BACKGROUND: Threatened abortion is a high risk pathological change during gestation. Fetus usually could be protected after the application of all kinds of medical interventions; however, whether the healthy development of the newborn could be assured simultaneously when a new life is protected?Especially the long-term impact on the normal development of the intelligence is an important issue deserving investigation.OBJECTIVE: To investigate the differences of intelligence level between protected fetus after threatened abortion and normal mature fetus, and the influencing factors.DESIGN: A case-controlled observational comparative study introducing children as the subjects.SETTINGS: Psychological department of a normal university; Department of gynecology and pediatrics of a district women and children' s health care hospital.PARTICIPANTS: Totally 170 children(mature and natural delivery after protection) of 5 to 7 years old, whose mothers experienced threatened abortions during gestation, and 182 children born in the same period(normal mature and natural delivery) of 5 to 7 years old, whose mothers did not have threatened abortion history were selected as the subjects. No other factors would affect the intellectual development in the subjects of both groups.INTERVENTIONS: The Chinese Version of Wechsler young children scale of intelligence(C-WYCSI) for children below 6 years old or Wechsler intelligence scale for children-Chinese revision( WISC-CR ) for children no younger than 6 years old were introduced in the individual test performed by trained psychological junior students for every testee.children in both groups [intelligence quotient(IQ) gained in the intelligence of mother on the intellectual development of the children in both groups.was found in the testees, the IQ of all tested children was within the normal dren was sinificantly lower in the threatened abortion group than in the normal were significant interactions between threatened abortion and gender, body mass at birth and the pregnant age of mother, etc.: if the mother experienced threatened abortion, the newborn would be even more easily to suffer from relative low body mass at birth(low body mass fetus accounted for 28% of threatened abortion group, which accounted for about 66% of the total low body mass at birth fetuses in our study); the male newborn would be even more easily to have relative low intellectual development(the difference of IQ between the male children of two groups was significant) (F = 2. 809, P < 0.05). Especially, the negative impact on children' s intellectual development would be even greater if the pregnant woman were older than 35 years old and had threatened abortion experience(the average IQ of 32 tested children was 86).CONCLUSION: Threatened abortion might be a potential innate factor that would affect the intellectual development of the children. For those high-risk individual cases with this kind of experience, early intervention should be prepared as early as possible to create a favorable substantial and culture environment for avoiding the actual occurrence of delayed intelligence.

Objective: To study the right hemisphere function state of NLD children. Methods: Adapting tachistoscopic vision and Benton Revised Visual Retention Test (VRT), three groups involving 20 children each were studied. Results: Under the tachistoscopic vision, NLD children achived poorly in recognition of nonverbal stimulus; and they do worse also in VRT test, with more errors of omission and distortion. Conclusion: Compared with normal children, the function of NLD children's right hemisphere is relatively weaker.

Objective To build experimental animal model of cerebral alveolar echinococcosis disease of sheep,in order to study of human alveolar hydatid disease of the brain.Methods Experiment animal models of ten Xinjiang big-tail sheep were performed by, direct skull puncture,intracerebral inoculation of echinococcus multilocularis.MRI was used to observe the growth status of cerebral alveolar echinococcosis disease of sheep after 8 months,and morphological and pathological characteristics after autopsy were ana-lysed.Results 4 sheep models (40%)were successful built which were confirmed by pathology and MRI.On MRI,4 cases all were single lesion,on T2 WI there was multiple follicles bubbles under the background of low signal in one case,and low signal in other three cases.Under the microscope,a large number of lymphocytes,eosinophils and plasma cells infiltrated the lesion area,around which small blood vessels were blocked and had inflammatory reaction were showed.Conclusion The method using artificial inocula-tion rat alveolar echinococcosis to establish experimental model of cerebral alveolar echinococcosis disease of sheep has the character-istic of feasibility,simplicity and repeatability.

Objective:To compare the efficiency and safety of T knife and Dual knife in endoscopic submucosal dissection (ESD) in the treatment of esophageal lesios.Methods:A total of 59 hospitalized patients with esophageal lesions who underwent ESD in the First Affiliated Hospital of Soochow University from June 2018 to January 2019 were enrolled in the study, and the patients were randomly divided into T knife group ( n=29) and Dual knife group ( n=30). The operation time, resection speed, complete resection rate, and complications of the two groups were compared. Results:There were no significant differences in gender, age and comorbidity between the T knife group and the Dual knife group (all P > 0.05). The operation time of T knife group and Dual knife group was 57.86±24.62 min and 66.28±29.48 min, respectively, and the difference was statistically significant ( t=1.189, P=0.024). The resection speed of the two groups was 22.80±7.31 mm 2/min and 16.20±7.24 mm 2/min, respectively, with significant difference ( t=3.484, P=0.001). The complete resection rate of the two group was 86.2% (25/29) and 86.7% (26/30), respectively, with no significant difference ( χ2 =0.108, P=0.742). There were 2 (6.9%) cases of complications in the T knife group, while 5 (16.7%) cases in the Dual knife group, the incidence of complications was no significant difference ( χ2=0.574, P=0.449). There was no perforation or bleeding in the both groups. Conclusion:In the treatment of esophageal lesions, T knife in ESD has the advantages of short operation time and high resection speed compared with Dual knife, and is worthy of clinical application.

Objective:To investigate the efficacy of different laparoscopic surgeries for gastrointestinal stromal tumors (GIST) of gastric cardia and fundus.Methods:The retrospective cohort study was conducted. The clinicopathological data of 251 patients with GIST of gastric cardia and fundus who underwent laparoscopic radical resection in 14 medical centers, including Guangdong Provincial People′s Hospital et al, from December 2007 to December 2021 were collected. There were 123 males and 128 females, aged 58(24,87)years. Observation indicators: (1) treatment; (2) clinicopathological data of patients undergoing different laparoscopic surgeries; (3) subgroup analysis for special laparoscopic techniques. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test or ANOVA. Measure-ment data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test or Kruskal-Wallis H test. Count data were described as absolute numbers or percentages. Comparison of ordinal data was conducted using the rank sum test. Results:(1) Treatment. Of the 251 patients,202 cases underwent gastric wedge resection, 26 cases underwent special laparoscopic techniques including 10 cases with serotomy and dissection and 16 cases with transluminal gastrectomy, 23 cases underwent structural gastrectomy including 6 cases with total gastrectomy and 17 cases with proximal partial gastrectomy. There were 24 patients had postoperative complications after surgery. (2) Clinicopathological data of patients undergoing different laparoscopic surgeries. The gender (male, female), age, tumor diameter, operation time, volume of intraoperative blood loss, length of incision, time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake, duration of postoperative hospital stay, cases with perioperative complications, cases with mitotic count as ≤5/50 high power field, 6?10/50 high power field, >10/50 high power field, cases be classified as very low risk, low risk, medium risk, high risk according to the National Institutes of Health risk classification, cases with tumor located at fundus and gastric cardia were 93, 109, (59±11)years, 3.50(0.40,10.00)cm, 88.00(25.00,290.00)minutes,20.00(25.00,290.00)mL, 4.00(2.00,12.00)cm, 3.00(1.00,9.00)days, 4.00(1.00,16.00)days, 5.00(1.00,18.00)days, 14, 164, 31, 7, 47, 83, 50, 22, 30, 172 in patients undergoing gastric wedge resection, respectively. The above indicators were 19, 7, (49±14)years, 2.55(0.20,5.00)cm, 101.00(59.00,330.00)minutes, 27.50(2.00,300.00)mL, 4.50(0,6.00)cm, 2.50(1.00,10.00)days, 4.00(1.00,16.00)days, 6.00(1.00,18.00)days, 3, 20, 5, 1, 15, 5, 2, 4, 24, 2 in patients undergoing special laparos-copic techniques, and 11, 12, (52±10)years, 5.00(0.80,10.00)cm, 187.00(80.00,325.00)minutes, 50.00(10.00,300.00)mL, 6.00(4.00,12.00)cm, 4.00(2.00,8.00)days, 6.00(3.00,14.00)days, 8.00(2.00,18.00)days, 7, 11, 5, 7, 2, 6, 6, 9, 13, 10 in patients undergoing structural gastrectomy. There were significant differences in the above indicators among the three groups of patients ( χ2=6.75, F=10.19, H=17.71, 37.50, 35.54, 24.68, 16.09,20.20, 13.76, χ2=13.32, Z=28.98, 32.17, χ2=82.14, P<0.05). (3) Subgroup analysis for special laparoscopic techniques. The time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake, classification of tumor location (endophytic type, exophytic type, parietal type) were 4.50(1.00,10.00)days, 8.00(3.00,12.00)days, 0, 8, 2 in patients undergoing serotomy and dissection, versus 2.00(1.00,4.00)days, 3.00(1.00,6.00)days, 16, 0, 0 in patients undergoing transluminal gastrectomy. There were significant differences in time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake between them ( Z=-2.65, -3.16, P<0.05); and there was a significant difference in classification of tumor location between them ( P<0.05). Conclusions:Gastric wedge resection is the most commonly used laparoscopic technique for GIST of gastric cardia and fundus. The application of special laparoscopic techniques is focused on the GIST of cardia to preserve the function of the cardia.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.