Objective:To analyze ultrasonographic manifestations and genetic etiology of nine fetuses with 7q11.23 duplication syndrome.Methods:Ultrasonographic finding, pregnancy outcome and follow-up of nine fetuses detected at the Prenatal Diagnosis Center of the Third Affiliated Hospital of Zhengzhou University from January 2017 to December 2021 were retrospectively analyzed.Results:The fetuses were found to harbor a duplication in the 7q11.23 region by chromosomal microarray analysis (CMA). Among these, five had shown ventriculomegaly, including four syndromic and one non-syndromic. For the remainders, one had ventricular septal defect and mild tricuspid regurgitation, one had echogenic intracardiac focus, whilst another two were normal. Five couples had accepted parental verification, and the results confirmed that the 7q11.23 duplication carried by their fetuses were de novo in origin. Following genetic counseling, seven couples had opted to terminate their pregnancies. Two fetuses were delivered at full term, and follow-up had found no abnormalities. Conclusion:Prenatal ultrasonographic manifestations of fetuses with 7q11.23 duplication syndrome are variable. CMA can provide assistance for their diagnosis and genetic counseling.

Objective: To investigate the subclinical eating disorders among college students and to analyze associated factors, so as to provide a basis for the prevention and treatment of eating disorders among adolescents. Methods: From November to December 2023, a total of 5 201 college students were selected by stratified random cluster sampling from one undergraduate college and one specialized college in Yangzhou City, Jiangsu Province. Data on general information, subclinical eating disorders, body image perception, depressive symptoms, anxiety symptoms, and mental health literacy were collected using questionnaires. The Chisquare test was used to compare the detection rates of subclinical eating disorders between groups, and binary Logistic regression was employed to analyze associated factors. Results: The detection rate of subclinical eating disorders among college students was 16.0%. Binary Logistic regression analysis showed that the prevalence of subclinical eating disorders among college students was higher in the following categories:being in a relationship (OR=1.22, 95%CI=1.04-1.44), being overweight and obese (OR=2.75, 3.82, 95%CI=2.24-3.38, 2.89-5.06), overestimation of body shape (OR=2.04, 95%CI=1.68-2.49), being in a depressive state (OR=2.53, 95%CI=1.99-3.21), experiencing anxiety (OR=2.63, 95%CI=2.16-3.20), and having substandard mental health literacy (OR=1.37, 95%CI=1.11-1.70). Conversely, low body weight (OR=0.15, 95%CI=0.10-0.22) and underestimation of body shape (OR=0.37, 95%CI=0.27-0.51) were associated with a lower risk (P<0.05). Conclusions The detection rate of subclinical eating disorders among college students is high, and it is associated with relationship status, body mass index classification, body shape perception, depressive and anxiety symptoms, and mental health literacy. Comprehensive interventions should be implemented to improve the subclinical eating disorders and promote the physical and mental health of college students.

T-cell exhaustion is the loss of T-cell function in patients with chronic infections and cancer.Pro-longed exposure to inflammatory signals or persistent antigens causes T cells to gradually lose their effector function and memory characteristics.Exhausted T cells affect cancer prognosis and the outcome of viral infection,and the severity of ex-haustion has a range of adverse effects on cancer prognosis.The extensive development of tumor immunotherapy has driven current research to understand the mechanism of T-cell exhaustion as well as to optimize tumor immunotherapy regimens by reversing T-cell exhaustion.This article reviews the mechanism of T-cell exhaustion,the characteristics of exhausted T cells,and the reversal of T-cell exhaustion status.

Objective:Cerebral ischemia reperfusion injury(CIRI)can cause damage to distant organs,such as the gastrointestinal tract,through the gut-brain axis.Melatonin is known to play a neuroprotective role by activating specific receptor pathways.However,the changes of melatonin receptors in the gastrointestinal tract after brain injury and their relationship with intestinal injury are still unclear.Methods:Twenty-four male Sprague-Dawley rats were randomly di-vided into the Sham group and CIRI group.The CIRI model was prepared by Zea-Longa method.The jejunum,ileum,and colon tissues of the rats were collected 2 h after ischemia and 24 h after reperfusion.The damage of intestinal and brain tissues was observed by using 2,3,5-triphenyl tetrazolium chloride(TTC)and HE staining.The positive expres-sion of zonula occludens-1(ZO-1)and Claudin5 was observed by immunofluorescence staining.The melatonin receptor 1(MT1)and melatonin receptor 2(MT2)expression was detected by reverse transcription-quantitative polymerase chain reaction(RT-qPCR),immunofluorescence staining and Western Blot.The correlation between the melatonin receptors and intestinal tight junction proteins was analyzed by general linear regression.Results:TTC staining showed that the infarct size of rats in the CIRI group was significantly higher than that in the Sham group.HE staining showed that intestinal villi was broken and shortened,and goblet cells were reduced in the CIRI group.The results of immuno-fluorescence staining revealed that the positive expression of ZO-1 and Claudin5 in the intestinal tissues of rats in the CIRI group was significantly lower than that in the Sham group(P＜0.05).Compared with the Sham group,the RT-qPCR revealed a significantly lower expression of MT1 and MT2 mRNA in the CIRI group(P＜0.05),and the decrease in colon tissue was the most obvious.The results of immunofluorescence staining and WB also showed that the expression of MTl and MT2 in the CIRI group was significantly lower than that in the Sham group(P＜0.05).A gen-eral linear regression analysis revealed the difference in mean fluorescence intensities of MT1+and MT2+between the Sham group and the CIRI group were positively correlated with the difference of ZO-1+and Claudin5+between the two groups.Conclusion:After CIRI,the expression of both MT1 and MT2 receptors in various intestinal segments was de-creased,and the decrease in colon tissue was the most significant.It is suggested that the poor recovery of stroke may be related to the decrease of melatonin receptor.

Objective:To analyze the correlation between cuproptosis genes and immune infiltration during the occurrence and development of multiple sclerosis(MS),and to predict the traditional Chinese medicine,to provide theoretical basis for the mecha-nism study of cuproptosis in MS immune infiltration and Chinese medicine to intervene in immune regulation.Methods:The gout chip of MS was downloaded from the GEO database and standardized;based on the processed data,immune cells and functions were ex-tracted and quantified,and the correlation and differences of immune cells and functions were analyzed;at the same time,cuproptosis genes related to MS were screened out,a risk model was constructed,and enrichment analysis was carried out;the prediction of cu-proptosis genes and immune-related biological processes were carried out.Results:① Among immune cells,T follicular helper cell and B cell showed the strongest positive correlation;among the immune functions,parainflammation and typeⅠIFN reponse showed the strongest positive correlation;②B cell,T helper cell and human leukocyte antigen were lowly expressed in MS patients,while major histocompatibility complex class Ⅰ,parainflammation and typeⅠIFN response were significantly expressed;③ The cupropto-sis genes associated with MS were SLC31A1,PDHA1,NLRP3,MTF1,GLS and DBT,of which DBT was the most likely risk factor for MS;④The occurrence and development of MS involves biological processes such as IL-4 production,T-helper cell differentiation,and acute inflammatory response,which were related to pathways such as arginine biosynthesis,citrate cycle,and propanoate metabo-lism;⑤Banxia,Danshen,Jianghuang and other traditional Chinese medicines may be used as potential molecular drug sources.Con-clusion:The expression of cuproptosis gene is closely related to MS-related immune cells and functions,which can provide support for the basic research of MS.

Objective:To explore the association of triglyceride glucose (TyG) index and its combination with body mass index (TyG-BMI) with non-alcoholic fatty liver disease (NAFLD) among medical workers.Method:A total of 1 642 medical workers in Beijing Jishuitan Hospital with the age of 36.0 (31.0, 44.0) years and 394 males (24.00%) underwent health check-up in the hospital from January to December 2022. Among them, NAFLD was diagnosed in 377 subjects (NAFLD group) and 1 265 had no NAFLD (control group). The anthrometric and clinical data were collected, including age, gender, height, weight, systolic blood pressure, diastolic blood pressure, laboratory test indicators, imaging findings, current and past medical history, long-term medication history, alcohol consumption history, etc. The factors associated NAFLD were analyzed with multivariate logistic regression model, the diagnostic value of TyG index and TyG-BMI for NAFLD was evaluated with receiver operating characteristic (ROC) curve.Results:Multivariate logistic regression analysis showed that TyG index ( OR=3.534, 95% CI: 2.383-5.243, P<0.001) and TyG-BMI ( OR=1.041, 95 CI:1.033-1.048, P<0.001) were independently correlated with NAFLD. ROC curve analysis showed that the area under the curve ( AUC) of TyG-BMI in diagnosis of NAFLD was 0.906 (95% CI:0.890-0.922), with a sensitivity and specificity of 85.7% and 81.6%, respectively; while the AUC of TyG index was 0.845 (95% CI:0.823-0.867) with a sensitivity and specificity of 69.8% and 84.1%, respectively. The AUC of TyG-BMI in female medical workers (0.911, 95% CI:0.892-0.931) was higher than that of male ones (0.852, 95% CI:0.815-0.890); the AUC of TyG index of female medical workers (0.832, 95% CI:0.801-0.863) was also higher than that in male ones (0.804, 95% CI:0.761-0.846). Conclusion:The prevalence of NAFLD among medical worker is associated with the TyG and TyG-BMI, and TyG-BMI has higher diagnostic value for NAFLD, especially among female medical workers.

Antibodies, Neutralizing/immunology* ; Antibodies, Viral/immunology* ; COVID-19/virology* ; COVID-19 Vaccines/immunology* ; Humans ; SARS-CoV-2/pathogenicity* ; Spike Glycoprotein, Coronavirus/immunology* ; Vaccines, Inactivated/immunology*

Objective:To explore the application effect of the caregiver self-management support project in main caregivers of adolescents with epilepsy.Methods:Using the convenient sampling method, the main caregivers of adolescents with epilepsy who were enrolled before implementation of the caregiver self-management support project of the First Affiliated Hospital of Zhengzhou University from January to August 2019 were included in the control group ( n=101) , and they were given routine follow-up. The main caregivers of adolescents with epilepsy who were enrolled after the implementation of the project from September 2019 to June 2020 were included in the study group ( n=101) . Before and after the intervention, the Connor-Davidson Resilience Scale (CD-RISC) , Simplified Coping Style Questionnaire (SCSQ) , Zarit Burden Interview (ZBI) , Life Satisfaction Index A (LSIA) and Medical Outcome Study Social Support Survey (MOS-SSS) were used to compare the psychological resilience, coping style, quality of life and social support of caregivers between the two groups. Finally, a total of 98 caregivers in the study group and 97 caregivers in the control group completed the study. Results:After the intervention, the scores of dimensions of CD-RISC, positive coping score of SCSQ, LSIA score and dimensions scores of MOS-SSS of main caregivers in the study group were higher than those in the control group, while the scores of negative coping of SCSQ and ZBI were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The caregiver self-management support project helps to strengthen the psychological resilience of the main caregivers of adolescents with epilepsy, enhance their active coping style and social support and improve their quality of life.

Objective:Intensive physicians have relatively insufficient knowledge and experience in treating patients with decompensated schistosomiasis cirrhosis (DSC) admitted in intensive care unit (ICU), but are relatively familiar with patients with decompensated alcoholic cirrhosis (DAC). For this purpose, the clinical characteristics and prognosis of these patients were compared and analyzed.Methods:A retrospective analysis was performed from January 2013 to May 2019 in our hospital and Quzhou People’s hospital. The demographic data, laboratory examination, liver function, Child-Pugh classification, complications of cirrhosis, ultrasonic imaging gastroscopy manifestations were recorded and analyzed. In addition, the treatments and prognosis were also compared.Results:A total of 30 patients (12 males and 18 females) with DSC (aged 57-88) and 31 patients with DAC (aged 41-75) were collected. Compared with patients with DAC, DSC patients were more likely to have coronary heart disease, lower proportion of hyponatremia and lower need of ventilator support. Although the incidences of jaundice and hepatic encephalopathy were significantly reduced ( P<0.05), but parameters of liver function and coagulation were no significant differences in both groups ( P>0.05). B-mode ultrasound of liver in patients with DSC displayed more proportion of patchy and diffuse echo changes and liver volume reduction ( P<0.05), whereas the manifestations of gastroscope in both groups were similar. No significant difference in main treatment measures like uses of somatostatin and three-chamber and two-capsule tube was observed. After treatment, the stop time of gastrointestinal bleeding was similar between groups of DAC and DSC [1.25 (0.5-4.125) days vs. 1.75 (1-2.375) days] ( P>0.05). In addition, the length of ICU stay in DAC group was similar to DSC group [(4.96±3.58) days vs. (3.82±1.99) days], so did the 28-day mortality [14.29% (2/14) vs. 18.18% (2/11)] (both P>0.05). Conclusions:In genenal, patients with decompensated schistosomiasis cirrhosis have the similar clinical characteristics, major biochemical indicators and accessory examination results like ultrasound and gastroscopic examinations to patients with decompensated alcoholic cirrhosis. After timely treatments, both of these patients could achieve a good prognosis.

Objective To understand the status of type 2 diabetes mellitus (T2DM) patients′ trust in their family physicians, and to explore the role of the trust on patients′ medication adherence. Methods A total of 1078 patients with T2DM were recruited by cluster and systematic sampling method, from ten rural communities in Sanlong township in Yancheng city and five rural communities of Pingchao township in Nantong city, during February to April in 2018. The survey covered their trust behavior and attitude scale (PTBAS), and an 8-item Morisky medication adherence scale ( MMAS-8). Both measurement data and enumeration data were subject to descriptive analysis by mean ± SD and proportion respectively. Multiple linear regression was employed to explore the determinants of trust in physicians. Ordered logistic regression analysis was used to explore the relationship between patient-physician trust and medication adherence. Results The mean scoring of patients′ trust and medication adherence was 20. 16 ± 2. 13, 7. 07 ± 1. 54 respectively. 55. 40 percent of the patients had high medication compliance, 28. 53 percent of them had medium compliance and 16. 07 percent had poor compliance. Multiple linear regression analysis showed that the patient′s occupation, course of disease, self-reported health status and mental health status influenced their trust behavior (P < 0. 05). Ordered logistic regression analysis showed that each 1 point increase in patient′s trust in physicians, the medication compliance increased by 11. 0％ (OR = 1. 110, P < 0. 001). Medication adherence is also affected by age, employment status, course of illness, and mental health status. Conclusions Diabetes patients′ trust in their family physicians improves their medication adherence.