Objective:To investigate the association of exposure to PM 2.5 and its constituents during pregnancy and fetal growth and to further identify critical windows of exposure for fetal growth. Methods:We included 4 089 mother-child pairs from the Jiangsu Birth Cohort Study between January 2016 and October 2019. Data of general characteristics, clinical information, daily average PM 2.5 exposure, and its constituents during pregnancy were collected. Fetal growth parameters, including head circumference (HC), abdominal circumference (AC), and femur length (FL), were measured by ultrasound after 20 weeks of gestation, and then estimated fetal weight (EFW) was calculated. Generalized linear mixed models were adopted to examine the associations of prenatal exposure to PM 2.5 and its constituents with fetal growth. Distributed lag nonlinear models were used to identify critical exposure windows for each outcome. Results:A 10 μg/m 3 increase in PM 2.5 exposure during pregnancy was associated with a decrease of 0.025 ( β=-0.025, 95% CI: -0.048- -0.001) in HC Z-score, 0.026 ( β=-0.026, 95% CI: -0.049- -0.003) in AC Z-score, and 0.028 ( β=-0.028, 95% CI:-0.052--0.004) in EFW Z-score, along with an increased risk of 8.5% ( RR=1.085, 95% CI: 1.010-1.165) and 13.5% ( RR=1.135, 95% CI: 1.016-1.268) for undergrowth of HC and EFW, respectively. Regarding PM 2.5 constituents, prenatal exposure to black carbon, organic matter, nitrate, sulfate (SO 42-) and ammonium consistently correlated with decreased HC Z-score. SO 42- exposure was also associated with decreased FL Z-scores. In addition, we found that gestational weeks 2-5 were critical windows for HC, weeks 4-13 and 19-40 for AC, weeks 4-13 and 23-37 for FL, and weeks 4-12 and 20-40 for EFW. Conclusions:Our findings demonstrated that exposure to PM 2.5 and its constituents during pregnancy could adversely affect fetal growth and the critical windows for different fetal growth parameters are not completely consistent.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Objective:To explore the intervention effect of sensorimotor training on cognitive function, balance and fall risk of elderly patients with schizophrenia.Methods:The 60 hospitalized elderly schizophrenic patients in Wuxi Mental Health Center were randomly divided into experimental group and control group from June to September 2021, with 30 cases in each group. The control group implemented traditional exercise on the basis of routine nursing. The experimental group received 8-week and 24 times sensorimotor training on the basis of the routine nursing. The Chinese version of the Mini Mental State Examination (MMSE) was used to assess the cognitive level of patients, the Modified Morse Fall Scale (MMFS) was used to assess the risk of falls, and the Berg Balance Scale (BBS) was used to assess the balance function.Results:After 8 weeks of intervention, the total score of MMSE was (26.72 ± 1.71), higher than the total score of the control group (22.36 ± 1.93), the factor scores of temporal orientation, spatial orientation, recollection, attention and calculation, memory and language ability in the experimental group were (4.90 ± 0.31), (4.72 ± 0.53), (2.86 ± 0.35), (4.66 ± 0.61), (2.83 ± 0.47), (6.76 ± 1.09), higher than scores of the control group (4.36 ± 0.56), (3.93 ± 0.66), (2.57 ± 0.50), (3.64 ± 1.03), (2.18 ± 0.67), (5.68 ± 1.02), and the difference was statistically significant( t values were 2.53-9.06, all P< 0.05). The total score of MMFS in the experimental group was (5.93 ± 1.49), which was lower than that in the control group (8.75 ± 2.30). The difference was statistically significant ( t=-5.51, P<0.01). The total score of BBS in the experimental group was (38.83 ± 1.71), which was higher than that in the control group (30.89 ± 1.93). The difference was statistically significant ( t=16.43, P<0.01). Conclusions:Sensorimotor training can improve the level of balance, cognitive function and reduce the risk of falls in elderly patients with schizophrenia.

Objective:To explore the feasibility, safety and effectivity of applying transmesenteric vein extrahepatic portosystemic shunt (TEPS) to treat extrahepatic portal vein obstructive disease (EHPVOD).Methods:From December 2020 to April 2021, 12 patients with EHPVOD in the Vascular Surgery Department of Zhengzhou University People′s Hospital were prospectively enrolled in the study. The infra-umbilical median longitudinal minilaparotomy was performed to expose the branch of superior mesenteric vein (SMV). RUPS-100 was introduced into the trunk of SMV. A balloon with a diameter of 20 mm was introduced through right internal jugular vein (RIJV) into inferior vena cava (IVC). Under fluoroscopy, RUPS-100 was used to puncture the balloon in IVC. A stiff guide wire was used to establish the pathway between RIJV and SMV. Finally the portosystemic shunt between IVC and SMV was established with a covered stent-graft. The total operative time, the time of establishing portosystemic shunt alone, the dosage of contrast agent, the preoperative and postoperative pressure of SMV were recorded. Paired t test was used to compare the preoperative and postoperative pressure of SMV. Results:All 12 patients were successfully performed TEPS. The total operative time was (113±32) min, the time of establishing portosystemic shunt alone was (31±5) min, the dosage of contrast agent was (129±48) ml. The postoperative pressure of SMV [(14.3±2.1) mmHg] decreased significantly ( t=20.125, P<0.01) compared to baseline [(27.8±2.7) mmHg]. All portal hypertension symptoms released after the operations.There was 1 case of delayed incision healing, 1 case of bacteremia and 1 case of slight hepatic encephalopathy, but all of them were cured. There was no death case. Postoperative CT showed all portosystemic shunts were patent. Conclusion:TEPS is a new, safe, effective and feasible treatment method for patients of acute and chronic EHPVOD.

Birth cohort is an important observational study which can continuously and dynamically collect the exposure changes and health outcomes from gametophyte development to adolescence and even old age. However, because of its complex design and difficult implementation, how to construct birth cohort with high quality and high efficiency is the main difficulty faced by epidemiologists at home and abroad. In 2016, China National Birth Cohort was officially launched. The network and information technology were used to explore, and a set of "cloud-based information platform" was established to support this queue construction, containing 16 units in China. After four years of development, the platform has formed a complete set of programs about the construction of cohort information platform, which including recruitment and follow-up management of participants, real-time data interaction, queue quality control, multi-level authority management and function division. The relevant design framework and functional elements provide the references to the future information construction of large-scale birth cohort and even population-based research in China.

The importance of gut microbes to human health has gradually attracted attention. With the use of animal models, it has been revealed that maternal microbes during pregnancy could influence their children's health outcomes through shaping their microbial composition and regulating the development of their metabolic and immune system. However, the physiological mechanism of the human body is more complex and is affected by the interaction of multiple factors. The research results obtained from animal models are often inconsistent with human studies. At present, the influence of maternal intestinal microbes during pregnancy on the microbial colonization in their offspring and on a series of children's health outcomes is still unclear. Establishing a sub-cohort to detect the microbiome of the women across pregnancy and of their offspring, and further to integrate with variety of environmental and behavioral exposures can better provide reliable support for the research on the mechanism of children's health and diseases. This paper briefly introduces the research objectives, content, progress, strength and limitations of the sub-cohort study.

Surgical minimally invasive techniques such as image intervention, laparoscopy, endoscopy, and assisted medical robotics have become the mainstream of minimally invasive surgery (MIS). However, the vague concept, diverse misunderstanding, and the lack of standards have led to a lot of malpractice in current MIS. Based on the analysis of the clinical situation and the domestic and foreign literatures, the authors have put forward the theory of comprehensive minimally invasive surgery (CMIS), and established the concepts of minimally invasive prevention, minimally invasive diagnosis and minimally invasive follow-up in the view of hepatobiliary surgery. The authors have proposed "three-All" principles of all personnel, all aspects and all processes, and established a comprehensive four-level criteria of outcomes, complications, time and costs for CMIS, in an attempt to provide feasible and practical concepts and standards for MIS from a clinical practice and theoretical level, with a view to standardizing minimally invasive procedures and solving the problem of MIS.

Large-scale cohort study has unique advantages in the field of etiology research for its large sample size a multi-time point data, but it also brings great difficulty in data management and quality control at the same time. Recently, China has initiated a number of large-scale population cohort studies, posing enormous challenges to the management and quality control of related cohort data. This paper summarizes the existing experience and consensus in the field of cohort study in China from the characteristics of the cohort data, aiming at the types and main forms of the four main sources of questionnaire data, clinical diagnosis and treatment data, biological sample detection data and observation outcome data, from the data storage, circulation and transmission work.The contents and methods of queue data management are comprehensively summarized. Corresponding data quality control strategies are advised in the questionnaire evaluation, data logic verification, survey object sampling and multi-database review, etc. The goal of this review is to provide guidance for the management of data and the formulation of quality control strategies in the cohort study in China.

Objective: To assess the clinical efficacy of Xuebijing injection in the prevention of postoperative systemic inflammatory response syndrome (SIRS) in the patients with ureteral stones and urinary tract infection during the perioperative period of ureteroscopy.Methods: Totally 64 cases with ureteral stones complicated with urinary tract infection treated with ureteroscopy were selected as the subjects and divided into two groups according to the digital method.The 32 cases in the control group were given the conventional antibiotics during the perioperative period for preventing the incidence of SIRS, and the observation group was given 500ml Xuebijing added to 100ml normal saline for intravenous drip additionally.The incidence of SIRS and the laboratory indicators after the operation were observed and compared between the groups.Results: The incidence of postoperative SIRS of the observation group was 9.38% , which was lower than that of the control group (34.38% , P <0.05);the incidence of sepsis of the observation group was 0%, while there was no statisticcally difference bettween the two groups(P＞0.05).The C-reactive protein (CRP), procalcitonin (PCT), leucocyte count and endotoxin in the observation group on the 2nd, 4th and 6th day after the operation were better than those in the control group, and the difference was statistically significant (P＜0.05).Conclusion: Xuebijing injection combined with antibiotics has significant clinical effect on the incidence of SIRS after ureteroscopy in the patients with ureteral stones and urinary tract infection, which can effectively improve the clinical indicators and reduce the incidence of sepsis, and is worthy of clinical promoted application.

BACKGROUND:IPS e.max Presshas an excelent biocompati bility and corrosion resistance, which obtains satisfactory clinical outcomes on dental veneers, inlay and onlay restorations. But little is reported on molar monolithic restoration by IPS e.max Presscrown.
OBJECTIVE:To evaluate the clinical effects of IPS e.max Press crown on molar repair after root canal therapy.
METHODS:Totaly 215 patients with 324 affected molars, including 88 males and 127 females, aged 22-58 years old, were enroled for repairing with IPS e.max Presscrown. Then the color, shape, fracture and edge coloring of the restoration, marginal discrepancy, secondary caries and gingival health status were assessed after a 3-year folow-up.
RESULTS AND CONCLUSION:During the folow-up, 324 dental restorations met the class A standards for color, marginal discrepancy, shape as wel as secondary caries. In addition,3restoration swere fractured, 14 restorations had margin coloring, and 8 restorations appeared to have gingival inflammation. More than 95% restorations were scored grade A. These results indicate that IPS e.max Press crown applied to molar repair after root canal therapy can achieve ideal outcomes.