Objective: To learn the status and influencing factors of 0-3-year-old children's development screening in Tongzhou District, Beijing Municipality, so as to provide the reference for early intervention measures. Methods: Data of children who were born from September 1, 2020 to August 31, 2022 and had received Denver Developmental Screening Test (DDST) in Tongzhou District Community Health Service Center before September 1, 2023 were collected through the Beijing Maternal and Child Healthcare Information System, including basic birth information, mother's situation and DDST results. The screening positive rates of DDST among children were analyzed, and factors affecting positive DDST were identified using a multivariable logistic regression model. Results: A total of 27 783 children aged 0-3 years were included, with a median age of 0.91 (interquartile range, 0.71) years. There were 14 320 boys (51.54%) and 13 463 girls (48.46%). There were 2 471 preterm births (8.89%) and 2 248 mothers with health problems during pregnancy (8.09%). The positive rate of DDST was 2.25%. Multivariable logistic regression analysis showed that gender (boy, OR=1.228, 95%CI: 1.045-1.444), preterm birth (OR=2.417, 95%CI: 1.890-3.092), low birth weight (OR=2.583, 95%CI: 1.980-3.371) and maternal health problems during pregnancy (OR=2.012, 95%CI: 1.591-2.545) were factors affecting positive DDST among children at ages of 0 to 3 years. Conclusions The positive rate of DDST among children at ages of 0 to 3 years was 2.25% in Tongzhou District. Gender, preterm birth, low birth weight and maternal health problems during pregnancy may affect positive screening for developmental delay.

Objective To investigate the role and its mechanism of tumor necrosis factor-α (TNF-α) in post-stroke cognitive impairment (PSCI). Methods Sixty male C57BL/6J mice aged 9-11 weeks were randomly divided into sham operation group, PSCI group, and infliximab group. A PSCI model was induced by middle cerebral artery occlusion. The infliximab group was given infliximab intraperitoneally (10 mg/kg, twice a week), and the PSCI group was injected with an equal volume of normal saline. Water maze and light-dark transition tests were used to evaluate cognitive impairment. Western blot analysis was used to detect hippocampal TNF-α and interleukin-18 ( IL-18 ). The levels of kynurenine and tryptophan in hippocampus were measured by high performance liquid chromatography (HPLC), and the changes of indoleamine 2,3-dioxygenase (IDO) activity (the ratio of kynurenine to tryptophan) were evaluated. Results Morris water maze experiment shows that the escape latency of mice was significantly prolonged in the PSCI group, the target quadrant stay time was significantly shortened, and the number of crossing target quadrants was significantly reduced compared with the sham operation group (all P < 0. 05). The escape latency of the infliximab group was significantly shorter than that of the PSCI group, the target quadrant stay time was significantly prolonged, and the number of crossings increased significantly ( all P < 0. 05 ). Light-dark transition test shows that the latency of the mice was significantly shortened and the number of errors was significantly increased in the PSCI group (all P < 0. 05). The latency of the infliximab group was significantly prolonged compared with the PSCI group, and the number of errors was significantly reduced (all P < 0. 05). Compared with the sham operation group, the levels of TNF-α and IL-18 in the mouse hippocampus of the PSCI group were significantly increased (all P < 0. 05), and the kynurenine/tryptophan ratio was significantly increased (P < 0. 05); the level of TNF-α in hippocampus and the ratio of kynurenine/ tryptophan in the infliximab group were significantly lower than those in the PSCI group (all P < 0. 05). Conclusion TNF-α inhibitor infliximab can alleviate PSCI in mice by reducing IDO activity.

Objective To investigate the effect of human urinary kallidinogenase (HUK) on cerebral ischemia reperfusion injury in mice.Methods One hundred and ten male ICR mice were randomly divided into sham operation,control and HUK groups.A cerebral ischemia-reperfusion model was induced by transient middle cerebral artery occlusion.The infarct volume was detected by triphenyltetrazolium chloride staining.Bcl-2,Bax,and caspase-3 expression levels in the ischemic cortex were detected by Western blot.Bcl-2 and Bax positive cells in the hippocampal CA1 area on the ischemic side were detected using Immunohistochemical staining.Apoptotic cells in the ischemic cortex were detected by TUNEL staining.Results No infarction and neurological deficits were found in the sham operation group.At 24 h after ischemia-reperfusion,the infarction voltne (P ＜0.01) and neurological deficit score (P =0.02) in the HUK group were significantly lower than those in the control group;at 72 h after ischemia-reperfusion,the infarction volume (P ＜ 0.01) and neurologic deficit score (P =0.03) in the HUK group were also significantly lower than those in the control group.Westem blot analysis showed that the expression level of Bcl-2 in the ischemic cortex in the HUK group was significantly higher than that in the control group (P ＜ 0.001),and the expression levels of caspase-3 (P ＜ 0.001) and Bax (P ＜ 0.001) in the cerebral cortex in the HUK group were significantly lower than those in the control group.No apoptotic cells were found in the sham operation group.The number of apoptotic cells in hippocampal CA1 area (P ＜ 0.01) and the number of Bax positive cells (P ＜0.01) in the HUK group were significantly less than those in the control group,while the number of Bcl-2 positive cells was significantly more in the control group (P ＜ 0.01).Conclusions HUK has a certain protective effect on ischemia-reperfusion injury in mice,its mechanism may be associated with the upregulation of Bcl-2 protein expression and downregulation of caspase-3 and Bax protein expression,thus inhibiting cell apoptosis.

Objective To explore the management strategy and indications for revisionary internal fixation after percutaneous kyphoplasty/percutaneous vertebroplasty (PKP/PVP) in cancellous vertebral fractures.Methods A retrospective analysis was made of the 676 cases of single-segment PKP/PVP at Department of Orthopaedics,The Affiliated Hospital to Qingdao University from January 2008 to January 2019.They were subjected to 4 different managements after their primary PKP/PVP:rehabilitation without any treatment in 637 cases,conservative treatment in 19 cases (including 3 ones who refused any revision),KP/VP revision in 12 cases and internal fixation revision in 8 cases.The rate of volume reduction after bone cement dispersion (Vx) was calculated using software Mimics 17.0 on the basis of primary CT data of all the patients.The correlation regression analysis was made between the revision rate and the approximate quantization value of Vx.The Glasgow Coma Score (GCS) of conscious state was used to evaluate the 39 patients after failure of their primary surgery before the surgical strategy for revision was worked out.The cobb angle,pelvic incidence angle (PI),pelvic inclination angle (PT),sacral inclination angle (SS),sagittal deviation (SVA),pain visual analogue scale (VAS) were measured and recorded before operation and at the last follow-up for the KP/VP revision group and internal fixation revision group,indicated as △cobb,△PI,△PT,△SS,△SVA and △VAS,respectively.The indexes were compared between the 2 groups.Results The incidence of osteoporotic vertebral fractures treated with internal fixation revision was 1.18％ (8/676).The correlation between Vx and revision rate was y =0.53 + 0.04x (P ＜ 0.05).The regression analysis showed that Vx was positively correlated with the revision rate (r2 =0.860,P =0.001) and the fitting curve was correlated (r2 =0.916,P =0.001).The GSC scores revealed 31 normal,6 mild disturbance and 2 moderate disturbance cases.There were no significant differences in gender,age or VAS scores between the KP/VP revision group and the internal fixation revision group (P ＞ 0.05).There was a significant difference in △cobb between the 2 revision groups (6.3° ± 7.5° versus 19.2° ± 14.8°) (P ＜0.05),but there were no significant differences between the 2 groups in △PI (4.1°±5.2° versus 3.3°±6.7°),△PT (0.7°±4.6° versus 0.4° ± 3.2°),△SS (3.7° ± 6.2° versus 3.1° ± 5.3°) or △SVA (-3.2 ± 11.9 mm versus-7.9 ± 9.5 mm) (P ＞ 0.05).Conclusions The outcomes of primary PKP/PVP have a great impact on the decision-making of internal fixation revision.The mode and extent of diffusion after initial vertebral cement perfusion are particularly related to the revision rate.The revision plan should depend on clinical symptoms.The internal fixation revision should be individualized to ensure the quality of life of the patients in line with the principles of "resolving symptoms" and "moderate correction".

OBJECTIVE To analyze the clinical manifestations and characteristics of adverse drug reactions （ADR） induced by dronedarone，and to provide reference for clinically safe drug use. METHODS Retrieved from PubMed database， Wanfang database，CNKI and VIP （up to August 31st， 2022），ADR cases of dronedarone were analyzed retrospectively in respect of patient’s age，gender，nationality，usage and dosage of dronedarone，and occurrence time，clinical manifestations，treatment measures and outcome of ADR，etc. RESULTS A total of 26 case reports were included，with a total of 27 patients. The age of the patients was 41-86 years old，with an average age of 68.8 years. The proportion of patients aged 60-79 was the largest （20 cases，74.1%）. There was no significant difference in the number of males （14 cases） and females （13 cases）. The patients came from 6 countries， of which the United States was the largest （16 cases，59.3%）. The dosage of 14 patients was 400 mg bid；one patient was 200 mg bid；the dosage for 12 patients was not specified. The most ADR cases （16 cases，59.3%） occurred within 1 month，of which 11 cases（40.7%） occurred within 1 week，and there were no ADR reports with medication more than 12 months. Organs/systems involved in ADRs were mainly liver and biliary diseases （7 case times，23.3%），skin and subcutaneous tissue diseases （6 case times， 20.0%），respiratory tract，thoracic and mediastinal diseases （5 case times，16.7%）. In addition，ADR also occurred in heart diseases， kidney and urinary system diseases，vascular diseases，medical examinations and eye diseases. Among 27 patients，there were 3 cases of death，the ADR were bronchiolitis obliterans with organizing pneumonia，toxic epidermal necrolysis and hepatic failure， respectively. One patient underwent liver transplantation. CONCLUSIONS Dronedarone can cause multiple organ system ADR. Before use，it is necessary to improve the examination including ECG，liver function，lung function，etc. and strengthen drug use monitoring within one month after the start of use，especially the ADR of hepatobiliary，skin and respiratory system. The occurrence of severe ADR has no obvious relationship with the duration of medication； even if it is taken safely for a long time，it still needs continuous pharmaceutical monitoring and follow-up to ensure the clinical medication safety of patients.

ObjectiveTo explore the importance of post-vaccination serological testing （PVST） for children exposed to hepatitis B virus （HBV）， and analyze the factors affecting the progress of PVST. MethodsThe study focused on hepatitis B surface antigen （HBsAg）-positive pregnant women and their newborns residing in Tongzhou District， Beijing， who delivered at various obstetric institutions from January 1， 2020 to March 31， 2022. The obstetric institutions and community health service centers conducted follow-up visits 1 to 2 months after the children had received three doses of the hepatitis B vaccine （HepB）. ResultsThe vaccination rate of hepatitis B immunoglobulin （HBIg） was 100.00% （800/800）， with a successful PVST follow-up rate of 85.88% （687/800） in Tongzhou District. The initial non-response rate to immunization was 0.29% （2/687）， but successful immunization was achieved after re-immunization. The mother-to-infant transmission rate of hepatitis B was 0. Children who did not undergo PVST accounted for 14.13% （113/800）， with the main reasons being delays due to the COVID-19 pandemic， parents’ reluctance to allow venous blood collection due to the young age of the children， and loss to follow-up because children moved back to their parents’ place of origin. Logistic regression analysis showed that the proportion of PVST was higher among high-risk children （OR=30.009，P=0.001）， children with family residing in Beijing （OR=2.218，P=0.002）， and children whose mothers were <35 years old （OR=1.687，P=0.020）. ConclusionPVST is necessary for assessing the status of HBV immune response in newborns after vaccination with HepB. The COVID-19 pandemic impacted the implementation of PVST for children exposed to HBV. Strengthening the management of non-high-risk children， those living outside Beijing， and children with mothers aged ≥ 35 years old may increase the rate of PVST in Tongzhou District.

OBJECTIVE：To systematic ally ev aluate the efficacy and safety of benralizumab in the treatment of severe eosinophilic asthma ，and to provide evidenced-based reference for clinical treatment. METHODS ：Retrieved from PubMed ， Embase，Cochrane Library ，ClinicalTrials.gov，CNKI，VIP and Wanfang database ，randomized controlled trials （RCTs）about benralizumab+routine treatment （trial group ）versus placebo+routine treatment （control group ）were collected during the inception to Dec. 2020. The relevant references were also retrieved manually. After data extraction ，the quality of included literatures was evaluated with bias risk evaluation tool 2.0 recommended by Cochrane systematic evaluator manual 6.1. Meta-analysis was conducted by using Rev Man 5.4 software. RESULTS ：Totally 5 studies involving 2 646 patients were included. Results of Meta-analysis showed that acute exacerbation rate of asthma [RR ＝0.67，95％ CI（0.61，0.74），P＜0.000 01]，asthma control questionnaire score [MD ＝－0.29，95％CI（－0.37，－0.21），P＜0.000 01] and the incidence of severe adverse event [RR ＝0.67，95％CI （0.53，0.84），P＝0.000 6] in trial group were significantly lower than control group. FEV 1[MD＝0.13，95％CI（0.09，0.17），P＜0.000 01] and asthma quality of life questionnaire score [MD ＝0.23，95％CI（0.13，0.33），P＜0.000 01] in trial group were significantly higher than control group. There was no statistical significance in the incidence of adverse event between 2 groups [RR ＝0.97，95％CI （0.92，1.02），P＝0.28]. CONCLUSIONS ：Benralizumab is effective and safe in the treatment of severe eosinophilic asthma. Due to the relatively limited data ，this conclusion needs to be confirmed by more studies.

【Objective】 To identify the influencing factors of infant motor development, and to explore the potential interactive factors, so as to provide scientific basis for early prediction and targeted prevention of infant motor developmental delay. 【Methods】 Data of infants receiving "0~1 motor development screening" at 21 community health service centers in Tongzhou District, from January 1st, 2020 to August 31st, 2021 were collected through the Beijing Maternal and Child Information System.Using the method of nested case-control study, 416 infants with positive screening results were selected as case group, 416 infants with negative screening result were selected into the control group by 1∶1 case-control matching of screening age.Chi-square test, Logistic regression analysis, and Exhaustive CHAID decision tree model were used to explore the influencing factors of infant motor development, the interaction effect was investigated by using the additive and multiplicative interaction models. 【Results】 Multivariate Logistic analysis showed that birth weight<2 500g (OR=3.28), cesarean section (OR=1.63), outdoor activity≤ 1h/d (OR=3.07), and no supplementation of vitamin D (OR=2.68) were risk factors for positive screening results of infant motor development (P<0.01).The Exhaustive CHAID decision tree showed that low birth weight was the primary risk factor for infant with positive screening results, followed by outdoor activity, vitamin D supplementation and delivery.The interaction analysis showed that there was a multiplicative interaction (OR=13.76, 95% CI:1.20 - 158.08) and an additive interaction (RERI=10.22, 95%CI:5.05 - 15.38) between non supplementation of vitamin D and low birth weight on infant motor development with positive screening results. 【Conclusions】 Attention should be paid to the early motor development of infants with low birth weight and those born by cesarean section, with emphasis on the dosage of vitamin D supplementation and outdoor activity duration.Moreover, the early screening and hierarchical management of infant motor development should also be strengthened.

OBJECTIVE： To analyze the clinical manifestations and characteristics of adverse drug reactions （ADR） induced by osimertinib mesylate， and to provide reference for clinical safe use of drugs. METHODS： Retrieved from PubMed， Wanfang database， CNKI and VIP during database establishment-Aug. 2018， ADR cases of osimertinib mesylate were analyzed retrospectively in respects of patient’s age， gender， nationality， usage and dosage of osimertinib mesylate， occurrence time of ADR， clinical manifestations， treatment measures and outcome， etc. RESULTS： A total of 20 articles were included， involving 21 patients. The age of the patients was 32-82 years old， and the proportion of patients aged 57-79 was the largest （80.9％）. The female with ADR （14 cases） were more than the male. The patients were from 5 countries， in which Japan took the most ratio （13 cases， 61.9％）. The dose of osimertinib mesylate was 160 mg/d in a patient and commonly recommended dose 80 mg/d for other patients. The most ADR cases （16 cases， 76.2％） occurred within 3 months， and no reports of ADR occurred more than 12 months. Organs/systems involved in ADRs were mainly respiratory system （11 case times， 45.8％） and digestive system （6 cases， 25.0％）， in addition， ADR also occurred in cardiovascular system， hematological system， systemic reactions， skin and eyes. Among 21 patients， 3 cases were mild ADR so that they were given same dose with same frequency. A patient suffered from interstitial pneumonia and was given medicine every other day and symptomatic treatment； the symptoms of the patient were relieved. Other 17 cases were relieved after drug withdrawal and symptomatic treatment， but 2 patients died of tumor progression. CONCLUSIONS： In clinical application of osimertinib mesylate， attention should be paid to ADR monitoring， especially short-term ADR， especially ADR of respiratory， digestive system.