OBJECTIVE To investigate the protective effects and potential mechanism of alisol B 23-acetate on acute alcoholic liver injury in mice. METHODS Fifty male Kunming mice were divided into the blank group， model group， and alisol B 23-acetate low-， medium- and high-dose groups （10， 20， 40 mg/kg）， with 10 mice in each group. Each group was given relevant drug solution or normal saline intragastrically， once a day， for 2 consecutive weeks. On the 15th day， mice in the blank group were given normal saline intragastrically， while the other four groups were given 12 mL/kg white wine intragastrically， twice at six-hour intervals， to establish an acute alcoholic liver injury model. On the 16th day of the experiment， the liver indexes of mice in each group were calculated； the serum levels of alanine transaminase （ALT）， aspartate transaminase （AST）， total cholesterol （TC）， triglycerides （TG）， malondialdehyde （MDA） and glutathione （GSH） were also determined. The histopathological morphology of their liver tissues was observed and scored. The protein expressions of cytochrome P450 2E1 （CYP2E1）， Kelch-like ECH-associated protein 1 （Keap1）， nuclear factor erythroid 2-related factor 2 （Nrf2） and NAD（P）H： quinone oxidoreductase 1 （NQO1） were measured in liver tissue. RESULTS Compared with model group， mice in each dosage group of alisol B 23-acetate showed varying degrees of recovery in body weight， along with improvements in pathological changes in liver tissues such as inflammatory cell infiltration and fatty vacu oles. Their liver indexes， histopathological scores of liver tissue， serum levels of ALT， AST， TC， TG and MDA， as well as the protein expressions of CYP2E1 and Keap1 in liver tissue， were all significantly decreased （ P ＜0.05 or P ＜0.01）. The serum GSH levels and the protein expressions of Nrf2 （except for the alisol B 23-acetate low-dose group） and NQO1 in liver tissue were significantly increased （ P ＜0.05 or P ＜0.01）， and the changes in the above quantitative indicators showed a dose-dependent pattern. CONCLUSIONS Alisol B 23-acetate can ameliorate acute alcoholic liver injury in mice， and its mechanism may be related to improving antioxidant capacity by regulating the Keap1/Nrf2/NQO1 signaling pathway while simultaneously improving liver lipid metabolism-related indexes.

Objective To develop a platform for reporting medication near miss events and evaluate its application effectiveness,aiming to enhance medication safety of patients.Methods Based on literature review,qualitative interviews,and expert group meetings,a medication near-miss event reporting platform was constructed,including 4 modules:event content filling,event risk grading,event handling,and statistical analysis.50 nurses were conveniently selected from the pediatric ward of a tertiary grade A hospital in Henan Province as the application subjects.The reporting situation and filling duration of medication near miss events,the score of the Medication Near Miss Reporting Disorder Scale,and the incidence of medication near miss events were compared after the application of the platform(from March to August 2023)and before the application(from September 2022 to February 2023).Results The reporting rate of medication near miss events after the application of the platform was higher than that before the application of the platform,and the comparison of the distribution of event nature and occurrence links showed statistically significant differences(P＜0.05).After the application of the platform,the reporting duration of medication near miss events was shorter than that before the application of the platform,and the score of the Medication Near Miss Reporting Disorder Scale was lower than that before the application of the platform.The differences were statistically significant(P＜0.001).There was no statistically significant difference in the incidence of medication near miss events before and after the application of the platform(P=0.241).Conclusion Using this platform can help improve the reporting rate of medication near miss events,reduce the time taken to fill out reports,and minimize reporting barriers for nurses.

Objective To develop a platform for reporting medication near miss events and evaluate its application effectiveness,aiming to enhance medication safety of patients.Methods Based on literature review,qualitative interviews,and expert group meetings,a medication near-miss event reporting platform was constructed,including 4 modules:event content filling,event risk grading,event handling,and statistical analysis.50 nurses were conveniently selected from the pediatric ward of a tertiary grade A hospital in Henan Province as the application subjects.The reporting situation and filling duration of medication near miss events,the score of the Medication Near Miss Reporting Disorder Scale,and the incidence of medication near miss events were compared after the application of the platform(from March to August 2023)and before the application(from September 2022 to February 2023).Results The reporting rate of medication near miss events after the application of the platform was higher than that before the application of the platform,and the comparison of the distribution of event nature and occurrence links showed statistically significant differences(P＜0.05).After the application of the platform,the reporting duration of medication near miss events was shorter than that before the application of the platform,and the score of the Medication Near Miss Reporting Disorder Scale was lower than that before the application of the platform.The differences were statistically significant(P＜0.001).There was no statistically significant difference in the incidence of medication near miss events before and after the application of the platform(P=0.241).Conclusion Using this platform can help improve the reporting rate of medication near miss events,reduce the time taken to fill out reports,and minimize reporting barriers for nurses.

【Objective】 To investigate the development of adaptability in children aged 2 - 6, and to explore its influencing factors, so as to provide reference for promoting the development of adaptability in young children. 【Methods】 Data were from the National Nutrition and Health Systematic Survey for Children in China, and 3 319 children aged 2 - 6 and their parents from 28 sites across 14 provinces were recruited in this study.The Development Scale for Children Aged 0 - 6 years (WS/T 580-2017) was used to measure the developmental quotient of children′s adaptive ability, and a survey questionnaire was used to collect relevant information about children and their parents. 【Results】 Among 3 319 children aged 2 - 6, the proportion of slightly low or low level of adaptability, moderate adaptability development, good and excellent adaptability development was 7.68%,66.25% and 26.06%, respectively.The proportion of children aged 5 - 6 with good and excellent adaptability was lower in 3-year-old and 4-year-old groups (χ²=59.29, P<0.05).Multiple stepwise linear regression showed that children′s gender (β=0.06), gestational age of birth (β=-0.05), only child (β=-0.04), left-behind child (β=-0.04), the main caregiver (β=-0.06), and the education level of parents (β=0.09, 0.10), whether parents actively pay attention to children′s emotions (β=-0.06) and whether children play with homemade toys (β=-0.04) were the influencing factors of children′s adaptive development quotient.Girls, full-term children, only children, non-left-behind children, children with parents as main caregivers, parents with a high level of education, parents who often take the initiative to pay attention to children′s emotions, and children who play with homemade toys had a higher level of adaptability development quotient. 【Conclusions】 The development level of adaptability in children aged 2 - 6 in China is mostly above the average level and is related to multiple factors.Targeted intervention work can be carried out on relevant factors in order to promote the development of children′s adaptability.

Objective:To investigate the safety and feasibility of the CHESS endoscpic ruler (CHESS ruler), and the consistency between the measured values and the interpretation values by endoscopic physician experience.Methods:From January 2021 to January 2022, a total of 105 liver cirrhosis patients with portal hypertension were prospectively enrolled from General Hospital, Xixia Branch Hospital, Ningnan Hospital of People′s Hospital of Ningxia Hui Autonomous Region (29 cases), and the First People′s Hospital of Yinchuan (25 cases), General Hospital of Ningxia Medical University (18 cases), Wuzhong People′s Hospital (10 cases), the Fifth People′s Hospital of Ningxia Hui Autonomous Region (10 cases), Shizuishan Second People′s Hospital (6 cases), Yinchuan Second People′s Hospital (5 cases), and Zhongwei People′s Hospital (2 cases) 8 hospitals. The clinical characteristics of all the patients, including gender, age, nationality, etiolog of liver cirrhosis, and Child-Pugh classification of liver function were recorded. A big gastroesophageal varices was defined as diameter of varices ≥5 mm. Endoscopist (associated chief physician) performed gastroscopy according to the routine gastroscopy procedures, and the diameter of the biggest esophageal varices was measured by experience and images were collected, and then objective measurement was with the CHESS ruler and images were collected. The diameter of esophageal varices of 10 randomly selected patients (random number table method) was determined by 6 endoscopists (attending physician or associated chief physician) with experience or measured by CHESS ruler. Kappa test was used to test the consistency in the diameter of esophageal varices between measured values by CHESS ruler and the interpretation values by endoscopic physician experience.Results:Among 105 liver cirrhosis patients with portal hypertension, male 65 cases and female 40 cases, aged (54.8±12.2) years old, Han nationality 82 cases, Hui nationality 21 cases and Mongolian nationality 2 cases. The etiology of liver cirrhosis included chronic hepatitis B (79 cases), alcoholic liver disease (7 cases), autoimmune hepatitis (7 cases), chronic hepatitis C (2 cases), and other etiology (10 cases). Liver function of 32 cases was Child-Pugh A, Child-Pugh B 57 cases, and Child-Pugh C 16 cases. All 105 liver cirrhosis patients with cirrhotic portal hypertension were successfully measured the diameter of gastroesophageal varices by CHESS ruler, and the success rate of application of CHESS ruler was 100.0% (105/105). The procedure time from the CHESS ruler into the body to the exit of the body after measurement was (3.50±2.55) min. No complications happened in all the patients during measurement. Among 105 liver cirrhosis patients with cirrhotic portal hypertension, 96 cases (91.4%) were recognized as big gastroesophageal varices by the endoscopists. Totally 93 cases (88.6%) were considered as big gastroesophageal varices by CHESS ruler. Eight cases were recognized as big gastroesophageal varices by the endoscopist, however not by the CHESS ruler; 5 cases were recognized as big gastroesophageal varices by the CHESS ruler, but not by the endoscopists; 4 cases were not recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler; 88 cases were recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler. The missed diagnostic rate of big gastroesophageal varices by the endoscopists experience was 5.4% (5/93), and the Kappa value of consistency coefficient between the measurement by the CHESS ruler and the interpretation by endoscopists experience was 0.31 (95% confidence interval 0.03 to 0.60). The overall Kappa value of consistency coefficient by 6 endoscopists measured by CHESS ruler in big gastroesophageal varices diagnosis was 0.77 (95% confidence interval 0.61 to 0.93).Conclusion:As an objective measurement tool, CHESS ruler can make up for the deficiency of subjective judgment by endoscopists, accurately measure the diameter of gastroesophageal varices, and is highly feasible and safe.

Objective:To explore the strategy of pregnancy in patients with tubal pregnancy (TP) undergoing salpingectomy.Methods:A retrospective cohort study was conducted to analyze the clinical data of patients who underwent hysterosalpingo contrast sonography (HyCoSy) at Reproductive Medicine Center of Peking University Third Hospital from January 1, 2019 to December 31, 2020 due to salpingectomy for TP. Patients were divided into 3 groups according to the time of pregnancy test and infertility history at the time to HyCoSy (TTH), group A: patients with no history of infertility, attempted pregnancy <1 year after TP ( n=33); group B: patients with history of infertility, attempted pregnancy <1 year after TP ( n=22); group C: patients attempted pregnancy ≥1 year after TP ( n=64). The remaining tubal patency and clinical outcome were analyzed. Results:There were no significant differences in age, number of pregnancies, history of repeated TP (RTP), number of antral follicles, pregnancy rate treated with in vitro fertilization (IVF), incidence of RTP in IVF and spontaneous pregnancy, and the time to pregnancy (TTP) from HyCoSy among groups A, B and C (all P>0.05). TTH from salpingectomy in group C [30.0 (20.0, 42.0) months] was significantly longer than that in groups A and B [13.0 (7.5, 16.5) months, 8.0 (7.0, 10.0) months, P<0.001]. The proportion of unobstructed fallopian tubes and the spontaneous pregnancy rate in group A were significantly higher than those in group C [72.7% (24/33) vs. 43.8% (28/64), P=0.025; 42.4% (14/33) vs. 12.5% (8/64), P=0.004], and the IVF treatment rate in group A [30.3% (10/33)] was significantly lower than that in groups B and C [86.4% (19/22), 71.9% (46/64), P<0.001]. The proportion of unobstructed fallopian tubes and the spontaneous pregnancy rate in group B were higher than those in group C, and the differences were not statistically significant (all P>0.05). The time required for spontaneous pregnancy in group A was less than that in groups B and C, but the difference was not statistically significant ( P>0.05). Logistic regression analysis showed that infertility (history/symptom) was a related factor of tubal patency and pregnancy outcome ( OR=0.366, 95% CI: 0.148-0.904, P=0.029; OR=8.504, 95% CI: 2.294-31.519, P=0.014). Conclusion:After salpingectomy on one side, patients without infertility (history/symptoms) can actively try to conceive for 6 months, if they are not pregnant, tubal patency test can be actively performed and decide on fertility strategy; for patients with infertility (history/symptom), IVF was recommended actively without tubal patency evaluation.

Objective:To explore the strategy of pregnancy in patients with tubal pregnancy (TP) undergoing salpingectomy.Methods:A retrospective cohort study was conducted to analyze the clinical data of patients who underwent hysterosalpingo contrast sonography (HyCoSy) at Reproductive Medicine Center of Peking University Third Hospital from January 1, 2019 to December 31, 2020 due to salpingectomy for TP. Patients were divided into 3 groups according to the time of pregnancy test and infertility history at the time to HyCoSy (TTH), group A: patients with no history of infertility, attempted pregnancy <1 year after TP ( n=33); group B: patients with history of infertility, attempted pregnancy <1 year after TP ( n=22); group C: patients attempted pregnancy ≥1 year after TP ( n=64). The remaining tubal patency and clinical outcome were analyzed. Results:There were no significant differences in age, number of pregnancies, history of repeated TP (RTP), number of antral follicles, pregnancy rate treated with in vitro fertilization (IVF), incidence of RTP in IVF and spontaneous pregnancy, and the time to pregnancy (TTP) from HyCoSy among groups A, B and C (all P>0.05). TTH from salpingectomy in group C [30.0 (20.0, 42.0) months] was significantly longer than that in groups A and B [13.0 (7.5, 16.5) months, 8.0 (7.0, 10.0) months, P<0.001]. The proportion of unobstructed fallopian tubes and the spontaneous pregnancy rate in group A were significantly higher than those in group C [72.7% (24/33) vs. 43.8% (28/64), P=0.025; 42.4% (14/33) vs. 12.5% (8/64), P=0.004], and the IVF treatment rate in group A [30.3% (10/33)] was significantly lower than that in groups B and C [86.4% (19/22), 71.9% (46/64), P<0.001]. The proportion of unobstructed fallopian tubes and the spontaneous pregnancy rate in group B were higher than those in group C, and the differences were not statistically significant (all P>0.05). The time required for spontaneous pregnancy in group A was less than that in groups B and C, but the difference was not statistically significant ( P>0.05). Logistic regression analysis showed that infertility (history/symptom) was a related factor of tubal patency and pregnancy outcome ( OR=0.366, 95% CI: 0.148-0.904, P=0.029; OR=8.504, 95% CI: 2.294-31.519, P=0.014). Conclusion:After salpingectomy on one side, patients without infertility (history/symptoms) can actively try to conceive for 6 months, if they are not pregnant, tubal patency test can be actively performed and decide on fertility strategy; for patients with infertility (history/symptom), IVF was recommended actively without tubal patency evaluation.

Objective: To explore the relationship between anemia and neuropsychological development in various domains among preschool children in China. Methods: Data came from the National Nutrition and Health Systematic Survey for children in China, and 3 261 preschool children aged 2-6 years and their parents from 28 sites across 14 provinces were recruited in this study. Parental and child characteristics were obtained by interview administrated questionnaires. Blood hemoglobin(Hb) concentration was determined by Hemocue method. Neuropsychological development quotients were assessed using the Development Scale for Children Aged 0-6 Years(WS/T 580-2017). Results: The average Hb level was (125.23±11.49)g/L and the overall anemia prevalence was 10.30% among preschool children. After adjusting the confounding factors(sex, age, ethnicity, region, feeding mode, maternal status during pregnancy, etc), developmental quotients of gross motor( β=-2.15, 95%CI =-3.89--0.41), fine motor( β=-2.46, 95%CI =-4.12--0.79), adaptive behavior( β=-2.59, 95%CI =-4.42--0.76), language( β=-3.65, 95%CI =-5.53--1.78), personal social behavior( β=-3.11, 95%CI =-4.94--1.28) and full scale( β=-2.79, 95%CI =-4.10--1.49) among children with anemia were significantly lower than non anemic infants( P <0.05). Conclusion Anemia was negatively associated with developmental quotient, as well as five domains of gross motor, fine motor, adaptive behavior, language, and personal social behavior in preschool children aged 2-6 years. It is suggested to carry out the work of anemia monitoring and intervention in preschool children to further improve their neuropsychological development.

Objective: To explore relationship between screen time and myopia in children aged 11-14 years in China. Methods: The data were extracted from "National Nutrition and Health Systematic Survey and Application for 0-18 Years Old Children". A total of 12 397 children aged 11-14 years old from 14 provinces and 28 districts/counties in seven regions of China were surveyed by using multi stage stratified random sampling method. Daily screen time and visual acuity information were collected through a questionnaire. Results: The myopia rate of 11-14 years old children in China was 45.0%, among which the rate of girls was higher than that of boys, and the rate of urban was higher than that of rural, and it increased with age ( χ 2=178.82,79.25, 495.96 , P <0.01). The daily screen time median of 12 397 children was 40.0 minutes, with boys(40.0 min) longer than girls( 35.0 min ) and urban children(40 min) longer than rural children(33.0 min) ( χ 2=20.86，102.68， P <0.01). The myopia rate of boys ( 42.5 %) with daily screen time greater than or equal to 60 minutes was higher than that of boys (36.4%) with daily screen time less than 60 minutes, and the myopia rate of girls (55.6%) with daily screen time greater than or equal to 60 minutes was higher than that of girls (48.0%)( χ 2=23.62，34.15， P <0.01). After adjusting for age, gender, region, time of medium and high intensity physical activity, intake of sugary food and sugary beverages, daily sleep time, multivariable Logistic regression model showed that girls with daily screen time greater than or equal to 60 minutes ( OR=1.14, 95%CI =1.03-1.27) had a higher risk of myopia than those with less than 60 minutes. After adjusting for confounding factors, there was no correlation between daily screen time and the degree of myopia in boys or girls( P >0.05). Conclusion Daily screen time greater than or equal to 60 minutes may be a risk factor for myopia in girls aged 11 to 14 years old. Given the complexity of the factors that affect vision, researches are needed to examine the relationship between screen time and myopia.

Objective:By comparing standard gonadotropin-releasing hormone antagonist regimen and gonadotropin-releasing hormone agonist-antagonist protocol (AAP regimen) in Patient-Oriented Strategies Encompassing Individualized Oocyte Number (POSEIDON) group 3 and group 4 patients with low prognosis, to study if AAP regimen could improve the clinical outcomes in low prognosis patients.Methods:A case-control study was performed, the clinical data of 646 cycles of prospective poor ovarian response (POR) patients (POSEIDON group 3 and 4) who received in vitro fertilization and embryo transfer (IVF-ET) in Peking University Third Hospital Department of Obstetrics and Gynecology, Reproductive Medical Center from January 2016 to May 2018 were retrospectively analyzed. The total number of AAP cycle was 323, and control group was selected from the database with 1∶1 matching of contemporaneous prospective POR patients (POSEIDON group 3 and group 4) with similar age and approaching date of oocyte retrieval. Patients' general information, ovarian stimulation indexes and clinical outcomes were compared. Results:AAP group had fewer antral follicle count (AFC) [3.00(2.00,4.00) vs. 4.00(2.00,5.00), P<0.001] and similar anti-Müllerian hormone (AMH) level [0.51(0.25,0.83) μg/L vs. 0.53(0.31,0.81) μg/L, P>0.05] compared with control group. AAP group had shorter duration of gonadotropin (Gn) used [10.00(8.00,11.00) d vs. 10.00(9.00,11.00) d, P=0.020] and lower dosage of Gn used [2 675.00(2 100.00,3 300.00) U vs. 3 075.00(2 550.00,3 750.00) U, P<0.001] than control group. AAP group had similar number of oocytes obtained [3.00(2.00,5.00) vs. 4.00(2.00,6.00), P>0.05] compared with control group. Under the same proportion of fertilization schemes (routine or intracytoplasmic sperm injection methods), AAP group had higher fertilization rate [74.15% (955/1288) vs. 69.13% (918/1328), P=0.004] and good-quality embryo rate [62.57% (585/935) vs. 56.94% (509/894), P=0.014], and ultimately had higher embryo implantation rate [22.31% (87/390) vs. 15.84% (64/404), P=0.020], cumulative clinical pregnancy rate [32.50% (78/240) vs. 22.86% (56/245), P=0.018] and cumulative live birth rate [25.83% (62/240) vs. 17.96% (44/245), P=0.036]. Conclusion:For POSEIDON patients with low prognosis and POR, controlled ovarian hyperstimulation with AAP regimen had better clinical outcomes compared with conventional antagonist regimen.