Objective: To examine the association between parent-child relationships and bullying behaviors among junior high school students, and to explore the moderating effect of community cohesion, so as to provide evidences for bullying intervention strategies. Methods: From November to December 2017, a cluster sampling method was used to survey 1 589 students in grades 6- 8 from three junior high schools in Jing an District,Shanghai. Anonymous electronic questionnaires collected data on parent-child relationships, community cohesion, and bullying behaviors. Multivariate Logistic regression analyzed the associations and moderation effects. Results: The prevalence of bullying behaviors among junior high school students was 7.80%. Spearman correlation analysis revealed negative associations between both parent-child relationships ( r =-0.13) and community cohesion ( r =-0.10) with bullying behaviors, while parent-child relationships positively correlated with community cohesion ( r =0.29) (all P <0.01). Junior high school students with positive parent-child relationships and higher perceived community cohesion showed lower risks of bullying behaviors ( OR=0.51, 95%CI =0.36-0.72; OR=0.58, 95%CI =0.45-0.76), with a significant interaction effect between the two factors (all P <0.05). Conclusions Positive parent-child relationships and community cohesion are negatively associated with bullying behaviors in middle school students. Supportive family relationships help reduce bullying, while stronger community cohesion enhances the protective effect of positive parent-child relationships against bullying.

Given that ovarian stimulation is vital for assisted reproductive technology (ART) and results in elevated serum estrogen levels, exploring the impact of elevated estrogen exposure on oocytes and embryos is necessary. We investigated the effects of various ovarian stimulation treatments on oocyte and embryo morphology and gene expression using a mouse model and estrogen-treated mouse embryonic stem cells (mESCs). Female C57BL/6J mice were subjected to two types of conventional ovarian stimulation and ovarian hyperstimulation; mice treated with only normal saline served as controls. Hyperstimulation resulted in high serum estrogen levels, enlarged ovaries, an increased number of aberrant oocytes, and decreased embryo formation. The messenger RNA (mRNA)‍-sequencing of oocytes revealed the dysregulated expression of lysine-specific demethylase 6b (Kdm6b), which may be a key factor indicating hyperstimulation-induced aberrant oocytes and embryos. In vitro, Kdm6b expression was downregulated in mESCs treated with high-dose estrogen; treatment with an estrogen receptor antagonist could reverse this downregulated expression level. Furthermore, treatment with high-dose estrogen resulted in the upregulated expression of histone H3 lysine 27 trimethylation (H3K27me3) and phosphorylated H2A histone family member X (γ-H2AX). Notably, knockdown of Kdm6b and high estrogen levels hindered the formation of embryoid bodies, with a concomitant increase in the expression of H3K27me3 and γ-H2AX. Collectively, our findings revealed that hyperstimulation-induced high-dose estrogen could impair the demethylation of H3K27me3 by reducing Kdm6b expression. Accordingly, Kdm6b could be a promising marker for clinically predicting ART outcomes in patients with ovarian hyperstimulation syndrome.
Female ; Mice ; Demethylation/drug effects* ; Embryonic Stem Cells ; Estrogens/administration & dosage* ; Gene Expression/drug effects* ; Histones/metabolism* ; Jumonji Domain-Containing Histone Demethylases/metabolism* ; Mice, Inbred C57BL ; Oocytes ; Ovary/drug effects* ; Reproductive Techniques, Assisted ; Animals

Objective To investigate the effects of combined assessment of normal morphology sperm rate(MNS)with sperm DNA fragmentation index(DFI)on the outcomes of in vitro fertilization-embryo transfer(IVF-ET).Methods A retrospective analysis was conducted on the clinical data of 641 patients who underwent IVF-ET in our center from June 2020 to February 2023.According to MNS and DFI levels,the patients were divided into group A(MNS＜4％,DFI＜25％,403 cases),group B(MNS ≥4％,DFI ≥25％,9 ca-ses),group C(MNS≥4％,DFI＜25％,125 cases),group D(MNS＜4％,DFI≥25％,104 cases),group A1(MNS＜1％,DFI＜25％,106 cases)and group D1(MNS＜1％,DFI≥25％,60 cases).The general information,semen parameters,embryo develop-ment and pregnancy outcomes were compared among all the 6 groups.Results No statistically significant differences were found be-tween female and male age among these groups(P＞0.05).Significant differences were observed in sperm motility,progressive motili-ty,sperm concentration and fertilization rates(P＜0.05),but no differences of usable embryo rates,good-quality embryo rates,clinical pregnancy rates,early miscarriage rates,or live birth rates(P＞0.05)among the groups A,B,C,D,A1 and D1.Conclusion The decreased MNS and increased DFI in males were associated with reduced sperm motility and concentration,affecting fertilization rates in IVF-ET,but had no significant impact on clinical pregnancy outcomes.The combined assessment of MNS with DFI had limited pre-dictive value for IVF-ET pregnancy outcomes.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Objective:To investigate the risk factors for moderate to severe pancreatitis (PEP) after endoscopic retrograde cholangiopancreatography (ERCP) .Methods:Data of 6 731 patients diagnosed as having biliary and pancreatic diseases with initial papilla who underwent endoscopic retrograde cholangiopancreatography (ERCP) from June 2010 to June 2020 in the First Affiliated Hospital of Air Force Medical University were retrospectively analyzed. Parameters related to intubation and postoperative complications were prospectively collected. The main end point was moderate to severe PEP. Logistic regression analysis was used to explore the risk factors for moderate to severe PEP.Results:The incidence of overall PEP and moderate to severe PEP in 6 731 ERCP patients with initial papilla were 5.3% ( n=359) and 1.0% ( n=68) respectively. Univariate analysis showed that female, indications of ERCP, cannulation method, cannulation time, cannulation attempts, times of inadvertent pancreatic duct cannulation and cannulation with or without trainee involvement were all associated with moderate to severe PEP ( P<0.10). Multivariate analysis showed that female ( OR=2.32, 95% CI:1.28-4.21, P=0.006), non-common bile duct stones indication ( OR=2.04, 95% CI:1.16-3.59, P=0.014), cannulation time ≥5 min ( OR=2.23, 95% CI: 1.20-4.13, P=0.011), inadvertent pancreatic duct cannulation time ≥1 ( OR=1.88, 95% CI: 1.03-3.44, P=0.040) and non-trainee involvement cannulation ( OR=1.81, 95% CI: 1.02-3.22, P=0.043) were independent risk factors for moderate to severe PEP. Conclusion:The independent risk factors for moderate to severe PEP include female, non-common bile duct stones indication, non-trainee involvement cannulation and difficult cannulation. Great importance should be attached to these factors above during the whole perioperative period of ERCP.

Objective To investigate application of femoston combined with Kuntai capsule in poor ovarian responders (PORs) receiving vitro fertilization. Methods 120 women with poor ovarian response after receiving IVF were s randomly elected. Pre-treatment with femoston plus Kuntai capsule was used for three menstrual cycles before the next cycle of assisted reproductive treatment. FSH, LH, E2, AMH, number of antral follicles, PSV, days of Gn, ampoules of Gn, cycle cancellation rate, E2 value of the day of HCG, follicle of less than 16mm, number of oocytes, fertilization rate, and number of good quality embryos were compared before and after treatment used. Results After pre-treatment, levels of FSH and LH were decreased, AMH, PSV were increased, E2 value of the day of HCG, number of antral follicles, follicle of less than 16 mm, oocytes, fertilization rate, and good quality embryos were increased; cycle cancellation rate was decreased, with significant differences (P< 0.05). Conclusions Femoston combined with kuntai capsule can effectively increase the functional reserve of the ovarian in poor ovarian responders, and can improve the outcome of IVF.

Objective To explore the treatment effect of sildenafil combined with pulmonary surfactant (PS) on newborn meconium aspiration syndrome ( NMAS) children with persistence pulmonary hypertension ( PPH) , and to summarize the nursing experience .Methods Sixty NMAS children with PPH were chosen and randomly divided into the control group and the observation group according to the random number table , each with 30 cases. All children received the routine treatment including high frequency oscillation assisted ventilation , proper rehydration , antibiotics and so on , and the control group received the intratracheal instillation of PS, and the observation group received the sildenafil on the basis of PS .The oxygenation index ( OI ) , alveolar-arterial oxygen difference ( A-aDO2 ) and pulmonary artery pressure ( PAP) were compared between two groups before and after the treatment .Results The differences were found in the OI and A-aDO2 4 and 12 h after the treatment between two groups (P<0.01); The OI was (11.7 ±2.8) in the observation group 36 h after the treatment, and was (19.1 ±3.4) in the control group, and the difference was statistically significant (t=9.202, P<0.01); the A-aDO2 was (12.1 ±3.2)mmHg in the observation group, and was (27.6 ± 5.5)mmHg in the control group, and the difference was statistically significant (t=13.342, P<0.01).The PAP was (40.4 ±10.7) mmHg in the observation group 24 ~36 h after the treatment, and was (49.3 ± 13.4)mmHg in the control group, and the difference was statistically significant (t=2.843, P<0.01).No serious complications were found in two groups .Conclusions The sildenafil combined with PS , meanwhile, the respiratory tract nursing and the high frequency oscillation assisted ventilation airway nursing were well , can further enhance the treatment effect of NMAS combined with PPH .

Objective To investigate the influence of high body mass index (BMI) on in vitro fertilization and embryo transfer (IVF-ET) pregnancy outcome in the patients with polycystic ovary syndrome (PCOS) .Methods A retrospective cohort study was conducted using existing data on 224 PCOS patients with IVF-ET by the standard long protocol in this hospital from Jan 2009 to Dec 2011 .All patients were divided into 2 groups according to BMI ,the high BMI group(BMI≥24 .0 ,64 cases) and the normal BMI group(18 .5≤BMI<24 .0 ,160 cases) .The differences of pregnaney outcomes between the high BMI and normal BMI PCOS pa-tients were compared .Results 1 .Basic testosterone(T) in the high BMI group was higher than that in the normal BMI group(P<0 .05) .2 .There were no statistical difference in the number of retrived oocytes ,dose of Gn ,Gn duration ,fertilization rate between the two groups(P>0 .05);the high BMI group demonstrated the higher endometrial thickness and lower good quality embryo rate than the normal BMI group(P<0 .05) .3 .There were no statistical difference in the clinical pregnancy rate and the abortion rate be-tween the two groups(P>0 .05) ,the high BMI group had the higher risk of developing gestational diabetes(GDM)than the normal BMI group(P<0 .05) .Conclusion PCOS patient with high BMI is liable to develop hyperandrogenism and increases the occurrence rate of pregnancy complication gestational diabetes mellitus (GDM ) ,but without affecting the clinical pregnancy rate .

Objective To explore the diagnostic value of optic diffusion tensor imaging (DTI) in detecting the impairment of optic nerve in neuromyelitis optica (NMO) patients.Methods Conventional MRI and optic DTI were performed in 28 NMO patients and 38 normal controls (NC).Fractional anisotropy (FA) values were measured in the anterior part,middle part and posterior part of intraorbital segment of optic nerve.The patients were classified into 3 groups based on the impairment of vision and visual evoked potential (VEP): monocular impairment (MI) group,10 eyes; biocular impairment (BI) group,36 eyes;and normal-appearing (NA) group,10 eyes.All patients were performed with the evaluation of expanded disability status scale (EDSS).One-way analysis of variance (ANOVA),receiver operating characteristic (ROC) curve,and Spearman correlation analysis were performed among the subgroups of NMO and normal controls.Results There was significantly statistical difference between the four groups (F =43.54,P ＜0.01).Decreased FA values were demonstrated in the MI group (0.29 ±0.08),BI group (0.27 ±0.08),and NA group (0.35 ±0.13) compared with NC (0.45 ±0.07) (P ＜0.01).FA value in BI group was significantly lower than that of NA group(P ＜0.01).Area under curve by ROC analysis in NC vs MI,NC vs BI,NC vs NA,and NC vs NMO was 0.92,0.95,0.74,and 0.91,respectively.The diagnostic sensitivity of ROC was 80％,86％,50％,and 79％,respectively.The diagnostic specificity of ROC was 95％ for the each compared groups.FA value showed no correlation with EDSS for each NMO groups,and showed negative correlation with disease duration for BI group (r =-0.371,P ＜ 0.05).Conclusions Various degrees of optic nerve injuries,indicated by decreased FA value,are present in NMO patients,and optic DTI may be a simple and effective tool for the quantitative evaluation of optic nerve in NMO patients.

Objective To investigate the distribution of different Human papilloma virus(HPV) subtype infection of women cervixes in parts of Guizhou Province and the high risk factors of HPV infection,in order to offer some evidences for the use of vaccine of cervix eaneers in the region, and offer a group of reliable data for the screen-ing statistics of cervix eaneer in the world. Methods A total of 2339 women having sexual life were checked for 21 HPV genotypes by DNA flow-through hybridization technique and liquid-hased pap test(LPT) in their exfoliated cer-vical cells. Cervix tissues were taken in some HPV positive women and (or) LPT positive women among them for bi-opsy by the vaginoscope. The high risk factors of HPV infection and the distribution feature of HPV subtype infection in the different cervix diseases were anlayzed. Results The total positive rate of HPV infection was 30.31% (709/ 2339 ) in the 2339 women. There were 20 HPV subtypes to be detected. HPV subtype infection from high to low were HPVI6,52,18,58 and 11. The rates of HPV subtype infection were 9.87% (231/2339) ,5.64% ( 132/2339), 4.95% (116/2339 ) ,4.19% (98/2339)and 2.99 % (70/2339). The peak age of HPV infection ranged from 31 to 35 years old. The earlier the first sexual life,the higher HPV infeetion (tendeney X2 test,P <0.05). 366 CIN pa-tients and 181 patients of invasive cervix carcinoma( ICC)were diagnosed through pathology examination. The rate of HPV infection were 34.26% (74/216)in CIN Ⅰ ,77.78% (56/72)in CIN Ⅱ ,82.05% (64/78)in CIN Ⅲ. Among the 181 ICC,the rate of HPV infection was 84.52% (131/155)in squamous carcinoma of the cervix (SCC) and 38.46% (10/26) in adenocareinoma of uterine cervix (AUC). The infeetion rate of HPV16 was 61.83% ( 81/131 ) in the SCC of HPV positive. The infection rate of HPV18 was 60% (6/10)of the AUC of HPV positive. HPV16 was related closely with SCC ( X2 = 11. 948 ,P < 0.001 , ORSCC/AUC = 5. 946). There was no significant difference be-tween HPV 18 in SCC and AUC( P > 0.05). Conclusions The major HPV subtypes are 16,52,18,58 in Guizhou province. There is a close correlation between HPV infection and cervix diseases. HPV infection often occurs in young and middle-aged women. The first sexual life is a high factor of HPV infection. High risk HPV infecting would cause cervix cancer. CIN and cervix cancers are caused by high risk HPV infection. HPV16 is related closely with SCC. There is no significant difference between HPV18 in SCC and AUC. HPV16/18 vaccine could be considered to re-duce the incidence of cervical carcinoma in Guizhou province.