Objective To investigate the environmental factors affecting neonatal neurobehavioral development and its sensitivities.Methods Neonatal behavioral neurological assessment (NBNA)and lead levels in umbilical cord blood and meconium were determined for103randomly selected neonates delivered at the section of Obstetrics and Gynecology,First Metallurgical Construction Company Hospital,from January to October1999,and the other relevant factors were investigated by questionnaire at the same time.The NBNB total score was described as a dependent variable and24relevant factors such as umbilical cord blood lead and meconium lead level,etc,as independent variables.Logistic regression analysis was used to ana-lyze the associated factors at P=0.10level.Results The factors selected in the Logistic regression model included:gestational age,month of taking medicine in gestational period,hemoglobin concentration,pregnant womans psychology,meconium lead level and taking medicine during gestational period.Conclusion Neonatal neurobehavioral development could be affected by many factors.Good nutrition,longer gestational age and maintaining good psychological status during pregnancy might be benefi-cial to neonatal neurobehavioral development.However,taking medicine during the gestational period and a high meconium lead level could be harmful to neonatal neurobehavioral development.

BACKGROUND: Logistic analysis of multi-ordered response-variable is used to probe into from another view the interrelationship between lead content in fetus faeces and neurobehavioral development under exposure to low-level lead in uterus.OBJECTIVE: To probe into multi-factors of neurobehavioral development in neonates and the sensibility.DESIGN: The total score of neurobehavior in neonates was taken as dependent variable and 24 indexes were as independent variables, such as induced factors, lead in umbilicus blood and lead in fetus faeces in questionnaire. Logistic progressive regression of multi-ordered response-variables was used in analysis and corresponding factors were screened at level of P=0.10.SETTING: Wuhan University of Science and Technology, Laboratory Room of Occupation Disease and Epidemic disease in Tongji Medical College of Huazhong University of Science and Technology and Occupation Hospital of China First Metallurgical Construction General Company.PARTICIPANTS: Totally 103 full-month borne and healthy neonates were randomized in Department of Gynecology of one occupation hospital in Qingshan District of New-type Industry Area of Huanhan City from January to October 1999 as the objects. The relatives agreed with topic research and questionnaire investigation and they provided neonatal faeces and received neonatal tests on time.off the umbilicus and preserved in freezing in refrigerator at -4 ℃. The faeces in 24 hours after birth was collected and the lead contents of umbilicus blood and faeces were assayed with graphite furnace atomic absorpBehavioral Neurological Assessment (NBNA) was used in examination on the 3rd day after delivery. Simultaneously, the self-designed questionnaire was adopted in the investigation for parturients. The questionnaire involved other possible factors of neonatal neurobehavioral development, including dependent variables, concerning to states of family, society, environment and health that affected neurological development in neonates and lead contents in umbilicus blood and faeces. Scores of neonatal neurobehavior were taken as response variables. Finally, the corresponding factors were screened.MAIN OUTCOME MEASURES: To screen the factors of neurobehavioral development of neonates.RESULTS: Totally 103 cases entered result analysis. Six factors were selected in the model, named pregnant weeks, the month of drug administration in pregnancy, hemoglobin, emotions in pregnancy, lead level in fetus faeces and drug administration.CONCLUSION: Neonatal neurobehavioral development was related to multiple factors. Good nutrient in pregnancy, long pregnant weeks and good emotions in pregnancy benefit neurobehavioral development of neonates. Drug administration during pregnancy is disadvantageous in neonatal neurobehavioral development, especially the medication at the early phase of pregnancy. The increased lead content in neonatal faeces does not benefit neonatal neurobehavioral development.

Objective:To study the learning curve in laparoscopic left lateral hepatic sectionectomy.Methods:The clinical data of 62 consecutive patients who underwent left lateral hepatic sectionectomy by a single operator from February 2015 to May 2022 in General Hospital of Northern Theater Command were retrospectively analyzed. There were 22 males and 40 females, with mean ±s.d. of (50.7±11.7) years. The learning curve was depicted and evaluated by using the cumulative summation test. The general information, operation and postoperative indicators of the growth level group and the master level group were compared.Results:The average operation time of the 62 consecutive subjects was (172.9±70.1) minutes. Intraoperative blood loss was 100 (50, 200) ml. Two patients were converted to open hepatectomy. Clavien-Dindo grade I postoperative complications occurred in 20 patients (32.3%), with grade Ⅱ in 1 patient (1.6%) and grade Ⅲb in another patient (1.6%). The learning curve reached its highest point on the 20th patient by using the cumulative summation test. The study subjects were then assigned into the growth level group (patient 1-20) and the master level group (patient 21-62). The master level group had a significantly wider spread of patient age [(52.9±11.0) years vs (46.1±11.9) years], decreased operation time [(146.8±55.6) min vs (227.9±66.7) min], shortened drainage tube removal time [4(3, 5) d vs 6(4, 7) d] and decreased postoperative hospital stay [5(5, 7) d vs 6.5(4, 9) d] (all P<0.05) when compared with the growth level group. Conclusion:Left lateral hepatic sectionectomy was safe and feasible, and a single operator went through a learning curve of 20 patients before he/she could master the operation more proficiently.