Objective To explore the psychomotor development in 12 month old infants born after in vitro fertilization with a control group of infants concieved naturally.Methods A matched control study was performed on psychomotor development of 12-month-old infants concieved with use of assisted reproductive technology(in vitro fertilization only).The control group was matched according to maternal age,parity,social class and level of parental education.The suitable mothers were invited to participate at the 28th week of gestation and were followed up to delivery.The infants of the two groups were followed up to 12 months old and a formal developmental assessment was done with the Children Development Center of China(CDCC) scales of infant development.Results The incidences of preterm birth,low birth weight and twin pregnancy were significantly higher in the assisted conception group.No statistically significant difference was found in the mental development index and psychomotor development index between assisted conception and control groups.Conclusions The levels of psychomotor development in 12 months old infants born after in vitro fertilization are normal.But as the incidences of preterm birth,low birth weight and multifetation are significantly higher in vitro fertilization group,it need to follow up the ongoing development of these children.

Objective: To investigate the developmental toxicity of 2,4-dinitrochlorobenzene in zebrafish embryos. Methods: AB wild-type male and female zebrafish were selected to mate and spawn, then the eggs were cultured with Holt buffer solution. Six dose groups ( 0.4, 0.8, 1.0, 1.2, 1.6, 2.0 μg/mL ), a solvent control group and a cosolvent control group, were set up with 20 embryos each. Malformations and death of embryos were observed at 48, 72 and 96 hpf ( hours post fertilization ), the mortality and 50% lethal concentration ( LC50 ) were also calculated. Results: At 48, 72 and 96 hpf, the LC50 of 2,4-dinitrochlorobenzene on zebrafish embryos were 1.668, 1.043 and 0.895 μg/mL, respectively, with a downward trend. After 72 hpf, when the concentration reached 2.0 μg/mL, all the zebrafish died. In the range of 0.4-2.0 μg/mL, the mortality of zebrafish at 48, 72 and 96 hpf increased with the increase of 2,4-dinitrochlorobenzene concentration ( all P<0.05 ); the malformation rate of zebrafish embryos at 48 hpf increased with the increase of 2,4-dinitrochlorobenzene concentration ( P<0.05 ). Zebrafish embryos exposed to 2,4-dinitrochlorobenzene led to yolk sac edema, pericardial edema and spinal curvature. Conclusion 2,4-dinitrochlorobenzene can affect the development of zebrafish embryos, which will lead to lethal and teratogenic effects.

Objective:To explore the seizure recurrence and prognosis of epilepsy in relapse after anti-epileptic drugs (AEDs) withdrawal, and the influencing factors for these conditions.Methods:From December 2009 to August 2018, patients from the Affiliated Brain Hospital of Nanjing Medical University who relapsed after AEDs withdrawal were collected and followed up for at least 18 months. The seizure recurrence and prognosis of these patients were prospectively observed. The Kaplan-Meier method was used for survival analysis. The associated risk factors of the second relapse in the enrolled patients were analyzed by multivariate Cox analysis. The included patients were divided into good prognosis group and poor prognosis group according to whether they had achieved seizure freedom for at least one year after the first relapse. A multivariate Cox regression model was used to analyze the independent risk factors affecting their prognosis.Results:A total of 56 patients with epilepsy in relapse after AEDS withdrawal were collected. The average follow-up period was 46.23 months (18-120 months) from the initial time of seizure recurrence, and 21 patients (37.5%) had the second seizure recurrence. The relapsing risk in patients who continued to be observed without adding AEDs was higher than those who were treated immediately with drugs [9/16 vs 30.0% (12/40)], but without statistically significant difference (χ2=2.220, P=0.071). The results of univariate analysis showed that focal seizures, seizure frequency more than once per month before remission and poly-drug therapy before AEDs withdrawal were associated with high risk of the second relapse. Poly-drug therapy was an independent risk factor for the second relapse by multivariate Cox analysis ( HR=3.383, 95% CI 1.257-9.105). Of the 56 patients with epilepsy in relapse after AEDs withdrawal, 47 patients (83.9%) had a good prognosis without seizure for at least one year, and of 33 patients who were followed up for three years or more, 26 (78.8%) had no seizure for at least two years. Between the group retreated immediately after the first recurrence and the group without immediate treatment [87.5% (35/40) vs 12/16],there were no statistically significant differences on the proportions of good prognosis (χ2=2.333, P=0.258). Univariate analysis showed that the course of epilepsy>6 months before initial treatment, the frequency of seizures>1/month before remission, symptomatic epilepsy and poly-drug therapy were associated with the poor prognosis. However, none of independent risk factors was found for the poor prognosis through the multivariate analysis. Conclusions:The prognosis of patients with epilepsy in relapse after AEDs withdrawal is well, and about 2/3 patients with epilepsy in relapse after AEDs withdrawal have no more seizure recurrences. The poly-drug therapy before AEDs withdrawal may be an independent risk factor for the second seizure relapse.

Objective:To compare the accuracy and timeliness of 3-lead electrocardiography (ECG) and pulse oximetry (POX) in neonatal heart rate (HR) monitoring after birth.Methods:This prospective study recruited 42 high-risk newborns with gestational age ≥37 weeks and birth weight >1 500 g who were born through cesarean section without resuscitation requirement in Xi'an People's Hospital (Xi'an Fourth Hospital) from October 2019 to August 2020. 3-lead ECG electrodes and POX sensors were attached to the neonates immediately after drying to continuously monitor the HR within 10 min after birth. All procedure was recorded by video camera, and data were independently analyzed by a clinician after the procedure was completed. Differences in time required to connect the devices, time to obtain a reliable HR and the interval between them, the time needed for obtaining a reliable HR after birth, the proportion of neonates with reliable HR obtained within 5 min after birth and the consistency in the reliable HR readings between the two devices were compared using Wilcoxon signed-rank test, McNemar test, Spearman's correlation coefficient, intraclass correlation coefficient or Bland-Altman bias analysis.Results:The median time required to connect POX and 3-lead ECG and to acquire a reliable HR were 13.0 s (10.0-17.0 s) vs 23.0 s (18.0-28.3 s) ( Z=-5.050, P<0.001), and 79.5 s (56.2-128.0 s) vs 11.0 s (10.0-13.3 s) ( Z=-5.646, P<0.001), respectively. The total time from the beginning of connecting the devices and birth to acquiring a reliable HR were both longer for POX than those for 3-lead ECG [92.0 s (71.3-139.0 s) vs 35.0 s (30.0-39.5 s), Z=-5.579, P<0.001; 110.5 s (85.8-153.5 s) vs 52.0 s (45.0-66.3 s), Z=-5.579, P<0.001]. Reliable HRs were obtained in 69.1% (29/42) and 2.4% (1/42) of the infants by 3-lead ECG and POX within 1 min after birth, respectively. The percentage of infants for obtaining a reliable HR detected by 3-lead ECG within 5 min after birth were more than those by POX, but with statistically significant differences only at the first 60 s, 90 s, 120 s and 150 s (all P<0.001). The median HRs obtained by 3-lead ECG and POX within 10 min after birth were 161 beats/min (147-175 beats/min) and 160 beats/min (146-176 beats/min), respectively ( r=0.966, P<0.001). The mean difference of HR detected by the two devices was 0.56 beats/min (95% CI:-4.3 to 5.4 beats/min). The intraclass correlation coefficient was 0.961, showing good internal consistency. Conclusions:Neonatal HR can be assessed accurately by 3-lead ECG within 1 min after birth, which is far earlier than that by POX. Therefore, 3-lead ECG can be an option for continuously HR monitor in neonatal resuscitation.

In this paper, we described basic connotations of comparative effectiveness research (CER), expounded the application of CER in chronic obstructive pulmonary disease (COPD). In addition, on the basis of research practice of Chinese medical treatment for COPD in recent years, we put forward the thought of the junction point of Chinese medicine in CER on COPD from the perspective in screening effective Chinese herbs, establishing treatment program/methods/technologies, and outcomes evaluation.
Comparative Effectiveness Research ; Humans ; Medicine, Chinese Traditional ; Outcome Assessment (Health Care) ; Pulmonary Disease, Chronic Obstructive ; therapy

Objective To evaluate the safety and feasibility of ketamine-propofol mixture anesthesia for 85 children with congenital heart disease undergoing cardiac catheterization.Methods Eighty-five children with congenital heart disease undergoing cardiac cathete-rization were randomly divided into ketamine group(K group,n=44)and ketamin-propofol group(KP group,n=41).K group:1 mg?kg-1 ketamine was injected intravenously and then infused at 50 ?g?kg-1?min-1 for anesthesia maintenance.KP group:anesthesia was induced with ketamine 1 mg?kg-1 and propofol 1 mg?kg-1 intravenously,and maintained by continuous infusion of ketamine(16.7 ?g?kg-1?min-1)and propofol(33.3 ?g?kg-1?min-1).Electrocardiogram,blood pressure,pluse,respiratory frequency,saturation of blood oxygen were continously monitored.Results Hemodynamic and respiratory function were stable in both 2 groups.Ketamine consumption in K group was significantly more than that in KP group[(52.1?2.8)?g?kg-1?min-1 vs(25.3?7.3)?g?kg-1?min-1],eye opening time and recovery time were also longer in K group than those in KP group [(50.2?16.5)min vs(40.4?18.3)min].Conclusion The ketamine-propofol mixture was a safe,efficacy anesthesia with excellent recovery in children with congenital heart disease undergoing cardiac catheterization.

0.05).But transitional PBL had much priority in enhancing students' learning interests. Conclusion The applicational of transitional PBL requires to be further deepened and improved in the realm of medical education.

Objective To observe the effect and security of lovasatin treating hyperlipidemia in children with steroid resistance nephrotic syndrome(SRNS).Methods Thirty-seven children with SRNS were administered lovasatin with normal liver function before lipid-lowing treatment.The changes of plasma lipids [total cholesterol(TC),trigly ceride(TG)] and lipoprotins [low density lipoprotein(LDL),very low density lipoprotein(VLDL),high density lipoprotein(HDL)],albumin(Alb),serum creatinine(Scr),aminotransferase(ALT),24 hours of urinary protein and drug side-effects were observated for 4 weeks.All children treated with regular glucocorticoids therapy for 2 months still presented with urinary protein significant positive.Results There were decreasing of plasma lipids and lipoproteins after 2 weeks of lovasatin treatment,especially for TG,24 hours of urinary protein(Pa

Objective:To evaluate the effects of the flowable resin used as pit and fissure sealant using different etching adhesive systems.Methods:60 caries-free extracted human premolars were randomly divided into 4 groups(n =1 5)and treated by Gluma, NT and 3M-Z350 flowable resin(group A);Clearifil SE Bond adhesive and 3M-Z350 flowable resin(group B),phosphoric acid etching,3M-Z350 flowable resin and phosphoric acid etching(group C)and 3Mconcise sealant(group D)respectively.After pro-cessing the tooth surface the pit and fissue of 1 0 sample in each group were sealed.The microleakage was measured by 1 % methyl-ene blue staining(n =8).The material-enamel interface was observed by SEM(n =2).The shear bond strength of the column-shaped samples with the diameter and the height of 3 mm(n =5)on the mesial or dental surface was examined by a test machine. The sealant cartridges and flowable resin cartridges with the diameter and height of 4 mm were used for the crushing strength exami-nation(n =1 0).Results:There was no significant difference in the microleakage among the 4 groups.SEMobservation showed that the resin tags of group A were long and dense and the resin tags of group B were short and sparse,bubbles and cracks were found on the local site in group A and B.The resin tags of group C were long and thin,but combined with tooth tightly;the resin tags of group D were short and dense;the penetration was poor at the bottom of the fissures in the 4 groups.The shear bond strength of Group A was the highest(P <0.01 ),that of group C was higher than that of group B and D(P <0.05).There was no significantly difference between group B and D(P >0.05).The compressive strength of flowable resin groups was higher than that of fissure seal-ant group(P <0.05).Conclusion:The shear bond strength and compressive strength of all-etching bonding system combined with flowable resin is superior to that of self-etching bonding system combined with flowable resin and the traditional sealant.Using Prime&Bond NT bond after acid etching may improve the shear bonding strength.

OBJECTIVEThis study aims to investigate the caries status of the first permanent molar and primary tooth among 7- to 9-year-old children in Tangshan city and the correlation between caries of primary tooth and the first permanent molar.

METHODSA stratified cluster sampling method was used on the basis of the Basic Approach of Oral Health Survey of WHO and the Guideline of the Third National Oral Health Survey. A total of 10 primary schools were randomly sampled in clusters that included 51 primary school sampling spots in Tangshan. The caries status of 1 794 children aged 7 years to 9 years was examined.

RESULTSThe prevalence rate of the first permanent molar caries was 47.49% (852/1 794), the mean number of DMFT was 1.30 ± 1.59, the mean number of DMFS was 1.96 ± 3.40, and the filling rate was only 2.35% (20/852). The preva- lence rate and mean DMFT of the first permanent molar caries showed significant difference between different ages and genders (P < 0.05). However, the mean DMFS of the first permanent molar caries only showed significant difference between the various ages (P < 0.05). The prevalence rate of the primary tooth caries was 83.11% (1 491/1 794), the mean number of dmft was 4.82 ± 3.55, the mean number of dmfs was 6.51 ± 5.61, and the filling rate was 12.41% (185/1 491). Caries of primary tooth was the first permanent molar caries risk factor [r = 0.277, OR = 5.736, P = 0.00, 95% CI (4.175, 7.881)]. Significant correlation was found between the caries of primary tooth and first permanent molar (r = 0.274, P < 0.001).

CONCLUSIONCaries status of the first permanent molar among 7- to 9-year-old children in Tangshan city is serious. Caries status of primary tooth may play an important role in predicting the first permanent molar caries in clinic and prevention.