Background During pregnancy, negative emotions such as anxiety and depression may induce cortisol disruption. Cortisol can be transmitted to the fetus through the placental barrier, thereby affecting the neurodevelopment of the offspring. Objective To investigate the relationship between placental cortisol, maternal depression during pregnancy, and neurodevelopment of 3-month-old infants. Methods From September 2022 to September 2023, 171 pregnant women ordered routine prenatal checks at the obstetrics outpatient department of a tertiary hospital in Ningxia were selected using a prospective cohort design. After providing informed consent, these women participated in a questionnaire survey that covered general individual characteristics, prenatal depression, and sleep quality. At birth, placental samples were collected to measure cortisol levels using ELISA kits. Follow-up assessments on the neurodevelopmental of 3-month-old infants were conducted using the Warning Sign for Children Mental and Behavioral Development. LASSO regression analysis was conducted to screen the influencing factors of depression during pregnancy. Huber regression analysis was then applied to assess potential linear relationship between depression during pregnancy and placental cortisol levels. Log-binomial regression was used to analyze the linear relationships between cortisol levels and neurodevelopmental delay in 3-month-old infants. Additionally, a mediation effect model was fitted using R 4.3.3 to assess possible mediating role of cortisol in the association between prenatal depression and neurodevelopmental delay in 3-month-old infants. Results The positive rate of prenatal depression was 33.33%. Nine factors affecting prenatal depression were identified by LASSO regression, including rural residence, high school education or above, extroverted personality characteristics, moderate early pregnancy reactions, baby sex expectation, prenatal anxiety, family dysfunction, exposure to stressful life events during pregnancy, and moderate prenatal sleep quality. The Huber regression model showed a positive linear correlation between prenatal depression and placental cortisol (P<0.05). With or without controlling confounding factors, the results of log-binomial regression modeling showed that cortisol levels were associated with a reduced risk of neurodevelopmental delay in 3-month-old infants (crude model: RR=0.988, 95%CI: 0.9768, 0.9996, P＜0.05; adjusted model: RR=0.988, 95%CI: 0.9764, 0.9993, P＜0.05). A mediating effect of placental cortisol between prenatal depression and the risk of neurodevelopmental delay in 3-month-old offspring was found statistically significant (P=0.045), accounting for 67.0% of the total effect. Conclusion Prenatal depression is associated with elevated placental cortisol levels, and higher cortisol levels are found to be related to a lower risk of neurodevelopmental delay in infants. Placental cortisol mediates the relationship between prenatal depression and infant neurodevelopment.

Background With economic development and globalization, shift work has become prevalent across industries. Its relationship with type 2 diabetes mellitus (T2DM) attracts increasing attention. Objective To thoroughly explore the relationship between shift work and T2DM, and analyze the impacts of specific shift patterns on T2DM, so as to provide a basis for formulating reasonable shift schedules. Methods We conducted a 1:2 matched case-control study among adults (20-60 years) who ordered occupational health examinations at the Wuxi No.8 People's Hospital from November to December 2023. The case group comprised 200 T2DM patients, while the controls were 400 age-stratified matched non-diabetic individuals. General demographic characteristics, behavioral habits, medical history, and shift work exposure data (including shift patterns, frequency, and length of service) 5 years prior to diagnosis were collected through standardized questionnaires. Logistic regression adjusted for selected confounders was employed to evaluate the association between shift work and T2DM. Results The logistic regression analysis demonstrated that shift work was associated with an increased risk of T2DM. After adjusting for confounding factors, shift workers had a 3.55 times higher risk of being diagnosed T2DM compared to non-shift workers (OR=3.55, 95%CI: 1.026, 12.263). The risk varied across different shift patterns, and the three-shift two-rotation system showed the highest risk (OR=4.17, 95%CI: 1.921, 9.035), followed by the two-shift system (OR=2.94, 95%CI: 2.016, 4.281) and four-shift three-rotation system (OR=2.66, 95%CI: 1.611, 6.093). Workers with more than 3 monthly shift days had a 2.74-fold increased risk (95%CI: 1.658, 4.512) compared to non-shift workers. Additionally, working more than 8 h daily (OR=1.74, 95%CI: 1.185, 2.562) and having more than 20 years of service (OR=2.51, 95%CI: 1.581, 3.976) were both significantly associated with a higher T2DM risk. The trend tests revealed that each incremental increase in monthly shift days and length of service elevated T2DM risk by 2.61 times (95%CI: 1.813, 3.765) and 1.49 times (95%CI: 1.147, 1.931), respectively (P<0.05). Conclusion Shift work is an independent risk factor for T2DM, with three-shift two-rotation system posing the highest risk. Shift frequency, daily working hours, and length of service are all significant factors affecting the risk of T2DM. These findings support industry-specific shift policy reform and targeted glucose monitoring and health interventions are recommended for workers engaged in high-risk shift patterns (e.g., three-shift two-rotation system, frequent shifts) and those with prolonged shift work history (>20 years).

AIM:To observe the anti-scarring effects and safety of triamcinolone acetonide(TA)-loaded hydrogel sustained-release sheeting on stab incision glaucoma surgery(SIGS)with “one-step tunnel method” in rabbit eyes.METHODS:A total of 48 healthy New Zealand white rabbits were randomly selected and divided into 4 groups(12 rabbits in each group), trabeculectomy(Trab)group, SIGS group, polyvinyl alcohol hydrogel(PVAH)sheeting was implanted under the conjunctiva flap during SIGS(PVAH group), and hydrogel sustained-release sheeting loaded with TA was implanted under the conjunctiva flap during SIGS(TA/PVAH group). On the 1, 2, 3, and 4 wk after surgery, the intraocular pressure, filtering bubble morphology, anterior chamber reaction, and other complications were observed and recorded in each group. Then animals were euthanized, and the surgery area tissues of right eye were taken for pathological tissue paraffin section. Masson staining, picric acid-Sirius rose red staining, as well as α-smooth muscle actin(α-SMA)and fibroblast growth factor 2(FGF2)immunohistochemistry staining was performed on every section. The infiltration of inflammatory cells, proliferation of fibroblasts and synthesis of type I and type III collagen fibers in local tissues were observed. The average positive area ratio of α-SMA and FGF2 antibody immunohistochemical staining in each group was calculated and compared.RESULTS: The TA/PVAH group maintained diffuse and elevated functional filtering blebs, while flat filtering blebs appeared in Trab, SIGS and PVAH groups at 2 wk after surgery. Functional filtering blebs were present in 1 eye(33%), 2 eyes(67%)in the PVAH and TA/PVAH group at 4 wk after surgery, respectively, while the other filtering blebs were flattened. Masson staining showed that the hydrogels in PVAH and TA/PVAH groups did not degrade at 4 wk after surgery. Compared with the Trab and SIGS groups, the filtration passages were more obvious, with less collagen fiber proliferation. Sirius red staining showed that the expression of type I collagen and type III collagen in the TA/PVAH group was less than that in the Trab group, SIGS group and PVAH group at 4 wk after surgery. Immunohistochemical staining showed that the α-SMA expression in the TA/PVAH group was significantly lower than that in the Trab and SIGS groups at 1 wk after surgery(P<0.01). The α-SMA expression was the highest in the Trab and SIGS groups at 2 wk after surgery, while the α-SMA expression in the PHAP and TA/PVAH groups was significantly lower than that in the first two groups(P<0.01). Compared with the Trab group, the expression of FGF2 in the PVAH and TA/PVAH group was significantly increased at 1, 2, 3 and 4 wk after surgery(P<0.05). Compared with the SIGS group, FGF2 expression in the TA/PVAH group was significantly increased at 4 wk after surgery(P<0.05).CONCLUSION:In SIGS surgery of rabbit eyes, implanting hydrogel sustained-release sheeting loaded with TA under conjunctival flap can effectively inhibit the scarring of the filtering bleb, which may be the interaction of the anti-scar effect of TA and the stent function of hydrogel.

Purpose/Significance By using data mining methods,the medication rules and prescription characteristics of traditional Chinese medicine(TCM)for treating hypertension with preserved ejection fraction heart failure are discussed.Method/Process The da-tabase is established based on the TCMprescription information of hypertensive patients with preserved ejection fraction heart failure ad-mitted to the Cardiovascular Disease Department of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from Janu-ary 2019 to July 2022.SPSS Statistics and Moderler software are used to analyze the frequency,taste,meridian tropism,efficacy,associ-ation rules,clustering and factor analysis of the prescriptions to explore medication rules.Result/Conclusion TCMin the treatment of hy-pertension with preserved ejection fraction heart failure is mainly to replenish qi and spleen,nourish the heart and calm the mind,relieve phlegm,relieve cough and asthma,and pay attention to promoting blood circulation and removing blood stasis,promoting water infiltra-tion and dampness,which can reflect the overall concept of TCMand the characteristics of diagnosis and treatment based on syndrome dif-ferentiation and provide references for clinical medication.

Objective:To investigate the pathogenic characteristics of viral encephalitis or meningitis in children living in Shijiazhuang city and surrounding areas, and to study the relationship between pathogenic and clinical findings.Methods:A total of 132 cerebrospinal fluid specimens were randomly collected from hospitalized children diagnosed with viral encephalitis or meningitis (January 2018 to December 2018) in the Department of Neurology of Hebei Children′s Hospital in Shijiazhuang city and surrounding areas. The nucleic acids of four viruses in cerebrospinal fluid were detected by real-time quantitative PCR. SPSS 21.0 software was used for statistical analysis.Results:Among the 132 cases, 78 were boys and 54 were girls, with a sex ratio of 1.44∶1. However, in the gender composition of children in each age group, there was no significant difference (χ 2=3.901, P=0.272). Of the 132 children, 121 had signs of fever, 109 had symptoms of headache, 92 had symptoms of vomiting, 17 had abnormal electroencephalogram(EEG), and 15 had abnormal head magnetic resonance imaging(MRI). 132 cerebrospinal fluid specimens were tested for pathogenic pathogens, and 80 of them were successfully detected. There was 1 case of human herpesvirus type I(HHV-I), 2 cases of varicella-zoster virus (VZV) and 77 cases of enterovirus(EV). The age group of 1~3 years′s EV detection rate was 66.67%, it is the highest, but overall, the EV detection rate, there was no significant difference among the four age groups (χ 2=3.147, P=0.369). The detection rate of EV in summer and autumn were 65.52% and 70.83%, respectively, which were significantly higher than those in spring and winter (33.33% and 0.00%), and there was a significant difference (χ 2=22.504, P=0.000). There was no significant difference in the positive rates of fever, headache and vomiting between EV-positive and non-EV-positive children ( P>0.05). There was no significant difference in the incidence of abnormal EEG and abnormal head MRI between EV-positive and non-EV-positive children ( P>0.05). Conclusions:In 2018, EV was the main pathogen of viral encephalitis and meningitis in children in Shijiazhuang city and surrounding areas, and EV detection rate was high in summer and autumn.

Objective: To explore the status quo and influencing factors of psychological stress in pregnant women in the third trimester, and to propose reasonable intervention measures to improve their current situation, and to provide reference and guarantee for their smooth transition through pregnancy. Methods: A questionnaire survey was conducted to investigate 92 pregnant women in the second trimester of pregnancy from the Second Affiliated Hospital of Wenzhou Medical University from June 2017 to June 2018 by using questionnaires, quality of life and stress scales.The results of the survey were investigated and analyzed. Results: The survey showed that the average psychological stress score of pregnant women in the third trimester was (1.79±0.46)points.The main stressors were psychological pressures to protect the health of pregnant women and the safety of the fetus.The planned pregnancy was the influencing factor of psychological stress (F=2.456, P=0.015). The negative life events and subjective support and stressors 1, 2, 3, etc.as independent variables, the results showed that stress source 2, positive life events and anxiety were the main influencing factors of patients' psychological stress (t=6.874, 3.692, 2.754, all P<0.05). Conclusion The psychological stress status of pregnant women in the third trimester is moderate, and the planned pregnancy is the influencing factor.The main psychological stress is to protect the health of the pregnant woman and the safety of the fetus.Therefore, the clinical counseling can be actively carried out in the clinic and the intervention of pregnant women's psychology should be strengthened to alleviate the bad mood and relieve psychological stress.

Objective: To investigate the pathogenic characteristics of viral encephalitis in children living in Hebei province. Methods: We randomly collected cerebrospinal fluid specimens from a total of 399 children diagnosed with viral encephalitis in Hebei Children′s Hospital from May to December 2017. Real-time fluorescence quantitative PCR and Sanger sequencing were used to detect viral nucleic acids in cerebrospinal fluid by an automatic laboratory station. Statistical analysis was performed on the experimental data using SPSS 21.0 software and the clinical data were analyzed. Comparison of infection rates of EV encephalitis in different months, using line × column chi-square test. The MRI and EEG positive rates of different viral encephalitis and viral encephalitis patients not infected with the virus were analyzed by Fisher′s exact probability test. The positive rate of infection with different viruses and non-virus agents was analyzed by Fisher′s exact probability test. Results: The result showed that 80 of 399 samples were positive, and the positive rate was 20.05%. It included 22 cases of enterovirus, 4 cases of influenza A virus, 3 cases of mumps virus, 2 cases of herpes simplex virus type 1, 1 case of herpes simplex virus type 2, 4 cases of EB virus, 7 cases of cytomegalovirus, 7 cases of herpes zoster virus, 8 cases of adenovirus, 14 cases of human herpesvirus type 6. Eight cases had combined viral infection. Eight cases had concurrent infections: 3 cases had enterovirus and herpesvirus type 6 concurrent infection, 1 case had enterovirus and Japanese encephalitis virus concurrent infection and 1 case had herpes simplex virus type 2 and adenovirus, 1 case had influenza A virus herpesvirus type 6, 1 case had mumps virus and herpesvirus type 6, 1 case had mumps virus and herpesvirus type 6, 1 case had herpes simplex virus type 1 and herpes zoster virus concurrent infections. Children with EV viral encephalitis in Hebei Province were highly prevalent in May and June (P=0.016). HHV6 virus encephalitis was more susceptible to infection than non-HHV6 virus (P=0.016); The rate of MRI positive findings in patients with different viral encephalitis was not statistically significant (P>0.05). The result of EEG of different viral encephalitis were P>0.05, which was not statistically significant. Conclusions EV was the most common pathogen of children with viral encephalitis in Hebei province. Encephalitis caused by influenza A virus cannot be ignored in clinical practice.

Objective:We aimed to investigate the clinical efficacy of neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermic chemoperfusion (IHCP) after the operation of patients with advanced ovarian cancer. Meth-ods:Analysis of 60 patients with advanced ovarian cancer was performed at the Zhengzhou People's Hospital from April 2009 to July 2012. The patients were divided into two groups, namely, the research and control groups. The research group was treated with neoadju-vant chemotherapy combined with cytoreductive surgery and IHCP twice (cisplatin at 80 mg), and subsequently, with chemotherapy (TC/TP). The control group underwent primary cytoreductive surgery and chemotherapy (TC/TP). We compared the differences be-tween the two groups in terms of the following parameters:operation time, bleeding volume, volume of ascites, and postoperative che-motherapy. Results:The treatments in the research group were more efficient than those performed on the control group in terms of all the intraoperative indicators, and the difference between the two groups was statistically significant (P<0.05). Conclusion:Compared with conventional methods, the neoadjuvant chemotherapy combined with cytoreductive surgery and IHCP after operation was more ef-fective for patients with advanced ovarian cancer. Thus, neoadjuvant chemotherapy combined with cytoreductive surgery and IHCP af-ter operation can be applied in clinical settings.

OBJECTIVE: To measure the intra-fraction displacements of the mediastinal metastatic lymph nodes by using four-dimensional CT (4D-CT) in non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Twenty-four patients with NSCLC, who were to be treated by using three dimensional conformal radiation therapy (3D-CRT), underwent a 4D-CT simulation during free breathing. The mediastinal metastatic lymph nodes were delineated on the CT images of 10 phases of the breath cycle. The lymph nodes were grouped as the upper, middle and lower mediastinal groups depending on the mediastinal regions. The displacements of the center of the lymph node in the left-right (LR), anterior-posterior (AP), and superior-inferior (SI) directions were measured. RESULTS: The mean displacements of the center of the mediastinal lymph node in the LR, AP, and SI directions were 2.24 mm, 1.87 mm, and 3.28 mm, respectively. There were statistically significant differences between the displacements in the SI and LR, and the SI and AP directions (p < 0.05). For the middle and lower mediastinal lymph nodes, the displacement difference between the AP and SI was statistically significant (p = 0.005; p = 0.015), while there was no significant difference between the LR and AP directions (p < 0.05). CONCLUSION: The metastatic mediastinal lymph node movements are different in the LR, AP, and SI directions in patients with NSCLC, particularly for the middle and lower mediastinal lymph nodes. The spatial non-uniform margins should be considered for the metastatic mediastinal lymph nodes in involved-field radiotherapy.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung/*radiography/radiotherapy ; Contrast Media/diagnostic use ; Female ; Four-Dimensional Computed Tomography/*methods ; Humans ; Iohexol/analogs & derivatives/diagnostic use ; Lung Neoplasms/*radiography/radiotherapy ; Lymphatic Metastasis/*radiography ; Male ; Mediastinum/radiography ; Middle Aged ; Radiographic Image Interpretation, Computer-Assisted ; Statistics, Nonparametric

ObjectiveTo investigate the role of NF-κB signaling pathway in the spinal cord in persistent postoperative pain evoked by skin/muscle incision and retraction (SMIR) in rats.MethodsNinety male SD rats weighing 200-250 g in which intrathecal (IT) catheter was successfully implanted without complication were randomly divided into 3 groups ( n =30 each):group sham operation ( group S ) ; groups SMIR and group pyrrolidine dithiocarbarnate (a NF-κB inhibitor) (group PDTC).Persistent postoperative pain was evoked by SMIR according to the method described by Flatters in groups SMIR and PDTC.PDTC 10 ng in 10 μl was injected IT over 30 s once a day for 7 consecutive days after operation in group PDTC.Mechanical paw withdrawal threshold to von Frey filament stimulation (MWT) was measured at 1 d before (T0,baseline) and 1,3,7,12 and 22 d after surgery (T1-5).Five animals in each group were sacrificed at each time point after MWT measurement and their lumbar segments of the spinal cord were removed for determination of TNF-α content (by ELISA).ResultsSMIR significantly decreased MWT after operation at T1-5 and increased TNF-α content in the spinal cord at T3-5.PDTC significantly attenuated SMIR-induced hyperalgesia and increase in TNF-α content in the spinal cord.Conclusion NF-κB signaling pathway in the spinal cord plays an important role in the development of SMIR-induced persistent postoperafive pain in rats.