Objective: To examine the developmental trajectory of fine motor ability in schoolage children with attention deficit hyperactivity disorder (ADHD) for two years, so as to provide scientific evidence to promote motor development in ADHD children. Methods: From April to June 2019, 31 children aged 6-8 years old were selected from a public elementary school. They were diagnosed with ADHD by two psychiatric professionals according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria. Additionally, 31 typical developmental children, matched for age, sex and IQ with the ADHD group, were recruited as the control group. Fine motor ability was assessed with tasks of hand manual dexterity in Movement Assessment Battery for Children-2 (MACB-2), and a followup assessment was conducted from April to June 2021. The development changes of fine motor ability between two groups of children were compared by using t test and repeated measures analysis of variance. Results: Between baseline and followup periods after two years, the total score of hand fine motor in the ADHD group did not show significant improvement (7.4±3.0, 8.0±3.4; t=-1.05, P>0.05), while there was a small effect size improvement in typically developing control group (9.5±2.1, 10.5±2.4; t=-2.12, effect size=0.38, P<0.05). Followup after two years, coin/peg throwing scores with dominant hand improved between ADHD group and control group (7.0±3.3, 9.5±3.2; 8.4±2.8, 11.6±1.6) (t=-3.74, -6.33, P<0.01; effect size=0.67, 1.14), with a smaller improvement in the ADHD group. The score for threading beads/threads decreased in between ADHD group and control group (7.9±2.4, 5.8±3.1; 9.2±1.1, 8.2±1.9) (t=3.89, 2.78, P<0.01; effect size=0.70, 0.50), with a greater decrease in the ADHD group. Conclusions The development speed of fine motor ability in children with ADHD aged 6-8 is slow and continues to lag behind normal developmental children. Fine motor development in children with ADHD should be closely monitored, and targeted interventions should be implemented when necessary.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.

Objective To observe the effects of melatonin on autophagy in cortical neurons of neonatal rats with hypoxic-ischemic brain damage(HIBD)and to explore its mechanisms via the PI3K/AKT signaling pathway,aiming to provide a basis for the clinical application of melatonin.Methods Seven-day-old Sprague-Dawley neonatal rats were randomly divided into a sham operation group,an HIBD group,and a melatonin group(n=9 each).The neonatal rat HIBD model was established using the classic Rice-Vannucci method.Neuronal morphology in the neonatal rat cerebral cortex was observed with hematoxylin-eosin staining and Nissl staining.Autophagy-related protein levels of microtubule-associated protein 1 light chain 3(LC3)and Beclin-1 were detected by immunofluorescence staining and Western blot analysis.Phosphorylated phosphoinositide 3-kinase(p-PI3K)and phosphorylated protein kinase B(p-AKT)protein expression levels were measured by immunohistochemistry and Western blot.The correlation between autophagy and the PI3K pathway in the melatonin group and the HIBD group was analyzed using Pearson correlation analysis.Results Twenty-four hours post-modeling,neurons in the sham operation group displayed normal size and orderly arrangement.In contrast,neurons in the HIBD group showed swelling and disorderly arrangement,while those in the melatonin group had relatively normal morphology and more orderly arrangement.Nissl bodies were normal in the sham operation group but distorted in the HIBD group;however,they remained relatively intact in the melatonin group.The average fluorescence intensity of LC3 and Beclin-1 was higher in the HIBD group compared to the sham operation group,but was reduced in the melatonin group compared to the HIBD group(P<0.05).The number of p-PI3K+and p-AKT+cells decreased in the HIBD group compared to the sham operation group but increased in the melatonin group compared to the HIBD group(P<0.05).LC3 and Beclin-1 protein expression levels were higher,and p-PI3K and p-AKT levels were lower in the HIBD group compared to the sham operation group(P<0.05);however,in the melatonin group,LC3 and Beclin-1 levels decreased,and p-PI3K and p-AKT increased compared to the HIBD group(P<0.05).The correlation analysis results showed that the difference of the mean fluorescence intensity of LC3 and Beclin-1 protein in the injured cerebral cortex between the melatonin and HIBD groups was negatively correlated with the difference of the number of p-PI3K+and p-AKT+cells between the two groups(P<0.05).Conclusions Melatonin can inhibit excessive autophagy in cortical neurons of neonatal rats with HIBD,thereby alleviating HIBD.This mechanism is associated with the PI3K/AKT pathway.