Deliberate self-harm among pediatric psychiatric inpatients in China: A single-center retrospective study

BACKGROUND

For children and adolescents, deliberate self-harm (DSH) is becoming a mental health problem of concern. Despite several studies on the prevalence and factors of DSH in the world, there is little information on DSH among children and adolescents in China. This study explores the prevalence, types, associated risk factors and tendency of DSH in pediatric psychiatric inpatients in China.

AIM

To understand the situation of DSH among hospitalized children and adolescents and its related factors.

METHODS

In this study, we retrospectively studied 1414 hospitalized children and adolescents with mental illness at Xiamen Mental Health Center from 2014 to 2019, extracted the demographic and clinical data of all patients, and analyzed clinical risk factors of DSH.

RESULTS

A total of 239 (16.90%) patients engaged in at least one type of DSH in our study. Cutting (n = 115, 48.12%) was the most common type of DSH. Females (n = 171, 71.55%) were more likely to engage in DSH than males (n = 68, 28.45%). DSH was positively associated with depressive disorders [OR = 3.845 (2.196-6.732); P < 0.01], female [OR = 2.536 (1.815-3.542); P < 0.01], parental marital status [OR = 5.387 (2.254-12.875); P < 0.01] and negative family history of psychiatric illness [OR = 7.767 (2.952-20.433); P < 0.01], but not with occupation, substance use and history of physical abuse.

CONCLUSION

Our findings suggest that for patients with depression, females, an abnormal marriage of parents, and no history of mental illness, attention should be paid to the occurrence of DSH.

[Contamination and Potential Ecological Risk Assessment of Heavy Metals in the Sediments of Yilong Lake, Southwest China]

The concentrations of Al, Ti, As, Cd, Cr, Cu, Ni, Pb, Zn, and Hg and chemical speciation of Cd, Cr, Cu, Ni, Pb, and Zn in four short cores sampled from the Yilong Lake, Yunnan Province were analyzed. The vertical and spatial features in the pollution levels and potential ecological risks of heavy metals in the sediments were studied. Except for the wide concentration ranges of Cd, the metals in the sediments showed narrow variations in their concentrations with coefficients of variation less than 0.3. According to the cluster analysis results, all metals could be classified into two groups:metals in group Ⅰ included As, Cd, Hg, and Pb, while metals in group Ⅱ included Al, Ti, Cr, Cu, Ni, and Zn. The metals in each group exhibited similar vertical variations in each core, but their variations were highly different between the cores. The correlation analysis results demonstrated that the variations in metal concentrations in the sediments were greatly regulated by the sediment texture. Therefore, the enrichment factor (EF) method was used for the differentiation of metals from the natural and anthropogenic sources and for the pollution assessment based on the total metal concentrations. The Cd and Pb in the sediments were mainly presented in the reducible speciation with percentages of 48% and 42%, respectively; Cr, Cu, Zn, and Ni were primarily (68%-82%) associated with the residual speciation. Based on the EF and chemical speciation of metals and their enrichment coefficients of the secondary phase, Cd was the typical pollutant with moderate pollution on average, and the other elements were observed in non-to weak pollution levels. Anthropogenic metals were mainly associated with the extractable speciation in the sediment. Combining the ecological risk index, the sediment quality guidelines, as well as the pollution level and chemical speciation of metals, As, Cu, Hg, Ni, Pb, and Zn in the surface sediments of Yilong Lake should have low potential ecological risk. However, Cd may pose a high potential ecological risk.

[Spatio-temporal Variations, Contamination and Potential Ecological Risk of Heavy Metals in the Sediments of Chenghai Lake]

Heavy metals pollution in the sediments is one of the main factors impacting the water quality and ecosystem health. In this study, concentrations of ten metals in nine sediment cores from the Chenghai Lake were determined. Chronology of a typical core (CH2012) was constructed by the ²¹⁰Pb and ¹³⁷Cs dating method. The spatio-temporal variations in concentrations and contamination characteristics of As, Cd, Cu, Hg, Ni, Pb, and Zn were evaluated. The potential eco-risks of heavy metals in the surface sediments were studied by combining the ecological risk index and sediment quality guidelines (SQGs) assessment as well as their pollution levels (enrichment factors, EF). The metal concentrations in each sediment core showed little vertical change with coefficients of variation of less than 0.20, except for Cd, whose coefficient of variation was 0.59. Spatially, the average concentrations of each metal showed minor difference among the cores, with ratios ranging from 1.2 to 1.8, suggesting similar sedimentary characteristics of metals in the whole lake. Cd and Pb were influenced by anthropogenic contamination that has started in the mid-1980s. The pollution level of Cd decreased in the past decade and still belongs to the moderate pollution degree, whereas the pollution level of Pb increased continually and could be classified as the weak pollution degree. The Hg contamination began in the late 1990s, with EFs ranging from 0.9 to 1.6, belonging to the weak pollution degree. The As, Cu, and Zn pollution occurred mainly near the surface sediments with weak pollution degrees. Spatially, there were no obvious trends in pollution levels of the metals. The heavy metals pollution is mainly influenced by atmospheric deposition that originates from non-ferrous metal smelting emissions, as well as agricultural and domestic discharges. As, Cu, Ni, Pb, and Zn in the surface sediments have low potential ecological risks, whereas Hg and Cd may pose middle-high potential risks.

N-Bromosuccinimide-Induced C-H Bond Functionalization: An Intramolecular Cycloaromatization of Electron Withdrawing Group Substituted 1-Biphenyl-2-ylethanone for the Synthesis of 10-Phenanthrenol

An NBS-induced intramolecular cycloaromatization for the synthesis of 10-phenanthrenols from electron-withdrawing group substituted 1-biphenyl-2-ylethanones is described. The in situ generated bromide was designed to act as an initiator for the radical C-H bond activation. An oxidative cross-dehydrogenative coupling reaction of a highly active C-H bond with an inert C-H bond readily occurs under mild conditions without the need for transition metals or strong oxidants.

A model to predict the onset of non-alcoholic fatty liver disease within 2 years in elderly adults

BACKGROUND AND AIM

Non-alcoholic fatty liver disease (NAFLD) is a common cause of chronic hepatitis, which leads to cirrhosis and hepatocellular carcinoma. However, it is difficult to identify subjects at high risk for NAFLD onset. This study aims to construct a model to predict the onset of NAFLD within 2 years in elderly adults.

METHODS

This study included and followed 3378 initial NAFLD-free subjects aged 60 years or over for 2 years, which were randomly divided into a training set and a validation set. NAFLD was diagnosed on ultrasound. Clinical and laboratory data were recorded at baseline. A model was constructed in the training set to predict the onset of NAFLD and validated in the validation set.

RESULTS

Body mass index, hemoglobin, fasting blood glucose, and triglycerides were identified as predictors for the onset of NAFLD. A risk score (R) was calculated by them. It classified the subjects into low-risk group (R ≤ -2.88), moderate-risk group (-2.88 < R ≤ -1.26), and high-risk group (R > -1.26). In the training set, 4.68% of the participants in the low-risk group, 11.59% of the participants in the moderate-risk group, and 31.02% of the participants in the high-risk group developed NAFLD. In the validation set, 5.84% of the participants in the low-risk group, 10.57% of the participants in the moderate-risk group, and 29.44% of the participants in the high-risk group developed NAFLD.

CONCLUSIONS

This study developed a model to predict the onset of NAFLD in elderly adults, which might provide indications for intervention to these subjects.

[Significance of CXCL12/CXCR4 expression in T-lymphoblastic lymphoma/leukemia]

Objective: To investigate the significance of CXCL12/CXCR4 expression in T lymphoblastic lymphoma/leukemia (T-LBL/ALL) and its prognostic significance. Methods: Using immunohistochemical EnVision method, CXCL12, CXCR4 and Ki-67 expression were evaluated in 72 cases of T-LBL/ALL and 30 selected cases of lymph node reactive hyperplasia (LH) as control. In addition, CXCL12 and CXCR4 mRNA expression levels were examined by real-time reverse transcription polymerase chain reaction (real-time RT-PCR) method. Results: Immunohistochemical results showed that the expression rates of CXCL12 and CXCR4 in T-LBL/ALL were 84.7%(61/72) and 91.6%(66/72), respectively, and these were not different from the expression in the LH control group. The expression indexes of Ki-67 <80% and ≥80% were 25 cases (34.7%, 25/72) and 47 cases (65.3%, 47/72), respectively. Real-time quantitative PCR demonstrated that CXCL12 and CXCR4 mRNA expression in T-LBL/ALL was 62.4% and 71.5%, respectively, and was statistically different (P<0.05) from that of the control group. Single factor analysis found that CXCL12 mRNA expression in T-LBL/ALL was positively correlated with Ann Arbor staging and KPS score (P<0.05); CXCL12 protein expression was positively correlated with splenomegaly (P<0.05); CXCR4 mRNA expression was positively correlated with the IPI score, clinical symptoms, mediastinal widening and bone marrow involvement (P<0.05); CXCR4 protein expression was positively correlated with mediastinal widening (P<0.05); CXCL12 mRNA expression was positively correlated with CXCL12 protein and CXCR4 protein expression (P<0.05), but not the CXCR4 mRNA and protein levels. There was no correlation between CXCL12 and CXCR4 protein expression and CXCR4 mRNA expression. Multivariate COX regression analysis showed that high expression of CXCR4 protein, hepatosplenomegaly and bone marrow involvement were risk factors for T-LBL/ALL outcome. Conclusions: CXCL12/CXCR4 expression is associated with disease progress, mediastinal widening, bone marrow involvement and adverse outcome in T-LBL/ALL. CXCL12/CXCR4 axis plays an essential role in the occurrence and development of T-LBL/ALL. However, CXCL12 and CXCR4 protein expression are not entirely reflected by mRNA transcription levels, and there may be other molecules involved in CXCL12/CXCR4 expression and regulation. With CXCR4 antagonists undergoing clinical trials, targeting the CXCL12/CXCR4 axis may be a promising treatment strategy for T-LBL/ALL.

[Posterior debridement combined with atlantoaxial fusion to upper cervical tuberculosis]

Objective: To explore clinical results of posterior debridement combined with atlantoaxial fusion for upper cervical Tuberculosis. Methods: From March 2007 to April 2012, 8 patients with upper cervical Tuberculosis underwent posterior debridement combined with atlantoaxial fusion in our hospital were selected for retrospective analysis. 3 cases were males and 5 females, aged 29-65 (43.5±13.2) years. According to the pedicle destruction, using different screws (pedicle screw or laminar screw) fixation.In the preoperative and final follow-up, Japanese Orthopaedic Association score (JOA) and neck disability index (NDI) were used to evaluate neurological function and calculate improvement rate JOA score. At final follow-up, clinical efficacy was evaluated by Odom's grade. situation of internal fixation, fusion of upper cervical were assessed by imaging examination. During follow-up, complications were documented and analyzed. Results: Postoperatively 12 months, all bony fusion were achieved. Tuberculosis were reached clinical cure in 12-18 months. The JOA score increased from 10.5±2.0 preoperatively to 15.6 ±1.1 in final follow-up(P<0.05), and the NDI decreased from 29.9 ± 6.2 preoperatively to 8.6±1.6 (P<0.05). At last follow-up, according to Odom's standard, excellent were obtained in 6 cases (75.0%), good 1 cases (12.5%) and ordinary 1 case (12.5%). No severe complications was documented during follow-up. Conclusions: The treatment of posterior debridement combine with atlantoaxial fusion, and structure grafting and local anti-Tuberculosis drug using intraoperative, not only could obtain reliable clinical efficacy, completely removal of lesions, but also obtain strong stability, which plays an important role in the treatment of cervical tuberculosis.

[Anterior retropharyngeal debridement combined with posterior atlantoaxial fusion for atlantoaxial Tuberculosis]

OBJECTIVE

To evaluate the clinical efficacy of anterior debridement combined with posterior atlantoaxial fusion for atlantoaxial Tuberculosis.

METHODS

From February 2005 to February 2013, 7 patients, 3 males and 4 females, with atlantoaxial Tuberculosis underwent anterior debridement combined with posterior atlantoaxial fusion in Department of Orthopedics Zhengzhou University People's Hospital were selected.In the preoperative and final follow-up, Japanese Orthopaedic Association score (JOA), neck disability index (NDI) and Frankel Classification were used to evaluate neurological function and calculate improvement rate.At final follow-up, clinical efficacy was evaluated by Odom's grade.Situation of internal fixation, fusion of upper cervical were assessed by X-ray, CT scan and MRI scan.

RESULTS

Bony fusion were achieved in 7 cases after operation in 12 months. Tuberculosis were reached clinical cure between 17 and 21 months. At follow The JOA score increased from (11.1±0.7) preoperatively to (15.3±0.5) in final follow-up(P<0.05), and the NDI decreased from (34.0±4.6) preoperatively to (10.1±1.3) in final follow-up (P<0.05). At last follow-up, according to Odom's standard, excellent were obtained in 5 cases, good 1 cases and ordinary 1 case. Frankel Classification of all cases improved from D class to E.

CONCLUSIONS

The treatment of anterior retropharyngeal debridement combine with atlantoaxial fusion, and local anti-tuberculosis drug using intraoperative, not only could obtain reliable clinical efficacy, completly removal of lesions, but also obtain strong stability, which plays an important role in the treatment of atlantoaxial Tuberculosis.

First Report of Leaf Spot Disease of Peony Caused by Seimatosporium botan in China

Tree peony (Paeonia suffruticosa Andrews), a perennial ligneous deciduous shrub in the Paeoniaceae family, is known for its beautiful and charming flowers. It is regarded as the flower symbol of China and is cultivated throughout the country. In August 2008, a previously unknown leaf spot was observed on peony cultivated in the Mountain Peony Garden located in the Luoyang area of Henan Province, China. In 2009, the leaf spot disease was observed in some gardens in the city of Luoyang, China. Initial symptoms appeared as small, round or irregular, brown, necrotic lesions in the middle of leaves. These lesions gradually enlarged up to 1 cm in diameter and were circular or irregular, brown to dark brown, and brown on the margins. In a humid atmosphere, black, sessile, discoid acervuli developed on the lesions, and the lesions sometimes became waxy-like, eventually coalesced, and nearly covered the entire leaf. Conidia produced in acervuli had two morphologically different types. One type had a single basal appendage, ellipsoid to fusiform, transversely three septate, 16 to 20 × 5 to 7 μm, smooth, basal cell obconic with a truncate base, subhyaline, 3 to 5 μm long; two central cells subcylindrical to dolioform, brown to dark brown, 8 to 10 μm long, apical cell conical with rounded apex, concolorous with the central cells, 4 to 5 μm long, basal appendage filiform, unbranched, excentric, 4 to 8 μm long. The other type had a single appendage at both ends, fusiform to subcylindrical, transversely three septate, 16 to 20 × 4 to 5 μm, smooth; basal cell obconic with a truncate base, subhyaline, 4 to 5 μm long; two central cells subcylindrical to dolioform, pale brown, 8 to 11 μm long; apical cell conical with an acute apex, hyaline to subhyaline, 4 to 5 μm long; basal appendage filiform, unbranched, excentric, 4 to 8 μm long; apical appendage filiform, unbranched, 4 to 8 μm long. Single conidial isolates of both types of conidia yielded identical colonies, which produced both types of conidia on potato dextrose agar (PDA), thus showing that both types of conidia belonged to the same fungus. Colonies on PDA were slimy in appearance, yellow to villous with an irregular taupe margin; reverse brown to grayish brown. Cultural and conidial characteristics of the isolates were similar to those of Seimatosporium botan (1). The DNA sequence for the fungus showed internal transcribed spacer region (ITS1-5.8S-ITS2) sequences (GenBank Accession No. HM067840) with 93% sequence identity to S. discosioides (Accession Nos. EF600970.1 and EF600969.1). This is the first submission of a S. botan sequence to GenBank. To determine pathogenicity, 20 healthy leaves of P. suffruticosa were inoculated by spraying a conidial suspension of S. botan onto the foliage. Ten leaves were sprayed with sterile water and served as controls. Plants were covered with plastic for 24 h to maintain high relative humidity. After 15 days, the symptoms described above were observed on leaves in all inoculated plants, whereas symptoms did not develop on the control plants. The pathogen was reisolated from inoculated leaves, fulfilling Koch's postulates. On the basis of morphology and ITS region sequences, we conclude that S. botan is the causal agent of leaf spots of P. suffruticosa. There is a report of S. botan on P. suffruticosa stems in Japan (1), but to our knowledge, this is the first report of leaf spot disease of peony caused by S. botan in China. References: (1) S. Hatakeyama et al. Mycoscience 45:106, 2004.

First Report of Pilidium concavum on Paeonia suffruticosa in China

Paeonia suffruticosa Andrews, a deciduous perennial shrub, is known for its beautiful and charming flowers. It is regarded as the flower symbol of China and cultivated throughout the country. Since 2006, large, brown necrotic spots have been observed on numerous P. suffruticosa plants in gardens in Luoyang, China. Spots appeared each year and were observed on more than 50% of the plants, sometimes affecting more than half of the leaf. Initial symptoms appeared as small, round, water-soaked lesions in the middle or on the margin of leaves. These areas enlarged up to 1 to 3 cm in diameter and were circular or irregular, brown to dark brown, and pale brown on the margins. In a humid atmosphere, black, sessile, discoid conidiomata developed on the spots and exuded a pink spore mass that turned brown with age. Conidiophores were hyaline, unicellular, cylindrical, and fusiform and 5.0 to 8.0 μm long and 1.4 to 2.0 μm wide. Pure cultures were obtained by plating the spores on potato dextrose agar (PDA) medium. In culture, the fungus produced a gray-to-brown colony with whitish aerial mycelium. The morphology and size of conidia were comparable with previous descriptions of Pilidium concavum (Desm.) Höhn. (1). The ITS1-5.8S-ITS2 region of the isolate was amplified by PCR with primers ITS1 and ITS4 and sequenced. The 472-nt sequence was 100% identical to that of the Pilidium concavum specimen voucher BPI 1107275 (GenBank Accession No. AY487094). To validate Koch's postulates, pathogenicity was tested by inoculating 10 leaves of P. suffruticosa with mycelia plugs from a colony growing on PDA; leaves inoculated with the plugs of PDA medium only served as the control. Leaves were covered with plastic for 24 h to maintain high relative humidity. After 7 days, 100% of the mycelium-inoculated leaves showed symptoms identical to those observed on P. suffruticosa leaves affected in the field, whereas all leaves inoculated with PDA medium only remained free of symptoms. Reisolation of the fungus from leaf lesions confirmed that the causal agent was Pilidium concavum. Thus, we concluded that Pilidium concavum is the causal agent of leaf spots of P. suffruticosa. This disease has been reported to be frequently occurring on P. suffruticosa stems imported from Japan (1), but to our knowledge, this is the first report of Pilidium concavum on P. suffruticosa in China. References: (1) M. E. Palm. Mycologia 83:787, 1991.

Salicylic Acid Enhances Jaceosidin and Syringin Production in Cell Cultures of Saussurea medusa

Addition of 20 muM salicylic acid to Saussurea medusa cell cultures at day 6 resulted in jaceosidin and syringin productions up to 95 mg l(-1 )and 631 mg l(-1) which were, respectively, about 2.5- and 2.7-fold higher than in the control. The biomass was increased from 8 to 12 g l(-1). Expression of chalcone synthase gene (chs) increased sharply after 12 h treatment and was sustained up to 48 h; chalcone isomerase gene (chi) expression reached a peak at 24 h and decreased after 48 h; and phenylalanine ammonia-lyase activity increased by 7.5-fold (96 U mg(-1) protein) higher than in the control after 24 h. These results indicate that salicylic acid enhances the production of jaceosidin and syringin which is accompanied by induction of the related phenylpropanoid biosynthetic enzymes.

[Effect of aging on the syndrome of essential debility and evil reality--an exploration on mechanism of senility by traditional Chinese medicine]

Effect of aging on essential debility and evil reality was explored by an epidemiological investigation of clinical syndrome with TCM in 878 cases of middle and old-aged patients, inquiring into their relation of senility with visceral weakness and stagnation of Qi, blood stasis, and phlegm turbid. The results indicated that (1) several viscera, feeble and damaged, were the basis of senility, and the feeble kidney was the stress; (2) the syndrome of stagnation of Qi, blood stasis and phlegm turbid speeded up process of senility. The mechanism of feeble phenomena appeared in the middle-old aged patients is that with the rise of age in the patients observed there was interaction between the feeble visceral function and the syndrome of stagnation of Qi, blood stasis and phlegm turbid, that is, there was interaction between essential debility and evil reality. Essential debility may lead to evil reality and the latter will worsen essential debility. Thus, on repeating themselves in alternate cycles, a systemic hypofunction will be formed up to exhaustion. Therefore, "to nourish essential debility first and to purge evil reality second" should be considered as an essential direction of preparing anti-aging drugs in TCM.