Objective:To compare the mid-term clinical effects of AngioJet rheolytic thrombectomy assisted catheter-directed thrombolysis (ART+CDT) with catheter-directed thrombolysis (CDT) in the treatment of acute deep venous thrombosis of lower extremities.Methods:Ninety-one patients admitted to the Department from Jan 2016 to Dec 2017 were placed with inferior vena cava filters and divided into ART+CDT group (30 cases)and CDT group (61 cases). Total urokinase dosge, thrombolytic time, operative cost, length of hospital stay, detumescence rate, thrombus clearance rate, cumulative patency rate of lower limb veins, Villalta score at 2 years and 5 years, thrombosis recurrence rate and chronic venous insufficiency quality of life questionnaire were compared between the two groups.Results:The success rate of surgery was 100% in both groups, there was no mortality. There were significant differences in the short-term postoperative outcomes between the two groups in terms of total dosage of urokinase, thrombolysis time, total cost of surgery, length of hospital stay, detumescence rate, venous patency scores before and after treatment, and venous patency rate (all P<0.05). For the mid- and long-term postoperative outcomes of 2 and 5 years, there were no significant differences in the incidence of PTS, recurrence rate of thrombus, chronic venous function scale, and cumulative patency rate at 2 years (all P>0.05). Conclusions:ART+CDT has a significant advantage over CDT alone in terms of early efficacy and early reopening of blood flow in patients. Both ART+CDT and CDT have a low incidence of PTS and a low recurrence rate of thrombus in the mid-term follow-up, and both have satisfactory performance in the mid- and long-term efficacy of interventional treatment of deep venous thrombosis of lower limbs.

Objective To investigate the epidemiological characteristics and mutation spectrum of monogenic diseases in Chinese population through a large-scale,multicenter carrier screening.Methods This study was conducted among a total of 33 104 participants(16 610 females)from 12 clinical centers across China.Carrier status for 223 genes was analyzed using high-throughput sequencing and different PCR methods.Results The overall combined carrier frequency was 55.58%for 197 autosomal genes and 1.84%for 26 X-linked genes in these participants.Among the 16 669 families,874 at-risk couples(5.24%)were identified.Specifically,584 couples(3.50%)were at risk for autosomal genes,306(1.84%)for X-linked genes,and 16 for both autosomal and X-linked genes.The most frequently detected autosomal at-risk genes included GJB2(autosomal recessive deafness type 1A,393 couples),HBA1/HBA2(α-thalassemia,36 couples),PAH(phenylketonuria,14 couples),and SMN1(spinal muscular atrophy,14 couples).The most frequently detected X-linked at-risk genes were G6PD(G6PD deficiency,236 couples),DMD(Duchenne muscular dystrophy,23 couples),and FMR1(fragile X syndrome,17 couples).After excluding GJB2 c.109G>A,the detection rate of at-risk couples was 3.91%(651/16 669),which was lowered to 1.72%(287/16 669)after further excluding G6PD.The theoretical incidence rate of severe monogenic birth defects was approximately 4.35‰(72.5/16 669).Screening for a battery of the top 22 most frequent genes in the at-risk couples could detect over 95%of at-risk couples,while screening for the top 54 genes further increased the detection rate to over 99%.Conclusion This study reveals the carrier frequencies of 223 monogenic genetic disorders in the Chinese population and provides evidence for carrier screening strategy development and panel design tailored to the Chinese population.In carrier testing,genetic counseling for specific genes or gene variants can be challenging,and the couples need to be informed of these difficulties before testing and provided with options for not screening these genes or gene variants.

Objective To investigate the epidemiological characteristics and mutation spectrum of monogenic diseases in Chinese population through a large-scale,multicenter carrier screening.Methods This study was conducted among a total of 33 104 participants(16 610 females)from 12 clinical centers across China.Carrier status for 223 genes was analyzed using high-throughput sequencing and different PCR methods.Results The overall combined carrier frequency was 55.58%for 197 autosomal genes and 1.84%for 26 X-linked genes in these participants.Among the 16 669 families,874 at-risk couples(5.24%)were identified.Specifically,584 couples(3.50%)were at risk for autosomal genes,306(1.84%)for X-linked genes,and 16 for both autosomal and X-linked genes.The most frequently detected autosomal at-risk genes included GJB2(autosomal recessive deafness type 1A,393 couples),HBA1/HBA2(α-thalassemia,36 couples),PAH(phenylketonuria,14 couples),and SMN1(spinal muscular atrophy,14 couples).The most frequently detected X-linked at-risk genes were G6PD(G6PD deficiency,236 couples),DMD(Duchenne muscular dystrophy,23 couples),and FMR1(fragile X syndrome,17 couples).After excluding GJB2 c.109G>A,the detection rate of at-risk couples was 3.91%(651/16 669),which was lowered to 1.72%(287/16 669)after further excluding G6PD.The theoretical incidence rate of severe monogenic birth defects was approximately 4.35‰(72.5/16 669).Screening for a battery of the top 22 most frequent genes in the at-risk couples could detect over 95%of at-risk couples,while screening for the top 54 genes further increased the detection rate to over 99%.Conclusion This study reveals the carrier frequencies of 223 monogenic genetic disorders in the Chinese population and provides evidence for carrier screening strategy development and panel design tailored to the Chinese population.In carrier testing,genetic counseling for specific genes or gene variants can be challenging,and the couples need to be informed of these difficulties before testing and provided with options for not screening these genes or gene variants.

Abstract Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.

Objective:To analyze the risk factors of postinflammatory hyperpigmentation (PIH) after laser in the treatment of acquired bilateral nevus of Ota-like macules (ABNOM).Methods:A retrospective study was conducted to follow up 120 patients with acquired bilateral nevus of Ota-like macules in the Department of Laser and Physiotherapy, Guangzhou Institute of Dermatology between January 2011 and December 2018, which accepted 1064-nm Q-switched neodymium: yttrium-aluminum-garnet laser treatment. The difference was analyzed between different age, sex, clinical classification, Fitzpatrick skin classification, ABNOM with melasma and postinflammatory pigmentation after laser treatment. Logistic regression was used to analyze the risk factors of postinflammatory hyperpigmentation after 1064-nm Q-switched neodymium: yttrium-aluminum-garnet laser treatment of acquired bilateral nevus of Ota-like macules.Results:Fifty-three ABNOM patients (44.17%) developed PIH after laser treatment. Univariate analysis showed that age, clinical classification, Fitzpatrick skin classification and the patients with both ABNOM and melasma all affected the occurrence of PIH after laser in the treatment of ABNOM, and the difference was statistically significant ( P<0.01). Logistic regression showed that older age, more severe clinical classification and the presence of ABNOM with melasma were the risk factors of PIH after treatment of ABNOM. Conclusions:ABNOM patients should be treated as early as possible. The risk of inducing PIH is great after laser treatment in patients with more severe clinical classification and patients with both ABNOM and melasma.

Objective: To understand the effect of pregnancyrelated anxiety on preschool childrens executive functions(EFs) and gender difference in order to optimize the early development environment of offspring life. Methods: This study was based on the ChinaAnhui Birth Cohort Study. Pregnant women from Maternal and Child Health Care Hospital in Maanshan, Anhui province between October 2008 and October 2010 were recruited. The general information of pregnant women and the pregnancyrelated anxiety were collected prospectively in the first trimester of pregnancy. A cohort of 3 556 children aged 3-5 were followed up and their basic characteristics were collected. Executive function of preschool children was assessed by Behavior Rating Inventory of Executive FunctionPreschool Version(BRIEF) (parent version). Results: In boys, compared with the control group, pregnancyrelated anxiety in the first trimester of pregnancy was associated with the risk of abnormality in working memory, planning/organization and GEC[OR(95%CI)=1.40(1.06-1.85), 1.64(1.06-2.54), 1.89(1.27-2.82)]. Anxiety in the both trimesters of pregnancy was associated with the risk of abnormality in inhibition, working memory, planning/organization and GEC[OR(95%CI)=2.60(1.45-4.67), 2.45(1.69-3.57), 2.23(1.28-3.88), 3.27(2.03-5.28)]. In girls, pregnancyrelated anxiety in the first trimester of pregnancy was associated with the risk of abnormality in inhibition and working memory[OR(95%CI)=1.79(1.13-2.83), 1.45(1.07-1.98)]. Anxiety in the third trimester of pregnancy was associated with the risk of abnormality in inhibition[OR(95%CI)=2.26(1.17-4.38)]. Anxiety in both trimesters of pregnancy was associated with the risk of abnormality in inhibition and working memory[OR(95%CI)=2.45(1.40-4.28), 2.02(1.35-3.01)]. Conclusion Pregnancyrelated anxiety significantly affected the executive function of preschool children, and there was a significant doseresponse relationship. Pregnancyrelated anxiety primarily affects working memory, planning/organization and GEC function in boys, and the working memory, inhibition function in girls.

Objective:To investigate the relationship between pregnancy-related anxiety and executive function in preschool children.Methods:From October 2008 to October 2010, pregnant women and live births were enrolled in the study. The expectant pregnant women and their live singleton fetuses were recruited from the antenatal care clinic of Ma'anshan maternal and Child Health Care Hospital. The cohort was followed up from April 2014 to June 2015. A total of 3 556 pairs of maternal and child were included in the final analysis. The questionnaire was used to collect the relevant information of pregnant women and the follow-up data of children. Pregnancy-related anxiety was assessed by using the Pregnancy-Related Anxiety Questionnaire, and the executive function of preschool children was assessed by using the Behavior Rating Inventory of Executive Function-Preschool (BRIEF) (Parent Version). Bi-nominal logistic regression was used to analyze the effect of pregnancy-related anxiety on executive function in preschool children.Results:The average age of 3 556 pregnant women was (26.78±3.42) years old, and the average age of preschool children was (4.32±0.46) years old. The proportion of primipara, only child and urban children was 94.96% (3 375/3 556), 91.37% (3 249/3 556) and 88.98% (3 164/3 556), respectively. The prevalence of pregnancy-related anxiety in the 1 st and 3 rd trimester was 17.60% (626/3 556) and 6.30% (224/3 556) respectively. The prevalence of abnormal global executive composite was 8.54% (304/3 556). The prevalence of anxiety in both trimesters was 7.68% (273/3 556). After controlling for confounding factors such as monthly family income, education years of parents, maternal age, pre-pregnancy weight, previous adverse pregnant outcomes, number of pregnancy, pregnant complications, the main residence of the children in the past six months, and Z score of birth weight, compared with the group without pregnancy-related anxiety in either 1 st or 3 rd trimester, pregnancy-related anxiety in the 1 st trimester increased the risk of preschool children's abnormality in inhibition, working memory, planning/organization and global executive composite, and the OR (95% CI) value was 1.52 (1.08-2.13), 1.41 (1.14-1.74), 1.62 (1.13-2.33), and 1.60 (1.18- 2.17), respectively. Anxiety in the 3 rd trimester increased the risk of children's abnormality in inhibition and global executive composite, and the OR (95% CI) value was 1.90 (1.15-3.12) and 1.69(1.05-2.71). Pregnancy-related anxiety in both trimesters increased the risk of abnormality in inhibition, working memory, planning/organization, and global executive composite in preschool children, and the OR (95% CI) value was 2.41 (1.61-3.62), 2.19 (1.66-2.88), 1.80 (1.11-2.92), and 2.41 (1.65-3.52), respectively. Conclusion:The exposure to pregnancy-related anxiety during pregnancy increases the risk of executive dysfunction in preschool children.

Objective:To investigate the relationship between pregnancy-related anxiety and executive function in preschool children.Methods:From October 2008 to October 2010, pregnant women and live births were enrolled in the study. The expectant pregnant women and their live singleton fetuses were recruited from the antenatal care clinic of Ma'anshan maternal and Child Health Care Hospital. The cohort was followed up from April 2014 to June 2015. A total of 3 556 pairs of maternal and child were included in the final analysis. The questionnaire was used to collect the relevant information of pregnant women and the follow-up data of children. Pregnancy-related anxiety was assessed by using the Pregnancy-Related Anxiety Questionnaire, and the executive function of preschool children was assessed by using the Behavior Rating Inventory of Executive Function-Preschool (BRIEF) (Parent Version). Bi-nominal logistic regression was used to analyze the effect of pregnancy-related anxiety on executive function in preschool children.Results:The average age of 3 556 pregnant women was (26.78±3.42) years old, and the average age of preschool children was (4.32±0.46) years old. The proportion of primipara, only child and urban children was 94.96% (3 375/3 556), 91.37% (3 249/3 556) and 88.98% (3 164/3 556), respectively. The prevalence of pregnancy-related anxiety in the 1 st and 3 rd trimester was 17.60% (626/3 556) and 6.30% (224/3 556) respectively. The prevalence of abnormal global executive composite was 8.54% (304/3 556). The prevalence of anxiety in both trimesters was 7.68% (273/3 556). After controlling for confounding factors such as monthly family income, education years of parents, maternal age, pre-pregnancy weight, previous adverse pregnant outcomes, number of pregnancy, pregnant complications, the main residence of the children in the past six months, and Z score of birth weight, compared with the group without pregnancy-related anxiety in either 1 st or 3 rd trimester, pregnancy-related anxiety in the 1 st trimester increased the risk of preschool children's abnormality in inhibition, working memory, planning/organization and global executive composite, and the OR (95% CI) value was 1.52 (1.08-2.13), 1.41 (1.14-1.74), 1.62 (1.13-2.33), and 1.60 (1.18- 2.17), respectively. Anxiety in the 3 rd trimester increased the risk of children's abnormality in inhibition and global executive composite, and the OR (95% CI) value was 1.90 (1.15-3.12) and 1.69(1.05-2.71). Pregnancy-related anxiety in both trimesters increased the risk of abnormality in inhibition, working memory, planning/organization, and global executive composite in preschool children, and the OR (95% CI) value was 2.41 (1.61-3.62), 2.19 (1.66-2.88), 1.80 (1.11-2.92), and 2.41 (1.65-3.52), respectively. Conclusion:The exposure to pregnancy-related anxiety during pregnancy increases the risk of executive dysfunction in preschool children.

Objective: To analyze the correlation between elective cesarean delivery and duration of breastfeeding in Ma′anshan city from 2013 to 2014. Methods: From May 2013 to September 2014, a total of 3 474 pregnant women with the first prenatal checkup were recruited from Ma′anshan maternal and child health care hospital. Finally, 3 109 pregnant women were included after exclusion of those with terminated pregnancies, adverse birth outcomes, twin or multiple pregnancies, breech traction, breech midwifery and loss of delivery information. Demographic data of pregnant women, mode of delivery and breast feeding of children were collected through questionnaires and hospital records. Logistic regression model was used to analyze the relationship between elective cesarean delivery and duration of breastfeeding in children, with the mode of delivery as independent variable and the duration of breastfeeding as dependent variable. Results: The age of 3 109 subjects was (26.6±3.6) years old, the rate of vaginal delivery was 51.1% (1 589), and the rate of elective cesarean delivery was 46.4% (1 443), among which the rate of non-indicative elective cesarean delivery was 26.4% (820), the rate of indicative elective cesarean delivery was 20.0% (623), and the rate of emergency cesarean delivery was 2.5% (77). The proportion of breastfeeding lasting until 4, 12 and 18 months was 45.0% (1 348/2 998), 23.7% (702/2 962) and 5.2% (154/2 944), respectively. After adjusting the confounding factors, compared with vaginal delivery, the OR (95%CI) values of breastfeeding for 4 months in indicative elective cesarean delivery and non-indicative elective cesarean delivery women were 0.870(0.714-1.059), 0.795(0.665-0.949), and the OR (95%CI) values of breastfeeding for 12 months were 0.772(0.611-0.975), 0.755(0.610-0.934), respectively. Conclusion Elective cesarean delivery may result in shorter duration of breastfeeding in children.

Objective: To observe the incidence of intensive care unit-acquired weakness (ICU-AW) of mechanically ventilated patients, and to identify the relevant risk factors. Methods: A prospective cohort study was conducted. The patients admitted to intensive care unit (ICU) of Fuxing Hospital, Capital Medical University, aged 18 years old or older, with the duration of mechanical ventilation ≥ 24 hours and expected to stay in ICU for ≥ 7 days from May 2015 to January 2016 were enrolled. From the 7th day after ICU admission, the patients were evaluated for consciousness every day. If the patient was awake and could cooperate with muscle strength measurement, the day was recorded as T1, and the patient's muscle strength was measured using the Medical Research Council scale (MRC) and recorded, then all patients were divided into two groups according to MRC score, ICU-AW group (MRC score < 48) and non-ICU-AW group (MRC score ≥ 48). The death, transfer or the 28th day of ICU admission were regarded as the end of observation. The data from the first day of ICU admission to T1 (before T1), including metabolic factors (the lowest value of blood sodium, blood potassium, blood calcium, albumin, and the highest value of blood glucose), mechanical ventilation factors (mode and duration of mechanical ventilation), organ dysfunction factors [occurrence and duration of sepsis, multiple organ dysfunction syndrome (MODS)], and drug factors (whether the patients used aminoglycoside, sedative, muscle relaxant or glucocorticoids, etc., the time of these drugs usage and the cumulative dose) of the patients were observed, recorded and analyzed, as well as the data from T1 to the end of the observation period, including the duration of mechanical ventilation, incidence of ventilator associated pneumonia (VAP), 28-day mortality, the length of ICU stay, and the cost of ICU and hospitalization. The relevant factors with statistical significance in univariate analysis were enrolled in multivariate analysis, and Logistic regression equation was established to screen the independent risk factors that might lead to ICU-AW. Results: 486 patients with mechanical ventilation were enrolled in this study, and 37 patients were enrolled according to the inclusion and exclusion criteria, including 15 patients with ICU-AW (with ICU-AW incidence of 40.5%) and 22 patients without ICU-AW. In the univariate analysis, ICU-AW group patients showed statistical differences in following factors as compared with the non-ICU-AW group: age, and the duration of invasive ventilation and the total duration of mechanical ventilation, braking time, sepsis, MODS and duration of them, the usage days and dosage of sedative and glucocorticoid before T1. The total duration of mechanical ventilation from T1 to the end of the observation period, total duration of mechanical ventilation during the observation period, and length of ICU stay of the ICU-AW group were significantly longer than those of the non-ICU-AW group [hours: 190 (110, 274) vs. 4 (0, 57), hours: 337 (237, 477) vs. 78 (43, 170), days: 20±7 vs. 14±7, all P < 0.05], the incidence of VAP, 28-day mortality and total hospitalization expenses were significantly higher than those of the non-ICU-AW group [26.7% (4/15) vs. 0% (0/22), 53.3% (8/15) vs. 9.1% (2/22), 10 thousands Yuan: 18.7±7.7 vs. 12.1±10.8, all P < 0.05]. Multivariate Logistic regression analysis showed that the total duration of mechanical ventilation between the patient awake and ICU admission [odds ratio (OR) = 1.03, 95% confidence interval (95%CI) was 1.01-1.05, P = 0.011] and the duration of MODS (OR = 1.79, 95%CI was 1.17-2.72, P = 0.007) were the independent risk factors for ICU-AW in mechanically ventilated patients. Conclusions ICU-AW is quite common in patients with mechanical ventilation and has a higher incidence. The risk factors associated with ICU-AW were the total duration of mechanical ventilation and duration of MODS.