Nanjing Maternity and Child Health Care Hospital

Many young and middle-aged adults with hypertension do not seek timely medical help. This study investigated the relationship between self-efficacy and medical help-seeking attitudes, specifically focusing on the mediating role of illness perception and the moderating effect of family support. A cross-sectional survey of 382 hypertensive adults aged 18-59 in Nanjing, China, demonstrated that self-efficacy was a significant positive predictor of help-seeking attitudes (β = 0.357, p < 0.001). This relationship was partially mediated by illness perception, explained 37.70% of the variance in the total effect. Furthermore, perceived family support moderated this pathway, and the positive effect of self-efficacy on illness perception was stronger for individuals reporting higher family support (β = 0.103, p = 0.004). These findings highlight how family environment and self-perception jointly influence healthcare-seeking behavior in younger hypertensive populations.

International Practice Guidelines Registry Platform (PREPARE-2024CN606).

Ovarian endometriosis (OvE) is a gynecological disorder with endometrial tissue in the ovaries, for which effective non-invasive diagnosis and curative treatments are currently lacking. Serum samples were collected from both discovery and validation cohorts to examine the metabolomic signatures. Fifty-six differential metabolites between patients with OvE and healthy controls were identified using untargeted metabolomic profiling. Weighted gene co-expression network analysis was further conducted to validate the differential metabolites. Subsequently, twenty-one metabolites were selected for further validation using targeted metabolomic profiling. Five machine learning algorithms confirmed the efficacy and stability of these metabolites for diagnosing OvE. Least absolute shrinkage and selection operator -logit regression identified six serum metabolites and two clinicopathological features with high diagnostic accuracy. Three differential metabolites were found to exhibit therapeutic potential for OvE in an in vivo study. Diagnostic, predictive, and therapeutic potential of serum metabolomes for OvE are provided in this study.

Although Myo-Inositol/D-Chiro-Inositol (Ins) and berberine (BBR) have each shown beneficial effects in polycystic ovary syndrome (PCOS), their combined therapeutic potential has not been systematically evaluated. Here, we demonstrate that Ins/BBR exerts superior efficacy compared with single treatments by targeting multiple pathogenic pathways in PCOS. In a DHEA+HFD-induced mouse model, Ins/BBR restored systemic sex steroid balance, normalized LH/FSH ratio, and improved estrous cyclicity. It also reduced ovarian cysts and enhanced fertility, accompanied by partial normalization of steroidogenic enzyme expression. At the cellular level, Ins/BBR alleviated mitochondrial defects and broadly reprogrammed metabolic landscape in granulosa cells, in specific, restoring nucleotide pools and amino acid turnover and preventing abnormal long-chain fatty acid accumulation. Together, these findings provide preclinical evidence that Ins/BBR acts through coordinated endocrine, ovarian and metabolic mechanisms, supporting its promise as a safe and effective therapeutic strategy for PCOS.

Aflatoxin B1 (AFB1) is a potent mycotoxin that impairs reproductive health, yet its impact on oocyte metabolism remains unclear. Our study aimed to characterize the metabolic profile of mouse oocytes exposed to AFB1.Using a murine model of chronic AFB1 exposure, we performed integrated metabolomic and proteomic analyses of oocytes. AFB1 exposure induced profound metabolic reprogramming, characterized by excessive activation of fatty acid β-oxidation (FAO) and one-carbon metabolism, and suppressed nucleotide metabolism. Functional assays further demonstrated that exogenous taurine supplementation improved quality of AFB1-exposed oocytes, specifically, alleviating meiotic defects and metabolic dysfunction. Collectively, these findings provide novel mechanistic insight into AFB1-induced metabolic perturbations in oocytes and highlight taurine as a promising intervention to mitigate mycotoxin-associated reproductive toxicity.

BackgroundResidual acetabular dysplasia (RAD) is a common complication following closed reduction (CR) for developmental dysplasia of the hip (DDH). This study aims to perform a meta-analysis to identify predictive factors for RAD in order to provide a theoretical basis for early clinical identification and prevention.MethodsA comprehensive literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library databases, covering the period from database inception to November 2024. The quality of the included studies was assessed using the Newcastle–Ottawa Scale, and data analysis was performed using StataSE-64 and RevMan 5.4 software. The odds ratio (OR) and 95% confidence interval (CI) were used for data synthesis. Evidence for all outcomes was graded according to the GRADE system.ResultsThis meta-analysis included 16 studies, including a total of 1,338 children who underwent CR for DDH. The analysis identified female sex (OR: 1.96; 95% CI: 1.01–3.81; p = 0.05) and femoral head coverage (FHC) (OR: 0.95; 95% CI: 0.92–0.97; p = 0.0002) as risk factors for RAD after CR. However, acetabular index (AI) (OR: 1.11; 95% CI: 0.94–1.31; p = 0.21), treatment age (<1 year vs. ≥1 year) (OR: 1.16; 95% CI: 0.95–1.42; p = 0.13), side of DDH occurrence (OR: 0.84; 95% CI: 0.52–1.36; p = 0.48), and number of affected sides (OR: 0.76; 95% CI: 0.05–12.72; p = 0.85) were not identified as risk factors for RAD. According to the GRADE assessment, all indicators were rated as “very low-quality evidence,” except for FHC, which was classified as “low-quality evidence.”ConclusionThe results of this study indicate that female sex and FHC are the primary risk factors for RAD after CR treatment of DDH. Given the inherent limitations of this study, further multicenter prospective clinical studies are needed to clarify the factors contributing to RAD after CR in children with DDH and to implement preventive measures to improve the long-term prognosis of these children.Systematic Review RegistrationPROSPERO CRD420251016618.

Fine particulate matter measuring less than 2.5μm in diameter (PM(2.5)) is a significant risk factor for acute asthma episodes in children. Nevertheless, the biological mechanism that underpins this correlation remains unclear. Here, we found that PM(2.5)-induced inflammatory cell infiltration and aggravated childhood asthma in a ferroptosis-dependent manner. GPX4 overexpression could reverse the PM(2.5)-induced increase in reactive oxygen species (ROS), malondialdehyde (MDA), and inflammatory factors, as well as the decrease in mitochondrial membrane potential. Mechanistically, PM(2.5) elevated DNMT3A expression and hypermethylated the promoter region of GPX4, leading to reduced GPX4 expression and promoting ferroptosis. Furthermore, the status of GPX4 DNA methylation was significantly associated with IL-6/8 levels in mild/moderate and severe childhood asthma patients. In conclusion, our research highlights the critical interplay between PM(2.5) exposure, DNA methylation, and ferroptosis in asthma exacerbation, providing clues for the treatment of childhood asthma.

Objective: To investigate the diagnostic consistency and the risk factors for extrauterine growth restriction (EUGR) assessed by the Fenton 2013 preterm growth charts (Fenton 2013) and the growth charts by International Fetal and Newborn Growth Consortium for the 21st Century (IG-21). Methods: This multicenter retrospective cohort study included 5 591 preterm infants with a gestational age (GA) at birth of less than 32 weeks admitted to 19 member hospitals of the Neonatal Perinatal Collaborative Network of Suxinyun from 2019 to 2024. Clinical data including baseline characteristics, complications, feeding practices and anthropometrics were processed and analyzed. EUGR was assessed using both the Fenton 2013 and the IG-21. A decrease in weight Z-score at discharge compared to admission by more than 1 was defined as longitudinal EUGR, and discharge weight below the P10 for the corresponding corrected GA was defined as cross-sectional EUGR. Diagnostic consistency was assessed using the Kappa coefficient between the 2 standards, and diagnostic performance of the 2 standards was compared using the McNemar test. Risk factors for EUGR under different definitions were analyzed using univariate analysis and multivariate Logistic regression analysis. Results: A total of 5 591 preterm infants were included, with a GA at birth of (29.7±1.6) weeks and a birth weight of (1 360±315) g and at discharge with a corrected GA of (36.3±2.0) weeks and weight of (2 246±370) g. Detection rates of cross-sectional and longitudinal EUGR diagnosed by Fenton 2013 were both higher than those by IG-21 (37.0% (2 214/5 991) vs. 23.7% (1 324/5 591), 61.1% (3 662/5 991) vs. 30.7% (1 714/5 591), χ2=326.77 and 1 358.05, both P<0.001). Using Fenton 2013 as a reference, IG-21 demonstrated superior diagnostic value and consistency in identifying cross-sectional EUGR compared with longitudinal EUGR (sensitivity of 100.0% (3 377/3 377) vs. 99.6% (1 922/1 929), specificity of 59.8% (1 324/2 214) vs. 46.6% (1 707/3 662), positive predictive value of 79.1% (3 377/4 267) vs. 49.6% (1 922/3 877), negative predictive value of 100.0% (1 324/1 324) vs. 99.6% (1 707/1 714), accuracy of 84.1% (4 701/5 591) vs. 64.9% (3 629/5 591), and Kappa 0.64 vs. 0.37, all P<0.001). In multivariate Logistic regression models, risk factors common to EUGR across both standards included smaller GA at birth, lower birth weight, boy, early-onset sepsis, late-onset sepsis and the elder age at full enteral feeding (all P<0.05). Hemodynamically significant patent ductus arteriosus remained an independent risk factor for longitudinal EUGR regardless of whether by the Fenton 2013 or IG-21 standard (adjust odds ratio (aOR)=1.25 and 1.27, 95%CI 1.09-1.42 and 1.11-1.45). In addition, under the IG-21 standard, severe bronchopulmonary dysplasia was an independent risk factor for cross-sectional EUGR (aOR=1.54, 95%CI 1.00-2.38), while severe necrotizing enterocolitis was an independent risk factor for longitudinal EUGR (aOR=2.18, 95%CI 1.01-4.73). Conclusions: IG-21 showed lower detection rates of both cross-sectional and longitudinal EUGR than Fenton 2013, suggesting greater clinical applicability of IG-21 by reducing overdiagnosis while maintaining sensitivity for predicting complications. Across both standards, cross-sectional EUGR facilitates early identification of growth restriction, whereas longitudinal EUGR better tracks dynamic growth patterns and complications of preterm infants.