Low-level exposure to environmental heavy metals during pregnancy is common, and the effects of such exposure on the growth and development of the fetus may continue after birth. In this paper, we reviewed the epidemiological studies on heavy metal exposure during pregnancy and children's physical development at home and abroad in recent years, focusing on the associations between four common heavy metals, namely, cadmium, mercury, lead, and arsenic, and children's physical development levels and growth trajectories. The results of existing studies showed that cadmium and mercury exposure during pregnancy was associated with early childhood obesity, lead exposure during pregnancy may lead to dual effects of childhood obesity and growth retardation, and arsenic exposure during pregnancy was associated with childhood growth retardation. At the same time, cadmium and lead exposure during pregnancy had a more significant effect on boys, and there was a sex effect. Most studies of children's growth trajectory showed that exposure to cadmium, arsenic, and lead during pregnancy was often associated with lower childhood body mass index (BMI)/weight-for-age Z-score (WAZ) and height-for-age Z-score (HAZ) growth trajectories, even into adolescence, where the first trimester and the third trimester may be critical windows for cadmium and lead exposure, respectively. The results of mercury exposure during pregnancy associated with children's growth trajectories were controversial due to differences in methods for evaluating mercury exposure. In addition, there may be certain combined effects of mixed exposure to heavy metals during pregnancy on the physical growth and development of children. There is still a need to further elucidate the effects of single metal and multiple heavy metal interactions on children's physical development by combining population-based epidemiological studies with multiple sample sources and time points, and to strengthen basic research to broaden the new understanding of involved mechanisms.

Sepsis is an inflammatory response syndrome caused by systemic immune disorders caused by infection.Platelets play an important role in the development of sepsis.Platelets can react with pathogenic microorganisms through adhesion, aggregation, activation, threshing, and have achieved the role of protecting in the body.At the same time, during sepsis, platelets can also interact with immune cells such as neutrophils and participate in formation of microthrombi and inflammation.Therefore, platelets have an antimicrobial effect and cooperate with other innate immune cells to form a complex intravascular immune defense system to prevent the spread of bacteria.However, if the internal immune function mediated by it is dysregulated, the host cells and tissues may be seriously collaterally damaged, resulting in sepsis-related organ dysfunction.This article reviewed the research progress of platelet immune mechanism and organ dysfunction in sepsis.

Objective To analyze the correlation between elective cesarean delivery and duration of breastfeeding in Ma'anshan city from 2013 to 2014. Methods From May 2013 to September 2014, a total of 3 474 pregnant women with the first prenatal checkup were recruited from Ma'anshan maternal and child health care hospital. Finally, 3 109 pregnant women were included after exclusion of those with terminated pregnancies, adverse birth outcomes, twin or multiple pregnancies, breech traction, breech midwifery and loss of delivery information. Demographic data of pregnant women, mode of delivery and breast feeding of children were collected through questionnaires and hospital records. Logistic regression model was used to analyze the relationship between elective cesarean delivery and duration of breastfeeding in children, with the mode of delivery as independent variable and the duration of breastfeeding as dependent variable. Results The age of 3 109 subjects was (26.6±3.6) years old, the rate of vaginal delivery was 51.1% (1 589), and the rate of elective cesarean delivery was 46.4% (1 443), among which the rate of non?indicative elective cesarean delivery was 26.4% (820), the rate of indicative elective cesarean delivery was 20.0% (623), and the rate of emergency cesarean delivery was 2.5% (77). The proportion of breastfeeding lasting until 4, 12 and 18 months was 45.0% (1 348/2 998), 23.7% (702/2 962) and 5.2% (154/2 944), respectively. After adjusting the confounding factors, compared with vaginal delivery, the OR (95%CI ) values of breastfeeding for 4 months in indicative elective cesarean delivery and non?indicative elective cesarean delivery women were 0.870(0.714-1.059), 0.795(0.665-0.949), and the OR (95%CI) values of breastfeeding for 12 months were 0.772(0.611-0.975), 0.755(0.610-0.934), respectively. Conclusion Elective cesarean delivery may result in shorter duration of breastfeeding in children.

Objective: To analyze the correlation between elective cesarean delivery and duration of breastfeeding in Ma′anshan city from 2013 to 2014. Methods: From May 2013 to September 2014, a total of 3 474 pregnant women with the first prenatal checkup were recruited from Ma′anshan maternal and child health care hospital. Finally, 3 109 pregnant women were included after exclusion of those with terminated pregnancies, adverse birth outcomes, twin or multiple pregnancies, breech traction, breech midwifery and loss of delivery information. Demographic data of pregnant women, mode of delivery and breast feeding of children were collected through questionnaires and hospital records. Logistic regression model was used to analyze the relationship between elective cesarean delivery and duration of breastfeeding in children, with the mode of delivery as independent variable and the duration of breastfeeding as dependent variable. Results: The age of 3 109 subjects was (26.6±3.6) years old, the rate of vaginal delivery was 51.1% (1 589), and the rate of elective cesarean delivery was 46.4% (1 443), among which the rate of non-indicative elective cesarean delivery was 26.4% (820), the rate of indicative elective cesarean delivery was 20.0% (623), and the rate of emergency cesarean delivery was 2.5% (77). The proportion of breastfeeding lasting until 4, 12 and 18 months was 45.0% (1 348/2 998), 23.7% (702/2 962) and 5.2% (154/2 944), respectively. After adjusting the confounding factors, compared with vaginal delivery, the OR (95%CI) values of breastfeeding for 4 months in indicative elective cesarean delivery and non-indicative elective cesarean delivery women were 0.870(0.714-1.059), 0.795(0.665-0.949), and the OR (95%CI) values of breastfeeding for 12 months were 0.772(0.611-0.975), 0.755(0.610-0.934), respectively. Conclusion Elective cesarean delivery may result in shorter duration of breastfeeding in children.

Objective To analyze the correlation between elective cesarean delivery and duration of breastfeeding in Ma'anshan city from 2013 to 2014. Methods From May 2013 to September 2014, a total of 3 474 pregnant women with the first prenatal checkup were recruited from Ma'anshan maternal and child health care hospital. Finally, 3 109 pregnant women were included after exclusion of those with terminated pregnancies, adverse birth outcomes, twin or multiple pregnancies, breech traction, breech midwifery and loss of delivery information. Demographic data of pregnant women, mode of delivery and breast feeding of children were collected through questionnaires and hospital records. Logistic regression model was used to analyze the relationship between elective cesarean delivery and duration of breastfeeding in children, with the mode of delivery as independent variable and the duration of breastfeeding as dependent variable. Results The age of 3 109 subjects was (26.6±3.6) years old, the rate of vaginal delivery was 51.1% (1 589), and the rate of elective cesarean delivery was 46.4% (1 443), among which the rate of non?indicative elective cesarean delivery was 26.4% (820), the rate of indicative elective cesarean delivery was 20.0% (623), and the rate of emergency cesarean delivery was 2.5% (77). The proportion of breastfeeding lasting until 4, 12 and 18 months was 45.0% (1 348/2 998), 23.7% (702/2 962) and 5.2% (154/2 944), respectively. After adjusting the confounding factors, compared with vaginal delivery, the OR (95%CI ) values of breastfeeding for 4 months in indicative elective cesarean delivery and non?indicative elective cesarean delivery women were 0.870(0.714-1.059), 0.795(0.665-0.949), and the OR (95%CI) values of breastfeeding for 12 months were 0.772(0.611-0.975), 0.755(0.610-0.934), respectively. Conclusion Elective cesarean delivery may result in shorter duration of breastfeeding in children.

Objective To explore medical equipment allocation with considerations on randomly distributed and dynamic injury conditions by analyzing injury conditions transition and medical equipment stochastic service process.Methods A casualty array change model was established by injury conditions evolution analysis,Poisson process and Markov chain.Medical equipment stochastic service processes in medical facilities were probed,and the service rules were constructed.Expert investigation was carried out to acquire conditions transition indexes and to determine the vectors for conditions transition without manual intervention and their changes after treatment,then simulation tools were used to optimize medical equipment allocation.Results The emergency treatment table in some field medical station was considered as the subject,and the optimum allocation was proposed for emergency treatment table with practical data and simulation calculation.Conclusion The emergency treatment table allocation proposed was similar to the actual one in the medical station.Markov-process-based medical equipment allocation responses injury conditions changes and the fluctuation of treatment sequence,which has the result reliable and the method versatile and practical,and lays a foundation for medical equipment allocation and optimization.

OBJECTIVE:To improve the quality standard for Guibi zhitong liquor. METHODS:TLC was used for the qualita-tive identification of Radix angelicae,Notopterygium incisum,Radix aucklandiae and Magnolia officinalis in the preparation;HPLC was used for the contents determination of imperatorin and cinnamaldehyde:the column was Waters Symmetry Shield RP-C18 with mobile phase of methanol-water for imperatorin(60:40,V/V)and methanol-water for cinnamaldehyde(35:65,V/V)at a flow rate of 1.0 mL/min,detection wavelength was 254 nm for imperatorin and 290 nm for cinnamaldehyde,column temperature was 25℃,and the injection volume was 20μL. RESULTS:The TLC spots of R. angelicae,N. incisum,R. aucklandiae and M. of-ficinalis were clear and well separated,negative control without interference. The linear range was 3.0-30.0 μg/mL for imperatorin (r=0.9998)and 3.978-39.78 μg/mL for cinnamaldehyde(r=0.9999);RSDs of precision,stability and reproducibility tests were lower than 2.0%;recoveries were 96.94%-102.64%(RSD=2.37%,n=6)and 96.78%-99.53%(RSD=1.00%,n=6). CONCLU-SIONS:The improved standard more effectively control the quality of the Guibi zhitong liquor.

Objective To analyse clinical features of dead children in pediatric intensive care unit(PICU) of Children's Hospital of Chongqing Medical University from 2005 to 2014.Methods Clinical data of 917 dead cases in PICU from January 2005 to December 2014 in this hospital were collected,then distribution characteristics of age,length of hospital stay,time of dead and transfer department were analysed.The death cause analysis was conducted as well.Results According to systematic classification of disease,the top 10 leading causes of death for 917 dead cases in PICU from 2005 to 2014 in this hospital were congenital deformity,infectious disease,respiratory disease,injury and poisoning,digestive system disease,tumor,symptoms,signs and abnormal clinical and laboratory findings not elsewhere classified,circulation system disease,nervous system disease,blood system disease.Compared with 2005-2014,the ratio of dead cases due to infectious diseases to the total cases was declined,while that due to non-infectious diseases was increased,there was statistically significant difference (x2 =26.29,P =0.00).Whereas,the ranks of septicopyemia and hand-foot-mouth disease in the rank order of death causes both were increased.Condusion Congenital deformity is the first cause of death in PICU of this hospital.The key to cutting children's mortality is to reduce newborn with congenital deformity.

Objective To observe the effects of radial artery pressure combined with somatosensory evoked potential monitoring on decreasing the incidence of brachial plexus paralysis in ankylosing spondylitis (AS)patients with kyphosis of thoracic and lumbar vertebra who were corrected surgically by pedicle subtraction osteotomy (PSO).Methods A total of 36 AS patients with kyphosis of thoracic and lumbar vertebra undergoing the surgery of PSO were selected from January 201 4 to December 201 4.During surgery,all patients were applied with artery pressure combined with somatosensory evoked potential monitoring for protecting brachial plexus.Results Positive monitoring indicators occurred in 2 patients during surgery.And then,the monitoring indicators returned to normal by adjusting body position on time;they were not with the symptom of brachial plexus paralysis after surgery.However,positive monitoring indicators occurred in 1 patient and didn′t return to normal by repeatedly adjusting body position.Thus,the patient was found with the symptom of mild brachial plexus paralysis after surgery and returned to normal at 1 week after treatment.There were no neural complications caused by operation during surgery.Conclusions Radial artery pressure combined with somatosensory evoked potential monitoring can indicate the change of compression degree of the brachial plexus in AS patients with kyphosis of thoracic and lumbar vertebra undergoing the surgery of PSO,and it can effectively decrease the incidence of brachial plexus paralysis by appropriate treatment.

Objective To explore the role of transvertebral transposition of the spinal cord in the treatment of the pa?tients suffering from angular kyphoscoliosis with neurologic deficit. Methods Twelve patients with at least 1 year follow?up, in?cluding 5 females and 7 males, suffering from neurologic deficit secondary to angular kyphoscoliosis underwent transvertebral transposition of the spinal cord and posterior correction from January 2005 to June 2013 were retrospectively analyzed. The initial age averaged 21±14 years. The etiologies of deformity were congenital kyphoscoliosis in 9 patients, idiopathic kyphoscoliosis in 3 patients. Preoperative spinal cord function graded by Frankel criteria was 3 cases of grade C and 9 of grade D. The initial major curve was 79.4°±16.2° with a global kyphosis of 68.3°±25.0°. The change of distance between spinal cord and canal on the convex side at the apex was measured on MR images to evaluate the efficacy of transposition;in addition, Cobb angle on coronal and sagit?tal plane was evaluated before surgery, on discharge and at the last follow?up. Results All patients were followed up for 2 years on average (1-5 years). The post operation spinal function evaluated by Frankel criteria were as follow:with grade C of 1 case, grade D of 4 cases and grade E of 7 (7 cases changed one grade, 1 case changed two grades, 4 cases did not change obvious). At the last follow?up, all the cases got obvious recovery of spinal function, with 1 case of grade C and 11 of grade D (10 cases changed one grade, 2 cases changed two grades). The distance between spinal cord and canal on the convex side at the apex changed from 11.9±6.4 mm to 9.8±6.9 mm. After surgery, the major curve improved to 39.3°±15.1° with 50.3%±20.5%correction rate, and the mean loss of correction was 6.1%±7.5%. The mean kyphosis was 41.3°±16.6°, demonstrating a 39.0%±13.0%correction rate im?mediately after operation, and showing 3.1%±4.2%correction loss at the final follow?up. No neurologic complications or no death occurred intra?and post?operatively. No screw or rod fracture, instrumentation loosening and pseudarthrosis were found during fol?low?up. Conclusion Transvertebral transposition of the spinal cord and posterior correction is a useful procedure for the recovery of neurologic deficit secondary to angular kyphoscoliosis, with good results of deformity correction.