Objective:To explore the relationship between suicide attempts,school bullying,and psychological resilience in children and adolescents with major depressive disorder(MDD)and school bullying and psychological resilience.Methods:A total of 784 patients with MDD aged 10 to 18 years were included.The Chinese version of the Olweus Bullying Victimization Questionnaire,Adolescent Psychological Resilience Scale,and a suicide attempt assessment were utilized to evaluate school bullying,psychological resilience,and suicide attempt.Stepwise logistic regression was applied to identify the associated factors of suicide attempts.Results:The occurrence of suicide at-tempts in children and adolescents with MDD was positively associated with physical bullying(OR=1.85,95％CI:1.14-3.02)and indirect bullying(OR=1.48,95％CI:1.06-2.04),and negatively associated with higher levels of goal focus(OR=0.62,95％CI:0.45-0.85)and positive cognition(OR=0.62,95％CI:0.45-0.85)at higher levels.Conclusion:Bullying significantly increases the risk of suicide attempts in children and adolescents with MDD,while higher psychological resilience could mitigate this risk.

Objective:To evaluate prenatal and postnatal management strategies for ovarian cysts in fetuses and infants under three months of age.Methods:This retrospective analysis included 94 cases managed at Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology (December 2013 to December 2023) with prenatal/postnatal imaging, management, and outcomes data. Cysts were stratified by diameter: <3 cm ( n=44), 3-4 cm ( n=19), and ≥4 cm ( n=31). Proportions of complex cysts and ovarian necrosis rates were compared using Chi-square tests. Results:Among 94 cases , 62 were simple ovarian cysts and 32 complex (including two initially simple cysts that converted to complex in utero). Prenatal diagnosis occurred in 67 cases (52 simple, 15 complex) without intrauterine intervention and 27 were postnatally detected (10 simple, 17 complex). Ovarian necrosis affected 93.8% (30/32) of complex cysts. Both 3-4 cm and ≥4 cm groups demonstrated significantly higher complex cyst rates [12/19 and 48.3% (15/31) vs. 11.4% (5/44), χ2=15.53 and 10.92, both P<0.001] and ovarian necrosis frequencies [12/19 and 45.2% (14/31) vs. 9.1% (4/44), χ2=17.72 and 11.07, both P<0.001] compared to the <3 cm group, whereas no significant differences existed between 3-4 cm and ≥4 cm groups (both P>0.05). Conclusions:For postnatal management, surgical intervention is recommended for complex ovarian cysts in fetuses and infants within three months of age. For simple cysts ≥4 cm, surgery is advised, while those measuring 3-4 cm warrant close monitoring due to elevated necrosis risk.

Objective:To explore the relationship between suicide attempts,school bullying,and psychological resilience in children and adolescents with major depressive disorder(MDD)and school bullying and psychological resilience.Methods:A total of 784 patients with MDD aged 10 to 18 years were included.The Chinese version of the Olweus Bullying Victimization Questionnaire,Adolescent Psychological Resilience Scale,and a suicide attempt assessment were utilized to evaluate school bullying,psychological resilience,and suicide attempt.Stepwise logistic regression was applied to identify the associated factors of suicide attempts.Results:The occurrence of suicide at-tempts in children and adolescents with MDD was positively associated with physical bullying(OR=1.85,95％CI:1.14-3.02)and indirect bullying(OR=1.48,95％CI:1.06-2.04),and negatively associated with higher levels of goal focus(OR=0.62,95％CI:0.45-0.85)and positive cognition(OR=0.62,95％CI:0.45-0.85)at higher levels.Conclusion:Bullying significantly increases the risk of suicide attempts in children and adolescents with MDD,while higher psychological resilience could mitigate this risk.

Objective:To evaluate prenatal and postnatal management strategies for ovarian cysts in fetuses and infants under three months of age.Methods:This retrospective analysis included 94 cases managed at Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology (December 2013 to December 2023) with prenatal/postnatal imaging, management, and outcomes data. Cysts were stratified by diameter: <3 cm ( n=44), 3-4 cm ( n=19), and ≥4 cm ( n=31). Proportions of complex cysts and ovarian necrosis rates were compared using Chi-square tests. Results:Among 94 cases , 62 were simple ovarian cysts and 32 complex (including two initially simple cysts that converted to complex in utero). Prenatal diagnosis occurred in 67 cases (52 simple, 15 complex) without intrauterine intervention and 27 were postnatally detected (10 simple, 17 complex). Ovarian necrosis affected 93.8% (30/32) of complex cysts. Both 3-4 cm and ≥4 cm groups demonstrated significantly higher complex cyst rates [12/19 and 48.3% (15/31) vs. 11.4% (5/44), χ2=15.53 and 10.92, both P<0.001] and ovarian necrosis frequencies [12/19 and 45.2% (14/31) vs. 9.1% (4/44), χ2=17.72 and 11.07, both P<0.001] compared to the <3 cm group, whereas no significant differences existed between 3-4 cm and ≥4 cm groups (both P>0.05). Conclusions:For postnatal management, surgical intervention is recommended for complex ovarian cysts in fetuses and infants within three months of age. For simple cysts ≥4 cm, surgery is advised, while those measuring 3-4 cm warrant close monitoring due to elevated necrosis risk.

Objective:To evaluate direct and indirect costs for schizophrenia,major depressive disorder(MDD)and bipolar disorder,and to compare their differences of cost composition,and to explore the drivers of the total costs.Methods:A total of 3 175 inpatients with schizophrenia,MDD,and bipolar disorder were recruited.In-patient's self-report total direct of medical costs outpatient and inpatient,out-of-pocket costs,and direct non-medical costs were regarded as direct costs.Productivity loss and other loss caused by damaging properties were defined as indirect costs.The perspectives of this study included individual and societal levels.Multivariate regression analysis was applied for detecting the factors influencing disease costs.Results:The total cost of schizophrenia was higher than those of MDD and bipolar disorder at individual and societal levels.The indirect costs of three mental disorders were higher than the direct costs,and the indirect cost ratio of bipolar disorder was higher than those of schizophre-nia and MDD.Age,gender,working condition and marital status(P＜0.05)were the important drivers of total costs.Conclusion:The economic burden of the three mental disorders is relatively heavy.Schizophrenia has heaviest disease burden,and the productivity loss due to mental disorders is the driving force of the soaring disease cost

Objective:To describe demographic,clinical and physiological characteristics,treatment between first-episode major depressive disorder(MDD)and relapse MDD,and to explore characteristics of relapse MDD.Methods:Totally 858 patients who met the diagnostic criteria for depression of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5),were included by using the Mini International Neuropsychiatric Interview(MINI),Clinician-Rated Dimensions of Psychosis Symptom Severity,and Hamilton Depression Scale etc.Among them,529(58.6％)were first-episode depression and 329(36.0％)were relapsed.The differences of demographic characteristics,clinical and physiological characteristics,treatment were compared byx2test and Kruskal-Wallis rank sum test.Multivariate logistic regression was used to explore the characteristics of MDD recur-rence.Results:Compared to first-episode MDD,relapse MDD had more comorbidity(OR=2.11,95％CI:1.00-4.44),more days out of role(OR=1.26,95％CI:1.01-1.56),more history of using psychiatric drug more than one month(OR=1.41,95％CI:1.02-1.97)and electroconvulsive therapy(OR=3.23,95％CI:1.42-7.36),and higher waist-hip ratio(OR=33.88,95％CI:2.88-399.32).Conclusion:Relapse MDD has positive as-sociation with comorbidity of mental disorders,out of role,and higher waist-hip ratio.

Objective To investigate the clinical significance of serum citrulline levels in evaluating the remnant bowel absorptive function with enterostomy in the neonatal period by means of tandem mass spectrum so as to guide clinical treatment with parenteral nutrition(PN) or not.Methods The serum amino acid profiles of 30 enterostomy infants including small intestinal enterostomy 17 cases of enterostomy and 13 cases of colon enterostomy and 20 cases of control infants in Wuhan Children's Hospital,Tongji Medical College University of Science & Technology from January 2016 to June 2018 were performed by using tandem mass spectrum,and the related amino acid with the bowel absorbing ability-citrulline was screened out.The Pearson correlation of the serum citrulline levels with the gain weight of the infants was studied.Results The weight of small intestinal enterostomy was significantly lower than colon enterostomy and control infants [(3.22 ± 1.00) kg vs.(5.63 ± 0.66) kg and (6.09 ± 0.85) kg],and there was statistical significance (F =57.23,P ＜ 0.05).Serum citrulline levels were significantly lower in small intestinal enterostomy compared with colon enterostomy and controls [(10.65 ± 5.82) μmol/L vs.(16.57 ± 4.33) μmol/L and (16.52 ± 4.20) μmol/L],and there was statistical significance (F =8.29,P ＜ 0.05).In enterostomy infants serum citrulline was positively correlated with gain weight everyday(r =0.65,P ＜ 0.05).Serum citrulline level ＜ 12 μmol/L had 81.3％ sensitivity and 71.4％ specificity for underweight.Conclusions Serum citrulline is a simple and accurate biomarker for evaluation of the absorptive function and adaptation of the enterostomy infants.Serum citrulline level ＜ 12 μmol/L is a strong predictor of PN-dependence in infants with temporary enterostomy.

OBJECTIVETo investigate the estrogen interference property of fenvalerate in neurodevelopmental toxicity.

METHODSThirty 4-week-old healthy female ICR mice were randomly divided into 6 groups: sham operation group, ovariectomized control group, ovariectomized with estrogen (10 µg/g) group, ovariectomized with fenvalerate (5 µg/g) group, sham operation with fenvalerate group, and ovariectomized with estrogen and fenvalerate group, with 5 mice in each group. Fenvalerate was injected intraperitoneally once a day for 7 consecutive days. Mice were sacrificed at 24 h after the last exposure to separate the hippocampus. Immunofluorescence was used to detect neuron marker (NeuN) and astrocyte marker (GFAP) in hippocampal CA1, CA3, and DG regions.

RESULTSCompared with the sham operation group (numbers of NeuN-positive cells: CA1 (54.00±1.73), CA3 (59.00 ± 1.73), DG (100.00 ± 4.58)), the sham operation with fenvalerate group (CA1 (37.67 ± 2.08), CA3 (41.33 ± 1.15), DG (80.67±0.58)) and ovariectomized control group (CA1 (44.00 ± 3.00), CA3 (51.00 ± 3.00), DG (83.00 ± 1.72)) showed significant decreases in number of neurons (NeuN-positive cells) in the hippocampus (P < 0.05). Compared with the ovariectomized control group, the ovariectomized with fenvalerate group (CA1 (47.67 ± 3.21), CA3 (49.00 ± 1.73), DG (87.33 ± 4.04)) showed no significant change in number of hippocampal NeuN-positive cells. Compared with the ovariectomized with fenvalerate group (CA1 (47.67 ± 3.21), DG (87.33 ± 4.04)), the sham operation with fenvalerate group and ovariectomized with estrogen and fenvalerate group (CA1 (40.00 ± 1.00), DG (78.67 ± 2.31)) experienced significant decreases in NeuN-positive cells (P < 0.05). Compared with the sham operation group (CA3 (11.00 ± 1.12), DG (10.67 ± 1.15)), the sham operation with fenvalerate group (CA3 (18.67 ± 2.07), DG (16.33 ± 1.53)) showed significant increase in number of astrocytes (GFAP-positive) cells (P < 0.05). Compared with the sham operation with fenvalerate group, the ovariectomized with fenvalerate group (CA3 (12.00 ± 1.00), DG (11.68 ± 1.16)) showed significant decrease in GFAP-positive cells (P < 0.05). Compared with the ovariectomized with fenvalerate group, the sham operation with fenvalerate group and ovariectomized with estrogen and fenvalerate group (CA3 (16.67 ± 2.13), DG (15.38 ± 1.42)) showed significant increases in GFAP-positive cells (P < 0.05).

CONCLUSIONThe interference with circulating estrogen is an important mechanism underlying the neurodevelopmental toxicity of fenvalerate.

Animals ; Estrogens ; pharmacology ; Female ; Hippocampus ; drug effects ; pathology ; Mice ; Mice, Inbred ICR ; Neurons ; drug effects ; pathology ; Nitriles ; toxicity ; Ovariectomy ; Pyrethrins ; toxicity

Objective To investigate whether fenvalerate can induce mouse hippocampal nerve cell damage by interfering with estrogen (E2) effect.Methods Hippocampus were dissected and cultured from Embryo 18 d ICR mice,the cells were cultured for 7 days.Fenvalerate (FEN,0,1,10,50 μg/ml),FEN(10,50 μg/ml) and estrogen receptor antagonist ICI 182,780 (1 μmol/L),FEN (0,10,50 μg/ml) and E2 (10 nmol/L) were applied to the cultured cells for 48h.Immunocytochemically stained with neurons and astrocytes to evaluate the levels respectively,and the growth of neurite.Result 1μg/ml FEN have no effect on neurons,neurites and protoplasmic astrocytes,10 and 50 μg/ml FEN can significantly decrease the neuron viability and the length of neurite as well as increase the level of protoplasmic astrocytes (P＜0.05 vs.control group).ICI 182,780 alone have no effect on neurons,neurites and protoplasmic astrocytes; ICI+10 μg/ml FEN significantly increase the cell viability and extend neurite length as well as decrease protoplasmic astrocytes (P＜0.05 vs.10 μg/ml FEN alone group); ICI+50 μg/ml FEN significantly increase the cell viability and decrease protoplasmic astrocytes (P＜0.05 vs.50 μg/ml FEN alone group).E2 alone have no effect on protoplasmic astrocytes,while can promote neuronal survival and neurite growth; E2+10 μg/ml FEN and E2+50 μg/ml FEN significantly decrease neuronal survival and neurite growth,as well as increase protoplasmic astrocytes (P＜0.05 vs.E2 alone group).Conclusion Fenvalerate can induce the loss of hippocampal neurons through disrupting estrogen nuclear receptor signaling,and inhibit the length of neurite through disrupting estrogen nuclear receptor and membrane receptor signaling.The effect of estrogen disruption play an important role in developmental neurotoxicity by fenvalerate.

Objective To investigate whether fenvalerate can induce mouse hippocampal nerve cell damage by interfering with estrogen (E2) effect.Methods Hippocampus were dissected and cultured from Embryo 18 d ICR mice,the cells were cultured for 7 days.Fenvalerate (FEN,0,1,10,50 μg/ml),FEN(10,50 μg/ml) and estrogen receptor antagonist ICI 182,780 (1 μmol/L),FEN (0,10,50 μg/ml) and E2 (10 nmol/L) were applied to the cultured cells for 48h.Immunocytochemically stained with neurons and astrocytes to evaluate the levels respectively,and the growth of neurite.Result 1μg/ml FEN have no effect on neurons,neurites and protoplasmic astrocytes,10 and 50 μg/ml FEN can significantly decrease the neuron viability and the length of neurite as well as increase the level of protoplasmic astrocytes (P＜0.05 vs.control group).ICI 182,780 alone have no effect on neurons,neurites and protoplasmic astrocytes; ICI+10 μg/ml FEN significantly increase the cell viability and extend neurite length as well as decrease protoplasmic astrocytes (P＜0.05 vs.10 μg/ml FEN alone group); ICI+50 μg/ml FEN significantly increase the cell viability and decrease protoplasmic astrocytes (P＜0.05 vs.50 μg/ml FEN alone group).E2 alone have no effect on protoplasmic astrocytes,while can promote neuronal survival and neurite growth; E2+10 μg/ml FEN and E2+50 μg/ml FEN significantly decrease neuronal survival and neurite growth,as well as increase protoplasmic astrocytes (P＜0.05 vs.E2 alone group).Conclusion Fenvalerate can induce the loss of hippocampal neurons through disrupting estrogen nuclear receptor signaling,and inhibit the length of neurite through disrupting estrogen nuclear receptor and membrane receptor signaling.The effect of estrogen disruption play an important role in developmental neurotoxicity by fenvalerate.