Abstract Objective This study sought to enhance the precision of endometrial lesion categorization in ultrasound imagery via a data enhancement framework base on deep learning (DL), addressing diagnostic accuracy challenges and contributing to future research. Materials and Methods Our study gathered ultrasound image datasets from 734 patients across six hospitals. We devised a data enhancement framework including Image Features Cleaning and Soften Label, validated across multiple DL models including ResNet50, DenseNet169, DenseNet201, and ViT-B. For optimal performance, we proposed a hybrid model integrating convolutional neural network (CNN) and transformer architectures to predict lesion types. Results The implementation of our novel strategies resulted in a substantial accuracy enhancement in the model. The final model achieved an accuracy of 0.809 and a macro-AUC of 0.911, underscoring DL's potential in endometrial lesion ultrasound image classification. Conclusion We successfully developed a data enhancement framework to accurately classify endometrial lesion in ultrasound images. The integration of anomaly detection, data cleaning, and soften label strategies enhanced the model's comprehension of lesion image features, thereby boosting its classification capacity. Our research offers valuable insights for future studies and lays the foundation for the creation of more precise diagnostic tools.

Postpartum depression (PPD) is among the most common postpartum complications. Its prevalence is associated with strong regional variability. Women in rural areas of China have a high risk of PPD. The aim of this study was to investigate the PPD status of women in rural South China and explore the effects of modifiable lifestyle behaviors during pregnancy on their PPD status, thereby providing a scientific basis for the prevention and intervention of PPD in rural China. A cohort study was conducted on 261 women from four maternal health institutions situated in rural areas of Guangdong Province and the Guangxi Zhuang Autonomous Region from October 2021 to December 2022. The questionnaires were administered to these women to obtain data about sociodemographic characteristics, health literacy, physical activity during pregnancy, and sleep and dietary status during pregnancy, as well as depression status on the 42nd day after delivery. The lifestyle behaviors during pregnancy and the PPD status of the study population were analyzed. Multiple linear regression models were used to determine the correlation between lifestyle behaviors and PPD status. Path analysis was performed to explore the interaction between various lifestyle behaviors. A total of 14.6% of women had a PPD status. Women who continued to work during pregnancy had an Edinburgh Postpartum Depression Scale (EPDS) score of 1.386 points higher than that of women who did not (В = 1.386, β = 0.141, p = 0.029). For every 1-point increase in the infant feeding-related knowledge score and pregnancy diet diversity score, the EPDS score decreased by 0.188 and 0.484 points, respectively, and for every 1-point increase in the Pittsburgh sleep quality index score, the EPDS score increased by 0.288 points. Age was related to infant feeding-related knowledge (indirect path coefficient = 0.023). During pregnancy, sedentary time was correlated with sleep quality (indirect path coefficient = 0.031) and employment status (indirect path coefficient = 0.043). Employment status, infant feeding-related knowledge, sleep quality, and diet diversity during pregnancy directly influenced the PPD status, while age and sedentary time during pregnancy indirectly influenced the PPD status. Promoting healthy lifestyle behaviors, including reducing sedentary time, improving sleep quality, and increasing dietary diversity, may be effective in reducing PPD occurrence.

Primrose syndrome is an autosomal dominant disorder characterized by craniofacial dysmorphism, mental retardation, developmental delay, progressive muscle atrophy and calcification of the earlobe due to a mutation in the ZBTB20. We reported a case of a Chinese boy with clinical symptoms resembling Primrose Syndrome, and performed genetic etiology analysis of the proband's family through Trio whole exome sequencing. A novel missense variant c.1927T>A(p.F643I) in exon 14 of the ZBTB20 (NM_001348803) was identified in the proband. This is the first report case of primrose syndrome in China, and our case extends the variant spectrum of ZBTB20 and further strengthens the understanding of primrose syndrome. However, there are no formal clinical guidelines for the management of this disease, and research on treatment and prognosis remains a challenge and focus in future.

To carry out genetic analysis for a fetus with confined placental mosaicism (CPM) for trisomy 2 (T2) in conjunct with fetal uniparental disomy (UPD). Amniocentesis and chromosomal karyotyping was carried out for a pregnant woman with a high risk for chromosome 2 anomalies indicated by non-invasive prenatal testing (NIPT). Single nucleotide polymorphism array (SNP-array) and trio-whole exome sequencing (Trio-WES) were carried out. Ultrasonography was used to closely monitor the fetal growth. Multifocal sampling of the placenta was performed after delivery for copy number variation sequencing (CNV-seq). The fetus was found to have a normal chromosomal karyotype. SNP-array has revealed multiple regions with loss of heterozygosity (LOH) on chromosome 2. Trio-WES confirmed the presence of maternal UPD for chromosome 2. Ultrasonography has revealed intrauterine growth restriction and oligohydramnios. Intrauterine fetal demise had occurred at 23+4 weeks of gestation. Pathological examination had failed to find salient visceral abnormality. The placenta was proved to contain complete T2 by CNV-seq. T2 CPM can cause false positive result for NIPT and may be complicated with fetal UPD, leading to adverse obstetric outcomes such as intrauterine growth restriction, oligohydramnios and intrauterine fetal demise.

BackgroundOver the past three years, the COVID-19 pandemic has brought an overwhelming impact on China’s hospital system and health care workers, which can lead to post traumatic stress disorder (PTSD) symptoms. Previous research has shown that the COVID-19 pandemic had long-term adverse effects on the mental health of health care workers. Indeed, PTSD symptoms have emerged as one of the significant mental health issues for health care workers arising from the COVID-19 pandemic. Therefore, we conducted this cross-sectional survey to investigate the prevalence of PTSD symptoms in health care workers and its relationship with the fear of COVID-19 and the COVID-19 burden after the full liberalization of COVID-19 prevention and control policy in China.MethodsThis study was conducted three years after the global COVID-19 pandemic (January 15 to January 16, 2023). This study was conducted via the Wenjuanxing platform and used the Chinese versions of the scales PC-PTSD-5, COVID-19 Anxiety Scale (FCV-19S), Social Support Scale, COVID-19 Stress Scale, GAD-2, and PHQ-2.ResultsThe prevalence of PTSD symptoms in health care workers was 24.3% (232/955). depression(P < 0.001), anxiety(P < 0.05), the fear of COVID-19(P < 0.001), and COVID-19 burden(P < 0.001) were highly correlated with PTSD symptoms in health care workers. Social support(P < 0.05) was a protective factor of PTSD symptoms.ConclusionsThis survey shows that PTSD symptoms were highly prevalent among Chinese health care workers after the COVID-19 pandemic. Governments and leaders of medical institutions should, through psychological interventions, address the current situation of PTSD symptoms among health care workers and develop targeted programs and strategies to reduce their psychological problems.

Objective: This study was aimed to describe the clinical features and outcomes of Omicron-associated croup in children. Methods: A total of 105 children aged 3-60 months (median age 11 months) with coronavirus disease 2019 (COVID-19) and cough were admitted to our hospital from December 16, 2022, to December 31, 2022. Their clinical features, treatment, and outcomes were reviewed. These children were followed up for 8 months. Results: Among the cases, 5 had complex medical histories, while the other children were generally healthy. Out of the cases, 41 (38.3%), 57 (54.4%), and 7 (6.7%) had mild, moderate, and severe laryngeal obstruction, respectively. They developed croup after 1-5 days of fever (median 2 days). The majority (90.5%) of COVID-19 children with croup did not have pneumonia, and most of them (64.8%) had decreased eosinophil counts. Additionally, most other blood routine indicators were normal. Five other viral infections (chlamydia pneumoniae, respiratory syncytial virus, adenovirus, coxsackie virus, and mycoplasma pneumoniae) were tested in 51 cases, and all results were negative. All cases recovered from croup after receiving prompt nebulization therapy and/or intravenous drip of hormone. The hospitalization rate was 6.7%. During the 8-month follow-up period, 71 cases experienced repeated fever due to various infections, but only 4 cases (4/105, 3.8%) had repeated croup. Conclusion: Omicron is a risk factor for croup, with most cases presenting mild to moderate laryngeal obstructions. Co-viral infection testing is unnecessary for such cases. The symptoms of Omicron-associated croup may be more severe than croup associated with other viruses; however, unnecessary hospitalizations can be avoided, leading to reduced healthcare expenses.

The coronavirus disease 2019 (COVID-19) pandemic triggered a global public health crisis and has brought an unprecedented impact on pregnant women. The problems faced by pregnant women in the rural areas of China during the epidemic are different from those in urban areas. Although the epidemic situation in China has gradually improved, studying the impact of the previous dynamic zero COVID-19 policy on the anxiety status and lifestyle of pregnant women in rural areas of China, is still necessary. A cross-sectional survey of pregnant women in rural South China was conducted from September 2021 to June 2022.Using questionnaires, sociodemographic characteristics, anxiety status, physical activity, sleep quality, and dietary status of the population were collected. Using the propensity score matching method, the effect of the dynamic zero COVID-19 strategy on the anxiety status and lifestyle of pregnant women was analyzed. Among the pregnant women in the policy group (n = 136) and the control group (n = 680), 25.7 and 22.4% had anxiety disorders, 83.1 and 84.7% had low or medium levels of physical activity, and 28.7 and 29.1% had sleep disorders, respectively. However, no significant difference (p > 0.05) was observed between the two groups. Compared with control group, the intake of fruit in the policy group increased significantly (p = 0.019), whereas that of aquatic products and eggs decreased significantly (p = 0.027). Both groups exhibited an unreasonable dietary structure and poor compliance with the Chinese dietary guidelines for pregnant women (p > 0.05). The proportion of pregnant women in the policy group, whose intake of stable food (p = 0.002), soybean, and nuts (p = 0.004) was less than the recommended amount, was significantly higher than that in the control group. The dynamic zero COVID-19 strategy had little impact on the anxiety status, physical activity, and sleep disorders of pregnant women in the rural areas of South China. However, it affected their intake of certain food groups. Improving corresponding food supply and organized nutritional support should be addressed as a strategic approach to improve the health of pregnant women in rural South China during the pandemic.

Abstract Background: A dicentric chromosome is an abnormal chromosome with two centromereson the same chromosome. They are rarely identified in genetic conditions. Robertsonian translocations (ROBs) involving acrocentric chromosomes (13, 14, 15, 21, and 22) are most frequently generate the dicentric chromosomes. In this report, we described a phenotypically abnormal fetus with mosaic karyotype 45,X/46,X,dic(X;18). This was a rare type of dicentric chromosome X, which has not been reported. Case presentation: At 16 weeks of gestation, A 39-year-old pregnant woman (gravida 2, para 1) was referred to the center of prenatal diagnosis for genetic counseling. The fetal ultrasonography indicated ventricular septal defect (VSD), pulmonary stenosis, cystic hygroma colli (CHC), choroid plexus cyst, and bilateral hydronephrosis. Subsequently, amniocentesis was performed, the G-banding karyotype analysis of the fetal sample showed a rare type of mosaicism of 45,X,dic(X;18)(p11.2;p11.2)[31]/45,X[26]. Single nucleotide polymorphism array (SNP array) (Affymetrix CytoScan 750K Array, Santa Clara, California) revealed arr[GRCh37]18p11.32p11.21(136228_15181208)x1-2 (Pathogenic); arr[GRCh37]Xp22.33p11.22(168552_52154982)x1 (Pathogenic); arr[GRCh37]Xp11.22q28(52705315_155233098)x1-2 (Pathogenic). After genetic counseling, the parent chose to terminate the pregnancy. Conclusions: We report a prenatal case of 45,X,dic(X;18)(p11.2;p11.2)[31]/45,X[26] mosaicism with multiple congenital anomalies. The C-banding analysis showed dicentric chromosome X. This was a rare type of dicentric chromosome X, which has not been reported. Our case report added the descriptive information on this fetus and could provide a reference for genetic counseling.

Abstract Background: TNM stage is widely applied to classify lung cancer and the foundation of clinical decisions. However, increasing studies have pointed out that this staging system is not precise enough especially for the N status. In this study, we aim to build a convenient survival prediction model that incorporated the current items of lymph node status. Methods: We collected data of resectable NSCLC(IA-IIIB) patients from Surveillance, Epidemiology, and End Results (SEER) database (2006-2015). X-tile program was applied to calculate the optimal threshold of metastatic lymph nodes ratio (MLNR). Then, independent prognostic factors were determined by multivariable cox regression analysis and enrolled to build a nomogram model. The calibration curve as well as the concordance index(C-index ) were selected to evaluate the nomogram. Finally, patients were grouped based on their specified risk points and divided into three risk levels. The prognostic value of MLNR and examined lymph nodes number (ELNs) were presented in subgroups. Results: 40853 NSCLC patients after surgery were finally enrolled and analyzed. Age, metastatic lymph nodes ratio, histology type, adjuvant treatment, and AJCC 8th T stage were deemed as independent prognostic parameters after multivariable cox regression analysis. Nomogram was built using those variables and its efficiency in predicting patients’ survival was better than the conventional AJCC stage system after evaluation. Our new model has a significant higher concordance index(C-index) (training set,0.683 v 0.641, respectively; P&lt;0.01; testing set, 0.676 v 0.638, respectively; p&lt;0.05). Similarly, the calibration curve shows the nomogram was in better accordance with the actual observation in both cohorts. And then, after risk stratification, we found MLNR is more reliable than ELNs in predicting overall survival(OS). Conclusions: We developed a nomogram model for NSCLC patients after surgery. This novel and useful tool outperforms the widely used TNM staging system and could benefits clinicians in treatment options and cancer control.

To assess the effectiveness of three-level prevention and control of thalassemia, we routinely collect samples from transfusion-dependent individuals and perform genetic analysis. Here, we report on a 10-year-old boy requiring blood transfusions with routine thalassemia gene test results of αα/αα, and βCD41/42/βN, but he had thalassemia-like changes in his appearance and a high need for frequent blood transfusions, suggesting a case of thalassemia major in childhood. Given these equivocal results, samples from the family members were collected for further analysis. A multiplex ligation-dependent probe amplification assay was used to detect a multicopy number variant of the α globin gene cluster in the proband. The variant was detected as a long fragment repeat of 380 Kb using CNV assay technique, which contains the entire α globin gene cluster, describing it as αααα380/αα. Analysis of family members suggested that both the brother and mother of the proband carried the variant, and both MCV and MCH values were reduced in carriers. Individuals carrying multiple copy number variants of the α globin gene cluster exist in the population. Individuals carrying such variants who are also heterozygous for the β0 thalassemia variant result in an imbalance in the α/β chain ratio, potentially leading to the creation of individuals with a severe anemia genotype. Most secondary prevention and control laboratories currently do not include variants with increased α gene copy number in their testing, which is one of the blind spots of prevention and control efforts. In order to provide more accurate genetic counseling to test subjects, especially in regions with high rates of thalassemia carriage, testing laboratories should pay attention to individual genotype-phenotype matches to avoid the under-detection of such variants.