Computer-administered neurobehavioral evaluation system (NES)was developed based on the neurobehavioral core test battery (NCTB)recommended by WHO/NIOSH in 1985. Compared with NCTB,the reliability and validity of NES was much improved and some disadvantages of NCTB were made up in NES. This article reviewed the history of NES development,its application in the evaluation of children's neurobehavioral functions and its defects. The studies suggested that some items of NES test,such as finger tapping,continuous performance test and hand-eye coordination,could be used to evaluate earlier damage induced by chemicals on neurobehavioral functions of children.

Background The Qingcaosha Reservoir is facing issues of algal blooms and eutrophication, and the resulting increase in the level of chlorination disinfection by-products in the water has been a major concern. Objective To evaluate the impact of "Algae Monitoring and Control Program in Qingcaosha Reservoir" (hereinafter referred to as the program) on the control of trihalomethanes (THMs) in conventional finished water. Methods From 2011 to 2019, water samples were collected from the Lujiazui Water Plant once per season, one sample each time, and the concentrations of four THMs (trichloromethane, dichlorobromomethane, monochlorodibromomethane, and tribromomethane) were measured in the samples. Using 2014 when the program was implemented as a cut-off point, the entire study period was divided into two phases: pre-implementation (2011–2013) and post-implementation(2014–2019). Segmented linear regression with interrupted time series analysis was applied to assess the concentrations and trends of THMs in the finished water before and after the program launch. Results The concentration of total THMs in finished water increased by 1.561 µg·L⁻¹ (P=0.010) for each season of time extension before launching the program. The change in the concentration of total THMs in finished water was not statistically significant after the program launch, but the THMs concentration showed a decreasing trend as the slope was −0.626 (P=0.001). From 2017 until the end of 2019, the average concentration of THMs in finished water of Lujiazui Water Plant dropped to 10 μg·L⁻¹ or less. Conclusions The algae and eutrophication control measures in Qingcaosha Reservoir have achieved good results, controlling THMs in finished water at a low level, and the trend of THMs has changed from a yearly increase pattern before the program to a yearly decrease pattern after the program.

Three-way laryngeal mask airway (tLMA) was used in 31 patients aged 4-68 yr, weighing 10- 79 kg undergoing tracheal foreign body removal under general anesthesia. Anesthesia was induced with propofol 3 mg/kg, vecuronium 0.12 mg/kg and remifentanil 0.4 μg/kg. tLMA was inserted. The patients were mechanically ventilated. Anesthesia was maintained with iv infusion of propofol 2 mg . Kg-1 ? H-1, vecuronium 0.08 mg·kg-1·h-1 and remifentanil 0.15 μg·kg-1 ·min-1 . Radial artery was cannulated for BP monitoring and blood sampling. The operation time was 6-34 min and mechanical ventilation time 19-45 min. There was no significant change in SP, DP, HR, VT, Ppeak and Ppeak CO, during operation as compared with the baseline values before anesthesia. SpO2 was significantly increased at T2-6. PCO2, PO2 and O2sat were obviously improved after tLMA was used. All the patients emerged bom anesthesia within 30 min after operation. No aspiration, obvious gastrointestinal inflation, and pharyngeal and laryngeal edema and injury occurred. Mild agitation occurred in a short time during the recovery period in one patient. No complication occurred.

This article reported a case of pyruvate dehydrogenase E1-α deficiency suggested by abnormal brain development during prenatal ultrasound imaging. Prenatal ultrasound revealed a mild enlargement of bilateral cerebral ventricles and the possibility of intracranial hemorrhage in the fetus at 25 +1 weeks of gestation. MRI showed the fetus with absent corpus callosum, enlarged bilateral cerebral ventricles and paraventricular cysts. After genetic counseling and careful consideration, the couple opted for pregnancy termination. To clarify the cause of the disease, whole-exome sequencing was performed on the fetal skin to detect possible variants, and which revealed a frameshift mutation c.924_930dup(p.R311Gfs*5) in exon 10 of the PDHA1 gene. Sanger sequencing confirmed the mutation was a de novo pathogenic variant, indicating that the fetus was affected by pyruvate dehydrogenase E1-α deficiency.

Objective:To explore the application and effect of scenario simulation teaching in ST-segment elevation myocardial infarction (STEMI) course for emergency training of "5+3" professional master.Methods:A randomized controlled trial was conducted among 48 "5+3" professional masters who would rotate in the emergency department, to compare the test results of the total and three scenes between scenario simulation teaching group ( n=24) and traditional teaching group ( n=24). The STEMI teaching was carried out through simulating the emergency room, standardized patients and first-aid simulators in the simulation teaching group, and the traditional teaching group was taught by conventional classroom teaching. After the class, "Theoretical Examination" and "Questionnaire Survey" were used to evaluate the teaching effect. The former was further divided into "first diagnosis and differential diagnosis of chest pain", "fast identification and processing of STEMI" and "rescue of cardiac arrest" for inter-group and intra-group evaluation. SPSS 20.0 was used to conduct t-test. Results:In the theoretical examination, the scenario simulation teaching group was superior to the traditional teaching group in the test of emergency processing for STEMI course [(82.38±2.41) vs . (68.00±1.95), t=4.64, P<0.001]. In the sub-analysis of scenario simulation teaching group, students in the role-play group had significantly higher scores than others in the non-role-play group [(90.50±3.04) vs . (79.67±2.79), t=2.09, P=0.049]. Scenario simulation teaching group was also superior to traditional teaching group in the "Questionnaire Survey". Conclusion:In the training and teaching of STEMI emergency processing, scenario simulation teaching group proves to be superior to traditional teaching, which deserves further promotion.

Objective To evaluate the clinical efficacy and adverse events of intensity-modulated radiotherapy ( IMRT ) in the treatment of intermediate risk localized prostate cancer, and analyze the significance of prostate-specific antigen ( PSA) level changes. Methods Clinical data of 66 patients with intermediate risk localized prostate cancer admitted to our hospital between 2007 and 2018 were retrospectively analyzed. Sixty patients were treated with endocrine therapy before radiotherapy. The radiation field covered the pelvic lymph node drainage area in 6 cases. Forty-seven patients received image-guided radiotherapy ( IGRT) . The median dose in the prostate and seminal vesicle was 78 Gy and 48 Gy in the pelvic lymph node drainage area. The survival rate was calculated using the Kaplan-Meier method. Results The median age was 77 years. The median follow-up time was 71. 3 months. The 5-year sample size was 47. The 3-and 5-year overall survival (OS) was 98％ and 90％.The 3-and 5-year cancer-specific survival (CSS) was 100％ and 93％.The 3-and 5-year biochemical relapse-free survival was 97％ and 86％. The mean time of PSA declining to the nadir was 5. 83 months. The median level of PSA nadir was 0. 06 ng/ml after IMRT. The incidence of grade I andⅡearly adverse events in the urinary system was 38％ and 6％. The incidence of grade I andⅡearly adverse events in the gastrointestinal system was 21％ and 3％. The incidence of grade I andⅡadvanced-stage adverse events in the urinary system was 9％ and 2％. The incidence of grade I advanced-stage adverse events in the gastrointestinal system was 5％. Conclusions IMRT yields high clinical efficacy in the treatment of intermediate risk localized prostate cancer with a low risk of adverse events in the early and advanced stage. The monitoring of PSA after IMRT contributes to the assessment of clinical prognosis.

Background Non-occupational carbon monoxide (CO) poisoning is a public health problem that seriously affect people’s health and lives. Objective To describe the prevalence of non-occupational CO poisoning during 2007—2018 in Shanghai, analyze its epidemiological characteristics and potential influencing factors, and explore effective prevention and control measures. Methods Daily reported non-occupational CO poisoning cases and meteorological factors from 2007 to 2018 were collected in Shanghai, epidemiological characteristics were analyzed by descriptive epidemiology methods, and a distributed lag nonlinear model was used to assess the association between temperature and non-occupational CO poisoning. Results A total of 2264 non-occupational CO poisoning events and 3866 cases from 2007 to 2018 were reported in Shanghai, including 59 death cases. More than half of the poisoning cases were female (56.3%), and young adults accounted for more cases than any other age group (54.8%). The poisoning events mainly occurred in winter (from December to next February); however, cases reported in summer increased in recent years. The peak period of the events was from 20:00 to 24:00. Households (85.2%) and restaurants (8.0%) were the common places of non-occupational CO poisoning events, and the main cause was improper use of gas water heater (36.9%). A nonlinear curve was found between daily average temperature of current day and the occurrence of non-occupational CO poisoning. Temperature was negatively associated with the risk of non-occupational CO poisoning when the temperature was lower than 9.6 ℃, while a positive association was found during 9.7-26.0 ℃. Conclusion Winter is a high season for non-occupational CO poisoning in Shanghai, rising cases reported in summer is also worthy of attention. Supervision should be strengthened to ban sales of unqualified gas water heaters, and health education on CO poisoning prevention and control should be conducted through multiple channels, in order to reduce the incidence of CO poisoning.

Background The substantial health damage attributed to heat waves, along with their increasing intensity and frequency in the context of global warming, highlights the importance of exploring the health effects of heat waves. Objective To calculate the excess heat stroke cases during heat waves in the summer of 2013—2023 in Shanghai, analyze the association between heat waves and heat stroke, and to further explore the modifying effects of heat wave characteristics on heat stroke. Methods Using a retrospective ecological study design, data on heat stroke cases were collected from the heat stroke case reporting system of the Chinese Center for Disease Control and Prevention, and concurrent meteorological data from Xujiahui Meteorological Station. A heat wave was defined as at least 3 consecutive days with daily maximum temperature meeting or exceeding 35 ℃ in this study, excess heat stroke cases related to heat waves were assessed as the difference between the numbers of heat stroke cases observed on a given day and the corresponding 31 d (15 d before and after that day) moving average, and statistical analyses using generalized linear model based on time series study were performed to assess the impact of heat waves on heat stroke. Results Overall 25 heat waves during the study period were observed, leading to a total of estimated 792.6 extra heat stroke cases. The risk of heat stroke significantly increased during heat waves (RR=2.60, 95%CI: 2.08, 3.26), but no statistically significant differences in heat wave effects were observed among different genders, ages, or regions. In terms of the timing of heat waves, the risk of heat stroke was highest during the first heat wave (RR=3.58, 95%CI: 2.82, 4.55), which was significantly higher than that during the second heat wave (RR=2.19, 95%CI: 1.66, 2.90), and no significant effect was observed during the third or subsequent heat waves. The impact of heat waves on heat stroke persisted for more than 4 d, with the risk higher on the fourth day and beyond (RR=2.95, 95%CI: 2.28, 3.83), significantly higher than on the first day of heat wave (RR=1.74, 95%CI: 1.18, 2.56). Conclusion Heat waves had a substantial effect on heat stroke in Shanghai from 2013 to 2023, and special attention need to be paid to heat waves with early onset and long duration.