Correlation between deformational plagiocephaly and/or brachycephaly and motor developmental delay in infants / 中国儿童保健杂志

【Objective】 To analyze the correlation between deformational plagiocephaly and/or brachycephaly (DPB) and motor developmental delay in infants, so as to provide theoretical basis for early motor development screening and intervention in DPB infants. 【Methods】 A total of 7 826 children aged 6 - 12 months who visited Mianyang Maternal & Child Health Care Hospital from January 2021 to December 2022 were inlcuded in this study. DPB infants were selected as the study subjects, and the prevalence rate was analyzed. 2 761 DPB infants were divided into mild, moderate, and severe DPB groups, and 1 900 normal children were included as the control group. Peabody Developmental Motor Scale-2 (PDMS-2) was used to evaluate the levels of gross and fine motor development in children in each case group and control group. Univariate analysis and LSD-t test were used to analyze the differences in gross motor quotient (GMQ) and fine motor quotient (FMQ) of children in each group. χ2 test was used to analyze the rate of motor developmental delay in children in each group. 【Results】 The prevalence rate of DPB was 35.47%. There were statistically significant differences in GMQ and FMQ among the mild DPB group, moderate DPB group, severe DPB group, and control group (F=171.271, 194.877, P<0.05). Further statistical comparison showed that there was no statistically significant difference in GMQ and FMQ between mild DPB group and control group (P>0.05). The GMQ and FMQ of the moderate and severe DPB groups were significantly lower than those of the control group (P<0.05). There was no statistically significant difference in the rate of developmental delay in gross and fine motor development between each case group and the control group (χ2=7.478, 5.777, P>0.05). 【Conclusions】 The prevalence of DPB in Mianyang area is relatively high, and DPB do not increase the probability of motor development delay. However, infants with moderate to severe DPB have significantly lower levels of motor development compared to healthy infants. It is recommended to screen infants with DPB as soon as possible, and conduct motor development screening and exercise promotion for infants with moderate to severe DPB.

Effect of stroke volume variation-guided fluid therapy on perioperative haemodynamics and tissue perfusion in patients with end-stage renal disease undergoing parathyroidectomy / 中华麻醉学杂志

Objective:To evaluate the effect of stroke volume variation (SVV)-guided fluid therapy on perioperative haemodynamics and tissue perfusion in the patients with end-stage renal disease (ESRD) undergoing parathyroidectomy.Methods:One hundred and twenty-one patients of either sex, aged 18-64 yr, of American Society of Anesthesiologists Physical Status classification Ⅲ, with body mass index of 18-28 kg/m 2, with ESRD undergoing elective parathyroidectomy, who received haemodialysis treatment within 24 h before surgery, were enrolled in this study. The patients were divided into standard restrictive fluid therapy group (group SRT, n=61) and goal-directed fluid therapy group (group GDT, n=60) using a random number table method. Group SRT received restrictive fluid therapy, with a continuous infusion of 0.9% normal saline at a rate of 4 ml·kg -1·h -1. Group GDT received goal-directed fluid therapy guided by SVV, and when the SVV≥10% lasted for 5 min, the 0.9% normal saline 3 ml/kg was infused within 5 min until SVV<10%. Systolic blood pressure (SBP) was maintained at ≥90 mmHg or mean arterial pressure(MAP) at ≥65 mmHg throughout the perioperative period in both groups. The intraoperative volume of fluid infused, usage rate and consumption of intraoperative vasoactive drugs were recorded, and arterial blood lactate (Lac) level, MAP, heart rate, cardiac output, and inferior vena cava collapse index (IVC-CI) after removal of endotracheal tube at the end of surgery were measured. MAP was continuously recorded within 12 h after surgery, and MAP variability (CV MAP) was calculated. The occurrence of cardiovascular and cerebrovascular events within 30 days after operation was also recorded. Results:Compared with group SRT, the intraoperative volume of fluid infused was significantly increased, the usage rate of ephedrine and norepinephrine was decreased, the consumption of ephedrine was reduced, and the percentage of postoperative IVC-CI<50% and cardiac output were increased, the percentage of Lac≥2.0 mmol/L and CV MAP were decreased ( P<0.05), and no significant change was found in the incidence of cardiovascular and cerebrovascular events within 30 days after surgery in group GDT ( P>0.05). Conclusions:Compared with restrictive fluid therapy, SVV-guided fluid therapy can optimize the perioperative hemodynamics and tissue perfusion in the patients with ESRD undergoing parathyroidectomy.

Genetic study of a fetus with a de novo Xp22.33;Yp11.2 translocation / 中华医学遗传学杂志

OBJECTIVE@#To delineate cytogenetic and molecular abnormalities of a fetus carrying a de novo 46,X,der(X),t(X;Y)(p22.3;p11.2).@*METHODS@#G-banded karyotyping and next-generation sequencing (NGS) were used to analyze the fetus, his father and sister. Single nucleotide polymorphism-based arrays (SNP-array), multiple PCR and fluorescence in situ hybridization (FISH) were utilized to verify the result.@*RESULTS@#G-banded karyotyping at 320 bands showed that the fetus had a normal karyotype, while NGS has identified a 3.58 Mb microdeletion at Xp22.33 and a Y chromosomal segment of about 10 Mb at Yp11.32p11.2. With the sequencing results, high-resolution karyotyping at 550-750 bands level has determined the fetus to be 46,X,der(X)t(X;Y)(p22.3;p11.2). The result was confirmed by PCR amplification of the SRY gene, FISH and SNP-array assays. The karyotypes of his father and sister were both normal. His sister also showed no amplification of the SRY gene, and her NGS results were normal too, suggesting that the karyotype of the fetus was de novo.@*CONCLUSION@#Combined karyotyping, NGS, SNP-array, PCR and FISH assay can facilitate diagnosis of XX disorder of sex development.

Cytogenetic and molecular genetic analysis of small supernumerary marker chromosomes in fetal amniotic fluid / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To explore the origin and mechanism of small supernumerary marker chromosomes (sSMC) in order to facilitate genetic counseling.</p><p><b>METHODS</b>Chromosome karyotypes of two fetuses and their immediate family members were analyzed by conventional G banding. High-throughput whole genome sequencing was used to determine the origin of sSMCs.</p><p><b>RESULTS</b>Fetus 1 was shown to have a karyotype of 47,XY,+mar but with normal FISH and B ultrasound findings. Its father also had a 47,XY,+mar karyotype with normal FISH results and clinical phenotype. High-throughput genome sequencing revealed that fetus 1 and its father were both 46,XY,dup(21)(q11.2;q21.1) with a 6.2 Mb duplication of the long arm of chromosome 21. The fetus was born with normal phenotype and developed well. Its grandmother also had a karyotype of 46,XX,t(15;21)(q13;p13) with normal FISH result and clinical phenotype. The karyotypes of its mother and grandfather were both normal. Analysis of fetus 2 showed a 47,XY,+mar karyotype with normal FISH results. High-throughput genome sequencing suggested a molecular karyotype of 46,XX. The fetus was born with normal phenotype and developed well. The karyotypes of its parents were both normal.</p><p><b>CONCLUSION</b>Considering their variable origins, identification of sSMC should combine conventional G banding analyses with high-throughput whole genome sequencing for precise delineation of the chromosomes.</p>

Gender differences of brain metabolic networks: a 18F-FDG PET study / 中华核医学与分子影像杂志

Objective To investigate the gender differences of glucose metabolic network in brains of healthy adults at resting state by 18F-FDG PET.Methods A total of 204 dextromanual,healthy individuals (104 males,average age:(53.45±11.51) years;100 females,average age:(54.11±12.09) years) were enrolled from June 2011 to June 2016 to construct brain metabolic networks.The nodal and global parameters,including clustering coefficient (Cp),characteristic path length (Lp) and betweenness centrality (Cb),were analyzed by graph theory.Permutation test with 1 000 repetitions was used.Results The brain metabolic networks derived from 18F-FDG PET data were with small-world properties in both male group and female group.Compared with Cb in females,Cb in males was significantly reduced in left postcentral gyrus,right angular gyrus and left temporal pole/middle temporal gyrus (permutation test,all P0.05).Conclusions There are gender-related differences of topological structure in whole-brain metabolic networks.Gender should be considered as a covariate while designing experiments,accounting for cerebral metabolic data from normal control and experimental patients as well as making clinical decisions.

Genetic analysis and counseling for two fetal cases with large de novo Yq deletions / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the deletion region for two fetal cases with large Yq deletions in order to provide genetic counseling and prenatal diagnosis.</p><p><b>METHODS</b>For both cases, amniotic fluid samples were cultured and analyzed with G banding and fluorescence in situ hybridization (FISH). Multiplex polymerase chain reaction was also carried out to amplify 15 sequence tagged sites (STS) of azoospermia factor (AZF) on the Y chromosome.</p><p><b>RESULTS</b>For both samples, the karyotypes were determined as 46,X,del(Y)(pter→q11:). No heterochromatin was found in C band. The karyotypes of their fathers were 46,XY, and heterochromatin was found in C band. STS analyses suggested that only sY82, sY84 and sY86 in AZFa were amplifiable while the other 12 STS were negative in amniotic fluid for the first case, which indicated deletions of AZFb, AZFd and AZFc. No AZF deletion was found in its father. For the second case, all 15 STS were amplifiable in the amniotic fluid, suggesting no AZF deletion. No AZF deletion was found in its father too.</p><p><b>CONCLUSION</b>Conventional karyotyping combined with FISH and molecular genetics techniques can enable characterization of AZF microdeletions and facilitate genetic counseling and prenatal diagnosis.</p>

Reader association participation-based crowd sourcing of virtual reference service in medical college and university libraries / 中华医学图书情报杂志

As a brand new service mode on Internet,crowd sourcing can solve the problems that need high cost and professionals by drawing on the wisdom of tens of thousands of Internet users. Medical college and university libraries should thus strengthen their virtual reference service teams and further improve their virtual reference service level by introducing the crowd sourcing concept,depending on the support of reader association and drawing on the wisdom of readers.

Analysis of two false positive cases from noninvasive prenatal testing / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To track and analyze two false positive cases from non-invasive prenatal testing for potential fetal aneuploidy.</p><p><b>METHODS</b>The two cases, respectively reported to have XO (+++) and T18 (1/20) XO(+), were analyzed with conventional karyotyping, fluorescence in situ hybridization (FISH) and massively parallel genomic sequencing (MPS).</p><p><b>RESULTS</b>The first fetus, who was suspected for XO(+++), was verified to have super female syndrome (47,XXX/46,XX) due to confined placental mosaicism by karyotyping of amniotic fluid cells, FISH analysis of placenta and massively parallel sequencing (MPS) of fetal tissue. The second fetus, suspected to have trisomy 18 (1/20) XO(+), was verified to have Turner syndrome by karyotyping, FISH and MPS analyses of umbilical cord blood cells. And the karyotype was 45,X[48]/46, X, der(X) del(X) (p11.21) del(X) (q13.3)[62].</p><p><b>CONCLUSION</b>Non-invasive prenatal testing carries a risk for false positive diagnosis of fetal sex chromosome and trisomy 18. Combined cytogenetic and molecular techniques are required to ensure an accurate diagnosis.</p>