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BACKGROUND: Enhancing the emergency competencies of healthcare professionals is essential for ensuring patient safety, optimizing emergency response efficiency, and fostering effective team collaboration. However, traditional simulation-based methods often struggle to accurately replicate real-life emergencies, resulting in outcomes that may not fully reflect actual performance, thereby undermining their effectiveness in training and developing the critical skills needed for emergency situations. OBJECTIVE: This study evaluated the effectiveness of using murder mystery games (MMGs) as a gamified learning method to enhance the emergency competencies of healthcare professionals. METHODS: Twelve scripts of emergency scenarios were developed for the MMGs, and five assessment scales were established, covering emergency response, scenario decision-making, team collaboration, emotional support, and human care. Questionnaire data were analyzed between the experimental and control groups using Chi-square tests for five dimensions and nineteen indicators of emergency competencies. RESULTS: The performance of the experimental group in emergency response and emotional support was significantly higher than that of the control group (P<0.001). The experimental group also showed notable excellence in scenario decision-making, team collaboration, and human care (P<0.005). CONCLUSIONS: Emergency capabilities can be significantly enhanced through murder mystery games, providing robust support for improving the quality of medical services.

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OBJECTIVE@#To analyze variants of SMN gene in a Chinese pedigree affected with Spinal muscular atrophy (SMA).@*METHODS@#A Chinese pedigree diagnosed at the Nanchang First Hospital in January 2020 was selected as the study subject. Peripheral blood samples were collected for the extraction of DNA. All exons of the SMN gene were detected by multiple ligation-dependent probe amplification (MLPA). Potential variants of the SMN gene were also detected by Whole exome sequencing (WES), and the result was verified by Sanger sequencing. cDNA extracted from fresh blood sample was used as a template to verify the location of variant on the SMN genes.@*RESULTS@#The proband was found to harbor a heterozygous deletion of the SMN1 Exon7+Exon8, and a heterozygous c.81G>A variant. The SMN1 Exon7+Exon8 deletion was inherited from her father and grandmother, whilst the c.81G>A variant was inherited from her mother and maternal grandfather. Her aunt was also a carrier of the heterozygous deletion, while her paternal aunt, her husband, and their daughter were not. cDNA amplification and Sanger sequencing confirmed that the c.81G>A variant was located in the SMN1 gene.@*CONCLUSION@#MLPA combined with NGS and Sanger sequencing can identify compound heterozygous variants of the SMN gene in the SMA patients.

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ObjectiveTo analyze the mental health status and its influencing factors in middle school students under the regular prevention and control of COVID-19， so as to provide references for the intervention and management of their mental health problems. MethodsFrom March 7 to 21， 2021， a stratified random sampling method was used to select 19 352 students from 17 schools in 3 districts and 9 counties of Linyi City， Shandong Province. Basic data were collected through a self-designed questionnaire. All students completed the Symptom Checklist 90 （SCL-90） to assess their mental health status. Then the factors affecting the mental health status of middle school students were screened using independent sample t-test， one-way ANOVA test and multiple stepwise regression analysis. Results① A total of 6 350 （32.81%） middle school students were found to have mental health problems. ② Each SCL-90 factor score and total average score yielded statistical difference among middle school students of different genders， relationships with classmate， closeness to friends， concerns about the epidemic， and pressure exerted by schoolwork （P<0.01）. Each SCL-90 factor score and total average score of middle school students were significant different in terms of the hours of smartphone usage for recreation per day， sleep duration per night in hours and exercise frequency （P<0.01）. ③ Multiple stepwise regression analysis denoted that female gender， poor relationship with classmate， no close friend and long hours of smartphone usage for recreation were the risk factors for mental health of middle school students （β=0.096， 0.183， 0.064， 0.232， P<0.01）. ConclusionThe prevalence rate of mild mental health problems is quite high among middle school students under the regular epidemic prevention and control. Additionally， female gender， poor relationship with classmate， no close friend and long hours of smartphone usage for recreation have a negative impact on middle school students' mental health.

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Objective:To improve clinicians' understanding of congenital nephrogenital diabetes insipidus (CNDI) and to reduce missed and misdiagnosis. Methords 　Based on the literature, the clinical data and gene mutation of 2 patients with CNDI who were admitted to the Department of Endocrinology and Metabolism of the First Affiliated Hospital of Henan University of Science and Technology on July 30, 2020 were analyzed retrospectively. Results:(1) The presentee, 4 years old, had irritable thirst, polydipsia and polyuria for more than 3 years. The sister, 2.5 years old, had irritable thirst, polydipsia and polyuria for more than 2 years. The clinical diagnosis was “CNDI”, and the symptoms improved after treatment with hydrochlorothiazide. (2) The genetic test revealed that the congenital nephrogenic uremia and her sister had a heterozygous mutation of c.170A>C (p.Q57P) and c.211G>A (p.Vl71M) in the aquaporin-2 gene, and the mother carried the AQP2 gene. c.170A>C(p.Q57P) mutation.Conclusion:CNDI is a rare disease. Early diagnosis and treatment can improve the prognosis of patients to the greatest extent, and prenatal diagnosis can guide eugenics.

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Objective:To evaluate the effect of esmketamine for labor analgesia on the occurrence of postpartum depression (PPD).Methods:Two hundred and forty-two cases of nulliparous parturients who selected natural labor and agreed to receive labor analgesia were selected and divided into conventional labor analgesia group (C-LA group, n=119) and esmketamine-based labor analgesia group (E-LA group, n=123). The epidural labor analgesia solution contained ropivacaine 100 mg and sufentanil 30 μg in 100 ml of normal saline in C-LA group. The epidural labor analgesia solution contained ropivacaine 100 mg, sufentanil 30 μg and esketamine 50 mg in 100 ml of normal saline in E-LA group. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen parturients for depression on admission to the predelivery room and at 2 h and 1, 7 and 42 days after delivery, and EPDS scores were recorded. The patients were diagnosed as having PPD when EPDS score ≥ 9 at 7-42 days after delivery. Peripheral venous blood samples were collected on admission to the predelivery room and at 1 day after delivery to determine the concentrations of serum estrogen, progesterone, 5-hydroxytryptamine and cortisol by enzyme linked inmunosorbent assay. Results:Compared with group C-LA, the EPDS scores were significantly decreased on the 1 and 42 days after delivery( P<0.01), no significant change was found in the incidence of PPD (1.7%/0.8%, P>0.05), no significant change was found in the concentrations of serum estrogen, progesterone, 5-hydroxytryptamine and cortisol on admission to the delivery room ( P>0.05), and the concentrations of serum progesterone and cortisol were significantly increased on 1 day after delivery in group E-LA ( P<0.05). Conclusions:Combination of esketamine is helpful in reducing the risk of postpartum depression when used for epidural labor analgesia, and the mechanism is related to slowing the declines in blood levels of sex hormones and stress hormones after delivery.

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Background Occupational injuries, which can result in absenteeism, disability, or death, are closely related to poor working conditions. However, the improvement of operating conditions are often time-consuming and require significant economic inputs. Both occupational psychology and enterprise risk factors have been proved to be related to the occurrence of occupational injuries, but their roles in the influence path of adverse working conditions leading to occupational injuries remain unclear. Objective To explore the roles of occupational psychology and enterprise risk factors in the impact of adverse working conditions on occupational injury, so as to provide a scientific basis for enterprises with adverse working conditions to carry out targeted occupational injury intervention programs. Methods The survey data of 5997 manufacturing enterprises were obtained from the European Survey of Enterprises on New and Emerging Risks (ESENER) database. The data on enterprise risk characteristics, occupational injuries, working conditions, and occupational psychological factors were extracted and assigned. Occupational injury differences by enterprise categories were examined by chi-square test. Correlations between interest variables were evaluated by Spearman test. Path analysis with Bootstrap method was conducted using AMOS 26 software, and ratio of chi-square statistic to degree of freedom (χ2/ν), comparative fit index (CFI), Tucker-Lewis index (TLI), and root mean square error of approximation (RMSEA) were used to evaluate the path model candidates. The effect size and its proportion were calculated for variables (occupational psychological factors, enterprise risk factors, and adverse working conditions) included in the final model. Results The M (P25, P75) scores of occupational injuries, adverse working conditions, and occupational psychological factors were 40 (20, 50), 50 (30, 60), and 20 (10, 30), respectively. The enterprises that reported occupational injuries accounted for 25.5% (1550 enterprises) of the total enterprises. Proportions of the enterprises that reported occupational injuries varied significantly by company scale, branch companies, temporary employment, language barriers, and establishment time (P<0.05). The results of Spearman test showed that occupational injuries were positively correlated with working conditions (rs=0.440), occupational psychological factors (rs=0.205), company scale (rs=0.307), temporary employment (rs=0.282), and language barriers (rs=0.158); but negatively correlated with branch companies (rs=−0.180) and establishment time (rs=−0.176) (P<0.05). In the path analysis, the fitness indexes of the final model were χ2/ν=2.85, CFI=0.997, TLI=0.993, and RMSEA=0.018 (90%CI: 0.011, 0.025). The indirect effect size values and constituent ratios of enterprise risk factors and occupational psychological factors in the effect of adverse working conditions on occupational injuries were 0.166 (30.01%) and 0.013 (3.13%) respectively. The indirect effect size value of occupational psychological factors in the effect of enterprise risk factors on occupational injuries and its constituent ratio were 0.022 and 6.85%. Conclusion Enterprises with adverse working conditions may control the risk of occupational injuries by offering better solutions to surmount language barriers and temporary employment, developing occupational psychological intervention and optimization programs such as improving working hours system. At the same time, large enterprises, enterprises without branches, or enterprises with a long history are the focus of occupational injury prevention and control.

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Background Falls are one of the most important types of occupational injuries. The incidence of falls is high in manufacturing workers. However, most of the studies on falls in China focus on primary and secondary school students and the elderly, and there are few studies on falls in the occupational population. Objective To evaluate efficiency of Bayesian network model in predicting fall injury risks in manufacturing enterprise staff, and impacts from work content, work environment, enterprise status, and health management on falls and their mutual relationships, and provide a scientific basis for enterprises to carry out fall-associated injury intervention. Methods Data from the European Survey of Enterprises on New and Emerging Risks (ESENER) were used. The survey provided data on work content, working environment, enterprise status, and health management of enterprises in European countries. The outcome indicator, was fall injury risks reported in enterprises. A total of 23 potential impact factors covering work content, working environment, enterprise status, and health management were screened by least absolute shrinkage and selection operator (LASSO) regression, followed by Bayesian network model for structure learning and parameter learning and area under the curve (AUC) for model fitness evaluation, using R and Netica 5.18. Diagnostic inference analysis was also conducted to identify key influencing factors and key influencing chains of fall injury risks based on the change rate of fall injury risks. Results In 5997 enterprises surveyed, 2573 (42.9%) enterprises reported fall injury risks. Ordered by their coefficient estimates from high to low, the 14 variables (mean-squared error=0.20) selected by LASSO regression were: manual handling, repetitive arm movement, poor posture, using desktop computers, and using robots in the category of work content; abnormal temperature and noise in the category of working environment; company size and employee quality in the category of enterprise status; mental health training, regular risk assessment, availability of psychologists, health and safety procedures, and provision of psychological counseling in the category of health management. The fitting result of Bayesian network model for fall injury risks was good (AUC=0.779). The Bayesian network diagnostic inference identified five key influencing factors, including abnormal temperature (change rate=35.9%), poor posture (change rate=27.3%), noise (change rate=23.4%), manual handling (change rate=18.2%), and repetitive arm movement (change rate=5.1%). The key influencing chain was "manual handling - poor posture - repetitive arm movement - fall injury risks" (combined change rate=16.9%). Conclusion The Bayesian network model has a good predictive performance in predicting the risk of falls in manufacturing enterprises. Manufacturing enterprises need to focus on jobs involving manual handling and repetitive arm movement, identify and improve workers' poor posture and mental health problems, and avoid workers working in harsh temperature or noise environment.

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Globally, manufacturing workers are one of the most vulnerable groups to occupational injuries. Occupational injuries can lead to absenteeism, disability or even death, and most of the inflicted workers involve young adults aged 18-40 years, suggesting a safety and health problem that needs close attention. In the working environment of manufacturing industry, there are a variety of occupational injury risk factors, involving individuals, equipment, environment, and management, which should be considered comprehensively. This study found comprehensive research coverage on the influencing factors of occupational injuries in manufacturing industry at individual, environmental, and management levels at home and abroad, and rich research results on the impacts of psychological factors on occupational injuries. However, factors associated with occupational injuries in equipment safety and engineering like man-machine environment need further research. Influencing factors at all levels should be comprehensively considered in the surveillance and intervention of occupational injuries in manufacturing industry to protect health and safety of workers.

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Objective:To observe the effect of combination of esketamine and sufentanil on postoperative analgesia and postpartum depression after cesarean section.Methods:A total of 150 primiparous women who underwent lower segment cesarean section under spinal anesthesia and postoperative analgesia at Changsha Maternal and Child Health Hospital from February to October 2021 were selected and randomly divided into three groups: A, B, and C, with 50 cases in each group. All three groups underwent combined spinal epidural anesthesia and received patient-controlled intravenous analgesia (PCIA) after surgery. The group A received low-dose esketamine via intravenous pump after fetal delivery, with PCIA formula esketamine combined with sufentanil; After the delivery of fetuses in the group B and the group C, an equal dose of physiological saline was pumped into the vein. The PCIA formula of esketamine combined with sufentanil for the group B and Sufentanil for the group C. We compared the pain Visual Analogue Scale (VAS) and Edinburgh Postpartum Depression Scale (EPDS) scores of three groups of patients at different time points after surgery, as well as the postoperative pain relief rate and incidence of adverse reactions.Resultsl:There was a statistically significant difference in VAS between the group A and the group B within 48 hours after surgery compared to the group C (all P<0.05), while there was a statistically significant difference in VAS between the group A and the group B within 24 hours after surgery (all P<0.05). The postoperative pain relief rate in the group A and group B was significantly lower than that in the group C, and the incidence of postpartum depression within 7 days after surgery was significantly lower than that in the group C. Moreover, the incidence of postpartum depression in the group A was lower than that in the group B within 3 days after surgery, and the differences were statistically significant (all P<0.05). There was no statistically significant difference in the incidence of postpartum depression among the three groups 42 days after surgery (all P>0.05), and there was no statistically significant difference in the incidence of adverse reactions among the three groups ( P>0.05). Conclusions:Esketamine combined with sufentanil can synergistically enhance the analgesic effect after cesarean section and reduce the incidence of early postpartum depression after surgery.

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Objective:To evaluate the application of ultrasound-guided lumbar quadratus muscle block in multimodal analgesia after cervical cancer radical surgery.Methods:A total of 120 patients who underwent elective open surgery for cervical cancer at Changsha Maternal and Child Health Hospital from January 2021 to January 2023 were selected and randomly divided into three groups: quadratus lumborum block (QLB) group, rectus sheath block (RSB) group, and patient-controlled intravenous analgesia (PCIA) group, with 40 patients in each group. After surgery, they underwent lumbar quadratus muscle block+ intravenous analgesia, rectus abdominis sheath nerve block+ intravenous analgesia, and simple intravenous analgesia. Three groups of patients were observed for their resting and active pain Visual Analogue Scale (VAS) at 2, 6, 12, 24, and 48 hours after surgery, as well as their postoperative pain relief rate, nausea and vomiting rate, skin itching incidence rate, first postoperative exhaust time, first ambulatory activity time, hospitalization time, and patient satisfaction.Resultsl:The resting and active VAS scores of the QLB group and RSB group were significantly lower than those of the PCIA group at 2, 6, 12, 24, and 48 hours after surgery, and the scores of the QLB group were lower than those of the RSB group at all time points, with statistical significance (all P<0.05). The postoperative pain relief rate and incidence of nausea and vomiting in the QLB group were significantly lower than those in the PCIA group (all P<0.05). The first postoperative exhaust time and first ambulation time of the QLB group were significantly earlier than those of the PCIA group and the RSB group, and the hospitalization time was significantly shorter than that of the PCIA group and the RSB group, with statistical significance (all P<0.05); The first postoperative exhaust time and first bedtime activity time in the RSB group were significantly earlier than those in the PCIA group (all P<0.05). The postoperative patient satisfaction scores of the QLB and RSB groups were higher than those of the PCIA group (all P<0.05), and there was no statistically significant difference in patient satisfaction scores between the QLB and RSB groups ( P>0.05). Conclusions:Ultrasound guided lumbar quadratus muscle block combined with low opioid intravenous analgesia can significantly reduce postoperative pain scores, shorten hospitalization time, and improve patient satisfaction. It is an important component of multimodal analgesia after cervical cancer radical surgery and can promote early recovery of patients.

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Background: How to promote the health (especially mental health) growth of left-behind children has become a hot social issue. Physical exercise is usually considered as a positive role in improving the physical and mental health of children, which can be considered to be integrated into the living environment of left-behind children. Objective: To discuss the changes of left-behind children in psychological health before and after the exercise-based intervention, thus providing a practical approach to improve the psychological growth of this disadvantaged group. Methods: An exercise-based social intervention experiment was designed and conducted in a township middle school in China, and 200 left-behind children with relatively low psychological health participated in the experiment. Results: Physical exercise had positive effects on rural left-behind children's sense of hope, self-esteem, self-efficiency, and self-concept, and it seems that the positive effects are durative due to the optimization of living environment. There was no significant difference in the psychological promotion effect of different programs (football and table tennis) on left-behind children. Hope, self-esteem, and self-efficiency significantly mediated the relationship between physical exercise and self-concept of left-behind children. Conclusion: Physical exercise contributes to promoting the development of rural left-behind children's positive psychology such as hope, self-esteem, self-efficiency, and thus relieving the negative psychology caused by long-term parental-child separation and improving self-concept.

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One case of 46, XY partial gonadal dysgenesis due to a congenital defect of DEAH-box RNA helicase 37(DHX37) was reported. The clinical and genetic data of a boy who was admitted to the Department of Endocrinology and Metabolism, the First Affiliated Hospital of Henan University of Science and Technology due to ambiguous external genitalia in September 2020 were collected and analyzed. This 3-month-old male patient showed a micropenis, bilateral cryptorchidism, 46, XY karyotype, a decrease in testosterone, anti-Müllerian hormone, inhibin B, an increase in follicle stimulating hormone. Testis biopsy indicated gonadal dysgenesis. The proband harbored a de novo heterozygous mutation in the DHX37 gene c. 923G>A(p.Arg308Gln). DHX37 variants need to be considered for 46, XY gonadal dysgenesis.

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Micropenis is an objective diagnosis based on accurate measurement of the length of the penis. Micropenis can be caused by many factors, including the structure of the hypothalamic-pituitary-gonadal axis or hormone defects. Therefore, examination of the endocrine system is extremely important for the diagnosis of the etiology. Once the diagnosis is confirmed, a multidisciplinary team of endocrinologists, geneticists, pediatricians, pediatric surgeons, and urologists are required to jointly develop individualized treatment plans. This article reviews the etiology, diagnosis and treatment of micropenis, aiming to raise awareness and concern about micropenis.

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Objective:To explore the key pathways and genes involved in microglia inflammation through transcriptome sequencing and bioinformatics analysis.Methods:BV2 cells were stimulated by lipopolysaccharide to establish microglia inflammation model. The levels of IL-6 and TNF-α were detected by ELISA and RT-qPCR. The established microglia inflammation model was sequenced by transcriptome sequencing, and the differentially expressed genes were screened by bioinformatics method. Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of differentially expressed genes were performed. The protein-protein interaction network of differentially expressed genes was constructed by using string database, and the protein-protein interaction network was visualized by using Cytoscape software. The protein interaction network module was extracted by using MCODE app. The hub gene was extracted by using cytohubba app and was verified through RT-qPCR. We conducted enrichment analysis of hub genes, predicted their targeted miRNAs and interacting drugs.Results:The microglia inflammation model was successfully established and verified by ELISA and RT-qPCR. We screened 434 differentially expressed genes by bioinformatics analysis of transcriptome sequencing results. GO analysis showed that these differentially expressed genes were mainly concentrated in cellular response to cytokine stimulus, inflammatory response, regulation of response to external stimulation. KEGG analysis showed that these differentially expressed genes were mainly concentrated in Chemokine signaling pathway, TNF signaling pathway, IL-17 signaling pathway. We constructed the protein interaction network of these differentially expressed genes, and carried out module analysis and extraction of hub genes. Most of hub genes are located in module 1, and the seed gene of module 1 is S1pr1. Hub genes include S1pr1, Cxcr4, Cx3cl1, Cx3cr1, Cxcl10, Cxcl2, Ccl4, Ccl5, Ccl9, Fpr1. RT-qPCR results showed that compared with the culture medium group, the mRNA expressions of S1pr1, Cxcr4, Cx3cl1 and Cx3cr1 were down-regulated, and the mRNA expressions of Cxcl10, Cxcl2, Ccl4, Ccl5, Ccl9 and Fpr1 were up-regulated in the LPS group. The enrichment analysis of hub genes mainly focused on chemokine-mediated signaling pathway, Class A/1 (Rhodopsin-like receptors), cell chemotaxis and so on. Drugs and miRNAs that may interact with hub genes were predicted. Conclusion:Through transcriptome sequencing and bioinformatics analysis of microglia inflammation model, differentially expressed genes were screened, hub genes and seed genes were extracted, which will help us further understand the molecular mechanism of microglia inflammation and provide potential targets for the treatment of related diseases.

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Avicel is made of a mixture of microcrystalline cellulose (MCC) and carboxymethyl cellulose (CMC), and used for virus plaque assay. The avicel in common use is produced by FMC Biopolymer. Due to the relatively fixed proportion of MCC and CMC, avicel in common use is not suitable for plaque determination experiment of all types of viruses. In this study, we evaluated the effect of avicel made of different proportions of MCC and CMC on virus plaque assay, and developed an improved avicel virus plaque assay featured with simple and convenient operation, good practicability and high stability. To generate avicel overlays with different proportions of MCC and CMC, twelve different 2×avicel solutions were prepared. Their overall viscosity and bottom viscosity were measured to evaluate the ease of operation. The results showed that most of the 2×avicel solutions (except the 4.8% MCC+1.4% CMC and 4.8% MCC+1.0% CMC group) were easy to absorb and prepare nutrient overlap than 2×CMC solution. In order to find the best scheme to detect the titer of porcine epidemic diarrhea virus (PEDV), these avicel overlay solutions with different proportion of MCC and CMC were used as a replacement in the standard plaque assay. By comparing the size, clarity, stability and titer accuracy of virus plaque, we identified that 0.6% MCC and 0.7% CMC was the most preferable composition of avicel overlay for PEDV plaque assay. In conclusion, we developed an improved virus plaque assay based on avicel, which may facilitate the research of virus etiology, antiviral drugs and vaccines.

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Platelet surface is rich in glycocalyx. It has been found that platelet glycosylation plays an important role in the physiological hemostasis mechanism, regulating the interaction between platelets and receptor proteins, and dynamically reshaping the surface glycosylation through its own glucose metabolism system. Platelet glycosylation also participates in platelet aging and clearance, and regulates platelet counts. Meanwhile, abnormal platelet glycosylation is closely related to primary immune thrombocytopenia, coronary heart disease and other related diseases, being a potential therapeutic target.

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Background Di(2-ethylhexyl)phthalate (DEHP) and dibutyl phthalate (DBP) are representative environmental endocrine disruptors of phthalate esters (PAEs). Some studies have shown that PAEs exposure may have an impact on lipid metabolism. Objective To investigate the effects of DEHP and/or DBP on lipid metabolism in rats and their possible mechanisms of action. Methods Thirty-six weaned healthy SD male rats, 3 weeks old, weighing 50-70 g, were divided into four groups, i.e., a corn oil control group, a DEHP (750 mg·kg−1) group, a DBP (500 mg·kg−1) group, and a DEHP+DBP (750 mg·kg−1+500 mg·kg−1) group. The rats were exposed to DEHP and/or DBP by oral gavage for 8 weeks, and weighed once a week. The rats were anesthetized 24 h after the last dose, and blood was taken from the apical part of the heart. Serum high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), and triglyceride (TG) were detected. Liver tissues and perigenital adipose tissues were collected, weighed, and one portion of the tissues was fixed in 10% neutral formalin for pathomorphological observation, and another portion was used for mRNA detection of lipid metabolism-related genes such as Janus kinase 3 (JAK3), signal transducer and activator of transcription 5b (STAT5b), and peroxisome proliferator-activated receptor γ (PPARγ). Results During the DEHP and/or DBP exposure period, the rats in all groups were free to eat and drink without death or injury observed. Compared with the control group: The body weight gain in the DEHP+DBP group was lower at all time points from the 2nd week onwards (P<0.05); the liver organ coefficients of the DEHP and the DEHP+DBP groups were higher (P<0.05); the serum LDL-C levels in the DEHP and the DBP groups were higher (P<0.05). Compared with the DEHP+DBP group: The body weight gains in the DEHP group at the 2nd, 4th, 5th, and 8th weeks were higher (P<0.05), and the body weight gains in the DBP group were higher at all time points except the 1st week (P<0.05); the liver organ coefficients in the DEHP group and the DBP group were lower (P<0.05); the serum TG level in the DEHP group was higher(P<0.05), and the serum LDL-C levels in the DEHP and the DBP groups were higher (P<0.05). The pathomorphological results of liver tissues showed that the hepatocytes in the DEHP, DBP, and DEHP+DBP groups were disordered with loss of cord-like arrangement, swelling (suggesting change of cell proliferation), and presented bilirubin pigmentation. The pathomorphological results of rat perigenital adipose tissues showed had irregular alignment, sizes, and arrangement of adipocyte in the DEHP, DBP, and DEHP+DBP groups. The results of rat liver lipid metabolism-related gene mRNA levels showed that the liver JAK3, STAT5b, and PPARγ mRNA levels in the DEHP, DBP, and DEHP+DBP groups were lower than those in the control group (P<0.05); the rat liver PPARγ mRNA levels in the DEHP and DBP groups were lower than those in the DEHP+DBP group (P<0.05). Conclusion DEHP and/or DBP can inhibit the increase of body weight to varying degrees, induce inflammatory damage to liver tissues, and cause abnormal lipid metabolism in rats, and the associated mechanism may be related to inhibiting the activation of JAK3/STAT5b/PPARγ signaling pathway in rat liver tissues.

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Objective:To identify the risk factors for chronic postsurgical pain (CPSP) after craniotomy.Methods:This was a single-center retrospective cohort study.The patients who underwent craniotomy in Beijing Tiantan Hospital, Capital Medical University from December 2019 to May 2020 were enrolled.The occurrence of CPSP, anxiety, depression and quality of life were determined by telephone follow-up with Short-form McGill Pain Questionnaire-2, Patient Health Questionnaire-9, Generalized Anxiety Disorder 7-Item, a five-level EuroQol five-dimensional questionnaire.The patients were divided into CPSP group ( n=106) and non-CPSP group ( n=252) according to the results of investigation.Then univariate analysis and logistic regression analysis were performed to identify the risk factors for CPSP. Results:There was significant difference in age, a history of preoperative pain, a history of alcohol addiction, transoccipital approach and degree of lesion resection between the two groups ( P<0.05). The results of logistic regression analysis showed that age ≥ 60 yr was a protective factor for CPSP after craniotomy; a history of preoperative pain ≥3 months, a history of alcohol addiction, transoccipital approach and partial resection of the lesion were independent risk factors for CPSP after craniotomy. Conclusion:Age≥60 yr is a protective factor for CPSP after craniotomy; a history of preoperative pain (≥3 months), a history of alcohol addiction, transoccipital approach and partial resection of the lesion are independent risk factors for CPSP after craniotomy.

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Objective:To examine the infection of the enterovirus and human herpes virus in children with suspected encephalitis.Methods:A total number of 365 suspected encephalitis cases were included in this study from August 2017 to December 2019 in Hunan Children′s Hospital. The clinical samples, the cerebrospinal fluid (CSF), serum, sputum, stool and urine were collected and preserved at-80 ℃condition. The enterovirus (EV) and human herpesvirus (HHV) were examined by a one-step nested reverse transcription PCR(RT-PCR) and a real-time fluorescent quantitative PCR (qPCR), respectively. The positive rate of the two viruses in clinical specimens of children with suspected encephalitis was examined. Among all cases, 132 cases were diagnosed with EV encephalitis or HHV encephalitis.Results:the EV encephalitis were identified in 20.5% (75/365) children with suspected viral encephalitis; whereas HHV encephalitis infection was identified as 15.6% (57/365). Among the 75 cases of EV encephalitis, echo 6 was the main sub-type of these diseases 52.0% (39/75) and others were EV71 (30.7%, 23/75), echo11 (6.7%, 5/75), Coxsackie virus A group 6(CA6, 4.0%, 3/75), echo30 (1.3%, 1/75), echo9 (1.3%, 1/75), echo4 (1.3%, 1/75),Coxsackie virus B group 1(CB1, 1.3%, 1/75))and poliovirus(1.3%, 1/75).Human herpes virus type 6 (HHV6) was the most common pathogen in 57 cases of HHV encephalitis, accounting for 35.1% (20/57).The other pathogens were Cytomegalovirus (CMV, 31.6%, 18/57), Epstein-Barr virus (8.8%, 7/57), Herpes simplex virus 1 (HSV1, 10.5%, 6/57), HSV2 (8.8%, 5/57), and Varicella zoster virus (VZV, 1.8%, 1/57) .The virus in CSF detected significantly earlier than that in serum after onset. Virus could be detected in CSF 2-7 days after onset,but 7-26 days in serum. Conclusions:This study uses nested PCR and qPCR to detect pathogens in clinical specimens of children. This not only expands our understanding of the clinical examination and diagnosis of viral encephalitis in children, but also promotes the method of this study to benefit more children.

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Objective@#To explore the influence of birthweight and delivery mode on overweight/obesity and abdominal obesity in primary school students, and to provide evidence for childhood obesity prevention.@*Methods@#After physical examination, questionnaire survey was conducted among 3 361 students and their parents from 3 primary schools in Guangzhou selected through stratified clustering sampling. Information about birthweight and delivery mode was collected. Logistic regression model was used to analyze the association of birthweight and delivery mode with overweight/obesity and abdominal obesity. The multiplicative interaction term and the Delta method was used to explore the potential interaction.@*Results@#The prevalence rate of overweight and obesity for primary school students was 21.33%, and the rate of abdominal obesity was 12.08%. Multivariate Logistic regression analysis showed that delivery by cesarean section was associated with 44% increased risk of overweight/obesity(OR=1.44, 95%CI=1.16-1.80), as compared to vaginal delivery. Higher birthweight was linked to increased risk of overweight/obesity(OR=1.62, 95%CI=1.09-2.42). There was no significant association of birth weight and delivery mode with abdominal obesity in multivariate analysis(P>0.05). Additionally, a positive additive interaction was seen between delivery mode and parental obesity for students risk of overweight/obesity(RERI=0.33, 95%CI=0.02-0.65), as well as for the risk of abdominal obesity(RERI=0.39, 95%CI=0.12-0.65).@*Conclusion@#Cesarean section delivery and higher birthweight are linked to increased risk of overweight and obesity in primary school students. The synergistic effect of cesarean section and parental obesity may increase the risk of childhood obesity.