BACKGROUND:In recent years,epidemiological studies have shown that obesity is a risk factor for knee osteoarthritis,and fatty acid intake,metabolism and biosynthesis are closely related to the development of obesity.However,the causal relationship between fatty acids and osteoarthritis is still unknown.OBJECTIVE:Using the Mendelian randomization analysis to investigate the causal relationship between five fatty acid phenotypes and knee osteoarthritis.METHODS:The genome-wide association study data on fatty acid ratios from the UK Biobank(met-D)and genome-wide association study data on knee osteoarthritis from the EBI-A database were pooled together.Single nucleotide polymorphisms were used as instrumental variables and sensitive single nucleotide polymorphisms were selected for analysis.Two-sample Mendelian randomization analysis was conducted to evaluate the causal relationship between fatty acids and knee osteoarthritis outcome risk.We used inverse variance weighting method,MR-Egger regression method,weighted median method,weighted model method,and simple model method to study the causal relationship between fatty acids and knee osteoarthritis.Further inverse Mendelian randomization analysis was performed in the same way to ensure the validity of the results.RESULTS AND CONCLUSION:The forward analysis and inverse variance weighting method showed a causal relationship between three types of fatty acid phenotypes and knee osteoarthritis.Among them,the proportion of saturated fatty acids to total fatty acids was positively correlated with the risk of knee osteoarthritis(odds ratio[OR]=1.825,95%confidence interval(CI):1.230,2.706,P=0.003),the proportion of omega 3 polyunsaturated fatty acids to total fatty acids was negatively correlated with the risk of knee osteoarthritis(OR=0.822,95%CI:0.688 8,0.981,P=0.03),and the proportion of omega 6 polyunsaturated fatty acids to total fatty acids was positively correlated with the risk of knee osteoarthritis(OR=1.268,95%CI:1.079,1.491,P=0.004).There were two types of fatty acid phenotypes that do not have a causal relationship with knee osteoarthritis,including total fatty acids(OR=0.925,95%CI:0.804-1.066,P=0.283)and the proportion of monounsaturated fatty acids to total fatty acids(OR=0.877,95%CI:0.756-1.018,P=0.084).The reverse analysis results indicated that when knee osteoarthritis was used as exposure data,there was no significant causal relationship with the phenotype of fatty acids.The sensitivity analysis results showed that the P-values of the bidirectional Mendelian randomization Cochran's Q-test and MR Egger regression were both greater than 0.05,indicating that there was no significant heterogeneity or pleiotropy in the causal effect analysis between fatty acid phenotype and knee osteoarthritis.To conclude,reducing the content of saturated fatty acids and omega 6 polyunsaturated fatty acids and increasing the content of omega 3 polyunsaturated fatty acids can reduce the risk of knee osteoarthritis.This provides valuable clues for studying the biological mechanisms of knee osteoarthritis and exploring the early prevention and treatment of knee osteoarthritis,as well as providing new directions for the development of interventional drugs.

Objective To investigate the attention characteristics of patients with stable schizophrenia.Methods Fifty-five stable schizophrenic patients and 55 healthy subjects were included in the study.The attention network test paradigm(ANT paradigm)was used to measure the attention of participants.The observed indexes included reaction time under four cues and three stimulus types and converted reaction time(alerting network,orienting network,and executive control network).Results Under different cue prompts and stimulus conditions,the reaction time of patients with stable-phase schizophrenia was higher than that of the control group(P<0.001).The alerting network[25.43(11.71,42.53)ms vs.39.32(27.46,51.98)ms,P=0.020]and executive control network[96.17(36.32,160.13)ms vs.44.43(18.52,89.73)ms,P<0.001]in the patient group were significantly lower than those in the control group,while there was no significant difference in the orienting network compared to the control group(P=0.136).Conclusion Patients with stable schizophrenia show significant impairment in the efficiency of the alerting and executive control networks,while the orienting network is not significantly impaired.

Objective To investigate the attention characteristics of patients with stable schizophrenia.Methods Fifty-five stable schizophrenic patients and 55 healthy subjects were included in the study.The attention network test paradigm(ANT paradigm)was used to measure the attention of participants.The observed indexes included reaction time under four cues and three stimulus types and converted reaction time(alerting network,orienting network,and executive control network).Results Under different cue prompts and stimulus conditions,the reaction time of patients with stable-phase schizophrenia was higher than that of the control group(P<0.001).The alerting network[25.43(11.71,42.53)ms vs.39.32(27.46,51.98)ms,P=0.020]and executive control network[96.17(36.32,160.13)ms vs.44.43(18.52,89.73)ms,P<0.001]in the patient group were significantly lower than those in the control group,while there was no significant difference in the orienting network compared to the control group(P=0.136).Conclusion Patients with stable schizophrenia show significant impairment in the efficiency of the alerting and executive control networks,while the orienting network is not significantly impaired.

BACKGROUND:In recent years,epidemiological studies have shown that obesity is a risk factor for knee osteoarthritis,and fatty acid intake,metabolism and biosynthesis are closely related to the development of obesity.However,the causal relationship between fatty acids and osteoarthritis is still unknown.OBJECTIVE:Using the Mendelian randomization analysis to investigate the causal relationship between five fatty acid phenotypes and knee osteoarthritis.METHODS:The genome-wide association study data on fatty acid ratios from the UK Biobank(met-D)and genome-wide association study data on knee osteoarthritis from the EBI-A database were pooled together.Single nucleotide polymorphisms were used as instrumental variables and sensitive single nucleotide polymorphisms were selected for analysis.Two-sample Mendelian randomization analysis was conducted to evaluate the causal relationship between fatty acids and knee osteoarthritis outcome risk.We used inverse variance weighting method,MR-Egger regression method,weighted median method,weighted model method,and simple model method to study the causal relationship between fatty acids and knee osteoarthritis.Further inverse Mendelian randomization analysis was performed in the same way to ensure the validity of the results.RESULTS AND CONCLUSION:The forward analysis and inverse variance weighting method showed a causal relationship between three types of fatty acid phenotypes and knee osteoarthritis.Among them,the proportion of saturated fatty acids to total fatty acids was positively correlated with the risk of knee osteoarthritis(odds ratio[OR]=1.825,95%confidence interval(CI):1.230,2.706,P=0.003),the proportion of omega 3 polyunsaturated fatty acids to total fatty acids was negatively correlated with the risk of knee osteoarthritis(OR=0.822,95%CI:0.688 8,0.981,P=0.03),and the proportion of omega 6 polyunsaturated fatty acids to total fatty acids was positively correlated with the risk of knee osteoarthritis(OR=1.268,95%CI:1.079,1.491,P=0.004).There were two types of fatty acid phenotypes that do not have a causal relationship with knee osteoarthritis,including total fatty acids(OR=0.925,95%CI:0.804-1.066,P=0.283)and the proportion of monounsaturated fatty acids to total fatty acids(OR=0.877,95%CI:0.756-1.018,P=0.084).The reverse analysis results indicated that when knee osteoarthritis was used as exposure data,there was no significant causal relationship with the phenotype of fatty acids.The sensitivity analysis results showed that the P-values of the bidirectional Mendelian randomization Cochran's Q-test and MR Egger regression were both greater than 0.05,indicating that there was no significant heterogeneity or pleiotropy in the causal effect analysis between fatty acid phenotype and knee osteoarthritis.To conclude,reducing the content of saturated fatty acids and omega 6 polyunsaturated fatty acids and increasing the content of omega 3 polyunsaturated fatty acids can reduce the risk of knee osteoarthritis.This provides valuable clues for studying the biological mechanisms of knee osteoarthritis and exploring the early prevention and treatment of knee osteoarthritis,as well as providing new directions for the development of interventional drugs.

Objective:To measure the morphological parameters of the fetal vertebral centrum ossification centers (COC) in the second-third trimester using MRI susceptibility weighted imaging (SWI), and to explore the growth and development trajectory of the vertebrae.Methods:Fetus in the second-third trimester with normal vertebrae development were prospectively and continuously included in Shandong Provincial Hospital Affiliated to Shandong First Medical University from December 2015 to December 2021, and the SWI scanning of fetal spine was performed. The following morphometric parameters of the C4, T6, L3, S1 vertebrae COC were measured, including sagittal diameter, transverse diameter, height, cross-sectional area and volume. The linear and nonlinear regression analysis was used to derive the best-fit curve for each parameters and gestational age.Results:A total of 112 fetuses were recruited with gestatonal age 21-39 (29.4±3.9) weeks, including 30 cases of C4, 58 cases of T6, 92 cases of L3, 62 cases of S1. Fetal spine in utero with global curvature was kyphosis, presenting two primary curves (thoracic and sacral kyphosis). The morphological parameters sagittal diameter, transverse diameter, height, cross-sectional area and volume of C4 followed the quadratic polynomial rule during 25 to 38 weeks (R 2=0.938, 0.943, 0.952, 0.957, 0.982). During 21 to 38 weeks, the sagittal diameter, transverse diameter and height of the T6 followed the exponential growth pattern (R 2=0.915, 0.923, 0.849) and the growth of the area and volume followed the quadratic polynomial growth pattern (R 2=0.943, 0.961). The L3 followed the quadratic polynomial rule during 21 to 39 weeks (R 2=0.910, 0.916, 0.914, 0.942, 0.948) The sagittal diameter, transverse diameter and height of the S1 followed the linear growth pattern (R 2=0.905, 0.911, 0.922) and the area and volume followed the quadratic polynomial growth pattern (R 2=0.930, 0.964) during 23 to 39 weeks. Conclusions:The growth and development of C4, T6, L3 and S1 COC of fetus in the second-third trimester has a good correlation with gestational age. The growth of fetal vertebral COC in the early stage is slow, but with the growth of gestational age, the growth rate of vertebral bodies accelerates.

Objective:To discuss the feasibility of prenatal MRI in evaluating fetal auricle developmental malformation and atresia of external auditory canal.Methods:Fifteen pregnant women (aged from 22 to 40 years old, mean age 31.3±5.2 years old) with fetal external ear developmental malformation suspected by ultrasound underwent MR scanning between November 2017 and May 2019. All of them were singleton. The gestational age ranged from 23 weeks to 35 weeks, with an average of (27.5±3.5) weeks. The sensitivity, specificity and accuracy of MRI and ultrasound in the diagnosis of fetal auricle malformation and atresia of external auditory canal were calculated and compared, using postnatal follow-up as the gold standard. Fisher exact test was used to compare the efficacy of MRI and ultrasound in diagnosing atresia of external auditory canal.Results:A total of 30 fetal external ears were detected in 15 fetuses, without auricle absence. Totally 19 external ears with developmental malformation were confirmed by postnatal follow-up, including 19 ears with auricle malformation and 15 ears with external auditory canal atresia. The accuracy of MRI and ultrasound in the diagnosis of auricle malformation was both 100% (19/19). For the diagnosis of external auditory canal atresia, the sensitivity, specificity and accuracy of MRI and ultrasound were 93.3% (14/15), 75.0% (3/4), 89.5% (17/19) and 33.3% (5/15), 25.0% (1/4), 31.6% (6/19), respectively. The sensitivity and accuracy of MRI in the diagnosis of atresia of external auditory canal were significantly higher than those of ultrasound, with statistically significant difference ( P=0.004, 0.001). Conclusion:MRI plays an important role in the diagnosis of fetal external ear developmental malformation, which can be used as an effective supplement to ultrasound, especially for the diagnosis of external auditory atresia.

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 explore associations between mental disorders and accidental death. Methods A case-control psychological autopsy study was conducted in Fengning county in Hebei province, Kailu county in Inner Mongolia, Meixian county in Shaanxi province, Chongzhou county in Sichuan province. One hundred and fifty-seven accidental death cases were identified, based on detailed interview and cause of death listed as"accidental death"(International Classification of Diseases 10th edition codes V01-X59),"suicide"(X60-X84) or"mental disorder"(F00-F98). We used 2008 census data for three of the four counties (Fengning county in Hebei Province stopped participating in the study in 2009), to select a multistage stratified random sample of adult community residents as the living controls. Finally, 140 living controls were randomly sampled. For each cases or controls, one family member and one associate (neighbor or friend) were interviewed separately by different interviewers. For each cases, socio-demographic data, quality of life, and psychiatric diagnosis 1 month prior to accidental death (or 1 month prior to interview for the living controls), and life events and social support 12 months prior to the death or interview (for controls) were evaluated during the interview. Axis Ⅰ mental disorders, Axis Ⅱ personality disorders were diagnosed based on Structured Clinical Interviews for DSM-Ⅳ-TR Axis Ⅰ Disorders (SCID-I) and Axis Ⅱ Personality Disorders (SCID-Ⅱ). Multivariate logistic regression was used to test the association between accidental death and mental disorders. Results The accidental death group was more likely being male (χ2=37.55, P<0.001) and unmarried (χ2=8.82, P=0.003). The prevalence of Axis Ⅰ mental disorder and of axis Ⅱpersonality disorder were higher in accidental death group than that in control group (19.7%( 31/157) vs. 3.6%(5/140), χ2=18.17, P<0.01; 11.5%(18/157) vs .3.6%(5/140), χ2=6.45, P=0.011; respectively). After adjusted for demographic variables, the adjusted OR was 1.78 (95%CI: 1.26-2.51, P=0.001) for mental disorders, and 1.48(95%CI: 1.02-2.15, P=0.040) for mental disorders other than substance use disorders. Conclusion Mental disorder is an independent risk factor for accidental death, whether or not substance use disorders were excluded.

Objective To explore associations between mental disorders and accidental death. Methods A case-control psychological autopsy study was conducted in Fengning county in Hebei province, Kailu county in Inner Mongolia, Meixian county in Shaanxi province, Chongzhou county in Sichuan province. One hundred and fifty-seven accidental death cases were identified, based on detailed interview and cause of death listed as"accidental death"(International Classification of Diseases 10th edition codes V01-X59),"suicide"(X60-X84) or"mental disorder"(F00-F98). We used 2008 census data for three of the four counties (Fengning county in Hebei Province stopped participating in the study in 2009), to select a multistage stratified random sample of adult community residents as the living controls. Finally, 140 living controls were randomly sampled. For each cases or controls, one family member and one associate (neighbor or friend) were interviewed separately by different interviewers. For each cases, socio-demographic data, quality of life, and psychiatric diagnosis 1 month prior to accidental death (or 1 month prior to interview for the living controls), and life events and social support 12 months prior to the death or interview (for controls) were evaluated during the interview. Axis Ⅰ mental disorders, Axis Ⅱ personality disorders were diagnosed based on Structured Clinical Interviews for DSM-Ⅳ-TR Axis Ⅰ Disorders (SCID-I) and Axis Ⅱ Personality Disorders (SCID-Ⅱ). Multivariate logistic regression was used to test the association between accidental death and mental disorders. Results The accidental death group was more likely being male (χ2=37.55, P<0.001) and unmarried (χ2=8.82, P=0.003). The prevalence of Axis Ⅰ mental disorder and of axis Ⅱpersonality disorder were higher in accidental death group than that in control group (19.7%( 31/157) vs. 3.6%(5/140), χ2=18.17, P<0.01; 11.5%(18/157) vs .3.6%(5/140), χ2=6.45, P=0.011; respectively). After adjusted for demographic variables, the adjusted OR was 1.78 (95%CI: 1.26-2.51, P=0.001) for mental disorders, and 1.48(95%CI: 1.02-2.15, P=0.040) for mental disorders other than substance use disorders. Conclusion Mental disorder is an independent risk factor for accidental death, whether or not substance use disorders were excluded.