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OBJECTIVE: To investigate the clinical features and outcomes of children with congenital hypothyroidism (CH) missed by neonatal screening. METHODS: The clinical and laboratory date of 31 children with CH missed by neonatal screening from February 2015 to February 2022 in Guangzhou Women and Children’s Medical Center were retrospectively analyzed. Whole-exome high-throughput sequencing analysis was performed in 17 patients. RESULTS: Among the 31 patients, 19 cases (61.3%) were preterm, 12 cases (38.7%) were term neonates. The median value of gestation age was 36 (26-40) weeks, birth weight was 2.35 (0.75-3.70) kg, diagnosed age was 20 d (7 d-4 years), dry blood spot thyrotropin was 4.18 (0.34-8.97) mU/L. Nine cases (29.0%) were same-sex twins and 4 cases (12.9%) had a family history of hypothyroidism. The initial clinical symptoms were growth retardation in 11 cases (35.5%), prolonged jaundice in 7 cases (22.6%), short stature, abdominal distension, fetal edema and goiter in 1 case (3.2%), respectively. Genetic analysis of the 17 children showed that DUOX2 gene mutations were detected in 10 cases (6 cases with biallelic mutations and 4 cases with monoallelic mutations), of whom 3 had a family history of hypothyroidism. A total of 22 patients were reevaluated at the age of 2-3 years, of whom 17 cases (77.3%) were transient CH and 5 cases (22.7%) were permanent CH. Among the 10 cases with DUOX2 gene mutations, 6 cases were transient CH, 1 case was permanent CH, and 3 cases (< 3 years old) were still under treatment with L-thyroxine. CONCLUSIONS: False negative results on neonatal screening for CH often occurs in preterm birth, low birth weight, same-sex twins, family history of hypothyroidism, and DUOX2 defects are the common molecular pathogenesis, most of whom are transient CH. Thyroid function should be evaluated in time for children with unexplained slow growth and delayed jaundice regression.

This study used a voxel-wise degree centrality (DC) method to evaluate differences in brain activity between patients with non-neuropsychiatric systemic lupus erythematosus (non-NP-SLE) and healthy controls (HCs) and to assess the relationship of DC values with clinical and neuropsychological data. Thirty-two female patients with non-NP-SLE and 28 well-matched HCs were recruited and underwent resting-state functional MRI. Differences in spontaneous brain activity between the two groups were evaluated using a DC method. Correlations between the altered DC values of specific brain regions and clinical and neuropsychological data were explored using Spearman correlation analysis. Receiver operating characteristics curve analysis was applied to differences in DC values in specific brain regions to determine their value in distinguishing patients with non-NP-SLE from HCs. Compared with HCs, DC values in patients with non-NP-SLE were significantly lower in the bilateral postcentral gyrus and the orbital part of the left superior frontal gyrus (LFMO). DC values in some specific brain regions such as the bilateral postcentral gyrus and the LFMO correlated with Mini-Mental State Examination scores in both subject groups. In patients with non-NP-SLE, DC values of the right postcentral gyrus were positively correlated with IgA levels, and DC values of the LFMO were positively correlated with Systemic Lupus Erythematosus Disease Activity Index 2000 scores, as well as IgA levels. Receiver operating characteristics curve analysis revealed that the DC values of specific brain regions can be used to differentiate patients with non-NP-SLE from HCs.

Along with the aging of the population and miniaturization of family structure, the problem of the left-behind elderly has become more and more prominent in China. According to the Report on the family development in China (2015) released by the National Health Commission of the People’s Republic of China, left-behind elderly people account for half of the total number of the elderly, of whom 10% live alone. The left-behind elderly not only suffer physiological obstacles such as body function decline, but also face a lack of support at the material level and loneliness at the spiritual level, which greatly affects their quality of life, accounting for their lower life satisfaction than that of the ordinary elderly. The rural areas of Sichuan Province are relatively backwards in terms of economic level and have limited pension security. Therefore, the left-behind elderly in rural areas are confronted with more complicated and severe pension problems compared with those in urban areas. Meanwhile, limited by economic and regional factors, a large number of rural labor forces in Sichuan Province have transferred to cities. These long-time migrant workers cannot provide material, spiritual and life care support for their left-behind parents in rural areas in a timely fashion, which changes their filial piety behaviors, and this affects the life satisfaction of the rural left-behind elderly. Therefore, it is necessary to understand the living conditions of empty-nest elderly and their children’s filial piety in rural areas of Sichuan province in order to verify the influence mechanism of filial piety on the life satisfaction of the elderly, and to explore how to improve the rural empty-nest elderly’s life satisfaction, enabling the elderly to live a healthy and happy life.

To investigate the relationship between the uncooperative behaviors of first-visit-dental children and correlative factors that include children's temperament, severe of dental caries and so on in order to help dentists to make personal dentistry therapy plan for each child to prevent and deal with children's uncooperative behaviors.From the pediatric dentistry clinic, 195 first-visit-dental children (aged 3-7 years) from Dec. 2007 to Dec. 2008 were randomly selected to accept dental examination and accepted corresponding treatment according to personal therapy plans. Children's clinic behavior was valued during treatment. The parents were asked to complete NYLS temperament parents scale questionnaires for 3-7 years old children.Among the 195 children, there were 114(58.46%) had dental fear and anxiety(DFA) and 66 (33.85%) had dental behavior management problem (DBMP). As the children's age increased, the incidence of DBMP decreased. There were no statistical relationship between genders and children's DFA/DBMP. The children's severity of dental caries was related to their dental behavior, the more serious the caries, the more incident the DFA/DBMP of children. There were no statistically significant differences for the DFA/DBMP of temperament type children. But the score of sensory threshold was higher in DFA children, while physiological rhythmicity was lower in DBMP, the differences were significant.In order to reduce the incidence of DFA/DBMP, we should pay more attention to children with serious caries, and provide them individual behavior management for different ages and temperament.