Objective To examine the reliability and validity of the Suicidal Behaviors Questionnaire-Revised(SBQ-R)among Chinese undergraduates and to find out cut-off score for screening the risk of suicide in clinical undergraduates.Methods A total of 488 Chinese undergraduates participated in this study.Of them,366 participants were asked to complete the Chinese version of SBQ-R,Psychache Scale,and Satisfaction with Life Scale.And 45 undergraduates were re-tested after four weeks;122 undergraduates were tested by using the Suicidality Module Section of the Mini International Neuropsychiatric Interview and the Chinese version of SBQ-R.Results ① The results showed that The Chinese version of SBQ-R had one factor with good fit indices.② The internal consistency reliability,split-half reliability,and one-month retest reliability of the total questionnaire were 0.76,0.79,and 0.93,respectively.③ The total score of the SBQ-R in Chinese was positively correlated with psychache but negatively correlated with satisfaction of life,indicating that the scale has good criterion-related validity.④ Receiver operating characteristics(ROC)curve evaluation suggested that the cut-off score was 9 in terms of identifying the clinical undergraduates at high risk of suicide.Conclusion SBQ-R is a reliable,valid,and practical instrument to measure the risk of suicide among Chinese undergraduates.SBQ-R＞9 is the best cut-off value for screening for high suicide risk in China.

Objective To describe the epidemiological characteristics, investigation and treatment process of the first monkeypox cluster outbreak in Wuhan, and to provide reference for the prevention and control of monkeypox cluster outbreak in the future. Methods Field epidemiological investigation was conducted on the cases, and throat swabs, anal swabs, shingles fluid, whole blood, and serum samples were collected from the cases. Subsequently, real-time fluorescence quantitative polymerase chain reaction was employed for the detection of monkeypox virus nucleic acid and subsequent gene sequencing. Results Two cases had a high-risk exposure behavior in a hotel in Wuhan on June 2, 2023. The first case exhibited the emergence of beige papules on June 5 and sought medical treatment at a tertiary hospital in Wuhan on June 11. The Chinese Center for Disease Control and Prevention conducted tests on herpes fluid samples, which yielded positive results for the presence of monkeypox virus nucleic acid. Genetic sequencing analysis revealed that the infecting strain of the monkeypox virus in this case belonged to the West African clade B.1. Conclusion Based on epidemiological investigation and laboratory results, this monkeypox cluster outbreak may be caused by latent men with men sexual transmission. Monkeypox has the risk of both overseas importation and local transmission in our country. It is very necessary to detect, report and deal with monkeypox outbreak early.

Objective To explore root cause of poor prognosis after successful endovascular treatment(EVT)in patients with acute ischemic stroke with large vascular occlusion(AIS-LVO)of anterior circulation.Methods Patients with AIS-LOV of anterior circulation who received successful EVT(postoperative modified thrombolysis incerebral infarction[mTICI]grade≥2b)were retrospectively and continuously collected in the Department of Neurology of Bozhou People's Hospital from January 2022 to March 2024.The baseline and clinical data of the patients were collected,including gender,age,vascular risk factors(hypertension,diabetes,coronary heart disease,hyperlipidemia,valvular heart disease,atrial fibrillation,smoking,and alcohol consumption),prior stroke or transient ischemic attack,baseline blood pressure,baseline National Institutes of Health Stroke scale(NIHSS)score,laboratory test indicators(pre-operative C-reactive protein and D-dimer,post-operative fasting blood glucose,lipid levels,homocysteine,etc).Meanwhile,the data of perioperative indicators was collected,including the time from onset to admission,the time from admission to puncture,the time from puncture to revascularization,the time from onset to puncture,the time from onset to revascularization,remedial measures(balloon dilation,stent placement,arterial thrombolysis)during the surgery or not,using tirofiban or not,postoperative complications(stroke-related pneumonia,stress ulcers,deep vein thrombosis,acute heart failure or renal failure,etc)or not.The patient's medical history and imaging data were collected,and these indicators were defined and collected,including Alberta stroke program early CT score(ASPECTS),location of occlusion(C1 segment of the internal carotid artery,C2 segment to C7 segment of the internal carotid artery,M1 segment of the middle cerebral artery),and the trial of org 10172 in acute stroke treatment(TOAST)classification and a postoperative transformation of cerebral infarction after ischemic stroke and symptomatic intracranial hemorrhage or not.According to the modified Rankin scale(mRS)score at 90 d after surgery,all patients were divided into poor prognosis group(mRS score≥ 3)and good prognosis group(mRS score≤2).The baseline and clinical data of two groups were compared using univariate analysis.Variables with P＜0.1 in the univariate analysis were selected as independent variables,and the poor prognosis was used as the dependent variable.Further,multivariate Logistic regression analysis was performed to identify the influencing factors of poor prognosis after EVT.Results Finally,a total of 192 patients with AIS-LVO of anterior circulation who received successful revascularization were included in this study.There were 101 male patients and 91 female patients.The poor prognosis group had 102 cases and the good prognosis group had 90 cases.Univariate analysis showed that the poor prognosis group had statistically significant differences with the good prognosis group in terms of age(Z=-3.088,P=0.002)and age distribution(x2=13.457,P=0.001),fasting blood glucose(Z=-3.347,P=0.001),baseline NIHSS score(Z=-4.469,P＜0.01),location of occlusion(x2=10.488,P=0.005),transformation of hemorrhage after ischemic stroke(x2=16.943,P＜0.01),and symptomatic intracranial hemorrhage(X2=25.449,P＜0.01),and the baseline ASPECTS of the poor prognosis group was significantly lower than that of the good prognosis group(Z=-4.547,P＜0.01).There were no significant differences in other baseline and clinical data(all P＞0.05).Further multivariate Logistic regression analysis showed that age＞80 years(OR,3.224,95％CI 1.033-10.058,P=0.044),baseline NIHSS score(OR,1.102,95％CI 1.013-1.199,P=0.023),baseline ASPECTS(OR,0.375,95％CI 0.212-0.665,P=0.001),and symptomatic intracranial hemorrhage(OR,7.127,95％CI 1.296-39.203,P=0.024)were independent influencing factors of poor prognosis.Conclusion The independent factors of 90 d poor prognosis after successful EVT in patients with AIS-LVO of anterior circulation are age＞80 years,baseline NIHSS score,baseline ASPECTS,and symptomatic intracranial hemorrhage.

The pathogenesis of bipolar disorder(BD)is unknown,and objective biomarkers with clinical guidance are lacking.Extracellular vesicles(EV)are lipid bilayer-enclosed vesicles that carry cargo from originating cells,influencing the processes of recipient cells.They are capable of crossing the blood-brain barrier and reflecting the ongoing processes in the central nervous system.Compelling data indicates that EV could mediate BD pathophysiological processes such as neurocognitive impairment,neuroinflammatory diffusion,and metabolic dysfunction.Therefore,EV has the potential to become a reliable biomarker and therapy for BD,providing new ideas for revealing the pathogenesis and clinical diagnosis and treatment of BD.

Objective:To study the epidemiological characteristics and pathogen status of infection of patients with herpetic pharyngitis in eastern region of Chengdu in 2022, in order to provide experimental basis for scientific prevention and control of herpetic pharyngitis.Methods:Information and fecal specimens were collected from patients diagnosed with herpetic angina at sentinel monitoring hospitals in eastern region of Chengdu from January to December 2022, their epidemiological characteristics were analyzed, real-time fluorescence quantitative PCR (RT-PCR) and semi nested RT-PCR (RT-snPCR) were used to detect and identify enterovirus subtypes.Results:Among the 236 cases of herpetic angina, the age of the affected children was mainly 0-9 years (99.15%), with children aged below 3 years accounting for 75.85% of the total cases, children in the 1-year-old group had the highest constituent ratio, accounting for 47.88% of the total cases; The virus detection rate in the 2-year-old group was higher than that in the 0-year-old group ( χ2=5.945, P=0.015). There were 142 male infected cases (60.17%) and 94 female cases (39.83%); there was a statistically significant difference in the virus detection rate between the male group (91.55%) and the female group (78.72%) ( χ2=7.938, P=0.005). In the seasonal distribution, the summer group had the highest constituent ratio (40.25%), while the winter group had the lowest constituent ratio (11.86%), The composition ratio of the summer group was significantly higher than that of the other groups, and the differences were statistically significant ( χ2=10.393, 19.199, 49.358, all P<0.001). The virus detection rate in the summer group was significantly higher than that in the spring group and the winter group ( χ2=16.951, 4.592, both P<0.05). The RT-PCR result showed that a total of 204 out of 236 children with herpetic angina were virus positive, with a detection rate of 86.44% (204/236), including coxsackievirus A (CV-A) 6 (22.55%), CV-A16 (5.88%), CV-A2 (2.94%), enterovirus type A71 (EV-A71) (2.94%), and other enteroviruses (65.69%). The RT-snPCR result showed that five viruses were identified from other enteroviruses, including CV-A4 (8.33%), CV-A5 (6.86%), CV-A10 (12.25%), CV-A12 (24.02%), and coxsackievirus B3 (CV-B3) (6.86%); another 15 positive samples of enterovirus were not successfully classified. We selected 9 strains of the virus in this study and 30 reference sequences from the NCBI database to. Conclusions:Herpetic angina in eastern region of Chengdu in 2022 is mainly found in male children under 3 years of age, and was concentrated between April and June. It has been confirmed that CV-A12 and CV-A6 were more common in intestinal viruses, and the 9 strains isolated in this study were homologous to multiple isolates.

Objective:To assess the relationship between visceral fat area(VFA) and diabetic peripheral neuropathy (DPN) in type 2 diabets mellitues(T2DM) patients.Methods:A total of 2 615 patients with T2DM were enrolled from the National Metabolic Management Center at Ningbo First Hospital between March 2018 and February 2021. The medical history, questionnaire survey, and laboratory parameters were collected, VFA was measured using bioelectrical impedance analysis, DPN was diagnosed based on neurophysiological examination. Patients were divided into four groups by VFA and body mass index as the following: VFA<100 cm 2 and body mass index<24 kg/m 2 group [VA(-)OB(-) group], VFA<100 cm 2 and body mass index≥24 kg/m 2 group [VA(-)OB(+ ) group], VFA≥100 cm 2 and body mass index<24 kg/m 2 group [VA(+ )OB(-) group], and VFA≥100 cm 2 and body mass index≥24 kg/m 2 group [VA(+ )OB(+ ) group]. Multivariable logistic regression analysis was done to determine the relationship between body mass index, VFA and DPN in patients with T2DM. Results:The proportion of DPN in this study was 46.96%. DPN group featured with older age, higher proportion of men, longer duration of disease, higher proportion of smoking, lower diastolic blood pressure, higher HbA 1C level, lower total cholesterol, lower high density lipoprotein-cholesterol, lower low density lipoprotein-cholesterol, higher blood creatinine levels, higher urinary albumin-to-creatinine ratio, higher VFA level (all P<0.01). Grouping according to VFA and body mass index, 68.1% in the VA(+ )OB(-) group had DPN, which was highest among the four groups. In multivariable logistic regression analysis, compared with VA(-)OB(-) group, VA(+ )OB(-) group had a significantly higher risk of DPN ( OR=2.234, 95% CI 1.339-3.728, P =0.002), VA(+ )OB(+ ) group took second place ( OR=1.281, 95% CI 1.030-1.592, P =0.026). Conclusions:VFA was associated with DPN in T2DM regardless of body mass index. The VA(+ )OB(-) group has the highest risk of DPN. Therefore, evaluation of visceral adiposity may have important clinical significance for the early screening and prevention of DPN in T2DM.

Objective:To identify Down syndrome (DS) fetal encephalopathy related genes and signaling pathways via bioinformatics analysis, and to explore their potential mechanisms underlying the occurrence and development of DS neuropathology.Methods:Retrospective study.In December 2021, dataset GSE59630 was downloaded from the gene expression omnibus (GEO), and differentially expressed genes (DEGs) between DS and normal fetal brain tissue were identified by R software.Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis and gene set enrichment analysis (GSEA) were performed on the genes identified.The protein-protein interaction (PPI) network was constructed based on search tool for the retrieval of interacting genes online database and Cytoscape software, and key modules and hub DEGs were identified.Real-time quantitative polymerase chain reaction technique was used to verify the expression of hub genes related to neurodegeneration in brain tissue of 3 pairs of DS and normal fetuses at the gestational age of 22-33 weeks.Results:A total of 225 DEGs were screened out from DS and normal fetal brain tissue, including 18 up-regulated genes and 207 down-regulated genes.GO functional enrichment analysis showed that DEGs were mainly enriched in neurogenesis, neuronal apoptosis, transcriptional regulation, mitochondrial energy metabolism, etc.KEGG pathway enrichment analysis revealed that DEGs were associated with a variety of neurodegenerative diseases.GSEA suggested that apoptosis and inflammatory responses play a vital part in the occurrence of DS neuropathology.Ten hub genes were identified by the PPI network established, and they were mainly related to histone acetylation and transcriptional regulation.According to the tissue verification result, the variations of RAB8A, TBP and TAF6 expression conformed to the microarray data. Conclusions:The key genes and signaling pathways identified by transcriptome analysis of fetal brain tissue facilitate the comprehensive understanding of the molecular mechanism of DS neuropathology.This study provides a novel insight into the clinical diagnosis and treatment of neurodevelopmental abnormalities and mental retardation in DS.

To explore the relationship between sleep duration and brachial-ankle pulse wave velocity(baPWV) in patients with type 2 diabetes mellitus(T2DM). A total of 1 755 patients with T2DM received standardized management of metabolic disease from March 1, 2018 to February 29, 2020 were included. All patients were classified into three groups according to the sleep duration: short(≤6 h), medium(>6 h to 8 h) and long(>8 h). Increased arterial stiffness was defined as baPWV≥1 600 cm/s. The prevalence of baPWV≥1 600 cm/s was 39.7%, 30.8% and 38.6% in short, medium and long sleep duration group, respectively( P<0.01). Multivariate logistic regression analysis showed that patients with long sleep duration( OR=1.317, P<0.05) but not short sleep duration( OR=1.169, P>0.05) had a higher risk for baPWV≥1 600 cm/s compared with the reference group with medium sleep duration. Stratified analyses by sex showed that the OR were 1.735( P<0.05) among female and 1.131( P>0.05) among male respectively for baPWV≥1 600 cm/s in long sleep duration group when compared with medium sleep duration group. Sleep duration>8 h was found to be associated with elevated baPWV in patients with T2DM. There were gender differences in the correlation between long sleep duration and baPWV.

Objective:To analyze clinical features, prognosis and risk factors of bronchopulmonary dysplasia (BPD) associated pulmonary hypertension (PH).Methods:Clinical data of 338 infants with BPD were collected from the neonatal intensive care unit (NICU) in Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University between January 2016 and December 2018. These infants were divided into PH group and non-PH group. The clinical features and prognosis were compared between these two groups by Chi-square test or nonparametric test. Risk factors for BPD-PH were analyzed with binary logistic regression model.Results:Among the 338 BPD infants, 314 had no PH (92.9%) and 24 had PH (7.1%), with an average gestational age of (27.1±1.8) weeks, and 206 were males and 132 females.PH infants had younger gestational age ((26.4±2.1) vs. (27.2±1.7) weeks, t=2.201, P=0.028) and lower birth weight ((798±255) vs. (1 003±240) g, t=4.030, P<0.01), compared to non-PH infants. Besides, duration of mechanical ventilation and non-invasive positive pressure ventilation were higher in PH group than that in non-PH group (14.3 (2.1, 43.7) vs. 0.5 (0, 4.7) d, Z=-4.553, P<0.01; 30.0 (22.5, 64.2) vs. 15.0 (7.0, 26.0) d, Z=-4.838, P<0.01). The proportions of maternal hypertension, small for gestational age (SGA), late onset sepsis, ventilator associated pneumonia, hemodynamically significant patent ductus arteriosus (hsPDA), patent ductus arteriosus (PDA) requiring ligation, severe BPD and severe extrauterine growth retardation (EUGR) were higher in PH group than those in non-PH group ((20.8% (5/24) vs. 6.4% (20/314), 33.3% (8/24) vs. 7.6% (24/314), 54.2% (13/24) vs. 7.3% (23/314), 25.0% (6/24) vs. 6.1% (19/314), 75.0% (18/24) vs. 39.2% (123/314), 45.8% (11/24) vs. 1.9% (6/314), 66.7% (16/24) vs. 7.3% (23/314), 75.0% (18/24) vs. 45.5% (143/314), all P<0.05). Multivariate logistic regression analysis showed that maternal hypertension ( OR=12.950, 95 %CI: 1.740-96.385), severe bronchopulmonary dysplasia ( OR=10.160, 95 %CI: 2.725-37.884), SGA ( OR=4.992, 95 %CI: 1.432-16.920), PDA requiring ligation ( OR=19.802, 95 %CI: 3.297-118.921), severe EUGR ( OR=20.316, 95 %CI: 2.221-185.853) were independent risk factors of BPD associated PH. In the 24 infants with PH, all 7 mild PH infants and 8 moderate PH infants survived, while 4 out of 9 severe PH infants died. Among the survivors, the longest duration of oxygen therapy was up to the corrected gestational age of 1 year and 2 months. Conclusions:PH is a severe complication of BPD, and associated with higher mortality and poor prognosis. Echocardiography screening and regular post-discharge follow up are recommended for BPD infants with risk factors of PH.

Objective To analyse the risk factors associated with spontaneous intestinal perforation (SIP) in extremely premature infants/extremely low birth weight infants. Method From January 2015 to December 2018, infants with gestational age (GA)<28 weeks or birth weight (BW)<1000 g admitted to our neonatal intensive care unit were enrolled to the retrospective nested case-control study.The clinical data of SIP infants (SIP group) and infants with the same GA but without SIP (control group) were randomly selected and compared. Multivariable Logistic regression was used to analyse the risk factors of SIP. Result A total of 409 extremely premature infants/extremely low birth weight infants were born during the study period. Among them, 25 SIP infants and 55 controls were enrolled. The incidence of SIP in infants with GA 22～25 weeks was 11.8％(16/136), which is higher than infants with GA 26～27 weeks (2.0％, 5/247) (χ2=16.057, P<0.001). The incidence of SIP in infants with BW 400～749 g was 13.0％(14/108), which is higher than infants with BW 750～999 g (3.4％, 8/236) (χ2=11.343, P=0.001). Multivariate Logistic regression analysis showed that twins (OR=4.153, 95％CI 1.392～12.384, P=0.011), umbilical veins catheterization (OR=15.942, 95％CI 1.026～247.789, P=0.048) and ibuprofen use within 3 days after birth (OR=15.387, 95％CI 1.519～155.883, P=0.021) were independent risk factors of SIP. Conclusion The smaller the GA and BW, the higher the incidence of SIP. Twins,umbilical veins catheterization and ibuprofen use early after birth may be independent risk factors of SIP.