Objective To understand the current situation of breastfeeding duration in children aged 0-5 years in Yunnan Province,and to explore the influencing factors of breastfeeding duration.Methods Using the data of the 6th National Health Service Survey in Yunnan Province,1582 children aged 0～5 years in Yunnan Province were selected as the research subjects,and the Kaplan-Meier method and Cox regression were used to analyze the influencing factors of breastfeeding duration.Results The mean duration of breastfeeding for children aged 0～5 years in Yunnan Province was 9.29 months,and region,time of complementary food addition,time of suckling and family income were the main factors influencing the duration of breastfeeding.Conclusion The duration of breastfeeding for children aged 0～5 years in Yunnan Province deviates significantly from the recommendations provided by both the World Health Organization(WHO)and China's child breastfeeding guidelines.Given the current situation,the relevant departments must enhance their focus on this issue.

Here, we report a previously unrecognized syndromic neurodevelopmental disorder associated with biallelic loss-of-function variants in the RBM42 gene. The patient is a 2-year-old female with severe central nervous system (CNS) abnormalities, hypotonia, hearing loss, congenital heart defects, and dysmorphic facial features. Familial whole-exome sequencing (WES) reveals that the patient has two compound heterozygous variants, c.304C>T (p.R102*) and c.1312G>A (p.A438T), in the RBM42 gene which encodes an integral component of splicing complex in the RNA-binding motif protein family. The p.A438T variant is in the RRM domain which impairs RBM42 protein stability in vivo. Additionally, p.A438T disrupts the interaction of RBM42 with hnRNP K, which is the causative gene for Au-Kline syndrome with overlapping disease characteristics seen in the index patient. The human R102* or A438T mutant protein failed to fully rescue the growth defects of RBM42 ortholog knockout ΔFgRbp1 in Fusarium while it was rescued by the wild-type (WT) human RBM42. A mouse model carrying Rbm42 compound heterozygous variants, c.280C>T (p.Q94*) and c.1306_1308delinsACA (p.A436T), demonstrated gross fetal developmental defects and most of the double mutant animals died by E13.5. RNA-seq data confirmed that Rbm42 was involved in neurological and myocardial functions with an essential role in alternative splicing (AS). Overall, we present clinical, genetic, and functional data to demonstrate that defects in RBM42 constitute the underlying etiology of a new neurodevelopmental disease which links the dysregulation of global AS to abnormal embryonic development.
Female ; Animals ; Mice ; Humans ; Child, Preschool ; Intellectual Disability/genetics* ; Heart Defects, Congenital/genetics* ; Facies ; Cleft Palate ; Muscle Hypotonia

This paper aims to focus on and implement strategies for preventing and resolving medical complaints and dis-putes at their emergence.The hospital promptly compiled a summary of the main problems and concerns reported from patients o-ver the past few years.It combined medical practices with the characteristics of admitted patients with severe diseases,complex treatment plans,and high risks.Since 2020,this hospital has been actively engaging with intractable high-risk patients and de-veloped a scheme that engaging clinical departments,medical management,and dispute management departments together to con-duct preoperative/pre-treatment communication.With a focus on patient management,this hospital upholds the concept of the pa-tient-centered humanistic philosophy in the process of doctor-patient communication to enhance the quality of communication.Consequently,the hospital has benefited from the communication scheme,achieving satisfactory effect in ensuring a solid medical safety and reducing the incidence of medical disputes.

Objective:To investigate the safety and efficacy of robot-guided ventricular partition puncture drainage in severe intraventricular hemorrhage.Methods:A total of 23 patients with severe intraventricular hemorrhage who underwent robot-guided ventricular partition puncture drainage (experimental group) and 19 patients who underwent robot-guided bilateral ventricular puncture drainage (control group) at Department of Neurosurgery, People's Hospital of Baise from January 2021 to December 2021 were included. The differences in residual hematoma volume within 24 h of surgery, drainage tube retention time, mortality rate within 30 d of surgery, incidence of complications (re-bleeding, intracranial infection, pulmonary infection, hydrocephalus) within 6 months of surgery, and scores of Glasgow coma scale (GCS), activity of daily living (ADL), and National Institutes of Health stroke scale (NIHSS) at 6 months after surgery were compared between the 2 groups.Results:Compared with the control group, the experimental group had significantly lower residual hematoma volume within 24 h of surgery ([8.854±3.519] mL vs. [5.668±2.873] mL), shorter drainage tube retention time ([6.580±1.981] d vs. [4.910±2.763] d), lower incidence of hydrocephalus within 6 months of surgery (42.105% vs. 8.696%), and significantly higher GCS and ADL scores and lower NIHSS scores at 6 months after surgery (8.790±2.898 vs. 11.610±2.948; 69.470±12.899 vs. 78.480±12.861; 13.950±5.265 vs. 9.870±4.124, P<0.05). Conclusion:Robot-guided ventricular partition puncture drainage is a safe and effective surgical method for severe intraventricular hemorrhage.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

Objective    To investigate the clinical effect of thoracoscopic lobectomy versus segmentectomy in the treatment of T1bN0M0 non-small cell lung cancer (NSCLC). Methods    Clinical data of 181 patients with T1bN0M0 NSCLC admitted to our hospital from 2012 to 2015 were retrospectively analyzed. They were divided into a lobectomy group and a segmentectomy group according to surgical methods. There were 117 patients in the lobectomy group (46 males and 71 females aged 61.32±8.94 years) and 64 patients in the segmentectomy group (20 males and 44 females aged 58.55±12.57 years). Perioperative indicators and prognosis were compared between the two groups. Results    The segmentectomy group had longer operation time, less intraoperative blood loss, shorter postoperative hospital stay and more preservation of lung function compared with the lobectomy group (P<0.05). The lobectomy group had higher consolidation tumor ratio, bigger tumor diameter, and more lymph node sampling compared with the segmentectomy group (P<0.05). There was no statistical difference in 5-year overall survival or recurrence-free survival between the two groups (P<0.05). Conclusion    For patients with T1bN0M0 NSCLC, thoracoscopic segmentectomy and lobectomy have similar prognosis, but segmentectomy has advantages with less injury and faster recovery over lobectomy.

OBJECTIVES: Neuropathic pain (NP) is a chronic pain caused by somatosensory neuropathy or disease, and genistein (Gen) might be a potential drug for the treatment of NP. Therefore, this study aims to investigate the effect of Gen on lipopolysaccharide (LPS)-induced inflammatory injury of dorsal root ganglion neuron (DRGn) in rats and the possible molecular mechanism. METHODS: The DRGn of 1-day-old juvenile rats were taken for isolation and culture. The DRGn in logarithmic growth phase were divided into a control group, a LPS group, a tubastatin hydrochloride (TSA)+LPS group, a Gen1+LPS group, a Gen2+LPS group, a Gen2+LPS+TSA group, a Gen2+pcDNA-histone deacetylase 6 (HDAC6)+LPS group, and a Gen2+pcDNA3.1+LPS group. The LPS group was treated with 1 μg/mL LPS for 24 h; the TSA+LPS group, the Gen1+LPS group, the Gen2+LPS group were treated with 5 μmol/L TSA, 5 μmol/L Gen, 10 μmol/L Gen respectively for 0.5 h, and then added 1 μg/mL LPS for 24 h; the Gen2+TSA+LPS group was treated with 10 μmol/L Gen and 5 μmol/L TSA for 0.5 h and then added 1 μg/mL LPS for 24 h; the Gen2+pcDNA-HDAC6+LPS group and the Gen2+pcDNA3.1+LPS group received 100 nmol/L pcDNA-HDAC6 and pcDNA3.1 plasmids respectively, and 24 h after transfection, 10 μmol/L Gen was pretreated for 0.5 h, and then added 1 μg/mL LPS for 24 h. Real-time RT-PCR was used to detect the HDAC6 mRNA expression in DRGn; CCK-8 method was used to detect cell viability of DRGn; flow cytometry was used to detect cell apoptosis of DRGn; ELISA was used to detect the levels of IL-1β, IL-6, and TNF-α in DRGn culture supernatant; Western blotting was used to detect the protein expression of HDAC6, Toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), and NF-κB p65 in DRGn. RESULTS: Compared with the control group, the expression levels of HDAC6 mRNA and protein, the expression levels of TLR4 and MyD88 protein in DRGn of LPS group rats were significantly up-regulated, the ratio of p-NF-κB p65/NF-κB p65 was significantly increased, and the activity of DRGn was significantly decreased, the apoptosis rate was significantly increased, and the levels of IL-1β, IL-6 and TNF-α in the DRGn culture supernatant were significantly increased (all P<0.05). Compared with the LPS group, the expression levels of HDAC6 mRNA and protein, TLR4 and MyD88 protein expression levels in DRGn of the TSA+LPS group, the Gen1+LPS group, the Gen2+LPS group and the Gen2+TSA+LPS group were significantly down-regulated, the ratio of p-NF-κB p65/NF-κB p65 was significantly decreased, the activity of DRGn was significantly increased, the apoptosis rate was significantly decreased, and the levels of IL-1β, IL-6 and TNF-α in the DRGn culture supernatant were significantly decreased (all P<0.05), and the above changes were most obvious in the Gen2+TSA+LPS group. Compared with the Gen2+LPS group, the expression levels of HDAC6 mRNA and protein, TLR4 and MyD88 protein expression levels in DRGn of the Gen2+pcDNA-HDAC6+LPS group were significantly up-regulated, the ratio of p-NF-κB p65/NF-κB p65 was significantly increased, the activity of DRGn was significantly decreased, and the apoptosis rate was significantly increased, and the levels of IL-1β, IL-6 and TNF-α in the DRGn culture supernatant were significantly increased (all P<0.05). CONCLUSIONS Gen can alleviate LPS-induced DRGn inflammatory injury in rats, which might be related to down-regulating the expression of HDAC6 and further inhibiting the activation of TLR4/MyD88/NF-κB signaling pathway.
Animals ; Ganglia, Spinal ; Genistein/pharmacology* ; Histone Deacetylase 6/metabolism* ; Interleukin-6/metabolism* ; Lipopolysaccharides ; Myeloid Differentiation Factor 88 ; NF-kappa B/metabolism* ; Neurons/metabolism* ; RNA, Messenger ; Rats ; Toll-Like Receptor 4/metabolism* ; Tumor Necrosis Factor-alpha/metabolism*

Objective:To explore the main factors of hypothyroidism after radiotherapy and to identify the optimal thyroid dosimetric parameters by analyzing the dosimetric parameters of the thyroid.Methods:The general clinical characteristics and dosimetric parameters of 206 patients with nasopharyngeal carcinoma treated in Cancer Hospital of University of Chinese Academy of Sciences were collected, and the correlation between them and the incidence of hypothyroidism was analyzed.Results:The incidence of hypothyroidism in patients with nasopharyngeal carcinoma after radiotherapy was 50.49%(104/206). Univariate analysis showed that gender, N-stage, volume, mean dose, V 20Gy, V 25Gy, V 30Gy, V 35Gy, V 40Gy, V 45Gy of thyroid were associated with the incidence of hypothyroidism. Multivariate analysis demonstrated that volume (≤12.82 cm 3) and mean dose of thyroid were the independent risk factors of hypothyroidism. Mean dose of thyroid combined with volume could significantly predict the incidence of hypothyroidism after radiotherapy. Conclusion:Mean dose of thyroid ≤ 47.21 Gy is the optimal dosimetric parameter for radiation-induced hypothyroidism, especially the patients with thyroid volume ≤ 12.82 cm 3 should pay more attention to the protection of thyroid gland during radiotherapy.

Objective:To seek any correlation of the ratio of knee flexor to knee extensor peak torque (H/Q) with the balance and walking ability of hemiplegic stroke survivors.Methods:Thirty stroke survivors with hemiplegia had the H/Q value of their knees measured at angular velocities of 60°/sec and 120°/sec using an isokinetic muscle strength test. Their motor control ability was assessed using the Pro-Kin balance test system, while their balance and walking were assessed using the Berg balance scale (BBS), the stand-to-walk timing test (TUGT) and the 10m walk test (10MWT). Any correlation was sought between the H/Q value of the affected knee, the test results, stability limits and offset index.Results:The average H/Q values of the affected knee joint at 60°/sec and 120°/sec were significantly lower than those of healthy joints. They were positively correlated with BBS scores and stability limits, and negatively correlated with TUGT and 10MWT times and with the offset indices.Conclusion:The H/Q value of the affected knee of a stroke survivor with hemiplegia predicts balance and walking ability. It may be a useful clinical indicator for evaluating their motor functioning.

Cryptococcal meningitis has become the largest cause for the death of infectious diseases in the central nervous system infectious disease worldwide. Most patients with cryptococcal meningitis have AIDS, autoimmune diseases, hematologic malignancies, and some other relevant diseases. It is mainly caused by infection with
Antiphospholipid Syndrome/complications* ; Cryptococcus neoformans ; Female ; HIV Infections ; Humans ; Meningitis, Cryptococcal/complications* ; Middle Aged ; Stroke