Association between maternal job burnout and adolescent depression: the chain mediating effect of maternal depression and parenting style / 中国当代儿科杂志

OBJECTIVES@#To investigate the association between maternal job burnout and adolescent depression and the mediating effect of maternal depression and parenting style.@*METHODS@#A cross-sectional study was conducted. The cluster random sampling method was used to select 2 572 adolescents from 7 middle schools in Shanghai, China, from April to May, 2021. A survey was performed for these adolescents and their mothers. The research tools included a general information questionnaire, Maslach Burnout Inventory-General Survey, Center for Epidemiologic Studies Depression Scale, short-form of Egna Minnen av Barndoms Uppfostran, and Children's Depression Inventory. A structural equation model was established, and the Bootstrap method was used to investigate the mediating effect.@*RESULTS@#The detection rate of depressive symptoms was 12.71% (327/2 572) among the adolescents. The scores of maternal job burnout, maternal depression, and negative parenting style were positively correlated with the score of adolescent depression (P<0.05), and the score of positive parenting style was negatively correlated with the score of adolescent depression (P<0.05). Maternal depression and parenting style played a mediating role between maternal job burnout and adolescent depression, including the individual mediating effect of maternal depression, the individual mediating effect of positive parenting style, and the chain mediating effect of maternal depression-negative/positive parenting style.@*CONCLUSIONS@#Maternal job burnout may affect adolescent depression through the mediating effect of depression, parenting style, and depression-parenting style, suggesting that the symptoms of adolescent depression can be reduced by alleviating maternal job burnout, improving maternal depression, increasing positive parenting behaviors, and reducing negative parenting behaviors.

The influence of family structure on depression and anxiety symptoms in adolescents: the mediating role of emotional neglect / 中国当代儿科杂志

OBJECTIVES@#To study the influence of family structure on depression and anxiety symptoms in adolescents and its mechanism.@*METHODS@#The cluster sampling method was used to select the students from seven middle schools in Shanghai, China. An online questionnaire survey was conducted using a self-made general status questionnaire, Childhood Trauma Questionnaire, Children's Depression Inventory, and Screen for Child Anxiety Related Emotional Disorders. The methods including one-way analysis of variance, chi-square test, binary logistic regression analysis, and mediating effect analysis were used to evaluate depression and anxiety symptoms in adolescents and the difference in childhood trauma and its mediating effect.@*RESULTS@#Compared with the adolescents from nuclear families, the adolescents from three-generation lineal families had a lower risk of depression symptoms (OR=0.794, 95%CI: 0.649-0.972, P<0.05), while those from host families had a higher risk of depression symptoms (OR=4.548, 95%CI: 1.113-18.580, P<0.05). The adolescents from inter-generational families and host families had a significantly higher score on the Childhood Trauma Questionnaire subscale of emotional neglect (P<0.05). Emotional neglect played a mediating role in the influence of inter-generational families and host families on depression symptoms in adolescents.@*CONCLUSIONS@#Parents and grandparents have a certain positive effect in family structures. Separation from parents may make adolescents perceive more emotional neglect, which may increase the occurrence of depression symptoms.

A prospective study of the decision tree prediction model for attention deficit hyperactivity disorder in preschool children / 中国当代儿科杂志

OBJECTIVES@#To study the clinical value of attention time combined with behavior scale in the screening of attention deficit hyperactivity disorder (ADHD) in preschool children.@*METHODS@#A total of 200 preschool children with ADHD diagnosed in Fujian Maternal and Child Health Hospital from February 2019 to March 2020 were enrolled as the ADHD group. A total of 200 children who underwent physical examination in the hospital or kindergartens during the same period were enrolled as the control group. Attention time was recorded. Chinese Version of Swanson Nolan and Pelham, Version IV Scale-Parent Form (SNAP-IV) scale was used to evaluate symptoms. With clinical diagnosis as the gold standard, the decision tree analysis was used to evaluate the clinical value of attention time combined with behavior scale in the screening of ADHD.@*RESULTS@#Compared with the control group, the ADHD group had significantly higher scores of SNAP-IV items 1, 4, 7, 8, 10, 11, 14, 15, 16, 18, 20, 21, and 22 (P<0.05) and a significantly shorter attention time (P<0.05). The variables with statistically significant differences between the two groups in univariate analysis were used as independent variables to establish a decision tree model. The accuracy of the model in predicting ADHD was 81%, that in predicting non-ADHD was 69%, and the overall accuracy was 75%, with an area under the ROC curve of 0.816 (95% CI: 0.774-0.857, P<0.001).@*CONCLUSIONS@#The decision tree model for screening ADHD in preschool children based on attention time and assessment results of behavior scale has a high accuracy and can be used for rapid screening of ADHD among children in clinical practice.

Clinical effect of psychological and behavioral intervention combined with biofeedback in the treatment of preschool children with attention deficit hyperactivity disorder / 中国当代儿科杂志

OBJECTIVE@#To study the clinical effect of psychological and behavioral intervention combined with biofeedback in the treatment of preschool children with attention deficit hyperactivity disorder (ADHD).@*METHODS@#Sixty children each with inattentive, hyperactive/impulsive or combined type ADHD were enrolled. According to the intervention measure, they were randomly divided into 4 groups: control, psychological and behavioral intervention, biofeedback treatment and comprehensive treatment (psychological and behavioral intervention + biofeedback). Attention concentration time and impulse/hyperactivity and hyperactivity index scores of the Conners Parent Symptom Questionnaire (PSQ) were evaluated after 4 months of treatment.@*RESULTS@#The attention concentration time increased in all types children with ADHD after psychological and behavioral intervention, biofeedback treatment or comprehensive treatment (P<0.05). In children with inattentive ADHD, hyperactive/impulsive ADHD or combined-type ADHD, biofeedback or comprehensive treatment reduced the impulse/hyperactivity index score (P<0.05). In children with inattentive or combined-type ADHD, psychological and behavioral intervention or comprehensive treatment reduced the hyperactivity index score (P<0.05). In children with hyperactive/impulsive ADHD, biofeedback treatment, psychological and behavioral intervention or comprehensive treatment reduced the hyperactivity index score (P<0.05).@*CONCLUSIONS@#In children with ADHD, psychological and behavioral intervention combined with biofeedback treatment can improve the attention concentration and impulsive/hyperactive and hyperactive symptoms. The treatment strategies are slightly different for children with different types of ADHD.

Clinical effect of integrated sandplay therapy in children with Asperger syndrome / 中国当代儿科杂志

OBJECTIVE@#To study the clinical effect of integrated sandplay therapy in preschool children with Asperger syndrome (AS).@*METHODS@#A total of 44 preschool children with AS were randomly divided into an experimental group and a control group, with 22 children in each group. The children in the control group were given routine training, and those in the experimental group were given integrated sandplay therapy in addition to the routine training. The treatment response was assess by the Social Responsiveness Scale (SRS), emotional recognition tools and changes in sandplay theme characteristics after 6 months of treatment.@*RESULTS@#Before intervention, there were no significant differences between the two groups in the total score of SRS, the score of each factor of SRS, and correct rates of facial expression recognition of the upright position, inverted position, upper face and lower face (P>0.05). After 6 months of intervention, both groups had significant reductions in the total score of SRS and the score of each factor of SRS (P<0.01); the control group had significant increases in the correct rates of facial expression recognition of all positions except the upright position (P<0.05), while the experimental group had significant increases in the correct rates of facial expression recognition of all positions (P<0.05). Compared with the control group after intervention, the experimental group had significantly lower total score of SRS and scores of all factors of SRS except social perception (P<0.01) and significantly higher correct rates of facial expression recognition of all positions (P<0.01). The experimental group had a significant change in the number of sandplay theme characteristics after intervention (P<0.01).@*CONCLUSIONS@#Integrated sandplay therapy can improve social responsiveness and emotion recognition ability in preschool children with AS.

Influence of genetic and environment factors on aggressive behavior in twin children / 中国当代儿科杂志

OBJECTIVE@#To investigate the influence of genetic and environmental factors on aggressive behavior in twin children, and to provide clues for further exploring the causal relationship between such factors and aggressive behavior.@*METHODS@#A questionnaire was used to investigate aggressive behavior, temperament type and parenting style among 261 twin children aged 4-12.8 years. The Holzinger method and the maximum likelihood method were used to construct a structural equation model for the estimation of heritability. Binary logistic regression analysis, multivariate linear regression analysis and general linear model analysis were used to analyze the association between aggressive behavior and environmental factors in twin children.@*RESULTS@#The heritability of aggressive behavior was 44.4% in twin children and the score of aggressive behavior showed moderate heritability (60.9% in boys and 65.6% in girls). The multivariate analysis showed that the score of aggressive behavior in twin children was affected by the mother's emotional warmth/understanding, the mother's punishment/severity and the father's overprotection (P<0.05). There was an interaction between the mother's emotional warmth/understanding and the father's overprotection (P<0.05).@*CONCLUSIONS@#Both genetic and environmental factors have influence on children's aggressive behavior, and parenting style is the main environmental factor affecting the aggressive behavior of twin children.

Correlation between blood-brain barrier permeability and physical disability in patients with neuromyelitis optica spectrum disorders / 上海交通大学学报（医学版）

Objective· To explore association between blood-brain barrier (BBB) permeability and physical disability in patients with neuromyelitis optica spectrum disorders (NMOSD).Methods· Clinical data of 105 patients with NMOSD was retrospectively analyzed in Department of Neurology at Changhai Hospital,Second Military Medical University and Renji Hospital,Shanghai Jiao Tong University School of Medicine from June 2009 to June 2016.According to the difference between the expanded disability status scale (EDSS) scores when discharged from hospital and when admitted to hospital,NMOSD patients were divided into disability-reduction group and disability-exacerbation group,and their clinical characteristics were compared between the two groups,then association between BBB permeability and physical disability was analyzed.Results · Between the disabilityreduction group and the disability-exacerbation group,there was no significant difference in gender,age,disease duration,inducing factor,clinical symptoms,and medication (all P＞0.05),and the abnormal rates of thoracic spinal cord in clinical examination were statistically different (P=0.023).There was no significant difference in biochemical data between the two groups (P＞0.05),and a statistically significant difference was observed in the rate of cerebrospinal/serum albumin ratio (QALB) in the cerebrospinal fluid examination (P=0.042).The percentages of exacerbation of disability in the QALB normal and high groups were 27.60％ (16/58) and 46.80％ (22/47),respectively,and there was a statistically significant difference between the two groups (x2=4.150,P=0.042).BBB permeability was positively correlated with physical disability (r=0.299,P=0.042).Conclnsion · The higher the BBB permeability of NMOSD patients on admission is,the higher the degree of physical disability is.The difference in BBB permeability provides key clues to the investigation of the immunological mechanisms of physical disability in NMOSD patients.

Correlation between blood-brain barrier permeability and physical disability in patients with neuromyelitis optica spectrum disorders / 上海交通大学学报（医学版）

Objective: To explore association between blood-brain barrier (BBB) permeability and physical disability in patients with neuromyelitis optica spectrum disorders (NMOSD). Methods: Clinical data of 105 patients with NMOSD was retrospectively analyzed in Department of Neurology at Changhai Hospital, Second Military Medical University and Renji Hospital, Shanghai Jiao Tong University School of Medicine from June 2009 to June 2016. According to the difference between the expanded disability status scale (EDSS) scores when discharged from hospital and when admitted to hospital, NMOSD patients were divided into disability-reduction group and disability-exacerbation group, and their clinical characteristics were compared between the two groups, then association between BBB permeability and physical disability was analyzed. Results: Between the disabilityreduction group and the disability-exacerbation group, there was no significant difference in gender, age, disease duration, inducing factor, clinical symptoms, and medication (all P>0.05), and the abnormal rates of thoracic spinal cord in clinical examination were statistically different (P=0.023). There was no significant difference in biochemical data between the two groups (P>0.05), and a statistically significant difference was observed in the rate of cerebrospinal/serum albumin ratio (QALB) in the cerebrospinal fluid examination (P=0.042). The percentages of exacerbation of disability in the QALB normal and high groups were 27.60% (16/58) and 46.80% (22/47), respectively, and there was a statistically significant difference between the two groups (χ2=4.150, P=0.042). BBB permeability was positively correlated with physical disability (r=0.299, P=0.042). Conclusion: The higher the BBB permeability of NMOSD patients on admission is, the higher the degree of physical disability is. The difference in BBB permeability provides key clues to the investigation of the immunological mechanisms of physical disability in NMOSD patients.

Research progress on myasthenia gravis related autoantibody and detection approaches / 上海交通大学学报（医学版）

Myasthenia gravis (MG) is an autoimmue disease mediated mainly by humoral immunity, which is characterised by skeletal muscle weakness and fatigue. Its pathogensis is closely related to the autoantibodies against the postsynaptic membrane components at neuromuscular junction (NMJ), including acetylcholine receptor (AChR) antibody, muscle-specific receptor tyrosine kinase (MuSK) antibody, and low-density lipoprotein receptor-related protein 4 (LRP4) antibody. In recent years, autoantibodies against antigens such as agrin, collagen Q, and cortactin have been identified. Based on serum antibody patterns, MG can be divided into different subgroups: AChR-MG, MuSK-MG, LRP4-MG and seronegative MG. The detection of autoantibody is vital in clinical for subgroup diagnosis, treatment and prognosis. With the development of medical techniques, the antibody detection approaches were improved, providing new opportunities for precise diagnosis and treatment of different subgroups. Thus, this paper reviewed the latest progress of MG autoantibody classification and the antibody detection approaches.

Molecular epidemiological analysis of α- and β-thalassemia in Fujian province / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the gene prevalence and spectrum of alpha- and beta-thalassemia in Fujian province.</p><p><b>METHODS</b>A total of 11 234 of neonatal cord blood samples were collected for a prevalence study of alpha- and beta-thalassemia. All subjects included in this study were registered in 9 cities of Fujian province. A complete blood count and high performance liquid chromatography (HPLC) were performed in all samples, with microcytosis (MCV≤ 79 f1 and MCH≤ 27 pg) or HPLC positive cases further studied by DNA analysis. alpha- and beta-thalassemia were determined by using gap-PCR and reverse dot blot (RDB) assays. Unknown positive samples were analyzed directly with DNA sequencing.</p><p><b>RESULTS</b>Of all 11 234 cord blood samples, 356 were identified as from alpha-thalassemia gene carriers, 7 deletion genotypes were identified including 236 (--SEA/ α α) cases, 67 (α 3.7/ α α) cases, 24 (alpha 4.2/alpha alpha) cases, 3 (alpha 3.7/ SEA) cases, 1 (alpha 4.2/ SEA) cases, 1 (alpha 3.7/ alpha 3.7) cases, 1 (alpha 3.7/ alpha 4.2) cases; 3 non-deletion genotypes were detected, including 7 (alpha alpha QS/ alpha alpha) cases, 3 (α α CS/α α) cases, 2 (α α WS/ α α) cases, the most common mutation was SEA/α α, which accounted for 66.29%, 148 individuals were found to have beta-hemoglobin gene mutations. 12 different mutations were identified, namely 65 IVS-2 654 (C>T) cases, 40 CD41-42(-TCTT, 12 CD17(A>T) cases, 10 -28(A>G) cases,7 CD27-28(+C) cases, 5 start codon ATG>AGG cases, 2 CD26(G>A) cases, 1 CD71-72(+A) cases, 1 IVS-1-1(G>T) cases, 1 CD43(G>T) cases, 2 -29(A>G) cases, 2 Codon 36 (-C) cases, the most common mutation was IVS-2 654(C>T) and CD41-42(-TCTT), which accounted for 70.95%. A novel beta-globin gene mutation CD36 (-C) allele was also detected. The carrier rate of thalassemia in Fujian population is 4.41%. In addition, 9 beta-thalassemia carriers were found with alpha-thalassemia mutation.</p><p><b>CONCLUSION</b>The research has revealed the type of gene mutations in alpha- and beta-talassemia in Fujian province. The beta-thalassemia mutations in Fujian province are complex, which were also obviously heterogeneous. This will significant value for screening the incidence, provide the valuable information for genetic counseling and prenatal diagnosis.</p>

Study on the risk factors related vertical transmission of HBV positive couples to their infant / 中华流行病学杂志

Objective To explore the risk factors and the rate of HBV vertical transmission from HBsAg-positive couple to their infant.Methods 46 families who had antenatal examination at Fujian Provincial Maternal and Child Health Hospital during August 2010 and November 2011 were chosen as research object.Cord blood was sampled after delivery for HBVM and HBV-DNA quantification.Those with HBV-DNA load ≥5 × 102 copies/ml were involved in the case group while those having ＜5 × 102 copies/ml were chosen as controls.Results The average positive rate of neonatal cord blood HBV-DNA was 45.7％ (21/46),while the positive rates of cord blood HBsAg and HBeAg were 34.8％(16/46) and 23.9％ (11/46) respectively.The positive rates of maternal serum HBV-DNA and paternal serum HBV-DNA were 52.2％ (24/46) and 69.6％ (32/46) respectively,with the positive rate of couple serum HBeAg as 39.1％ (18/46) and 32.6％(15/46) respectively.Results from univariate analysis showed that hepatitis B surface markers,serum HBeAg-positive,serum HBV-DNA positive,and serum HBV-DNA load of the couples were risk factors to the HBV vertical transmission(x2＝8.731,8.414,8.932,9.663,10.823,3.962,13.638,36.501 ;P＜0.05).Data from the multivariate analysis showed that maternal serum HBV-DNA positive and paternal serum HBV-DNA load were risk factors to the HBV vertical transmission [OR＝ 17.6 (1.3-238.4) ;OR ＝ 3.5 (1.6-7.6)].Serum HBV-DNA loads of the couples were positively correlated with the cord blood HBV-DNA load,while the load levels of the couple' s serum HBV-DNA were higher than cord blood HBV-DNA.There appeared dose-response relationship between couple' s serum HBV-DNA load level and the cord blood HBV-DNA load level.Results from the analysis of ROC curve showed that both maternal serum HBV-DNA load level (103 copies/ml) and paternal serum HBV-DNA load level (104 copies/ml) were demarcation points to better forecast the occurrence of vertical transmission of HBV,because there showed higher sensitivity and specificity for the forecasting process.Neonatal outcomes showed no significant difference between the case group and the control group.The negative conversion rate became 15.0％ (3/20) when the HBV-DNA positive infants were followed up for 7 months.Conclusion Both maternal serum HBV-DNA positive and paternal serum HBV-DNA load were risk factors of HBV vertical transmission.When the maternal serum HBV-DNA load appeared ＞103 copies/ml and paternal serum HBV-DNA load ＞ 104 copies/ml,the rate of HBV vertical transmission would increase.

A correlation analysis between the rate of vertical transmission of HBV and HBsAg-positive father to infant and the rate of neonatal cord blood HBV-DNA / 中华流行病学杂志

Objective To study the influence of HBV-DNA with different load levels of HBsAg-positive among fathers on the rate of neonatal cord blood HBV-DNA.Methods Using HBsAg and HBV-DNA as screening indicators for pregnant women and their husbands from an obstetric clinic.161 pregnant women whose HBsAg and HBV-DNA were negative,but HBsAg was positive among their husbands and their newborns,were selected.Blood samples from those pregnant women,their husbands and their newborns were collected to detect the related indicators.Using ELISA to detect hepatitis B virus markers(HBVM),and FQ-PCR to detect the levels of HBV-DNA load.According to neonatal cord blood HBV-DNA detection guideline,newborns with cord blood HBV-DNA positive were selected as cases,others as controls.Results(1)Result of the study showed that there was a dose-response relationship between paternal serum HBV-DNA load levels and neonatal cord blood HBV-DNA positive rates in newborns(trend χ~2=64.117,P=0.000).The rate of vertical transmission of HBV from HBsAg-positive father to infant in the paternal serum HBV-DNA＞1.0×107 copies/ml group was significantly higher than HBV-DNA＜1.0×107 copies/ml group(χ~2=71.539,P=0.000).(2)There was a positive rank correlation between semen positive HBeAg and vertical transmission of HBV from HBsAg-positive father to infant(χ~2=6.892,P=0.009).Conclusion There was a dose-response relationship between paternal serum HBV-DNA load levels and neonatal cord blood HBV-DNA positive in newborns.Paternal serum HBV-DNA≥1.0×107 copies/ml and with HBeAg positive status were risk factors of vertical transmission of HBV from HBsAg-positive father to infant.