Objective To investigate the value of pulse oxygen perfusion index(PI)and blood lactic acid(BLA)concentration in early prediction of retinopathy of prematurity(ROP).Methods A retrospective case-control study was conducted on 128 preterm infants who met the inclusion criteria and were admitted to the neonatal intensive care unit of our hospital from September 2018 to December 2022.Among them,46 patients with ROP were in the ROP group,and 82 pa-tients without ROP were in the non-ROP group.Basic data of these preterm infants were recorded after admission.PI val-ues were continuously monitored with the Masimo Radical-7(USA)SpO2 blood oxygen saturation detector,and BLA con-centrations were detected with the ABL90FLEX blood gas analyzer.The receiver operating characteristic(ROC)curve and area under curve(AUC)were used to evaluate the value of PI and BLA concentration in early prediction of ROP.Results There were no significant differences in gestational age,birth weight,sex,and delivery mode between the two groups(all P＞0.05).The PI values after birth were significantly different between the two groups(Fgroup=15.393,Pgroup＜0.001).The PI values of preterm infants in the ROP group decreased significantly at 1 h,12 h and 24 h after birth and slightly at 48 h to 96 h after birth compared with the non-ROP group.The PI values of preterm infants in the two groups sta-bilized at 96 h after birth.The PI values of preterm infants in the ROP group were lower than those in the non-ROP group at all time points within 96 h after birth(all P＜0.05).The PI values showed interaction effects between the two groups at different time points(Finteraction=5.061,Pinteraction＜0.001).There was a significant difference in BLA concentration between the two groups after birth(Fgroup=91.158,Pgroup＜0.001).In the ROP group,the BLA concentration increased significantly at 1 h after birth and slightly at 12 h and 24 h after birth compared with the non-ROP group.The BLA concentration in the ROP group was higher than that in the non-ROP group at all time points after birth(all P＜0.05).The BLA concentration showed no interaction effects between the two groups at different time points(Finteraction=0.567,Pinteraction＞0.05).The AUC of PI values at 1 h,12 h and 24 h after birth and BLA concentration at 1 h after birth for predicting ROP was 0.77,0.82,0.83,and 0.82,respectively.The AUC of combined PI values at 1 h,12 h and 24 h after birth and BLA concentration at 1 h after birth for predicting ROP was 0.94,higher than the predictive value of a single indicator.Conclusion PI and BLA concentration have good clinical value for early prediction of ROP.

ObjectiveTo explore the effect of Naoxin'an capsule against mitochondrial dysfunction and oxidative damage in brains of rats with vascular cognitive impairment （VCI） induced by chronic cerebral ischemia. MethodA total of 150 rats were randomized into modeling group （130 rats） and sham-operated group （20 rats） with the random number table method. The two-vessel occlusion （2-VO） was employed to induce VCI in rats， and finally 87 rats developed VCI. The VCI rats were classified into model group， positive drug group （Aricept， 0.5 mg·kg^-1）， and low-， medium- and high-dose Naoxin'an capsule groups （0.18， 0.36， 0.72 g·kg^-1， separately）， with 17-18 rats in each group. The administration lasted 8 weeks. The learning and working memory of VCI rats were assayed by novel object recognition test and Y-maze test. The 8-oxoguanine （8-OxoG） level was measured based on immunofluorescence staining. Spectrophotometry was performed to determine the activity of mitochondrial respiratory chain complexes Ⅰ， Ⅱ， Ⅲ， and Ⅳ， mitochondrial swelling， mitochondrial membrane potential （MMP）， and activity of pyruvate dehydrogenase （PDH） and α-ketoglutarate dehydrogenase （KGDH）. The submicroscopic structure of mitochondria was observed with electron microscope. The phosphorylation of cAMP response element-binding protein （CREB） and the expression of peroxisome proliferator-activated receptor γ coactivator-1α （PGC-1α）， nuclear respiratory factor 1 （NRF-1）， and mitochondrial transcription factor A （mt-TFA） were determined by Western blot. The mitochondrial status Ⅳ H₂O₂ generation， activity of cerebral superoxide dismutase （SOD） and glutathione peroxidase （GSH-Px）， and malondialdehyde （MDA） content were measured with the photochemical method. ResultCompared with the sham-operated group， model group showed decrease in new object discrimination index （P<0.01） and spontaneous alternation rate in the Y-maze test （P<0.01）， increase in ROS production in the brain （P<0.01）， reduction in MMP and mitochondrial swelling A value （P<0.01）， obvious mitochondrial swelling， vacuoles and cristae fractures in mitochondria， decrease in the level of phosphorylated CREB， expression of PGC-1α， NRF-1 and mt-TFA （P<0.01）， and activity of the respiratory chain complexes Ⅰ， Ⅱ， Ⅲ， and Ⅳ （P<0.01）， PDH and KGDH in the brain （P<0.01）， rise of the production of H₂O₂ at state IV （P<0.01） and the content of MDA （P<0.01）， and reduction in the activity of SOD and GSH-Px （P<0.01）. Compared with the model group， each dose of Naoxin'an capsules can improve the new object discrimination index （P<0.05， P<0.01） and the rate of spontaneous alternation （P<0.05， P<0.01）， decrease ROS production in the brain （P<0.01）， improve the MMP and swelling A value （P<0.05， P<0.01）， alleviate mitochondrial swelling and mitochondrial submicroscopic damage， elevate the phosphorylated CREB level， the expression of PGC-1α， NRF-1 and mt-TFA （P<0.05， P<0.01）， and the activity of mitochondrial respiratory chain complexes Ⅲ， and Ⅳ， PDH and KGDH （P<0.01）， decrease state Ⅳ H₂O₂ generation （P<0.01） and MDA content （P<0.05， P<0.01）， and raise the activity of SOD and GSH-Px （P<0.01）. ConclusionBy activating the CREB/PGC-1α pathway， Naoxin'an capsule can protect the structure and function of mitochondria， enhance the antioxidant capacity， and inhibit the mitochondrial dysfunction and oxidative damage induced by chronic cerebral ischemia， thus improving the VCI.

Objective To evaluate the effect of applying sitting posture corrector on improving reading and writing posture of elementary school students， and provide scientific evidence for prevention and control of myopia in children and adolescents. Methods One elementary school each in urban and suburban areas of Shanghai was selected using a convenience sampling strategy. Furthermore， two classes each in Grade 3 and 4 were selected as the intervention group （282 students were included in the study）， and the other two classes each in Grades 3 and 4 were selected as the control group （294 students were included in the study）. Students in the intervention group used the sitting posture corrector in the classrooms for 4 months （from September 2020 to January 2021）， while those in the control group did not use the sitting posture corrector. Relevant data were collected before and after the intervention through a self-administered questionnaire and visual examination. Statistical analysis was performed using chi-square test and generalized estimating equation. Results Before the intervention， 13.5% （38/282） of students in the intervention group and 12.2% （36/294） in the control group had good reading and writing posture （ χ ² = 0.195， P >0.659）. After the intervention， 18.4% （52/282） of students in the intervention group had good reading and writing posture， which was higher than that （11.2%， 33/294） in the control group （ χ ²=5.957， P =0.015）. Before and after the intervention， there was no significant differences in the prevalence of myopia between students in the intervention and control groups （all P >0.05）. Generalized estimating equation analysis showed that students in the intervention group were 1.502 times more likely to have good reading and writing posture than those in the control group after the intervention （ P =0.043）. Conclusion Applying sitting posture corrector in schools could improve students' reading and writing posture.

Objective:To investigate the relationship between snoring and the risk of cardiovascular and cerebrovascular events.Methods:By searching PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructur, Wanfang Database, VIP Chinese journal database and Chinese biomedicine databases from the establishment to June 10, 2019, relevant domestic and foreign literature, extract data and apply Newcastle-Ottawa Quality Assessment Scale (NOS)method to quality evaluation, and finally integrate the data and analyze with Stata12.0 software.Results:A total of 11 articles and 145 267 participants met the inclusion criteria.Meta-analysis results showed that the correlation strength and 95% CI of snoring with cardiovascular and cerebrovascular events and stroke risk were 1.10 (1.03-1.17) and 1.26 (1.11-1.43)respectively , and all of them had statistical significance.Conclusion:Snoring is an independent risk factor for the risk of cardiovascular events and is more closely linked to stroke.

Objective To analyze clinicopathological characteristics and the potential risk-related factors of female breast hyperplasia in different age groups.Method From Jan 2015 to Dec 2016,patients diagnosed with breast hyperplasia in 12 hospitals were evaluated.All patients completed the self-designed questionnaires on women'health,including basic demographic information,clinic examination information,radiologic information and pathologic results.The patients were divided into a young group (＜ 45 years old) and an elderly group (from 45 to 75 years old).Results There were 3 684 cases of breast hyperplasia,including 2 291 cases in young group and 1 393 cases in elder group,respectively Clinically breast pain type were most commonly observed in both young and older groups (50.3％ vs.42.7％,P ＜ 0.001).While pathological research based on biopsy showed that breast adenopathy were the most common changes in both groups (67.9％ vs.61.7％,P ＜0.001).More breast cancer cases were identified in elder group than that in young group,especially in clinically lump type patients (9.4％ vs.4.2％,P ＜ 0.001).Compared with elder group,patients in young group have different distribution characteristics regarding to fertility factors,lifestyle factors and psychology scale including anxiety and depression.Conclusion Distributions of clinicopathological characteristics and risk factors of female breast hyperplasia differ across different age groups.

Objective To study the impact of interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) for patients with cardiac arrest (CA). Methods A prospective study was conducted. A total of 122 CA patients admitted to Department of Emergency of Shandong Provincial Mining Industry Group Company Central Hospital from July 2013 to December 2017 were enrolled. They were divided into standard cardiopulmonary resuscitation (S-CPR) group (n = 62) and IAPP-CPR group (n = 60) according to order of admission. The patients in S-CPR group received external cardiac compression, open airway, endotracheal intubation, mechanical ventilation, routine drug rescue, and defibrillation when ventricular fibrillation was found. And the patients in IAPP-CPR group received the IAPP-CPR on the basis of the routine chest compression. During the relaxation period, the patients were subjected to abdominal lifting and compressing with amplitude of 4-5 cm, frequency of 100 times/min, and the time ratio of lifting to compressing was 1:1. The data of demographics and clinical signs of patients were collected. The markers of respiratory and circulatory performance of all patients after CPR were determined. The rates of restoration of spontaneous circulation (ROSC), successful resuscitation, and the prognosis were recorded. With the success of CRP as the dependent variable, the factors with statistical significance showed by univariate analysis were used as the independent variable to carry out two classification Logistic regression analysis for screening the influence factors of CPR success. Receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of various factors on the success of CPR. Results 122 patients were enrolled in the analysis. Compared with the S-CPR group, heart rate (HR), mean arterial pressure (MAP), arterial partial pressure of oxygen (PaO2), and end-tidal carbon dioxide partial pressure (PETCO2) were significantly increased at 30 minutes after CPR in IAPP-CPR group [HR (bpm): 66.3±11.5 vs. 53.1±12.6, MAP (mmHg, 1 mmHg = 0.133 kPa): 65.4±6.5 vs. 53.2±5.4, PaO2(mmHg): 77.7±11.8 vs. 61.8±14.3, PETCO2(mmHg):45.5±9.6 vs. 31.8±8.2, all P < 0.05], and arterial partial pressure of carbon dioxide (PaCO2) and lactic acid (Lac) were significantly lowered [PaCO2(mmHg): 46.7±6.2 vs. 57.9±9.5, Lac (mmol/L): 2.1±1.5 vs. 4.4±2.2, both P < 0.05]. The time of CA to ROSC in IAPP-CPR group was significantly shorter than that in S-CPR group (minutes: 6.3±1.8 vs. 11.2±1.4, P < 0.05), the ROSC rate and CPR success rate were significantly higher than those in S-CPR group [ROSC rate: 61.7% (37/60) vs. 43.5% (27/62), CPR success rate: 40.0% (24/60) vs. 21.0% (13/62), both P < 0.05], and 24-hour survival rate and survival and discharge rate of patients were significantly higher than those in the S-CPR group [24-hour survival rate: 46.7% (28/60) vs. 29.0% (18/62), survival and discharge rate: 20.0% (12/60) vs. 11.3% (7/62), both P < 0.05]. Logistic regression analysis showed that PaO2, PaCO2 and PETCO2 were the factors that affect the success of CPR [PaO2: β= -3.76, odds ratio (OR) = 0.23, 95% confidence interval (95%CI) = 0.12-0.86, P = 0.031; PaCO2:β=1.41,OR=4.09,95%CI=1.70-9.82,P=0.002,PETCO2:β=0.78,OR=2.18,95%CI=1.42-3.35,P=0.000]. ROC curve analysis showed that the above three factors had good predictive value for the success of CPR. The predictive value of PaCO2 and PETCO2 were better, the area under ROC curve (AUC) was 0.93 and 0.92, respectively, when the cut-off values was 46.7 mmHg and 48.8 mmHg, the sensitivity was 92.0%, 88.0%, respectively, and the specificity was both 94.3%. Conclusions PaO2, PaCO2 and PETCO2 are the factors that influence the success of CPR. PaCO2 and PETCO2 have great value in predicting the success of CPR. Compared with the S-CPR group, IAPP-CPR group results in better hemodynamic and pulmonary ventilation effects, and remarkably improve ROSC and successful resuscitation. IAPP-CPR has obvious clinical value for CA patients.

Objective: To explore the therapeutic effects of edaravone, oxiracetam combined with Shuxuetong on cerebral hematoma and improvement of neurological function in patients with cerebral hemorrhage. Methods: A total of 96 patients with cerebral hemorrhage were randomly divided into observation group and control group by the random number table method, with 48 cases in each group.The observation group received intravenous drip of edaravone (4.0g added into 0.9% sodium chloride injection to 250mL, intravenous drip, 1 time/d), oxiracetam(30mg added into 0.9% sodium chloride injection to 100mL solution, 30min intravenous drip, 2 times/d), and Shuxuetong injection(4mL added into 0.9% sodium chloride injection to 250mL, intravenous drip, 1 time/d) on the basis of routine treatment, and the control group was treated with routine treatment for cerebral hemorrhage.The efficacy and safety in the two groups after treatment of 21 days were observed. Results: After treatment, the neurological deficit score and cerebral hematoma volume of the two groups were improved(all P<0.05), but the improvements of the observation group was significantly better than those of the control group[(4.44±3.20)points vs.(10.53±2.86)points, (21.83±3.85)points vs.(26.71±3.49)points, (7.83±5.31)mL vs.(13.74±6.16)mL, t=9.818, 6.506, 5.035, all P<0.01]. The total effective rate of the observation group was higher than that of the control group(87.5% vs.52.1%, χ²=14.740, P<0.05). No drug-related adverse reactions occurred in two groups. Conclusion The application of oxiracetam and edaravone combined with Shuxuetong injection in patients with cerebral hemorrhage can effectively improve the brain edema and nerve defect, it has a positive significance to promote the patients' recovery after cerebral hemorrhage, and it is worthy of clinical application.

Objective To explore the diagnostic value of ultrasonography in diagnosing deep infiltrating endometriosis (DIE) with involvement of pelvic tissues.Methods Data of 118 DIE patients confirmed with surgery and pathology who underwent transvaginal ultrasonography before surgery were retrospectively analyzed.Taking surgical and pathologic findings as the gold standards,the sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of ultrasonography in diagnosis of DIE with involvement of uterosacral ligament,intestine,vaginal rectal septum,vagina,bladder and ureter were calculated,respectively.Results Uterosacral ligament involvement was found in 85 patients,with sensitivity of 95.29％ (81/85) and specificity of 90.91％ (30/33).Intestinal involvement was observed in 60 patients,with sensitivity of 98.33％ (59/60) and specificity of 91.38％ (53/58).Vaginal rectal septum involvement was noticed in 39 patients,with sensitivity of 79.49％ (31/39) and specificity of 92.41％ (73/79).Vaginal involvement was detected in 18 patients,with sensitivity of 55.56 ％ (10/18) and specificity of 96.00 ％ (96/100).Bladder involvementwas found in 17 patients,with sensitivity of 76.47％ (13/17) and specificity of 94.06％ (95/101).Ureter involvement was also found in 9 patients,with sensitivity of 100％ (9/9) and specificity of 99.08％ (108/109).Conclusion Transvagina ultrasonography has great value in diagnosis of DIE with involvement of pelvic tissues.

Objective To determine the effects of delayed umbilical cord clamping on the postpartum hemorrhage,instant and long-term newborn anemia,newborn jaundice.Methods In total,303 infants were selected during October 2016 to June 2017 in three hospitals in Beijing.They were randomly allocated into two groups receiving instant clamping of umbilical cord (less than 60s after delivery,n=158) and delayed clamping of umbilical cord(after cord pulsation ceased,n=145).Relevant indicators of maternal and neonatal outcomes are compared.Results There were significant differences between two groups in instant hemoglobin concentration and in 5～7 days (P＜0.05).There were no differences between two groups in transcutaneous bilirubin,the risk of anemia in three months,the risk of jaundice in 5～7 days and the need of blue-light therapy (P＞0.05).There were no differences between two groups of women in postpartum hemorrhage,the length of third stage of labor and the rate of breast feeding (P＞0.05).Conclusion Clamping the umbilical cord when cord pulsation has ceased does not have negative effects on delivery process and postpartum hemorrhage,but it increases the instant hemoglobin concentration and hemoglobin concentration after delivery in 5～7 days.Still it is unclear whether it will affect the risk of jaundice.