Objective:To assess the level of phrases and sentences development of health toddlers in urban Beijing and to identify the characteristics of toddlers' grammar. Methods:This is a quantitative Cross-sectional Study. Using Chinese Communicative Development Inventory mandarin version (CCDI), a questionnaire survey was conducted among the parents or care givers of 1056 toddlers(16~30months), randomly stratified selected in two urban districts of Beijing. Results:The scores of phrases and sentences development both in girls and boys increase very quickly like a line. Toddlers of 16 months can speak five kinds of phrases and sentences, toddlers of 24 months can speak sixty seven kinds, toddlers of 30 months can speak ninety one kinds, which account for 90% of the whole phrases and sentences scores of the inventory. The younger the toddlers are and the bigger the differences of the score of phrases and sentences between the individuals are. Conclusion:The stages of age before 23 months in girls and before 25 months in boys are key and quick ones of toddlers' phrases and sentences develop. The phrases and sentences development of toddlers shows bigger differences between individuals.

Standardized training program for residents in Shanghai is one of the important measures in the health care reform.In accordance with Implementary methods of standardized training for residents in shanghai (for trial implementation),the department of stomatology in the affiliated Changzheng Hospital quickly initialized the standardized training program by defining the training objectives,establishing the training mechanisms,formulating the training contents and building the system of the assessment.Special attention was paid to improve the professional skill of the residents including ① clinical diagnostic ability; ② medical theoretical level and the medical thinking ability; ③ interpersonal communicational skill; ④ professionalism; ⑤ scientific research ability.Useful exploration was made to test the feasibility of the training program based on the practices and the effect was encouraging.

OBJECTIVE:To investigate characteristics and regularity of ADR induced by antineoplastic drugs and provide ref-erence for the safe drug use. METHODS:7 417 ADR reports induced by antineoplastic drugs from 91 hospitals from 2009 to 2013 were collected in the ADR monitoring center of PLA. According to the classification in national ADR monitoring cencer,Excel soft-ware was performed to statistically analyze the data. RESULTS:Among 7 417 ADR reports,1 475 were severe ADR(19.89%), 196 were the new and general ADR(2.64%),and 44 were new and severe ADR(0.59%);the elderly patients aged from 45-59 years accounted for the highest proportion (41.01%);intravenous administration was the main administration route causing ADR (88.96%);the incidence of antineoplastic drugs was higher in plant-derived drugs(26.55%),platinum drugs(24.86%)and an-ti-metabolism drugs (19.46%);ADR mostly manifested as lesions of digestive system (38.80%),blood system (16.53%) and general system(12.79%);43.60%ADR occurred within 12 hours after administration. CONCLUSIONS:Highly poisonous,nar-row-range security antineoplastic drugs could easily induce ADR. Risk prevention of antineoplastic drugs should be strengthened to undertake monitoring for high-risk patients and antineoplastic drugs,and severe ADR. More attention should be attached to the reac-tions after 12 h administration to reduce ADR incidence as much as possible.

Objective To investigate the induction factors of hypotension during cesarean sec-tion for perilous placenta previa under combined spinal-epidural anesthesia(CSEA)and to construct a nomogram prediction model.Methods A total of 130 parturients who underwent cesarean section for perilous placenta previa under CSEA from January 2020 to December 2023 in Yulin Maternity and Child Healthcare Hospital were selected as study subjects.A self-designed general information ques-tionnaire was used to investigate the basic information and the occurrence of hypotension of the sub-jects.According to the occurrence of intraoperative hypotension,the patients were divided into hypo-tension group(47 cases)and non-hypotension group(83 cases).Univariate analysis was performed on the general information of the two groups,and multivariate Logistic regression analysis was used to explore the induction factors of intraoperative hypotension.Results Univariate analysis showed that there were statistically significant differences in body mass index,anesthesia level,presence of multiple pregnancy,preoperative systolic blood pressure,operative time,and the occurrence of Bezold-Ja-risch reflex between the two groups(P＜0.05).Multivariate Logistic regression analysis revealed that body mass index ≥ 24 kg/m2,anesthesia level was in the eighth thoracic vertebra(T8)or a-bove,multiple pregnancy,preoperative systolic blood pressure＜90 mmHg,operative time＞1.5 h,and the occurrence of Bezold-Jarisch reflex were independent risk factors for hypotension during ce-sarean section for perilous placenta previa under CSEA(P＜0.05).A regression equation for the induction factors of hypotension during cesarean section for perilous placenta previa under CSEA was constructed:Logit(P)=-23.211+1.079 ×(body mass index≥24 kg/m2)+1.101 × anesthesia level(≥T8)+3.193 x multiple pregnancy+2.214 x preoperative systolic blood pressure(＜90 mmHg)+4.606 × operative time(＞1.5 h)+2.011 × occurrence of Bezold-Jarisch reflex.The nomogram showed high discrimination and accuracy for patients with preoperative systolic blood pres-sure＜90 mmHg.After 1,000 times of Bootstrap resampling for the nomogram model,a calibration curve was obtained,and the consistency index was calculated as 0.850,indicating good calibration of the nomogram model.The receiver operating characteristic(ROC)curve was plotted,with an ar-ea under the curve of 0.896 and 95％confidence interval of 0.802 to 0.956,suggesting good pre-dictive performance.Conclusion Body mass index ≥24 kg/m2,anesthesia level ≥ T8,multiple pregnancy,preoperative systolic blood pressure＜90 mmHg,operative time＞1.5 h,and the oc-currence of Bezold-Jarisch reflex are induction factors for hypotension during cesarean section for perilous placenta previa under CSEA.

Objective To investigate the induction factors of hypotension during cesarean sec-tion for perilous placenta previa under combined spinal-epidural anesthesia(CSEA)and to construct a nomogram prediction model.Methods A total of 130 parturients who underwent cesarean section for perilous placenta previa under CSEA from January 2020 to December 2023 in Yulin Maternity and Child Healthcare Hospital were selected as study subjects.A self-designed general information ques-tionnaire was used to investigate the basic information and the occurrence of hypotension of the sub-jects.According to the occurrence of intraoperative hypotension,the patients were divided into hypo-tension group(47 cases)and non-hypotension group(83 cases).Univariate analysis was performed on the general information of the two groups,and multivariate Logistic regression analysis was used to explore the induction factors of intraoperative hypotension.Results Univariate analysis showed that there were statistically significant differences in body mass index,anesthesia level,presence of multiple pregnancy,preoperative systolic blood pressure,operative time,and the occurrence of Bezold-Ja-risch reflex between the two groups(P＜0.05).Multivariate Logistic regression analysis revealed that body mass index ≥ 24 kg/m2,anesthesia level was in the eighth thoracic vertebra(T8)or a-bove,multiple pregnancy,preoperative systolic blood pressure＜90 mmHg,operative time＞1.5 h,and the occurrence of Bezold-Jarisch reflex were independent risk factors for hypotension during ce-sarean section for perilous placenta previa under CSEA(P＜0.05).A regression equation for the induction factors of hypotension during cesarean section for perilous placenta previa under CSEA was constructed:Logit(P)=-23.211+1.079 ×(body mass index≥24 kg/m2)+1.101 × anesthesia level(≥T8)+3.193 x multiple pregnancy+2.214 x preoperative systolic blood pressure(＜90 mmHg)+4.606 × operative time(＞1.5 h)+2.011 × occurrence of Bezold-Jarisch reflex.The nomogram showed high discrimination and accuracy for patients with preoperative systolic blood pres-sure＜90 mmHg.After 1,000 times of Bootstrap resampling for the nomogram model,a calibration curve was obtained,and the consistency index was calculated as 0.850,indicating good calibration of the nomogram model.The receiver operating characteristic(ROC)curve was plotted,with an ar-ea under the curve of 0.896 and 95％confidence interval of 0.802 to 0.956,suggesting good pre-dictive performance.Conclusion Body mass index ≥24 kg/m2,anesthesia level ≥ T8,multiple pregnancy,preoperative systolic blood pressure＜90 mmHg,operative time＞1.5 h,and the oc-currence of Bezold-Jarisch reflex are induction factors for hypotension during cesarean section for perilous placenta previa under CSEA.

Objective:To analyze and compare the differentially expressed genes (DEGs) of Yes-associated protein (YAP)-positive and negative hepatocytes and further understand the preliminary functional characteristics of YAP-positive hepatocytes in an early mouse model of nonalcoholic steatohepatitis (NASH) with transcriptome sequence (RNA-Seq).Methods:C57BL/6 mice were fed with methionine-choline deficiency (MCD) diet for 2 weeks to establish an early NASH model, and the control group was fed with normal diet. Liver tissue was stained with hematoxylin-eosin (HE) and Sirius red, and the pathological score was recorded. The expression of YAP and P-YAP were determined by immunohistochemistry (IHC) in liver tissues. Primary hepatocytes with viability greater than 90% were isolated and purified by collagenase perfusion combined with Percoll density gradient centrifugation. YAP-positive and negative hepatocytes were assessed by YAP antibody, flow cytometry and RNA-Seq analyses. Sequencing results were screened by GO, KEGG and interaction network analysis methods. RT-PCR was used to verify the expression levels of YAP and some DEGs in liver tissue model group. Two samples mean was compared by independent samples t-test. Results:Compared with the control group, the HE-stained liver tissue of MCD-induced mice at 2 weeks showed steatosis (pathological score 1.07±0.21), accompanied by lobular inflammation (pathological score 1.13±0.32) and ballooned hepatocyte (pathological score 0.80) ±0.20). Sirius red staining showed non-significant liver fibrosis (pathological score 0.40±0.40). IHC showed partial YAP-positive hepatocytes expression in an early stage of NASH. RNA-Seq analysis showed that clean reads of YAP-positive and negative hepatocytes were 49 310 604 and 5 4820 036, respectively. Compared with YAP-negative hepatocytes, YAP-positive hepatocytes had differential expression of 5 565 genes, including 1 662 up-regulated genes and 3 903 down-regulated genes. GO analysis of up-regulated genes showed that the metabolic processes related to mitochondrial functions, such as purine nucleoside triphosphate and nucleoside triphosphate were significantly enriched in biological processes (BP), while down-regulated gene analysis showed that olfactory-related receptor were significantly enriched in BP. KEGG analysis showed that DEGs were enriched in 292 pathways, and oxidative phosphorylation (OXPHOS) pathway was significantly enriched in signaling pathway. RT-PCR validated that inflammatory factors (interleukin-1β, interleukin-6), YAP and its target genes (Cyr61, Ankrd1), and Cox5b and Sdhc genes were significantly up-regulated in the OXPHOS pathway, which was consistent with the sequencing results. In addition, eight key genes with interaction network analysis were predicted.Conclusion:Changes in hepatocyte metabolic levels may be associated with increased YAP activity in an early stage of NASH.