Dysphagia increases the risks of mortality and palindromia post stroke, and influences the rehabilitation and quality of life. All the patients with stroke need a set of clinical screening, and those positive would accept comprehensive evaluation, both bedside and lab-oratory. Many approaches have been used for dysphagic rehabilitation, but it is not clear what the best is.

Objective To examine the cognitive function in healthy first-degree relatives (FDRs) of patients with bipolar Ⅰ disorder.Methods Cognitive function were studied in one hundred twenty healthy FDRs of patients with bipolar Ⅰ disorder and one hundred normal controls using digital symbol, digital span, visual reproduction, trail making test A (TMT-A) and trail making test B (TMT-B).Results Compared with normal controls, FDRs showed impairment in all indexes of the tests, including digital symbol, digital span (forward, reversed and forward + reversed), visual reproduction, TMT-A and TMT-B (t=-3.44、-4.23、-4.32、-4.98、-2.59、4.32、3.78, respectively, Ps≤0.01).By analysis of covariance (covariant: age and years of education), FDRs were still impaired in these indexes (P<0.05).Compared with sex-matched normal controls, male FDRs showed impairment in all indexes of the tests, but female FDRs only showed impairment in digital span (reversed, forward + reversed), TMT-A and TMT-B (P<0.05).Conclusions Attention, memory and executive function are impaired in healthy first-degree relatives of patients with bipolar Ⅰ disorder.

OBJECTlVE To study the anti-HBV activity of prepared recombinant human serum aIbu-min-interferon α-2b fusion protein(HSA-IFNα-2b) in vitro. METHODS HepG2 ceIIs were infected with recombinant adenovirus with green fIuorescence protein and 1.6-foId HBV DNA(AdGFP-HBV). The ex-pression of HBV antigens,HBsAg and HBeAg in cuIture medium was detected by ELISA assay. The tox-icity of HSA-IFNα-2b on HepG2 ceIIs was evaIuated by mTT assay.The reIative expression of HBV RNA in ceIIs and the absoIute quantity of HBV DNA in cuIture supernatant were determined by quantitative PCR assay. The activity of HBV enhancer Ⅰ was detected by DuaI-Reporter gene assay. RESULTS HBV couId repIicate and express in HepG2 ceIIs after infection with AdGFP-HBV. The expression of HBsAg and HBeAg in cuIture serum of HepG2 ceIIs infected with AdGFP-HBV decreased by 51.32%(P﹤0.01)and 50.26%(P﹤0.01),respectiveIy,when HSA-IFNα-2b 500 kU·L-1 was added. The same concentration of HSA-IFNα-2b didn't inhibit the proIiferation of HepG2 ceIIs,but inhibited HBsAg in a concentration-dependent manner. The regression formuIa between HBsAg inhibitory rate(Y)and con-centration of HSA-IFNα-2b(X)was Y=21.11 IgX+11.91(r 2 = 0.954),IC50 = 63.76 kU·L-1 . HBV RNA in ceIIs and HBV DNA in the cuIture serum decreased by 52.83%(P﹤0.01)and 53.07%(P﹤0.01), respectiveIy,when HSA-IFNα-2b 500 kU·L-1 was added. The activity of enhancer Ⅰ decreased by 40.04%(P﹤0.01)when HSA-IFNα-2b 500 kU·L-1 was added. CONCLUSlON The ceII modeI of HBV repIication for evaIuating anti-HBV agents is successfuIIy estabIished. HSA-IFNα-2b exhibits noticeabIe anti-HBV effect invitro.

Objective To investigate the transfer rate of alkaloids in extraction and purification process of Cortex Phellodendri Amurensis (CPA) and to ascertain the optimal purification technology.Methods We purified the alkaloids from Cortex Phellodendri Amurensis by AB-8 macroporous resin.With the contents of berberine hydrochloride and palmatine hydrochloride as the reference indexes,content determination of alcohol extract,sample solution and eluent from AB-8 macroporous resin were determined by HPLC.Results The optimal technology was as follows:using 8-fold 75 %(V/V) ethanol as extract,extracting for 3 times and lasting one hour for each time.The transfer rate of alkaloids was 83.75 %under the above condition.The transfer rate of alkaloids was about 80 %when the concentration of sample solution(pH value being 8 and centrifugation) was 0.1 g/mL,and the transfer rate of alkaloids in eluent was 75.14 %.Conclusion The optimum technology is stable and feasible,and the purification effect of alkaloids from Cortex Phellodendri Amurensis by AB-8 macroporus resin is good.

Objective:To analyze the monitoring results of iodine deficiency disorders (IDD) in Hainan Province from 2011 to 2023, key prevention and control measures taken during this period, and the impact of related events on the monitoring results.Methods:From 2011 to 2023, a systematic sampling method was used to divide 21 cities (districts, counties) in Hainan Province into 5 districts based on east, west, south, north, and center each year. One township (street) was selected from each district, and 40 children aged 8 - 10 (non boarding students) and 20 pregnant women were selected from each township (street) for determination of iodine level of their household salt and urine samples. Based on the monitoring results, the impact of key events such as the pre reduction (2011), post reduction (implementation of new iodized salt standard, 2012 - 2023), salt industry system reform (2017), and the two-year campaign for endemic disease prevention and control (2019, 2000), on the salt iodine coverage rate and qualified iodized salt consumption rate, the urinary iodine level and its distribution in children and pregnant women were analyzed in Hainan Province. B-ultrasound was used to detect the situation of thyroid enlargement was analyzed.Results:(1) In 2011, the median iodine level in edible salt of residents in Hainan Province was 32.1 mg/kg. It was 30.8 mg/kg after the implementation of the new standard in 2012. In 2013, the salt iodine level of residents had significantly decreased to 25.9 mg/kg, with 24.5, 24.2, and 23.8 mg/kg in 2017, 2019, and 2020, respectively. The differences of median salt iodine levels between different years were statistically significant ( H = 29.01, P < 0.001). The coverage rate of iodized salt among residents in Hainan Province from 2011 to 2023 was 98.08% (80 727/82 308), and the difference between different years was statistically significant (χ 2 = 9.51, P = 0.023). The consumption rate of qualified iodized salt was 95.65% (78 738/82 308), and the difference between different years was statistically significant (χ 2 = 21.80, P < 0.001). (2) The median urinary iodine level of children from 2011 to 2023 was 177.5 μg/L, with a median of 204.2 μg/L in 2011. After the implementation of the new standard, the median urinary iodine level of children was 194.9 μg/L in 2012. In 2013, the median urinary iodine level in children decreased to 167.8 μg/L, and had remained within the range of 100 - < 200 μg/L thereafter. In 2017, 2019, and 2020, the median urinary iodine levels were 170.4, 172.8, and 186.3 μg/L, respectively. There was no statistically significant difference in different years ( H = 1.67, P = 0.061). The proportion of children with urinary iodine < 100 μg/L from 2011 to 2023 was 16.29% (8 740/53 634), and the proportion of children with urinary iodine between 100 and < 200 μg/L was 43.96% (23 575/53 634). The differences between different years were statistically significant (χ 2 = 21.50, 23.40, P < 0.001). The childhood goiter rate from 2011 to 2023 was 0.19% (101/53 634). (3) The median urinary iodine level of pregnant women was 153 μg/L in 2011, it was 154.7 μg/L in 2012 after the implementation of the new standard, and it had remained within the range of 100 - < 150 μg/L since then. The median urinary iodine level of pregnant women was 126.2 μg/L in 2013. The median urinary iodine level in 2017, 2019 and 2020 were 123.5, 133.8, and 135.4 μg/L, respectively. There was a statistically significant difference in the median urinary iodine levels of pregnant women between different years ( H = 92.10, P < 0.001). From 2011 to 2023, the proportion of pregnant women with a median urinary iodine level < 150 μg/L was the highest (55.75%, 14 761/26 477). Conclusion:From 2011 to 2023, although the monitoring results of iodine deficiency disorders in children and pregnant women in Hainan Province have fluctuated, they are still in a state of continuous elimination of IDD.

Objective To explore the application status and development trend of machine learning in the field of pharmacovigilance worldwide,and to provide reference for the research on the application of machine learning in the field of pharmacovigilance.Methods Relevant literature was searched in the Web of Science with the key words of"machine learning"and"pharmacovigilance"from the inception to March 1,2023.R language and other software were used to quantitatively analyze the literature data in this field.The clustering,co-occurrence and emergence visual analysis were carried out on the characteristics of annual published papers,institutions,countries,keywords and other aspects.Results A total of 904 literature were included.The number of literature published showed a fluctuating upward trend since 1994.There was cross-regional,cross-regional and cross-agency cooperation among the cooperative network institutions.The top 5 countries in the number of publications were the United States,China,Japan,South Korea and India,China and the United States had relatively close cooperation in this field.Signal detection,social media and electronic health records were high-frequency keywords in this field.Clustering and association rule analysis showed that this field focused on three aspects signal recognition,unstructured text mining and analysis,and processing and analysis of electronic medical information.At present,machine learning has made significant progress in signal recognition,social media information mining,and unstructured text processing of electronic medical information,which broaden the data sources of pharmacovigilance,improve the real-time monitoring ability of adverse drug reactions,bringing innovation impetus to the field of pharmacovigilance.Conclusion The rapid development of big data and artificial intelligence technologies has led to an increasing integration of machine learning into the field of pharmacovigilance,which promotes technical exchanges and cooperation and cross-disciplinary integration.It is necessary to optimize each machine learning algorithm to improve its accuracy and stability in pharmacovigilance,strengthen the protection measures of data privacy and security to ensure the safety of patient information.Integrating expertise in the fields of science,medicine,and data statistics with a view to promoting technological progress in the field of pharmacovigilance.

Objective: To explore the effect of PDCA nursing model combined with token reward on the compliance and negative emotions of children with hypospadias. Methods: A total of 120 children with hypospadias who were admitted to Children′s hospital affiliated to Zhengzhou University from February 2017 to December 2017 were selected as study subjects. According to the time of admission, they were divided into observation group and control group, with 60 cases in each group. The control group was given routine nursing care, the observation group was given PDCA nursing mode combined with token rewards intervention on the basis of routine care. The self-made children's behavioral compliance assessment table was used to compare the compliance of the two groups of children. Achenbach Child Behavior Check List (CBCL) scores were performed before and after the intervention. The hospitalization time and the incidence of complications were calculated. Results: There was no significant difference in CBCL scores between the two groups at admission (t=0.965, P=0.102). The scores of compliance and CBCL scores of the observation group were (43.12±3.99) points and (17.62±7.30) points respectively, the scores of control group were (30.67±4.53), (24.23±6.67), the difference was statistically significant (t=15.977, 5.184, P<0.01). The hospitalization time and complication rate of the observation group were (18.73±0.84)d, 15.00% (9/60), which were significantly lower than (20.92±1.90) d, 31.67% (19/60) of the control group, and the difference was statistically significant (t=8.166, χ²=4.658, P<0.01 or 0.05). Conclusions The PDCA nursing model combined with token reward can improve the compliance of children with hypospadias and improve their negative emotions.

With the rapid progress of exploration of basic and clinical gastroenterology, the understanding of gut-brain axis, interaction of metabolism-neuroimmunity-intestinal microecology leading to gastrointestinal inflammation and regulatory mechanism of enteric nervous system had significantly changed the recognition of definition, clinical manifestation, diagnosis and management of gastroparesis. In this article, the implications of these changes for the clinical practice of gastroparesis were reviewed and prospected.

OBJECTIVE To mine the risk sig nals o f iodine contrast media from spontaneous reporting system. METHODS Reporting odds ratio ，proportional reporting ratio ，Medicines and Healthcare Products Regulatory Agency and Bayesian confidence propagation neural network were used to mine risk signals of 5 iodine contrast media （iopamidol，iohexol，iopromide，ioversol， iodixanol）. RESULTS 1 164（2 446 case times ）adverse drug reaction of iodine contrast media were included ，a total of 14 risk signals involving systems/organs such as respiratory system （3，2，4，3，2 for the above 5 iodine contrast media ）and immune system and 32 specific adverse drug reaction signals including anaphylactic shock ，rash and flushing （11，7，7，3，4 for the above 5 iodine contrast media ）were found in 5 iodine contrast media. CONCLUSIONS The risk signals of 5 iodine contrast media verify that there is a certain correlation between these drugs and above adverse drug reactions. It is suggested that before using iodine contrast media in clinic ，it is necessary to pay attention to whether the patient has a history of tumor and combined medication ，evaluate the patient’s renal function ，and give preventive measures such as hydration in advance. When using iodine contrast media ，it is necessary to pay attention to the temperature ，dose and injection rate. And medical staff need to follow up the patient ’s situation in time after using iodine contrast media to avoiding the impact of delayed adverse reactions.

Objective: To evaluate the safety and efficacy of enhanced recovery after surgery (ERAS) in robot-assisted laparoscopic pyeloplasty in pediatric patients. Methods: Sixty pediatric patients of both sexes with hydronephrosis, aged 3-12 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing robot-assisted laparoscopic pyeloplasty from March 2018 to April 2019, were divided into 2 groups using a random number table method: control group (group C, n=28) and ERAS group (n=32). In ERAS group, preoperative ERAS education was carried out, the time of preoperative food and water deprivation was shortened, pediatric patients drank glucose water at 2 h before surgery, anesthetic regimen was optimized, lung protective ventilation and target-directed fluid therapy were performed, and intraoperative warming and multi-mode antiemetic measures were carried out during operation, and multi-mode analgesic measures were taken after operation, and pediatric patients received water and food intake early through the mouth and got out of bed as soon as possible after operation.In group C, the traditional concept was adopted for perioperative management.Immediately after tracheal intubation, at 30 min and 1 and 2 h after establishing pneumoperitoneum, at 5 min after the end of pneumoperitoneum and at 5 min after extubation, the airway peak pressure and tidal volume were recorded, and blood gas analysis was performed.The occurrence of cardiovascular events was recorded during surgery.The postoperative time of extubation, time of first intake, the first postoperative off-bed time, the first flatus time, time of pulling out the ureter and drainage tube, and length of hospital stay were recorded.The Pediatric Anesthesia Emergence Delirium scale was used to assess the agitation during the recovery period.The Faces Pain Scale-Revised scale was used to assess the degree of pain within 72 h after surgery.When Faces Pain Scale-Revised scale score ≥4, fentanyl 0.25 μg/kg was intravenously injected as rescue analgesic.The requirement for rescue analgesia was recorded.The overall complications were evaluated by using Clavin-Dindo grading, and postoperative complications included nausea and vomiting, abdominal distension, abdominal pain, incision infection, abdominal infection, anastomotic leakage, fever, etc. Results: Compared with group C, the preoperative food and water deprivation time was significantly shortened, the time of postoperative extubation was prolonged, the postoperative length of hospital stay, time of first intake, the first postoperative off-bed time, the first flatus time, and time of pulling out the ureter were shortened, airway peak pressure was decreased at 1 and 2 h of pneumoperitoneum, arterial blood lactate concentrations were decreased at each time point of pneumoperitoneum (P<0.05 or 0.01), and no significant change was found in the incidence of postoperative agitation, nausea and vomiting, incision infection, abdominal infection or fever in group ERAS (P>0.05). No intraoperative adverse cardiovascular events were found, and no pediatric patients required rescue analgesia after operation in two groups. Conclusion ERAS can be safely and effectively used for the pediatric patients undergoing robot-assisted laparoscopic pyeloplast.