Objective: To investigate the availability and use of child safety seats among children aged 0-3 years, so as to provide the basis for improving riding safety for children. Methods: Parents of children aged 0-3 years in Huangpu District, Shanghai Municipality, were recruited using the stratified multistage random sampling method from May to July 2024. Demographic information, family travel patterns, the use of child safety seat and related health beliefs were collected using questionnaire surveys. Factors affecting the use of child safety seats were identified using a multivariable logistic regression model. Results: Totally 514 valid questionnaires were recovered, with an effective rate of 96.98%. The respondents included 122 fathers (23.74%) and 392 mothers (76.26%), with a median age of 34.00 (interquartile range, 5.00) years. There were 446 families equipping with child safety seats, accounting for 86.77%; and 169 families using child safety seats, accounting for 32.88%. Multivariable logistic regression analysis showed that the parents who had children aged >1-2 years (OR=0.597, 95%CI: 0.366-0.973), travelled 2-4 times per month (OR=0.359, 95%CI: 0.213-0.607) or once per month or less (OR=0.384, 95%CI: 0.202-0.729), and scored high in perceived barrier (OR=0.634, 95%CI: 0.486-0.827) were less likely to use child safety seats; the parents who had children with local household registration (OR=2.506, 95%CI: 1.356-4.633), travelled 5-<10 km (OR=1.887, 95%CI: 1.148-3.101) or ≥10 km (OR=2.319, 95%CI: 1.355-3.967), always wore seat belts (OR=2.342, 95%CI: 1.212-4.524), scored high in perceived susceptibility (OR=1.392, 95%CI: 1.091-1.778) and self-efficacy (OR=1.413, 95%CI: 1.156-1.727) were more likely to use child safety seats. Conclusions Equipping family cars with child safety seats and using them can prevent and reduce traffic injuries among children aged 0-3 years. It is recommended to strengthen publicity to promote the use of child safety seats.

OBJECTIVE: To explore the clinical characteristics and genetic factors in four patients with Disorder of sex development (DSD). METHODS: Four patients who visited Tianjin Medical University General Hospital between January 2023 and January 2024, presenting with short stature, abnormal external genitalia, or infertility as their chief complaints, were selected as the study subjects. Clinical data were collected, and peripheral or umbilical cord blood samples were obtained for karyotyping analysis and low-depth whole-genome sequencing (CNV-seq). Quantitative fluorescence PCR (QF-PCR) was used to detect the sex-determining region Y (SRY) gene and azoospermia factor (AZF) on the Y chromosome, while fluorescence in situ hybridization (FISH) was employed to determine the location of the SRY gene. Whole exome sequencing (WES) was performed for genetic testing, and Sanger sequencing was used for familial validation of the candidate variants. The study procedure and protocol were approved by the Medical Ethics Committee of Tianjin Medical University General Hospital (Ethics No.: IRB2024-WZ-006). RESULTS: Case 1 had a karyotype of 45,X[22]/46,XY[8], with CNV-seq indicating a mosaic deletion of 7.44 Mb (copy number = 0.2) at Yp11.31-p11.2, a mosaic deletion of 5.32 Mb (copy number = 0.3) at Yq11.1-q11.221, and a deletion of 10.26 Mb (copy number = 0) at Yq11.221-q11.23. Y chromosome microdeletion analysis showed SRY and AZFa (+), AZFb+c (-). Case 2 had a karyotype of 45,X[12]/46,X,del(X)(q26.3)[18], with CNV-seq indicating a mosaic deletion of 132.62 Mb (copy number = 1.4) at Xp22.33-q26.3 and a deletion of 19.62 Mb (copy number = 1) at Xq26.3-q28. Case 3 had a karyotype of 46,XX, with CNV-seq showing two copies of the X chromosome and no Y chromosome. Y chromosome microdeletion analysis showed SRY (+) and AZFa+b+c (-), and FISH confirmed a translocation of the SRY gene to the terminal end of the short arm of the X chromosome. Case 4 had a karyotype of 46,XY, with CNV-seq showing one copy each of the X and Y chromosomes. Y chromosome microdeletion analysis showed SRY(+) and AZFa+b+c (+), and WES revealed a c.1103del variant in the AR gene (maternal origin), which was classified as a pathogenic variant based on the guidelines from the American College of Medical Genetics and Genomics (ACMG) (PVS1+PP1+PM2_Supporting). CONCLUSION The combined application of multiple detection techniques such as chromosomal karyotyping analysis, CNV-seq, QF-PCR, and WES can identify the genetic etiology of DSD patients, providing a basis for clinical consultation and treatment plan formulation.
Humans ; Male ; Female ; Chromosomes, Human, Y/genetics* ; Disorders of Sex Development/genetics* ; Sex-Determining Region Y Protein/genetics* ; Karyotyping ; In Situ Hybridization, Fluorescence ; Exome Sequencing ; Adult ; Child

Objective:To explore the rehabilitation effects of individual computer story-version magnanimous therapy (ICSMT) on patients with end-stage renal disease undergoing maintenance hemodialysis (MHD).Methods:A total of 120 patients with end-stage renal disease receiving MHD treatment at the Department of Nephrology Hemodialysis Center of Huadu District People's Hospital of Guangzhou from August 2022 to April 2024 were selected as the study subjects.They were randomly divided into control group ( n=60, receiving routine clinical treatment) and ICSMT group ( n=60, receiving routine clinical treatment combined with ICSMT for psychological intervention) by random number table method.The patients in the two groups were evaluated by the self-rating anxiety scale (SAS), self-rating depression scale (SDS), enterprising and magnanimous questionnaire (EMQ), the short-form-36 health survey (SF-36), and activity of daily living scale (ADL) before intervention and at 4-week post-intervention.Blood pressure, blood urea nitrogen (BUN), hemoglobin (Hb), and serum albumin (ALB) levels were also measured before the intervention and at the 4-week post-intervention.The clinical global impression scale (CGI) was used to evaluate clinical efficacy before the intervention, at the 2-week post-intervention, and at the 4-week post-intervention.Statistics analysis was performed using SPSS 29.0.1.0(171). Independent-samples t-test, paired t-test, Mann-Whitney U test and Wilcoxon signed-rank test were used for statistical analysis. Results:After 4 weeks of intervention, the SAS and SDS in the ICSMT group (49.0 (48.0, 50.0), 50.0 (49.0, 51.0)) were significantly lower than those in the control group (51.0 (50.0, 52.0), 52.0 (51.0, 53.0)) (both P<0.001). The enterprising subscore of the EMQ in the ICSMT group (35.0 (32.0, 37.0)) was significantly higher than that in the control group (31.0 (29.0, 34.0)) ( P<0.001). Furthermore, the differences of enterprising and magnanimous subscores between the two groups before and after intervention in the ICSMT group (2.0 (1.0, 4.0), 1.0 (-1.0, 2.0))were significantly higher than those in the control group (-1.0 (-1.0, 0), -1.0 (-1.2, 0)) (both P<0.05). Systolic and diastolic blood pressure values in the ICSMT group (130 (126, 134) mmHg, 85 (80, 88) mmHg)were significantly lower than those in the control group (145 (138, 152) mmHg, 93 (88, 99) mmHg)(1 mmHg=0.133 kPa) after 4 weeks of intervention(both P<0.05). After 4 weeks of intervention, the level of BUN in the ICSMT group (5.5 (3.7, 8.4) mmol/L) was significantly lower than that in the control group (9.1 (6.8, 11.4) mmol/L), while the level of Hb and ALB in the ICSMT group ((115.0±10.0)g/L, (38.3±3.2)g/L)were significantly higher than those in the control group ((104.0±12.0)g/L, (37.1±2.9)g/L) (all P<0.05). After 4 weeks of intervention, the physical functioning, role-physical, general health, vitality, social functioning, role-emotional, and mental health subscores of SF-36 in ICSMT group were all significantly higher than those in the control group (all P<0.05). After 4 weeks of intervention, the score of ADL in the ICSMT group (15.42±1.58)was significantly lower than that in the control group (16.78±2.06) ( t=-4.08, P<0.05). At the 2-week post-intervention and the 4-week post-intervention, the severity of illness (SI) and global improvement (GI) in the ICSMT group were significantly lower than those in the control group, while the efficacy index (EI) in the ICSMT group was significantly higher than that in the control group (all P<0.05). Conclusion:ICSMT can effectively promote the physical, psychological, and social functional rehabilitation of end-stage renal disease patients undergoing MHD, significantly improving their quality of life.

Amoenucles A-F (1-6), six previously undescribed nucleoside derivatives, and two known analogs (7 and 8) were isolated from the culture of Aspergillus amoenus TJ507. Their structures were elucidated through spectroscopic analysis, single-crystal X-ray crystallography, and chemical reactions. Notably, 3 and 4 represent the first reported instances of nucleosides with an attached pyrrole moiety. Of particular significance, the absolute configuration of the sugar moiety of 1-4 was determined using nuclear magnetic resonance (NMR), electric circular dichroism (ECD) calculations, and a hydrolysis reaction, presenting a potentially valuable method for confirming nucleoside structures. Furthermore, 1, 2, and 5-8 exhibited potential tumor necrosis factor α (TNF-α) inhibitory activities, which may provide a novel chemical template for the development of agents targeting autoimmune and inflammatory diseases.
Aspergillus/chemistry* ; Tumor Necrosis Factor-alpha/antagonists & inhibitors* ; Molecular Structure ; Nucleosides/isolation & purification* ; Crystallography, X-Ray ; Animals ; Humans ; Mice ; Magnetic Resonance Spectroscopy

Objective:To explore the clinical characteristics and genetic factors in four patients with Disorder of sex development (DSD).Methods:Four patients who visited Tianjin Medical University General Hospital between January 2023 and January 2024, presenting with short stature, abnormal external genitalia, or infertility as their chief complaints, were selected as the study subjects. Clinical data were collected, and peripheral or umbilical cord blood samples were obtained for karyotyping analysis and low-depth whole-genome sequencing (CNV-seq). Quantitative fluorescence PCR (QF-PCR) was used to detect the sex-determining region Y ( SRY) gene and azoospermia factor ( AZF) on the Y chromosome, while fluorescence in situ hybridization (FISH) was employed to determine the location of the SRY gene. Whole exome sequencing (WES) was performed for genetic testing, and Sanger sequencing was used for familial validation of the candidate variants. The study procedure and protocol were approved by the Medical Ethics Committee of Tianjin Medical University General Hospital (Ethics No.: IRB2024-WZ-006). Results:Case 1 had a karyotype of 45, X[22]/46, XY[8], with CNV-seq indicating a mosaic deletion of 7.44 Mb (copy number = 0.2) at Yp11.31-p11.2, a mosaic deletion of 5.32 Mb (copy number = 0.3) at Yq11.1-q11.221, and a deletion of 10.26 Mb (copy number = 0) at Yq11.221-q11.23. Y chromosome microdeletion analysis showed SRY and AZFa (+ ), AZFb+ c (-). Case 2 had a karyotype of 45, X[12]/46, X, del(X)(q26.3)[18], with CNV-seq indicating a mosaic deletion of 132.62 Mb (copy number = 1.4) at Xp22.33-q26.3 and a deletion of 19.62 Mb (copy number = 1) at Xq26.3-q28. Case 3 had a karyotype of 46, XX, with CNV-seq showing two copies of the X chromosome and no Y chromosome. Y chromosome microdeletion analysis showed SRY (+ ) and AZFa+ b+ c (-), and FISH confirmed a translocation of the SRY gene to the terminal end of the short arm of the X chromosome. Case 4 had a karyotype of 46, XY, with CNV-seq showing one copy each of the X and Y chromosomes. Y chromosome microdeletion analysis showed SRY(+ ) and AZFa+ b+ c (+ ), and WES revealed a c. 1103del variant in the AR gene (maternal origin), which was classified as a pathogenic variant based on the guidelines from the American College of Medical Genetics and Genomics (ACMG) (PVS1+ PP1+ PM2_Supporting). Conclusion:The combined application of multiple detection techniques such as chromosomal karyotyping analysis, CNV-seq, QF-PCR, and WES can identify the genetic etiology of DSD patients, providing a basis for clinical consultation and treatment plan formulation.

Objective:To construct a device-related pressure injury prevention program for orthopedic patients based on evidence-based and SSKINS (S: skin, S: surface, K: keep moving, I: incontinence, N: nutrition, S: self-care) clinical management model, and to provide reference for clinical nursing practice.Methods:In June 2023, a research team was set up to retrieve the literature related to device-related pressure injury in orthopedic patients, and the evidence was extracted and screened with reference to the SSKINS clinical management model, and the first draft of the protocol was formulated based on clinical practice. The final plan was determined through two rounds of expert consultations from October to December 2023.Results:The response rate of the two rounds of expert correspondence was 100%(20/20). The expert authority coefficients were 0.897 and 0.907, the overall Kendall coordination coefficients of the two rounds were 0.116 and 0.136 respectively, and the Kendall coordination coefficients of all levels were 0.104-0.213 (all P<0.001). The final protocol contains 6 first-level items (assessment and examination, the use and adjustment of device, prophylactic dressings, skin protection, nutritional support, health education) and 31 second-level items. Conclusions:The proposed orthopedic device-related pressure injury prevention program is scientific and practical, and can provide a reference for the prevention and management of clinical medical staff.

Objective To understand the current situation of thirst in patients with cirrhosis and analyze its influencing factors,in order to improve medical staff's attention to thirst symptoms in patients with cirrhosis and provide theoretical basis for clinical intervention.Methods A total of 220 patients with cirrhosis who were hospitalized in the infection department of a tertiary A general hospital in Wuhan from March to June 2024 were selected by convenience sampling method.General data questionnaire,Numerical Score Scale and Thirst Distress Scale were used to investigate the factors affecting thirst sensation in patients with cirrhosis.Results A total of 202 valid questionnaires were collected,and the effective questionnaire recovery rate was 91.82％.The results showed that the incidence of thirst in patients with cirrhosis was 59.41％;the score of thirst was 3.00(3.00,6.00)points,and the mean score of thirst was 3.09.Among them,43.07％of the patients with cirrhosis were in the moderate to severe level of thirst.The score of Thirst Distress Scale is 6.00(6.00,17.00)points,and the average score of thirst distress was 11.62 points,which was in the medium level.47.03％of patients with cirrhosis indicated thirst distress,and 23.76％of patients with cirrhosis which was in the moderate and severe level of distress.The results of multiple linear regression analysis showed that the degree of ascites,the use of diuretics,the stage of disease,and the degree of thirst distress were the factors influencing the degree of thirst in patients with cirrhosis(P＜0.05).Gender,marital status,degree of ascites,use of diuretic drugs,disease stage and degree of thirst were the factors influencing degree of thirst distress in patients with cirrhosis(P＜0.05).Conclusion The incidence and severity of thirst in patients with cirrhosis are relatively high,and are affected by many factors.Medical staff should pay more attention to the management of thirst symptoms in patients with cirrhosis,and formulate targeted nursing measures or nursing programs according to the related influencing factors of thirst,so as to improve the comfort level of patients and improve the disease experience of patients.

Objective:To explore the effect of the forward moving pelvic floor exercise program in urinary incontinence management among patients undergoing radical prostatectomy.Methods:From June 2022 to January 2024, 150 patients undergoing radical prostatectomy of the Urology Surgery Department, the First Affiliated Hospital of Zhengzhou University were selected using convenience sampling. Patients were randomly divided into an observation group and a control group, with 75 cases in each group. Control group received conventional perioperative management for prostate cancer, while observation group implemented a forward moving pelvic floor exercise program in addition to conventional management. The incidence of urinary incontinence, urinary control capabilities before and after intervention (including maximum urinary flow rate, average urinary flow rate, voided urine volume, and residual urine volume), and quality of life scores [evaluated using the Chinese version of the Incontinence Quality of Life Questionnaire (I-QOL) ] were compared between two groups of patients.Results:The incidence of urinary incontinence of observation group was lower than that of control group. Furthermore, patients with urinary incontinence in observation group exhibited significantly lower urine leakage volume and fewer episodes of urinary incontinence over 24 hours at one month postoperatively compared to control group, with statistically significant differences ( P<0.05). There were no statistically significant differences in maximum urinary flow rate, average urinary flow rate, voided urine volume, or residual urine volume between the two groups before intervention ( P>0.05). Following intervention, both groups demonstrated increased maximum urinary flow rate, average urinary flow rate, and voided urine volume compared to baseline, with observation group exhibiting higher values than control group ( P<0.05), and residual urine volume of both groups decreased compared to baseline, with observation group showing lower values than control group, these differences were statistically significant ( P<0.05). The difference in I-QOL scores between the two groups before intervention was not statistically significant ( P>0.05). Following intervention, I-QOL scores decreased in both groups, but observation group had higher score than control group, and the difference was statistically significant ( P<0.05) . Conclusions:The forward moving pelvic floor exercise program effectively reduces the incidence of urinary incontinence in patients undergoing radical prostatectomy, alleviates the severity of incontinence, and improves both urodynamic outcomes and quality of life.

In recent years，with the increase in environmental pollution，organisms are exposed to more internal and external oxidative stress factors than ever before.Nuclear factor erythroid 2-related factor 2（nuclear factor erythroid 2-related factor 2，NRF2），as a core transcription factor in response to oxidative stress，maintains cellular redox homeostasis by inducing the expression of various antioxidant factors.The nasal cavity，as the "gateway" of the respiratory tract，is often accompanied by oxidative stress（oxidative stress，OS）damage，leading to the occurrence of allergic rhinitis（allergic rhinitis，AR）.Recent studies have revealed some associations between the NRF2 signaling pathway and the mechanism of AR development.Activation of NRF2 provides a potential protective effect against AR，and some natural NRF2 activators have shown therapeutic potential in clinical experiments.Therefore，this article briefly reviews the relationship between NRF2 and AR，aiming to provide a new therapeutic target and perspective for the treatment of AR.
NF-E2-Related Factor 2/metabolism* ; Humans ; Rhinitis, Allergic/metabolism* ; Signal Transduction ; Oxidative Stress

Objective:To explore the effect of the forward moving pelvic floor exercise program in urinary incontinence management among patients undergoing radical prostatectomy.Methods:From June 2022 to January 2024, 150 patients undergoing radical prostatectomy of the Urology Surgery Department, the First Affiliated Hospital of Zhengzhou University were selected using convenience sampling. Patients were randomly divided into an observation group and a control group, with 75 cases in each group. Control group received conventional perioperative management for prostate cancer, while observation group implemented a forward moving pelvic floor exercise program in addition to conventional management. The incidence of urinary incontinence, urinary control capabilities before and after intervention (including maximum urinary flow rate, average urinary flow rate, voided urine volume, and residual urine volume), and quality of life scores [evaluated using the Chinese version of the Incontinence Quality of Life Questionnaire (I-QOL) ] were compared between two groups of patients.Results:The incidence of urinary incontinence of observation group was lower than that of control group. Furthermore, patients with urinary incontinence in observation group exhibited significantly lower urine leakage volume and fewer episodes of urinary incontinence over 24 hours at one month postoperatively compared to control group, with statistically significant differences ( P<0.05). There were no statistically significant differences in maximum urinary flow rate, average urinary flow rate, voided urine volume, or residual urine volume between the two groups before intervention ( P>0.05). Following intervention, both groups demonstrated increased maximum urinary flow rate, average urinary flow rate, and voided urine volume compared to baseline, with observation group exhibiting higher values than control group ( P<0.05), and residual urine volume of both groups decreased compared to baseline, with observation group showing lower values than control group, these differences were statistically significant ( P<0.05). The difference in I-QOL scores between the two groups before intervention was not statistically significant ( P>0.05). Following intervention, I-QOL scores decreased in both groups, but observation group had higher score than control group, and the difference was statistically significant ( P<0.05) . Conclusions:The forward moving pelvic floor exercise program effectively reduces the incidence of urinary incontinence in patients undergoing radical prostatectomy, alleviates the severity of incontinence, and improves both urodynamic outcomes and quality of life.