ObjectiveTo analyze the impact of maternal postpartum depression (PPD) at 2 months postpartum on caregiving for infants aged2 to 24 months, and to provide a scientific basis for future maternal and infant healthcare services. MethodsBased on the Shanghai Maternal-Child Pairs Cohort, 1 060 mother-child pairs were selected from those fully participating in follow-up visits at 2, 6, 12, and 24 months postpartum. Pregnancy and childbirth-related information was collected using standardized questionnaire surveys and hospital obstetric and maternity records. The Edinburgh postpartum depression scale was used to assess the maternal postpartum depressive symptoms at 2 months postpartum. At 2, 6, 12, and 24 months postpartum, questionnaire survey was used to evaluate the maternal responsiveness in caregiving and the provision of early learning opportunities for infants. Scores for responsive caregiving and early learning opportunities at 2, 6, 12, and 24 months were grouped based on the 25th percentile (P₂₅) of total scores. The mixed-effects model was used to analyze the longitudinal impact of maternal postpartum depression at 2 months on the caregiving of 2 to 24-month-old infants. ResultsThe longitudinal results from the mixed-effects model did not show an impact of maternal PPD on infant responsive caregiving within 12 months and early learning opportunities within24 months. However, cross-sectional analysis revealed that, compared to the non-PPD group, the risk of low responsive caregiving at 2 months in the PPD group was 93% higher (OR=1.931, 95%CI: 1.113‒3.364, P=0.019). The risks for low provision of early learning opportunities at2 months and 24 months increased by 59% (OR=1.589, 95%CI: 1.082‒2.324, P=0.017) and 60% (OR=1.598, 95%CI:1.120‒2.279, P=0.010), respectively. ConclusionMaternal postpartum depression increases the risk of low responsive caregiving at 2 months, but its long-term effects warrant further research.

Fabry disease (FD) is a rare X-linked inherited lysosomal storage disorder caused by variants in the GLA gene, which encodes α-galactosidase A (α-Gal A). These mutations lead to reduced or absent α-Gal A activity, resulting in the accumulation of its substrates in various organs and tissues. This accumulation causes multi-system damage and can be life-threatening. This article reviews the current landscape of various treatment strategies for FD, including specific therapies (such as enzyme replacement therapy, chaperone therapy, substrate reduction therapy, and gene therapy), symptomatic management, as well as dietary and exercise interventions, aiming to provide a reference for the clinical management of FD.

Micro-computed tomography(Micro-CT)is a non-invasive technology that is widely used in animal experiments to assist in the detection of bone,lung,oral,metabolic,middle and inner ear diseases,as well as tumors,and in other animal disease models.The technique can provide diverse scientific and reliable imaging data for animal experiments and has accordingly become an indispensable experimental method in animal experiments.In this review,we introduce the imaging principles of Micro-CT,review its application in the study of animal disease models,summarize the limitations of Micro-CT technology,and consider its future prospects.

With social development and technology progress, there is an increasing use of daily electronic products and radioactive medical devices, which increases the risk of exposure to radiation in medical practices, daily life activities, and work. Notably, the effects of radiation exposure on pregnant women and their offspring have attracted increasing attention. Comprehensive and accurate assessment and intervention of the effects of radiation exposure on pregnant women and their offspring are of great significance to reduce birth defects and achieve eugenics. This article reviews the effects of radiation exposure during pregnancy on offspring health based on animal experiments and clinical studies, and describes the possible mechanisms, so as to provide the basis for further studies.

Objective:To analyze the clinical data of children with active lupus nephritis(LN) with poor first-line treatment and further treatment with belimumab, and explore the efficacy and safety of belimumab in the treatment of children with LN, so as to provide experience and guidance for clinical treatment of children with LN.Methods:From August 2020 to September 2021, 12 children with LN whose systemic lupus erythematosus disease activity index(SLEDAI)score was ≥8 and with poor first-line treatment were collected, and their clinical manifestations, treatment process, SLEDAI score, complement C3, complement C4, anti-dsDNA antibody titer, and proteinuria relief were analyzed retrospectively.Results:Before treatment with belimumab, the SLEDAI score was 8 in 3 cases, 10 in 5 cases, 12 in 2 cases and 16 in 2 cases.Theurine protein was positive in 6 cases.The anti-dsDNA antibody titer was higher than normal value in 8 cases.The complement C3 decreased in 8 cases and the complement C4 decreased in 6 cases.The SLEDAI scores and the anti-dsDNA antibody of 12 children and 24-hour urine protein quantification of 6 children with positive urine protein began to decrease within 4 weeks after treatment with belimumab.Anti-dsDNA antibody decreased to normal in 12th week and 24 h urine protein decreased to normal in 16th week.The levels of complement C3 and C4 began to rise within 4 weeks, complement C3 returned to normal within 24 weeks, and complement C4 returned to normal within 28 weeks.Conclusion:For LN children with poor response to first-line therapy or persistent disease activity, the addition of belimumab resulted in increased complement, decreased disease activity index and anti-dsDNA antibody titer, and effective relief of proteinuria.The application of belimumab has a certain effect on active LN children with poor response to first-line therapy, which is worthy of clinical promotion.

Objective:To explore sex and rural-urban differences in the associations of different blood pressure levels with the risk of prediabetes.Methods:We used a multi-stage stratified cluster random sampling method to investigate 21 637 residents aged ≥18 years from 10 survey areas in Hubei province in 2020. The data on questionnaire, physical measurements, and laboratory indicators of the participants were collected. The associations of different blood pressure levels with risk of prediabetes by sex and regions were analyzed using multivariate logistic regressions after complex weighting.Results:A total of 16 111 subjects were included. The prevalence (95% CI) of prediabetes, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and IFG complicated with IGT were 25.1% (14.4%-35.9%), 12.7% (3.2%-22.1%), 8.1% (6.3%-9.8%), and 4.4% (2.3%-6.5%), respectively. After multivariate adjustment, the risk of prediabetes, IFG, IGT, and IFG complicated with IGT increased with the increment of blood pressure (both P for trend <0.05). The positive dose-response relationships between blood pressure levels and risk of prediabetes were also significant among male, urban, and rural residents (both P for trend <0.05), and the interactions between sex and blood pressure showed significant associations for risk of prediabetes and IGT (both P for interaction <0.05). Conclusions:Higher blood pressure levels were associated with an increased risk of prediabetes. The association with prediabetes was stronger in males, but no significant difference was found between urban and rural residents. More distinctive and effective prevention and control strategies should be developed for different populations.

Objective To establish a mathematical prediction model for chronic obstructive pulmonary disease (COPD) by applying an artificial neural network (ANN) and logistic regression analysis method. Methods A cross-sectional survey was conducted in 2015 to collect epidemiological data of COPD of 2 400 residents from Hubei Province. Subjects were randomized into training group and test group at a ratio of 7:3. The prediction models of COPD were established using ANN and logistic multiple regression. The predictive performance of the two models was compared. Results Information from a total of 1 569 subjects was valid and analyzed, including 1,099 cases in the training group and 470 cases in the test group. The area under curve (AUC) of ANN for training group and test group was 0.80 and 0.78, respectively. The AUC of logistic regression for training group and test group was 0.75 and 0.74, respectively. Conclusion It is feasible to apply ANN and logistic regression models to predict COPD, which can provide scientific evidence for COPD prevention and treatment.

Objective:To explore the clinical characteristics of malignant tumors with arthritis as the first symptom in children, so as to strengthen the early recognition of juvenile idiopathic arthritis(JIA) and avoid misdiagnosis and treatment.Methods:Nine cases of children with malignant tumor with arthritis as the first symptom were collected from February 2015 to August 2019 in our hospital.The clinical manifestations, laboratory and imaging features of nine cases were analyzed retrospectively.Results:There were nine children, including five males and four females, with an average age of 6.2 years and an average course of 61.4 days.There were seven cases of acute lymphoblastic leukemia(ALL), one case of neuroblastoma(NB) and one case of anaplastic large cell lymphoma(ALCL). Joint symptoms: polyarthritis in four cases and oligoarthritis in five cases.Eight cases had extraarticular symptoms.Nine cases had elevated inflammatory indexes, six cases had mild abnormal blood routine examination, one case was positive for HLA-B27, and other rheumatoid factor, anti CCP antibody, RA33 antibody and antinuclear antibodies spectrum were negative.Bone destruction was found in five cases.There was no significant difference in clinical manifestations and examinations between nine cases of children with malignant tumor and JIA.Conclusion:Arthritis can be the first manifestation of malignant tumor in children.However, JIA lacks specific diagnostic indicators.In clinical practice, malignant tumors with the first manifestation of arthritis can be regarded as JIA and treatment will be delayed.Clinicians need to raise awareness.

Objective:To analyze the relationship between hyperphosphatemia and steroid-sensitive nephrotic syndrome(SSNS)in children.Methods:A retrospective study was carried out in 61 children with SSNS at Department of Paediatric Nephrology and Rheumatism and Immunology, Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2017 to December 2018.The changes of serum phosphorus levels during the active and remission stages were observed, and the correlation between serum phosphorus level and serum albumin, blood lipid, renal function, blood calcium, blood phosphorus, urine protein and other indicators were analyzed.Results:Serum phosphorus level of 61 children with SSNS was 1.79(1.65-1.91)mmol/L in the active phase of the disease, of which 33 patients(54.1%)had hyperphosphatemia, while serum phosphorus level was 1.64(1.46-1.79)mmol/L after the complete remission, and 15(24.6%)patients had hyperphosphatemia.Serum phosphorus level was positively correlated with ratio of urine protein/creatinine, serum lipoprotein A and calcium-phosphorus product( r=0.239, P<0.05; r=0.188, P<0.05; r=0.623, P<0.05), and negatively correlated with levels of serum albumin and serum calcium( r=-0.201, P<0.05; r=-0.195, P<0.05). Conclusion:The morbidity of hyperphosphatemia in children with SSNS is quite high during the active stage of the disease.The disorder of blood phosphorus significantly improve with remission of the disease.

ABSTRACT OBJECTIVE：To analyze spatial distribution characteristics of pharmaceutical industry in the Yangtze RiverEconomic Belt，and to provide reference for regional pharmaceutical industry planning. METHODS：Based on the central analysis，agglomerated sub group analysis and secondary assignment program analysis of social network analysis，the industrial relevancebetween regional pharmaceutical industry and regional cities were studied（using the image matrix of agglomerated sub group），using regional pharmaceutical enterprises in the Yangtze River Economic Belt as the research object. RESULTS &CONCLUSIONS：The study involved 111 listed pharmaceutical companies in 82 regional cities，and 82 urban nodes formed aregional pharmaceutical industry distribution network，which could generate 8 urban cohesion subgroups，represented by Shanghai，Chengdu and Chongqing；Shanghai and Hangzhou in the Yangtze River Delta，Chengdu and Chongqing in the Chengdu and Chongqing economic circle have more advanced position in network centrality. The centrality of Shanghai was the highest（25.926），followed by Chongqing and Chengdu（both were 19.753）. It shows that the spatial distribution of the pharmaceuticalindustry in the Yangtze River Economic Belt shows a distribution pattern dominated by the Yangtze River Delta urbanagglomeration. At the same time，the Chengdu-Chongqing urban agglomeration also shows a greater influence. The regional citiesplay different roles in industrial development. Chongqing and Taizhou have shown stronger industrial radiation capabilities，while?Shanghai and Hangzhou have shown stronger industrial absorption capacity.