To analyze the clinical features and genetic variants of a child with type 4 familial partial lipodystrophy (FPLD4) and the initial manifestation of diabetes.The male patient with the age of 13 years and 5 months, and the diabetes course was about 3 years, the patient was admitted to Children′s Hospital of Soochow University on November 10, 2021(4 th hospitalization at the hospital), in the course of diabetes, the children repeatedly suffered from diabetes ketoacidosis, and lipid metabolism complications gradually emerged.The gene sequencing showed that the proband and his mother carried dual gene mutations of PLIN1 c. 1325delG(p.G442Afs*99) and SPINK1 c. 194+ 2T>C(p.? ). The PLIN1 gene was the causal gene of FPLD4.The mutations of c. 1325delG in the PLIN1 gene had not been previously reported.Based on the clinical phenotype, family history and genetic testing findings, the patient was diagnosed as FPLD4.In addition, the mutation of SPINK1 c. 194+ 2T>C(p.? ) might increase the risk of chronic pancreatitis.This case report enriched the clinical characteristics and genotype data of FPLD4.Gene sequencing assisted the accurate diagnosis of the type of diabetes.The effects of dual gene mutations on disease progression should be concerned, which were of great significance to develop treatment regimen and disease management.

Objective:To investigate the value of serum insulin-like growth factor-1 (IGF-1), dehydroepiandrosterone sulphate (DHEAS), anti-Müllerian hormone (AMH) and bone morphogenetic protein 6 (BMP-6) in prediction of rapidly progressive puberty(RPP) in girls.Methods:The data of 750 girls who visited the Department of Endocrinology, Metabolism and Genetic Disorders, Children′s Hospital of Soochow University from August 2017 to October 2018 because of breast development were retrospectively analyzed.After following up these girls for 6 months to 1 year, those who were lost to follow up, received early treatment and failed to meet the inclusion criteria were excluded.The remaining 138 girls were divided into the central precocious puberty group (CPP, 32 cases), the early puberty with RPP group (EP-RPP, 33 cases), the early puberty with slow progression puberty group (EP-SPP, 32 cases) and RPP group (41 cases) according to the inclusion criteria.The healthy control group consisted of 33 undeveloped girls aged 8 to 9 who underwent physical examination in the same hospital over the same period.The serum concentrations of IGF-1, DHEAS, AMH and BMP-6 were measured.The general information, clinical manifestations, laboratory examination results and radiological features were compared among different groups.Statistical analysis was performed by using SPSS 22.0, and the receiver operating characteristic curve (ROC) was drawn to investigate the value of IGF-1, DHEAS, AMH and BMP-6 in prediction of RPP.Results:(1)The serum follicle stimulating hormone(FSH) peak value was 15.10(13.86-19.80) IU/L in the EP-SPP group, 11.99(9.18-16.16) IU/L in the EP-RPP group and 11.43(9.37-15.63) IU/L in the RPP group.The ratio of serum FSH/luteinizing hormone(LH) peak values was 3.20(2.44-4.58) in the EP-SPP group, 1.86(1.05-3.16) in the EP-RPP group and 0.76(0.49-0.99) in the RPP group.The serum FSH peak value and the ratio of serum FSH/LH peak values in the EP-SPP group were significant higher than those in the EP-RPP group(all P<0.05). There was no significant difference in the serum FSH peak value between the EP-RPP group and the RPP group( P>0.05). (2)The serum IGF-1 levels of the healthy control group, EP-SPP group, EP-RPP group, CPP group and RPP group were 166.00(126.50-188.00) μg/L, 199.00(170.50-262.50) μg/L, 252.00(233.00-291.50) μg/L, 288.00(252.00-376.00) μg/L and 382.00(264.0-499.50) μg/L, respectively.The serum IGF-1 levels of the EP-SPP group, EP-RPP group, CPP group and RPP group were all significantly higher than those in the healthy control group (all P<0.05). The serum IGF-1 levels in the EP-RPP group were higher than those in the EP-SPP group( P<0.01). As the puberty rapidly progressed, the serum IGF-1 levels gradually increased.The RPP group had the highest IGF-1 levels, and the difference in IGF-1 levels between the RPP group and EP-RPP group was statistically significant( P<0.01). (3)The serum DHEAS levels were 41.65(14.80-59.88) μg/L in the healthy control group, 42.50(30.15-79.83) μg/L in the EP-SPP group, 52.32(43.08-98.54) μg/L in the CPP group, 63.30(34.00-81.55) μg/L in the EP-RPP group and 70.89(51.85-100.02) μg/L in the RPP group.The DHEAS levels of the healthy control group, EP-RPP group and RPP group gradually increased.The RPP group had the highest DHEAS levels.There was significant difference in DHEAS levels among the healthy control group, EP-RPP group and RPP group ( P<0.05). There was no significant difference in DHEAS levels among the EP-SPP group, CPP group and EP-RPP group( P>0.05). (4)The serum AMH and BMP-6 levels in the EP-RPP group, EP-SPP group, RPP group, CPP group and healthy control group were not significantly different( P>0.05). (5)The area under the ROC curve of serum IGF-1 levels was 0.765, the cut-off value was 232.5 μg/L, the specificity for the cut-off value was 83.30%, and the sensitivity was 75.00%.The combined area under the ROC curve of the serum FSH peak value and the ratio of serum FSH/LH peak values was 0.795. Conclusions:Serum IGF-1 levels and the combination of the serum FSH peak value and the ratio of serum FSH/LH peak values can be used as effective indicators of slowly and rapidly progressive puberty in early adolescent girls.Serum DHEAS cannot be used as an early warning index of RPP, but it plays a critical role in the regulation of puberty initiation and process.Serum DHEAS levels may be related to the Tanner stage.

Objective:To understand the employment psychology of college students in traditional Chinese medicine universities through analyzing relevant influencing factors, and to provide solutions to improve employment quality of the medical students.Methods:An online questionnaire survey on employment psychology and employment situation was conducted from August to September in 2017 among 384 students who had graduated from Longhua Hospital of Shanghai University of Traditional Chinese Medicine from 2013 to 2017. SPSS 19.0 was used for chi-square test and linear trend test on the survey results.Results:A total of 374 valid questionnaires were recovered, with the effective recovery rate of 97.4%. The results showed that the most important factors to be considered were professional counterparts (77.01%, 288 students), salary (75.67%, 283 students) and development prospect (69.52%, 260 students) and the most important psychological characteristics were hesitation and contradiction (50.8%, 190 students) and anxiety (25.13%, 94 students). The study found that employment psychology was related to students' family situation, category, temperament and performance during their education period.Conclusion:Students have different employment psychology, which can be improved by consummating career planning, broadening employment channels, combing employment policies, supplementing professional shortcomings, and improving comprehensive skills. Meanwhile, colleges and universities can expand their practice bases, provide employment counseling, and improve education resources, speed up the construction of the second classroom, pay attention to special groups to conduct employment guidance and improve the quality of employment.

Objective: To investigate the proteomic characteristics of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention to identify related biomarkers. Methods: Seventy-one subjects were enrolled in the study. We assessed blood glucose, blood lipids, body mass index (BMI), and phlegm-dampness pattern, which was confirmed by a traditional Chinese med-icine clinician. Of the participants, we included healthy participants with normal weight (NW, n =23), overweight/obese participants with normal metabolism (ONM, n = 19), overweight/obese participants with pre-diabetes (OPD, n = 12), and overweight/obese participants with marginally-elevated blood lipids (OML, n = 17). Among them, the ONM, OPD, and OML groups were diagnosed with phlegm-dampness pattern. The data-independent acquisition (DIA) method was first used to analyze the plasma protein expression of each group, and the relevant differential proteins of each group were screened. The co-expressed proteins were evaluated by Venn analysis. The pathway analyses of the differential proteins were analyzed using Ingenuity Pathway Analysis (IPA) software. Parallel reaction monitoring (PRM) was used to verify the differential and common proteins in each group. Results: After comparing ONM, OPD, and OML groups with NW group, we identified the differentially expressed proteins (DEPs). Next, we determined the DEPs among OPD, OML, and ONM groups. Using Venn analysis of the DEPs in each group, 24 co-expressed proteins were screened. Two co-expressed proteins were verified by PRM. IPA analysis showed that pathways including LXR/RXR activation, acute phase response signaling, and FXR/RXR activation were common to all three groups of phlegm-damp overweight/obesity participants. However, the activation or inhibition of these pathways was different among the three groups. Conclusion: Participants with overweight/obesity have similar proteomic characteristics, though each type shows specific proteomic characteristics. Two co-expressed proteins, VTN and ORM1, are potential biomarkers for glucose and lipid metabolism diseases with overweight/obesity caused by phlegm-dampness retention.

Objective: To investigate the association between gene polymorphism of vesicular monoamine transporter type 2(VMAT2) and schizophrenia in Han Chinese population. Methods: 430 patients with schizophrenia and 470 age-sex matched controls were recruited from four mental health centers. All patients were diagnosed by two psychiatrists based on the Structured Clinical Interview for DSM Disorders (SCID). The ligase detection reactions (LDR) method was used to assess the polymorphism of the two SNPs (rs363371 and rs363324) of VMAT2. Results: No associations of two SNPs with schizophrenia was found. When we stratified males and females for the analysis, we found that that in the recessive model of rs363371, there was an obvious significant association between rs363371 and schizophrenia in males (OR=0.564, 95% CI=0.357–0.892, p=0.014) but not females. For the association between rs363324 and schizophrenia, no association was found in either males or females. No association was found when stratifying early-onset schizophrenia and late-onset schizophrenia. Conclusion Our findings indicate that both rs363371 and rs363324 were not associated with schizophrenia, while it seemed that the AA genotype of rs363371 plays a protective effect in male Chinese in developing schizophrenia.

Objective:To explore the influence of family function on the psychological resilience of mothers of premature infants.Method:Totally 2 836 mothers of premature infants who met the inclusion criteria were investigated with general information questionnaire, family APGAR index (APGAR) and Connor-Davidson resilience scale (CD-RISC) in three third-class A general hospitals and two specialty hospitals in Ningxia.SPSS 23.0 software was used for statistical analysis.Pearson correlation was used to analyze the relationship between psychological resilience and family function of preterm mothers.Hierarchical regression was used to analyze the impact of family function on psychological resilience of preterm mothers.Results:Total score of resilience scale in mothers of premature infants was (68.38±16.59) and the total score of family function was (9.07±1.53). There were 1 550 cases with good family function and 1 286 cases with family dysfunction.The total score of psychological elasticity and the score of all dimensions in the group with good family function were higher than those in the group with family dysfunction( P<0.05). The total score of psychological elasticity ( r=0.771, P<0.01) and self-improvement ( r=0.410, P<0.05), tenacity ( r=0.492, P<0.01), optimism( r=0.438, P<0.05) were positively correlated with family function.Stratified regression analysis showed that cooperation( β=1.016) and intimacy( β=0.389) were the important influencing factors of preterm mothers' psychological resilience ( P<0.05). Conclusion:Psychological resilience of mothers of premature infants is closely related to their family function.Good family function can help mothers of premature infants improve their psychological resilience and promote their mental health.

Objective:To understand the current situation of defeat and job burnout of junior clinical nurses, and to explore the effect of defeat on job burnout of junior clinical nurses.Methods:The cross-sectional survey method was used to select the clinical nurses with a nursing age of less than 5 years from the Seventh Affiliated Hospital of Sun Yat-Sen University from June to August 2019 by using cluster sampling method. The general data questionnaire, Defeat Scale (DS) and Maslach Burnout Inventory (MBI) were used to investigate, and the effect of defeat on job burnout of junior nurses was analyzed. A total of 400 questionnaires were issued and 360 valid questionnaires were recovered.Results:The total score of DS of 360 junior nurses was (35.53±8.54) and the total score of MBI was (61.85±17.70) . The scores of each dimension and total score of DS of junior nurses were positively correlated with emotional exhaustion, depersonalization, and total score of job burnout ( P<0.05) , and negatively correlated with the score of personal achievement dimension in job burnout ( P<0.05) . The results of stratified regression analysis showed that the low sense of achievement in defeat had a predictive effect on the job burnout of junior nurses ( P<0.05) . Conclusions:Junior nurses have different degrees of job burnout, and defeat has a certain correlation with job burnout. Nursing managers should pay attention to defeat of junior nurses in their career development and take effective measures from the management level to help junior nurses cope with setbacks and difficulties reasonably, so as to reduce the level of job burnout.

Objective: To explore the correlation between moxibustion sensation and distance of moxa stick and provide reference for clinical practice. Methods: A total of 16 healthy volunteers aged 18-35 years old in college were recruited and given mild moxibustion at Shousanli (LI 10), Zusanli (ST 36), Shenshu (BL 23) and Tianshu (ST 25) with moxa stick, and the occurrence and frequency of moxibustion sensation were recorded at distances of 5 cm, 4 cm, 3 cm and 2 cm. Mild moxibustion scale was used to count the score. Results: Warm was the main moxibustion sensation, burning pain and soreness decreased with the rise of distance; for the same acupoint, score of mild moxibustion scale increased with the decrease of distance; score ranged between 5.5 and 6.5 at distance 3 cm, which was the most comfortable distance for volunteers. Conclusion: The distance of 3 cm is the most comfortable distance in mild moxibustion.

Objective: To explore the beneficial regulatory effect of mild moxibustion from different distances at Zusanli (ST 36) of healthy population on the functions of temperature-related brain regions. Methods: In 20 recruited healthy subjects, the change of the temperature-related brain regions induced by mild moxibustion from different distances at Zusanli (ST 36) was observed by functional magnetic resonance imaging (fMRI). Results: In comparison of the values in amplitude of low-frequency fluctuation (fALFF) during and before moxibustion, it has been found that in moxibustion of 2 cm distance, fALFF value increased in the brain regions of the left anterior cingulated cortex and lateral surrounding cerebral regions, and fALFF value decreased in the cerebral regions of the peripheral cortex of the calcarine fissure; in moxibustion of 3 cm distance, fALFF value increased in the brain regions of the right and medial side and paracingulated gyrus, and fALFF value decreased in the cerebral zone of the left middle temporal gyrus; in moxibustion of 4 cm distance, fALFF value increased in the brain regions of the right and medial and paracingulated gyrus; and in moxibustion of 5 cm distance, fALFF value increased in the brain regions of the left hippocampus. In comparison of the value of regional homogeneity (ReHo), it has been found that in moxibustion of 2 cm distance, ReHo value increased in the cerebral zone of the posterior lobe of the right cerebellum, and ReHo value decreased in the cerebral zone of the right occipital lobe; in moxibustion of 3 cm distance, ReHo value increased in the brain regions of the left cerebellar posterior lobe and left frontal lobe, and ReHo value decreased in the cerebral zone of the right inferior temporal gyrus; in moxibustion of 4 cm distance, ReHo value increased in the brain regions of the right superior frontal gyrus and ReHo value decreased in the brain regions of the right parietal lobe and angular gyrus; in moxibustion of 5 cm distance, ReHo value increased in the cerebral zone of the right frontal lobe and ReHo value decreased in the cerebral zone of the right brainstem. Conclusion: In moxibustion of 3 cm distance, the changes in the brain regions basically conform to the transmission route of body trunk temperature.

OBJECTIVETo compare the clinical short-term safety and efficacy between robotic right colectomy (RRC) and laparoscopic right colectomy(LRC) with meta-analysis.

METHODSA search of the Medline, Embase, Ovid, CNKI and WANFANG databases was performed for studies comparing clinical or oncologic outcomes of RRC with LRC before July 2014. The RevMan 5.2 software was used for meta-analysis. The operative time, estimated blood loss, length of hospital stay, conversion rate to open surgery, postoperative complications and related outcomes were evaluated.

RESULTSSix studies including 217 RRC cases and 400 conventional LRC cases were enrolled and analyzed. The meta-analysis showed that RRC had longer operative time (MD=48.05, 95% CI: 26.52 to 69.57, P<0.01), less estimated blood loss (MD=-17.74, 95% CI: -28.32 to -7.16, P=0.01), faster postoperative intestinal peristalsis recovery (MD=-0.79, 95% CI: -1.10 to -0.48, P<0.01), lower postoperative overall complications (OR=0.63, 95% CI: 0.42 to 0.93, P=0.02). Conversion rate and postoperative hospital stay between the two groups were not significantly different (all P>0.05).

CONCLUSIONCompared to LRC, RRC is associated with less estimated blood loss, faster postoperative intestinal peristalsis recovery, lower postoperative overall complications, and longer operative time.