Objective To investigate the effectiveness and safety of electroconvulsive therapy(ECT)in reducing suicidal ideation and depressive symptoms of major depressive disorder patients,as well as its effect on cognitive function.Methods A total of 160 adolescent patients with major depressive disorder were recruited for this study.The ECT group(n=81)received conventional antidepressant medication combined with 8 sessions of electroconvulsive therapy,and the control group(n=79)received conventional antidepressant medication only.Depressive symptoms,suicidal ideation,and cognitive functioning were assessed using 17-item Hamilton rating scale for depression(HAMD-17)and self-rating idea of suicide scale(SIOSS),at baseline(before ECT),after ECT,and at 2 and 6 weeks after treatment.The Montreal cognitive assessment(MoCA)was used to evaluate the cognitive function of the patients,and the patients were followed up for side effects such as dizziness and nausea.Results Generalized estimating equation(GEE)analysis of HAMD-17 and SIOSS scores showed significant group×time interaction effects(P<0.01).Both groups exhibited a reduction in HAMD-17 scores before and after treatment(scores at four time points:ECT group 24.59±4.56 vs.13.25±4.32 vs.6.20±1.95 vs.3.62±2.04,control group 23.48±3.66 vs.15.42±3.11 vs.10.10±2.05 vs.4.68±2.01;P<0.01).The mean difference in HAMD-17 scores before and after treatment was-9.62±3.13 in the ECT group,and was-8.16±1.71 in the control group.Additionally,suicidal ideation reduced in both groups after treatment(SIOSS scores at four time points:ECT group 18.57±2.85 vs.10.93±3.52 vs.8.02±2.79 vs.3.70±1.96,control group 18.97±3.03 vs.15.51±2.98 vs.11.11±2.18 vs.6.44±1.78;P<0.01).For cognitive function scores,there was no interaction between group and time(P=0.21),the difference in the change in MoCA scores at different follow-up time points was significant(P<0.01),and the difference in the change in MoCA scores between the two groups was not significant(P=0.05),and the cognitive functions of the two groups could be restored to the baseline level at 6 weeks after treatment.No severe side effects were reported in either group of patients during the study.Conclusions Our findings confirm that ECT is effective and safe for improving suicidal ideation and depressive symptoms in adolescents with major depressive disorder.The impairment of cognitive function by ECT in adolescent patients with major depressive disorder is reversible.

Objective To investigate the effectiveness and safety of electroconvulsive therapy(ECT)in reducing suicidal ideation and depressive symptoms of major depressive disorder patients,as well as its effect on cognitive function.Methods A total of 160 adolescent patients with major depressive disorder were recruited for this study.The ECT group(n=81)received conventional antidepressant medication combined with 8 sessions of electroconvulsive therapy,and the control group(n=79)received conventional antidepressant medication only.Depressive symptoms,suicidal ideation,and cognitive functioning were assessed using 17-item Hamilton rating scale for depression(HAMD-17)and self-rating idea of suicide scale(SIOSS),at baseline(before ECT),after ECT,and at 2 and 6 weeks after treatment.The Montreal cognitive assessment(MoCA)was used to evaluate the cognitive function of the patients,and the patients were followed up for side effects such as dizziness and nausea.Results Generalized estimating equation(GEE)analysis of HAMD-17 and SIOSS scores showed significant group×time interaction effects(P<0.01).Both groups exhibited a reduction in HAMD-17 scores before and after treatment(scores at four time points:ECT group 24.59±4.56 vs.13.25±4.32 vs.6.20±1.95 vs.3.62±2.04,control group 23.48±3.66 vs.15.42±3.11 vs.10.10±2.05 vs.4.68±2.01;P<0.01).The mean difference in HAMD-17 scores before and after treatment was-9.62±3.13 in the ECT group,and was-8.16±1.71 in the control group.Additionally,suicidal ideation reduced in both groups after treatment(SIOSS scores at four time points:ECT group 18.57±2.85 vs.10.93±3.52 vs.8.02±2.79 vs.3.70±1.96,control group 18.97±3.03 vs.15.51±2.98 vs.11.11±2.18 vs.6.44±1.78;P<0.01).For cognitive function scores,there was no interaction between group and time(P=0.21),the difference in the change in MoCA scores at different follow-up time points was significant(P<0.01),and the difference in the change in MoCA scores between the two groups was not significant(P=0.05),and the cognitive functions of the two groups could be restored to the baseline level at 6 weeks after treatment.No severe side effects were reported in either group of patients during the study.Conclusions Our findings confirm that ECT is effective and safe for improving suicidal ideation and depressive symptoms in adolescents with major depressive disorder.The impairment of cognitive function by ECT in adolescent patients with major depressive disorder is reversible.

Objective:To explore the epidemiological characteristics and spatiotemporal clustering of foodborne infection of Vibrio ( V.) parahaemolyticus in Ningbo, Zhejiang Province, from 2014 to 2022, and provide reference and evidence for the prevention and control of related diseases. Methods:The incidence data on of foodborne infection of V. parahaemolyticus in Ningbo from 2014 to 2022 were collected from Ningbo Foodborne Disease Surveillance System, and the case counts and the positive rates in different districts (counties, cities) were calculated. Spatial autocorrelation analysis and spatiotemporal scanning analysis were conducted to analyze the spatiotemporal clustering of the diseases. Results:A total of 1 822 cases of foodborne infection of V. parahaemolyticus were reported in Ningbo from 2014 to 2022, with an overall positive rate of 3.78%. Spatial autocorrelation analysis showed that the positive rate of foodborne infection of V. parahaemolyticus in Ningbo was unevenly distributed from 2014 to 2022, Ninghai was a high-high clustering area, while Zhenhai was a high-low clustering area, and Jiangbei was a low-low clustering area. The annual incidence was high during July-September. Spatiotemporal scanning analysis found one class Ⅰ spatiotemporal clustering area and three class Ⅱ spatiotemporal clustering areas, with the class Ⅰ spatiotemporal clustering area being observed in Jiangbei and Zhenhai from 2019 to 2022. Conclusions:Spatiotemporal clustering of foodborne infection of V. parahaemolyticus existed in Ningbo from 2014 to 2022, with an annual high incidence period from July to September. The key areas for the prevention and control of foodborne infection of V. parahaemolyticus are coastal districts (counties, cities) in Ningbo.

Objective To analyze the short-term clinical efficacy and prognosis of one-stop transcatheter aortic valve replacement (TAVR)+percutaneous coronary intervention (PCI) in the treatment of aortic valve disease with coronary heart disease. Methods The clinical data of patients with aortic valve disease complicated with coronary heart disease who underwent one-stop TAVR+PCI treatment at the Department of Cardiovascular Surgery, the Second Hospital of Hebei Medical University from January 2018 to June 2023 were retrospective analyzed. The preoperative and postoperative clinical data were compared, and 1-month follow-up results were recorded. Results A total of 37 patients were enrolled, including 22 males and 15 females, with an average age of 69.14±6.47 years. Thirty-six patients recovered and were discharged after the surgery, and 1 (2.7%) patient died during the surgery. Self-expanding TAVR valves were implanted through the femoral artery in all patients. One coronary artery was opened by PCI in 35 (94.6%) patients, and two coronary arteries were opened by PCI in 2 (5.4%) patients. All PCI opened arteries had a stenosis>70%. During the postoperative hospitalization, the complications included pulmonary infection in 11 (30.6%) patients, severe pneumonia in 10 (27.8%) patients, liver function injury in 14 (38.9%) patients, renal function injury in 5 (13.9%) patients, cerebral infarction in 1 (2.8%) patient, atrial fibrillation in 1 (2.8%) patient, ventricular premature beats in 2 (5.6%) patients, atrioventricular block in 2 (5.6%) patients, and complete left bundle branch block in 5 (13.9%) patients. The median postoperative ventilation assistance time was 12.0 (0.0, 17.0) h, the ICU monitoring time was 1.0 (0.0, 2.0) d, and the postoperative hospitalization time was 5.0 (4.0, 7.0) d. There was a significant improvement in the New York Heart Association cardiac function grading after surgery (P<0.001). After surgery, there were 21 (58.3%) patients had minor perivalve leakage, 6 (16.7%) patients had minor to moderate perivalve leakage, and no moderate or above degree of perivalve leakage. After one month of postoperative follow-up, 36 patients showed significant improvement in heart function. There were no patients with recurrent acute coronary syndrome, re-PCI, or cardiovascular system disease related re-hospitalization. Conclusion The one-stop TAVR+PCI treatment for patients with aortic valve disease and coronary heart disease can obtain satisfactory short-term clinical efficacy, which is worth further trying and studying.

Objective:To summarize the clinical experience in the diagnosis and treatment of abdominal pregnancy in the sac of lesser omentum after in vitro fertilization and embryo transfer (IVF-ET). Methods:A case of abdominal pregnancy in the sac of lesser omentum after IVF-ET was reported in detail and summarized, and its clinical characteristics were analyzed.Results:After two blastocysts were transplanted 23 d, the patient had a sudden left upper abdominal pain. Ultrasound showed no pregnancy sac in utero, left epigastric dysplasia echo, and a small amount of fluid in the abdominal cavity. Puncture of the posterior vaginal fornix was nonclotting, and there was a clear indication of laparoscopic exploration. After cleaning up the blood in the pelvic and abdominal, the gestational tissue of lesser omentum sac was cleared. The patient recovered well after surgery.Conclusion:Abdominal pregnancy in the sac of lesser omentum after IVF-ET is extremely rare and should be treated timely. Laparoscopic surgery is recommended to determinate abdominal pregnancy in the first trimester.

Objective:To summarize the clinical experience in the diagnosis and treatment of abdominal pregnancy in the sac of lesser omentum after in vitro fertilization and embryo transfer (IVF-ET). Methods:A case of abdominal pregnancy in the sac of lesser omentum after IVF-ET was reported in detail and summarized, and its clinical characteristics were analyzed.Results:After two blastocysts were transplanted 23 d, the patient had a sudden left upper abdominal pain. Ultrasound showed no pregnancy sac in utero, left epigastric dysplasia echo, and a small amount of fluid in the abdominal cavity. Puncture of the posterior vaginal fornix was nonclotting, and there was a clear indication of laparoscopic exploration. After cleaning up the blood in the pelvic and abdominal, the gestational tissue of lesser omentum sac was cleared. The patient recovered well after surgery.Conclusion:Abdominal pregnancy in the sac of lesser omentum after IVF-ET is extremely rare and should be treated timely. Laparoscopic surgery is recommended to determinate abdominal pregnancy in the first trimester.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Currently, there are insufficient sources of platelets for clinical transfusion, and there are risks of alloimmune reactions and transfusion-transmitted infections (TTI) after transfusion. In recent years, platelets derived from human induced pluripotent stem cells (hiPSCs) have become one of the hottest research topics in the transfusion community, and studies have shown that they have the potential to address the limitations of platelet transfusion and alleviate the conflict between platelet supply and demand in clinical settings. However, the efficiency of hiPSCs in producing functional platelets in vitro is still low, and the yield and quality are still far below clinical transfusion standards. In this review, the basis and applications related to hiPSCs-derived platelets, studies related to human leukocyte antigen (HLA) gene-silenced hiPSC-derived platelets, and challenges faced by hiPSCs-derived platelet products were reviewed, providing references for in-depth research and future clinical applications of hiPSCs-derived platelets.

Objective:To explore the possible correlation between allostatic load (AL) and clinical symptoms in patients with first-episode schizophrenia (FES) and AL influence upon the onset.Methods:Patients with FES (schizophrenia group, n=93) who received treatment at Beijing Huilongguan Hospital from October 2017 to July 2019 and the healthy controls (control group, n=111) recruited during the same period were enrolled in the research. Systolic blood pressure, diastolic blood pressure, resting heart rate, body mass index, waist-hip ratio, high-density lipoprotein cholesterol, total cholesterol, glycosylated hemoglobin, high-sensitivity C-reactive protein, 12-hour urine adrenaline, 12-hour urine norepinephrine, 12-hour urine cortisol, and serum dehydroepiandrosterone of all subjects were collected to calculate the AL index. The positive and negative symptom scale (PANSS) was used to assess the psychopathological symptoms of patients. Covariance analysis was used to compare the differences of AL index and the thirteen biological components between FES patients and controls. Pearson correlation analysis was used to explore the correlation between AL index and clinical symptoms, and the Logistic regression analysis was used to explore the risk factors of schizophrenia. Results:AL index among schizophrenic patients was higher than the controls (5.87±1.90 vs. 3.50±2.21, F=65.97, P<0.001). AL index was possitively correlated with PANSS positive symptoms ( r=0.25, P=0.019) and was a risk factor of schizophrenia ( OR=1.76, 95% CI: 1.47-2.11, P<0.01). Conclusions:The AL is possitively correlated with positive symptoms in the FES, and the higher AL may be one of important inducements to the schizophrenia onset.

Objective:To explore the possible correlation between allostatic load (AL) and clinical symptoms in patients with first-episode schizophrenia (FES) and AL influence upon the onset.Methods:Patients with FES (schizophrenia group, n=93) who received treatment at Beijing Huilongguan Hospital from October 2017 to July 2019 and the healthy controls (control group, n=111) recruited during the same period were enrolled in the research. Systolic blood pressure, diastolic blood pressure, resting heart rate, body mass index, waist-hip ratio, high-density lipoprotein cholesterol, total cholesterol, glycosylated hemoglobin, high-sensitivity C-reactive protein, 12-hour urine adrenaline, 12-hour urine norepinephrine, 12-hour urine cortisol, and serum dehydroepiandrosterone of all subjects were collected to calculate the AL index. The positive and negative symptom scale (PANSS) was used to assess the psychopathological symptoms of patients. Covariance analysis was used to compare the differences of AL index and the thirteen biological components between FES patients and controls. Pearson correlation analysis was used to explore the correlation between AL index and clinical symptoms, and the Logistic regression analysis was used to explore the risk factors of schizophrenia. Results:AL index among schizophrenic patients was higher than the controls (5.87±1.90 vs. 3.50±2.21, F=65.97, P<0.001). AL index was possitively correlated with PANSS positive symptoms ( r=0.25, P=0.019) and was a risk factor of schizophrenia ( OR=1.76, 95% CI: 1.47-2.11, P<0.01). Conclusions:The AL is possitively correlated with positive symptoms in the FES, and the higher AL may be one of important inducements to the schizophrenia onset.