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 determine the humoral immunity in advanced maternal-age women with recurrent spontaneous abortion(RSA).Methods A retrospective study was performed between January 2022 and October 2023 in the Department of Reproductive Immunity of Shanghai First Maternity and Infant Hospital.Women with RSA were recruited and multiple autoantibodies were tested.Multivariate logistic regression was performed to compare the associations between different age groups(20 to 34 years old in the low maternal-age group and 35 to 45 years in the advanced maternal-age group)and multiple autoantibodies,while controlling for three confounding factors,including body mass index(BMI),previous history of live birth,and the number of spontaneous abortions.Then,we investigated the differences in the humoral immunity of advanced maternal-age RSA women and low maternal-age RSA women.Result A total of 4 009 women with RSA were covered in the study.Among them,1 158 women were in the advanced maternal-age group and 2 851 women were in the low maternal-age group.The prevalence of antiphospholipid syndrome,systemic lupus erythematosus,Sjogren's syndrome,rheumatoid arthritis,and undifferentiated connective tissue disease was 15.6% and 14.1%,0.0% and 0.1%,0.9% and 0.9%,0.3% and 0.0%,and 23.7% and 22.6% in the advanced maternal-age group and low maternal-age group,respectively,showing no statistical difference between the two groups.The positive rates of antiphospholipid antibodies(aPLs),antinuclear antibody(ANA),extractable nuclear antigen(ENA)antibody,anti-double stranded DNA(dsDNA)antibody,anti single-stranded DNA(ssDAN)antibody,antibodies against alpha-fodrin(AAA),and thyroid autoimmunity(TAI)were 19.1% and 19.5%,6.6% and 6.6%,9.2% and 10.5%,2.0% and 2.0%,2.2% and 1.2%,5.1% and 4.9%,and 17.8% and 16.8%,respectively.No differences were observed between the two groups.1.6% of the women in the advanced maternal-age group tested positive for lupus anticoagulant(LA),while 2.7% of the women in the low maternal-age group were LA positive,with the differences being statistically significant(odds ratio=0.36,95% confidence interval:0.17-0.78).In the 4 008 RSA patients,the cumulative cases tested positive for the three antibodies of the aPLs spectrum were 778,of which 520 cases were positive for anti-β2 glycoprotein Ⅰ antibodies(β2GPⅠ Ab)-IgG/IgM,58 were positive for aCL-IgG/IgM,73 were positive for LA,105 were positive for both β2GPⅠAb-IgG/IgM and aCL-IgG/IgM,17 were positive for both β2GPⅠ Ab-IgG/IgM and LA,2 were positive for both aCL-IgG/IgM and LA,and 3 were positive for all three antibodies.Conclusion Our study did not find a difference in humoral immunity between RSA women of advanced maternal age and those of low maternal age.

Objective:To investigate the pre-pregnancy vitamin D level and pregnancy outcome in patients with unexplained recurrent spontaneous abortion (URSA).Methods:A prospective study was performed in 4 534 patients with URSA from May 2017 to April 2019 at Shanghai First Maternity and Infant Health Hospital Affiliated to Tongji University. The serum Vitamin D levels was obtained before pregnancy. Pregnancy complications and newborns outcomes were recorded after pregnancy.Results:The serum vitamin D level of patients with URSA before pregnancy was (42.22±16.27)nmol/L, and the proportions of vitamin D deficiency, insufficiency and sufficiency were 72.3%, 24.0 %, and 3.7%, respectively. The Vitamin D level was positively correlated with age ( P<0.05); The age of vitamin D<50 nmol/L group was lower than that of vitamin D≥50 nmol/L group ( P<0.05); patients with vitamin D<50 nmol/L had higher proportion of spontaneous abortions ≥3 times than those with the vitamin D≥50 nmol/L ( P<0.05); The level of vitamin D was negatively correlated with the ratio of CD3 + CD4 + T cells in peripheral blood ( P<0.05); In multivariate logistic regression analysis, the final model adjusted for age, abortion frequency and season. The risk of pregnancy failure was increased in vitamin D <50 nmol/L group [30.6%(76/248) vs 17.9%(12/67), χ 2=3.67, P=0.02], OR=2.02(95% CI: 1.02-3.9); In the group of vitamin D<50 nmol/L before pregnancy, the risk of newborns entering NICU was increased, OR=3.16(95% CI: 1.15-8.65). Conclusions:Vitamin D deficiency is prevalent in URSA patients before pregnancy, which correlates with the times of previous spontaneous abortions and recurrent pregnancy failure. Vitamin D deficiency before pregnancy is one of the high-risk factors for URSA.

Abortion, Habitual ; drug therapy ; Abortion, Spontaneous ; drug therapy ; Adult ; Aspirin ; therapeutic use ; Female ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Prednisone ; therapeutic use ; Pregnancy ; Pregnancy Outcome

AIM To investigate the preventive effects of taurine on the left ventricle hypertrophy in renovascular hypertensive rats. METHODS Two-kidney 1-clip (2K1C) rats were used to establish the model of renovascular hypertension. The myocardial local aldosterone(Ald) and AngⅡconcentration (MDC,MAC) were measured by radioimmunoassay. Expression of oncogene c-fos mRNA was analyzed by means of in situ hybridization. The myocardial collagen concentration (MCC) was measured by biochemical method. The myocardial tissue structure was observed under the microscope ,and the myocardial fiber diamension (MFD) was measured with micrometer. The linear correlation between MCC, MFD and MAC or MDC was analysed respectively. RESULTS Compared with sham operated rats ,the MCC, MAC, MDC and MFD were significantly increased in 2K1C rats ( P