Objective To investigate the main dietary patterns of children in urban areas of Maanshan City, and to explore the association between dietary patterns and subthreshold autism trait (SAT), attention-deficit/hyperactivity disorder (ADHD) symptoms and comorbid behaviors in 3-year-old children. Methods Based on the birth cohort of Maanshan Maternal and Infant Health from June 2015 to June 2016，regular physical examinations were conducted from 4 to 2 to 1, and follow-up was conducted until the age of 3. A semi-quantitative food frequency questionnaire was employed to assess dietary intakes. SAT and ADHD symptoms were assessed by Clancy autism behavior scale (CABS) and the 10-item Chinese version of the Conners Abbreviated Symptom Questionnaire (C-ASQ). Social-demographic information was also collected. Results The detection rates of SAT, ADHD symptoms, and comorbidity were 11.03%, 5.28%, and 2.71%, respectively. The older the father, the higher the mother's education level, and the higher the per capita monthly income of the family, the lower the SAT detection rate (P<0.05). The higher the father's educational level, the lower the detection rate of ADHD symptoms (P<0.05). The older the mother and the higher the education level, the lower the detection rate of comorbid behavior in their children (P <0.05). After adjusting for demographic influencing factors, the low intake level was used as a reference. The vegetarian type with moderate intake level was negatively correlated with SAT, while the processed food type with high intake level was positively correlated with SAT. The vegetarian type with high intake level was negatively correlated with ADHD symptoms, while the snack type with high intake level was positively correlated with ADHD symptoms. The vegetarian type with high intake level was negatively correlated with comorbidity. Conclusion Unhealthy dietary patterns are related to children's SAT and ADHD symptoms. Correcting children's unhealthy eating patterns may help reduce children's behavior problems.

Objective To investigate the correlations between lipoprotein associated phospholipase A2(Lp-PLA2),platelet aggregation rate(PAG),the ratio of mean platelet volume to platelet count(MPV/PLT)and major adverse cardiovascular events(MACE)in elderly patients with coronary heart disease(CHD).Methods The clinical data of 162 elderly patients with CHD admitted to Jianhu Hospital affiliated to Nantong University from August 2020 to September 2021 were collected retrospectively.All the patients were treated with aspirin orally and followed up for 1 year.The development of MACE within 1 year was recorded.MACE occurred in 30 patients(development group)and the other 132 patients without MACE were assigned to non-development group.Serum Lp-PLA2,PAG,and MPV/PLT were compared between the 2 groups at admission.Logistic regression was used to analyze the relationship between these parameters and MACE in elderly CHD patients.Receiver operating character(ROC)curve was used to evaluate the value of serum Lp-PLA2,PAG,MPV/PLT alone and jointly at admission in predicting MACE within 1 year.Results The proportions of patients with age≥75 years and hypertension in the development group were significantly higher than those in the non-development group(P<0.05).Serum Lp-PLA2,PAG,MPV/PLT in the development group were also significantly higher than those in the non-development group(P<0.05).Binary logistic regression analysis showed that hypertension,Lp-PLA2,PAG,and MPV/PLT were influence factors of MACE in elderly CHD patients(P<0.05).ROC curve results showed that the area under curve(AUC)values of Lp-PLA2,PAG,MPV/PLT alone or jointly were 0.832,0.817,0.841 and 0.939 in predicting MACE in elderly CHD patients.Conclusion Overexpression of Lp-PLA2,PAG and MPV/PLT are closely related to the development of MACE in elderly CHD patients.During hospitalization,the risk of MACE can be assessed by detecting Lp-PLA2,PAG,and MPV/PLT,and timely clinical intervention can be carried out.

Objective:To analyze the associations between prenatal and 1-year-old exposure to antibiotics and allergic symptoms in children aged 6-11 months and 18-23 months.Methods:In this study, a prospective birth cohort study was adopted. A total of 2 122 pregnant women were enrolled in Maternal and Child Health Care Center of Ma′anshan from June 2015 to June 2016, and they were followed up from the beginning of pregnancy to children′s 24 months of age. Excluding 564 pairs of mothers and children who were lost to follow-up or with incomplete information on the use of antibiotics and children′s allergic symptoms, a total of 1 558 pairs of mothers and children were included in the analysis of this study. The parents and children′s general demographic information, early-life antibiotic exposure and other data were collected, the information about allergic symptoms in children aged 6-11 months and 18-23 months were investigated by reference to the "International Study of Asthma and Allergies in Childhood (ISAAC)". The univariate and multivariate binary unconditional logistic regression model was used to was used to estimate associations between the effects of early-life antibiotic exposure on allergic symptoms in 2-year-old children.Results:The antibiotic usage rate of pregnant women during pregnancy was 3.4% (53), and the antibiotic usage rates of children between 0 to 2 months, 3 to 5 months, and 6 to 11 months were separately 15.2%(237), 15.5%(242) and 17.3%(269). The total prevalence of allergic diseases in children aged 6 to 11 months was 24.1% (375 children), and the total prevalence of allergic diseases in children aged 18 to 23 months was 22.0% (342 children). After adjust parental (maternal) education level, family monthly income per capita, parental (maternal) allergy history, parental (maternal) age at pregnancy, mother′s Body Mass Index (BMI) before pregnancy, exposure to second-hand smoke during pregnancy, delivery method, child gender, birth weight, preterm birth, the use of antibiotics when children were 3-5 months old ( RR=1.61,95% CI:1.19-2.17) and 6-11 months old ( RR=1.43,95% CI:1.06-1.93) were the risk factors for allergic symptoms at 6-11 months of age; and the use of antibiotics when children were 0-2 months old (RR=1.41, 95% CI: 1.03-1.95), 3-5 months old ( RR=1.54, 95% CI: 1.12-2.11) and 6-11 months old ( RR=1.58, 95% CI: 1.17-2.14) were the risk factors for allergic symptoms at 18-23 months of age. Conclusion:Children′s exposure to antibiotics within 1 year of age was a risk factor for allergic symptoms in children aged 6-11 months and 18-23 months, children should avoid unnecessary antibiotic use in infancy.

Objective:To analyze the associations between prenatal and 1-year-old exposure to antibiotics and allergic symptoms in children aged 6-11 months and 18-23 months.Methods:In this study, a prospective birth cohort study was adopted. A total of 2 122 pregnant women were enrolled in Maternal and Child Health Care Center of Ma′anshan from June 2015 to June 2016, and they were followed up from the beginning of pregnancy to children′s 24 months of age. Excluding 564 pairs of mothers and children who were lost to follow-up or with incomplete information on the use of antibiotics and children′s allergic symptoms, a total of 1 558 pairs of mothers and children were included in the analysis of this study. The parents and children′s general demographic information, early-life antibiotic exposure and other data were collected, the information about allergic symptoms in children aged 6-11 months and 18-23 months were investigated by reference to the "International Study of Asthma and Allergies in Childhood (ISAAC)". The univariate and multivariate binary unconditional logistic regression model was used to was used to estimate associations between the effects of early-life antibiotic exposure on allergic symptoms in 2-year-old children.Results:The antibiotic usage rate of pregnant women during pregnancy was 3.4% (53), and the antibiotic usage rates of children between 0 to 2 months, 3 to 5 months, and 6 to 11 months were separately 15.2%(237), 15.5%(242) and 17.3%(269). The total prevalence of allergic diseases in children aged 6 to 11 months was 24.1% (375 children), and the total prevalence of allergic diseases in children aged 18 to 23 months was 22.0% (342 children). After adjust parental (maternal) education level, family monthly income per capita, parental (maternal) allergy history, parental (maternal) age at pregnancy, mother′s Body Mass Index (BMI) before pregnancy, exposure to second-hand smoke during pregnancy, delivery method, child gender, birth weight, preterm birth, the use of antibiotics when children were 3-5 months old ( RR=1.61,95% CI:1.19-2.17) and 6-11 months old ( RR=1.43,95% CI:1.06-1.93) were the risk factors for allergic symptoms at 6-11 months of age; and the use of antibiotics when children were 0-2 months old (RR=1.41, 95% CI: 1.03-1.95), 3-5 months old ( RR=1.54, 95% CI: 1.12-2.11) and 6-11 months old ( RR=1.58, 95% CI: 1.17-2.14) were the risk factors for allergic symptoms at 18-23 months of age. Conclusion:Children′s exposure to antibiotics within 1 year of age was a risk factor for allergic symptoms in children aged 6-11 months and 18-23 months, children should avoid unnecessary antibiotic use in infancy.

Objective:To examine the relationship between pre-pregnancy BMI, gestational diabetes (GDM) and different indicators of childhood obesity at the age of 4.Methods:Based on Ma’anshan Birth Cohort Study, singleton children who were born in Ma’anshan of Anhui province from October 2013 to April 2015, were followed for 4 years, consecutively. During the first questionnaire survey, data including pre-pregnancy weight, height and socio-demography were collected. During 24-28 week of gestation, 75 g oral glucose tolerance test was conducted for them. Childhood height, weight, waist circumference and body composition were measured at the age of 4. Comparisons between groups were performed using chi-square test, analysis of variance or t-test. The relationship between pre-pregnancy overweight/obesity, GDM and childhood obesity-related characteristics were analyzed by logistic regression model and generalized linear model analysis. Results:The prevalence rates of overweight and obesity in children at the age of 4 were 13.08% and 6.03%, respectively. After adjustment for characteristics related to mothers and their children, significantly increased risk of obesity ( OR=3.27, 95% CI: 2.15-4.98), larger waist circumference ( OR=2.32, 95% CI: 1.72-3.14) and higher waist-to-weight ratio ( OR=2.29, 95% CI: 1.73-3.02) were seen in the offspring of women with pre-pregnancy overweight/obesity. Body composition (skeletal muscle, body fat, body fat percentage) of the offspring were strongly correlated with pre-pregnancy overweight/obesity of the mothers ( P<0.05). Maternal GDM was associated with higher risk of childhood obesity ( OR=1.78, 95% CI: 1.14-2.79), on mothers without GDM during pregnancy. However, neither larger waist circumference, or higher waist-to-weight ratio seemed to increase the risk. Moreover, maternal GDM was not associated with body composition measures (skeletal muscle, body fat, body fat percentage). Conclusion:Pre-pregnancy BMI and maternal GDM were independent risk factors for obesity in 4-year-old children, and pre-pregnancy BMI was correlated with various indicators of body composition in children.

Objective To assess the association between early adiposity rebound (AR) and indices of obesity and metabolic risk in 5-year-old children. Methods Based on Ma’anshan Birth Cohort Study (MABC), single live births born in Ma'anshan of Anhui province from October 2013 to April 2015 were followed for up to 5 years consecutively. As of August 2019, 720 children with continuous measurements (≥8 times) and metabolic indicators were obtained. Physical examination and laboratory tests were used to obtain information on the birth status, length/height, weight, waist circumference, body composition and metabolic indicators of children. The 2 test, F test, t-test, non-parametric test, general linear model and logistic regression model were used for statistical analysis. Results 43.5% of the children had AR≤4 years. After controlling for gender, it was found that earlier AR was associated with overweight/obesity (OR=2.71, 95%CI: 1.81~4.05), larger waist circumference (OR=1.88, 95%CI: 1.25~2.82), and body fat percentage ≥90th percentile (OR=2.09, 95%CI: 1.26~3.48). In the earlier AR group, the insulin resistance and metabolic score were higher, but the difference was not statistically significant. At 5 years of age, the prevalence of obesity and overweight was 6.0% and 12.8%, respectively. Children with overweight/obesity, larger waist circumference, higher waist-to-weight ratio and body fat percentage ≥ 90th percentile were associated with higher insulin resistance and metabolic score, and all the differences were statistically significant (all P<0.001). Conclusion Earlier AR increased the risk of overweight/obesity, larger waist circumference, and body fat percentage ≥90th percentile at age of 5 years. Each index of the commonly used measures of childhood obesity was closely related with insulin resistance and metabolic risk factors at 5 years old.

Objective:To investigate the efficacy and safety of oral sirolimus in the treatment of refractory vascular anomalies.Methods:From February 2017 to February 2018, 20 cases of vascular deformity with no obvious improvements after multiple therapies in our hospital were included. Among them, 5 have Kaposiform hemangioendothelioma (KHE) with Kasabach-Merritt phenomenon (KMP), 10 have lymphatic malformation, 3 have venous malformation and 2 have lymphatic venous malformation. A single course of oral sirolimus lasted for 3 months. Initial dose was 0.8 mg/m 2 once, oral administration twice per day, and subsequent dose was adjusted to maintain the concentration of blood drug at 10-15 ng/ml. Before and after taking sirolimus, the general information, tumor changes and the adverse reactions were gathered. Efficacy was evaluated at the end of the treatment course. Effective: tumor volume reduced by more than 50% and or platelets stabilized in the normal range. Partly effective: tumor volume reduced by 25%-50%. No effect: tumor volume reduced by less than 25% or no significant change. Results:All the patients were treated with sirolimus orally for 1-3 courses, among which 11 were effective, 6 were partially effective, and 3 were ineffective. They were followed up for more than 3 months after the end of the whole course and no tumor enlargement was observed. All the 5 cases with KHE and KMP had significantly reduced tumor size and the platelets were stable in the normal range, but 2 of them suffered from severe pneumonia, one of them eventually perished. Two of the remaining children had elevated liver enzymes and high fever. The lesions of 10 patients with lymphatic malformations were reduced, and 4 of them had mild liver dysfunction. Two with lymphatic venous malformations had shrunk in different degree, and 3 with venous malformations had no effect. Three of them showed significant relief of pain symptoms, and their pain score was significantly lower than that before oral administration (8.7±1.2 vs 1.3±1.2, P=0.001). Except for 1 case with venous malformation had oral ulcer. No obvious adverse reaction were observed in the remaining 11 patients. Conclusions:Oral sirolimus may be effective and safe in the treatment of refractory vascular anomalies, but it should be treated with caution in little infants.

Objective:To investigate the efficacy and safety of oral sirolimus in the treatment of refractory vascular anomalies.Methods:From February 2017 to February 2018, 20 cases of vascular deformity with no obvious improvements after multiple therapies in our hospital were included. Among them, 5 have Kaposiform hemangioendothelioma (KHE) with Kasabach-Merritt phenomenon (KMP), 10 have lymphatic malformation, 3 have venous malformation and 2 have lymphatic venous malformation. A single course of oral sirolimus lasted for 3 months. Initial dose was 0.8 mg/m 2 once, oral administration twice per day, and subsequent dose was adjusted to maintain the concentration of blood drug at 10-15 ng/ml. Before and after taking sirolimus, the general information, tumor changes and the adverse reactions were gathered. Efficacy was evaluated at the end of the treatment course. Effective: tumor volume reduced by more than 50% and or platelets stabilized in the normal range. Partly effective: tumor volume reduced by 25%-50%. No effect: tumor volume reduced by less than 25% or no significant change. Results:All the patients were treated with sirolimus orally for 1-3 courses, among which 11 were effective, 6 were partially effective, and 3 were ineffective. They were followed up for more than 3 months after the end of the whole course and no tumor enlargement was observed. All the 5 cases with KHE and KMP had significantly reduced tumor size and the platelets were stable in the normal range, but 2 of them suffered from severe pneumonia, one of them eventually perished. Two of the remaining children had elevated liver enzymes and high fever. The lesions of 10 patients with lymphatic malformations were reduced, and 4 of them had mild liver dysfunction. Two with lymphatic venous malformations had shrunk in different degree, and 3 with venous malformations had no effect. Three of them showed significant relief of pain symptoms, and their pain score was significantly lower than that before oral administration (8.7±1.2 vs 1.3±1.2, P=0.001). Except for 1 case with venous malformation had oral ulcer. No obvious adverse reaction were observed in the remaining 11 patients. Conclusions:Oral sirolimus may be effective and safe in the treatment of refractory vascular anomalies, but it should be treated with caution in little infants.

Objective To reduce the perioperative complications of simultaneous pancreas and kidney transplantation (SPK ) and boost the clinical efficacy by exploring its perioperative management in diabetics with end-stage renal disease .Methods Retrospective analysis was performed for the clinical data of 5 diabetics with end-stage renal disease undergoing SPK since 2017 .Results The cold ischemic time of all allografts was under 8 hours .No surgical complications occurred in recipients post-transplantation .Two patients were complicated with hyperkalemia and their serum potassium levels normalized after treatment .One case of bleeding in abdominal cavity was cured conservatively . Renal functions of two patients with delayed renal function post-transplantation gradually recovered after hematodialysis . One case of peritransplant fluid collection recovered after debridement and drainage .Another case of acute left heart failure and cardiac arrest at 45 days post-transplantation resumed normal heart rhythm after rescue .However ,his consciousness could not be restored and his families gave up subsequent treatments . Transplanted kidneys and pancreases of these 4 patients normalized .Follow-up was conducted until March 20 , 2019 . They became insulin and dialysis independent and serum creatinine and blood glucose normalized .Diabetic complications were relieved and their quality-of-life also improved significantly .Conclusions SPK is an effective treatment for diabetics with end-stage renal disease .While maintaining normal serum creatinine and blood glucose , it may liberate patients from insulin dosing and dialytic maintenance ,lower diabetic complications and improve quality-of-life .

Objective: To observe the clinical efficacy and safety of Q-modulated laser combined with compound repair of oligosaccharides in the treatment of melasma. Methods: From January 2017 to December 2018, 90 patients with chloasma were divided into Q-switched laser treatment group (control group) and Q-switched laser combined repair oligopeptide treatment group (experimental group) according to random number table method. In the experimental group, the interval between microneedle introduction of oligopeptide and Q-switched laser therapy was 2 weeks, and the treatment was carried out alternately. Each treatment lasted for 4 months, with a total of 8 treatments completed. The control group was treated with Q-switched laser only. Each patient was treated four times, once a month for four months. All patients were evaluated before treatment and 1 month after treatment. Evaluation indicators: (1) Macular severity index (MASI), calculating its decline rate, analyzing the improvement of chloasma; (2) Applying Visia skin analyzer to evaluate the characteristic count of brown spots, calculating its decline rate; (3) Doctors Subjectively Evaluate Patient Pigmentation Legacy; (4) Patient self-evaluation. Measuring data were tested by t-test and counting data by Chi square test. Results: All subjects completed the treatment. Most of the chloasma in the two groups improved significantly after treatment. In the control group, the MASI decreased by 75.61%, 1 case of inefficiency, 13 cases of improvement, 28 cases of marked improvement and 3 cases of recovery. In the experimental group, the MASI decreased by 85.25%, 0 cases of inefficiency, 6 cases of improvement, 27 cases of significant improvement and 12 cases of recovery. Comparing the improvement of the two groups, the experimental group was better than the control group, the difference was statistically significant (χ²=9.00, P=0.03). After treatment, the number of chloasma brown spots in the two groups improved significantly. In the control group, the decrease rate of chloasma brown spots was (1.59 ± 1.33)% and in the trial experiment was (3.45± 1.54)%. The experimental group was better than the control group, and the difference between the two groups was statistically significant (P=0.01). The overall evaluation of therapeutic effect by doctors showed that 95.56% (43/45) of the patients in the experimental group had clearance rate greater than 75%, which was better than 86.67% (39/45) of the control group. There was a significant difference between the two groups (P<0.05). The self-evaluation result showed that the improvement rate of the experimental group was 66.67% (30/45) which was more than 75%, which was better than 37.78% (17/45) of the control group. The difference was statistically significant (P=0.04). Conclusions Q-switched laser combined with compound repair oligopeptide can effectively treat chloasma with less adverse reactions.