A Study of Ladder Model Conversation Training Strategy to Improve the Conversation Ability of Children with Autism / 听力学及言语疾病杂志

Objective To study the intervention effect of Ladder Model conversation training strategy on im-proving the conversation skills of children with autism.Methods A multi-probe design across participants was a-dopted to examine the intervention effectiveness of the strategy on two 7～8 year old autistic children.Intervention lasted for 4 weeks for subjuct A and 3 weeks for subject B.Thirty-five minutes each time,three times a week.The number and type of conversation initiation,maintenance and interruption were evaluated in the baseline period,in-tervention period,maintenance period and generalization period.The overlap rate and simplified time-series analysis were used to evaluate the outcome.Results The number of conversation initiation of subject A(overlap rate 8.33％,C=0.89,P＜0.01)and subject B(overlap rate 20％,C=0.83,P＜0.01)was significantly higher in in-tervention periods than that in baseline,but no significant difference was observed between the other adjacent peri-ods.The number of conversation maintenance of subject A(overlap rate 0％,C=0.89,P＜0.01)and subject B(o-verlap rate 10％,C=0.91,P＜0.01)was significantly higher in intervention periods than that in baseline,but no significant difference was found between the other adjacent periods.The type of conversation initiation and mainte-nance that subjects improved were mainly in verbal forms.The main type of interruption was"unexplained re-sponse",the proportion of interruption decreased obviously after intervention.Conclusion The strategy has posi-tive effect on improving conversation initiation and maintenance of children with autism,and reducing the proportion of interruption.

Application of Main Concept Analysis and Story Narration Assessment in Aphasia Discourse Assessment / 听力学及言语疾病杂志

Objective To compare the application of main concept analysis(MCA)and story narration as-sessment(SNA)in aphasia discourse assessment,and study their clinical applicability.Methods A total of 8 apha-sic and 22 healthy control subjects were recruited.Local sequential picture materials were used to elicit language samples.The differences between groups in the assessment results of the MCA and the SNA were compared,the consistency of the assessment results of the two methods were also analyzed.The inter-rater and the intra-rater reli-ability of the two methods was discussed.Results The results of the MCA showed that the number of accurate and complete(AC)main concepts(P＜0.01),the number of accurate and complete main concepts per minute(AC/min)(P＜0.05)and main concept scores(MC scores)(P＜0.05)of the aphasia group were significantly lower than those of the healthy group.The number of absent(AB)main concepts(P＜0.05)were significantly higher than those of the control group.As for the result of SNA,the score of the content of sub picture description(P＜0.05),the total score of sub picture description(P＜0.05)and the total score of overall description(P＜0.05)in the aphasia group were significantly less than those in the control group(P＜0.05).No significant difference be-tween the standardized scores of the two methods were observed,and inter-rater and the intra-rater reliability were both in a good range.Conclusion The clinical applicability of the two methods is excellent and the evaluation results are conststent.The MCA has outstanding advantages in evaluating the quality and quantity of information,while SNA examines the syntax and content organization,which can reflect the overall discourse performance.

A Review of the Relationship between Language Ability and Theory of Mind in Children with Specific Language Disorders / 听力学及言语疾病杂志

Children with specific language impairment(SLI)have normal cognitive abilities but experience language deficits.The heterogeneity of language disorders makes SLI children optimal subjects for investigating the correlation between language ability and theory of mind.This paper provides a comprehensive review of foreign em-pirical studies examining the relationship between language ability and theory of mind in SLI groups from various perspectives.The findings indicate that specific types of language disorders exhibit delayed development in theory of mind,which is closely associated with their language ability deficits.Among all linguistic elements,syntactic de-fects demonstrate the most concentrated evidence regarding their impact on theory of mind.It is noteworthy that al-though SLI children offer valuable insights into the correlation between language and theory of mind,further investi-gation is still required to comprehensively comprehend this association.The present study also provides recommenda-tions for future research endeavors in this domain.

Research progress on the neurocognitive development of small for gestational age / 中国儿童保健杂志

Small for gestational age (SGA) infants are more likely to experience neurocognitive impairments compared to appropriate for gestational age (AGA) infants. This paper reviews recent research on the neurocognitive development of SGA children. SGA can lead to a "brain-sparing effect" due to growth restriction, which may affect cerebral blood flow and brain structure. However, this does not guarantee normal brain development. Restrictive blood flow can result in changes in brain structure, such as reduced total white matter and gray matter volume in various brain regions, including the cerebral cortex, hippocampus and cerebellum, ultimately leading to decreased head circumference. SGA children also exhibit lower scores in all neurocognitive domains, including intelligence, attention, memory, and executive function. This may result in poor academic performance and an increased risk of social, behavioral, and neurological problems, such as cerebral palsy, epilepsy, visual and hearing impairments, as well as comorbidities like attention deficit hyperactivity disorder(ADHD), autism spectrum disorder(ASD), anxiety, depression, and schizophrenia. Several risk factors for SGA-related neurocognitive impairments have been identified, including gestational hypertension, abnormal gestational weight, smoking, and catch-up growth. Studies have shown that the best interventions to improve cognitive dysplasia include nutrient supplementation, continued breastfeeding, high-quality education, and appropriate early intervention (responsive parenting) are effective in improving cognitive outcomes for SGA children.

Comprehensive spoken communication function of children with disabilities based on ICF-CY / 中国康复理论与实践

ObjectiveTo investigate the comprehensive spoken communication performance of children with disabilities, and explore the related individual and environmental factors. MethodsFrom August to November, 2022, questionnaires of Communication Function Scale for Children based on ICF-CY were distributed online to parents of healthy children and children with disabilities aged two years to five years and eleven months in Shanghai, Nanjing and other areas. ResultsA total of 500 copies were sent out, and 407 valid questionnaires were returned, including 84 healthy children, 85 with hearing impairment, 119 with mental retardation, 35 with cerebral palsy and 84 with autism. There were significant differences in the comprehensive spoken communication function performance among the children with different impairment types (F = 127.618, P < 0.001). The comprehensive spoken communication ability was significantly poorer in the children with disabilities than in the healthy children (P < 0.05), and the ability was better in hearing-impaired children than in the children with other disabilities (P < 0.05). The higher the education of mother (r = -0.311, P < 0.001) and father (r = -0.280, P < 0.001), and family annual income (r = -0.228, P < 0.001), the better the children's comprehensive spoken communication performance; the children's comprehensive spoken communication performance was better when the family used Putonghua as unified communication language (r = 0.210, P < 0.001). ConclusionThe comprehensive spoken communication performance for children with disabilities is heterogeneous among different impairment types, and is affected by parents' education, family annual income, and family communication language.

Developing curriculum of speciality of education and rehabilitation using WHO rehabilitation competency framework / 中国康复理论与实践

ObjectiveTo construct rehabilitation competency framework (RCF) of the speciality of education and rehabilitation (SER-RCF) based on World Health Organization RCF, to innovate the curriculum system. MethodsThe competency for undergraduate level professionals in the speciality of education and rehabilitation were analyzed to develop curriculum using RCF theory and methodology. ResultsTalent training was a kind of competency-based and outcome-based education. SER-RCF integrated the competencies and activities in the areas of professionalism, practice, learning and development, management and leadership, and research required for professional work in education and rehabilitation around core values and beliefs. It also designed the training objectives of the speciality of education and rehabilitation: to be ethical and correct, to be physically and mentally healthy, to have a solid foundation, to be sustainable, to be co-operative and enjoyable, and to be reflective and enquiring. SER-RCF played a central role in developing the curriculum system of rehabilitation, education and psychology, and practice. ConclusionReshaping the undergraduate level curriculum system of education and rehabilitation based on RCF is not only the implementation of the construction concept of new medicine and new liberal arts, but also can effectively connect with the international standard of rehabilitation higher education.

Spatial language understanding and expression in children with autism: a study of “(go/come) to” sentence in Chinese / 中国康复理论与实践

Objective To investigate the characteristics of spatial orientation language comprehension and expression behavior ofchildren with autism. MethodsA three-ladder test was designed to test the comprehension and expression of "(go/come) to" sentences, including general subject-predicate sentences, conjunctive-predicate sentences with displacement purposes, and conjunctive-predicate sentences with displacement modes. March to June, 2022, the test was conducted on 17 children with autism from a special education school and 17 healthy children matched the scores of Peabody Picture Vocabulary Test-Chinese revised from a kindergarten. The typical errors were analyzed for children with autism. ResultsThe main effects of sentence ladders (F > 3.718, P < 0.05) and children groups (F > 8.782, P < 0.001) were significant on comprehension and expression of sentences, while the performance was poor for the complex sentences and for the children with autism. The common types of errors in expression were missing components, mixed sentences, autonomous sentences, inaccurate wording, inconsistent content, blending errors and non-response. The numbers and the distribution of error types were quite different from the children with autism to the healthy children. ConclusionChildren with autism are more difficult to understand and express "(go/come) to" sentences, mainly manifested in a higher error frequency and more kinds of error.

Comprehension of Chinese spoken garden path sentences for children with high-functioning autism / 中国康复理论与实践

ObjectiveTo explore the psychological and behavioral characteristics of understanding Chinese garden path sentences in children with high-functioning autism (HFA). MethodsFrom April to August, 2019, 35 children with HFA and 35 age-matched typically developing (TD) children were recruited by social recruitment method in the Key Laboratory of Speech and Hearing of East China Normal University in Shanghai. The Garden Path Sentence Comprehension Test was designed based on the psycholinguistic method, and the mental process and the ability of understanding garden path sentences were tested by the agent task experiment paradigm. Finally, the processing strategies and error types of Chinese spoken garden path sentences for HFA children were explored. ResultsThe score in understanding garden path sentences was lower (t = -2.941, P < 0.01), and the reaction time in processing garden path sentences was significantly longer (t = 6.132, P < 0.001) in HFA children than in TD children, however, there was no significant difference in the number of childern mastering garden path sentences between two groups (χ2 = 2.954, P > 0.05). In terms of the error types of "animate noun + verb + animate noun + 's + noun" (AVA) and "animate noun + verb + inanimate noun + 's + noun" (AVI) garden path sentences, both groups showed more errors in "pursuit of correct word order" than in "pursuit of semantically correct" (t > 2.503, P < 0.05). In "inanimate noun + verb + animate noun + 's + noun" (IVA) sentences, HFA children showed less erros in "pursuit of correct word order" than in "pursuit of semantically correct" (t = -6.523, P < 0.001), however, no difference was found between them in TD children (t = 2.024, P > 0.05). ConclusionThe processing and comprehension ability of Chinese spoken garden path sentences in HFA children aged five to seven yeas are poor. HFA children are more sensitive to semantics, and garden path sentences with semantic violations are more likely to lead to HFA children's understanding errors. In the garden path sentence patterns of AVA and AVI, HFA children appear similar sentence understanding and processing strategies as TD children. In the garden path of IVA, HFA children use a sentence processing strategy combining word order and semantics, but semantics play a more prominent role, while TD children use a more stable word order processing strategy.

Analysis of COL1A1 and COL1A2 gene variants in two fetuses with osteogenesis imperfecta / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis of two fetuses with an osteogenesis imperfecta (OI) phenotype.@*METHODS@#Two fetuses diagnosed at the Affiliated Hospital of Weifang Medical College respectively on June 11, 2021 and October 16, 2021 were selected as the study subjects. Clinical data of the fetuses were collected. Amniotic fluid samples of the fetuses and peripheral blood samples of their pedigree members were collected for the extraction of genomic DNA. Whole exome sequencing (WES) and Sanger sequencing were carried out to identify the candidate variants. Minigene splicing reporter analysis was used to validate the variant which may affect the pre-mRNA splicing.@*RESULTS@#For fetus 1, ultrasonography at 17+6 weeks of gestation had revealed shortening of bilateral humerus and femurs by more than two weeks, in addition with multiple fractures and angular deformities of long bones. WES revealed that fetus 1 had harbored a heterozygous c.3949_3950insGGCATGT (p.N1317Rfs*114) variant in exon 49 of the COL1A1 gene (NM_000088.4). Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), it was classified as a pathogenic variant (PVS1+PS2+PM2_Supporting) for disrupting the downstream open reading frame resulting in premature translational termination, being de novo in origin, and lacking records in the population and disease databases.For fetus 2, ultrasonography at 23 weeks of gestation also revealed shortening of bilateral humerus and femurs by one and four weeks, respectively, in addition with bending of bilateral femurs, tibias and fibulas. Fetus 2 had harbored a heterozygous c.1557+3A>G variant in intron 26 of the COL1A2 gene (NM_000089.4). Minigene experiment showed that it has induced skipping of exon 26 from the COL1A2 mRNA transcript, resulting in an in-frame deletion (c.1504_1557del) of the COL1A2 mRNA transcript. The variant was inherited from its father and had been previously reported in a family with OI type 4. It was therefore classified as a pathogenic variant (PS3+PM1+PM2_Supporting+PP3+PP5).@*CONCLUSION@#The c.3949_3950insGGCATGT (p.N1317Rfs*114) variant in the COL1A1 gene and c.1557+3A>G variant in the COL1A2 gene probably underlay the disease in the two fetuses. Above findings not only have enriched the mutational spectrum of OI, but also shed light on the correlation between its genotype and phenotype and provided a basis for genetic counseling and prenatal diagnosis for the affected pedigrees.

A Comparative Study on Auditory Processing Abilities between Children with and without Learning Difficulties / 听力学及言语疾病杂志

Objective To study the auditory processing abilities of children with learning difficulty and deter-mine the proportion of the children with auditory processing disorder.Methods A single factor completely random-ized experimental design was used.Seventeen children with learning difficulties and 31 normal children from grade 2 to grade 4 in Beijing were induded in this study.The abilities of low-pass filtered speech,competing sentences,di-chotic digits and frequency patterns were tested through auditory processing disorder screening test software.Results There were significant differences in the abilities of listening sentences and digits in competitive environment and recognizing frequency patterns between children with learning difficulty and without.The auditory processing ability of children with learning difficulties was obviously poorer than normal children.The incidence of auditory processing disorder among the children with learning difficulties was 41.176%~58.824%.Conclusion The auditory process-ing ability in the competitive environment of children with learning difficulties was obviously poorer and they need in-tervention specifically.

The Influencing Factors of Competing Sentences Test in the Normal-hearing Adults / 听力学及言语疾病杂志

Objective To study the influencing factors of the competing sentences test in normal-hearing adults, in order to provide references for the preparation of the competing sentences test with children and the development of the diagnostic tools of the central auditory processing disorders.Methods According to the three kinds of test tables of semantic competition, sentence constituent competition and phonetic competition for the competing sentences test, the 2×3×3 factors mixed experimental design were used to test the 48 normal-hearing adults(forty-six right-handed adults and two left-handed adults) with the competing sentences test.The correct rate was obtained and the influencing factors were analyzed.Results ①The average correct rate of the Competing Sentences Test for the forty-six right-handed normal-hearing adults was 94.98%,and for the two left-handed normal-hearing adults was 96.12%.②The right-handed subjects'' right ear accuracy rate was significantly higher than that of the left ear(P0.05)with the right-handed subjects.④For the results of three types sentences,the correct rate of semantic competition was the highest, the second was the sentence constituent competition and phonetic competition was the lowest with the right-handed subjects.Conclusion No gender factors were found to affect the results of the competing sentences test among adults.The normal-hearing right-handed adults have the right ear advantage in the competing sentences test, prompting us to become concerned about the choice of the ear sides.Different competition types of sentences will have a greater impact on the difficulty of the competing sentences test, so we should pay more attention to this in the preparation of competitive sentences test tables.

Hepatectomy combined with splenectomy in patients with hepatocellular carcinoma with Barcelona Clinic Liver Cancer Stage A and portal hypertension / 中华肝胆外科杂志

Objective To evaluate the peri-operative and survival outcomes of hepatectomy combined with splenectomy in patients with hepatocellular carcinoma with Barcelona Clinic Liver Cancer Stage A and portal hypertension.Methods We retrospectively analyzed the data on patients with hepatocellular carcinoma with Barcelona Clinic Liver Cancer Stage A and portal hypertension who underwent surgery at the Shengli Oilfield Central Hospital between July 2008 and June 2015.According to the operative method,the patients were classified as the experimental group (hepatectomy combined with splenectomy) and the control group (hepatectomy).We compared and analyzed the clinical data between these two groups,which included the operation time,blood loss,duration of hepatic portal occlusion,width of surgical resection margin,liver function,PLT,HBV reactivation,time to remove drainage tube,complications,upper gastrointestinal hemorrhage rate and survival outcomes.Results (1) The operation time,blood loss,PLT at 1 week and 1 month after surgery in the experimental group were all significantly higher than the control group [(161.4 ± 38.3) min vs.(119.2±36.4) min,(268.7±72.1) vs.(201.3±61.3) ml,(189.2±51.3) ×109/L vs.(81.9±32.2) ×109/L,(327.4±69.1) ×109/L vs.(84.5±28.5) × 109/L (all P＜0.05),respectively].The time to remove drainage tube,duration of hepatic portal occlusion,width of resection surgical margin,TBil,complications and upper gastrointestinal hemorrhage rates of the two groups were not significantly different (all P ＞ 0.05).The HBV reactivation rate,ALT and AST in the experimental group were significantly lower than the control group [3.9％ (2/51) vs.18.2％ (12/66),(45.7 ± 11.4) U/L vs.(58.3±14.7) U/L,(48.1±12.4) U/Lvs.(61.3±15.1) U/L (allP＜0.05),respectively].(2) The 1,3 and 5-year recurrence free survival rates were not significantly different between the experimental and control groups [84.3 ％,34.1％,27.3 ％ vs.78.8 ％,42.1％,9.7 ％ (all P ＞ 0.05),respectively].The 1,3 and 5-year overall survival rates in the experimental Group were significantly higher than the control group [94.1％,66.3 ％,33.5 ％ vs.90.9％,46.7％,16.1％ (all P ＜ 0.05),respectively].Conclusion Combined liver and spleen resection was a safe and efficacious modality to treat patients with BCLC A hepatocellular carcinoma,which reduced the incidence of HBV reactivation and improved the overall survival.

Research progress of hemodynamic signal and liver regeneration / 中华消化外科杂志

Liver has great ability in regeneration,and liver regeneration is closely related to the prognosis of patients who received liver surgeries.The mechanisms of liver regeneration include biochemical theory and hemodynamic theory.Portal perfusion with moderate pressure is an important factor for starting liver regeneration.Hepatic artery buffer response,fluid shear stress and gasotransmitter play important roles in the liver regeneration.Learning the mechanisms of hemodynamic signal is of great importance for the treatment of liver diseases.

Anatomical symmetry of the intrahepatic Glisson system / 解剖学报

Objective To observe the anatomical symmetry of the structures and istribution of the Glissonean pedicle of the intrahepatic Glisson system ,integrating with embryology and comparative anatomy .Methods Morphology of the Glissonean pedicle of liver was examined through peeling and dissecting 20 adult corpses without liver pathological changes.The relevant data were collected and analyzed statistically .Meanwhile, we tried to elucidate elaborating the symmetry theory of liver anatomy through the dissection anatomy ,embryonic anatomy and comparative anatomy .Results The angle between main stem of Glisson system/left branch of Glisson system(GM/GL) was (76.7 ±17.36)°.The angle between GM/GR was (81.4 ±13.8)°.The length of the the Glisson pedicle of left hepatic was (3.1 ±0.76) cm.The length of the the Glisson pedicle of middle hepatic was ( 2.61 ±0.72 ) cm.The length of the the Glisson pedicle of right hepatic was (1.5 ±0.50)cm.The shapes of the Glissonean pedicle stem of the left hepatic presenting arch , the number of radial level 3 branches were between 2-8.The shapes of the Glissonean pedicle stem of the middle hepatic continuing the main of Glissonean pedicle , the number of radial level 3 branches were between 2-6.The shapes of 30%of the Glissonean pedicle of the right hepatic presenting Y and V , 70% of the Glissonean pedicle of the right hepatic presenting C , the number of radial level 3 branches were between 3-8.Conclusion In the light of morphology ,embryology and comparative anatomy, it is reasonable to divide the liver into left ,middle,right lobe by Glissonean pedicle of radial level 2 branches and the liver is an axiality and symmetry organ .

An applied anatomical study of the right posterior sectional Glissonean pedicle / 中华肝胆外科杂志

Objective To study the anatomical structure and the distribution of the right posterior sectional Glissonean pedicle so as to provide the anatomical basis for liver resection of the right posterior section.Method By studying the morphological features of the right posterior sectional Glissonean pedicle through peeling and dissecting 20 adult corpses without liver pathological.Result In 95％ of the right posterior sectional Glissonean pedicles there were shared branches.The angle between the GRL/GRA was 81.4° ± 13.8°.In 30％,the right posterior sectional Glissonean pedicle presented as a Y or a V.In a Y shaped,the angle between G6/G7 was 71 ° ±3.92°.The shapes of 70％ of the right posterior sectional Glissonean pedicle presented as a C.The number of branches at the tertiary level was between 3-8.Conclusion The distribution of the right posterior sectional of the Glissonean pedicle did not entirely fit the description of Couinaud's segments.Obvious individual differences existed.Under this circumstance,understanding the anatomy of the right posterior sectional Glissonean pedicle before carrying out partial hepatectomy would be helpful in reducing surgical risks and postoperative complications.