Objective: To under the prevalence of malnutrition and its associated factors in school aged children with cerebral palsy, so as to provide a basis for relevant departments to formulate targeted policies. Methods: From July to August 2023, the researchers selected 333 children with cerebral palsy and 960 children with other diseases aged 6-18 years who were residents of a social welfare institution in Guangzhou, China. Their height and weight were measured and a nutritional status analysis was carried out using a cluster sampling method. Multivariate Logistic analysis was performed to analyze the relative factors and malnutrition status of school aged children with cerebral palsy. Results: The prevalence of growth retardation among school aged children with cerebral palsy was 74.5%, with rates of stunting, normal nutrition status, and overweight/obesity being 17.7%, 7.2%, and 0.6%, respectively. The results of the univariate analysis revealed statistically significant differences in the detection rate of malnutrition among school aged children with cerebral palsy based on gender, gross motor function classification system (GMFCS) grading, and the presence of swallowing disorders ( χ 2=6.02, 15.23, 32.16, P <0.05). The results of the multivariate Logistic regression analysis showed that gender ( OR=0.37, 95%CI =0.15-0.91), dysphagia (OR=4.10, 95%CI =1.39-12.12), and GMFCS classification ( OR=1.45, 95%CI =1.04-3.01) were influencing factors of malnutrition ( P <0.05). Conclusions The detection rate of malnutrition among children and adolescents with cerebral palsy in welfare institutions was found to be relatively high, and influenced by various factors. Corresponding nutritional interventions should be developed and implemented based on the risk factors of malnutrition in school aged children with cerebral palsy to improve their nutritional status.

Objective: To explore the association between maternal pre pregnancy and pre delivery overweight with overweight and obesity among offspring during adolescence in Guangzhou, and to provide evidence for child obesity prevention. Methods: Based on the routine physical examination of primary and secondary school students in Guangzhou, random sampling was used to 6 middle schools and questionnaire survey was conducted among 3 384 students and their parents. Students with overweight and obesity were included in the case group, and the other students were included in the control group. Propensity Score Matching (PSM) was adopted to reduce selection bias. Logistic regression model and χ 2 test were used to analyze the data before and after PSM. Results: The result of univariate analysis showed that there were statistically significant differences between overweight/obese group and the control group by gender, schooling stage (middle and high schools), picky eater, family history of obesity, family monthly income, delivery mode, high birthweight, and gestational weight gain before PSM( χ 2=42.38, 10.64, 14.47, 26.85, 10.58, 13.59 , 15.53, 20.64, P <0.05). After PSM, results showed that there were no statistically significant differences between overweight/obese group and the control group in middle and high schools, and mother delivery mode( P >0.05). Logistic regression analysis showed that the risk of overweight and obesity of maternal pre pregnancy on adolescent offspring was 1.54 times higher than control group (95% CI =1.01-2.36) before PSM, and the overweight and obesity of maternal predelivery also increased the risk of overweight and obesity of adolescent offspring( OR=2.35, 95%CI =1.67-3.31). After PSM, maternal overweight and obesity pre pregnancy ( OR=2.17, 95%CI =1.41-3.34) and maternal overweight and obesity pre delivery( OR=2.99, 95%CI =2.08-4.31) significantly increased the risk of overweight and obesity in adolescent offspring. Conclusion Maternal overweight and obesity pre pregnancy and pre delivery are associated with increased risk of overweight and obesity in adolescent offspring.

Previous studies suggest that the reduction of SMAD3 (mothers against decapentaplegic homolog 3) has a great impact on tumor development, but its exact pathological function remains unclear. In this study, we found that the protein level of SMAD3 was greatly reduced in human-grade IV glioblastoma tissues, in which LAMP2A (lysosome-associated membrane protein type 2A) was significantly up-regulated. LAMP2A is a key rate-limiting protein of chaperone-mediated autophagy (CMA), a lysosome pathway of protein degradation that is activated in glioma. We carefully analyzed the amino-acid sequence of SMAD3 and found that it contained a pentapeptide motif biochemically related to KFERQ, which has been proposed to be a targeting sequence for CMA. In vitro, we confirmed that SMAD3 was degraded in either serum-free or KFERQ motif deleted condition, which was regulated by LAMP2A and interacted with HSC70 (heat shock cognate 71 kDa protein). Using isolated lysosomes, amino-acid residues 75 and 128 of SMAD3 were found to be of importance for this process, which affected the CMA pathway in which SMAD3 was involved. Similarly, down-regulating SMAD3 or up-regulating LAMP2A in cultured glioma cells enhanced their proliferation and invasion. Taken together, these results suggest that excessive activation of CMA regulates glioma cell growth by promoting the degradation of SMAD3. Therefore, targeting the SMAD3-LAMP2A-mediated CMA-lysosome pathway may be a promising approach in anti-cancer therapy.

Objective: To investigate the incidence of adolescent depressive symptoms in primary and secondary schools in Guangzhou and the effect of gestational complications on adolescent depression, so to provide scientific basis for depression prevention among adolescent. Methods: Stratified cluster random sampling method was used to select 808 primary and secondary schools in 11 districts of Guangzhou. A total of 96 756 parents of adolescents aged 10-20 were surveyed for adolescents depressive symptoms and maternal gestational complications. Results: The parental reported rates of mild, moderate and major depressive symptoms of adolescents were 5.5%, 3.5%, and 0.5%, respectively. Univariate analysis showed that the severity of adolescent depression symptoms had statistical significance with maternal gestational hypertension, gestational diabetes mellitus, cholestasis, hypothyroidism, hyperthyroidism, gestational anemia and viral hepatitis ( χ 2=12.42~158.91， P <0.01). Multivariate Logistic regression showed that maternal gestational diabetes mellitus ( OR =1.41, 95% CI =1.18- 1.68 ), hypothyroidism during pregnancy ( OR =1.61, 95% CI = 1.15-2.26), and hyperthyroidism during pregnancy ( OR =1.40, 95% CI =1.03-1.91), anemia during pregnancy ( OR = 1.46 , 95% CI =1.35-1.59), and viral hepatitis during pregnancy ( OR =1.67, 95% CI =1.38-2.02) were positively correlated with the severity of adolescent depression symptoms reported by parents( P <0.05). Conclusion Gestational diabetes mellitus, gestational hypothyroidism, gestational hyperthyroidism, gestational anemia and gestational viral hepatitis are associated with adolescent depressive symptom.

Background::Parkinson’s disease (PD) is the second most common neurodegenerative disease after Alzheimer’s dementia. Mitochondrial dysfunction is involved in the pathology of PD. Coiled-coil-helix-coiled-coil-helix domain-containing 2 (CHCHD2) was identified as associated with autosomal dominant PD. However, the mechanism of CHCHD2 in PD remains unclear.Methods::Short hairpin RNA (ShRNA)-mediated CHCHD2 knockdown or lentivirus-mediated CHCHD2 overexpression was performed to investigate the impact of CHCHD2 on mitochondrial morphology and function in neuronal tumor cell lines represented with human neuroblastoma (SHSY5Y) and HeLa cells. Blue-native polyacrylamide gel electrophoresis (PAGE) and two-dimensional sodium dodecyl sulfate-PAGE analysis were used to illustrate the role of CHCHD2 in mitochondrial contact site and cristae organizing system (MICOS). Co-immunoprecipitation and immunoblotting were used to address the interaction between CHCHD2 and Mic10. Serotype injection of adeno-associated vector-mediated CHCHD2 and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) administration were used to examine the influence of CHCHD2 in vivo.Results::We found that the overexpression of CHCHD2 can protect against methyl-4-phenylpyridinium (MPP+)-induced mitochondrial dysfunction and inhibit the loss of dopaminergic neurons in the MPTP-induced mouse model. Furthermore, we identified that CHCHD2 interacted with Mic10, and overexpression of CHCHD2 can protect against MPP +-induced MICOS impairment, while knockdown of CHCHD2 impaired the stability of MICOS. Conclusion::This study indicated that CHCHD2 could interact with Mic10 and maintain the stability of the MICOS complex, which contributes to protecting mitochondrial function in PD.

Objective:To investigate early cardiac rehabilitation program on short term and long term effect of patients with acute myocardial infarction after percutaneous coronary intervention.Methods:A total of 98 acute myocardial infarction patients who undergo percutaneous coronary intervention were randomly assiged to the study group ( n=49) and the control group ( n=49). Participants in the control group received exercise training, while the study group carried out early cardiac rehabilitation program. The cardiac function, activity of daily living and exercise endurance were compared in both groups before and 1 week after intervention, in addition, the patient`s quality of life and the incidence of adverse cardiac events were also compared before and 6 months after intervention. Results:After 1 week of intervention, the value of LVEF, LVDD, scores of activity of daily living and 6MWT were (56.74 ± 8.92)%, (49.29 ± 5.09)mm, (76.00 ± 5.95) and (378.12 ± 48.54)m in the study group, those index were (52.10 ± 7.44)%, (48.47 ± 4.04)mm, (72.93 ± 6.51), (355.69 ± 46.36)m in the control group, the LVEF, scores of activity of daily living and 6MWT were significantly increased in the study group compared to the control group ( t=0.878-2.792, P<0.05). After 6 months of intervention, the scores physical function, role-physical, bodily pain, general health, vitality, social function, role-emotional, mental health were [(75.14 ± 12.15), (56.38 ± 7.65), (68.79 ± 6.65), (68.48 ± 10.91), (80.82 ± 7.12), (66.44 ± 9.61), (77.75 ± 13.05), (77.07 ± 8.46)] and [(72.70 ± 10.97), (52.05 ± 5.61), (62.07 ± 5.51), (65.76 ± 8.45), (78.33 ± 8.71), (65.20 ± 6.84), (72.53 ± 9.66), (75.49 ± 5.76)] in the study group and control group, respectively. The scores of role-physical, bodily pain, role-emotional were significantly increased in the study group compared to the control group ( t=2.248-3.448, P<0.05). The study group showed lower incidence of angina and arrhythmia compared to the control group (4.08% and 6.12% vs 16.33% and 20.41%), the differences had statistical significance ( χ2=4.009 and 4.346, P<0.05). Conclusion:Early cardiac rehabilitation program improve the cardiac function and exercise endurance in patients with acute myocardial infarction after percutaneous coronary intervention, reduce the the incidence of adverse cardiac events and improved patients` quality of life.

Objective:To investigate the characteristics of senile neurodegenerative diseases (NDDs) inpatients in south China, especially in Guangdong province, and explore the influencing factors for their medical expenses.Methods:The medical records of 7231 patients with NDDs≥65 years were collected in the electronic health database of our hospital from January 2010 to December 2019, including gender, age, admission ways, chief complaints, length of hospital stays and medical expenses. On the basis of median of the medical expenses (21 345 yuan) of these patients, they were divided into low cost (<21 345 yuan) group and high cost (≥21 345 yuan) group. Univariate Logistic analysis and multivariate Logistic regression analysis were conducted to screen the influencing factors for medical expenses and the independent influencing factors.Results:(1) The main age group of geriatric inpatients with NDDs were 70-79 years (40.96%); the admission source was mainly outpatient (56.70%), and length of hospital stays of a large percent of patients (44.50%) were 8-14 d. (2) From 2010 to 2019, the number of hospitalized geriatric patients with NDDs showed an increasing trend year by year, the overall trend of length of hospital stays was shortened, and the medical expenses showed gradual increase; the causes of hospitalization, percentages of patients caused by infection, abnormal blood pressure and water-electrolyte metabolism disturbances showed decreased trend, percentages of patients caused by heart diseases, cerebrovascular accidents and mental-psychological diseases showed increased trend, and the proportions of patients caused by fracture/trauma/wound injuries were generally stable. The proportion of patients returning home and mortality rate after hospital discharge were declined, and the proportion of patients returning to other medical or community institutions was increased. (3) Living in ICU, length of hospital stays, diabetes, nosocomial infection, chronic kidney disease, urinary tract infection, tumble, body mass index, and anticholinergic drugs were independent risk factors influencing the medical expenses ( P<0.05). Conclusions:An aging trend is noted in patients with NDDs; the number of hospitalized patients and medical expenses increase year by year, and the length of hospital stays gradually decreases. In view of the many factors that influence the medical expenses of this disease, it is suggested to develop the corresponding standardized treatment plan for the main influencing factors in clinical practice.

PURPOSE: Rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone administered every 3 weeks (R-CHOP-21) is the standard care for diffuse large B-cell lymphoma (DLBCL). It is unknown whether the dose-dense R-CHOP (R-CHOP-14) could improve the outcome of the disease in Asian population. MATERIALS AND METHODS: Newly diagnosed DLBCL patients were centrally, randomly assigned (1:1) to receive R-CHOP-14 or R-CHOP-21. R-CHOP-14 was administered every 2 weeks, and R-CHOP-21 was administered every 3 weeks. Primary end point was disease-free survival (DFS). Secondary end points included overall survival (OS), progression-free survival (PFS), response rate and toxicities. RESULTS: Seven hundred and two patients were randomly assigned to receive R-CHOP-14 (n=349) or R-CHOP-21 (n=353). With a median follow-up of 45.6 months, the two groups did not differ significantly in 3-year DFS (79.6% for R-CHOP-14 vs. 83.2% for R-CHOP-21, p=0.311), 3-year OS (77.5% for R-CHOP-14 vs. 77.6% for R-CHOP-21, p=0.903), or 3-year PFS (63.2% for R-CHOP-14 vs. 66.1% for R-CHOP-21, p=0.447). Patients with an International Prognostic Index (IPI) score ≥ 2 had a poorer prognosis compared to those with an IPI score < 2. Grade 3/4 hematologic and non-hematologic toxicities were manageable and similar between R-CHOP-14 and R-CHOP-21. CONCLUSION: R-CHOP-14 did not improve the outcome of DLBCL compared to R-CHOP-21 in Asian population. With manageable and similar toxicities, both of the two regimens were suitable for Asian DLBCL patients. For high-risk patients with IPI ≥ 2, new combination regimens based on R-CHOP deserve further investigation to improve efficacy.
Asian Continental Ancestry Group ; B-Lymphocytes ; Cyclophosphamide ; Disease-Free Survival ; Doxorubicin ; Follow-Up Studies ; Humans ; Lymphoma, B-Cell ; Prednisone ; Prognosis ; Rituximab ; Vincristine

Objective To investigate the characteristics of sleep structures in patients with multiple dreams through the retrospective analysis of polysomnography in patients with multiple dreams,and to provide a theoretical basis for the treatment of multiple dreams.Methods Twenty-two cases with multiple dreams in Department of Neurology,the People's Hospital of Zhengzhou University from July 2015 to Ferbuary 2018 were included in multi-dream group and 12 healthy people in control group.The sleep parameters related to polysomnography during the visit were collected and recorded,and the differences between the two groups were compared.Resluts There was no statistically significant difference in apneahypopnea index,sleep latency,rapid eye movement (REM) sleep latency,slow-wave sleep ratio,and REM-arousal index between the two groups.Compared with the control group,sleep efficiency (73.46％ ± 12.41％ vs 90.43％ ± 4.42％,t=-4.555,P=0.000),REM period ratio (16.28％ ± 5.59％ vs 21.59％ ± 2.70％,t =-3.727,P =0.001) decreased in the multi-dream group;whereas ratio of light sleep (66.49％ ±9.97％ vs 59.85％ ±3.01％,t =2.966,P =0.006),awakening numbers (13.4 ±6.98 vs 6.08 ± 3.34,t =3.411,P =0.002),arousal index (20.11 ± 10.69 vs 11.82 ± 8.09,t =2.338,P =0.026),non-REM arousal index (20.22 ± 10.53 vs 12.08 ± 8.69,t =2.283,P =0.029) increased.Conclusion The sleep efficiency of patients with multiple dreams is reduced,and their perceived dreams may originate from light sleep periods.

Objective:To study the mechanism of interleukin-10(IL-10)inhibiting the function of dendritic cells(DCs).Meth-ods:Cultured C57BL/6 mouse bone marrow-derived DCs were divided into 5 groups:control group,LPS stimulated group,IL-10 treated group,IL-10+Rapamycin treated group and Rapamycin treated group .The regulatory mechanism of IL-10 on dendritic cells were evalua-ted from DCs function ,Flow cytometry was used to analyse the expression of DCs surface co-stimulator CD80 ,CD40 expression ,the abil-ity of uptaking antigen and stimulating T cell to proliferate;ELISA was used to detect the cytokines IL-6 and TNF-α.Western blot was used to analyse the autophagy related protein LC3.Compared the differences between the groups.Results:(1)Compared to LPS stimu-lated group,IL-10 treated group,DCs surface co-stimulator CD40,CD80 were decreased,IL-6 and TNF-αsecretion level and the ability to stimulate T cell to proliferate were decreased ,the ability to capture OVA antigen was increased .Compared to IL-10 treated group ,the DCs surface co-stimulator CD80 was decreased ( P<0.05 ) ,IL-6 and TNF-αsecretion level and the ability to stimulate T cell to prolifer-ate were increased(P<0.0001)in IL-10+rapamycin treated group.In addition,autophagy related proteins LC3Ⅱ/LC3Ⅰwas decreased in IL-10 treated group.Conclusion:IL-10 may regulate functions of DCs through inhibiting the autophagy of DCs .