Objective:To analyze the impact of adolescent pregnancy on maternal and infant outcomes.Methods:A retrospective cohort study was conducted on 5 765 parturbirths in Jining Medical College Hospital from January 1, 2019 to December 31, 2020. The parturbirths were divided into adolescent group (maternal age<20 years, 280 cases), age group 1 (maternal age 20-24 years, 1 733 cases) and age groups 2 (maternal age 25-34 years, 3 752 cases). All information was collected through the hospital′s electronic case system. General data, pregnancy characteristics and outcomes were compared among the three groups by analysis of variance (ANOVA), χ 2 tests and binary logistics regression analysis was used to analyze the impact of adolescent pregnancy on maternal and infant outcomes. Results:In the adolescent group, the proportion of women with an education of junior high school or below, rural residence, no fixed income, unmarried, and no history of induced abortion were all significantly higher than those in age group 1 and age group 2 (82.50% vs 17.37%, 14.37%; 59.29% vs 42.70%, 43.36%; 80.71% vs 15.52%, 14.71%; 75.71% vs 12.23%, 9.97%; 82.50% vs 71.84%, 71.91%) (all P<0.05); there was no significant differences in age at menarche, body mass index before pregnancy, and weight gain during pregnancy among the three groups (all P>0.05). The proportion of preterm birth, low birth weight infants and transferring to neonatal intensive care unit (NICU) in the adolescent group were all significantly higher than those in age group 1 and age group 2 (5.36% vs 1.10%, 1.57%; 5.00% vs 0.23%, 0.05%; 21.79% vs 6.12%, 15.17%); the incidence of anemia in pregnancy in the adolescent group was significantly higher than that in age group 1 (15.36% vs 9.75%), and the incidence of postpartum hemorrhage was significantly higher than that in the age group 2 (10.71% vs 6.08%). The incidence of failed vaginal trials leading to cesarean section, amniotic fluid contamination, and episiotomy was significantly lower in the adolescent group than those in age group 2 (8.57% vs 15.22%, 10.71% vs 18.10%, 33.95% vs 40.01%) (all P<0.05). The incidence of failed vaginal trials leading to cesarean section was inversely associated with gestational age (adolescent group, OR=0.252, 95% CI: 0.123-0.515; age group 1, OR=0.673, 95% CI: 0.567-0.799) (both P<0.05); the risks of low birth weight infants (adolescent group, OR=7.440, 95% CI: 3.426-16.156; age group 1, OR=0.103, 95% CI: 0.032-0.330) and transferring to the NICU (adolescent group, OR=1.661, 95% CI: 1.120-2.463; age group 1, OR=0.360, 95% CI: 0.290-0.448) showed a U-shaped distribution in different pregnancy age groups, they were both higher in the adolescent group than those in the age group 2 (both P<0.05); the risk of episiotomy (adolescent group, OR=0.002, 95% CI: 0-0.016; age group 1, OR=1.308, 95% CI: 1.151-1.485) showed an inverted U-shape distribution across the different pregnancy age groups, it was lower in the adolescent group than that in age group 2 (both P<0.05). Conclusion:Adolescent pregnancy is associated with a lower risk of conversion to cesarean section and episiotomy due to failed vaginal delivery, but may increase the risk of low birth weight infants and transferring to NICU.

Objective:To explore the relationship among physical exercise, self-control, and mobile phone dependence in adolescents.Methods:The entire group of random sampling method was used to extract 882 students from five junior high schools in Nanchang city from September 2020 to March 2021.A longitudinal survey was conducted using the sports activity rating scale, self control scale, and adolescent mobile phone dependence scale on all participants for 2 times with an interval for 6 months.The questionnaire results in the first stage were marked as T1.The questionnaire results in the second stage were marked as T2.SPSS 26.0 statistical software was used to conduct reliability analysis, common method bias test and Pearson correlation analysis on each variable in sequence.AMOS 23.0 was used for cross-lag analysis to explore the relationship among physical exercise, self-control and mobile phone dependence.Results:The score of physical exercise of adolescents was (17.71±5.62), the score of self-control was (51.48±9.71), and the score of mobile phone dependencies was (56.67±12.93). Adolescent physical exercise, self-control, and mobile phone dependence were all related to stability across time.There were positive correlation between T1 physical exercise and T2 physical exercise ( r=0.489), T1 self-control and T2 self-control ( r=0.482), as well as T1 mobile phone dependencies and T2 mobile phone dependencies ( r=0.498)(all P<0.01). Cross-lag analysis showed that: adolescent physical exercise behavior could unidirectionally predict self-control( β=0.197, P<0.01)and mobile phone dependence( β=-0.224, P<0.01) after 6 months, and self-control could predict the mobile phone dependence( β=-0.560, P<0.01) of junior high school students after 6 months.The mediating effect results showed that self-control had a mediating effect between physical exercise and mobile phone dependence of junior high school students, there were gender differences.The mediating effect accounted for 22.22%(-0.018/-0.081). Conclusion:Physical exercise can indirectly reduce the mobile phone dependence of junior high school students by affecting self-control.

Rhodotorula toruloides is a non-conventional red yeast that can synthesize various carotenoids and lipids. It can utilize a variety of cost-effective raw materials, tolerate and assimilate toxic inhibitors in lignocellulosic hydrolysate. At present, it is widely investigated for the production of microbial lipids, terpenes, high-value enzymes, sugar alcohols and polyketides. Given its broad industrial application prospects, researchers have carried out multi-dimensional theoretical and technological exploration, including research on genomics, transcriptomics, proteomics and genetic operation platform. Here we review the recent progress in metabolic engineering and natural product synthesis of R. toruloides, and prospect the challenges and possible solutions in the construction of R. toruloides cell factory.
Gene Editing ; Metabolic Engineering ; Rhodotorula/metabolism* ; Lipids

Objective:To construct and validate a prediction model for the risk of intermediate cesarean delivery for primiparous women with failed vaginal trial of labor.Methods:Clinical data of 6 128 pregnant women who gave birth in the Affiliated Hospital of Jining Medical College from January 2019 to December 2020 were collected. The puerpera was randomly divided into train set ( n=4 290) and validation set ( n=1 838). The factors influencing the conversion to cesarean section in primiparous women with failed vaginal trial of labor were analyzed with univariate and binary multivariate logistic regression, and a risk prediction model was established based on the influencing factors. The predictive power of the model was assessed by receiver operating characteristic (ROC) curve and the Hosmer-Lemeshow goodness-of-fit test in train set and validation set. Results:Among 6 128 pregnant women 1 042 cases failed in vaginal trial of labor and were transferred to cesarean section. Univariate analysis showed age, occupation, gestational weight gain, days of gestation, body temperature before delivery, fetal heart condition at delivery, fetal abdominal circumference, Bishop score, premature rupture of membranes, gestational illness, mode of induction of labor, labor analgesia, and fetal orientation were significantly associated with converting to cesarean delivery (all P<0.05). The multivariate binary logistic regression analysis showed that the age, gestational weight gain, body temperature, gestational co-morbidities, days of gestation, premature rupture of membranes, amniotic fluid contamination, induction of labor, and abnormal occipital position were independent risk factors for intermediate cesarean delivery ( OR=1.03-8.06, all P<0.05); while height, occupation, Bishop score, and labor analgesia were protective factors for intermediate cesarean delivery ( OR=0.17-0.96, all P<0.05). A risk prediction model was constructed based on the risk factors and protective factors. In train set, the area under the ROC curve(AUC) of the model was 0.902 (95% CI: 0.89-0.92, P<0.001), with the best cutoff value of 0.138, the sensitivity and specificity were 0.837 and 0.825, respectively; and the Hosmer-Lemeshow goodness-of-fit test showed P=0.192. In validation set the AUC of the model was 0.917 (95% CI: 0.90-0.93, P<0.001), and the sensitivity and specificity were 0.826 and 0.851, respectively; the total correct rate of the model was 87.21% (1 603/1 838). Conclusion:The risk prediction model of failed vaginal trial of labor in primiparous women for intermediate cesarean delivery constructed in this study has good clinical prediction efficacy and high correctness rate.

Objective:To investigate the current status of women′s level of birth experience and lactation initiation time and explore the effect of level of birth experience on lactation initiation time.Methods:This was a cross-sectional study. A convenience sampling method was used to select 622 maternal cases attending the Affiliated Hospital of Jining Medical College from November, 2020 to January, 2021, and the distribution of their labor experience level and lactation initiation time was investigated by questionnaire and follow-up assessment.Results:There were 622 women with transvaginal deliveries who had lactation initiation times of more than 72 h in 241 cases (38.75%). The scores for each dimension of the Childbirth Experience Questionnaire (CEQ) were (49.63 ± 8.58)points, and the scores for each dimension of CEQ were perceived safety, professional support, involvement and self-efficacy in descending order. The results of the correlation analysis showed that there was a negative correlation between the scores on each dimension of CEQ and the total score and lactation initiation time ( r values were -0.436 to -0.146, all P<0.01). Stratified regression analysis showed that after controlling for age, number of births, gestational weeks of labour, illness during pregnancy and labour analgesia as the underlying variables affecting lactation initiation time, the scores for self-efficacy, involvement, perceived safety and professional support in the CEQ all affected lactation initiation time after delivery ( t values were -6.76 to -2.02, all P<0.05). Conclusions:The birth experience and lactation of women who deliver via vaginal birth need to be taken into account. The more negative the birth experience, the longer the lactation initiation time. The women′s involvement in the birth process, their own competence, perceived safety and level of professional support are all valid influencing indicators of lactation initiation time.

Objective:To investigate the effect of attention and interpretation therapy on posttraumatic stress disorder and perceived stress of parents with children having developmental dislocation of the hip.Methods:Totally 96 parents with children having developmental dislocation of the hip from women and children hospital of Hubei province were divided into experimental group ( n=46) and control group ( n=46) according to the random number table method. The control group received routine postoperative DDH care. On the basis of this, the experimental group was given attention and interpretation therapy for 8 weeks. Before intervention and at the end of intervention, the effects were assessed by Posttraumatic Stress Checklist-Civilian Version (PCL-C) and Chinese Perceived Stress Scale (CPSS). Results:After intervention, the scores of arousal symptoms, avoidance/numbing, re-experiencing symptoms and total PCL-C scores were 8.47±2.30, 10.67±2.67, 7.49±2.63, 26.62±4.10, in addition, the scores of sense of tension, sense of out of control and total scores of CPSS were 11.71±2.21, 11.27±2.95, 22.98±3.77, which were significantly lower than those in the control group (9.45±2.33, 12.39±2.43, 8.93±2.79, 30.77±5.30, 12.86±3.05, 13.09±3.46, 25.95±4.52), the difference was statistically significant ( t value was 2.013-4.135, P<0.05). Conclusion:Attention and interpretation therapy can effectively relieve posttraumatic stress disorder symptom and alleviate perceived stress level of parents with children having developmental dislocation of the hip.

OBJECTIVE： To improve the efficiency and accuracy of checking total parenteral mutrition （TPN） prescription. METHODS： Excel vba technology was used to edit vba code and construct TPN prescription algorithm. The key indicators and standard of TPN prescription checking were determined. Established algorithm was used to check the prescriptions from PIVAS of our hospital in May 2018， results of which was compared with the results of manual checking （using potassium concentration， monovalent cation concentration and alanyl-glutamine combined with amino acid as indexes）. RESULTS： TPN prescription algorithm was established through confirming 17 key indicators as glycolipid ratio， heat-nitrogen ratio， monovalent cation concentration， the checking standard was set as. It took 15 seconds to check 2 638 TPN prescriptions received within one month in PIVAS of our hospital； 449 irrational prescriptions （excessive dose， incompatibility， inappropriate proportion and volume of nutrition） of them and reasons had been marked out. By comparing 3 evaluation indexes， 1， 1， 0 irrational prescriptions were checked by manually and 4， 12， 4 checked by established algorithm， respectively. CONCLUSIONS： TPN prescription algorithm can check prescription in batches based on Excel vba technology， and mark out the substandard prescription automatically. Hereby， it improves the efficiency and accuracy of TPN prescriptions by PIVAS.

OBJECTIVE： To provide experience and reference for the study of medical insurance budget impact analysis （BIA） in China. METHODS： Retrieved from PubMed， ProQuest， CNKI， Wanfang database and CBM， related literatures about medical insurance BIA research in China and the United States were collected since the establishment of the database. The basic information， analysis results and data sources were summarized and sorted out， and descriptive analysis of the included literature was carried out on basis of seven key elements such as model design， research perspective， treatment cost， reference scenario， target population， research time limit and discount/inflation， sensitivity analysis. RESULTS： A total of 72 literatures were included in this study， involving 24 （33.33％） studies in China， 48 （66.67％） studies in the United States； the indications of 45 studies were chronic diseases （62.50％）， and those of 21 studies were acute diseases （37.50％）. Among the research methods， 49 studies （68.06％） used BIA alone and 23 studies （31.94％） adopted BIA combined with pharmaceutical economics. In terms of model design， 50 studies （69.44％） adopted cost calculation models. In terms of research perspective， 60 studies （81.94％） were based on the perspective of medical insurance department research. In the calculation of treatment cost， 69 studies （95.84％） included drug cost. In terms of reference scenarios， 61 studies （84.72％） compared the economics of different drug-based treatment groups. For target population， only 31  （43.06％） studies used real world data. In terms of research duration and discount/inflation， 14 studies （19.44％） used treatment or length of hospitalization to indicate research duration， and 19 studies （26.39％） used discount rate or inflation rate to adjust costs. As for sensitivity analysis， 62 studies （86.11％） conducted sensitivity analysis， of which 49 （68.06％） used single factor sensitivity analysis. CONCLUSIONS： There are still some limitations in medical insurance BIA research literature in China and the United States， such as unreasonable use of data， incomplete coverage of the cost， and unreasonable setting of sensitivity analysis variables. It is recommended that BIA research should standardize data sources to improve the quality of budget evidence quality， reasonably evaluate market size to improve the authenticity of prediction， scientifically set variables and their scope of change to improve the stability of results， establish BIA research paradigms or evaluating standards so as to guide BIA research scientifically.

OBJECTIVE:To put forward relevant suggestions for formulating and implementing medical insurance budget impact analysis(BIA)research guideline in China. METHODS:The medical insurance BIA guidelines or relevant documents were retrieved from ISPOR,Canada and the United States. Their similarities and differences were compared. The experiences of them were summarized in respects of research framework,data source and report format of medical insurance BIA. RESULTS &CONCLUSIONS:ISPOR,Canada,USA and other guidelines or relevant documents have some similarities in normalization requirements of research perspectives,target population calculation based on natural reason and epidemiological data,3-5 years as the research time limit and some other respects. But the calculation of additional costs as drug price addition,distribution fee should be specifically adjusted according to the unique characteristics of the health systems of countries or regions. Based on the actual conditions of our own health care system,our country can draw up the guidelines for medical insurance BIA impact analysis,which contain model design,research perspective,target population,current use of intervention measures,prediction on the effects of new intervention measure introduction on the market,cost,time range,discount and uncertainty analysis of current and new interventions,situational analysis and verification,so as to better play its role in the formulation and adjustment of medical insurance catalogues and in drug price negotiations.

Objective To investigate the relationship between peripheral blood mtDNA content and acute coronary syndrome. Methods A total of 244 patients who received coronary angiography(CAG)was enrolled in this study. They were divided into acute coronary syndrome(ACS)group(n=183)and control group(n=61)ac-cording to the CAG results. A quantitative real-time PCR-based method was used to measure relative content of mtDNA in peripheral blood. According to lesion blood vessel counts ,ACS patients were divided into single lesion group,double lesion group and three lesions group. Gensini score was used to quantitatively evaluate the severity of coronary stenotic lesions. Then we analyzed the relationship of mitochondrial DNA content with the lesion counts and the Gensini score. Results The ACS group had a lower mtDNA content ,as compared to controls (P <0.001).The lesion blood vessel count and mtDNA content in the single ,double and three vascular lesions group were all significanlty lower than that of the control group(P<0.05)and that of the double,three vascular lesions group were both significantly lower than that of the single vascular lesion group(P<0.05). According to the Gensi-ni score,all patients were divided into four groups,where with mtDNA content was decreased with the increase of the Gensini score(P < 0.01). The linear regression analysis showed that Gensini score was negatively correlated with mtDNA content(r=-0.644,P<0.001). ROC curve analysis showed that the area under the curve of mtDNA content for ACS diagnosis was 0.855(P<0.001),with the sensitivity and specificity of 0.756 and 0.833,respec-tively. Conclusion MtDNA content is closely associated with ACS and the Gensini score ,the latter indicating the severity of coronary stenotic lesions. MtDNA content detection has its value in the diagnosis of ACS.