Objective: To analyze the characteristics of pediatric pesticide poisoning cases admitted to a children s hospital in Jiangxi Province, so as to provide references for the prevention and treatment of pediatric pesticide poisoning. Methods: Medical records of 349 pesticide poisoning hospitalized cases from 2009 to 2023 in a children s hospital in Jiangxi Province were retrospectively reviewed to summarized clinical features, categories of pesticides involved, therapeutic interventions, and prognostic outcomes. Results: Among the cases of pesticide poisoning in children, there were 217 boys and 132 girls with an average age of 4 years and 8 months; 35.82% of cases occurred during April-June, followed by 27.22% during July-September, during October-December accounting for 22.35%, with 14.61% during January-March. There were 75 (21.49%), 148 (42.41%), 126 cases ( 36.10% ) during 2009-2013, 2014-2018, 2019-2023. In terms of pesticide type, insecticides ranked first (166 cases, 47.56% ), followed by herbicides (116 cases, 33.24%) and rodenticides (58 cases, 16.62%). The average hospitalization time was 4 days, and a total of 73 cases (20.92%) required admission to the intensive care unit among pesticide poisoning cases. There were 11 deaths, including 6 cases who were associated with paraguat esposure of paraquat. Self poisoning accounted for 34 cases, with an average age of 12 years and 2 months; 50.00% (17 cases) were concentrated in 2022-2023, accounting for 64.71% (22 cases) in girls; 8 cases of self poisoning resulted in death, accounting for 72.73% of the total number of deaths. Conclusions The period of April to June repesents the peak time for pediatric pesticide poisoning cases, and the proportion of accidental ingestion is relatively high. It is necessary to strictly prevent child poisoning.

Objective:To explore the impact of female body mass index (BMI) on pregnancy outcomes in artificial insemination with donor sperm (AID).Methods:A retrospective cohort study was conducted on 4 484 couples with 9 852 AID treatment cycles treated at Reproductive Center of Guangdong Institute of Reproductive Science from January 2011 to September 2024. Participants were divided into four groups based on BMI: low BMI group (BMI<18.5 kg/m 2), normal BMI group (18.5 kg/m 2≤BMI<24.0 kg/m 2), overweight group (24.0 kg/m 2≤BMI<28.0 kg/m 2), and obese group (BMI≥28.0 kg/m 2). General characteristics and pregnancy outcomes were compared across groups. Kaplan-Meier survival analysis was used to calculate cumulative pregnancy rates from one to six cycles. Generalized estimating equations (GEE), univariate and multivariate logistic and Cox regression analysis were performed, adjusting for age, basal follicle-stimulating hormone, basal luteinizing hormone, endometrial thickness, clinical diagnosis, and treatment protocol, to explore correlations between female BMI and clinical pregnancy rate, spontaneous abortion rate, and cumulative pregnancy rate. Results:1) There were no statistically significant differences in clinical pregnancy rate and spontaneous abortion rate among the low BMI group, the normal BMI group, the overweight group, and the obesity group (all P>0.05). 2) Cumulative pregnancy rates for AID cycles 1-6 were 17.60%, 31.60%, 43.08%, 54.37%, 61.83% and 73.68%, respectively. 3) Multivariate GEE analysis revealed that female age ( OR=0.962, 95% CI: 0.950-0.974, P<0.001), endometrial thickness ( OR=1.040, 95% CI:1.011-1.069, P=0.006), and natural cycles ( OR=1.171, 95% CI: 1.060-1.294, P=0.002) influenced clinical pregnancy rates. Compared with the normal BMI group, there were no statistically significant differences in clinical pregnancy rates of low BMI group, overweight group, and obese group (all P>0.05). Multivariate logistic analysis showed that female age ( OR=1.051, 95% CI: 1.012-1.091, P=0.010), endometrial thickness ( OR=0.920 , 95% CI: 0.847-1.000, P=0.049) and polycystic ovary syndrome ( OR=1.927, 95% CI: 1.044-3.556, P=0.036) influenced spontaneous abortion rates. Compared with the normal BMI group, there were no statistically significant differences in spontaneous abortion rates of low BMI group, overweight group and obese group (all P>0.05). 4) Cox regression analysis indicated that female age ( HR=0.939, 95% CI: 0.928-0.950, P<0.001), endometrial thickness ( HR=1.039, 95% CI: 1.013-1.066, P=0.003) and natural cycles ( HR=1.957, 95% CI: 1.785-2.146, P<0.001) influenced cumulative pregnancy rates. Compared with the normal BMI group, there were no statistically significant differences in cumulative pregnancy rates of low BMI group, overweight group and obese group (all P>0.05). Conclusion:Female BMI does not significantly affect clinical pregnancy rates, spontaneous abortion rates and cumulative pregnancy rates in AID.

Objective:To analyze the effects of parental adverse childhood experiences on their offspring's prosocial behaviors,as well as to examine the moderating role of parental positive childhood experiences.Methods:A total of 3 090 parents of preschool children were selected to participate in this study.The Adverse Childhood Ex-periences International Questionnaire(ACE-IQ)and Benevolent Childhood Experiences Scale(BCEs)were used to examine parental adverse childhood experiences(i.e.,abuse,neglect,and dysfunctional households,etc)and posi-tive childhood experiences(i.e.,internal and external perceived safety,support,and positive personality traits,etc),Children Strength and Difficulties Question(SDQ)were performed to test offspring prosocial behaviors.Results:Parents'ACE-IQ scores were negatively correlated with offspring SDQ scores(r=-0.15)and parents'BCEs scores moderated(β=0.19)the relationship between parental ACE-IQ scores and offspring SDQ scores(β=-0.12).Conclusion:The study suggests that parental adverse childhood experiences are negatively associated with offspring pro-social behavior.Additionally,it indicates that an increase in positive childhood experiences can en-hance the relationships of parents'adverse childhood experiences.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective To explore the advantages of high-frequency ultrasound-guided"cross-shaped"positioning method in accurate positioning and surgical effect in open reduction and internal fixation of rib fractures.Methods Retrospective analysis of 97 cases of multiple rib fractures treated surgically in our department from october 2019 to october 2024.Patients were divided into three groups based on different localization methods.The control group designed the surgical incision according to the results of chest three-dimensional reconstruction,the ultrasound group determined the incision based on the control group combined with high-frequency ultrasound,and Based on the method used in the ultrasound group,the"cross-localization"technique was combined to determine the incision in the cross-shaped group.The comparison of surgical-related data included fracture positioning accuracy,incision length of per singer rib,postoperative drainage volume,duration of drainage tube retention,postoperative pain score,operative time,intraoperative blood loss,length of hospital stay and incision infection rate.Additionally,commonly used inflammatory markers(white blood cell count,neutrophil percentage,CRP,IL-6,NF-κB)and pain-related biomarkers(PGE2,5-HT)were also included in the comparative analysis.Results In the control group,ultrasound group,and crossover group,aside from wound infections,the respective accuracies of fracture localization were 68.97％vs 87.50％vs 97.22％,the length of single rib incision was(3.50±1.23)cm vs(2.70±0.62)cm vs(2.45±0.58)cm,the volume of drainage on the day of surgery was(170.55±27.85)ml vs(150.69±24.67)ml vs(120.34±18.45)ml,the duration of drainage tube retention was(4.17±1.12)days vs(3.67±0.95)days vs(3.12±0.65)days,the postoperative pain scores were(6.86±2.15)vs(5.54±1.15)vs(4.89±1.53),the operation times were(75.84±15.62)minutes vs(67.74±11.85)minutes vs(57.35±9.36)minutes,the intraoperative blood loss was(85.78±11.78)ml vs(72.65±8.92)ml vs(62.23±9.63)ml,and the length of hospital stay was(8.42±1.47)days vs(7.12±1.14)days vs(6.56±1.32)days.The crossover group showed superior results in all metrics compared to the other two groups,with statistically significant differences(P＜0.05).The inflammatory and pain stress indicators for the control,ultrasound,and crossover groups were as follows:white blood cell counts[(16.39±4.15)× 109/Lvs(13.25±2.45)× 109/L vs(12.02±2.77)× 109/L],neutrophil percentages[(80.14±12.21)vs(72.36±10.34)vs(65.73±8.83)],CRP[(31.86±6.87)mg/L vs(27.72±5.65)mg/L vs(24.69±4.11)mg/L],IL-6[(46.35±11.42)pg/L vs(41.42±8.75)pg/L vs(35.53±9.51)pg/L],NF-B[(22.55±4.98)pg/L vs(17.34±3.62)pg/L vs(15.91±3.84)pg/L],PGE2[(240.37±21.65)ng/L vs(209.45±23.24)ng/L vs(180.21±18.72)ng/L],and 5-HT[(290.62±34.37)ng/L vs(270.85±26.98)ng/L vs(210.62±19.64)ng/L].The crossover group demonstrated statistically significant differences compared to both the control and ultrasound groups(P＜0.05).There was no statistically significant difference in incision infection among the three groups(P＞0.05).Conclusion The ultrasound-guided"cross"positioning method for rib fracture open reduction and internal fixation can more accurately locate the incision,shorten the incision length and hospitalization time,reduce postoperative inflammatory response and patient pain,and facilitate rapid recovery after surgery.

Objective To explore the therapeutic effect of precise disconnection of pargastric varices guided by endoscopic ultrasound in the treatment of esophagogastric variceal bleeding.Method A retrospective analysis was conducted on 20 patients with cirrhosis esophagogastric variceal bleeding treated with endoscopic ultrasound-guided precise disconnection of pargastric varices from January 1,2024 to December 31,2024.The efficacy was analyzed.Result All 20 patients successfully completed the precise disconnection of pargastric varices under the guidance of endoscopic ultrasound.The injection of tissue gel combined with the placement of spring coils(14 cases)and the injection of tissue gel alone(4 cases)successfully blocked the pargastric varices.All patients did not experience perforation,esophageal and cardia stenosis,massive bleeding,septicemia,or ectopic embolization.One patient who received tissue gel alone had slight bleeding from the pargastric varices after surgery and improved after 3 days of treatment to reduce portal vein pressure.Another one patient who received tissue gel alone had a low-grade fever and normal body temperature after 3 days of anti-infection treatment.Conclusion Precise disconnection of pargastric varices under the guidance of endoscopic ultrasound has a good therapeutic effect on esophagogastric variceal bleeding,with fewer complications such as ectopic embolization,massive bleeding,infection,and perforation.However,close follow-up observation is still needed to address the issue of pargastric varices.

Objective:To explore the impact of female body mass index (BMI) on pregnancy outcomes in artificial insemination with donor sperm (AID).Methods:A retrospective cohort study was conducted on 4 484 couples with 9 852 AID treatment cycles treated at Reproductive Center of Guangdong Institute of Reproductive Science from January 2011 to September 2024. Participants were divided into four groups based on BMI: low BMI group (BMI<18.5 kg/m 2), normal BMI group (18.5 kg/m 2≤BMI<24.0 kg/m 2), overweight group (24.0 kg/m 2≤BMI<28.0 kg/m 2), and obese group (BMI≥28.0 kg/m 2). General characteristics and pregnancy outcomes were compared across groups. Kaplan-Meier survival analysis was used to calculate cumulative pregnancy rates from one to six cycles. Generalized estimating equations (GEE), univariate and multivariate logistic and Cox regression analysis were performed, adjusting for age, basal follicle-stimulating hormone, basal luteinizing hormone, endometrial thickness, clinical diagnosis, and treatment protocol, to explore correlations between female BMI and clinical pregnancy rate, spontaneous abortion rate, and cumulative pregnancy rate. Results:1) There were no statistically significant differences in clinical pregnancy rate and spontaneous abortion rate among the low BMI group, the normal BMI group, the overweight group, and the obesity group (all P>0.05). 2) Cumulative pregnancy rates for AID cycles 1-6 were 17.60%, 31.60%, 43.08%, 54.37%, 61.83% and 73.68%, respectively. 3) Multivariate GEE analysis revealed that female age ( OR=0.962, 95% CI: 0.950-0.974, P<0.001), endometrial thickness ( OR=1.040, 95% CI:1.011-1.069, P=0.006), and natural cycles ( OR=1.171, 95% CI: 1.060-1.294, P=0.002) influenced clinical pregnancy rates. Compared with the normal BMI group, there were no statistically significant differences in clinical pregnancy rates of low BMI group, overweight group, and obese group (all P>0.05). Multivariate logistic analysis showed that female age ( OR=1.051, 95% CI: 1.012-1.091, P=0.010), endometrial thickness ( OR=0.920 , 95% CI: 0.847-1.000, P=0.049) and polycystic ovary syndrome ( OR=1.927, 95% CI: 1.044-3.556, P=0.036) influenced spontaneous abortion rates. Compared with the normal BMI group, there were no statistically significant differences in spontaneous abortion rates of low BMI group, overweight group and obese group (all P>0.05). 4) Cox regression analysis indicated that female age ( HR=0.939, 95% CI: 0.928-0.950, P<0.001), endometrial thickness ( HR=1.039, 95% CI: 1.013-1.066, P=0.003) and natural cycles ( HR=1.957, 95% CI: 1.785-2.146, P<0.001) influenced cumulative pregnancy rates. Compared with the normal BMI group, there were no statistically significant differences in cumulative pregnancy rates of low BMI group, overweight group and obese group (all P>0.05). Conclusion:Female BMI does not significantly affect clinical pregnancy rates, spontaneous abortion rates and cumulative pregnancy rates in AID.

In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.

Objective:To analyze the effects of parental adverse childhood experiences on their offspring's prosocial behaviors,as well as to examine the moderating role of parental positive childhood experiences.Methods:A total of 3 090 parents of preschool children were selected to participate in this study.The Adverse Childhood Ex-periences International Questionnaire(ACE-IQ)and Benevolent Childhood Experiences Scale(BCEs)were used to examine parental adverse childhood experiences(i.e.,abuse,neglect,and dysfunctional households,etc)and posi-tive childhood experiences(i.e.,internal and external perceived safety,support,and positive personality traits,etc),Children Strength and Difficulties Question(SDQ)were performed to test offspring prosocial behaviors.Results:Parents'ACE-IQ scores were negatively correlated with offspring SDQ scores(r=-0.15)and parents'BCEs scores moderated(β=0.19)the relationship between parental ACE-IQ scores and offspring SDQ scores(β=-0.12).Conclusion:The study suggests that parental adverse childhood experiences are negatively associated with offspring pro-social behavior.Additionally,it indicates that an increase in positive childhood experiences can en-hance the relationships of parents'adverse childhood experiences.

Objective:To investigate the efficacy and safety of intravesical injections of botulinum toxin A (BTX-A) for the treatment of pediatric refractory urinary frequency and incontinence (UFI), and to analyze the factors predicting the therapeutic effect of BTX-A injections.Methods:A retrospective case series study was made on 35 children with UFI [(12.3±4.2) years old], including 13 males (37.1%) and 22 females (62.9%), treated in the First Affiliated Hospital of Zhengzhou University from January 2021 to March 2024.Urotherapy and drug treatments were ineffective in all children, who then received intravesical injections of BTX-A.The urodynamic study (UDS) was performed 1 week before treatment and 3 months after treatment, and the Overactive Bladder Symptom Score (OABSS) and Incontinence Quality of Life (I-QOL) were collected.Perioperative and postoperative adverse events were also recorded.A global response assessment (GRA) score of ≥2 at 3 months postoperatively was defined as effective treatment.According to the postoperative GRA score, the patients were divided into effective and ineffective groups to explore the predictive factors affecting the outcome of BTX-A treatment, such as age, gender, preoperative urodynamic parameters, and the types of urinary incontinence. t-test was used to compare quantitative data such as age, UDS parameters, OABSS, and I-QOL scores.The comparison of count data such as gender and urinary incontinence types was conducted using Fisher′s exact test. Results:The bladder compliance, bladder capacity ratio, OABSS and I-QOL scores of patients significantly improved after BTX-A injection (all P<0.05).The 77.1% (27/35) of the patients were satisfied with BTX-A treatment effects.The main adverse event during the follow-up was a temporary increase in postvoid residual urine after injecting BTX-A (7 cases), which was alleviated by the Creade action or clean intermittent catheterization.There was significant difference in age [(13.00±4.32) years vs.(10.00±2.67) years] and preoperative bladder compliance [(11.21±5.74) mL/cmH 2O vs.(5.13±2.42) mL/cmH 2O] between effective (27 cases) and ineffective groups (8 cases) ( t=2.383, 2.899, all P<0.05).The differences in preoperative bladder capacity ratio, maximum filling detrusor pressure, postvoid residual urine, voiding efficiency, gender, and the types of urinary incontinence were not statistically significant between the two groups (all P>0.05). Conclusions:Intravesical injection of BTX-A is a safe and effective treatment for children with refractory UFI.A young age and poor bladder compliance at treatment are associated with poor prognosis of BTX-A treatment.