Objective:To explore the resting-state network(RSN) of college students with high obsessive-compulsive tendency by electroencephalographic (EEG) microstate analysis, with the aim of informing early identification and intervention of obsessive-compulsive disorder (OCD).Methods:From December 2021 to February 2022, a total of 687 college students from Anhui Medical University were investigated by obsessive-compulsive inventory-revised(OCI-R). Thirty students were selected as the high obsessive-compulsive tendency group (OCI-R>25) and thirty-two students were selected as the low obsessive-compulsive tendency group (OCI-R<15), and 4-minute resting-state EEG data were collected for all subjects. The collected EEG data were analyzed to explore the EEG microstate by spectral decomposition, and intergroup differences in different frequency bands were compared separately using Python (v3.9.0) permutation test for independent samples. Additionally, partial correlation analysis was performed between microstate parameters that exhibited significant between-group differences and symptom scale scores, controlling for age, gender and years of education.Results:(1) The scores of self-rating anxiety scale (37.77±6.01 vs 29.75±6.08), the self-rating depression scale (42.97±8.52 vs 32.78±6.61), OCI-R (34.07±7.10 vs 6.25±3.81), and the Padua inventory-Washington State University revision (56.70±12.98 vs 21.22±10.28) in high obsessive-compulsive tendency group were higher than those of the low obsessive-compulsive tendency group( t=5.215-19.401, all P<0.01). (2) EEG microstate analysis revealed that in the theta band, compared to the low obsessive-compulsive tendency group, the high obsessive-compulsive tendency group showed longer duration ((109.05±19.29)ms vs (100.86±12.02)ms) and higher coverage ((23.27±8.39)% vs (19.51±5.41)%) of microstate A, along with a lower occurrence of microstate B ((1.81±0.43)times/s vs (2.02±0.36)times/s), (all P<0.05). In the beta band, compared to the low obsessive-compulsive tendency group, the high obsessive-compulsive tendency group showed higher duration ((84.17±9.08)ms vs (79.52±5.92)ms) and coverage ((20.30±6.91)% vs (17.43±3.36)%) of microstate A (both P<0.05). (3) Correlation analysis showed that, in the theta band, both the duration and coverage of microstate A were positively correlated with the contamination/washing compulsions factor (CWCF) score ( r=0.482, P=0.011; r=0.406, P=0.035, respectively), while the occurrence of microstate B was negatively correlated with CWCF score ( r=-0.430, P=0.025). Conclusion:The duration and coverage of microstate A may be an early warning signal for the development of contamination/washing compulsions symptoms. In addition, the theta and beta bands are sensitive bands for obsessive-compulsive symptoms.

Objective:To explore the resting-state network(RSN) of college students with high obsessive-compulsive tendency by electroencephalographic (EEG) microstate analysis, with the aim of informing early identification and intervention of obsessive-compulsive disorder (OCD).Methods:From December 2021 to February 2022, a total of 687 college students from Anhui Medical University were investigated by obsessive-compulsive inventory-revised(OCI-R). Thirty students were selected as the high obsessive-compulsive tendency group (OCI-R>25) and thirty-two students were selected as the low obsessive-compulsive tendency group (OCI-R<15), and 4-minute resting-state EEG data were collected for all subjects. The collected EEG data were analyzed to explore the EEG microstate by spectral decomposition, and intergroup differences in different frequency bands were compared separately using Python (v3.9.0) permutation test for independent samples. Additionally, partial correlation analysis was performed between microstate parameters that exhibited significant between-group differences and symptom scale scores, controlling for age, gender and years of education.Results:(1) The scores of self-rating anxiety scale (37.77±6.01 vs 29.75±6.08), the self-rating depression scale (42.97±8.52 vs 32.78±6.61), OCI-R (34.07±7.10 vs 6.25±3.81), and the Padua inventory-Washington State University revision (56.70±12.98 vs 21.22±10.28) in high obsessive-compulsive tendency group were higher than those of the low obsessive-compulsive tendency group( t=5.215-19.401, all P<0.01). (2) EEG microstate analysis revealed that in the theta band, compared to the low obsessive-compulsive tendency group, the high obsessive-compulsive tendency group showed longer duration ((109.05±19.29)ms vs (100.86±12.02)ms) and higher coverage ((23.27±8.39)% vs (19.51±5.41)%) of microstate A, along with a lower occurrence of microstate B ((1.81±0.43)times/s vs (2.02±0.36)times/s), (all P<0.05). In the beta band, compared to the low obsessive-compulsive tendency group, the high obsessive-compulsive tendency group showed higher duration ((84.17±9.08)ms vs (79.52±5.92)ms) and coverage ((20.30±6.91)% vs (17.43±3.36)%) of microstate A (both P<0.05). (3) Correlation analysis showed that, in the theta band, both the duration and coverage of microstate A were positively correlated with the contamination/washing compulsions factor (CWCF) score ( r=0.482, P=0.011; r=0.406, P=0.035, respectively), while the occurrence of microstate B was negatively correlated with CWCF score ( r=-0.430, P=0.025). Conclusion:The duration and coverage of microstate A may be an early warning signal for the development of contamination/washing compulsions symptoms. In addition, the theta and beta bands are sensitive bands for obsessive-compulsive symptoms.

Standardized patient (SP) has been widely used for medical teaching and assessment in medical colleges at home and abroad. Pediatric consultations are mostly directed toward parents, so in pediatric education, SP is usually referred to as standardized family (Sfam), which is trained to portray the patient's family members. At present, the development of Sfam in pediatric teaching in China is relatively slow. Based on the characteristics of pediatric teaching, the paper summarizes the necessity of Sfam, the application of different types of Sfam, the integration of Sfam with other clinical teaching methods, and the value of Sfam in pediatric teaching, and also discusses the future direction and prospects of Sfam combined with artificial intelligence in pediatric teaching. After years of development, Sfam has been proved to be an effective teaching model. We hope this paper can help more pediatric clinical educators gain a deeper understanding of the Sfam teaching method, and promote the application of Sfam in pediatric teaching to maximize its role in advancing the development of pediatric education.

Idiopathic nephrotic syndrome(INS)in children is a type of primary glomerular disease caused by a variety of causes.Recent research has highlighted the pivotal roles of immune dysfunction and gut microbiota imbalance in its development.Regulatory T cell dysfunction is key in INS progression,and changes in gut microbiota composition and its metabolic byproducts are closely tied to immune system disruption.This study aims to perform a systematic review of the relationship between immune dysfunction and gut microbiota dysbiosis in INS children.

Idiopathic nephrotic syndrome(INS)in children is a type of primary glomerular disease caused by a variety of causes.Recent research has highlighted the pivotal roles of immune dysfunction and gut microbiota imbalance in its development.Regulatory T cell dysfunction is key in INS progression,and changes in gut microbiota composition and its metabolic byproducts are closely tied to immune system disruption.This study aims to perform a systematic review of the relationship between immune dysfunction and gut microbiota dysbiosis in INS children.

AIM: To investigate the mechanism of elemene synergistic bortezomib against multiple myeloma based on ROS-NF-κB-p38MAPK signaling pathway. METHODS: CCK-8 assay was used to detect cell activity. Nude mice were randomly divided into control group, bortezomib (BTZ) group, elemene (ELE) group and combination group. Each group was treated with BTZ, ELE and BTZ combined with ELE, respectively. Tunel staining was performed to observe the apoptosis of tumor tissues. The expressions of Caspase-3, Bcl-2, NF-κB and p38 MAPK were detected by Western Blot. Cell cycle, apoptosis and reactive oxygen species (ROS) expression were detected by flow cytometry using human myeloma U266 cells. RESULTS: When 4.0 μmol/L ELE combined with 50 nmol/L BTZ treated U266, the cell activity was significantly reduced compared with that of NC, BTZ and ELE groups (P< 0.05). The tumor volume of nude mice in BTZ group, ELE group and combined group was significantly reduced compared with the control group (P <0.05), and the combined group was the smallest. Tunel staining results showed that the apoptosis level in the control group was lower than that in the BTZ group, ELE group and the combined group (P<0.05), and the combined group had the lowest apoptosis level. Compared with the control group, the expressions of Caspase-3 and p38 MAPK in BTZ group, ELE group and combination group were significantly increased, while the expression of Bcl-2 was significantly decreased. The apoptosis level and expression of ROS in BTZ group, ELE group and the combined group was significantly increased compared with the control group (P<0.05). CONCLUSION: ELE can enhance the role of BTZ in promoting apoptosis of myeloma cells, which may be achieved by regulating ROS/NF-κB/p38 MAPK signaling pathway to enhance the level of apoptosis of tumor cells to achieve anti-tumor effect.

Pediatric idiopathic nephrotic syndrome (INS) is characterized by massive albuminuria, hypoproteinemia, edema and hyperlipidemia, with a long course and high probability of relapse and prolongation. Long-term complications caused by long-term usage of hormones and immunosuppressants in children with INS seriously affect their physical and mental health and quality of life. Most children with steroid-sensitive nephrotic syndrome can be cured before adulthood, while some of them relapse in adulthood. Long-term prognosis of children with steroid-resistant nephrotic syndrome is poor. There have been few studies in China followed the long-term outcomes and its related factors of children with INS over 10 years. The paper reviewed the literatures on the long-term outcomes of children with INS, including renal survival, growth, mental health, learning and work, marriage and fertility, disease recurrence and long-term related complications, to explore the factors related to the poor long-term outcomes of children with INS and to assist in clinical decision-making and follow-up management.

Objective:To explore the differences of the resting-state functional connectivity(FC) between goal-directed network and habituation networks in patients with early- and late-onset obsessive compulsive disorder (OCD) and the correlation between the strength of FC in the differential brain regions and cognitive flexibility.Methods:From October 2019 to April 2021, 40 patients with OCD were included in this study, including 22 patients with early-onset OCD and 18 patients with late-onset OCD.The cognitive flexibility of all subjects was assessed using the Wisconsin card sorting test (WCST), the Stroop task and the trail making test (TMT). The brain regions which were associated with goal-directed network(caudate, orbitofrontal cortex, ventromedial prefrontal cortex, and anterior cingulate cortex) and the brain regions which were associated with habituation network(putamen, supplementary motor area and insula) were selected as FC regions of interest (ROI). The DPABI and SPM12 plug-ins in the matlab2011a platform were used for whole brain FC analysis to compare the difference of FC between patients with early-onset OCD and patients with late-onset OCD on the two networks.The data were analyzed by SPSS 25.0 with χ2 test, independent samples t-test, and Pearson correlation analysis. Results:Compared with patients with early-onset OCD, patients with late-onset OCD had significantly enhanced FC of the left supplementary motor area with the left putamen and left insula.The total number of persistent errors of WCST in patients with late-onset OCD was greater than that in patients with early-onset OCD ((20.61±11.30), (14.95±8.94), P<0.05). The FC of the left putamen-left supplementary motor area was significantly and positively correlated with the total number of sustained responses ( r=0.678, P=0.003) and the total number of incorrect responses ( r=0.590, P=0.013) in patients with late-onset OCD.The FC of the left supplementary motor area-left insula was significantly positively correlated with the number of responses required to complete the first classification in patients with late-onset OCD ( r=0.485, P=0.049). Conclusion:Patients with late-onset OCD have stronger habituation network FC than patients with early-onset OCD, and the enhanced FC correlates with patients' cognitive flexibility performance, while late-onset OCD has more impaired cognitive flexibility than early-onset OCD.

Objective: To analyze the epidemiological characteristics and trends of chronic disease mortality among children aged 0-14 in China during 2012-2021, so as to provide scientific basis for the formulation of prevention strategies for chronic diseases in children. Methods: The descriptive epidemiological analysis was conducted for chronic disease mortality among children aged 0-14 during 2012 to 2021 from China Cause of Death Surveillance Data Set, and the Joinpoint regression models were used to analyze the average annual percentage change (AAPC) of child chronic disease mortality. Results: From 2012 to 2021, the mortality rates of chronic diseases among children aged 0-14 years in China (23.33/100 000, 19.54/100 000, 19.27/100 000, 17.69/ 100 000 , 16.87/100 000, 16.44/100 000, 14.49/100 000, 13.79/100 000, 11.61/100 000, 9.43/100 000)showed a decreasing trend (AAPC=-7.94%, P <0.01). The overall mortality rates for boys and girls and for chronic diseases were decreasing in both urban and rural areas (AAPC=-8.44%, -7.05%, -8.42%, -6.77%, P <0.05). The average annual mortality rate of chronic diseases was higher in boys (16.81/100 000) than in girls (13.96/100 000) ( χ 2=526.44, P <0.01). The average annual mortality rate from chronic diseases among children was higher in urban (15.98/100 000) than in rural areas (13.46/100 000) in the central region, and higher in rural (19.75/100 000) than in urban areas (15.96/100 000) in the western region ( χ 2=117.63, 190.25, P < 0.01 ). Except for malignant tumors, the trend of overall mortality rates of congenital abnormalities, neurological and mental disorders, cardiovascular diseases, and digestive system diseases were all decreasing (AAPC=-11.48%, -2.92%, -7.82%, -12.51 %, P <0.05). Conclusions The overall mortality rate of chronic diseases in children in China shows a downward trend during 2012-2021, but the situation of chronic disease prevention and control is still severe. Targeted prevention strategies should be adopted, focusing on the prevention and health care of males, children under 5 years old.

Objective: To investigate the correlation between serum asymmetric dimethylarginine (ADMA) and cystatin C (CysC) in degenerative calcific aortic valvular disease and its clinical application value. Methods: One hundred and eighty patients with degenerative calcific aortic valvular disease who were treated in Beijing Luhe Hospital Affiliated to Capital Medical University from June 2016 to June 2018 were selected as the study subjects, and another 82 healthy subjects from the same hospital in the same period were selected as the control group. Serum ADMA and CysC levels were detected by enzyme-linked immunosorbent assay and latex-enhanced immunoturbidimetric assay. Risk factors of degenerative calcific aortic valvular disease were analyzed by Logistic regression analysis. Evaluation of the diagnostic efficacy of serum ADMA and CysC for degenerative calcific aortic valvular disease was used by receiver operating characteristic curve. Results: There were no significant differences in the general data between the two groups in terms of age, gender, body mass index, drinking history, smoking history, and history of hypertension (P>0.05). The systolic blood pressure(SBP), diastolic blood pressure (DBP), heart rate (HR), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterin(LDL-C), CysC and ADMA levels of the study group were significantly higher than those of the control group [(131.51 ± 19.09) mmHg (1 mmHg=0.133 kPa) vs. (126.48 ± 16.68) mmHg, (91.11 ± 16.35) mmHg vs. (86.89 ± 10.71) mmHg, (74.39 ± 15.22) beats/min vs. (70.09 ± 13.01) beats/min, (4.51 ± 1.12) mmol/L vs. (4.15 ± 0.92) mmol/L, (1.91 ± 0.63) mmol/L vs. (1.60 ± 0.65) mmol/L, (2.59 ± 1.13) mmol/L vs. (2.27 ± 0.85) mmol/L, (1.01 ± 0.22) mg/L vs. (0.79 ± 0.16) mg/L, (20.17 ± 6.38) ng/L vs. (11.88 ± 4.22) ng/L], and left ventricular ejection fraction (LVEF), high density lipoprotein cholesterin (HDL-C) levels were significantly lower than those of the control group [(56.45 ± 9.21)%vs. (60.87 ± 10.02)%, (1.56 ± 0.63) mmol/L vs. (1.76 ± 0.62) mmol/L], there were significant differences (P<0.05). Logistic multivariate regression analysis showed that serum CysC and ADMA were independent risk factors for degenerative calcific aortic valvular disease (P<0.05). Receiver operator characteristic (ROC) curve analysis showed that area under curve (AUC) of serum CysC for degenerative valvular heart disease was 0.785, with a sensitivity of 71.67%, and a specificity of 73.17%. The AUC of serum ADMA for degenerative valvular heart disease was 0.862, with a sensitivity of 71.67%, and a specificity of 87.80%. The AUC of serum CysC combined with ADMA in the diagnosis of degenerative valvular heart disease was 0.910, with a sensitivity of 85.56%, and a specificity of 84.15%, which was significantly higher than the two alone (Z=4.897 and 3.335, P<0.05). Conclusions Serum ADMA is positively correlated with CysC in patients with degenerative valvular heart disease, and can be used as diagnostic serum markers for degenerative calcific aortic valvular disease. It has clinical reference value for improving the diagnosis of degenerative calcific aortic valvular disease.