Objective To explore the influencing factors of self injury or suicide in adolescent patients with depression.Methods A total of 96 adolescents who were diagnosed with depressive disorder at Yunnan Psychiatirc Hospital and Kunming Psychiatirc Hospital from January 2023 to May 2024 were selected for the study.The case group consisted of 61 adolescents who had self-injury or suicidal behaviors within 30 days,while the control group consisted of 35 adolescents who had no self-injury or suicidal behaviors within at least 30 days.Assessments were performed using the Patient Health Questionnaire-9(PHQ-9),Millon Screening Inventory for Borderline Personality Disorder(MSI-BPD),House-Tree-Person Drawing Test(HTP),and the Columbia Suicide Severity Rating Scale(C-SSRS).Among these,72 subjects underwent skin pressure pain threshold testing using the Algometer HP-50,with 12 in the self-harm or suicide group within 2 days and 60 in the group beyond 2 days.Results(1)Analysis of gender and age between the two groups showed statistically significant differences(P<0.05),with a higher proportion of females and younger ages in the 30-day group;(2)The PHQ-9 score for the 30-day group was(19.59±5.99),with a score of(2.41±0.97)for item 9("Thoughts that it would be better to be dead or to hurt oneself in some way"),and an MSI-BPD score of(7.43±1.61).The scores for the group over 30 days were(10.89±7.99),(1.00±1.11)for item 9,and(5.40±3.13)for MSI-BPD.Independent samples t-test analysis showed significant differences(P<0.01);(3)In the 30-day group,five drawing characteristics from the 47 HTP characteristics(shift of center of gravity,hair not disheveled or no hair,no mountains,no sun,and no flowers or grass)were found to occur at a higher rate,with statistical significance(P<0.05);(4)In the binary logistic regression analysis of 96 patients with the 30-day suicide or self-injury behavior as the dependent variable,the absence of flowers and PHQ-9 question 9 score are the risk factors for adolescent depression patients to have self-injury or suicide behavior within 30 days(OR no flowers=7.934,OR score on PHQ-9 question 9=3.554).(5)Among the 72 subjects the skin pressure pain threshold for adolescents who exhibited self-injure or suicide behaviors within 2 days(8.83±4.27 N)was significantly higher than that for patients beyond 2 days(6.48±3.00 N),with statistical significance(t=-2.201,P<0.05).Additionally,the score for item 9 of the PHQ-9 was higher(2.50±0.67 vs 1.87±0.95),also showing statistical significance(t=-2.201,P<0.05).Conclusion The absence of flowers or grass in HTP painting,and stronger suicidal ideation or suicide attempt are risk factors for self-injury or suicidal behavior in adolescents with depression.Furthermore,those who self-injure or commit suicide within 2 days have a higher pain threshold compared to those beyond 2 days.

Objective:To investigate the feasibility of transcatheter edge-to-edge repair (TEER) using a short-clip strategy for patients with moderate-to-severe or greater degenerative mitral regurgitation caused by commissural prolapse.Methods:This retrospective study included patients with severe mitral regurgitation secondary to commissural prolapse who underwent TEER at the Second Affiliated Hospital of Zhejiang University School of Medicine between September 2022 and July 2024. Preoperative clinical and imaging data, intraoperative details, procedural outcomes, and 1-month postoperative follow-up results were collected.Results:A total of 19 patients were enrolled, aged (74.1±6.1) years, including 12 males. Among them, 10 patients had external commissural prolapse, and 9 patients had internal commissural prolapse. Preoperatively, all patients exhibited severe mitral regurgitation (4+), with an effective regurgitant orifice area of (0.55±0.17) cm2, left atrial volume of (104.77±36.57) ml, left ventricular end-diastolic volume of (102.29±32.47) ml, left ventricular end-diastolic dimension of (5.34±0.59) mm, and prolapse width of (1.18±0.34) cm. All procedures utilized short clips (NTR or NTW clips) to target the prolapsed commissural region and were completed successfully without intraoperative complications. At 1-month follow-up, no mortality, stroke, single-leaflet device attachment, myocardial infarction, or unplanned mitral reintervention occurred. Mitral regurgitation severity improved to ≤2+ in all patients, with left atrial volume of (74.49±33.83) ml, left ventricular end-diastolic volume of (85.90±18.05) ml, and left ventricular end-diastolic dimension of (4.93±0.37) mm (all P<0.05). Conclusion:The short-clip strategy, focusing on precise clip placement at the commissural interface, is feasible and effective for TEER in patients with severe mitral regurgitation due to commissural prolapse.

Objective:To investigate the feasibility of transcatheter edge-to-edge repair (TEER) using a short-clip strategy for patients with moderate-to-severe or greater degenerative mitral regurgitation caused by commissural prolapse.Methods:This retrospective study included patients with severe mitral regurgitation secondary to commissural prolapse who underwent TEER at the Second Affiliated Hospital of Zhejiang University School of Medicine between September 2022 and July 2024. Preoperative clinical and imaging data, intraoperative details, procedural outcomes, and 1-month postoperative follow-up results were collected.Results:A total of 19 patients were enrolled, aged (74.1±6.1) years, including 12 males. Among them, 10 patients had external commissural prolapse, and 9 patients had internal commissural prolapse. Preoperatively, all patients exhibited severe mitral regurgitation (4+), with an effective regurgitant orifice area of (0.55±0.17) cm2, left atrial volume of (104.77±36.57) ml, left ventricular end-diastolic volume of (102.29±32.47) ml, left ventricular end-diastolic dimension of (5.34±0.59) mm, and prolapse width of (1.18±0.34) cm. All procedures utilized short clips (NTR or NTW clips) to target the prolapsed commissural region and were completed successfully without intraoperative complications. At 1-month follow-up, no mortality, stroke, single-leaflet device attachment, myocardial infarction, or unplanned mitral reintervention occurred. Mitral regurgitation severity improved to ≤2+ in all patients, with left atrial volume of (74.49±33.83) ml, left ventricular end-diastolic volume of (85.90±18.05) ml, and left ventricular end-diastolic dimension of (4.93±0.37) mm (all P<0.05). Conclusion:The short-clip strategy, focusing on precise clip placement at the commissural interface, is feasible and effective for TEER in patients with severe mitral regurgitation due to commissural prolapse.

【Objective】 To investigate the safety and effectiveness of suctioning flexible ureteroscopy with intelligent pressure-control at different times after drainage for patients with urogenic sepsis complicated with upper urinary tract stones. 【Methods】 Clinical data of 59 patients treated in the Department of Urology, Affiliated Hospital of Nantong University during May 2022 and May 2023 were collected.The patients were divided into early lithotripsy (≤1 week) group (n=27) and late lithotripsy (>1 week) group (n=32).Baseline data, imaging data and postoperative data of the two groups were compared. 【Results】 There were no significant differences between the two groups in the stone-free rate, total incidence of complications, incidence of high-grade complications, length of stay after lithotripsy, hospitalization costs after lithotripsy and total hospitalization costs (P>0.05). 【Conclusion】 Both early lithotripsy (<1 week) and late lithotripsy (>1 week) are safe and effective in the treatment of urogenic sepsis after drainage.

Objective Based on the acupuncture literature data set,a named entity recognition method of acupuncture literature based on dictionary and deep learning model is proposed to improve the effect of acupuncture literature entity recognition.Methods In this paper,the entity recognition methods of acupuncture literature were explored,and the vector representation effects based on word2vec and ALBERTmodels and ALBERT+domain dictionary were compared.On this basis,a named entity extraction method combining domain dictionary and ALBERT-BiLSTM-CRF deep learning model was proposed.Results According to the extraction effect of three model entities,the P value of word2vec-BiLSTM-CRF is 81.82%,the R value is 70.76%,and the F1 value is 75.48%;ALBERT-BiLSTM-CRF has an P value of 83.10%,a R value of 81.14%and a F1 value of 81.98%."ALBERT-BiLSTM-CRF+dictionary"is 92.57%,91.42%and 91.85%.In terms of entity categories,the top three entities with the highest accuracy rate are acupuncture,needling and needling site,which are 98%,ninety-seven percent and ninety-seven percent respectively,while the three entities with the lowest accuracy rate are acupoint matching corresponding symptoms,disease names and sample size,which are 50.00%,50.68%and 52.43%respectively.Conclusion Compared with the original ALBERT-BiLSTM-CRF model,the precision rate,recall rate and F1 value increased after adding the dictionary,and the convergence speed of the model after adding the dictionary was twice that without adding the dictionary.It is effective to use"ALBERT-BiLSTM-CRF+dictionary"model to identify named entities in acupuncture literature.

Objective:This study evaluates the agreement between a new low-load sleep monitoring system, QSA600, based on millimeter-wave radar technology, and polysomnography (PSG) in diagnosing obstructive sleep apnea (OSA).Methods:A total of 155 subjects were recruited for a parallel agreement study in the sleep laboratory of the Department of Otorhinolaryngology Head and Neck Surgery at Shanghai Sixth People′s Hospital from July to September 2023. The subjects underwent simultaneous monitoring with both PSG and the QSA600 system. One hundred and forty-five subjects consisting of 75 males and 70 females included in the final analysis, with an average age of (35.30±12.41) years, an average height of (168.23±8.08) cm, and an average weight of (68.28±13.74) kg. The subjects were divided into four groups based on the apnea-hypopnea index (AHI): <5.0 events/h (non-OSA group, 39 cases), ≥5.0-<15.0 events/h (mild OSA group, 47 cases), ≥15.0-<30.0 events/h (moderate OSA group, 25 cases), and≥30.0 events/h (severe OSA group, 34 cases). Intraclass correlation coefficients (ICC), Pearson correlation coefficients ( r), and Bland-Altman analysis were employed to assess the agreement between the two monitoring techniques regarding AHI and other parameters. Sensitivity and specificity of the QSA600 in diagnosing OSA were evaluated at different AHI thresholds. Statistical analyses were conducted using MATLAB R2022a. Results:Using AHI 5 events/h, 15 events/h and 30 events/h as thresholds, the sensitivity for diagnosing mild, moderate, and severe OSA was 88.68%, 89.83% and 97.06%, respectively. The specificity was 94.87%, 98.84% and 99.10%, respectively. The areas under the receiver operating characteristic (ROC) curve was 0.973 4, 0.990 9 and 0.999 5, respectively. The comparison of key indicators between QSA600 and PSG diagnostic results revealed:a Pearson correlation coefficient of 0.987 2( P<0.001) between the AHI measurement values. The mean difference between the Bland-Altman measurement values of the two was -1.43(95% CI:-8.74-5.88) events/h and the ICC between the two was 0.985 0(95% CI: 0.975 4-0.990 4). Conclusions:As a new low-load sleep monitoring system, QSA600 demonstrates high concordance with traditional PSG in diagnosing OSA and stratifying its severity, which has promising potential for clinical application. (Clinical trial registration number: NCT06038006)

Objective:To analyze the association between the pre-pregnancy oral microbiota of women and fetal overgrowth, and the possible mechanisms involved.Methods:A nested case-control study design based on a pre-pregnancy cohort was used to select 51 mothers who delivered macrosomia and/or large-for-gestational-age (LGA) infants from the population recruited at the Maternal and Child Health Care Hospital of Jiading District in Shanghai from October 2016 to December 2021 as the case group. A control group was formed by selecting 204 mothers who delivered infants with normal birth weight and appropriate for gestational age during the same period, in a 1:4 ratio. The LGA subgroup consisted of 48 mothers who delivered LGA infants from the total population, and a corresponding control group of 192 was randomly selected from the remaining mothers who delivered non-LGA infants in a 1∶4 ratio for the LGA subgroup analysis. The 16S rRNA gene sequencing technique was utilized to detect pre-pregnancy saliva samples to compare the characteristics of the oral microbiota, differential microorganisms, and differential functional pathways between groups. Nonparametric Wilcoxon rank-sum tests, two independent samples t-tests, or Chi-square (or Fisher's exact) tests were used for statistical analysis. Factor analysis was conducted on the pre-pregnancy diet data of women, and the primary dietary pattern of each study subject was identified based on the highest score of the dietary pattern factors. For microbiota count data, α and β diversity indices were calculated using R and QIIME2 software, and the corresponding microbiota functional count data were acquired through PICRUSt2. Results:(1) General data: There was no significant difference in the time interval from pre-pregnancy sampling to pregnancy and from sampling to delivery between the two groups. In the case group, there were three cases of macrosomia and 48 cases (94.1%) of LGA. The corresponding control group for the LGA subgroup consisted of 192 cases. There were no significant differences in dietary patterns between the case group and the control group. (2) α diversity analysis: The species richness index of the case group was lower than that of the control group [(367.27±84.57) vs. (408.71±93.08), multivariate analysis, P=0.009], while no significant differences were found between the two groups in the Shannon and Simpson indices; the species richness index of the LGA subgroup was also lower than that of the corresponding control group [(371.04±83.92) vs. (408.04±94.21), multivariate analysis, P=0.033], with no significant differences in the Shannon and Simpson indices. (3) β diversity analysis: There was a statistically significant difference in the unweighted UniFrac distance of the oral microbiota between the case group and the control group ( R2=0.006, F=1.479, P=0.048). No significant differences were found in the β diversity indices of the oral microbiota between the LGA subgroup and the corresponding control group. (4) Differential microbiota analysis: There were 14 differential microbiotas from phylum to genus between the case group and the control group. At the genus level, members of the G1 genus of the Streptococcaceae were enriched in the case group, while the Lautropia, Dialister, Leptotrichia, and Rothia were enriched in the control group. In the LGA subgroup and its corresponding control group, there were 14 differential microbiota from phylum to genus; at the genus level, Leptotrichia, Rothia, G6 genus of the Saccharibacteria, and Selenomonas were enriched in the control group (all LDA value>2, and all P<0.05). (5) Differential functional analysis: In the case group, metabolic pathways such as nicotinate degradation [log 2 fold change ( FC)=3.510, q=0.005], de novo synthesis of pyrimidine nucleotides (log 2FC=0.078, q=0.005), and L-tyrosine degradation pathway (log 2FC=0.710, q=0.034) were enriched in the oral microbiota of women. In the LGA subgroup, compared to the corresponding control group, metabolic pathways related to nicotinate degradation were enriched in the oral microbiota (log 2FC=3.660, q=0.012). Conclusions:There are differences in the structure of the pre-pregnancy oral microbiota of mothers with overgrown fetuses compared to those with normally grown fetuses, and mothers of normally grown fetuses show higher diversity in their pre-pregnancy oral microbiota. The enrichment of certain pathogenic bacteria and the reduction of symbiotic bacteria in the pre-pregnancy oral microbiota are associated with fetal overgrowth, and this association may be mediated by functional pathways such as nicotinate degradation.

Objective:To investigate effects and underlying mechanisms of glutathione persulfate (GSSH) on the level of testosterone in male obese mice.Methods:Totally 45 mice were divided into 3 groups on average. Low-fat diet (LFD)+normal saline (NS) group: 15 mice were fed with LFD for 10 weeks, followed by LFD together with daily intraperitoneal injection of saline for 45 d; high-fat diet (HFD)+NS group: 15 mice were fed with high-fat diet for 10 weeks, followed by HFD and daily intraperitoneal injection of NS for 45 d; HFD+GSSH group: 15 mice were fed with HFD for 10 weeks, followed by a HFD for 45 d and daily intraperitoneal injection of GSSH (200 mg/kg). After the treatment, all mice were killed with their necks-severed, testis and serum were taken out from the mice. Serum levels of testosterone and malondialdehyde (MDA), the mRNA levels of key enzymes for testosterone synthesis ( StAR, 3β- HSD, Cyp11a1 and Cyp17a1) were measured by RT-PCR. The testicular protein levels of StAR, 3β-HSD, NR5A1 and EHD3 were measured by Western blotting assay. Protein levels of NR5A1, SOD and Nrf2 were measured in mouse Leydig TM-3 cells that were treated with 50 μmol/L and 100 μmol/L GSSH, respectively, following with treatment with 100 μmol/L H 2O 2 . Results:1) After treatment, the body weight of mice in HFD+GSSH group did not change significantly, while the body weight of mice in HFD+NS group raised by 24.53% (from 32.46 g to 40.43 g) during the 45-day-intraperitoneal injection ( P=0.002). 2) Serum level of testosterone in HFD+NS group [(12.9±1.7) μg/L] was significantly lower than that in LFD+NS group [(18.3±1.2) μg/L, P=0.020]. However, serum level of testosterone in HFD+GSSH group was (25.42±2.1) μg/L, which was significantly higher than that in HFD+NS group ( P=0.030). The RT-PCR test results showed that compared with LFD+NS group, the expression levels of all key genes involved in testosterone synthesis ( StAR, 3β- HSD, Cyp11a1, Cyp17a1) showed a significant decrease in HFD+NS group ( P=0.003, P=0.007, P<0.001, P<0.001). The expression levels of these genes were restored in the mouse testes of HFD+GSSH group ( P=0.002, P<0.001, P<0.001, P=0.006). 3) Similarly, compared with LFD+NS group [(9.00±1.59) nmol/mL], the serum MDA level of HFD+NS group [(10.61±1.73) nmol/mL] raised significantly ( P=0.016), while GSSH reversed the raised HFD+NS high level of serum MDA in HFD+GSSH group [(9.23±0.94) nmol/mL, P=0.048]. 4) Both levels of NR5A1, EHD3, StAR, and 3β-HSD were reduced in HFD+NS group ( P=0.002, P=0.012, P=0.004, P=0.043), but their levels were significantly restored in HFD+GSSH group ( P<0.001, P=0.017, P=0.004, P<0.001). 5) The levels of NR5A1, Nrf2 and SOD were obviously down-regulated in TM3 cells treated with H 2O 2 ( P<0.001, P=0.002, P=0.004). Conclusion:GSSH can raise serum level of testosterone in HFD-fed mice by up-regulating expression of genes which are important for testicular testosterone biosynthesis.

Objective:To investigate effects and underlying mechanisms of glutathione persulfate (GSSH) on the level of testosterone in male obese mice.Methods:Totally 45 mice were divided into 3 groups on average. Low-fat diet (LFD)+normal saline (NS) group: 15 mice were fed with LFD for 10 weeks, followed by LFD together with daily intraperitoneal injection of saline for 45 d; high-fat diet (HFD)+NS group: 15 mice were fed with high-fat diet for 10 weeks, followed by HFD and daily intraperitoneal injection of NS for 45 d; HFD+GSSH group: 15 mice were fed with HFD for 10 weeks, followed by a HFD for 45 d and daily intraperitoneal injection of GSSH (200 mg/kg). After the treatment, all mice were killed with their necks-severed, testis and serum were taken out from the mice. Serum levels of testosterone and malondialdehyde (MDA), the mRNA levels of key enzymes for testosterone synthesis ( StAR, 3β- HSD, Cyp11a1 and Cyp17a1) were measured by RT-PCR. The testicular protein levels of StAR, 3β-HSD, NR5A1 and EHD3 were measured by Western blotting assay. Protein levels of NR5A1, SOD and Nrf2 were measured in mouse Leydig TM-3 cells that were treated with 50 μmol/L and 100 μmol/L GSSH, respectively, following with treatment with 100 μmol/L H 2O 2 . Results:1) After treatment, the body weight of mice in HFD+GSSH group did not change significantly, while the body weight of mice in HFD+NS group raised by 24.53% (from 32.46 g to 40.43 g) during the 45-day-intraperitoneal injection ( P=0.002). 2) Serum level of testosterone in HFD+NS group [(12.9±1.7) μg/L] was significantly lower than that in LFD+NS group [(18.3±1.2) μg/L, P=0.020]. However, serum level of testosterone in HFD+GSSH group was (25.42±2.1) μg/L, which was significantly higher than that in HFD+NS group ( P=0.030). The RT-PCR test results showed that compared with LFD+NS group, the expression levels of all key genes involved in testosterone synthesis ( StAR, 3β- HSD, Cyp11a1, Cyp17a1) showed a significant decrease in HFD+NS group ( P=0.003, P=0.007, P<0.001, P<0.001). The expression levels of these genes were restored in the mouse testes of HFD+GSSH group ( P=0.002, P<0.001, P<0.001, P=0.006). 3) Similarly, compared with LFD+NS group [(9.00±1.59) nmol/mL], the serum MDA level of HFD+NS group [(10.61±1.73) nmol/mL] raised significantly ( P=0.016), while GSSH reversed the raised HFD+NS high level of serum MDA in HFD+GSSH group [(9.23±0.94) nmol/mL, P=0.048]. 4) Both levels of NR5A1, EHD3, StAR, and 3β-HSD were reduced in HFD+NS group ( P=0.002, P=0.012, P=0.004, P=0.043), but their levels were significantly restored in HFD+GSSH group ( P<0.001, P=0.017, P=0.004, P<0.001). 5) The levels of NR5A1, Nrf2 and SOD were obviously down-regulated in TM3 cells treated with H 2O 2 ( P<0.001, P=0.002, P=0.004). Conclusion:GSSH can raise serum level of testosterone in HFD-fed mice by up-regulating expression of genes which are important for testicular testosterone biosynthesis.

Autism spectrum disorder is a set of neurodevelopmental disorders with unclear etiology and pathogenesis and no cure. Studies have found that the gut microbiota plays a vital role in the occurrence and development of autism spectrum disorder. By supplementing with probiotics, diet management or fecal microbial transplantation, the balance of gut microbiota can be adjusted to improve the behaviors and symptoms of patients with autism spectrum disorder. This article reviews from the perspective of regulating the balance of gut microbiota to treat autism spectrum disorder, and aims to provide assistance for the research and treatment of autism spectrum disorder.