BackgroundObsessive-compulsive disorder （OCD） is a common neuropsychiatric illness and is listed as one of the top ten disabling conditions causing loss of income and reduced quality of life. Psychological distress is an important cause of anhedonia in OCD patients， and is closely related to psychosomatic symptoms. Therefore， exploring the role of anhedonia in the relationship between psychological distress and psychosomatic symptoms is of great significance for optimizing clinical psychological treatment protocols for OCD patients. ObjectiveTo explore the role of anhedonia in the relationship between psychological distress and psychosomatic symptoms in OCD patients， with the aim of providing references for managing psychosomatic symptoms in patients. MethodsA total of 90 patients who met the diagnostic criteria for OCD according to the International Classification of Diseases， tenth edition （ICD-10）， and who visited the Mental Health Center outpatient clinic of General Hospital of Ningxia Medical University from September 2023 to November 2024 were selected as the study objects. The instruments and techniques used for the evaluation were： Dimensional Anhedonia Rating Scale （DARS）， 10-item Kessler Psychological Distress Scale （K10） and Psychosomatic Symptom Scale （PSSS）. Model 4 of the Process for SPSS 26.0 was used to test the mediating role of anhedonia in the relationship between psychological distress and psychosomatic symptoms， with Bootstrapping used to assess the significance of mediating effect. ResultsA total of 84 patients （93.33%） completed the valid questionnaire. K10 score was positively correlated with PSSS total score， psychological symptom score and physical symptom score （r=0.559， 0.460， 0.551， P<0.01）. K10 score was negatively correlated with DARS total score （r=-0.527， P<0.01）. The total score of DARS was negatively correlated with PSSS total score （r=-0.497， P<0.01）. Anhedonia mediated the relationship between psychological distress and psychosomatic symptoms， with an indirect effect value was 0.148 （95% CI： 0.042~0.278）， accounting for 26.48% of the total effect. ConclusionPsychological distress can affect the psychosomatic symptoms in OCD patients both directly and indirectly via anhedonia.

Objective:To explore the mediating role of working memory (WM) in the cortisol-awakening response (CAR) and multiple object tracking (MOT) in children with attention deficit hyperactivity disorder (ADHD).Methods:92 children with ADHD (ADHD group) and 94 typically developing children (control group) were selected from January 2022 to October 2022. Salivary cortisol levels were detected and analyzed in all children at four time points after awakening. Children's WM and MOT performance were assessed by the 1-back and MOT paradigms, respectively. SPSS 26.0 software was used for t-test and Pearson correlation analysis of the data, and plug-in PROCESS model 4 of SPSS 26.0 was used for mediated effects analysis. Results:(1) ADHD group showed significantly lower CAR, 1-back accuracy and MOT performance((30.97±5.63), (81.33±10.64) %, (2.36±0.37)) than the control group((32.41±3.48), (91.19±7.12) %, (2.62±0.28))( t=-2.09, -7.22, -5.31, all P<0.05). (2) Pearson analysis showed that CAR was positively correlated with 1-back accuracy ( r=0.293, P<0.01) and MOT performance ( r=0.740, P<0.01). 1-back accuracy was positively correlated with MOT performance ( r=0.368, P<0.01). (3) WM partially mediated the effect of CAR on MOT in children with ADHD, accounting for 6.13% (0.003/0.049) of the total effect. Conclusion:Children with ADHD have deficits in MOT.WM plays a mediating role between CAR and MOT performance in children with ADHD.

Objective:To characterize and analyze the genetic variation of hemagglutinin (HA) of influenza A (H1N1) pdm09 subtype virus in Shandong Province, and explore the genetic variation patterns for providing reference for influenza monitoring, epidemic prevention and control, and vaccine strain selection.Methods:HA gene sequences of the recommended strains of influenza vaccine from 2009 to 2024 and the representative strains of each branch were downloaded from the GISAID Influenza Data Platform, and were phylogenetically analyzed and characterized in terms of amino acid site variation with the HA gene sequences of 298 influenza A (H1N1) virus strains isolated from Shandong Province. A phylogenetic tree was constructed using the maximum likelihood (ML) method of the IQ-TREE online tool, and the amino acid site variants were viewed using MegAlign software. The potential glycosylation sites of the HA gene were predicted using the NetNGlyc 1.0 online software.Results:The HA gene homology of the 298 influenza A (H1N1) viruses isolated in Shandong Province ranged from 91.2% to 100.0%. The evolutionary branches were gradually distantly related over time, but the direction of evolution was roughly the same as that in other provinces. Amino acid mutations in the HA occurred every year and most were found in the antigenic determinants.Conclusions:The HA genes of influenza viruses isolated in Shandong Province from 2009 to 2024 are still in the process of continuous evolution, and continuous monitoring of the epidemiological trends and the evolutionary directions of influenza viruses is essential for early warning of influenza virus pandemics.

Objective:To understand the current situation of nurses' willingness to engage in telecare in county-level hospitals in Henan Province and analyze its influencing factors.Methods:Using the convenient sampling method, a total of 1 300 clinical nurses from 6 Class Ⅱ Grade A county-level hospitals in Zhengzhou, Hebi, Zhoukou and other cities in Henan Province were selected as the research objects from August 2022 to January 2023. General Data Questionnaire and Clinical Nurses' Willingness to Engage in Telecare Questionnaire were used to investigate the research objects. Non-parametric test and multiple linear regression were used to analyze the influencing factors of clinical nurses' willingness to engage in telecare.Results:A total of 1 300 questionnaires were sent out in this study, and 1 183 were effectively collected, with an effective recovery rate of 91.00% (1 183/1 300). The total score of Clinical Nurses' Willingness to Engage in Telecare Questionnaire of 1 183 nurses in county-level hospitals was [105.00 (98.00, 112.00) ] points, and all items were scored [3.50 (3.27, 3.73) ]. Multiple linear regression analysis showed that professional title, post, whether they knew about telecare, and the number of times of receiving training on nursing information each year were the influencing factors of nurses' willingness to engage in telecare in county-level hospitals ( P<0.05) . Conclusions:In Henan Province, 1 183 nurses in county-level hospitals have a high willingness to engage in telecare. Relevant departments should further strengthen the publicity of relevant contents of telecare, carry out practical operation training related to nursing information, improve the nursing information ability of nurses in county-level hospitals and strengthen the awareness of health management services, so as to promote the successful implementation of telecare services in rural areas.

OBJECTIVE: To explore the genetic basis for a Chinese pedigree affected with genetic epilepsy with febrile seizures plus (GEFS+). METHODS: Clinical data of the proband and his family members were collected. Following extraction of genomic DNA, the proband was subjected to high-throughput sequencing. Candidate variant was verified by Sanger sequencing of the proband and other family members. RESULTS: The pedigree, including 6 patients with febrile seizures from 3 generations, was diagnosed with typical GEFS+. Among them, 2 had febrile seizures (FS), 1 had febrile seizures plus (FS+), and 3 had febrile seizures with focal seizures. High-throughput sequencing revealed that the proband has carried a heterozygous missense variant of c.4522T>A (p.Tyr1508Asn) of the SCN1A gene. Sanger sequencing confirmed that other five patients and one normal member from the pedigree have also carried the same variant, which yielded a penetrance of 85.7%. CONCLUSION The c.4522T>A (p.Tyr1508Asn) of the SCN1A gene probably underlay the disease in this pedigree. The pattern of inheritance was consistent with autosomal dominant inheritance with incomplete penetrance. Above finding has enriched the variant spectrum of the SCN1A gene.
Epilepsy/genetics* ; Humans ; NAV1.1 Voltage-Gated Sodium Channel/genetics* ; Pedigree ; Phenotype ; Seizures, Febrile/genetics*

Objective:To analyze the clinical curative effect of protective sleep nursing on neonatal hyperbilirubinemia.Methods:Eight neonates with hyperbilirubinemia who were admitted from April 2019 to August 2019 were enrolled. They were divided into control group (40 cases) and observation group (40 cases) by random digits table method. Both groups were given routine nursing. On basis of control group, observation group was given protective sleep nursing. The clinical effect, sleep time, discomfort reactions and nursing satisfaction were compared between the two groups.Results:After nursing, the sleep time, crying time and bilirubin level were (18.67 ± 1.45) h/d, (0.82 ± 0.12) h/d, (191.58 ± 12.74) μmol/L in the observation group, and (17.63 ± 1.33) h/d, (1.05 ± 0.15) h/d, (202.42 ± 13.08) μmol/L in the control group, there were significant differences between the two groups ( t values were 3.343, 7.573, 3.755, P<0.05). The duration and regression time of jaundice were (5.26±1.24), (8.70±2.12) d in the observation group, and (7.14±1.18), (12.95±2.31) d in the control group, there were significant differences between the two groups ( t values were 6.946, 8.573, P<0.05). The good rate of sleep quality, incidence rates of vomiting, skin damage and needle falling out, and nursing satisfaction rate were 90.00%(36/40), 7.50%(3/40), 5.00%(2/40), 10.00%(4/40), 100.00%(40/40) in the observation group, and 72.50% (29/40), 27.50%(11/40), 22.50%(9/40), 32.50%(13/40), 87.50%(35/40) in the control group, there were significant differences between the two groups ( χ2 values were 4.021-6.050, P<0.05). Conclusions:The application of protective sleep nursing in treatment of neonatal hyperbilirubinemia can effectively prolong their sleep time, improve their sleep quality, which is conducive to improving their symptoms, reducing discomfort reactions.And satisfaction of their family members is relatively higher.

Objective:To investigate the clinical effect of botulinum toxin type A injection in the prevention and treatment of frontal traumatic scars immediately after operation.Methods:From January 2016 to January 2018, among the 152 patients with frontal trauma admitted to the Department of Plastic Surgery, Daping Hospital, Army Military Medical University, patients with wounds almost perpendicular to the Langer line were selected. Immediately after debridement and suture, botulinum toxin type A was injected with a concentration of 2 U botulinum toxin per 0.10 ml of solution, 0.05 to 0.10 ml (1 to 2 U) per 1 cm was injected into the frontal muscle according to frontal muscle strength.With reference to the observer scar assessment scale and Vancouver scar scale, the color, width, texture, thickness, pain, and itching of the postoperative scar of the frontal wound were evaluated at follow-up.Results:A total of 44 patients were included, 22 males and 22 females, aged (31.5 ± 8.4) years old, with a wound length of 1-12 cm(average, 3.5 cm) and a Botox injection volume around wounds of 0.10-0.90 ml (2-18 U) . The patients were followed up for 6 to 24 months. One patient had mild to moderate ptosis, which completely disappeared within one month. Within 6 weeks after operation, the scars in 44 patients were pink and hard. 3-6 months later, the scars gradually became soft, narrow and flat with similiar skin color, no pain and itching left in 42 patients. The satisfaction rate was 95.5% (42/44). Two patients were dissatisfied because of scar pigmentation and width.Conclusions:Immediate injection of botulinum toxin type A after debridement and suture of the frontal trauma wound can effectively prevent and improve scar appearance with a high rate of satisfaction.

Objective:To isolate and identify the virus from stool samples of children with hand, foot and mouth disease (HFMD) in Linyi City, Shandong Province in 2017, and analyze its genetic characteristics.Methods:Nucleic acid was detected in fecal specimens of children with hand, foot and mouth disease. Human rhabdomyosarcoma cells were used for virus isolation. The whole genome of the virus was sequenced, and the phylogenetic analysis and gene recombination analysis of the isolates were carried out by comparing with human enterovirus.Results:A coxsackievirus A group 2 type(CoV-A2), named SD17-430, was successfully isolated from fecal specimens of children with severe HFMD. Phylogenetic analysis further confirmed that the coxsackievirus genotype belonged to D2 genotype. The coding region of SD17-430 capsid protein had high homology with CoV-A2 international original strain, while the coding region of non-structural protein had high homology with CoV-A4 (MH086949) and CoV-A14 (KP036482).Conclusions:Compared with the original strain, CoV-A2 SD17-430 strain has a greater degree of genetic variation, and may have genetic recombination with multiple enteroviruses during its evolution. We should continue to strengthen the overall monitoring of HFMD pathogens in order to further understand the changes of pathogen spectrum and provide data reference for formulating more effective strategies for HFMD prevention and control.

Objective:To construct and rescue enhanced green fluorescent protein(EGFP)-labeled EGFP-EV-A71 recombinant virus.Methods:pMD19T-SDLY107 full-length plasmid was used as a template, and 2A protease recognition sequence was added to the 5′end of the structural protein VP4. EGFP gene was amplified using the pEGFP-N1 plasmid as a template and inserted into the above-mentioned recombinant plasmid. RD cells were transfected to rescue the recombinant virus EGFP-EV-A71 after enzymatic digestion and in vitro transcription. The cell culture infectious dose 50% endpoint (CCID 50) was determined. Real-time fluorescent quantitative PCR (qRT-PCR) was used to detect the virus replication level at different time points, and the virus replication curve was drawn to compare the replication ability of the recombinant virus and the parent virus. Lactate dehydrogenase (LDH) and cell proliferation (CCK-8) experiments were used to determine the cell injury rate and survival rate of infected cells, respectively. Results:Recombinant EV-A71 infectious cDNA clones containing specific restriction sites and EGFP were successfully constructed. Typical cytopathic effect and green fluorescence was observed. The qRT-PCR replication curve showed that the recombinant virus had similar replication kinetics to the parent virus.Conclusions:EGFP-labeled enterovirus type 71 recombinant virus EGFP-EV-A71 was successfully rescued.

Objective:To investigate the clinical effect of botulinum toxin type A injection in the prevention and treatment of frontal traumatic scars immediately after operation.Methods:From January 2016 to January 2018, among the 152 patients with frontal trauma admitted to the Department of Plastic Surgery, Daping Hospital, Army Military Medical University, patients with wounds almost perpendicular to the Langer line were selected. Immediately after debridement and suture, botulinum toxin type A was injected with a concentration of 2 U botulinum toxin per 0.10 ml of solution, 0.05 to 0.10 ml (1 to 2 U) per 1 cm was injected into the frontal muscle according to frontal muscle strength.With reference to the observer scar assessment scale and Vancouver scar scale, the color, width, texture, thickness, pain, and itching of the postoperative scar of the frontal wound were evaluated at follow-up.Results:A total of 44 patients were included, 22 males and 22 females, aged (31.5 ± 8.4) years old, with a wound length of 1-12 cm(average, 3.5 cm) and a Botox injection volume around wounds of 0.10-0.90 ml (2-18 U) . The patients were followed up for 6 to 24 months. One patient had mild to moderate ptosis, which completely disappeared within one month. Within 6 weeks after operation, the scars in 44 patients were pink and hard. 3-6 months later, the scars gradually became soft, narrow and flat with similiar skin color, no pain and itching left in 42 patients. The satisfaction rate was 95.5% (42/44). Two patients were dissatisfied because of scar pigmentation and width.Conclusions:Immediate injection of botulinum toxin type A after debridement and suture of the frontal trauma wound can effectively prevent and improve scar appearance with a high rate of satisfaction.