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Research progress of COL4A1 gene and cerebral small vessel disease
Wang Zekun, Xie Yunfang, Wang Huanyuan, et al
Journal of Developmental Medicine(Electronic Version)    2023, 11 (3): 211-216.   doi: 10.3969/j.issn.2095-5340.2023.03.010
Abstract(717)   PDF (1158KB) (875)  
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Role and mechanism of the PI3K / Akt signaling pathway in the embryonic neurodevelopment of mice
Li Shen, Guo Xiaolan, Guo Jin, et al
Journal of Developmental Medicine(Electronic Version)    2023, 11 (5): 321-330.   doi: 10.3969/j.issn.2095-5340.2023.05.001
Abstract(435)   PDF (1089KB) (2509)  
【Abstract】 Objective To explore the role and mechanism of the phosphatidylinositol-3-kinase/
serine-threonine kinase (PI3K/Akt) signaling pathway in the embryonic neurodevelopment of mice,
for further clarifying the molecular mechanism of PI3K/Akt - related embryonic neurodevelopmental
abnormalities. Method Experimental animals were C57BL/6J mice and were randomly divided into
6 groups on embryonic day 7.5 (E7.5). In the experimental group, 12.5, 25, 50, 75 and 100 mg/kg of
LY294002 (the inhibitor of PI3K/Akt signaling pathway) were injected intraperitoneally, and the control
group mice were injected with normal saline solution. Pregnant mice were sacrificed and embryos
were examined under dissecting microscope on E13.5. After determining the optimal model dose,
embryonic nerve and spine samples were taken. Quantitative real-time polymerase chain reaction (RTqPCR) was used to detect the mRNA expressions of key genes of apoptosis and Shh (sonic hedgehog)
signaling pathway. The protein expression levels were determined by western blotting (WB). The mouse
neural stem cell NE-4C cell line was used for the study. The cell survival after treatment by different
concentrations of LY294002 was measured by methylthiazolyldiphenyl tetrazolium bromide (MTT).
The cell apoptosis was detected by TdT-mediated dUTP nick-end labeling (TUNEL), and cell cycle
was detected by flow cytometry. Statistical methods were performed by one-way analysis of Variance
and Dunnett's t test. Result The animal results showed that LY294002 affected embryonic neural
development, causing neural tube defects (NTDs). The optimal modeled dose was 50 mg/kg in which
the incidence of NTDs was 80.7% (46/57), all of which were myelomeningoeele and spina bifida. The
RT-qPCR results showed that, compared with the control group, the relative mRNA expressions of
tumor suppressor gene P53 and cysteinyl aspartate-specific proteinase 3 (Caspase3) were higher in nonmalformation, myelomeningoeele and spina bifida groups (P<0.01); and the relative mRNA expressions
of phosphatidylinositol-4,5-bisphosphate-3-kinase catalytic subunit alpha (PIK3CA) and Shh pathway
key genes [ smoothened (Smo), glioma-associated oncogene homolog 1 (Gli1), Gli2 ] were lower in the
three groups (P<0.01). The WB results showed that, compared with the control group, the relative protein
expressions of PI3K and Gli2 were lower in non-malformation, myelomeningoeele and spina bifida groups
(P<0.01); while the relative protein expressions of Smo and Gli1 were lower in myelomeningoeele and
spina bifida groups (P<0.01), but there was no significant difference in non-malformation group. The cell
experiment results showed that LY294002 inhibited cell proliferation, blocked the cell cycle in the G1 phase
and induced apoptosis. The MTT assay showed that the inhibition of cell survival was stronger with
increasing LY294002 concentration. The TUNEL staining showed that the ratios of positive cells to
total cells in the 20 and 25 μmol/L treated groups were higher than those in the control group (4.22±0.16,
8.56±0.24, 1.00±0.14, t=6.225 and 15.089, respectively, all P<0.001). The flow cytometry results showed
that the percentage of G1 cells in total cells was significantly increased [ (53.1±3.1) %, (66.4±2.1) %, and
(76.3±1.6) %, F=31.627, P<0.001] with the increase concentration of LY294002 (0, 20 and 25 μmol/L), and the proportion of cells in S and G2 phase were gradually decreased. Conclusion  The inhibition of PI3K/Akt signaling pathway during the embryonic neurodevelopment of mice can inhibit Shh signaling pathway, promote cells apoptosis, and affect embryonic neural tube closure of mice, leading to the occurrence of NTDs.
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A case report of Aarskog-Scott syndrome and literature review
Huang Xuejiao, Li Fang, Ma Hongwei
Journal of Developmental Medicine(Electronic Version)    2023, 11 (3): 205-207.   doi: 10.3969/j.issn.2095-5340.2023.03.008
Abstract(411)   PDF (888KB) (308)  
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Analysis of influencing factors for neonatal nosocomial infection by Logistic regression model combined with decision tree model
Song Jia, Tian Jiaran, Ping Lili, et al
Journal of Developmental Medicine(Electronic Version)    2023, 11 (4): 262-269.   doi: 10.3969/j.issn.2095-5340.2023.04.004
Abstract(403)   PDF (1159KB) (674)  
【Abstract】 Objective To provide the basis for reducing the nosocomial infection rate of neonates by
Logistic regression model and decision tree model analyzing its risk factors. Method A total of 1 552
hospitalized neonates admitted to the Department of Neonatology, Handan Central Hospital from January
to December 2020 were included in the study, and they were divided into the infected group (n=48) and
the non-infected group (n=1 504) according to whether developed nosocomial infection. The risk factors of
nosocomial infection in neonates were analyzed using the receiver operating characteristic (ROC) curve
area under the curve (AUC) compared the predictive effect of Logistic regression model and decision
tree model. Result Among the neonates, the infection rate was 3.1% (48/1 552). A total of 21 pathogenic organisms were detected in nosocomial infection specimens and detection rate was 43.8%. The Gram-negative bacteria accounted for 47.6% (10/21), mainly Klebsiella pneumoniae. The Gram-positive bacteria accounted for47.6% (10/21). The results of the univariate analysis showed that the proportion of gestational age of <32 weeks,birth weight ≤ 2 500 g, hospital length> 14 d, mechanical ventilation, combined antibiotics ≥3 types,length of the antibiotic use ≥7 d of the infected group were higher than those of the non-infected group. All the differences were statistically significant (all P<0.05). The results of the multivariate Logistic regression analysis showed that birth weight ≤ 1 000 g (OR=20.077, P=0.001), birth weight 1 001-1 500 g (OR=5.673,P=0.020), birth weight 1 501-2 500 g (OR=7.839, P=0.003), length of hospitalization> 21 d (OR=11.162,P=0.003), mechanical ventilation (OR=5.306, P<0.001) and combined antibiotics ≥3 types (OR=10.832,P<0.001) were independent risk factors for nosocomial infection. Exhaustive CHAID decision treemodel analysis results showed that gestational age, length of hospital stay, mechanical ventilation,and combined antibiotics ≥3 types were important variables affecting neonatal nosocomial infection.Combined antibiotics ≥3 types was the main factors of nosocomial infection in neonates. ROC comparisonshowed that there was no significant difference in AUC comparison between the two models (0.951 vs 0.944,Z=0.806, P=0.420). Conclusion In the analysis of risk factors for nosocomial infection in neonates, theLogistic regression model can screen out independent risk factors, including low birth weight, long-termhospitalization, mechanical ventilation, combined antibiotics ≥3 types and so on. The decision tree modelsuggests that the combination of antibiotics has the greatest impact on the risk of nosocomial infections. The two models can complement each other and have a good evaluation value.
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Evaluation of the effect of nutritional support based on the concept of enhanced recovery after surgery in the perioperative management of cesarean section
Jiang Xiaoyang, Wang Chuanxia, Zhu Shanfang, et al
Journal of Developmental Medicine(Electronic Version)    2023, 11 (3): 199-204.   doi: 10.3969/j.issn.2095-5340.2023.03.007
Abstract(397)   PDF (989KB) (532)  
【Abstract】 Objective To explore the feasibility and clinical significance of nutritional support based
on the concept of enhanced recovery after surgery (ERAS) in the perioperative management of cesarean
section. Method A total of 100 women with elective cesarean section who delivered at full term from
March 2021 to February 2022 in Lu'an Hospital Affiliated to Anhui Medical University were included in
the study. The parturients were divided into study group (n=50) and control group (n=50) according to the random number method. The study group received nutritional support based on ERAS concept, while the control group received traditional dietary support according to routine caesarean section. Preoperative anxiety and depression, preoperative and postoperative hunger and thirst, postoperative lactation, exhaust time, postpartum 24 h blood loss, postoperative discharge time and postoperative complications were compared between the two groups. The statistical methods performed by t test and χ2 test.  Result The incidence of maternal anxiety 1 h before operation in the study group was lower than that in the control group [14.0% (7/50)vs 32.0% (16/50), χ2=4.574, P=0.032]. Maternal hunger score of study group and control group 1 h before operation [(1.72±0.64) vs (4.06±0.89) points, t=15.092, P<0.001], and 3 h after operation [(2.76±1.10) vs (4.02±0.89) points, t=6.297, P<0.001], 3 h preoperative thirst score [(2.50±0.65) vs (4.12±0.85) points,t=10.736, P<0.001], 1 h preoperative thirst score [(2.06±0.71) vs (4.94±0.71) points, t=20.233, P<0.001],3 h postoperative thirst score [(3.48±1.43) vs (4.76±0.80) points, t=5.523, P<0.001], the above data in the studygroup were lower than those in the control group, the differences were statistically significant. The time of first successful lactation in the study group was shorter than that in the control group [(38±12) vs (55±11) h, t=7.494,P<0.001]. There were no significant differences in 24 h postpartum blood loss and postoperative discharge time between the two groups (all P<0.05). The maternal exhaust time in the study group was shorter than that in the control group [(21.8±5.3) vs (25.3±6.1) h, t=3.067, P=0.003]. The incidence of breast distension inthe study group was lower than that in the control group [4.0% (2/50) vs 16.0% (8/50), χ2=4.000, P=0.046].
Conclusion Nutritional support based on ERAS concept can not only promote recovery after cesarean
section and reduce surgical complications, but also relieve maternal anxiety and hunger during perioperativeperiod, which has certain clinical benefits.
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Analysis of prenatal diagnosis results and pregnancy outcomes of 16 cases with chromosome 8 abnormality detected by non-invasive prenatal testing
Yu Yiqing, Zhou Xiya, Jiang Yulin, et al
Journal of Developmental Medicine(Electronic Version)    2023, 11 (5): 338-345.   doi: 10.3969/j.issn.2095-5340.2023.05.003
Abstract(393)   PDF (887KB) (521)  
【Abstract】 Objective To explore the prenatal diagnosis, genetic counseling and pregnancy outcomes of patients with chromosome 8 abnormality detected by non-invasive prenatal testing (NIPT). Method From April 1, 2016 to October 31, 2022, among the pregnant women who underwent NIPT in Peking Union Medical College Hospital, 16 cases underwent prenatal diagnosis for chromosome 8 abnormality. All the 16cases underwent amniocentesis for prenatal chromosomal karyotyping and chromosomal microarray analysis(CMA). Fluorescence in situ hybridization (FISH) of uncultured cells on chromosome 8 was completed in some cases. Clinical data, prenatal genetic diagnosis results, and pregnancy outcomes were analyzed retrospectively. Result ① 13 cases without other chromosomal abnormality were considered as isolated NIPT chromosome 8 abnormality group (isolated group). One case was diagnosed as trisomy 8 mosaicism,and the pregnant woman decided to continue the pregnancy after counseling. No abnormality was found inprenatal ultrasound examination and postnatal neonatal follow-up. The other 12 cases were normal in theprenatal genetic testing and continued the pregnancy except three cases lost follow-up. No abnormality was found in neonates during follow-up. ② Three cases with other chromosomal abnormalities were considered asnon-isolated NIPT chromosome 8 abnormality group (non-isolated group). One case was diagnosed as trisomy16 mosaicism with fetal heart abnormality by ultrasound, and the pregnancy was terminated. The other twocases were normal in the prenatal genetic testing. One pregnant woman was diagnosed as left breast cancer at29 gestational weeks of pregnancy, who terminated the pregnancy via cesarean section, and no abnormalitywas found in the newborn during follow-up. One case lost follow-up. Conclusion Further prenatal diagnosis should be performed in cases with chromosome 8 abnormality detected by NIPT. The recommended genetic testing regimen includes chromosomal karyotyping, CMA and FISH analysis of uncultured cells. For cases diagnosed as trisomy 8 mosaicism, detailed genetic counseling should be performed. If no abnormality is detected by ultrasound, the prognosis of the fetus would be good in general, and the pregnancy could be considered to continue.
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Influencing factors of rehabilitation treatment effect in patients with postpartum pelvic floordysfunction and establishment of nomogram prediction model
Wu Zhirong, Zhu Yuping, Wan Lijuan
Journal of Developmental Medicine(Electronic Version)    2023, 11 (3): 187-193.   doi: 10.3969/j.issn.2095-5340.2023.03.005
Abstract(380)   PDF (1017KB) (544)  
【Abstract】 Objective To investigate the influencing factors of the rehabilitation treatment effect of
postpartum pelvic floor dysfunction (PFD) patients, and to construct a nomogram model to predict the
rehabilitation effect of PFD. Method From April 2020 to April 2022, 384 patients with PFD who were
admitted to Huai'an Hospital Affiliated to Xuzhou Medical University and Huai'an Maternal and Child Health
Hospital were selected as the research objects. All patients underwent biofeedback electrical stimulation
therapy and Kegal training. After three months, the rehabilitation effect was determined and the patients
were divided into good rehabilitation group (n=311) and poor rehabilitation group (n=73). The influencing
factors of the rehabilitation effect of PFD patients were screened out through multivariate Logistic regression analysis, R 3.6.1 software was used to establish a line graph model to predict the rehabilitation effect of PFD. The predictive performance of the model was evaluated by the receiver operator characteristic (ROC), and the H-L goodness of fit test was performed. Result Among the 384 patients, the rate of poor recovery was 19.01%. There were differences in the proportion of elderly pregnant women, prenatal body mass index (BMI), number of deliveries, neonatal birth weight, pelvic floor muscle classification, stress urinary incontinence (SUI) degree classification, and Kegel training compliance between the two groups (all P<0.05). Multivariate Logistic regression analysis results show that the main factors affecting the rehabilitation effectof PFD were prenatal BMI (OR=1.741, 95%CI: 1.284-2.360, P<0.001), number of deliveries ≥2 (OR=2.229,95%CI: 1.412-7.385, P<0.005), birth weight of newborns (OR=2.688, 95%CI: 1.278-8.635, P<0.001),pelvic floor muscle classification ≤ class 1 (class 1: OR=2.223, 95%CI: 1.663-8.349, P=0.040; class 0:OR=3.223, 95%CI: 1.056-9.840, P=0.001), and poor Kegel training compliance (OR=3.092, 95%CI: 1.726-9.699, P=0.001) ; the above five influencing factors were introduced into R software to establish a nomogrammodel, the area under the curve (AUC) was 0.853 (95%CI: 0.794-0.912). H-L goodness of fit test indicatedthat the model had a high degree of differentiation and consistency in predicting the rehabilitation effectof PFD patients (χ2=0.837, P=0.416). Conclusion  The nomogram prediction model constructed based on five influencing factors, including prenatal BMI, number of deliveries≥2, neonatal birth weight, pelvic floor muscle class ≤ class 1, and Kegel training compliance, has a strong effect in predicting the effect of rehabilitation therapy in PFD patients.
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Research progress on pathogenesis of tic disorder in children
Zhao Liping, Hu Xiaohong, Li Zhongyuan
Journal of Developmental Medicine(Electronic Version)    2024, 12 (3): 224-228.   doi: 10.3969/j.issn.2095-5340.2024.03.011
Abstract(379)   PDF (836KB) (857)  
【Abstract】Pediatric tic disorder (TD) is not rare, and may interfere with daily life, learning and socialization, or cause subjective discomfort, pain or injury. Some children can't completely control their tics even after behavioraltraining and medication. In this paper, we review the progress of research on the pathogenesis of TD in children,share the latest opinions and conclusions, and lay the foundation for exploring new treatment opinions to better improve the conditions of TD children.
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Video games for the assessment and treatment of attention deficit hyperactivity disorder in children: a systematic review
Luo Jie, He Fan, Zheng Yi
Journal of Developmental Medicine(Electronic Version)    2023, 11 (6): 401-410.   doi: 10.3969/j.issn.2095-5340.2023.06.001
Abstract(370)   PDF (1034KB) (383)  
【Abstract】 Objective To explore the effectiveness of video games applied to the assessment and
treatment of attention deficit hyperactivity disorder (ADHD) in children. Method A systematic review
approach was used to search for original researches on video game diagnosis or interventions related to
children with ADHD by means of a subject search in PubMed, Web of Science, Embase, China Knowledge
Network, and Wanfang Databases. The search period was from January 1990 to December 2022. Article
characteristics such as author, country, game name, platform used, characteristics, study design, study
population, age, male ratio, golden standard, training process, and main findings were extracted from the
literature. Result After initial screening, full-text revision, and study selection, 30 articles were included.Computers were the most common platform used in early studies of video games, but as hardware technology。has evolved, the platforms used for games have become more diverse. In diagnostic-related studies, thedesign principle of most games was based on a sustained-operation trial or a similar GO /No-GO Task to testsubjects' executive functions. In evaluating the validity of game-based diagnostics, some studies used clinicaldiagnosis as the golden standard, while others used relevant scales. Video game-based assessment tools wereeffective in distinguishing ADHD cases from controls and in differentiating ADHD subtypes. In interventionrelatedstudies, the most common type of intervention for game therapy was cognitive training, which aimedto improve one or more aspects of executive functioning, such as attention, working memory, reaction time,cognitive flexibility, and motor skills. Video game-based therapeutic interventions were widely accepted asgenerally effective in improving cognitive domains and reducing ADHD symptoms. Conclusion  Video games have utility and effectiveness in the assessment and treatment of ADHD in children, and their mainmechanisms may be gamification and cognitive training.
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Prenatal screening for common fetal chromosomal aneuploidies in twin pregnancy
Yu Yiqing, Qi Qingwei
Journal of Developmental Medicine(Electronic Version)    2023, 11 (4): 285-292.   doi: 10.3969/j.issn.2095-5340.2023.04.008
Abstract(369)   PDF (851KB) (421)  
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Editorial
Ectronic Periodicals
  • Director: National Health and Family Planning Commission
  • Host: People's Health Press
  • Publishing: People's health electronic audio and video press Co., Ltd.
  • Editor in chief:Zhichun Feng
  • Quarterly: Quarterly
  • ISSN: 2095-5340
  • CN: 11-9335/R
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