Mental health status of infected children between 7 to 12 years old in Fangcang Shelter Hospital during the COVID-19 Shanghai lockdown in 2022: a cross-section study.

Background: There has been an increase in research on the potential adverse effects on children's mental health, especially depression and anxiety, during the coronavirus disease 2019 (COVID-19) pandemic over the past few months. Therefore, the aim of the present study was to investigate depression and anxiety symptoms among children in shelter hospitals during the 2022 Shanghai lockdown. Methods: A total of 98 infected children aged 7-12 years were enrolled in this study between April 19 and June 4, 2022. The Children's Depression Inventory (CDI), Anxiety Scale for Children-Autism Spectrum Disorder (ASC-ASD), and Anxiety Scale or Children-Autism Spectrum Disorder Parent Form (ASC-ADS-P) were used to assess children's depression and anxiety symptoms. Children's guardians completed the survey by verbally asking their child/children the questions. The guardians additionally completed the ASC-ASD-P. Results: The prevalence of depression and anxiety was 12.2% and 13.3%, respectively. A total of 66 respondents reported no physical symptoms. Linear regression showed that myalgia [7.198, 95% confidence interval (CI): 3.163-11.232], headache (7.189, 95% CI: 3.842-10.535) coryza (5.362, 95% CI: 2.654-8.070), and number of quarantine days (4.378, 95% CI: 3.409-5.348) were significantly correlated with higher levels of depression, whereas chills (14.337, 95% CI: 9.799-18.875), coryza (9.309, 95% CI: 6.467-12.152), headache (7.193, 95% CI: 3.182-11.204), myalgia (5.571, 95% CI: 0.684-10.459), number of quarantine days (3.190, 95% CI: 1.796-4.584), and gender (male) (-4.137, 95% CI: -6.609 to 1.665) were associated with anxiety scores. Persistent fever was correlated with depression (P=0.007), whereas physical discomfort, such as persistent fever, cough, sore throat, headache, myalgia, and coryza were correlated with anxiety (all P<0.05). Conclusions: The findings of the present study indicated a moderate prevalence of depression and anxiety among infected children in a shelter hospital during the 2022 Shanghai lockdown. Therefore, the findings of this study could provide scientific basis for the development of targeted psychological intervention. It could be helpful for policy-makers to focus on psychological health among infected children and help to optimize future interventions.

Application of the Cycle Management Model in Improving Outpatient Appointment Services.

To explore the application of plan-do-check-action (PDCA) cycle management model in the management outpatient appointment, and improve the efficiency of outpatient appointment services. The data of outpatients from January 2019 to December 2020 were collected from a tertiary class B general hospital affiliated to a university in Shanghai. Through the investigation and analysis of the current situation, the reasons were found for the low rate of outpatient appointment. PDCA management was carried out, and measures were formulated for continuous improvement and the effective measures were standardized. The appointment rate, recognition rate and the utilization rate of self-service appointment (handheld hospital and self-service machine) were analysed after the intervention of PDCA. Through PDCA cycle management model, the appointment rate of outpatients increased from 9.93% before improvement to 82.50% after improvement, and the recognition rate of patients increased from 51.39% to 92.76%. The utilization rate of self-service appointment increased from 1.03% to 56.38%. Through the construction of multi-channel, wide coverage and convenient operation of the appointment service system, the PDCA cycle management model effectively improves the efficiency of the outpatient appointment services.

Coronavirus Disease 2019 (COVID-19) Learning Online: A Flipped Classroom Based on Micro-Learning Combined with Case-Based Learning in Undergraduate Medical Students.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, medical colleges in China had to use online teaching. This study explored the effect of COVID-19 knowledge learning online in a flipped classroom based on micro-learning combined with case-based learning (CBL). METHODS: There were 74 undergraduate medical students who were randomly grouped to an observation group and a control group with 37 participants in each virtual classroom on the Network Teaching Platform. Students learning in the control group utilized face-to-face lecture with PowerPoint pre-provided, while students learning in the observation group were conducted in a flipped classroom based on micro-learning combined with CBL. We compared the effect of both formats of COVID-19 knowledge learning online and the impact on clinical practice attitude in two groups. RESULTS: All 74 students (100%) responded pretest, posttest and retention test, and completed the questionnaire online. Both formats significantly improved COVID-19 knowledge acquisition at the conclusion of online COVID-19 curriculum. Students' knowledge test scores including total score and scores of five knowledge dimensions of COVID-19 were significantly higher in the observation group than those in the control group (P<0.05). Compared with students in the control group, students in the observation group performed better in retention test and had a significantly more positive clinical practice attitude (P<0.05 in all items). CONCLUSION: A flipped classroom based on micro-learning combined with CBL showed greater effectiveness in COVID-19 knowledge gain in undergraduate medical students and made their attitude toward clinical practice more positive.

Pelvic floor muscle exercise for chronic low back pain.

OBJECTIVE: To assess the effect of pelvic floor muscle exercise in patients with chronic low back pain. METHODS: Adults (aged ≥ 18 years) with chronic low back pain (with or without radiculopathy) were randomized to undergo either routine treatment (ultrasonography, short wave diathermy and lumbar strengthening exercises; control group) or routine treatment with pelvic floor exercises (intervention group) for 24 weeks. Pain, disability (Oswestry Disability Index [ODI] score) and trunk muscle function were assessed at baseline and after completion of treatment. RESULTS: The study included 47 patients (control group n = 24; intervention group n = 23). Pain severity and ODI scores were significantly lower in the intervention group than in the control group after 24 weeks. There were no significant between-group differences in trunk muscle function. CONCLUSION: Pelvic floor exercise in combination with routine treatment provides significant benefits in terms of pain relief and disability over routine treatment alone.

[Effects of controlling specific dangerous pesticides on prevention of acute pesticide poisoning in rural area].

OBJECTIVE: To investigate the effects of controlling the specific dangerous pesticides on prevention of acute pesticide poisoning in rural area. METHODS: The data of reported cases of pesticide poisoning were analyzed to find out the specific dangerous pesticide in acute pesticide poisoning. Then the occurrence of occupational pesticide poisoning and fatality of non-occupational pesticide poisoning were estimated under the hypothesis of removing the specific dangerous pesticides. RESULTS: The data indicated that parathion (including methyl parathion) was the specific dangerous pesticide inducing occupational pesticide poisoning. After removing the use of parathion, the hazard of pesticides which caused occupational pesticide poisoning would be significantly decreased (P < 0.01). Parathion was also the most dangerous pesticide which caused non-occupational pesticide poisoning, with its fatality up to 15.8%. If parathion was well controlled, the fatality of non-occupational pesticide poisoning would be declined from 9.4% to 7.4%. The analyses of related literatures also revealed the similar results. CONCLUSION: The occurrence of occupational pesticide poisoning and fatality of non-occupational pesticide poisoning may decrease if the most dangerous pesticides are well supervised.

Influence of vitamin D receptor haplotypes on blood lead concentrations in environmentally exposed children of Uygur and Han populations.

OBJECTIVE: To explore the association between polymorphism of vitamin D receptor (VDR) and lead poisoning in Uygur and Han children in China. METHODS: The BsmI, ApaI and TaqI restriction sites of VDR genotyping were determined by polymerase chain reaction-restriction fragment length polymorphism in 443 Uygur and 469 Han children from Xinjiang province. The correlation between the polymorphism of VDR haplotypes and blood lead levels was explored. RESULTS: The genotype frequencies of VDR had significant differences in Han and Uygur children (p <0.01). According to VDR-BsmI, ApaI and TaqI haplotype analysis in Han children, haplotypes Atb and AtB were considerably decreased in the lead poisoning group (p <0.05) while haplotype aTb and ATb were significantly increased in the lead poisoning group (p <0.01). However, such results were not found in Uygur children (p < 0.05). CONCLUSION: A significant difference was seen in the frequency distribution of the VDR genotype among the different races. Haplotypes Atb and AtB might be protective factors while haplotypes ATb and aTb might be risk factors in Han children.

[Detection of Y chromosome microdeletions in semen of patients with azoospermia: study of 241 cases].

OBJECTIVE: To set up a simple and reliable method to screen Y chromosome microdeletions in semen of azoospermic patients, and to explore the incidence and loci of Y chromosome microdeletions in Chinese azoospermia. METHODS: Two hundred and forty-one semen samples, 51 containing blood, were collected from 241 Chinese azoospermic patients. 45 normal semen samples and 1 anticoagulated blood sample from female were used as controls. DNA was quickly abstracted by incubating the cells with a lysis buffer containing polymerase chain reaction (PCR) buffer and protease K, and was used to detect the deletion of 15 kinds of sequence tagged site (STS) distributed in AZFa, AZFb, and AZFc by 4 sets of multiplex PCR. Agarose electrophoresis was used to observe and compare the PCR products from the semen samples and their corresponding blood samples, and the PCR products from 1 semen sample were confirmed by sequencing. RESULTS: All multiplex PCR reactions were amplified successfully. The sequencing of the PCR products from the semen samples confirmed the PCR reactions. No microdeletion was detected in the 45 normal semen samples. Microdeletion was found in 26 out of the 241 semen samples of azoospermic patients (10.8%): 2 patients (7.7%) had the deletions located in AZFa, 2 patients (7.7%) in AZEb, 3 patients (11.5%) in both AZFb + AZFc, and other 19 patients (73.1%) in AZFc. The detection results of the blood samples were completely consistent with those of the semen samples. The STS deletion recommended by European Academy of Andrology (EAA) and European Molecular Genetics Quality Network (EMQN) were all found in these 26 cases. CONCLUSIONS: The semen samples of azoospermic patients present a convenient, reliable, and noninvasive substitute for blood in screening of Y chromosome microdeletions, and can be employed in study and clinical examination. The EAA/EMQN recommendations allow the detection of complete AZF deletions in Chinese azoospermia.

Lack of association of delta-aminolevulinic acid dehydratase genotype with blood lead levels in environmentally exposed children of Uygur and Han populations.

AIM: A cross-section study was conducted to explore the association between polymorphism of delta-aminolevulinic acid dehydratase (ALAD) and lead poisoning in Uygur and Han children in China. METHODS: The ALAD genotyping was determined by PCR-RFLP in 443 Uygur and 469 Han children aged 6-10 years from Urumqi in Xinjiang province. RESULTS: The blood lead levels of 912 environmentally exposed children ranged from 0.5 to 48.2 microg/dL, with a mean of 5.45 microg/dL and a standard deviation of 0.22 microg/dL, and 23. Thirty-one percent individuals were with blood lead level > or =10 microg/dL. The mean and standard deviation of blood lead levels were 5.57 +/- 0.223 microg/dL and 5.30 +/- 0.224 microg/dL in Uygur and Han children, respectively. The frequencies of the allele ALAD1 and ALAD2 in Uygur subjects were 90.52% and 9.48%, and in Han subjects were 95.73% and 4.27%, respectively (chi-square = 19.55, p < 0.05). No statistic correlation between the distribution of ALAD alleles and the blood lead level was found in both populations. CONCLUSION: A significant difference was seen in the frequency distribution of ALAD genotype between the different races. The genetic susceptibility of ALAD polymorphism to lead toxicity may exhibit in a lead dose-dependent manner.

[Y chromosome microdeletions of 664 Chinese men with azoospermia or severe oligozoospermia].

OBJECTIVE: To explore the incidence and location of Y chromosome microdeletions in Chinese azoospermia and severe oligozoospermia, as well as the relationship between the deletion region and testicular phenotype. METHODS: Semen samples or blood samples were collected from 664 Chinese patients (584 with azoospermia and 80 with severe oligozoospermia). DNA was extracted by incubating cells with a lysis buffer containing polymerase chain reaction (PCR) buffer and proteinase K, and was assayed for deletion of 15 sequence tagged sites (including 6 loci recommended by European Academy of Andrology and European Molecular Genetics Quality Network (EAA/EMQN) distributed in AZFa, AZFb and AZFc by 4 multiplex PCRs. The histological phenotypes of testes of some azoospermic patients harboring Y chromosome microdeletion were studied by fine needle aspiration. RESULTS: Sixty-six (11.3%) cases of microdeletions were found in the 584 patients with azoospermia, and deletions of AZFc region are the leading group (72.7% of all deletions), followed by AZFbc (13.6%), AZFabc (6.1%), AZFb (4.5%) and AZFa (3.0%). In the 80 men with severe oligozoospermia, 10 (12.5%) cases of AZFc microdeletions were detected. While azoospermia (n=19) with AZFc region deletion showed variable testicular phenotype, deletions of AZFb+c and AZFa+b+c (n=7) resulted in severe impaired spermatogenesis characterized by Sertoli cell only syndrome and spermatogenic arrest at spermatogonia. CONCLUSION: In the Chinese men with azoospermia and severe oligozoospermia, the incidence of Y chromosome microdeletions and the frequency of the deletions of the three AZF regions are similar to those described previously in other populations. Massive deletions of AZFb+c and AZFa+b+c impair spermatogenesis severely.

[Polymorphism of vitamin D receptor and lead poisoning genetic polymorphism in Han, Uygur and Kazak child in China].

OBJECTIVE: To explore the relationship between the polymorphism of vitamin D receptor (VDR) and genetic polymorphism in Han, uygur and Kazak child in China. METHODS: The VDR genotyping was determined by PCR-RFLP in 469 Han, 443 Uygur and 516 Kazak child from Xinjiang province. The correlation between the polymorphism of VDR and blood lead levels were explored. RESULTS: The frequencies of the allele BsmIB and BsmIb in Han child were 6% and 94%, and in Uygur were 18% and 82%, in Kazak were 43% and 57% respectively. Statistic correlation between the distribution of VDR-BsmI alleles and the blood lead level was found in Han and Uygur. CONCLUSION: The genetic susceptibility of VDR polymorphism to lead toxicity may exhibit in a lead dose-dependent manner.