Effect of Shuanglu Tongnao Formula on Neuronal Ferroptosis in Ischemic Stroke Rats by Regulating the SIRT1/Nrf2/GPx4 Signaling Pathway / 医药导报

Objective To explore the effect of Shuanglu Tongnao Formula on neuronal ferroptosis in ischemic stroke rats and its regulatory mechanism on the silent information regulator 2 homolog 1(SIRT1)/nuclear factor erythroid 2-related fac-tor 2(Nrf2)/glutathione peroxidase 4(GPx4)signaling pathways.Methods Twenty rats were selected as sham operation group by the random number table method,and the remaining seventy rats were made ischemic stroke rat models by the middle cerebral artery occlusion method.The rats that had been successfully modeled were randomly divided into the model control group,Shuanglu Tongnao formula group,Shuanglu Tongnao formula+SIRT1 inhibitor group(Shuanglu Tongnao formula+EX527 group),with 20 rats in each group.After 14 days,the rats were scored for neurological injury;TTC staining was applied to detect the area of cerebral infarction in rats;HE staining was applied to detect pathological changes in rat brain tissue;Nissl staining was applied to detect the number of neurons in rat brain tissue;the kit was applied to detect the levels of ferri ion(Fe2+),superoxide dismutase(SOD),glutathione(GSH),and malonaldehyde(MDA)in rat brain tissue;immunohistochemistry was applied to de-tect the positive expression of acyl-CoA synthetase long-chain family member 4(ACSL4),transferrin receptor(TFR),and ferritin heavy polypeptide 1(FTH1)proteins in rat brain tissue;Western blotting method was applied to detect the expression of SIRT1,Nrf2,GPx4,and cystine/glutamate antiporter solute carrier family 7 member 11(SLC7A11)proteins in rat brain tissue.Results Compared with the sham operation group,the neurological deficit score,cerebral infarction area,the contents of Fe2+and MDA,and the protein expressions of ACSL4 and TFR in model control group were increased(P<0.05);the number of neurons,the con-tents of SOD and GSH,the protein expression of FTH1,SIRT1,Nrf2,GPx4,and SLC7A11 were all reduced(P<0.05).Compared with the model control group,the neurological deficit score,cerebral infarction area,the contents of Fe2+and MDA,and the protein expression of ACSL4 and TFR in the Shuanglu Tongnao formula group were reduced(P<0.05),and the number of neurons,the contents of SOD and GSH,the protein expressions of FTH1,SIRT1,Nrf2,GPx4,and SLC7A11 are all increased(P<0.05).The results of the SIRT1 inhibitor supplementation experiment showed that the SIRT1 inhibitor reversed the inhibitory effect of Shuan-glu Tongnao formula on neuronal ferroptosis,while also inhibited the expression of Nrf2 and GPx4(P<0.05).Conclusion The Shuanglu Tongnao formula may inhibit neuronal ferroptosis in ischemic stroke rats by activating the SIRT1/Nrf2/GPx4 signa-ling pathway.

Effects of Zhuangyao Shuanglu Tongnao Formula on neuronal apoptosis of rats with ischemia-reperfusion induced injury / 中成药

AIM To investigate the effects of Zhuangyao Shuanglu Tongnao Formula on neuronal apoptosis in rats with cerebral ischemia-reperfusion injury based on the study of oxidative stress and inflammatory response.METHODS The rats were randomly divided into the sham operation group,the model group,the edaravone group(3.0 mg/kg),the low,medium and high dose groups(9.0,18.0,36.0 g/kg)of Zhuangyao Shuanglu Tongnao Formula,with 18 rats in each group.The middle cerebral artery occlusion/reperfusion was conducted by thread embolism method to simulate cerebral ischemia reperfusion injury in rats followed by 6 days corresponding drugs administration.Subsequently,the rats had their neurological function deficit scored by Zeal Longa scoring method;their sizes of cerebral infarction areas measured by TTC staining;their pathological damage and apoptosis of neurons in hippocampal CA1 area of ischemic penumbra of the brain tissue detected by HE staining and TUNEL staining;their SOD activity and levels of GSH,MDA,IL-6,IL-1β,TNF-α in brain tissue detected by kits;and their protein expressions of Bax,Bcl-2,caspase-3,cleaved-capase-3,TLR4,NF-κB p65,Nrf2,HO-1 in rat brain tissue determined by Western blot.RESULTS Compared with the model group,the groups intervened with edaravone,medium and high dose of Zhuangyao Shuanglu Tongnao Formula displayed improvements in the scores of nerve function defects,the rate of cerebral infarction,the rate of neuronal apoptosis,the levels of IL-6,IL-1β,TNF-α and MDA in the ischemic penumbra of brain tissues,the protein expressions of Bax and TLR4,the ratio of cleaved-capase-3/caspase-3 and p-NF-κB p65/NF-κB p65(P＜0.05),the levels of GSH,the activity of SOD and the protein expressions of Bcl-2,Nrf2 and HO-1(P＜0.05).CONCLUSION Being an inhibitor of oxidative stress and inflammatory response,Zhuangyao Shuanglu Tongnao Formula can alleviate brain injury in rats with cerebral ischemia reperfusion injury through the inhibition of neuronal apoptosis and improvement of neural function mediated by the inhibition of TLR4/NF-κB signal pathway and activation of Nrf2/HO-1 signal pathway.

Effect of active music therapy on cognitive function for older adults with cognitive impairment: a systematic review based on ICD-11 and ICF / 中国康复理论与实践

ObjectiveTo conduct a systematic review of the effect of active music therapy on cognitive function for older adults with cognitive impairment based on International Classification of Diseases, the 11th Revision (ICD-11), and International Classification of Functioning, Disability and Health (ICF). MethodsA PICO framework was constructed. Thematic keyword searches were conducted in databases including PubMed, Web of Science, Embase, CNKI, VIP, and Wanfang data, for literature on the effect of active music therapy on cognitive function for older adults with cognitive impairment, published up to November 5th, 2023. Information on authors, countries, publication date, sample characteristics, study designs, intervention methods, measurement tools and outcomes were extracted. The methodological quality of the researches was evaluated using the Physiotherapy Evidence Database (PEDro) scale. ResultsEight researches from six countries were included, which were all randomized controlled trials involving 356 older adults with mild cognitive impairment and dementia. The articles were published from 2014 to 2020, with an average of 7.4 of the PEDro scale. Active music therapy was used by singing and playing instruments. Interventions took place in hospitals, nursing homes, and health centers. The intervention duration ranged from mostly 30 to 60 minutes a time, with a few 120 minutes a time. Interventions were implemented mostly one to three times a week, lasting from eight to twelve weeks. Health outcomes focused on cognitive function, including overall cognitive function, executive function, attention function and memory function. ConclusionA theoretical framework for the benefits of active music therapy on the cognitive function for older adults with cognitive impairment has been constructed based on ICD-11 and ICF. Active music therapy can improve overall cognitive function, executive function, attention function and memory function for older adults with cognitive impairment.

Health benefit of mindfulness intervention for older adults with insomnia disorders: a systematic review / 中国康复理论与实践

ObjectiveTo conduct a systematic review of the health benefits of mindfulness interventions for older adults with insomnia disorders. MethodsThematic keyword search was conducted in databases including Web of Science, PubMed, Embase, EBSCO, CNKI, VIP and Wanfang data, for literature on the impact of mindfulness intervention on sleep quality in older adults with insomnia disorders, published up to August, 2023. The methodological quality of the researches was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Insomnia disorders, sleep function and mindfulness interventions were coded using International Classification of Diseases 11th Revision, International Classification of Functioning, Disability and Health, and International Classification of Health Interventions Beta-3； and a systematic review was conducted following the PRISMA. ResultsNine researches from four countries were included, involving 800 participants, and all the researches were randomized controlled trials. The average score of PEDro scale was 7.1. The health-related conditions were insomnia disorders and insomnia disorders complicated with mild cognitive impairment. Mindfulness interventions used included mindfulness-based therapy for insomnia, mindfulness-based stress reduction, mindfulness-based cognitive therapy and mindfulness meditation. Interventions were implemented in institutions or health centers, care facilities, and community health service centers, varying from six to eight weeks. Health benefits of mindfulness intervention included improvements in sleep quality and psychological and behavioral health. ConclusionMindfulness interventions effectively improve sleep quality in older adults with insomnia disorders, alleviate negative emotional states such as depression, anxiety and perceived stress, and improve the quality of life.

Differential study of intensity modulated radiation therapy(IMRT)for cervical cancer in two different radiotherapy devices / 医疗卫生装备

Objective To investigate the differences between Elekta Synergy and Varian Halcyon accelerators in intensity modulated radiotherapy for cervical cancer.Methods Totally 60 cases of postoperative cervical cancer patients treated with radiotherapy in the radiotherapy center of some hospital from June 2021 to December 2022 were selected retrospectively,who were divided into a Halcyon group(30 cases)and a Synergy group(30 cases)according to the equipment involved.The Halcyon group with dynamic IMRT technique and the Synergy group with static IMRT technique were compared in terms of dosimetric parameters in the target area and organs at risk,gamma passing rate,setup error and treatment efficiency.SPSS 24.0 software was used for statistical analysis.Results The two groups had the dosimetric distributions meet clinical requirements.The Halcyon group behaved better than the Synergy group in target area homogeneity index,conformity index and gradient index(P＜0.001),which had lower irradiation dose in some endangered organs;the gamma passing rate was higher in the Halcyon group than that in the Synergy group(P＜0.01),while the dispersion was lower in the Halcyon group;there were no significant differences between the setup errors of the two groups in the left-right,head-foot,and up-down directions(P＞0.05);the two groups had no statistical differences in the number of monitor units(P＞0.05),while the Halcyon group had the plan execution time and total treatment time much shorter than those of the Synergy group(P＜0.001).Conclusion Halcyon accelerator gains advantages in dosimetric parameters and treatment efficiency over the traditional Synergy C-arm accelerator in intensity modulated radiotherapy for cervical cancer.[Chinese Medical Equipment Journal,2023,44(9):53-58]

Mental health services for children with intellectual and developmental disabilities: a WHO-FICs-based study / 中国康复理论与实践

ObjectiveTo systematically analyze the typical mental health conditions and psychological disorders of children with intellectual and developmental disabilities (IDD), to construct a mental health service system and psychological interventions to these mental health conditions of children with IDD . MethodsBased on the framework of the World Health Organization Family International Classifications (WHO-FICs), the mental health conditions and related functioning were analyzed, and the mental health service framework and proposed mental health interventions were constructed.There were six main categories of mental health conditions for children with IDDConclusionThis study systematically analyzed the typical mental health status and related psychological functional impairments of children with IDD. Based on the World Health Organization health service system, a mental health service framework for children with IDD was constructed. Referring to the WHO's continuum of health services, a system of psychological intervention methods for children with IDD was established. Furthermore, the WHO-FICs were used to describe and code the functions of children with IDD, and the ICHI-β3 was applied to code and analyze the related psychological interventions. Resultsmood disorders (anxiety and depression), behavioral disorders (disruptive disorders and challenging behaviors, aggressive behaviors), traumatic disorders (post-traumatic stress disorder), mental disorders (schizophrenia), suicide and self-harm, and learning disabilities (developmental learning disabilities, attention deficit hyperactivity disorder). Mental health services for children with IDD involved in six dimensions: leadership and governance, fundraising, human resources, service delivery, mental health technologies, and information and research. Mental health services went through the continuum of health services from prevention, treatment, rehabilitation to health promotion. We delivered mental health services for children with IDD in three aspects: identifying and diagnosing mental health problems or conditions, analyzing the main factors caused mental health problems, and analyzing the environmental factors. Mental health service interventions mainly covered five categories: antidepressants, psychotherapy, stress management training, physical exercise training, healthy lifestyle education, consultation and support. Children with IDD may obtain the mental health services in hospitals, rehabilitation institutions, community and school settings.

Effect of psychological intervention on anxiety or depression in children and adolescents with hearing impairment: a systematic review / 中国康复理论与实践

ObjectiveTo systematically review the effect of psychological intervention on anxiety and depression in hearing-impaired children and adolescents. MethodsThe literature was researched from the databases of PubMed, Web of Science, Embase, CNKI, and Wanfang Database on psychological intervention on anxiety and depression for hearing-impaired children and adolescents until July, 2023. After screening, author, country, study object, study design, intervention mode, outcome, and measurement tools were extracted from the literature. ResultsEight articles from three countries were included, including eight randomized controlled trials, involving 404 participants, publishing mainly from 2013 to 2023. The types of psychological intervention included family support education, emotional intelligence training, cognitive behavioral therapy, self-confidence group training, and play therapy, and so on, which improved social phobia, and relieved the levels of anxiety and depression of children and adolescents with hearing impairment. ConclusionPsychological intervention can effectively alleviate the anxiety and depression of children and adolescents with hearing impairment.

Astragalus polysaccharide inhibits IDO1 expression in colon tumor microenvironment to increase intratumoral CD8~+ T cell infiltration / 中国中药杂志

This study aims to investigate the regulatory effects of Astragalus polysaccharide(APS) and APS combined with 5-fluorouracil(5-FU) on indoleamine-2,3-dioxygenase(IDO1) in the colon tumor microenvironment. Sixty Balb/c mice were randomized into a blank group, a model group, an APS group, an APS + 5-FU group, an APS + low-dose 5-FU group, and a 5-FU group. A tumor model was established by subcutaneous transplantation with CT-26 mouse colon cancer cells in other groups except the blank group. After successful modeling, each group was treated with corresponding drugs for 7 days. The general condition, body weight, and tumor volume of the mice were observed and measured daily during the treatment period. The mice were sacrificed at the end of treatment, and the tumor suppression rate and spleen index of the mice were calculated. Western blot and fluorescence quantitative PCR were employed to determine the protein and mRNA levels, respectively, of IDO1 in the tumor tissue of mice. High performance liquid chromatography was employed to measure the levels of tryptophan(Trp) and kynurenine(Kyn) in the tumor tissue of mice. Hematoxylin-eosin(HE) staining was performed to observe the histological changes of the tumor tissue, and immunohistochemistry to detect the changes of CD4 and CD8 expression in the tumor tissue. Compared with that in the model group, the tumor volume of mice in each treatment group significantly reduced. The body weights of mice in APS + 5-FU group and 5-FU group significantly reduced from day 4 to day 7 of treatment. In addition, the APS + 5-FU group and 5-FU group showed significantly decreased spleen index. The protein and mRNA levels of IDO1 were significantly down-regulated in the APS, APS + 5-FU, and APS + low-dose 5-FU groups. The drug interventions significantly increased the Trp content and decreased the Kyn content. The APS + 5-FU group showed significantly reduced infiltration of CD4~+ T lymphocytes and increased infiltration of CD8~+ T lymphocytes. APS inhibited the expression of IDO1 in the colon tumor microenvironment to increase CD8~+ T lymphocyte infiltration, and the combination of APS with 5-FU demonstrated better effect.

Discipline of rehabilitation psychology using ICF: paradigm and contents / 中国康复理论与实践

@#Objective To discuss the paradigm and contents of rehabilitation psychology using bio-psycho-social model of functioning, disability and health of International Classification of Functioning, Disability and Health (ICF). Methods In perspectives of rehabilitation sciences and psychological sciences, paradigm and contents of modern rehabilitation psychology with the functioning framework of ICF were constructed in accordance with the development of modern rehabilitation science. Results A holistic rehabilitation model was constructed based on ICF, involving the body, mind and environment. Based on the functional model of ICF, the main contents of modern rehabilitation psychology were not only related to the function and structure of the body, but also related to the activities and participation, and emphasized the interaction with environment. The modern rehabilitation psychology would not only research about the physical dysfunction, but also the intervention of activity and environment. Based on ICF, common terminology and coding methods might be used to enable rehabilitation psychologists to communicate with relevant professionals in the multidisciplinary and interdisciplinary field of rehabilitation. Conclusion Constructing the theoretical framework and research paradigm of modern rehabilitation psychology based on ICF can form the system of rehabilitation psychology integrated with psychological science and rehabilitation science.

Research on competency of professionals in rehabilitation psychology using World Health Organization rehabilitation competency framework / 中国康复理论与实践

@#Objective To explore competency of professionals in rehabilitation psychology using Rehabilitation Competency Framework (RCF) and develop the curriculum system of rehabilitation psychology at graduate level.Methods Using RCF and Rehabilitation Competency Framework to a specific context, we constructed competency of professionals in rehabilitation psychology and education programme with the functioning framework of International Classification of Functioning, Disability and Health in accordance with disciplinary development and vocational need.Results A competency framework for professionals in rehabilitation psychology based on RCF was constructed; the educational goals based on competency-based education (CBE) in accordance with vocational competency and job responsibilities had been formulated; the curriculum system of rehabilitation psychology was developed in rehabilitation psychology at graduate level based on RCF and CBE, to develop professionals of rehabilitation psychology work in a team.Conclusion Disciplinary development and vocational requirement are integrated in competency of professionals in rehabilitation psychology based on RCF, which provide theories and methods to develop graduate programme and curriculum in rehabilitation psychology.

Rethinking the marketing strategy of anti-tumor drugs by single-arm trials supported / 中华肿瘤杂志

Single-arm trial refers to a clinical trial design that does not set up parallel control group, adopts open design, and does not involve randomization and blind method. These features, on the one hand, speed up the process of clinical trials, significantly shorten the time to market and meet the needs of patients with advanced malignancies, but also lead to the uncertainty of single-arm clinical trials themselves. Recently, the US Food and Drug Administration held a meeting of the oncologic drug advisory committee to discuss six tumor indications that have been accelerated approved, which once again triggered the discussion of single-arm trials. The basis of accelerated approval by single-arm trial is actually a compromise on the level of evidence-based medical evidence requirements after assessing the benefit risk. Therefore, the sponsor should strictly grasp the applicable conditions of single-arm trial in anti-tumor drugs and conduct single-arm trial scientifically. Post-marketing clinical trial should be implement as early as possible to ensure the benefit of patients. Based on the characteristics of single-arm trial, combined with two guidance relevant to single-arm trial issued by National Medical Products Administration recently, this article is supposed to propose and summarize the strategy of single-arm trial supporting the marketing of anti-tumor drugs.

Study of clinically-indicated replacement of peripheral intravenous catheters in old adults / 中国实用护理杂志

Objective@#To evaluate the safety of clinically-indicated replacement of peripheral intravenous catheters (PIVCs) in old adults.@*Methods@#Total of 1 627 patients with peripheral intravenous catheters in emergency wards at a tertiary hospital in shanghai were recruited. Patients were randomly divided into an experimental group (817 cases) and control group (810 cases) by random digits tale method. PIVCs in the experiment were replaced only when clinical indications appeared, while PIVCs in the control group were routinely changed every 72-96 hours. Indwelling time, complications associated with PIVCs and nurse compliance were compared after indwelling peripheral intravenous catheters.@*Results@#PIVC indwelling time was (3.43±1.36) days in the experimental group, and (3.18±1.16) days in the control group ,there was significant difference between two groups (t value was 4.07, P<0.05). The incidence of phlebitis, occlusion, infiltration, and accidental removal in experimental group was 11.26% (92/817), 17.97% (146/817), 10.77% (88/817), 3.91% (32/817), while in the control group 9.88% (80/810), 15.06% (122/810), 11.23% (91/810), 3.70% (30/810). The two groups showed no statistically difference in catheter phlebitis, occlusion, infiltration, and accidental removal (χ2 values were 0.82, 2.33, 0.09, 0.05, P>0.05). The severity of phlebitis in the experiment group was higher than that in the control group, and there was significant difference between two groups (χ2 value was 20.99, P<0.05). Nurse compliance achieved in the experimental group 100.00% (817/817) was higher than that in the control group 87.65% (710/810), which showed statistically difference (χ2 value was 107.47, P<0.05).@*Conclusion@#Indwelling time in the clinically- indicated replacement group was longer than that of the routine replacement group. Peripheral intravenous catheters in old adults can be remove as clinically-indicated with a close monitoring of complications.

Study of clinically-indicated replacement of peripheral intravenous catheters in old adults / 中国实用护理杂志

Objective:To evaluate the safety of clinically-indicated replacement of peripheral intravenous catheters (PIVCs) in old adults.Methods:Total of 1 627 patients with peripheral intravenous catheters in emergency wards at a tertiary hospital in shanghai were recruited. Patients were randomly divided into an experimental group (817 cases) and control group (810 cases) by random digits tale method. PIVCs in the experiment were replaced only when clinical indications appeared, while PIVCs in the control group were routinely changed every 72-96 hours. Indwelling time, complications associated with PIVCs and nurse compliance were compared after indwelling peripheral intravenous catheters.Results:PIVC indwelling time was (3.43±1.36) days in the experimental group, and (3.18±1.16) days in the control group ,there was significant difference between two groups ( t value was 4.07, P<0.05). The incidence of phlebitis, occlusion, infiltration, and accidental removal in experimental group was 11.26% (92/817), 17.97% (146/817), 10.77% (88/817), 3.91% (32/817), while in the control group 9.88% (80/810), 15.06% (122/810), 11.23% (91/810), 3.70% (30/810). The two groups showed no statistically difference in catheter phlebitis, occlusion, infiltration, and accidental removal ( χ2 values were 0.82, 2.33, 0.09, 0.05, P>0.05). The severity of phlebitis in the experiment group was higher than that in the control group, and there was significant difference between two groups ( χ2 value was 20.99, P<0.05). Nurse compliance achieved in the experimental group 100.00% (817/817) was higher than that in the control group 87.65% (710/810), which showed statistically difference ( χ2 value was 107.47, P<0.05). Conclusion:Indwelling time in the clinically- indicated replacement group was longer than that of the routine replacement group. Peripheral intravenous catheters in old adults can be remove as clinically-indicated with a close monitoring of complications.

A non-coated enzyme-linked immunosorbent assay for screening zika virus envelope protein / 南方医科大学学报

OBJECTIVE@#To establish a non-coated enzyme-linked immunosorbent assay (ELISA) based on zika virus envelope (E) protein for detecting the expression of E protein in infected cells.@*METHODS@#Adherent Vero-143 cells infected with zika virus in a 96-well plate were fixed, and the antibodies against zika virus E protein were added at an optimized concentration to establish the non-coated ELISA method for E protein. The antiviral activities of lignans compound C1 was evaluated using this method. The accuracy of this non-coated ELISA was verified by RT-PCR, and the cross reaction with dengue virus was assessed.@*RESULTS@#After optimization, the background absorbance at 450 nm of uninfected cells was reduced to about 0.20. The antiviral activities of lignans compound C1 detected by this method were basically consistent with the results of RT-PCR. No cross reaction with dengue virus was found in this assay.@*CONCLUSIONS@#A non- coated ELISA method based on zika virus E protein was established, which can be used for screening antiviral agents against zika virus.

Terminology, Diagnosis and Classification of Intellectual Disability Using WHO ICD-11 and ICF / 中国康复理论与实践

Objective To review the nomenclature and terminology, diagnostic criteria, classification and evaluation of intellectual disability using WHO ICD-11 and ICF.Methods The theories and approaches of ICD-11 and ICF were adopted to analyze the nomenclature and terminology, diagnostic criteria, classification and evaluation of intellectual disability.Results ICD-11 and ICF had established the nomenclature and terminology, diagnostic criteria, classification and evaluation of intellectual disability from the perspectives of content model of ICD-11 and functioning of ICF respectively. Intellectual disability had used nomenclature of disorder of intellectual development and one of sub-categories of mental, behavioral or neurodevelopmental disorders. Intellectual disability was also defined as both impairment of intellectual function (b117) and functional limitation of adaptive behaviors (d1-d9) using ICF. Occurrence age of intellectual disability was before 18 years old for diagnostic criteria of ICD-11 and ICF.Conclusion The nomenclature and terminology, diagnostic criteria and classifications of intellectual disability have been reviewed and updated using the theories and approaches of ICD-11 and ICF. It provides theoretical supports, approaches, and standardized tools for the development of rehabilitation service for people with intellectual disability.

Assessment and Classification of Severe Intellectual Disability for Children Aged 6-18 / 中国康复理论与实践

Objective To explore the assessment and classification for children aged 6-18 with severe intellectual disability.Methods A total of 36 children with severe intellectual disability were assessed with Wechsler Preschool and Primacy Scale of Intelligence (WPPSI-Ⅳ) (CN) and Adaptive Behavior Assessment System (ABAS-Ⅱ) (CNC).Results The ratio intelligence quotient of WPPSI-Ⅳ was (32.4±4.91), consistent with the results from ABAS-Ⅱ.Conclusion WPPSI-Ⅳ and ABAS-Ⅱ can be used for assessment and classification of severity of intellectual disability for children aged 6-18 and intelligence quotient less than 45.

Individualized Services and Support Plan for People with Intellectual Disability Based on ICF / 中国康复理论与实践

Objective To analyze the unmet needs of services and support, and design structured, standardrized and individualized service and support plans for people with intellectual disability using ICF framework.Methods In respective of intellectual function and adaptive behavior, a structured, standardrized and individualized service and support plan had been constructed according to process of individualized plan using ICF.Results Based on ICF model of functioning and disability, the structured and standardized service and support plan had been constructed, including functional diagnosis and service needs reporting, and individualized services protocols.Conclusion With the analysis of functioning and reporting of unmet needs of service using ICF, the structured, standardrised and individualized service and support plan can be developed to promote the total rehabilitation for people with intellectual disabilities.

Vocational Rehabilitation for People with Intellectual Disability: Theoretical Framework, Approaches and Services / 中国康复理论与实践

Objective To establish the theoretical framework and approaches of services provision of vocational rehabilitation (VR) for people with intellectual disability (ID) to promote the decent employment of people with ID.Methods The employment difficulties of people with ID had been analyzed using ICF, and the content and the procedure of VR for people with ID had been explored.Results According to ICF, the employment difficulties of people with ID included functioning, barriers of employment and environmental factors. VR services for people with ID included assessment of employment barriers and vocational capacity, vocational counseling, vocational skill development and training, vocational guidance, support and assistance service, VR and politics development and research. The procedures of VR services for people with ID included assessing employment difficulties and vocational abilities, establishing employment setting and target, planning and implementing individualized VR program, and follow-up services.Conclusion It is necessary to use ICF to develop structured and individualized VR framework and approaches of VR for people with ID.

Effects of hypoxic exosomes on the proliferation, migration and invasion of hepatocellular carcinoma Huh7 cells / 中华肝脏病杂志

Objective@#To explore the effects of hypoxic exosomes secreted from hepatocellular carcinoma Huh7 cells on the proliferation, migration and invasion under co-cultured normoxic condition.@*Methods@#Hypoxic exosomes secreted from Huh7 cells under hypoxic conditions were extracted by differential ultracentrifugation. Transmission electron microscopy, nanoparticles tracking analysis and western blot were used for the identification of hypoxic exosomes. Hypoxic exosomes were co-cultured with Huh7 cells under normoxic conditions. CCK8, cell scratch and transwell assay were used to detect the changes of cell proliferation, migration and invasion. Statistical analysis was performed by one-way ANOVA and t-test.@*Results@#Hypoxic exosomes secreted from Huh7 cells ranged in size from 30 to 150 nm in diameter, and expressed exosome surface markers CD9, CD63 and TSG101. Hypoxic exosomes significantly enhanced the proliferation of normoxic Huh7 cells (A value of hypoxic exosomes and control group at 48 and 72 h were 2.131 ± 0.092 and 1.760 ± 0.104,t= 3.740,P<0.01, 3.121 ± 0.157 and 2.298 ± 0.085,t= 8.289,P< 0.01). The migration distance between hypoxic exosome and control group at 48 and 72 h were (0.37 ± 0.06 cm)and(0.19 ± 0.05 cm),t= 4.813,P< 0.05, (1.15 ± 0.07 cm) and(0.62 ± 0.08 cm),t= 8.874,P< 0.05, and invasion ability [hypoxic exosomes and control group were (123 ± 18), (44 ± 12),t= 6.203,P< 0.01].@*Conclusion@#Hypoxic exosomes secreted from hepatocellular carcinoma Huh7 cells can promote cell proliferation, migration and invasion in hypoxic environment, suggesting that intercellular information transmission mediated by hypoxic exosomes may be one of the key mechanisms for the amplification of malignancy of hepatocellular carcinoma cells in hypoxic microenvironment.

Analysis of the discrepancy of crown-root morphology of central incisors among different skeletal malocclusion using cone-beam CT / 中华口腔医学杂志

Objective@#To investigate the discrepancy of crown-root morphology of upper and lower central incisors in adult patients with different skeletal malocclusions using cone-beam CT (CBCT).@*Methods@#Patients visiting the Department of Orthodontics, College of Stomatology, Xi′an Jiaotong University from January 2015 to December 2017 were selected, including 108 cases (52 males, 56 females, aged from 18 to 30 years, mean age 25.8 years). According to CBCT data and cephalometric analysis, 66 patients with average angle were selected as the sagittal skeletal group, including 24 Class Ⅰ patients, 20 Class Ⅱ and 22 Class Ⅲ patients. In the other selected 66 skeletal Class Ⅰ patients including 21 low angle patients, 24 average angle patients (from the sagittal skeletal Class Ⅰ subgroup) and 21 high angle patients. Invivo 5 software was used to locate the CBCT image three dimensionally and then obtain the middle labio-lingual section of right central incisor. Auto CAD 2007 software was applied to measure the angle formed by the long axis of root and the extension line of the long axis of crown (Collum angle), and the angle between the long axis of crown and the lip tangent line passing through the center of the labial surface of crown (labial surface angle). One-way ANOVA and Scheff were used to analyze the discrepancies among classifications and Pearson correlation analysis was used to determine the correlation between the Collum angles and labial surface angles.@*Results@#Significant differences were found in Collum angles and labial surface angles among different sagittal skeletal patterns (P<0.05). The Collum angle of maxillary central incisors in Class Ⅱ patients was 5.18°±4.97° and the average labial surface angle was 17.78°±3.74°, which were both significantly higher than that of maxillary central incisors in Class Ⅰ and Ⅲ subgroups (P<0.05). Similarly, the above two angles of mandibular central incisors in Class Ⅲ were 5.59°±5.64° and 15.32°±3.05°, which were significantly higher than that of mandibular central incisors in Class Ⅰ and Ⅱ subgroups (P<0.05). There was no significant difference among different vertical skeletal patterns (P>0.05). Notably, the Collum angles of maxillary or mandibular central incisors presented significantly positive correlation with labial surface angles (maxillary: r=0.723, P<0.001; mandibular: r=0.752, P<0.001).@*Conclusions@#The long axis of the crown of the maxillary central incisor in skeletal Class Ⅱ patients and the mandibular central incisor in skeletal Class Ⅲ patients are obviously deviated toward the lingual side relative to the long axis of the root, and correspondingly there is a greater labial surface angle of the crown, which indicates that equivalent positioning deviation during bracket bonding can cause greater torque expression error.