03, P<0.05). Time and group effect were significant in the four time points of the total score of suicidal ideation in the last week in BSI-CV ( F=96.78,6.35,both P<0.05),but the interaction between group and time was not significant. At weeks 8 and 12,the scores of the intervention group were lower than those of the control group ( Z=-3.11,-3.30;both P<0.01). In BSI-CV,time effects in the total score of suicidal intention was significant at four time points ( F=11.83, P<0.05),but the interaction between group and time was not significant ( F=2.56, P=0.059). There was no significant difference in suicide tendency between the two groups at each time point ( F=0.001, P=0.975). The total scores of suicidality in 2 groups at 4,8 and 12 weeks were all lower than baseline ( P<0.05). Conclusions:Compared with the control group,the cognitive behavioral therapy for suicide prevention showed superior effects on suicidal ideation and depression,but the intervention effect on suicidal tendency was not significant. Further studies are needed to investigate the long-term effects of cognitive behavioral therapy for suicide prevention in patients with depression who have attempted suicide.

Objective:To investigate the effectiveness of suicide prevention cognitive behavioral therapy for depression patients with suicide attempt.Methods:Eligible participants were recruited from the inpatient department of Beijing Huilongguan Hospital from September 2021 to August 2022. A total of 112 patients were randomly allocated into the intervention group (56 cases) and the control group (56 cases) by a random number table. Patients in the intervention group received 12 sessions of cognitive behavioral therapy for suicide prevention over 8 weeks,while participants in the control group received supportive psychotherapy. Patient Health Questionnaire Depression Scale (PHQ-9) and the Beck Scale for Suicide Ideation-Chinese Version (BSI-CV) were used to assess changes in depressive symptoms,suicidal ideation,and suicidal tendencies in both groups at baseline,4-week of treatment,the end of treatment,and at follow-up (weekends 4,8,12). General data and scale scores between the two groups were analyzed by t test,Mann-Whitney rank sum test,and χ 2 test; repeated measure ANOVA were used to assess the baseline and intervention effects. Results:The change of PHQ-9 at each time point of the 2 groups showed a downward trend,and the group x time interaction was significant ( F=2.75, P=0.047). Since the 8th week,the PHQ score in the intervention group was significantly lower than that in the control group ( t=7.03, P<0.05). Time and group effect were significant in the four time points of the total score of suicidal ideation in the last week in BSI-CV ( F=96.78,6.35,both P<0.05),but the interaction between group and time was not significant. At weeks 8 and 12,the scores of the intervention group were lower than those of the control group ( Z=-3.11,-3.30;both P<0.01). In BSI-CV,time effects in the total score of suicidal intention was significant at four time points ( F=11.83, P<0.05),but the interaction between group and time was not significant ( F=2.56, P=0.059). There was no significant difference in suicide tendency between the two groups at each time point ( F=0.001, P=0.975). The total scores of suicidality in 2 groups at 4,8 and 12 weeks were all lower than baseline ( P<0.05). Conclusions:Compared with the control group,the cognitive behavioral therapy for suicide prevention showed superior effects on suicidal ideation and depression,but the intervention effect on suicidal tendency was not significant. Further studies are needed to investigate the long-term effects of cognitive behavioral therapy for suicide prevention in patients with depression who have attempted suicide.

Objective To investigate the prevalence and correlates of depression in residents aged 15 and older in Hainan province.Methods Stratified multistage random sampling methods were utilized to identify 12 117 individuals (≥15 years old) from 59 villages (neighborhoods) in 24 towns (streets) within 6 counties (cities) in Hainan Province from September 2010 to November 2011.The subjects were screened with an expanded version of the General Health Questionnaire (GHQ-12) and the respondents were divided into three groups by high risk,moderate risk and low risk of mental disorder,followed by formal diagnosis according to the Structured Clinical Interview for DSM-IV-TR (SCID-I/P) by psychiatrists among 100％ subjects in group with high risk,40％ subjects in group with moderate risk and 10％ subjects in group with low risk.The adjusted rate,standardized rate,and 95％ confidence interval (95％CI) of the one-month and lifetime prevalence were also calculated among the 3 groups of individuals who were diagnosed with depressive disorder.The difference in whether they suffered depression was determined by the chi-squared test.Correlations to depressive disorder and the odds ratio (OR) were explored with multiple regression analysis.Results There were 97 cases of depressive disorders (1-month) and 166 cases of lifetime depressive disorders finally confirmed.The adjusted rate of 1-month prevalence was 1.38％ (95％CI:1.12-1.59) and the life-time adjusted prevalence rate was 2.80％ (95％CI:2.51-3.09).Female (OR=1.55,95％CI:1.12-2.14),mid-age(50-64 y,OR=1.84,95％CI:1.13-2.99),being divorced or living separated (OR=4.87,95％CI:1.86-12.73),suffering chronic diseases (OR=2.19,95％CI:1.56-3.07),and low family income were significantly associated with suffering depressive disorder.Conclusions The prevalence of the depressive disorder among residents aged 15 and older in Hainan province is lower than the nationwide prevalence.People who are female,mid-age,being divorced or not living with the partner,earning a low income,and suffering chronic diseases have more predisposition to develop the depressive disorder in Hainan province.

Objective To investigate the prevalence and correlates of depression in residents aged 15 and older in Hainan province.Methods Stratified multistage random sampling methods were utilized to identify 12 117 individuals (≥15 years old) from 59 villages (neighborhoods) in 24 towns (streets) within 6 counties (cities) in Hainan Province from September 2010 to November 2011.The subjects were screened with an expanded version of the General Health Questionnaire (GHQ-12) and the respondents were divided into three groups by high risk,moderate risk and low risk of mental disorder,followed by formal diagnosis according to the Structured Clinical Interview for DSM-IV-TR (SCID-I/P) by psychiatrists among 100％ subjects in group with high risk,40％ subjects in group with moderate risk and 10％ subjects in group with low risk.The adjusted rate,standardized rate,and 95％ confidence interval (95％CI) of the one-month and lifetime prevalence were also calculated among the 3 groups of individuals who were diagnosed with depressive disorder.The difference in whether they suffered depression was determined by the chi-squared test.Correlations to depressive disorder and the odds ratio (OR) were explored with multiple regression analysis.Results There were 97 cases of depressive disorders (1-month) and 166 cases of lifetime depressive disorders finally confirmed.The adjusted rate of 1-month prevalence was 1.38％ (95％CI:1.12-1.59) and the life-time adjusted prevalence rate was 2.80％ (95％CI:2.51-3.09).Female (OR=1.55,95％CI:1.12-2.14),mid-age(50-64 y,OR=1.84,95％CI:1.13-2.99),being divorced or living separated (OR=4.87,95％CI:1.86-12.73),suffering chronic diseases (OR=2.19,95％CI:1.56-3.07),and low family income were significantly associated with suffering depressive disorder.Conclusions The prevalence of the depressive disorder among residents aged 15 and older in Hainan province is lower than the nationwide prevalence.People who are female,mid-age,being divorced or not living with the partner,earning a low income,and suffering chronic diseases have more predisposition to develop the depressive disorder in Hainan province.

Objective:To comparison of three different beta blockers on murine hemangioma (EOMA cells) cells in vitro and in vivo effects.Preliminary study on the therapeutic effect of propranolol on vascular tumor in mice and possible mechanisms , provide a reference for beta blockers in the treatment of infantile hemangioma .Methods: Comparative study on the effects of three kinds of different β-receptor blockers---metoprolol, propranolol and butoxamine , on the proliferation and apoptosis of Mouse Hemangioendothelioma Endothelial cell (EOMA cells) was conducted in vitro.EOMA cells were cultured in vitro,randomly divided into different groups,propranolol and timolol were added into the medium respectively ,after 24 h intervention.MTT assay and acridine orange staining assay were conducted respectively to detect cell viability and apoptosis level .EOMA cells were transplanted into nude mice in vivo.Tumor volume growth to 100 mm3 ,animals were randomly divided into 4 groups respectively ,the control group ,metoprolol group,Bhutto Samin group and propranolol group ,drug group according to 2 mg/( kg? d) oral gavage ,control group were given an equal volume of saline ( NS ) , every two days measurement tumor volume size .Serum levels of tumor necrosis factor alpha ( TNF-α) and vascular endothelial growth factor ( VEGF ) were detected by enzyme linked immunosorbent assay ( ELISA ) in the end of the experiment.Results:For propranolol,after 24 h treatment,significant differences of cell viability and apoptosis were noted (P<0.05) at the concentration of 50 μmol/L,while continuing to increase to 800 μmol/L,the cell survival rate decreased sharply to close to 10%. Acridine orange staining at the 50 μmol/L group after 24 h revealed many apoptotic cells .For metoprolol and butoxa mine ,significant differences of cell viability and apoptosis were noted ( P<0.05 ) at the concentration of 100 μmol/L,while continuing to increase to 800μmol/L,the cell survival rate decreased sharply to close to 20%.It was significantly higher than propranolol group at the same concentration ( P<0.05 ) .It showed a similar trend in acridine orange staining .In vivo experiments showed that the end of the experiment of metoprolol , butoxamine group and propranolol drugs in mice tumor volume , respectively ( 1 642.8 ±89.3 ) , ( 1 529.3 ± 119.1) and (752.7±46.5)mm3,significantly lower than the control group of mice tumor volume of (2 023.3±123.0) mm3(P<0.001).Metoprolol,butoxamine mice and propranolol drugs group ,serum VEGF levels for (606.5±105.8 ) pg/ml,(534.3±243.2 ) pg/ml and (420.1±123.7) pg/ml, significantly lower than the PBS control group [(825.8±145.7) pg/ml,(P<0.05)],the TNF alpha result was followed by(301.3±62.3) pg/ml,(305.1±53.8) pg/ml and (288.8±59.5) pg/ml,significantly lower than the normal control group [(444±100.4) pg/ml,P<0.05].Conclusion:Three kinds of beta-blockers can effectively inhibit EOMA cells proliferation and induce apoptosis in vitro, the role of propranolol more significantly than butoxamine and metoprolol .Three kinds of beta blockers restrain the growth of the hemangioma in vivo ,in which the inhibitory effect of propranolol is stronger than the metoprolol and butoxa mine.Three kinds of beta blockers can lower the levels of VEGF and TNF-αin vivo.Indicating that propranolol on vascular tumor in mice may be one of the mechanisms of β1 and β2 receptor synergy effect and its mechanism in the treatment of hemangioma may be associated with VEGF and TNF-α.