Depression is a major cause of disability and has adverse effects.Despite the many types of anti-depressants,clinical treatments of depression remain poor.Therefore,novel anti-depressant mechanisms need to be explored.The beneficial effects of irisin on the nervous system are gradually being elucidated,and studies have found that irisin has an anti-depressant effect,which may become a new treatment for depression.This study explored the mechanism of irisin and its upstream and downstream anti-depressants by reviewing the existing studies explaining the link between irisin and depression,and proposes that SIRT1/PGC-1α may mediate FNDC5/irisin to regulate BDNF to promote neurogenesis and improve depression,which provides a new idea to study irisin and its upstream and downstream anti-depressants.

AIM: To observe the clinical effect of invisible anchor hook intraocular lens(IOL)fixation surgery.METHODS: Prospective and uncontrolled case study. A total of 19 patients(19 eyes)with aphakia, IOL dislocation, or lens dislocation from January 2019 to December 2020 were selected for this study, all of whom underwent anchor hook IOL scleral fixation implantation surgery. The main postoperative observation indicators are best corrected visual acuity(BCVA), uncorrected visual acuity(UCVA), corneal endothelial cell density, tilt of IOL position, and complications.RESULTS: The UCVA(LogMAR)before and at 1 mo after surgery was 1.06±0.63 and 0.40±0.26, respectively(P<0.01), BCVA(LogMAR)before and at 1 mo after surgery was 0.27±0.51 and 0.06±0.15, respectively(P=0.09), and the average corneal endothelial cell density was 2406±625 and 2004±759 cells/mm2(P=0.13). The complications that occurred at 1 d postoperatively were 2 and higher grade aqueous flare(3 eyes), wrinkling of the corneal posterior elastic layer(2 eyes), and transient elevated intraocular pressure(2 eyes). No IOL dislocation occurred during 24 mo follow-up.CONCLUSION:The anchor hook type IOL scleral interlayer fixation technique, which involves anterograde insertion and retrograde fixation of the interstitial thread, is similar to the principle of anchor hook and achieves good IOL stability and visual effects.

The impact of prenatal exposure to a mixture of heavy metals on birth weight in newborns has been a topic of ongoing interest. In this study, 258 mothers and infants from the New Hampshire Birth Cohort Study (NHBCS) were selected as the study subjects, and the concentrations of seven heavy metals in the placenta, including Aluminum (Al), Cobalt (Co), Chromium (Cr), Nickel (Ni), Plumbum (Pb), Selenium (Se) and Arsenic (As) were collected. And the birth weight of newborns, the relevant covariates of mothers and newborns were collected. Three analytical methods, Weighted Quantile Sum (WQS) regression, Quantile g-computation (QGC) and Bayesian kernel machine regression (BKMR) were employed. After adjusting for maternal gestational age, pre-pregnancy BMI, smoking status, education level, parity, gestational age and newborn gender, the combined three methods showed that the total effect of mixed exposure of seven heavy metals on birth weight was negative. Specifically, the WQS analysis revealed that Se had the greatest impact on birth weight, followed by Al. The QGC results showed that the heavy metal associated with the reduction of birth weight was mainly Se and Al in female and male infants, respectively. The BKMR analysis demonstrated a negative combined effect of the seven heavy metals on birth weight in both male and female infants, with Se having the highest posterior inclusion probabilities (PIPs) for female infants (0.45), and Al having the highest PIPs for male infants (0.64) after stratification by gender. In summary, mixed exposure to heavy metals during pregnancy was associated with a decrease in newborn birth weight. Furthermore, there are gender effects with Se and Al associated with decreased birth weight in female and male infants, respectively. These findings provide a theoretical basis for the development of public health policies aimed at preventing adverse pregnancy outcomes and improving the health of newborns.

The impact of prenatal exposure to a mixture of heavy metals on birth weight in newborns has been a topic of ongoing interest. In this study, 258 mothers and infants from the New Hampshire Birth Cohort Study (NHBCS) were selected as the study subjects, and the concentrations of seven heavy metals in the placenta, including Aluminum (Al), Cobalt (Co), Chromium (Cr), Nickel (Ni), Plumbum (Pb), Selenium (Se) and Arsenic (As) were collected. And the birth weight of newborns, the relevant covariates of mothers and newborns were collected. Three analytical methods, Weighted Quantile Sum (WQS) regression, Quantile g-computation (QGC) and Bayesian kernel machine regression (BKMR) were employed. After adjusting for maternal gestational age, pre-pregnancy BMI, smoking status, education level, parity, gestational age and newborn gender, the combined three methods showed that the total effect of mixed exposure of seven heavy metals on birth weight was negative. Specifically, the WQS analysis revealed that Se had the greatest impact on birth weight, followed by Al. The QGC results showed that the heavy metal associated with the reduction of birth weight was mainly Se and Al in female and male infants, respectively. The BKMR analysis demonstrated a negative combined effect of the seven heavy metals on birth weight in both male and female infants, with Se having the highest posterior inclusion probabilities (PIPs) for female infants (0.45), and Al having the highest PIPs for male infants (0.64) after stratification by gender. In summary, mixed exposure to heavy metals during pregnancy was associated with a decrease in newborn birth weight. Furthermore, there are gender effects with Se and Al associated with decreased birth weight in female and male infants, respectively. These findings provide a theoretical basis for the development of public health policies aimed at preventing adverse pregnancy outcomes and improving the health of newborns.

Abstract OBJECTIVE To carry out clinical comprehensive evaluation of prophylactic drugs for clean surgery(type I incision) in children, and to promote the rational use of antibiotics during perioperative period. METHODS According to the Guidelines for the Management of Comprehensive Clinical Evaluation of Drugs(trial edition of 2021), the clinical comprehensive evaluation system of prophylactic drugs for clean surgery(type I incision) was established by using the methods of literature research, brainstorming, expert interview and Delphi, and the evaluation evidence was collected to carry out the comprehensive evaluation of multi-dimensional and multi-level evidence. RESULTS The clinical comprehensive evaluation system was constructed, including 5 first-class indicators(safety, effectiveness, economy, suitability, and accessibility), 11 second-class indicators and 30 third-class indicators. The clinical comprehensive evaluation score of cefazolin was 86.09, and that of cefuroxime was 81.86. The former was better than the latter in safety, effectiveness, economy and suitability, while the latter was better than the former in accessibility. CONCLUSION The clinical comprehensive evaluation of prophylactic drugs for clean surgery(type I incision) in children constructed in this study is scientific, and the results provides a basis for the selection of antibiotics for clean surgery(type I incision) in hospital

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

OBJECTIVE：To provi de reference for standardizing pediatric clinical trials and promoting the development and application of pediatric medication in China. METHODS ：Chinese Clinical Trial Registry （Chi CTR ）database were searched to collect all clinical trials related to pediatric population under 18 years old from the inception to Oct. 1st，2019. Those clinical trials were analyzed statistically in respect of name of registered project ，involved disease/system ，research stage ，registration time ， registration status ，regional distribution of research institutions ，source of funds ，research type ，whether data management committee was set up ，situation of recruited research objects ，ethics committee approval status ，whether blind method was adopted ， whether to collect human specimens and whereabouts of human specimens. RESULTS ：A total of 231 pediatric drug clinical trials were included. The clinical trials involved 21 kinds of diseases/systems ，mainly were tumors and tumor-like lesions ，ophthalmic diseases and allergic disease. The research stage has the most items （85 trials，36.80％）in post-marketing drug clinical trials ；there were 77 items of phase Ⅰ-Ⅳ clinical trials （33.33％）. The number of pediatric drug clinical trials was increased year by year ，and among which 179 trials were pre-registered （77.49％），52 trials were supplementary registration （22.51％）. Beijing ，Shanghai， Guangdong，Chongqing and Zhejiang were the major regions where pediatric drug clinical trials were carried out ，and the clinical trial projects of which accounted for 66.23％（153/231）of the total number of included projects. The funding sources were mainly self-financing（57.85％），hospital finance （20.18％），and local government finance （10.31％）. The main type of research was intervention study and observational study ，accounting for 88.31％ in total. Totally 145 trials（62.77％）had not yet determined whether to set up a data management committee ；201 trials（87.01％）had passed the review of the ethics committee of the relevant institution；168 trials（72.73％）did not clarify whether the blind method was used ；133 trials（57.58％）had collected 001-001） human specimens ，and the collected human specimens were 3360875。E-mail：794446155@qq.com mainly destroyed after use. CONCLUSIONS ：The number of pediatric drug clinical trials registered in Chi CTR is increasing but there i s regional imbalance. Researchers have gradually established the concept of pediatric clinical trial registration ，and have realized the importance of data management to research quality ，and the management of collected trial specimens is relatively standardized. It is suggested that relevant departments increase the publicity of clinical trial registration and improve the clinical trial registration management system ； relevant researchers should increase the awareness of clinical trial registration ，standardize registration application and trial project management.

Objective: To study the application value of improved early warning score in the practice of theory and practice interactive infiltration training mode for neurosurgery interns. Methods: A total of 84 neurosurgery interns were selected as study samples and randomly divided into control group and intervention group by random double blind method, each group had 42 interns. The control group adopted the interactive infiltration model of theory and practice. The Intervention group adopted the interactive infiltration training mode of theory and practice under the improved early warning scoring system design. Statistics and comparison of the performance of the two groups of trainee nurses, the evaluation of teaching teachers and patients, the self-evaluation of trainee nurses, and the occurrence of nursing errors during the internship. Results: The related examination results between the two groups showed significance (t value was 7.182,5.462,5.530, P<0.01). The evaluation for nursing students by teachers and patients also showed significant difference (t value was 6.989-8.790, P<0.01). The incidence of error event in the intervention group was 9.52% (4/42), lower than that in the control group [30.95% (13/42)]. There was statistical difference between two groups (χ² value was 14.227, P<0.01). Conclusions The application of the improved early warning score in the theory and practice interactive infiltration training mode of neurosurgery interns can improve the satisfaction of teachers and patients to interns, enhance the self-satisfaction of interns and reduce the incidence of nursing errors of interns.

Objective:To understand the application status of rectal drip therapy, so as to make recommendations for its rational application.Methods:In order to analyze the actual situation of rectal drip therapy and the cognition status of the safety, absorption degree and convenience of rectal drip therapy, a questionnaire survey was conducted from 947 different medical institutions in 22 provinces, 4 direct-controlled municipalities and 4 autonomous regions from July 4 to July 15, 2019.Results:(1) A total of 1 505 valid questionnaires were collected from 947 medical institutions in China, 95 medical institutions indicated that 156 drugs were administered by rectal drip, including 35 drugs in tertiary medical institutions, 50 drugs in secondary medical institutions, 67 drugs in primary medical institutions, and 4 drugs in profit medical institutions.(2) The proportion of oral preparations that was used in rectal drip, and in tertiary and secondary medical institutions were 68.57%(24 cases) and 62.00%(31 cases), respectively, both of which was higher than that proportion in primary medical institutions (13 cases, 19.40%). The proportion of injections in primary medical institutions was 80.60%(54 cases) that was higher than that of tertiary medical institutions (11 cases, 31.43%) and secon-dary medical institutions (19 cases, 38.00%), and the differences were statistically significant (all P<0.001). (3) The proportion of digestive system medication rectal dripping in tertiary medical institutions (13 cases, 37.14%) and secondary medical institutions (20 cases, 38.46%) was higher than that in primary medical institutions (3 cases, 4.41%), and the difference was statistically significant ( P<0.001). The proportion of rectal dripping of Traditional Chinese Medicine (TCM) injections in primary medical institutions (47 cases, 69.12%) was higher than that in tertiary medical institutions (1 cases, 2.86%) and secondary medical institutions (0, 0), and the difference was statistically significant ( P<0.001). (4) Among the results of 1 505 questionnaires, 18.61%(280 questionnaire) of doctors thought that rectal drip therapy was safe, 39.34%(592 questionnaire) agreed it was easy to absorb, and 37.34%(562 questionnaire) hold the view that it was convenient.(5) The number of questionnaires in the two groups of used (group A) and not used (group B) was 100 and 1 405, respectively.The cognitive differences in the safety, absorption degree and convenience of rectal drip therapy between the two groups were statistically significant (all P<0.001). Conclusion:There are various drugs used in rectal drip therapy, so it should be strengthened in the management and standardized in pediatrics.

Objective: To set up a chyle (n-hexane) testing method based on n-hexane extraction system. Methods: The hydrothorax specimen which was positive in chyle testing was selected and the feasibility was evaluated by replace Diethyl ether with n-hexane. The optimal extraction volume ratio for the new chyle testing was confirmed and sultan Ⅲ dye process was improved. Then, the new chyle testing method and its standard operation process was established.A total of 120 specimens with triglyceride(TG)in different levels were collected and divided into three groups with 40 specimens for each group (group A. TG≤1.7 mmol/L; B. 5.6Results: N-hexane can replace Diethyl ether in the Chyle test. The extraction volume ratio of 1 ml sample plus 400 μl N-hexane is the best one and the sultan Ⅲ tube dying method is better than former direct smear. Compared with the old Chyle test using Diethyl ether, the new Chyle test using N-hexane is in good consistency with the Kappa value 0.95. The clinical coincidence rate of the above Chyle test reaches 94.8%(127/134) after the verification of 134 specimens. Conclusions A new N-hexane test is established successfully. It was convenient to operate with high security and little contamination and thus has a wide clinical application value.(Chin J Lab Med, 2018, 41: 527-530)