Objective:To investigate the causal impact of maternal smoking around birth(MSAB)on off-spring's risk of attention deficit hyperactivity disorder(ADHD),autism spectrum disorder(ASD),bipolar disorder(BD),and major depressive disorder(MDD).Methods:The datasets for MSAB and 4 psychiatric disorders were extracted from genome-wide association studies(GWAS).Mendelian randomization(MR)was employed,using in-verse variance weighting(IVW)as the primary analysis method.Sensitivity analyses and outlier correction were conducted using weighted median(WM),MR-Egger regression,and MR-PRESSO.The results were expressed as odds ratios(OR)and corrected for false discovery rate(FDR).Results:MR analysis showed significant causal re-lationships between MSAB and increased risk of ADHD(OR=5.36,95％CI=2.58-7.63,PFDR=0.003),MDD(OR=1.92,95％CI=1.29-2.88,PFDR=0.003),and BD(OR=6.33,95％CI=1.56-8.73,PFDR=0.013).However,no statistically significant association was found between MSAB and ASD(OR=1.66,95％CI=0.23-5.87,PFDR=0.616).Conclusion:This study suggests a potential causal link between maternal smoking around the time of birth and an increased risk of attention deficit hyperactivity disorder,bipolar disorder,and major depressive disorder in offspring.

Objective:To investigate the causal impact of maternal smoking around birth(MSAB)on off-spring's risk of attention deficit hyperactivity disorder(ADHD),autism spectrum disorder(ASD),bipolar disorder(BD),and major depressive disorder(MDD).Methods:The datasets for MSAB and 4 psychiatric disorders were extracted from genome-wide association studies(GWAS).Mendelian randomization(MR)was employed,using in-verse variance weighting(IVW)as the primary analysis method.Sensitivity analyses and outlier correction were conducted using weighted median(WM),MR-Egger regression,and MR-PRESSO.The results were expressed as odds ratios(OR)and corrected for false discovery rate(FDR).Results:MR analysis showed significant causal re-lationships between MSAB and increased risk of ADHD(OR=5.36,95％CI=2.58-7.63,PFDR=0.003),MDD(OR=1.92,95％CI=1.29-2.88,PFDR=0.003),and BD(OR=6.33,95％CI=1.56-8.73,PFDR=0.013).However,no statistically significant association was found between MSAB and ASD(OR=1.66,95％CI=0.23-5.87,PFDR=0.616).Conclusion:This study suggests a potential causal link between maternal smoking around the time of birth and an increased risk of attention deficit hyperactivity disorder,bipolar disorder,and major depressive disorder in offspring.

ObjectiveTo observe the therapeutic effect of BD-77 by nebulized inhalation on animal models of various respiratory viral infections and investigate the mechanism of broad-spectrum antiviral action of BD-77 using proteomics. MethodThe influenza virus H1N1/FM1 experiment used ICR mice and divided them into a normal group， model group， Tamiflu group， and BD-77 groups of 75 and 37.5 g·L^-1 for inhalation of 20 min and 25 min. Human coronavirus 229E and OC43 experiment divided the BALB/c mice into a normal group， model group， chloroquine phosphate group， and BD-77 groups of 75， 37.5， 18.75， and 9.375 g·L^-1， with 10 mice in each group. Influenza virus H1N1/FM1 and human coronaviruses 229E and OC43 infection-induced pneumonia models were used to detect mouse lung index， and real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the viral load in lung tissue. Enzyme-linked immunosorbent assay （ELISA） was used to detect related inflammatory factors in lung tissue， and proteomics analysis was performed on the lung tissue of OC43-infected mice. ResultCompared with that in the normal group， the lung index of mice in each infection group was significantly increased （P<0.01）， and viral nucleic acid could be detected in the lung tissue of mice infected with human coronaviruses 229E and OC43. The levels of interleukin-6 （IL-6）， IL-10， and tumor necrosis factor-α （TNF-α） in the lung tissue of mice infected with human coronavirus 229E were all significantly increased （P<0.01）. BD-77 could significantly reduce the lung index of mice infected with influenza virus H1N1/FM1 and human coronaviruses 229E and OC43 （P<0.05， P<0.01）， cut down the viral load in the lungs of mice infected with human coronaviruses 229E and OC43 （P<0.01）， and lower the contents of IL-6， IL-10， and TNF-α in the lung tissue of mice infected with human coronavirus 229E （P<0.01）. Proteomics analysis of the lung tissue of OC43-infected mice showed that BD-77 regulated the AMPK signaling pathway， TNF signaling pathway， NOD-like signaling pathway， IL-17 signaling pathway， Forkhead box protein O （FoxO） signaling pathway， transforming growth factor-β （TGF-β） signaling pathway， and other signaling pathways. ConclusionNebulized inhalation of BD-77 is effective in treating pneumonia caused by influenza virus H1N1/FM1 and human coronaviruses 229E and OC43 infection in mice and may exert its antiviral effects by regulating the balance of cellular metabolism， enhancing the immune function of the host， and attenuating inflammatory responses.

Objective:To evaluate the safety and feasibility of neoadjuvant chemotherapy (NACT) combined with radical surgery for elderly patients with locally advanced gastric cancer (LAGC).Methods:One hundred and fourty eight patients with LAGC after NACT and gastrectomy between 2012 and 2020 were retrospectively reviewed. They were divided into two groups: (1) <65 years old (111 cases) and (2) ≥65 years old (37 cases) and their clinicopathological and prognostic data were compared.Results:There was no significant difference between the two groups in the incidence of hematological complications such as anemia ( χ2=0.235, P=0.628), leukopenia ( χ2=0.613, P=0.434), neutropenia ( χ2=0.011, P=0.918) and thrombocytopenia ( χ2=0.253, P=0.615) and non-hematological complications such as nausea ( χ2=0.092, P=0.762), vomiting ( χ2=0.166, P=0.683), diarrhea ( χ2=0.015, P=0.902) and mucositis ( χ2=0.199, P=0.766) due to NACT. There were no statistical differences between the older patients and the younger in operation duration ( t=0.270, P=0.604), intraoperative bleeding ( t=1.140, P=0.250) and R 0 resection rate ( χ2=0.105, P=0.750). The incidence of postoperative complications was 25.2% and 37.8% in the younger patients and the olders ( χ2=2.172, P=0.141). Pleural effusion ( χ2=7.007, P=0.008) and pulmonary infection ( χ2=10.204, P=0.001) was significantly higher in the older patients than in the youngers. The 3-year progression-free survival rate ( t=0.494, P=0.482) and 3-year overall survival rate ( t=0.013, P=0.908) were comparable between the two groups. Conclusions:NACT combined with radical surgery is safe and effective in elderly patients with LAGC, except for higher perioperative pulmonary-related complications.

OBJECTIVE To assess the effect of medication therapy management(MTM) on symptom improvement and medication adherence in depressed female patients, and to explore the depression severity and adherence characteristics of female patients of different ages. METHODS A total of 180 female depressed patients from February 2022 to July 2022 were recruited and randomly divided into two groups according to age and depression severity: the control group and the management group,with 90 cases in each group. Patients in the control group were given conventional therapy, while those in the management group were given MTM on top of conventional therapy. The self-rating depression scale(SDS)was applied at enrollment and 3 months after treatment to assess symptom improvement in both groups, and the Morisky Medication Adherence Scale- 8(MMAS-8) was applied at the end of 4, 8 and 12 weeks of treatment to compare adherence differences between the two groups, and subgroup analysis was performed based on stratification factors. RESULTS A total of 147 patients completed all assessments and follow-up, and there was no statistically significant difference in drop-out rate between the control group and the management group(χ2=3.006, P=0.083). Patients who dropped-out with different depression severity were compared with those who did not, with a statistically significant difference(χ2=13.927, P=0.001). For the comparison of SDS scores by age group, the highest SDS scores before and after treatment were found in adolescence, followed by menopause, and the lowest in childbearing age, with statistically significant differences(P＜0.05). The SDS scores of each subgroup of different age groups and each subgroup of different depression severity in the management group were lower than those of the corresponding groups in the control group, with statistically significant differences except for the menopausal subgroup and the mild subgroup(P＜0.05). The overall compliance score of 176 patients was (5.69±1.37) points. In the full assessment the adherence scores were the highest in childbearing, followed by adolescence, and the lowest and the lowest in menopause, with statistically significant difference(χ2=6.61, P=0.037). The adherence scores of the different age groups were higher in the management group than those in the control group,with statistically significant differences in adolescence(χ2=25.573, P＜0.001), childbearing age(χ2=7.772, P=0.005)and menopause(χ2=19.776, P＜0.001) for the full assessment. Except for the 1st and 2nd follow-up in childbearing age, there were statistically significant differences between management group and control group at three age groups in the three follow-up visits(P＜0.05). CONCLUSION The depression severity in female depressed patients varies by age, with the heaviest in adolescence and the least severe in childbearing age. The overall level of medication adherence is low in female patients. The adherence is highest in childbearing age and lowest in menopause. MTM boasts to be effective in promoting symptom improvement and adherence in female depressed patients of different ages.

Objective:To identify the clinical factors associated with pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in locally advanced middle and low rectal cancer and establish a scoring system.Methods:In this retrospective analysis the clinical data of patients with locally advanced middle and low rectal cancer treated with nCRT combined with surgery at Union Hospital of Tongji Medical College, Huazhong University of Science and Technology from Jan 2016 to Jan 2020 were studied. Patients were divided into pCR group and non-pCR group. Single factor analysis and Logistic multivariate regression analysis were performed to explore pCR related factors after nCRT, and a pCR prediction scoring system was established.Results:The pCR was achieved in 33 patients (20.8%). Univariate analysis showed that the maximum thickness of the tumor≤25mm before nCRT ( P=0.046), concurrent oxaliplatin-combined intensive chemotherapy ( P=0.013), the NLR≤1.65 before nCRT ( P=0.004) and the serum CEA≤5 ng/ml before nCRT ( P=0.016) were significantly associated with pCR. In multivariate analysis, concurrent oxaliplatin-combined intensive chemotherapy, the NLR before nCRT and serum CEA before nCRT were independent related factors of pCR. The probability of pCR for patients with score of 0, 1, 2, and 3 was 42% (10/24), 30% (19/63), 5% (3/57) and 7% (1/15), respectively. The probability of pCR in patients with score≤1 point was 33% (29/87), and 6% (4/72) for score?1 point ( P?0.001). The area under the curve of the scoring system is 0.729 (95% CI: 0.638-0.820, P?0.001). Conclusions:Concurrent oxaliplatin-combined intensive chemotherapy, NLR≤1.65 before nCRT and serum CEA≤5 ng/ml before nCRT are independent predictors of pCR in locally advanced middle and low rectal cancer and the scoring system constructed in combination with above indicators can effectively predict pCR.

Objective:To evaluate the clinical outcomes of additional surgery after non-curative endoscopic submucosal dissection (ESD) for early gastric cancer.Methods:Sixty-nine patients with early gastric cancer who underwent ESD and were diagnosed as having non-curative resection by postoperative pathology at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2014 to December 2020 were included in the retrospective observation. Patients were divided into the additional surgery group ( n=12) and the follow-up group ( n=57). The differences in clinical and pathological data of the two groups, the surgical outcomes of the additional surgery group, three-year recurrence-free survival and tumor-specific survival of the two groups, and the independent risk factors affecting three-year recurrence-free survival in the follow-up group were analyzed. Results:Compared with the follow-up group, the rates of submucosal infiltration [66.7% (8/12) VS 21.1% (12/57), χ 2=7.927, P=0.005], vascular invasion [33.3% (4/12) VS 1.8% (1/57), P=0.003] and nerve invasion [16.7% (2/12) VS 0.0% (0/57), P=0.028] in the additional surgery group were significantly higher. In the additional surgery group, the interval between the additional surgery and ESD was 18.5 d (7-55 d), the surgical time was 286.4±85.9 min, and the number of dissected lymph nodes was 25.6±7.4. Four patients (33.3%) had residual tumor. Postoperative complications occurred in 4 patients (33.3%) (all were discharged after conservative treatment), and there was no perioperative death. One patient developed liver metastases 17 months after the surgery, and died 22 months after surgery due to liver metastases. One patient died 22 months after surgery due to non-tumor causes. The three-year recurrence-free survival and three-year tumor-specific survival in additional surgery group were 91.7% (11/12) and 91.7% (11/12), respectively, and those in the follow-up group were 87.7% (50/57) and 100.0% (57/57), respectively. Multivariate Cox regression analysis showed that tumor size ≥2 cm was an independent risk factor for three-year recurrence-free survival in the follow-up group ( P=0.037, HR=15.595, 95% CI: 1.181-205.952). Conclusion:Additional surgery and close follow-up are safe and feasible therapeutic strategies for early gastric cancer patients who underwent non-curative ESD. Clinicians should make reasonable choice based on the pathological results, patients' physical condition and surgery intention. But for patients with primary tumor size ≥2 cm, additional surgery is recommended.

Objective To investigate the differences between subjective and objective sleep quality in recurrent depressive patients and the correlative factors. Methods Thirty-two cases of recurrent depressive patients(the recurrent group) and 32 cases of first episode depressive patients(the control group)who met the inclusion were recruited in this study. The subjectivesleep quality ,mood and objective sleep quality of patients were estimated by Pittsburgh sleep quality index(PSQI),Hamilton anxiety Scale(HAMA),Hamilton depression Scale(HAMD),respectively. O ne whole-night polysomnography (PSG) was recorded. Results On subjec-tivesleep quality,the total sleep time was shorter,the sleep latency was longer,and the sleep efficiency was lower in the recurrent group compared with the control group. On objectivesleep quality ,the wake times were increased , the NREM1 phase was longer,the NREM2 phase was shorter,the RME phase was longer,the proportion of REM phase was increased,and the latency of REM phase was shorter in the recurrent group compared with the control group(P<0.05,respectively). There were significant differences between the subjective and objective sleep quali-ty in both groups,while the differences in the recurrent group were more significant(P < 0.01). In the recurrent group,thedifference of the total time between the subjective and objective sleep was positively correlated with PSQI score,the duration of disease and the number of attacks(P < 0.05),while,the differences of the sleep latency and sleep efficiency between the subjective and objective sleep were both positively correlated withPSQI score and the HAMA-14 score,respectively(P<0.05). Conclusion There was a significant difference between the subjec-tive and objective sleep quality of patients with recurrent depression ,and the differences were related to the course of disease,the number of attack,PSQI score and HAMA-14 score.

A hugh performance luquud chromatographuc ( HPLC) method was extablushed for determunatuon of the content of 7 polycycluc aromatuc hydrocarbons ( PAHs) un soul and earthworm samples based on accelerated solvent extractuon ( ASE) for extractuon and solud phase extractuon ( SPE) column for sample purufucatuon. In thus method, the samples were furst extracted by the muxed solutuon of n-hexane and acetone extractuon (4∶1, V/V) , and then purufued by SPE column ( suluca gel column for soul sample purufucatuon and Al2 O3-suluca gel column for earthworm sample purufucatuon ) , eluted by 10 mL of elutuon of n-hexane and duchloromethane (9∶1, V/V), and evaporated to dryness wuth rotary evaporator. After that, the pretreated samples were re-dussolved wuth acetonutrule to a constant volume, followed by a fultratuon wuth a 0. 22-μm organuc fulter membrane for the quantufucatuon by HPLC. The recoverues of the method for 7 PAHs were 83. 5%-110. 2% un soul samples and 81. 2%-97. 1% un earthworm samples. The detectuon lumuts of the method for 7 PAHs were 0. 15-0. 85 μg/kg. The method had good reproducubuluty and met the qualuty control requurements of sample analysus.

Objective To evaluate the effectiveness and prospect of innovative interactive follow-up mode for rehabilitation ofpostopera-tive breast cancer patietns in new medical environment. Methods The novel patient-centered medical care was promoted,and Pink Ribbon Clubs was established in different regions. Meanwhile,the patients’ self-support groups were formed, and a specialist for out-patients follow-up of outpatients by telephone or on the internet was arranged to provide psychological assessment,with timely and effective response. All data concerning to the follow-up were recorded and the patients were required to complete the relevant questionnaires. Results Compared with the same period in 2013,the follow-up rate was significantly increased to 80. 25%,and the patients showed higher satisfaction. The incidence of lymphedema in the patients was significantly reduced from 13% in 2013 to 7%. The quality of life was significantly improved and self-rat-ing score on depression was decreased from (51. 90 ± 8. 55) to (35. 81 ± 6. 21). Conclusion The kind of“Trinity” interactive mode is an effective follow-up mode with the clinical benefit in patients’ rehabilitation of physical and mental health,which is worthy of further applica-tion.