Objective To analyze the risk factors and effective predictive indicators for postpartum hemor-rhage(PPH)in pregnant women with severe pre-eclampsia(sPE)in singleton pregnancies.The findings will serve as a valuable reference for the clinical prevention and management of PPH in these patients.Methods A retrospective analysis was conducted on 932 pregnant women with sPE at two tertiary hospitals in Guangzhou from January 1,2016,to December 31,2022.Among these,95 cases were complicated by PPH.A comparative analysis was performed between the sPE group and the sPE with PPH group.Results(1)The incidence of assisted reproductive technology,intrapartum blood loss,placental abruption,elevated D-dimer levels,increased monocyte counts,and higher SIRI levels were significantly higher in the PPH group,whereas platelet counts were significantly lower(P<0.05).(2)The results indicated that intrapartum blood loss,D-dimer levels,and platelet counts were inde-pendently associated with PPH in pregnant women with sPE.(3)The area under the curve(AUC)for intrapartum blood loss,D-dimer,and platelet counts were 0.805,0.717,and 0.571,respectively.The optimal cutoff value for D-dimer was determined to be 2.295 μg/mL.The combined AUC for intrapartum blood loss and D-dimer was 0.859.(4)Intrapartum blood loss values were significantly higher in the PPH group for both vaginal delivery and cesarean section(P<0.001).The corresponding optimal cutoff values were 285 mL and 375 mL,respectively.Conclusions Intrapartum haemorrhage,D-dimer levels,and platelet count were identified as independent risk factors for PPH in pregnant women with sPE.Specifically,pregnant women with sPE who experienced blood loss exceeding 285 mL during vaginal delivery or 375 mL during caesarean section,along with a D-dimer level greater than 2.295 μg/mL,demonstrated an increased likelihood of developing PPH.Therefore,it is crucial to enhance clinical monitoring of these relevant indicators in high-risk populations.

Objective To analyze the risk factors and effective predictive indicators for postpartum hemor-rhage(PPH)in pregnant women with severe pre-eclampsia(sPE)in singleton pregnancies.The findings will serve as a valuable reference for the clinical prevention and management of PPH in these patients.Methods A retrospective analysis was conducted on 932 pregnant women with sPE at two tertiary hospitals in Guangzhou from January 1,2016,to December 31,2022.Among these,95 cases were complicated by PPH.A comparative analysis was performed between the sPE group and the sPE with PPH group.Results(1)The incidence of assisted reproductive technology,intrapartum blood loss,placental abruption,elevated D-dimer levels,increased monocyte counts,and higher SIRI levels were significantly higher in the PPH group,whereas platelet counts were significantly lower(P<0.05).(2)The results indicated that intrapartum blood loss,D-dimer levels,and platelet counts were inde-pendently associated with PPH in pregnant women with sPE.(3)The area under the curve(AUC)for intrapartum blood loss,D-dimer,and platelet counts were 0.805,0.717,and 0.571,respectively.The optimal cutoff value for D-dimer was determined to be 2.295 μg/mL.The combined AUC for intrapartum blood loss and D-dimer was 0.859.(4)Intrapartum blood loss values were significantly higher in the PPH group for both vaginal delivery and cesarean section(P<0.001).The corresponding optimal cutoff values were 285 mL and 375 mL,respectively.Conclusions Intrapartum haemorrhage,D-dimer levels,and platelet count were identified as independent risk factors for PPH in pregnant women with sPE.Specifically,pregnant women with sPE who experienced blood loss exceeding 285 mL during vaginal delivery or 375 mL during caesarean section,along with a D-dimer level greater than 2.295 μg/mL,demonstrated an increased likelihood of developing PPH.Therefore,it is crucial to enhance clinical monitoring of these relevant indicators in high-risk populations.

This study analyzed the clinical and laboratory data of 3 children diagnosed with mitochondrial disease-associated primary adrenal insufficiency (PAI) at the Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from October 2018 to November 2023.All patients were normal at birth but gradually developed symptoms and were diagnosed with PAI between the ages of 1 year and 1 month and 7 years and 3 months.The children presented typical clinical symptoms of PAI, including skin and mucosal hyperpigmentation (3 cases), electrolyte disturbances (3 cases), and hypoglycemia (2 cases), as well as multisystem abnormalities related to mitochondrial disease, including recurrent infections, growth retardation, cachexia, and hyperlactatemia.Genetic testing revealed significant single deletions in mitochondrial DNA in all patients: Patient 1: m.11219_15954del, Patient 2: m.8483_13459del, and Patient 3: m.8649_16084del.Treatment with Hydrocortisone acetate replacement therapy improved the electrolyte disturbances and hypoglycemia, but issues with recurrent infections, growth retardation, and cachexia persisted.This study suggests that in clinical practice, the possibility of mitochondrial disease should be highly suspected when PAI patients present with multisystem abnormalities, especially in conjunction with hyperlactatemia.

We report a family with multiple endocrine neoplasia type 1(MEN1), in which the proband presented with primary amenorrhea and was diagnosed with both a pituitary prolactinoma and an ACTH-secreting adenoma. Genetic testing identified a heterozygous MEN1 gene c. 1449_1476del mutation in the proband, as well as in six additional family members, who exhibited variable clinical phenotypes. Following initial transsphenoidal pituitary surgery, the proband's symptoms and biochemical abnormalities persisted, with elevated ACTH and cortisol levels. Functional imaging using [ 68Ga]-DOTA-TATE PET/CT confirmed residual pituitary tumor tissue, and a second surgery resulted in biochemical remission.

Objective:To investigate the current status of screen exposure among children aged 3-4 years in Shanghai and its relationship with children developmental risks.Methods:A cross-sectional study was conducted, and the stratified cluster random sampling method was used to select 22 102 children of 3-4 years of age across 16 districts in Shanghai in 2023, and their parents were surveyed online. The screen exposure behavior questionnaire (ScreenQ) was used to assess children′s screen exposure behaviors. The Chinese edition early human capability index (eHCI) was used to evaluate whether children were at developmental risk, and the overall characteristics of newly enrolled 3-4 years of age children in Shanghai were calculated by using sampling weights. After controlling for confounding factors, a stepwise Logistic regression model was used to analyze the association between screen exposure behaviors and children′s developmental status (whether at developmental risk).Results:A total of 21 454 children completed the survey, with an age of (3.8±0.3) years, including 11 275 boys (52.6%) and 10 179 girls (47.4%). After weighting, 38.4% of newly enrolled children aged 3-4 years in Shanghai had daily screen time ≥1 h; 55.3% had screen devices in their bedrooms; 40.8% and 62.5% used screens to assist with falling asleep and emotional regulation, respectively; 19.2% of children were frequently exposed to fast-paced screen content (e.g., content with rapid actions or scene changes); 10.4% of parents never discussed or asked questions about content during screen viewing; and 9.2% of parents never discussed screen content or reasons for preferences after screen use. After confirming no multicollinearity among screen exposure behaviors and controlling confounding factors, stepwise Logistic regression analysis revealed that daily screen time ≥1 h (standardized OR=1.98, P<0.001), using screens for emotional regulation (standardized OR=1.59, P<0.001), lack of parent-child interaction after screen use (standardized OR=1.38, P=0.002), presence of screen in children′s bedrooms (standardized OR=1.27, P=0.012), and exposure to fast-paced screen media (standardized OR=1.23, P=0.010) were the top 5 influencing factors of children developmental risks. Conclusions:Screen exposure among preschool children is prevalent and significantly associated with developmental risks. Early screen exposure behaviors should be addressed, daily screen time should be strictly controlled, and healthy screen use habits should be established to mitigate their impact on child development.

This study analyzed the clinical and laboratory data of 3 children diagnosed with mitochondrial disease-associated primary adrenal insufficiency (PAI) at the Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from October 2018 to November 2023.All patients were normal at birth but gradually developed symptoms and were diagnosed with PAI between the ages of 1 year and 1 month and 7 years and 3 months.The children presented typical clinical symptoms of PAI, including skin and mucosal hyperpigmentation (3 cases), electrolyte disturbances (3 cases), and hypoglycemia (2 cases), as well as multisystem abnormalities related to mitochondrial disease, including recurrent infections, growth retardation, cachexia, and hyperlactatemia.Genetic testing revealed significant single deletions in mitochondrial DNA in all patients: Patient 1: m.11219_15954del, Patient 2: m.8483_13459del, and Patient 3: m.8649_16084del.Treatment with Hydrocortisone acetate replacement therapy improved the electrolyte disturbances and hypoglycemia, but issues with recurrent infections, growth retardation, and cachexia persisted.This study suggests that in clinical practice, the possibility of mitochondrial disease should be highly suspected when PAI patients present with multisystem abnormalities, especially in conjunction with hyperlactatemia.

We report a family with multiple endocrine neoplasia type 1(MEN1), in which the proband presented with primary amenorrhea and was diagnosed with both a pituitary prolactinoma and an ACTH-secreting adenoma. Genetic testing identified a heterozygous MEN1 gene c. 1449_1476del mutation in the proband, as well as in six additional family members, who exhibited variable clinical phenotypes. Following initial transsphenoidal pituitary surgery, the proband's symptoms and biochemical abnormalities persisted, with elevated ACTH and cortisol levels. Functional imaging using [ 68Ga]-DOTA-TATE PET/CT confirmed residual pituitary tumor tissue, and a second surgery resulted in biochemical remission.

Objective:To investigate the current status of screen exposure among children aged 3-4 years in Shanghai and its relationship with children developmental risks.Methods:A cross-sectional study was conducted, and the stratified cluster random sampling method was used to select 22 102 children of 3-4 years of age across 16 districts in Shanghai in 2023, and their parents were surveyed online. The screen exposure behavior questionnaire (ScreenQ) was used to assess children′s screen exposure behaviors. The Chinese edition early human capability index (eHCI) was used to evaluate whether children were at developmental risk, and the overall characteristics of newly enrolled 3-4 years of age children in Shanghai were calculated by using sampling weights. After controlling for confounding factors, a stepwise Logistic regression model was used to analyze the association between screen exposure behaviors and children′s developmental status (whether at developmental risk).Results:A total of 21 454 children completed the survey, with an age of (3.8±0.3) years, including 11 275 boys (52.6%) and 10 179 girls (47.4%). After weighting, 38.4% of newly enrolled children aged 3-4 years in Shanghai had daily screen time ≥1 h; 55.3% had screen devices in their bedrooms; 40.8% and 62.5% used screens to assist with falling asleep and emotional regulation, respectively; 19.2% of children were frequently exposed to fast-paced screen content (e.g., content with rapid actions or scene changes); 10.4% of parents never discussed or asked questions about content during screen viewing; and 9.2% of parents never discussed screen content or reasons for preferences after screen use. After confirming no multicollinearity among screen exposure behaviors and controlling confounding factors, stepwise Logistic regression analysis revealed that daily screen time ≥1 h (standardized OR=1.98, P<0.001), using screens for emotional regulation (standardized OR=1.59, P<0.001), lack of parent-child interaction after screen use (standardized OR=1.38, P=0.002), presence of screen in children′s bedrooms (standardized OR=1.27, P=0.012), and exposure to fast-paced screen media (standardized OR=1.23, P=0.010) were the top 5 influencing factors of children developmental risks. Conclusions:Screen exposure among preschool children is prevalent and significantly associated with developmental risks. Early screen exposure behaviors should be addressed, daily screen time should be strictly controlled, and healthy screen use habits should be established to mitigate their impact on child development.

Objective To investigate the clinical manifestations,molecular genetics and gonadal pathol-ogy characteristics of patients with disorders of sex development(DSD),and to summarize the clinical experi-ence of identifying rare diseases from common symptoms.Methods The clinical data of 416 patients with DSD diagnosed and treated in the multidisciplinary center of DSD of Guangzhou Women and Children's Medical Cen-ter from May 2018 to August 2023 were retrospectively analyzed,summarized and discussed.Results Accord-ing to chromosome karyotype,416 cases of DSD were classified into three types:92 cases(22.1％)of abnormal sex chromosome karyotype,285 cases(68.5％)of 46,XY karyotype and 39 cases(9.4％)of 46,XX karyotype.Among the 92 patients with abnormal sex chromosome karyotype,59 cases were raised as males,18 cases(30.5％)complained of short penis with hypospadias and cryptorchidism.The most common karyotype was 45,X/46,XY(58 cases,63.0％).Among the 285 patients with 46,XY karyotype,238 cases were raised as males,and 63 cases(26.5％)complained of short penis and hypospadias;47 cases were raised as females,and 13 ca-ses(27.7％)complained of inguinal mass.A total of 216 patients with 46,XY karyotype were subjected to whole exome gene detection,and 155 cases(71.8％)were found to have molecular pathogenesis with the clinical phe-notype.Among the 39 patients with 46,XX karyotype,19 cases were raised as males,and 8 cases(42.1％)com-plained of short penis and hypospadias.In the 18 cases of gonad biopsy,17 cases showed testicular tissue in go-nads.Whole exome sequencing was performed in 14 cases.NR5A1 gene heterozygous mutation,SRY gene muta-tion and SOX3 gene mutation were found in 2 cases,respectively(14.3％).Twenty cases were raised as females,and 14 cases(70.0％)complained of clitoral hypertrophy.Gonad biopsy was performed in 8 cases,with 7 cases of ovotestis(87.5％)and 1 case of NR5A1 gene heterozygous mutation(14.3％).Conclusions The etiologies of DSD are complex and diverse,and the clinical manifestations are various,which can be manifested as hypospa-dias,micropenis,cryptorchidism and other common symptoms of the urinary system.Different etiologies have dif-ferent treatment options.Therefore,chromosome karyotype,molecular genetic testing and gonadal pathology can be used to clarify the cause of disease,especially for rare diseases,improve the detection rate,reduce the rate of missed diagnosis,and ensure reasonable treatment,especially sex selection.

Plant metabolites are important for plant development and human health. Plants of celery (Apiumgraveolens L.) with different-colored petioles have been formed in the course of long-term evolution. However, the composition, content distribution, and mechanisms of accumulation of metabolites in different-colored petioles remain elusive. Using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS), 1159 metabolites, including 100 lipids, 72 organic acids and derivatives, 83 phenylpropanoids and polyketides, and several alkaloids and terpenoids, were quantified in four celery cultivars, each with a different petiole color. There were significant differences in the types and contents of metabolites in celery with different-colored petioles, with the most striking difference between green celery and purple celery, followed by white celery and green celery. Annotated analysis of metabolic pathways showed that the metabolites of the different-colored petioles were significantly enriched in biosynthetic pathways such as anthocyanin, flavonoid, and chlorophyll pathways, suggesting that these metabolic pathways may play a key role in determining petiole color in celery. The content of chlorophyll in green celery was significantly higher than that in other celery cultivars, yellow celery was rich in carotenoids, and the content of anthocyanin in purple celery was significantly higher than that in the other celery cultivars. The color of the celery petioles was significantly correlated with the content of related metabolites. Among the four celery cultivars, the metabolites of the anthocyanin biosynthesis pathway were enriched in purple celery. The results of quantitative real-time polymerase chain reaction (qRT-PCR) suggested that the differential expression of the chalcone synthase (CHS) gene in the anthocyanin biosynthesis pathway might affect the biosynthesis of anthocyanin in celery. In addition, HPLC analysis revealed that cyanidin is the main pigment in purple celery. This study explored the differences in the types and contents of metabolites in celery cultivars with different-colored petioles and identified key substances for color formation. The results provide a theoretical basis and technical support for genetic improvement of celery petiole color.
Anthocyanins ; Apium/metabolism* ; Chlorophyll/metabolism* ; Color ; Gene Expression Regulation, Plant ; Humans ; Metabolomics ; Plant Proteins/genetics* ; Tandem Mass Spectrometry