Objective The pathogenesis of intractable epilepsy was explored by examining the expression of the P-gp , GST-Pi as well as MDR1 in peripheral blood of the patients with intractable epilepsy. The potential of the above mentioned three genes as the biomarkers for treatment of intractable epilepsy was investigated. Methods Thirty-one sub?jects with refractory epilepsy, 33 subjects under good circumstances by antiepileptic drugs, and 37 healthy subjects were included in the present study. fluorescence quantitative polymerase chain reaction and flow cytometry were used to detect mRNA levels of MDR1 and GST-Pi and P-gp of MDR1 in the peripheral blood of the patients, respectively. Results The expression levels of MDR1 and GST-Pi were significantly higher in the AEDs intractable group(1.36±0.14,0.585±0.257) than in the treatment group(0.82±0.15,0.309±0.217, P<0.05)The expression levels of MDR1 and GST-Pi were signifi?cantly higher in the AEDs treatment group than in the normal group(0.27±0.07,0.134±0.223,P<0.05). The expression levels of P-gp were significantly higher in the AEDs of the intractable group(0.104±0.084)than in the treatment group (0.063 ± 0.030, P<0.05). The GST-Pi gene expression levels were significantly higher in three(0.535 ± 0.256)or two (0.425±0.254)kinds of antiepileptic drugs combination therapy than in single drug treatment(0.267±0.265, P<0.05). Leucocyte P-gp levels were significantly higher in combination therapy of three kinds of antiepileptic drugs(0.141 ± 0.096)than in combination therapy of two kinds of antiepileptic drugs(0.071±0.020)or in monotherapy(0.050±0.020, P<0.05). Conclusion MDR1 and GST-Pi gene expression levels of peripheral blood can be used as the reference in?dex for treatment of intractable epilepsy and the resistant index of combination treatment for intractable epilepsy.

Objective To investigate the influencing factors of pain and the changes of vital signs in newborn infants. Methods Forty two newborn infants were rated by the behavioral scale of acute pain in newborn infants. The scores of pain were compared among infants with different gender,gestational age,birth weight,birth age,type of puncture and whether by vaginal birth or not. At the same time,the respiration rate,heart rate,blood pressure and oxygen saturation (SO2)were dynami-cally recorded by the multi-function monitor in the process of puncture. Results The average score of pain was 7.6. There was no significant difference among newborn infants with different gender,gestational age,birth weight and type of puncture(P> 0.05),while significant differences among infants with different birth age and whether by vaginal birth or not (P=0.015 and 0.043 respectively). In the process of puncture,the SO2 was significantly decreased,while the respiration rate,heart rate,sys-tolic and diastolic blood pressure were significantly increased. Conclusions Pain is prevalent in newborn infants and accom-panied by obvious changes of vital signs. The means of childbirth and birth age have significant influence on the neonatal pain. It is suggested to pay close attention to the neonatal pain and take effective interventions.

AIM:To look for a better method to deal with interstitial lung disease,interferon-gamma(IFN-?)combined with methylprednisolone(M-pred)to influence human embryonic lung fibroblast on proliferation,collagen synthesis and the expression of transforming growth factor-?1(TGF-?1)protein and mRNA were investigated.METHODS:Exponentially growing cells were preincubated for 48 h before harvested.The microculture tetrazolium(MTT)assay was used to measure the inhibition ratios of M-pred combined with different concentrations of IFN-?.The expression of proliferation cell nuclear antigen(PCNA)was detected by immunocytochemical analysis.Hydroxyproline kit was adopted to detect collagen synthesis.The expressions of TGF-?1 mRNA and protein were detected respectively by RT-PCR and Western blotting.RESULTS:Methylprednisolone,IFN-? as well as the combination of methylprednisolone and IFN-? inhibited the proliferation of HELF and the expression of PCNA in comparison with control group(P

Objective To investigate the physical and mental development of small and appropriate for gestational age preterm infants in their early life. Methods This study recruited 220 preterm infants, who were discharged from our hospital and visited preterm following-up clinic at regular intervals from February 2009 to December 2012. All of those infants were divided into two groups based on whether their birth weight below 10th percentile for their gestational ages or not. Weights, lengths and head circumferences were measured up to seventh month age adjusted by gestational age. Meanwhile, mental tests were conducted by the professional staffs working on the children developmental assessment at their adjusted months of 5th, 6th or 7th. All of physical and mental scores were compared between the two groups. Results The SGA group was statistically less than the AGA group on the Z-score of weights from the ifrst to sixth month adjusted by gestational age (P<0.05). The difference disappeared on the seventh adjusted month age (P>0.05). The SGA group was statistically less than the AGA group on the Z-score of lengths from the ifrst to iffth month adjusted by gestational age (P<0.05). The difference disappeared on the sixth and seventh adjusted month age (P>0.05). The SGA group was statistically less than the AGA group on the Z-score of head circumferences from the ifrst to seventh month adjusted by gestational age (P<0.05). The SGA babies scored statistically less than the AGA babies with a mean development quotient score of 96.7 and 102.9, respectively (P<0.05). The scores of movement, cognitive, language in the SGA group were statistically less than those in the AGA group(P<0.05). Conclusions Preterm SGA could achieve satisfactory weight catch-up gain, with a decreasing difference from preterm AGA while they were getting older. But the length catch-up growth of preterm SGA seemed unsatisfactory with a big differece from preterm AGA. There was the worst catch-up on head circumference in those preterm SGA, backward in mental development, particularly in their movement, cognitive and language capacity.

Objective:To explore the manifestations of magnetic resonance imaging(MRI)on acute traumatic lateral patellar dislocation of children and adolescents.Methods:MRI images of the affected side and healthy side of 110 children and adolescents with acute traumatic lateral patellar dislocation who were treated in the Second Hospital of Tangshan from July 2016 to April 2022 were retrospectively analyzed.The correlation of the medial patellofemoral ligament(MPFL)on the affected side between the tear location and tear degree was compared and analyzed.According to the cartilage injury grading system of international cartilage repair society(ICRS),the articular cartilage injury of affected side was divided into 4 grades,and the correlation between the articular cartilage injury grading and the articular cartilage injury location was compared and analyzed.Three methods of measuring patellar height,which included Insall-Salvati index(ISI),patellotrocheal index(PTI)and Caton-Deschamps index(CDI),were used to compare and analyze the differences of MRI data of patellar height between the affected side of knee joint and the healthy knee joint of pediatric children.Results:In 110 patients with MPFL injury,73 cases were partial tears and 37 cases were complete tears.There was significant difference in the injury at MPFL patellar attachment location between complete tears(22 cases)and partial tears(19 cases)(x2=11.740,P<0.05),and there was significant difference in MPFL multiple injury between partial tear(40 cases)and complete tear(8 cases)(x2=10.990,P<0.05).There were no significant differences in the injuries of MPFL middle segment and the origin of femur between partial tears and complete tears.There were 162 lesions in 110 cases with osteochondral injury,which included 55 lesions on the patellar side,33 lesions on the femur side and 74 multiple lesions according to the part of injury.There was significant difference between the location of osteochondral injury and injury grading(x2=38.153,P<0.05).The ISI,PTI and CDI on the affected side were significantly lower than those on the healthy side in pediatric patients with acute traumatic lateral patellar dislocation of children and adolescents(x2=30.853,12.586,19.656,P<0.05),respectively.Conclusion:The complete tears are more likely to occur in the injury of MPFL patellar attachment location of pediatric patients with acute traumatic lateral patellar dislocation of children and adolescents,while multiple injuries are more likely to be in partial tears.There is correlation between the articular cartilage injury grading and the articular cartilage injury location in pediatric patients.MRI is an important method to diagnose MPFL injury,which can provide more evidence for clinical treatment.

Under the limitation of cross-sectional studies, more researchers are turning their attention to maternal and child cohort studies. However, some problems do exist in the traditional maternal and child cohort studies, if data is only gathered from the hospitals. The limitation would include the contents of research and the high rate of loss to follow-up. With the integration of different medical traits and the progress in big data, the development of maternal and child related cohorts, with characteristics of dynamic follow-up and data sharing, through combining the information and health service systems of different institutions, seem in urgent need. This paper aims to provide some basic achievements in conducting maternal and child cohorts that can serve the related health problems through full-life cycle, and provide new references on conducting cohort studies, aiming at special population or diseases.

Objective:To investigate sleep quality in pregnant women during their first and second trimester and to identify risk factors.Methods:Data was from the Chinese Pregnant Women Cohort Study. A total of 3 618 pregnant women were included, with the exclusion 346 women who had missing information. Sociodemographic, health-related behavior, depression and sleep quality information were collected and analyzed. Logistic regression analysis were used to explore the influencing factors of sleep quality in pregnant women.Results:Among the 3 618 pregnant woman 28.2% had poor sleep quality in their first trimester and 28.7% in the second trimester. 15.2% pregnant women had progressively worse sleep and 13.0% had persistently poor sleep had pregnant women were generally suffered from poor sleep quality, difficulty falling asleep, sleep disorders and daily fatigue. Regular diet ( OR=0.75, 95% CI: 0.62-0.92) and work ( OR=0.84,95% CI: 0.71-0.99) in the first trimester were protective factors of sleep quality in pregnant women. Age ≥30 year old ( OR=1.19, 95% CI: 1.03-1.37), passive smoking ( OR=1.18, 95% CI: 1.02-1.36) and depression ( OR=2.25, 95% CI: 1.95-2.61) in the first trimester were risk factors. Conclusions:The rate of poor sleep quality are high among Chinese pregnant woman during their first and second trimester. The risk factors of sleep quality are multiple. Regular diet and work, reduction of tobacco exposure, alleviation of depression symptom may help improve sleep quality among pregnant women.

Objective:To investigate the effect of changes in physical activities on depressive symptoms in the second trimester of pregnancy.Methods:Data from the Chinese Pregnant Women Cohort Study, from July 25, 2017 to November 26, 2018, were used. Women who had effectively completed the survey of physical activity and depressive symptoms in the first and second trimesters of pregnancy, were recruited. Both International Physical Activity Questionnaire-short and Edinburgh Postnatal Depression Scale were used, respectively. Pregnant women who had completed two surveys were included in our study and were divided into two groups according to the depressive symptoms, measured at the baseline. Among the pregnant women without depressive symptoms at the baseline, logistic regression was used to analyze the effects of changes in physical activity on the prevention of depressive symptoms. Effect on the reduction of depressive symptoms was analyzed, using the same method.Results:The prevalence rates of depressive symptoms were 23.83 % and 20.57 % in the baseline and second trimester, respectively. After adjusting for age, education level, occupation, family annual income and pre-pregnancy BMI, data from the logistic regression showed that women without depressive symptoms and with increased and adequate physical activities in the baseline, were with lower risks to develop depressive symptoms in the second trimester ( OR=0.479, 95 %CI: 0.335-0.684; OR=0.566, 95 %CI: 0.394-0.815). Among women with depressive symptoms in the baseline survey, association between physical activity and depressive symptoms was not statistically significant ( P>0.05). Conclusions:Increased and adequate physical activities showed preventive effects on depressive symptoms during pregnancy, but the remission effect was not obvious in women with depressive symptoms. Pregnant women should be encouraged to increase their physical activities while screening programs should also be carried out to reduce the depressive symptoms during pregnancy.

Objective:To prospectively explore the associations between total and different types of physical activities and gestational diabetes mellitus (GDM) in the first trimester of pregnant women, in Beijing.Methods:Data of 909 participants from the Chinese Pregnant Women Cohort study were extracted and studied. Four types of physical activities, including household/care-giving, occupational, sports/exercise and outdoor ways of transportation (walking/cycling/E-biking) in early pregnancy were studied by using the pregnancy physical activity questionnaire (PPAQ). All the participants were followed up and related data on GDM collected. Logistic regressions were conducted for data analysis on the associations of interests.Results:A total of 206 pregnant women (22.7 %) were diagnosed with GDM. After adjusting for age, pre-pregnancy BMI, family history of diabetes and other types of physical activities, results from the logistic regression showed that women with moderate level of household/care-giving activities were with the lower odds on GDM ( OR=0.654, 95 %CI: 0.436-0.980). Women who had met the guideline of exercise were less likely to have GDM ( OR=0.518, 95 %CI: 0.287-0.934). There was no significant association appeared between total physical, occupational and outdoor ways of transportation (walking/cycling/E-biking) activities with GDM. Conclusions:Sports/exercise and household/care-giving activities in early pregnancy appeared important on GDM prevention. Pregnant women are encouraged to wisely arranging their sports/exercise activities and engaging in moderate household/care-giving activities in the first trimester of pregnancy, to prevent GDM.

It is believed that the basic pathogenesis of oculomotor nerve paralysis （ONP） is qi and blood depletion and channel obstruction. Taking channel pattern differentiation as the core， it is recommended to use acupuncture mainly based on location， syndrome and channel deficiency-excess differentiation. Location and channel tropism differentiation mainly follows the principle of “where the channels and collaterals pass， the main treatment can reach”， and commonly uses acupuncture points on Dumai （督脉）， the hand Shaoyang （少阳） Sanjiao （三焦） channel， the hand Taiyang （太阳） small intestine channel， three yang channels of the foot， the hand Shaoyin （少阴） heart channel， the foot Jueyin （厥阴） liver channel， and others， and combines scalp acupuncture with electro-acupuncture to enhance channel stimulation. Pattern and channel tropism differentiation is to differentiate the entered channel according to clinical symptoms and zang-fu patterns. The differentiation of deficiency-excess should be payed attention to， and the principle of “supplementing the deficiency， and draining the excess” should be followed. The supplementing and draining method should be used rationally by considering the differences in the supplementing and draining acupoints themselves， as well as the actual condition of the patients. Simultaneously， it is suggested to combine manipulation and stimulation amount and effect in clinical practice.