Objective To investigate the changes in discharge rates of pain-sensitive neurons (PSN) in thalamic parafaseicular nucleus ( Pf) following coronary artery occlusion (CAO) and the effects of urapidil, a partial 5-HT agonist. Methods One-hundred male SD rats weighing 260-300 g were operated upon under urethane anesthesia and local infiltration of the skin incision. The animals were tracheotomized and mechanically ventilated. A hole was drilled in the skull until the brain was exposed. A single-barrel glass electrode was inserted, aiming at the PSN, the discharges of which were filtered, amplified and recorded. Chest was opened and heart was exposed. A tie was placed around the anterior descending branch of left coronary artery which can be occluded whenever needed. The study was divided into 3 groups : group I CAO alone; group II CAO + urapidil and group III CAO + urapidil + methysergide ( a potent serotonin antagonist). Urapidil 0.21 mg.kg-1 was given intravenously 15 min after CAO. Methysergide 0.1 mg.kg-1 was given iv 20 min after urapidil. Results Discharges of PSN were recorded in 45 animals out of the 100, and the recordings were complete for investigation in 31 animals. CAO evoked significant increase in the discharge frequency of PSN in 18/31 animals. After intravenous urapidil the increased frequency of nociceptive discharges was inhibited; however intravenous methysergide could partially antagonize the antinociceptive effect of urapidil. Conclusion The results indicate that (1 )the nociceptive response could be induced by CAO in rats; (2) Pf nucleus of thafamus is involved in the myocardial ischemia-induced nociceptive response of central nervous system; (3) serotonin plays a critical role in the modulation of the nociceptive signal of acute myocardial ischemia.

In the process of promoting the implementation and transformation of the Q3D guideline of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) in China, the risk assessment of elemental impurities in naturally sourced excipients often faces challenges such as multiple types of elemental impurities and insufficient detection methods. In this paper, an inductively coupled plasma mass spectrometry (ICP-MS) method for screening 12 elemental impurities in titanium dioxide was established using the optimized acid extraction pre-treatment method. The accuracy and repeatability of the method were good. The recoveries of cadmium, lead, mercury, cobalt, nickel, lithium, barium, molybdenum, copper, chromium and iron were 83.6%−101.6%, the recovery of antimony was 54.1%, and the RSD was 1.1%−10.2% (n=6). The evaluation results of elemental impurities showed that the risk of cadmium, mercury, cobalt, nickel, lithium, barium, molybdenum, copper, chromium and antimony was low, while the risk of lead was high, and it is recommended that a lead salt test be added to the pharmacopoeia standard for this product. Based on the statistical data, the differences in the control levels of elemental impurities and whiteness of 29 batches of titanium dioxide samples from 10 domestic and foreign manufacturers were compared and analyzed. The Pearson correlation coefficient method was used to analyze the correlation between residual elemental impurities and whiteness, and a heat map was used to visualize the results. The results showed that whiteness was significantly negatively correlated with the amount of residual barium and the sum of residual elemental impurities. It is suggested that the manufactures should include whiteness as an internally controlled indicator to further improve the quality of titanium dioxide used as a pharmaceutical excipient.

Objective To evaluate the efficacy of long-pulsed tunable Nd: YAG laser on capillary hemangioma and to analyse its influencial factors. Methods A retrospective review was conducted on 124 patients with 135 vascular lesions treated with long-pulsed tunable Nd:YAG laser from February, 2007 to January, 2008. Working parameters, including spot size (3-5 mm), pulse duration (10-30 ms) and fluence (120-200 J/cm2) were determined based on the size, color and depth of lesions and adjusted according to the immediate reaction of lesions. The interval of two treatments was 1 month. Results Of the 135 lesions, 100 experienced a more than 95% subsidence, 22 achieved 60%-94% subsidence, 11 got 30% -59% subsidence, and 2 reached less than 30% subsidence. The cure rate and effective rate were 74.07% and 90.37% respectively. Smaller lesions showed a better response to the treatment than larger ones (P<0.0001), whereas the sites and depth of lesions had no effect on the efficacy (both P>0.05). Atrophy scar occurred in 4 (2.96%) lesions, and blisters in 12 (8.89%) lesions after the treatment. No purpura or pigmentary changes occurred. Conclusion The long-pulsed tunable Nd:YAG laser is an effective treatmnt for capillary hemangioma with fast action and few side reactions.

Objective: To analyze the epidemiological characteristics of plant and mushroom poisoning events among people aged 0-19 in Guizhou Province from 2015 to 2019, so as to provide the basis for prevention and control of food poisoning events among children and adolescents. Methods: Data of people aged 0 to 19 involved in plant and mushroom poisoning incidents reported by the foodborne disease outbreak surveillance system in Guizhou Province from 2015 to 2019 were collected, verified, sorted and statistically analyzed. Results: From 2015 to 2019, there were 590 cases of plant and mushroom poisoning among people aged 0 to 19 in Guizhou Province, 1 441 people were poisoned and 5 died. In May and September, family and collective dining halls were the places with the highest incidence of plant and poisonous mushroom poisoning incidents, accounting for 90.68% (535/590) of the total incidents. Poisonous mushrooms and masanberry accounted for 71.69% (423/590) of the food poisoning causes, and 5 people died of poisoning were caused by poisonous mushrooms. Conclusion In the cases of plant and mushroom poisoning among people aged 0-19 years in Guizhou Province,preschool primary and middle school students in rural areas are most vulnerable population of poisoning, so it is necessary to strengthen the publicity and education on the prevention and control of toxic plant and mushroom poisoning among children and teenagers in rural areas, so as to reduce the occurrence of relevant poisoning incidents.

Objective: To analyze the rule and characteristics of school food poisoning incident in Guizhou Province during 2011-2018. Methods: Data of school food poisoning incidents were collected from the Foodborne Disease Outbreak Surveillance System in Guizhou Province during 2011-2018 and statistically analyzed. Results: A total of 78 cases of food poisoning occurred in schools in Guizhou Province during 2011-2018. Among the 1 506 cases, 869 hospitalized and 1 died. May was peak time for school food poisoning. Most of the incidents (83.33%, 65/78) occurred in the school canteens. Plant origin products (50%, 39/78), especially spoiled rice, were the most common types of food poisoning in school(16.67%, 13/78). Conclusion Primary and secondary school students were the largest group for school food poisoning in Guizhou province. It was necessary to strengthen the supervision and management of school canteens and surrounding places, as well as to improve the food safety awareness of food operators and students, preventing similar incidents from happening again.

Objective: To analyze the epidemiological characteristics, clinical manifestations and imaging charac-teristics of 76 cases with neonatal cerebral infarction, in order to provide evidence for the diagnosis, treatment and prognosis for neonal cerebral infarction. Method: Newborns with cerebral infarction admitted into the Neonatal Center, Beijing Children′s Hospital, Capital Medical University from January 2007 to December 2017 were enrolled.According to neurological sequelae, the participants were divided into good prognosis group and poor prognosis group for retrospective analysis, and their cranial magnetic resonance imaging(MRI) changes and mental development were followed up. Results: The incidence of convulsion was the highest in 76 cases (73.7%, 56/76 cases), among which unilateral limb twitching was characteristic in 39.2% (22/56 cases). Clinical physical examination showed no significant positive signs in 13.2%(10/76 cases) of the patients, but middle cerebral artery involvement accounted for 80.3% (61/76 cases), and there was no abnormal discharge of electroencephalogram in 29.2% (19/65 cases) of the patients.Among 41 children (29.3%) received follow-up, 12 cases had neurological sequelae, and 15 cases (36.6%) received anticoa-gulant therapy.The median area of original damage of T2 sequence cerebral infarction was 10.3%, the median area of diffusion weighted image damage was 2.0%, and the median area of damage of T2 sequence was 1.0%.The median ratio of craniocerebral lesion damage was 8.4%.The ratios of poor prognosis were 14.9%, 4.8%, 0.5% and 14.4%, respectively. Conclusions Neonatal convulsion is the most common manifestation of neonatal cerebral infarction.Unilateral limb clonus is characteristic.The larger the infarct involvement area and the larger the intracranial lesion change area through reexamination, the poorer prognosis of the children.Early anticoagulant therapy could not improve the prognosis of neonatal cerebral infarction.

Objective:To evaluate the effect of multimodal non-drug treatment during induction of general anesthesia on emergence delirium (ED) in the preschool children.Methods:A total of 210 pediatric patients of either sex, aged 3-6 yr, of American Society of Anesthesiologists Physical Status classification Ⅰor Ⅱ, undergoing elective operation for snoring with expected operation time <2 h, were involved in this study. The patients were divided into 2 groups according to the parity of the numbers randomly generated by the computer: multimodal non-drug treatment group (group N, n=102) and control group (group C, n=108). In group N, multiple modes of non-drug intervention (including parents′ company, carrying favorite toys, watching favorite video programs with portable multimedia devices, etc) were used during anesthesia induction, and the children left their parents and entered the operating room after completion of general anesthesia. The children directly entered the operating room with the medical staff for anesthesia induction (without parents′ company and other intervention measures) in group C. The patients were endotracheally intubated and received combined intravenous-inhalational anesthesia and general anesthesia in both groups. The anxiety was evaluated by modified Yale preoperative anxiety scale (m-YPAS) score at 24 h before operation (T 0) and immediately before induction of general anesthesia (T 1). The Pediatric Anesthesia Emergence Delirium scale score (PAED score, ED was defined as PAED score > 12), FLACC scale score and Ramsay Sedation Scale score were recorded when orientation recovered after admission to postanesthesia care unit (T 2) and at 6, 24 and 72 h after operation. The patients were divided into ED group and non-ED group (NED group) according to the occurrence of ED, and the risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify ED-related risk factors and construct the prediction model. The accuracy of the prediction model was evaluated by the receiver operating characteristic curve. Results:Compared with group C, the m-YPAS at T 1 and PAED score and incidence of ED at T 2 were significantly decreased ( P<0.05), and no significant change was found in FLACC score and Ramsay sedation score at all time points in group N ( P>0.05). Age, m-YPAS score at T 1, multimodal non-drug treatment during anesthesia induction, FLACC score at T 2 and Ramsay sedation score at T 2 were the risk factors for ED ( P<0.05). The area under the receiver operating characteristic curve was 0.944, the 95% confidence interval was 0.914-0.974, with a Yonden index of 0.779, sensitivity of 94.9%, specificity of 83%, and the cutoff value of 0.14. Conclusions:Multimodal non-drug treatment during induction of general anesthesia can effectively reduce the development of ED in the preschool children.

Objective:To investigate the epidemic distribution and characteristics of brucellosis in Heze City, and to provide a basis for formulating prevention and control measures in the future.Methods:The data of Heze City brucellosis reported from January 1, 2017 to December 31, 2021, were collected from the China Disease Prevention and Control Information System. The epidemiological case questionnaires of brucellosis in Heze City from January 1, 2017 to December 31, 2021 were collected from the centers for disease control and prevention of various cities, counties and districts. Retrospective analysis was used to conduct a descriptive analysis of the distributions, clinical manifestations and epidemiological history 3 weeks prior to the onset of the disease in Heze City from 2017 to 2021.Results:From 2017 to 2021, a total of 1 543 cases of brucellosis were reported in Heze City, with no death. The highest incidence was in 2018 (5.16/100 000). The peak period was from March to June each year (759 cases). There were cases reported in all counties (districts) of the city, and the counties (districts) with more cases were Mudan District (386 cases), Cao County (271 cases), Yuncheng County (251 cases), Shan County (138 cases) and Juye County (132 cases). The minimum age of onset was 11 months, and the maximum was 84 years old, mainly between the ages of 20 to 69 (1 381 cases). The gender ratio between males and females was 2.50 ∶ 1.00 (1 102 ∶ 441). Farmers had the highest incidence of the disease (1 329 cases). Main clinical manifestations were fever, hyperhidrosis, fatigue, muscle and joint soreness. Epidemiological history investigation within 3 weeks before the onset of the disease revealed 1 124 cases of close contact with animals, including 1 044 cases of contact with sheep.Conclusions:From 2017 to 2021, the incidence of brucellosis in Heze City shows a trend of first rising and then decreasing, and the epidemic affects all counties (districts) of the city, mainly middle-aged and elderly men. In the future, it is necessary to strictly control the flow of diseased animals, increase immunization and quarantine, and block the transmission route.

Objective To assess the efficacy of oral treatment and parenteral treatment in community acquired pneumonia( CAP) children by meta-analysis method. Methods Searches were made in MEDLINE、EMBASE and Cochrane Central Register of Controlled Trials ( CENTRAL ) from the establishment of the data base till September 2016. All randomized controlled trials about oral and parenteral treatment in community ac-quired pneumonia children were eligible. Review Manager 5. 3 was used to analyze the studies enroued in this meta-analysis. Results 4582 literatures were reviewed. Seven(n=5030)eligible trials were used for meta-a-nalysis. The treatment failure between community acquired pneumonia children treated with oral treatment and parenteral treatment was found no significant difference(OR =0. 82, 95% CI =0. 63-1. 08,P <0. 05). The treatment failure of oral treatment group was found to be significantly higher than parenteral treatment group in CAP children under 1 year of age(OR=2. 25,95%CI=1. 61-3. 14,P<0. 01). The treatment failure of children who had used antibiotics before included in the study was found to be significantly higher than those who had not used(OR=1. 94,95%CI=1. 50-2. 50,P<0. 01). The death rate of oral treatment group was found to be signif-icantly lower than the parenteral treatment group(OR=0. 31,95%CI=0. 11-0. 85,P=0. 02). There was no sig-nificant difference of relapse rate (OR=1. 28,95%CI=0. 34-4. 82) and loss to follow-up rate(OR=1. 08,95%CI=0. 77-1. 51) between the two group. Conclusion Oral treatment is as effective as parenteral treatment in CAP children. The death rate of oral treatment group is significantly lower than the parenteral treatment group.

Objective To investigate the clinical and genetic characteristics of focal dermal hypoplasia (FDH) in children. Methods Clinical data, relevant examinations, histopathological features and genetic test results of a male newborn with FDH who was admitted to the neonatal ward of Beijing Children's Hospital of Capital Medical University were retrospectively analyzed. Reports of pediatric FDH patients with complete clinical data were retrieved from PubMed, Wanfang database and China National Knowledge Infrastructure from the establishment of these databases to March 2018 and characteristics of FDH was summarized. Results The case we reported here was a male neonate diagnosed with FDH in China, who was born with microcephaly, bilateral auricular cartilage dysplasia, tooth germ dysplasia and bipedal deformity and his skin, bone, gingiva, bilateral iris and pupils were all involved. Histopathological examination of the skin suggested dermal dysplasia. Genetic analysis showed a suspected chimeric nucleotide variation in PORCN gene (c.268 C>T), whereas no abnormalities were found in his parents and sister. A total of 60 cases (including the one we reported) of FDH diagnosed in childhood were reviewed, and 19 of them were confirmed in neonatal period. Fifty-seven of the 60 cases (95.0%) developed typical skin dysplasia and 56 cases (93.3%) with skeletal malformations, while other clinical manifestations vary. Histopathological examination suggested as dermis dysplasia, adipose tissue migration and reduction of appendage and collagen fibers. Among the 60 children, 19 (including four onset at neonatal period) underwent genetic testing and the results indicated PORCN gene mutation. Mutations in the four with neonatal-onset were c.956dupA, c.1061T>C, c.749C>T and c.268C>T. As the reported case was a boy, with only one X chromosome, the PORCN gene mutation could directly affected its function resulting in the abnormal phenotype. It was a de novo mutation as the same mutation was not detected in his parents. Conclusions FDH is a hereditary disease involving multiple systems with various clinical manifestations. Skin histopathological examination and genetic testing should be performed as soon as possible for early diagnosis and intervention. Accurate diagnosis is essential for genetic counseling, reproductive planning, prospective guidance and prognosis.