Objective To explore the structural changes and potential improvement in the reporting system,and to provide reference for improving the efficiency of drug safety supervision.Methods Descriptive statistical analysis and structural analysis were used to analyze the source of adverse drug reaction(ADR)reports,the occupation of the reporter,the age of the patient,the type of drug and the route of administration in China from 2014 to 2023.Results The structural variation of the source of ADR report,the occupation of the reporter,the age of the patient,the type of drug and the route of administration in China were 20.00%,6.20%,27.20%,9.40%and 16.62%,respectively.Among them,patients aged 65 and over(VSV=13.20)had the largest change value and positive change;the source of drug business enterprises(VSV=-9.70),intravenous injection route(VSV=-6.51)and traditional Chinese medicine category(VSV=-4.70)showed negative changes.Conclusions It is necessary to improve the laws and regulations of the industry,enhance the ability of enterprises to implement the main responsibility,improve the public's awareness and participation awareness of ADR,strengthen the monitoring and guidance strategies of drug safety in specific age groups,improve the monitoring level of adverse reactions of traditional Chinese medicine,and strengthen the supervision of adverse reactions of intravenous injection.

Objective To observe the value of prenatal ultrasound evaluation on morphology of Sylvian fissure(SF)during the second and third trimesters for screening fetal abnormal cerebral cortical development.Methods Totally 876 fetuses in the second and third trimesters were retrospectively included.Prenatal ultrasound was performed to observe the morphology of fetal SF and whether there was complicated abnormalities of the development of cerebral cortical and other structures.Then prenatal ultrasound was regularly reexamined,and the pregnancy outcome,while the growth and development of newborns were followed up.Results Among 876 fetuses,normal SF morphology was observed in 861 fetuses(861/876,98.29％),while 11 fetuses(11/876,1.26％)had delayed SF development(normal SF morphology but inconsistent with gestational week)and 4 fetuses(4/876,0.46％)had abnormal SF morphology,all complicated with abnormal cerebral cortical development and/or intracranial and extracranial structural malformations,and reexamination of prenatal ultrasound showed that SF morphology was consistent with the gestational week in 4 fetuses,SF morphology still did not match the gestational week in 4 fetuses,and SF morphology was still abnormal in 2 fetuses.Among these 15 fetuses,6 were successfully born and grew well after followed up until 10-15 months,4 were induced labor,while the rest 4(3 with delayed SF development and 1 with abnormal SF morphology)complicated with other severe malformations and 1 with abnormal SF morphology were induced labor or lost to follow-up,hence not undergoing ultrasound re-examination.Conclusion Prenatal ultrasound evaluation on SF morphology during the second and third trimesters had important value for screening fetal abnormal cerebral cortical development.

Objective To explore the structural changes and potential improvement in the reporting system,and to provide reference for improving the efficiency of drug safety supervision.Methods Descriptive statistical analysis and structural analysis were used to analyze the source of adverse drug reaction(ADR)reports,the occupation of the reporter,the age of the patient,the type of drug and the route of administration in China from 2014 to 2023.Results The structural variation of the source of ADR report,the occupation of the reporter,the age of the patient,the type of drug and the route of administration in China were 20.00%,6.20%,27.20%,9.40%and 16.62%,respectively.Among them,patients aged 65 and over(VSV=13.20)had the largest change value and positive change;the source of drug business enterprises(VSV=-9.70),intravenous injection route(VSV=-6.51)and traditional Chinese medicine category(VSV=-4.70)showed negative changes.Conclusions It is necessary to improve the laws and regulations of the industry,enhance the ability of enterprises to implement the main responsibility,improve the public's awareness and participation awareness of ADR,strengthen the monitoring and guidance strategies of drug safety in specific age groups,improve the monitoring level of adverse reactions of traditional Chinese medicine,and strengthen the supervision of adverse reactions of intravenous injection.

Objective To observe the value of prenatal ultrasound evaluation on morphology of Sylvian fissure(SF)during the second and third trimesters for screening fetal abnormal cerebral cortical development.Methods Totally 876 fetuses in the second and third trimesters were retrospectively included.Prenatal ultrasound was performed to observe the morphology of fetal SF and whether there was complicated abnormalities of the development of cerebral cortical and other structures.Then prenatal ultrasound was regularly reexamined,and the pregnancy outcome,while the growth and development of newborns were followed up.Results Among 876 fetuses,normal SF morphology was observed in 861 fetuses(861/876,98.29％),while 11 fetuses(11/876,1.26％)had delayed SF development(normal SF morphology but inconsistent with gestational week)and 4 fetuses(4/876,0.46％)had abnormal SF morphology,all complicated with abnormal cerebral cortical development and/or intracranial and extracranial structural malformations,and reexamination of prenatal ultrasound showed that SF morphology was consistent with the gestational week in 4 fetuses,SF morphology still did not match the gestational week in 4 fetuses,and SF morphology was still abnormal in 2 fetuses.Among these 15 fetuses,6 were successfully born and grew well after followed up until 10-15 months,4 were induced labor,while the rest 4(3 with delayed SF development and 1 with abnormal SF morphology)complicated with other severe malformations and 1 with abnormal SF morphology were induced labor or lost to follow-up,hence not undergoing ultrasound re-examination.Conclusion Prenatal ultrasound evaluation on SF morphology during the second and third trimesters had important value for screening fetal abnormal cerebral cortical development.

Objective To explore prenatal ultrasonic characteristics of fetal Currarino syndrome(CS)and methods for prenatal diagnosis of CS.Methods Two fetuses with CS confirmed by genetic examination were retrospectively analyzed,while 6 CS fetuses with complete prenatal ultrasonic data in literature were reviewed.Prenatal ultrasonic characteristics of CS fetuses and the method for prenatal diagnosis of CS were discussed.Results Among 8 CS fetuses diagnosed with prenatal ultrasound,4 were female singletons with a clear family history of CS,and MNX1 gene mutation was found in 1 fetus.The other 4 fetuses were 2 pairs of male monochorionic twins,all with MNX1 gene mutation.Among 8 CS fetuses,complete triad(sacral agenesis abnormalities,anorectal malformation and presacral mass)were displayed only in 2 fetuses,while all 8 had sacral agenesis abnormalities and 6(6/8,75.00％)were detected with prenatal ultrasound,6 had low location of conus medullaris and 2(2/6,33.33％)detected with prenatal ultrasound.Conclusion Prenatal ultrasound was the first choice for non-invasive diagnosis of fetal CS.When one of sacral agenesis abnormalities,anorectal malformation and presacral mass was found with prenatal ultrasound,the possibility of CS should be considered,and fetal MRI,genetic examination and prenatal genetic counselling should be recommended if necessary.

0bjective To analyze the clinical characteristics, pathological types, treatment and prognosis in children with steroid resistant nephrotic syndrome (SRNS) in Northwest China, in order to provide reference for the treatment of SRNS. Methods:The clinical data, renal pathological results, treatment plan and efficacy of 102 children diagnosed with SRNS in the Department of Nephrology, Xi'an Children's Hospital of Shaanxi Province from January 1st, 2018 to December thirty-first, 2020 were analyzed retrospectively. All children were divided into groups according to age, clinical classification, pathological type, treatment scheme and treatment outcome, and the risk factors affecting the prognosis of children with SRNS were discussed. The measurement datas conforming to normal distribution were expressed as xˉ± s, and t test was used for comparison between groups. Measurement datas that did not conform to normal distribution were represented by M ( Q1, Q3), and Kruskall-Wallis test was used for comparison between groups.Enumeration datas were compared by χ 2 test. Risk factors were analyzed by multiple factor Logistic regression analysis. Results:The median age of onset of 102 children with SRNS was 3.0 years. Focal segmental glomerulosclerosis (FSGS) accounted for 36.3% (37/102), minimal lesions accounted for 33.3% (34/102), and mesangial proliferative glomerulonephritis accounted for 23.5% (24/102). The prevalence rates of hypertension (35.1% (13/37)), 24-h urine protein quantification (130.5 (91.5, 159.6) mg/(kg·24 h) and renal insufficiency (21.6% (8/37)) in FSGS group were higher than those in non-FSGS group (13.8% (9/65), 65.8 (51.2,85.5) mg/(kg·24 h), 4.6% (3/65)). The differences between the two groups were statistically significant (statistical values were χ 2=6.32, Z=5.90, χ 2=7.09; P values were 0.012, <0.001, 0.008). Logistic multivariate regression analysis showed that the hypertension ( OR=4.055, 95% CI 1.178-3.962) and 24 hour urinary protein ( OR=1.036, 95% CI 1.020-1.053) were associated with the increased risk of FSGS ( P values were 0.026 and <0.001). ROC curve ananlysis showed that the optimal critical value of 24 hour urinary protein was 85.65 mg/(kg·24 h) in FSGS. After treatment, complete remission was 61.8%(63/102), partial remission was 14.7%(15/102), and no remission was 23.5%(24/102). By the end of follow-up the treatment effective rate in the small lesion group (94.1%(32/34)) was higher than that in the FSGS Group (51.3%(19/37)), and the difference between the two groups was statistically significant (χ 2=16.02, P<0.001). In the initial immunosuppressive treatment, the complete remission rate of hormone combined with calcineurin inhibitor group (77.1%(37/48)) was higher than that of hormone combined with cyclophosphamide Group (11.1%(3/27)). There was significant difference between the two groups ( Z=32.28, P<0.001). Conclusion:The most common pathological type in children with SRNS was FSGS, and the age of onset was generally small. The prognosis of patients with pathological type FSGS was the worst, and the prognosis of small lesions was better. Hypertension and 24-hour urinary protein quantification were the risk factors of FSGS. Calcineurin inhibitors were the first choice for the second-line immunosuppressants of SRNS in children.