Coronary Artery Calcification (CAC) is a major risk factor for various cardiovascular diseases. Low-Density Lipoprotein Cholesterol (LDL-C) is a significant factor in atherosclerotic cardiovascular diseases and is usually elevated in patients with Type 2 Diabetes Mellitus (T2DM). However, the association between LDL-C levels and incident CAC in asymptomatic T2DM patients remains unclear. This study is a single-center retrospective cohort study conducted from January 2018 to December 2023, including 2,631 asymptomatic T2DM patients who underwent regular health screenings. All participants were confirmed to be free of CAC at baseline by computed tomography (CT). Based on baseline LDL-C levels, participants were divided into three groups (T1: 0.66–2.43 mmol/L; T2: 2.44–3.18 mmol/L; T3: 3.19–7.21 mmol/L). The follow-up endpoint was the occurrence of incident CAC, with a total follow-up period of 72 months. Kaplan-Meier survival curves were used for analysis, followed by log-rank tests. Univariate and multivariate Cox proportional hazards regression models were employed to investigate the relationship between LDL-C and incident CAC, and subgroup analysis was performed to test the robustness of the LDL-C and CAC relationship. During a median follow-up period of 29.9 months, 885 (33.64

BACKGROUND:Sjogren's Syndrome (SS) plays important roles in the development of essential hypertension. Nevertheless, with the limitation of reverse causality and confounder in observational studies, such a relationship remains unclear. We aimed to assess the causal relationship of SS and hypertension by the Mendelian randomization (MR) approach. METHODS:We used MR to investigate a causal association between SS and essential hypertension. Inverse variance weighted (IVW), MR Egger regression, Maximum likelihood, Weighted median, and MR pleiotropy residual sum and outlier test (MR-PRESSO) were used in this MR analysis. RESULTS:In this study, we found that the ratio of IVW is 1.00024 (95% CI: 1.00013- 1.00036, P=0.0387), This result was also confirmed by sensitivity analysis methods such as Maximum likelihood is 1.00025 (95% CI: 1.00013-1.00037, P=0.036), MR Egger is 1.00071 (95% CI: 1.00047-1.00095, P=0.0045), and Weighted median is 1.00040 (95% CI: 1.00021- 1.00059, P=0.0322). And MR-Egger intercept method revealed the absence of horizontal pleiotropy in this investigation (P>0.05). The Cochran's Q Test indicated an absence of heterogeneity among them (P>0.05). Heterogeneity and horizontal pleiotropy tests further demonstrate that the results of MR are relatively stable. The above results all suggest that pSS may promote the risk of hypertension. CONCLUSIONS:Our study provides evidence of a causal relationship of SS and hypertension. It is suggested to pay attention to early screening for hypertension, reduce disability and mortality rates, and improve patient prognosis in patients with SS.

AIM:To unravel whether ferroptosis involves with the actions by circPDE3B-mediated facilitation of esophageal squamous cell carcinoma (ESCC) progression. METHODS:Human ESCC tissues and cell lines were prepared for the evaluation of ferroptosis. Cellular iron, ROS, GSH, and MDA levels were measured to assess ferroptosis. Flow cytometry was employed to analyze apoptosis and cell cycle. Subcellular fractionation and fluorescence in situ hybridization (FISH) were conducted to validate the localization of circPDE3B. RNA pull-down, RNA immunoprecipitation (RIP), and luciferase assay were subjected to identify the molecular mechanisms. Nude mouse xenograft model was carried out to evaluate the function of circPDE3B/SLC7A11/CBS in vivo. RESULTS:Increased circPDE3B in human ESCC specimens was positively correlated with ferroptosis-related molecules, SLC7A11 and CBS. Functionally, circPDE3B knockdown triggered ferroptosis, apoptosis, and cell cycle arrest in ESCC cells. Whereas, these effects were obviously blocked by miR-516b-5p inhibitor. Mechanistically, not only circPDE3B sponged miR-516b-5p to upregulate CBS, but also directly bound with HNRNPK to stabilize SLC7A11. In mice, depletion of circPDE3B restrained ESCC growth, while this was abolished by overexpression of CBS or SLC7A11. CONCLUSION:In summary, circPDE3B promotes ESCC progression by suppressing ferroptosis through recruiting HNRNPK/SLC7A11 and miR-516b-5p/CBS axes.

Objective To investigate the effect of PDCA mode combined with spouse participation psychological intervention on psychological status and independent living ability of patients with hypertensive intracerebral hemorrhage（HICH） after operation. Methods A total of 300 patients with HICH were divided into study group and control group according to random number table method, with 150 cases in each group. Both groups were given routine intervention. On this basis, the study group was given PDCA mode combined with spouse participation psychological intervention for 3 months. Before and after the intervention, the independent living ability of patients was assessed with the functional independence measure（FIM）, the psychological status was assessed with the self-reporting inventory-90（SCL-90）, the anxiety and depression were assessed with the self-rating anxiety scale（SAS） and self-rating depression scale（SDS）, and the limb function of patients was assessed with the Fugl-Meyer motor function assessment（FMA）. The scores of the above scales before and after intervention and the nursing satisfaction of the two groups after intervention were compared. Results After the intervention, the scores of sphincter control ability, communication ability, self-care ability, transfer ability and action ability of FIM of the two groups were significantly higher than those before intervention（P＜0.01）, and the scores of the study group were significantly higher than those of the control group（P＜0.01）.After the intervention,the scores of SCL-90of the two groups were significantly lower than those before intervention（P＜0.01）,and the scores in the study group were significantly lower than those in the control group（P＜0.01）.After the intervention,SAS and SDS scores of the two groups were significantly lower than those before intervention（P＜0.01）,and the scores in the study group were significantly lower than those in the control group（P＜0.01）.After the intervention,the scores of upper and lower limbs of FMA of the two groups were significantly higher than those before intervention（P＜0.01）,and the scores in the study group were significantly higher than those in the control group（P＜0.01）.The total nursing satisfaction rate of the study group was significantly higher than that of the control group（P＜0.01）.Conclusions PDCA mode combined with spouse participation psychological intervention can enhance the independent living ability of patients with HICH after operation,improve their limb movement function and psychological status,alleviate their anxiety and depression,and improve nursing satisfaction.

目的:探讨与分析二胎护士产后返岗工作风险因素,并探究相关干预措施.方法:采用便利抽样法,选择2021年1月至2021年11月本院的二胎产后返岗护士30例作为研究对象,调查所有护士的一般资料、工作风险并进行多因素分析,提出了相应的干预措施.结果:在30例护士中,工作量与时间分配、工作环境及仪器设备、患者护理、护理专业与工作、管理及人际关系的工作风险维度评分为(3.09±0.25)分、(2.87±0.14)分、(3.01±0.21)分、(2.68±0.18)分、(2.78±0.28)分.多元线性回归分析显示学历、职称、返岗时间、值夜班等为影响二胎护士产后返岗工作风险的重要因素(P<0.05).干预后工作量与时间分配、工作环境及仪器设备、患者护理、护理专业与工作、管理及人际关系等工作风险维度评分为(1.04±0.11)分、(1.24±0.23)分、(1.53±0.15)分、(1.14±0.22)分、(1.32±0.11)分.结论:二胎产后返岗护士在工作中容易出现各种风险,学历、职称、返岗时间、值夜班为影响二胎护士产后返岗工作风险的重要因素,需针对这4个重要因素,增加详细的管理对策,从多方面提高二胎产后返岗护士的返岗适应水平.

目的 探讨早产儿护理管理中应用家长参与综合管理模式的效果评价.方法 选择53例早产儿为研究对象,随机分为观察组(n=27)与对照组(n=26).对照组给予常规护理干预,观察组接受家长参与综合管理护理模式干预.并对两组患儿发育情况进行对比,评估两组家长焦虑自评量表(SAS)评分及护理知识掌握情况,记录早产儿并发症情况.结果 患儿在干预1个月、3个月内,观察组其发育情况均高于对照组(P<0.05);两组SAS评分干预前差异较小(P>0.05),经干预后观察组SAS评分明显低于对照组(P<0.05);两组护理知识掌握情况中,观察组中喂养、抚触、发育知识评分比较均高于对照组(P<0.05);且两组干预后,观察组呛奶、感染、营养不良等并症发生率均低于对照组(P<0.05).结论 在早产儿护理中,采用家长参与综合管理护理模式,可有效提高家长护理知识,减少并发症的发生,从而使患儿健康生长发育,对其家长焦虑情绪也有所改善.

OBJECTIVES:The association between visceral adiposity index (VAI) and the prevalence of non-alcoholic fatty liver disease (NAFLD) has not been fully determined. Here, we aimed to explore the association between VAI and NAFLD in the general US population, and further investigate whether the association involves population differences. DESIGN:Cross-sectional population-based study. SETTING:The National Health and Nutrition Examination Survey (2003-2018). PARTICIPANTS:A total of 7522 participants aged 20 years or older who have complete information for NAFLD assessment test were included in this study. PRIMARY AND SECONDARY OUTCOME MEASURES:NAFLD was assessed by the modified fatty liver index for the US population (USFLI) using a cut-off point of 30. Correlation between VAI and NAFLD prediction scores was calculated using the partial correlation analysis. Logistic regression models were further used to estimate ORs and 95% CIs. RESULTS:Insulin resistance (IR), inflammation and waist circumference-adjusted partial correlation analysis indicated that VAI scores were positively correlated with USFLI (r=0.404 for men, and r=0.395 for women; p<0.001). In a comparison of the highest versus the lowest quartiles of VAI, multivariable logistic regression analysis demonstrated a positive association between VAI and NAFLD (OR (95% CI)=1.97 (1.12 to 3.47) for men, OR (95% CI)=4.03 (1.98 to 8.20) for women). The stratified analyses revealed that the positive association involves age/gender-specific and ethnic differences. As for the impact of metabolic disorders, our results revealed that the association was independent of IR and diabetes, but it would be confounded by other metabolic disorders. However, no significant association was found between VAI and hepatic fibrosis. CONCLUSION:VAI is positively associated with the prevalence of NAFLD, but not hepatic fibrosis among US adults, and the association involves age/gender-specific and ethnic differences. The results reported here have important public health implications in NAFLD screening in the future.

目的 探讨新生儿儿科重症监护(NICU)护士心理健康状况和影响因素.方法 将2018年3月～2020年6月NICU的护理人员59例作为研究对象,通过问卷调查的方式了解NICU护士的心理健康状况,探讨影响心理健康状况的相关因素,与国内常模相关因子进行比较,分析SCL-90量表各个心理因子、护理工作积极性评分、护理质量评分及职业倦怠发生率.结果 NICU护士SCL-90量表总分、躯体化、强迫症状、焦虑、抑郁、恐惧评分较国内常模低(P<0.05);人际关系敏感、敌对、偏执与精神病性评分与国内常模之间无明显差异(P>0.05);护理工作积极性评分为(96.11±3.12)分;护理质量评分中基础护理为(94.81±3.08)分,安全护理为(96.53±4.48)分,服务态度为(96.72±4.39)分,专业技术为(97.84±5.13)分;性别、年龄、工作环境、工作状况、工作年限、患儿病情及知识技能缺乏均为NICU护士心理健康状况的影响因素(P<0.05).结论 NICU护士容易出现焦虑与抑郁等情绪,影响其心理健康状况的相关因素较多,开展针对性预防策略,加强心理疏导,可在最大程度上缓解其出现的焦虑与抑郁、紧张情绪,使得护士的工作积极性不断提高,职业倦怠发生率得以降低,进而不断提高工作质量.

Background: Dyslipidemia is an extremely prevalent but preventable risk factor for cardiovascular disease. However, many dyslipidemia patients remain undetected in resource limited settings. The study was performed to develop and evaluate a simple and effective prediction approach without biochemical parameters to identify those at high risk of dyslipidemia in rural adult population.Methods: Demographic, dietary and lifestyle, and anthropometric data were collected by a cross-sectional survey from 8,914 participants living in rural areas aged 35-78 years. There were 6,686 participants randomly selected into a training group for constructing the artificial neural network (ANN) and logistic regression (LR) prediction models. The remaining 2,228 participants were assigned to a validation group for performance comparisons of ANN and LR models. The predictors of dyslipidemia risk were identified from the training group using multivariate logistic regression analysis. Predictive performance was evaluated by receiver operating characteristic (ROC) curve.Results: Some risk factors were significantly associated with dyslipidemia, including age, gender, educational level, smoking, high-fat diet, vegetable and fruit intake, family history, physical activity, and central obesity. For the ANN model, the sensitivity, specificity, positive and negative likelihood ratio, positive and negative predictive values were 90.41%, 76.66%, 3.87, 0.13, 76.33%, and 90.58%, respectively, while LR model were only 57.37%, 70.91%, 1.97, 0.60, 62.09%, and 66.73%, respectively. The area under the ROC cure (AUC) value of the ANN model was 0.86 +/- 0.01, showing more accurate overall performance than traditional LR model (AUC = 0.68 +/- 0.01, P<0.001).Conclusion: The ANN model is a simple and effective prediction approach to identify those at high risk of dyslipidemia, and it can be used to screen undiagnosed dyslipidemia patients in rural adult population. Further work is planned to confirm these results by incorporating multi-center and longer follow-up data.

Natural bioactive compounds abundantly presented in foods and medicinal plants have recently received a remarkable attention because of their various biological activities and minimal toxicity. In recent years, many natural compounds appear to offer significant effects in the regulation of ferroptosis. Ferroptosis is the forefront of international scientific research which has been exponential growth since the term was coined. This type of regulated cell death is driven by iron-dependent phospholipid peroxidation. Recent studies have shown that numerous organ injuries and pathophysiological processes of many diseases are driven by ferroptosis, such as cancer, arteriosclerosis, neurodegenerative disease, diabetes, ischemia-reperfusion injury and acute renal failure. It is reported that the initiation and inhibition of ferroptosis plays a pivotal role in lipid peroxidation, organ damage, neurodegeneration and cancer growth and progression. Recently, many natural phytochemicals extracted from edible plants have been demonstrated to be novel ferroptosis regulators and have the potential to treat ferroptosis-related diseases. This review provides an updated overview on the role of natural bioactive compounds and the potential signaling pathways in the regulation of ferroptosis.

Objective: This study is aimed to explore the potential association among the estrogen receptor alpha (ESRα) promoter methylation, lipid metabolism and the risk of type 2 diabetes mellitus (T2DM). Methods: A total of 1143 rural residents were recruited randomly from Henan Province, China. The circulating methylation levels in ESRα promoter region were determined by quantitative methylation-specific polymerase chain reaction. Serum high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC) and fasting plasma-glucose (FPG) were measured. Results: The ESRα promoter methylation levels were negatively associated with HDL-C levels whether gender stratification was performed (P < 0.05) and positively correlated with LDL-C in men (P < 0.05). Each unit standard deviation (SD) increment in TG was associated with a 43% increase (95% CI: 1.25, 1.64) in the risks of T2DM in all participants, a 36% increase (95% CI: 1.13, 1.64) in the risks of T2DM in men and a 49% increase (95% CI: 1.21, 1.83) in the risks of T2DM in women. Furthermore, each SD increment in HDL-C was associated with a reduction of 25% (OR = 0.75, 95% CI: 0.58, 0.97) in the risks of T2DM in men, and the risk of T2DM in men may be more susceptible to HDL-C than that in women (P for interaction < 0.05). Additionally, we found that the risk of T2DM in participants with lower methylation levels (≤4.07%) were more susceptible to HDL-C (P for interaction < 0.05). Conclusions: These findings suggested that lipid metabolism was associated with ESRα promoter methylation levels and the risk of T2DM. Besides, the levels of ESRα promoter methylation and gender can modify the association of HDL-C and T2DM.

Objectives To explore the factors affecting neonatal physical development in pregnant women with or without gestational diabetes mellitus (GDM). Methods The subjects were selected from the pregnant woman giving birth in 2(nd) Affiliated Hospital of Zhengzhou University, from November 2015 to May 2016. The age, occupation, education level, gestational age, body weight before pregnancy, body weight at delivery, body height, delivery pattern, GDM status of pregnant women and neonatal gender, birth weight (BW), chest circumference (CC), head circumference (HC) and birth length (BL) were collected through medical records and questionnaires. The clinical data were retrospectively analyzed and studied. Results The significant differences were found between women with GDM and without GDM in following neonatal variables (P<0.05): BW, CC, and HC. GDM status increased the incidence of macrosomia (OR = 2.241, 95% CI: 1.406-3.573), large CC (OR = 2.470, 95% CI: 1.687-3.6153). Gestational weight gain (GWG) above IOM guideline was risk factor for macrosomia (OR = 1.763, 95% CI:1.098-2.833), large HC (OR = 1,584, 95% CI: 1.093-2.296) and large CC (OR = 1.707, 95% CI:1.163-2.506). Underweight was risk factor for short BL (OR = 2.543, 95% CI:1.161-5.571) and small CC (OR = 1.901, 95% CI:1.064-3.394). Female neonate was prone to appear short BL(OR = 2.831, 95% CI: 1.478-5.422) and small HC (OR = 2.750, 95% CI: 1.413-5.350), and not likely to macrosomia (OR = 0.538, 95% CI: 0.343-0.843), longer BL (OR = 0.584, 95% CI: 0.401-0.850), large HC (OR = 0.501, 95% CI: 0.352-0.713), and (OR = 0.640, 95% CI: 0.446-0.917). For women with GDM, gestational age was an risk factor of neonatal BW (low BW: OR = 0.207, 95% CI: 0.085-0.503; macrosomia: OR = 1.637, 95% CI: 1.177-2.276), BL (short BL: OR = 0.376, 95% CI: 0.241-0.585; long BL: OR = 1.422, 95% CI: 1.054-1.919), HC (small HC: OR = 0.343, 95% CI: 0.202-0.583; large HC: OR = 1.399, 95% CI: 1.063-1.842) and CC (small CC: OR = 0.524, 95% CI: 0.374-0.733; large CC: OR = 1.485, 95% CI: 1.138-1.936). Conclusions In our study, gestational age, GDM status, neonatal gender, GWG and pre-pregnancy body mass index (BMI) are associated the abnormal physical development of neonates. In women with GDM, gestational age was correlate with neonatal abnormal physical developments.

Objective:To explore the current status of clinical nurses' perception of authentic leadership, scientific research ability, and self-transcendence, and analyze the path relationship among them.Methods:This study was a cross-sectional study. In June 2020, convenience sampling was used to select clinical nurses from two Class Ⅲ Grade A hospitals in Zhengzhou as the research object. The survey was conducted using the General Information Questionnaire, Authentic Leadership Questionnaire (ALQ) , Nursing Research Capacity Self-evaluation Questionnaire, and Self-Transcendence Scale (STS) . This study collected 913 questionnaires, of which 897 were valid questionnaires, with a valid rate of 98.25%.Results:Among 897 clinical nurses, the ALQ total score, Nursing Research Capacity Self-evaluation Questionnaire total score and the STS total score were (58.72±6.72) , (47.42±18.23) and (37.94±7.86) respectively. The structural equation model showed that with self-transcendence as an intermediary, the indirect effect of authentic leadership on scientific research ability was 0.15.Conclusions:Self-transcendence plays a mediating role between nurses' perception of authentic leadership and scientific research ability. Nursing managers should take effective measures to cultivate authentic leadership behaviors, promote the improvement of nurses' self-transcendence level, and thereby enhance nurses' scientific research capabilities.

医学营养治疗是除了药物之外又一控制血糖、治疗糖尿病的重要手段.目前控制2型糖尿病患者血糖水平的6种营养策略包括选择适量和合适的碳水化合物、食用特定的蛋白质、增加多不饱和脂肪酸摄入、采用地中海饮食模式、按时用餐及加强餐后运动.这一系列的营养策略为医疗保健专业人员提供选择,以帮助2型糖尿病患者达到血糖控制的最佳水平.本综述对这些策略进行介绍,并对其机制及研究中矛盾的地方进行分析和讨论,为2型糖尿病营养治疗的进一步研究提供方向.

Gene polymorphism is one of the few factors that increases the risk of prostate cancer. T to C substitution in the 5’ promoter region of the CYP17 gene is hypothesized to increase the rate of gene transcription, increase androgen production, and thereby increase the risk of prostate cancer. Nevertheless, the inconsistencies originating from studies on CYP17 polymorphism and prostate cancer prompted this meta-analysis, to decipher the association between CYP17 polymorphism and prostate cancer. Most case-control studies addressing CYP17 polymorphism and prostate cancer were exhaustively searched from Web of Science, Google Scholar, and PubMed. The various genotype distributions as well as the minor allele distributions were retrieved. Pooled odds ratios ( ORs) with their 95% CI and estimates of the Hardy–Weinberg Equilibrium were calculated. Analyses were performed using the RevMan v.5.3 software and SPSS v.21. There was high-pooled heterogeneity ( I 2 = 87.0%, OR = .42, CI [.39, .45], and p < .001) among the A2 versus A1 allele. With the per-allele model (A2 versus A1), ethnicity was a major risk factor to prostate cancer, with Asians recording the highest risk ( OR = 12.61, 95% CI [8.77, 18.12]). From the genotype models, A1/A1 versus A2/A2 ( OR = 3.02, 95% CI [2.65, 3.44]) and A1/A2 versus A2/A2 ( OR = 4.39, 95% CI [3.86, 5.00]) were all significantly associated with prostate cancer. Although some genotype models were associated with the risk of prostate cancer, we should be mindful when interpreting the results of this study because of the limited number of studies and the small sample size used.

目的 构建河南省新生儿专科护士培训内容.方法 通过文献分析法和访谈法,初步确定河南省新生儿专科护士培训内容,采用德尔菲法邀请28名专家进行3轮专家咨询.结果 3轮专家问卷回收率分别为86％、92％、100％;专家权威系数分别为0.82、0.86和0.88;第3轮咨询后,肯德尔和谐系数为0.311.最终形成含一级条目3个,二级条目11个,三级条目66个的培训内容.结论 河南省新生儿专科护士培训内容的设置具有较好的科学性,为河南省新生儿专科护士培训提供依据.

目的 了解大学生食品营养标签使用情况,为开展相关营养教育提供依据.方法 采取整群抽样的方式,对郑州市三所高校1 960名在校大学生进行问卷调查.结果 大学生食品营养标签知识得分均值12.1±2.8分(总分24分),不同性别、专业、年级、学习过营养课程与否、家庭居住地、母亲文化程度均值比较,差异有统计学意义(P＜0.05),获取食品营养标签知识的途径主要以电视、广播为主(1 431人占78.9％),有652(35.9％)人能够完全答对食品营养标签内容;使用营养标签态度上:有1 376(75.8％)人认为在食品包装上标示营养标签有必要,1 015(55.9％)人对营养标签标示内容表示信任;使用行为上:购买食品时经常浏览营养标签的有466(25.7％)人.结论 郑州市大学生的食品营养标签知识水平不高,对食品上标示营养标签态度积极,但使用率低,获取食品营养标签知识途径单一,今后学校应利用多种渠道,加强宣教,引导大学生消费时养成阅读营养标签的习惯.

Objective:To investigate the mortality and causes of death in neonates from different medical institutions in Henan province.Methods:A retrospective analysis was performed on the death cases of 62 different medical institutions in 18 cities of Henan province in 2018, in order to compare the differences of neonatal mortality, age of death and the causes of death between maternal and child health care hospitals and general hospitals.Results:(1) A total of 80 780 newborns were admitted to 62 hospitals and 311 neonates died with a mortality rate of 3.85‰.A total of 33 339 newborns were admitted to 24 maternal and child health care hospitals, and 102 neonates died with a mortality rate of 3.06‰.Among them, 54 cases(52.9%) were premature infants and 48 cases(47.1%)were full-term infants.A total of 47 441 newborns were admitted to 38 general hospitals, and 209 neonates died with a mortality rate of 4.41‰.Among them, 111 cases(53.1%) were premature infants and 98 cases (46.9%) were full-term infants.Neonatal mortality in general hospitals was higher than that in maternal and child health care hospitals( P<0.05). (2) Neonatal death mainly occurred within one week after birth, especially within the first day.There were 67 cases of death(65.7%) in 24 maternal and child health care hospitals within the first day, including 34 cases (50.7%) of full-term infants and 33 cases (49.3%)of premature infants.And there were 87 cases of death(41.6%) in 38 general hospitals within the first day, including 50 cases (57.5%) of premature infants and 37 cases (42.5%) of full-term infants.Neonatal mortality within the first day after birth in maternal and child health care hospitals was higher than that in general hospitals( P<0.05). (3) The leading causes of neonatal death were non-infectious pulmonary diseases(128 cases, 41.2%), followed by birth asphyxia(73 cases, 23.5%) and infection(51 cases, 16.4%), but the causes of death in sequence varies from maternal and child health care hospitals and general hospitals.(4) For early death (within one week after birth) in both general hospitals and maternal and child health care hospitals, the main causes were birth asphyxia for full-term neonates, and pulmonary diseases(mainly respiratory distress syndrome)and birth asphyxia for premature infants.For late-stage death (2-4 weeks after birth) of neonates, infection was the leading cause in both term and preterm infants in general hospitals.For maternal and child health hospitals, the main causes of death for full-term infants were infection, and pulmonary diseases (mainly pulmonary hemorrhage and respiratory distress syndrome) for premature infants. Conclusion:There are some differences between maternal and child health care hospitals and general hospitals in neonatal mortality, mortality within the first day after birth, and causes of death.Therefore, it is necessary to strengthen the corresponding software and hardware constructions for newborns in different medical institutions to further reduce the neonatal mortality rate.

目的 探讨n-3多不饱和脂肪酸(polyunsaturated fatty acid,PUFA)对PM2.5暴露的2型糖尿病(type 2 diabetes,T2DM)大鼠炎症反应和氧化应激的影响.方法 将70只4周龄雄性SD大鼠随机分为7组:空白对照组,T2DM模型对照组,PM2.5气管滴注组,玉米油对照组和n-3 PUFA低、中、高剂量(75、150和300 mg/kg)干预组.用高糖高脂饲料联合一次性腹腔注射STZ方法诱导大鼠2型糖尿病.造模成功后,除空白对照组和T2DM模型组外,其余5组大鼠经气管缓慢滴注PM2.5悬浮液5 mg/kg染毒,每天1次,连续1周.随后n-3 PUFA干预各组予以富含n-3 PUFA的鱼油灌胃,玉米油对照组予以等体积玉米油灌胃,每天1次,共4周.采用酶联免疫法检测大鼠血清和肝脏肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白介素6(interleukin-6,IL-6)和白介素10(interleukin-10,IL-10)水平,免疫比浊法测定大鼠血清C反应蛋白(C-reactive protein,CRP),WST-1法检测大鼠血清和肝脏超氧化物歧化酶(superoxide dismutase,SOD)水平,硫代巴比妥酸(thiobarbituric acid,TBA)法检测丙二醛(malondialdehyde,MDA)含量,尿酸酶法测定血尿酸(serum uric acid,SUA),苏木精-伊红染色法观察肝脏石蜡切片组织病理变化.结果 T2DM模型组大鼠血清IL-6和CRP水平显著高于空白对照组(P＜0.05);PM2.5气管滴注组大鼠血清IL-6水平均显著高于T2DM模型组(P＜0.05),n-3 PUFA各组大鼠血清IL-6水平均显著低于玉米油对照组(P＜0.05).T2DM模型组大鼠血清SOD水平显著低于空白对照组而血尿酸水平显著高于空白对照组(P＜0.05);PM2.5气管滴注组大鼠肝脏MDA和血尿酸水平均显著高于T2DM模型对照组(P＜0.05);各剂量n-3 PUFA干预组血尿酸水平均显著低于玉米油对照组(P＜0.05).结论 PM2.5暴露增加了T2DM大鼠炎症反应和氧化应激,而n-3 PUFA干预可改善PM2.5暴露的T2DM大鼠炎症反应和氧化应激状态.

OBJECTIVE:To detect variants of ARSA gene in a child featuring late infantile metachromatic leukodystrophy (MLD).METHODS:PCR and Sanger sequencing was carried out for the patient and her parents.RESULTS:The patient had typical features of MLD including ARSA deficiency, regression of walking ability, and demyelination. Compound heterozygous variants of the ARSA gene, namely c.960G>A and c.244C>T, were detected in the patient, for which her mother and father were respectively heterozygous carriers. ARSA c.960G>A was known to be pathogenic, while ARSA c.244C>T was a novel variant. The same variants were not detected among 50 healthy controls.CONCLUSION:The compound heterozygous variants c.960G>A and c.244C>T of the ARSA gene probably underlie the MLD in this patient.