Objective:To investigate the causal impact of maternal smoking around birth(MSAB)on off-spring's risk of attention deficit hyperactivity disorder(ADHD),autism spectrum disorder(ASD),bipolar disorder(BD),and major depressive disorder(MDD).Methods:The datasets for MSAB and 4 psychiatric disorders were extracted from genome-wide association studies(GWAS).Mendelian randomization(MR)was employed,using in-verse variance weighting(IVW)as the primary analysis method.Sensitivity analyses and outlier correction were conducted using weighted median(WM),MR-Egger regression,and MR-PRESSO.The results were expressed as odds ratios(OR)and corrected for false discovery rate(FDR).Results:MR analysis showed significant causal re-lationships between MSAB and increased risk of ADHD(OR=5.36,95％CI=2.58-7.63,PFDR=0.003),MDD(OR=1.92,95％CI=1.29-2.88,PFDR=0.003),and BD(OR=6.33,95％CI=1.56-8.73,PFDR=0.013).However,no statistically significant association was found between MSAB and ASD(OR=1.66,95％CI=0.23-5.87,PFDR=0.616).Conclusion:This study suggests a potential causal link between maternal smoking around the time of birth and an increased risk of attention deficit hyperactivity disorder,bipolar disorder,and major depressive disorder in offspring.

Objective:To investigate the causal impact of maternal smoking around birth(MSAB)on off-spring's risk of attention deficit hyperactivity disorder(ADHD),autism spectrum disorder(ASD),bipolar disorder(BD),and major depressive disorder(MDD).Methods:The datasets for MSAB and 4 psychiatric disorders were extracted from genome-wide association studies(GWAS).Mendelian randomization(MR)was employed,using in-verse variance weighting(IVW)as the primary analysis method.Sensitivity analyses and outlier correction were conducted using weighted median(WM),MR-Egger regression,and MR-PRESSO.The results were expressed as odds ratios(OR)and corrected for false discovery rate(FDR).Results:MR analysis showed significant causal re-lationships between MSAB and increased risk of ADHD(OR=5.36,95％CI=2.58-7.63,PFDR=0.003),MDD(OR=1.92,95％CI=1.29-2.88,PFDR=0.003),and BD(OR=6.33,95％CI=1.56-8.73,PFDR=0.013).However,no statistically significant association was found between MSAB and ASD(OR=1.66,95％CI=0.23-5.87,PFDR=0.616).Conclusion:This study suggests a potential causal link between maternal smoking around the time of birth and an increased risk of attention deficit hyperactivity disorder,bipolar disorder,and major depressive disorder in offspring.

This article presented the maternal and infant outcomes of glycogen storage disease type Ⅲa (GSDⅢa) in a woman with full-term pregnancy. The woman exhibited symptoms of hypoglycemia when she was three months old, which were alleviated with intravenous glucose infusion. At the age of 19, during surgical treatment for scoliosis, she was found with liver cirrhosis, splenomegaly, and thrombocytopenia. Glycogen debranching enzyme deficiency was detected through liver biopsies, leading to the clinical diagnosis of GSDⅢ (unspecified genotype). The patient was admitted after conceiption due to "irregular lower abdominal pain for 1 day" at 34 weeks and 3 days. Through multidisciplinary management in the late pregnancy, which included medication adjustments, dietary instruction, and platelet transfusions both at half an hour before and during the operation, the patient underwent a cesarean section at 37 +1 weeks of gestation and delivered a healthy boy with normal Apgar scores at 1, 5, and 10 min. The mother followed a high-protein diet postpartum and the newborn experienced hypoglycemia after birth. Intravenous glucose was supplied to the infant, restabilizing his blood glucose. Maternal and neonatal blood glucose both remained stable. Postpartum whole-exome sequencing identified compound heterozygous variants in the mother, which were in the AGL gene at chr1:100379102-100379103 with gene variant information of NM_000642.2:c.3971_3972delAT(p.Tyr1324*) and at chr1:100345603 with gene variant information of NM_000642.2:c.1735+1G>T, confirming the diagnosis of GSDⅢa. The newborn carried a heterozygous variant in the AGL gene at chr1:100379102-100379103 with gene variant information of NM_000642.2:c.3971_3972delAT(p.Tyr1324*). Postpartum follow-ups showed stable blood glucose levels for the mother and normal growth and development for the newborn.

Objective:To investigate the mRNA expression of adenosine triphosphate binding cassette subfamily C member 8 (ABCC8) in gliomas and its application value as an index for predicting the prognosis of gliomas.Methods:The data of sex, age, histopathological type, WHO grade, isocitrate dehydrogenase (IDH) mutation, 1p/19q deletion, survival time and ABCC8 mRNA expression of 304 patients with gliomas (study group) in the Chinese glioma Genome Atlas (CGGA) database were collected. The prognostic factors of patients with gliomas were determined by univariate and multivariate Cox regression analysis. This result was verified by the data of 506 glioma patients in TCGA database and 271 glioma patients in REMBRANDT database.Results:The expression of ABCC8 mRNA in 304 cases of gliomas in the study group was 15.93±1.23. ABCC8 mRNA expression was correlated with age, histopathological type, WHO grade, IDH mutation status, 1p/19q deletion status and WHO molecular grade ( P<0.01). The median survival time of patients in ABCC8 mRNA high expression group was 85.60 months, which was significantly longer than 14.07 months in low expression group ( P<0.001). Univariate Cox regression analysis showed that age, histopathological type, WHO grade, IDH mutation status, 1p/19q deletion status, postoperative radiotherapy, postoperative chemotherapy and ABCC8 mRNA expression were related to the overall survival time of patients ( P<0.05). Multivariate Cox regression analysis showed that WHO grade ( HR=3.117, 95% CI: 1.970-4.930), 1p/19q deletion status ( HR=0.285, 95% CI: 0.155-0.526), postoperative chemotherapy ( HR=0.680, 95% CI: 0.488-0.948) and ABCC8 mRNA expression ( HR=0.690, 95% CI: 0.491-0.971) were independent factors for the overall survival of patients. In the TCGA dataset, the median survival time of patients with high ABCC8 mRNA expression group was 133.70 months, which was longer than 19.60 months of patients with low ABCC8 mRNA expression group ( P<0.001). In Rembrandt dataset, the median survival time of patients with high ABCC8 mRNA expression group was 37.93 months, which was longer than 15.83 months of patients with low expression group ( P<0.001). Conclusions:The expression level of ABCC8 mRNA in glioma is related to the degree of malignancy. The higher degree of malignancy, the lower the expression. The expression level of ABCC8 mRNA is an independent factor for the overall survival of patients with gliomas. The overall survival of patients with high ABCC8 mRNA expression is longer than that of patients with low ABCC8 mRNA expression.

Background::The potential impact of β cell function and insulin sensitivity on adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM) remains uncertain. We aimed to investigate the association between β cell dysfunction, insulin resistance, and the composite adverse pregnancy outcomes.Methods::This observational study included 482 women diagnosed with GDM during pregnancy. Quantitative metrics on β cell function and insulin sensitivity during pregnancy were calculated using traditional equations. The association of β cell dysfunction and insulin resistance with the risk of the composite adverse pregnancy outcomes was investigated using multivariable-adjusted logistic regression models.Results::Multivariable-adjusted odds ratios (ORs) of adverse pregnancy outcomes across quartiles of homeostatic model assessment for insulin resistance (HOMA-IR) were 1.00, 0.95, 1.34, and 2.25, respectively ( P for trend = 0.011). When HOMA-IR was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 1.34 (95% confidence interval 1.16-1.56) for each 1-unit increase in HOMA-IR. Multivariable-adjusted ORs of adverse pregnancy outcomes across quartiles of homeostatic model assessment for β cell function (HOMA-β) were 1.00, 0.51, 0.60, and 0.53, respectively ( P for trend = 0.068). When HOMA-β was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 0.57 (95% CI 0.24-0.90) for each 1-unit increase in HOMA-β. However, other quantitative metrics were not associated with the composite adverse pregnancy outcomes. Conclusions::We demonstrated a significant association of β cell function and insulin sensitivity with the risk of adverse pregnancy outcomes. We have provided additional evidence on the early identification of adverse pregnancy outcomes besides the glycemic values.

Objective To analyze the expression of KCNJ11 mRNA in gliomas and its prognostic value. Methods The clinical, histopathological and molecular pathological features of 273 patients with gliomas were collected from CGGA. We analyzed the differences of KCNJ11 mRNA expression in different types of gliomas and the survival time of patients with high and low expression of KCNJ11 mRNA in different subtypes of gliomas. Results The expression levels of KCNJ11 mRNA in young glioma and primary glioma patients were higher than those in old glioma and recurrent glioma patients, respectively (P=0.008, 0.001). The expression of KCNJ11 mRNA in oligodendroglioma was the highest, astrocytoma was the second, and glioblastoma was the lowest (P=0.000). The expression of KCNJ11 mRNA in WHOⅡ grade glioma was the highest, WHOⅢ was the second, and WHOⅣ was the lowest (P=0.000). The expression levels of KCNJ11 mRNA in IDH-mutant type glioma patients were higher than those in IDH-wild type glioma patients (P=0.000). The expression of KCNJ11 mRNA in deletion of 1p/19q glioma patients was higher than that in non-deletion of 1p/19q ones (P=0.000). The expression of KCNJ11 mRNA in MGMT methylated glioma patients was higher than that in non-methylated ones (P=0.036). The survival time of patients with high expression of KCNJ11 mRNA (≥2.77) was longer than that with low expression (P=0.000). Multivariate Cox analysis showed that the high expression of KCNJ11 mRNA was an independent factor affecting the good prognosis of patients with glioma. Conclusion The expression of KCNJ11 mRNA is negatively related to the malignant degree of the tumor. The high expression of KCNJ11 mRNA is an independent factor affecting the good prognosis of patients with glioma.

Objective:To investigate the mRNA expression of adenosine triphosphate binding cassette subfamily C member 8 (ABCC8) in gliomas and its application value as an index for predicting the prognosis of gliomas.Methods:The data of sex, age, histopathological type, WHO grade, isocitrate dehydrogenase (IDH) mutation, 1p/19q deletion, survival time and ABCC8 mRNA expression of 304 patients with gliomas (study group) in the Chinese glioma Genome Atlas (CGGA) database were collected. The prognostic factors of patients with gliomas were determined by univariate and multivariate Cox regression analysis. This result was verified by the data of 506 glioma patients in TCGA database and 271 glioma patients in REMBRANDT database.Results:The expression of ABCC8 mRNA in 304 cases of gliomas in the study group was 15.93±1.23. ABCC8 mRNA expression was correlated with age, histopathological type, WHO grade, IDH mutation status, 1p/19q deletion status and WHO molecular grade ( P<0.01). The median survival time of patients in ABCC8 mRNA high expression group was 85.60 months, which was significantly longer than 14.07 months in low expression group ( P<0.001). Univariate Cox regression analysis showed that age, histopathological type, WHO grade, IDH mutation status, 1p/19q deletion status, postoperative radiotherapy, postoperative chemotherapy and ABCC8 mRNA expression were related to the overall survival time of patients ( P<0.05). Multivariate Cox regression analysis showed that WHO grade ( HR=3.117, 95% CI: 1.970-4.930), 1p/19q deletion status ( HR=0.285, 95% CI: 0.155-0.526), postoperative chemotherapy ( HR=0.680, 95% CI: 0.488-0.948) and ABCC8 mRNA expression ( HR=0.690, 95% CI: 0.491-0.971) were independent factors for the overall survival of patients. In the TCGA dataset, the median survival time of patients with high ABCC8 mRNA expression group was 133.70 months, which was longer than 19.60 months of patients with low ABCC8 mRNA expression group ( P<0.001). In Rembrandt dataset, the median survival time of patients with high ABCC8 mRNA expression group was 37.93 months, which was longer than 15.83 months of patients with low expression group ( P<0.001). Conclusions:The expression level of ABCC8 mRNA in glioma is related to the degree of malignancy. The higher degree of malignancy, the lower the expression. The expression level of ABCC8 mRNA is an independent factor for the overall survival of patients with gliomas. The overall survival of patients with high ABCC8 mRNA expression is longer than that of patients with low ABCC8 mRNA expression.

Objective:To investigate the impact of menopause hormone therapy (MHT) on life quality improvement in women aged 40-65 years who suffered from menopausal syndrome.Methods:A retrospective cohort study was performed to analyze the clinical data of patients aged 40-65 years attending the menopause clinic of the Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, between April 2010 and November 2019. The menopause rating scale (MRS) was implemented to evaluate the scale and severity of menopausal syndrome.Results:The total MRS scores were 9.25, 5.25, 4.67 and 4.25 before and 3, 6 and 12 months after menopausal hormone therapy, respectively. Compared with baseline, MRS score decreased significantly after menopausal hormone therapy (all P<0.001). Furthermore, After treatment, the decrease of MRS score in 50-54 years old group was significantly higher than that in 40-44 years old group ( P=0.043). Other characteristics such as marriage, income and body mass index, were not associated with the decrease of MRS score (all P>0.05). Conclusion:MHT can significantly improve menopausal syndrome in women aged 40 to 65 years, and the effect in 50-54 years old group is better than that in 40-44 years old group.

Objective:To investigate the impact of menopause hormone therapy (MHT) on life quality improvement in women aged 40-65 years who suffered from menopausal syndrome.Methods:A retrospective cohort study was performed to analyze the clinical data of patients aged 40-65 years attending the menopause clinic of the Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, between April 2010 and November 2019. The menopause rating scale (MRS) was implemented to evaluate the scale and severity of menopausal syndrome.Results:The total MRS scores were 9.25, 5.25, 4.67 and 4.25 before and 3, 6 and 12 months after menopausal hormone therapy, respectively. Compared with baseline, MRS score decreased significantly after menopausal hormone therapy (all P<0.001). Furthermore, After treatment, the decrease of MRS score in 50-54 years old group was significantly higher than that in 40-44 years old group ( P=0.043). Other characteristics such as marriage, income and body mass index, were not associated with the decrease of MRS score (all P>0.05). Conclusion:MHT can significantly improve menopausal syndrome in women aged 40 to 65 years, and the effect in 50-54 years old group is better than that in 40-44 years old group.

Objective:To evaluate the clinical, radiological and arthroscopic outcomes after surgical repair for chronic lateral meniscus posterior root (LMPR) avulsion combined with anterior cruciate ligament (ACL) reconstruction.Methods:From July 2015 to June 2017, a total of 33 patients who underwent transtibial pull-out suture repair for chronic LMPR avulsion combined with anatomic single-bundle ACL reconstruction with hamstring graft were retrospectively reviewed. There were 30 males and 3 females with an average age of 27.7±7.5 years (range 17-45 years) and a mean BMI of 25.2±3.7 kg/m 2 (range 19.4-36.7 kg/m 2). All patients were available for at least two years of follow-up. A second-look arthroscopy was performed to evaluate the healing status of the repaired meniscus. Subjective knee function was assessed through Lysholm and Tegner scores. Objective knee stability was evaluated using KT-1000 arthrometer side-to-side difference (SSD) and pivot shift test under anesthesia. The tibiofemoral relationship was evaluated by anterior tibial subluxation (ATS) measured on axial MRI. Between patients with preoperative ATS ≥6 mm (18 patients in the ATS positive group) and <6 mm (15 patients in the ATS negative group), the postoperative ATS and the reduction of ATS was also compared. Results:After a mean follow-up of 27.5±4.0 months (range 24-39 months), the LMPR avulsion completely healed in 23 (70%) cases, partially healed in 9 (27%) cases, failed to heal in 1 (3%) case on second-look arthroscopy. The Lysholm score was increased from 60.4±13.6 to 82.7±11.1 at 1 year and to 91.4±9.1 at 2 years operatively ( F=155.996, P<0.001). The Tegner score was increased from 3(2, 5) to 4(3, 5) at 1 year and 6(4, 6) at 2 years postoperatively (χ 2=47.791, P<0.001). The KT-1000 SSD was decreased from 9.1±3.3 mm to 2.0±1.7 mm ( t=11.197, P<0.001). The result of pivot shift test was also improved (10 grade I, 20 grade II, 3 grade III, preoperatively vs 30 grade 0, 3 grade I, postoperatively, U=5.161, P<0.001). The ATS was reduced from 5.7±3.9 mm to 3.5±3.2 mm ( t=3.530, P=0.001). However, there was no statistically significant decrease in the ATS of the ATS negative group ( t=0.400, P=0.695). The ATS of the ATS positive group was reduced from 8.7±1.8 mm to 5.0±3.3 mm ( t=4.765, P<0.001), and the ATS reduction of the ATS positive group was greater than that of the ATS negative group (3.7±3.3 mm vs 0.3±2.8 mm, t=3.115, P=0.004). Conclusion:In patients undergoing ACL reconstruction, the transtibial pull-out suture repair for chronic LMPR avulsion yielded meniscus healing rate of 97% with improved subjective knee function and objective knee stability and better restored the tibiofemoral relationship for patients with excessive ATS.