Significance and successful construction of stable transfection of MH7A cells with lower TRAF2 expression using lentiviral vector / 安徽医科大学学报

Objective To construct a stable synovial cell line MH7A from rheumatoid arthritis(RA)patients using lentiviral vectors that interfere with the expression of tumor necrosis factor receptor associated factor 2(TRAF2),and to study the role of TNF-α-TRAF2 signaling in MH7A abnormal proliferation.Methods Based on the design principles of human TRAF2 gene sequence and shRNA sequence,three pairs of TRAF2 shRNA interference se-quences were designed and synthesized.The primers were annealed by PCR,and a linear vector was obtained by double enzyme digestion PLKO.1-puro.The linearized vector was connected to the annealed primers through Solu-tion I,and the connected products were introduced into receptive cells.The plates were coated,and positive colo-nies were selected for sequencing.Three different recombinant plasmids of PLKO.1-TRAF2-shRNA lentivirus were constructed,and lentivirus packaging plasmids was used to package logarithmic growth phase HEK 293T cells.Vi-rus solution was collected to infect MH7A cells.At the same time,puromycin was used to screen MH7A stable transgenic strains with low TRAF2 expression.CCK-8 method,Western blot,and qPCR were used to detect the proliferation function of MH7A induced by TNF-α and low expression of TRAF2,as well as downstream signal TRAF2,P65 protein expression and mRNA levels.Results PLKO.1-TRAF2-shRNA(1),PLKO.1-TRAF2-shR-NA(2),and PLKO.1-TRAF2-shRNA(3)lentivirus vector plasmids and control group lentivirus vector plasmids PLKO.1-puro were successfully constructed.The three TRAF2-shRNA lentivirus vector plasmids and control group lentivirus vector plasmids PLKO.1-puro were respectively introduced into the lentivirus packaging plasmid of HEK 293T to obtain virus solution.After infecting MH7A cells with the virus solution,they were treated with puromycin(2.00 μ G/mL)screening and obtaining MH7A stable transgenic plants after 2 days.Through qPCR and Western blot results,it was found that the expression of TRAF2 mRNA and protein in PLKO.1-TRAF2-shRNA(1)MH7A stably transfected cells was significantly reduced compared to the negative control group.The results of CCK-8 and Western blot showed that after knocking down TRAF2 in MH7A,the proliferation of MH7A cells with low TRAF2 expression induced by TNF-α and the phosphorylation level of P65 were significantly reduced.Conclusion A sta-ble transgenic strain of PLKO.1-TRAF2-shRNA(1)MH7A cells was successfully constructed to investigate the role of TNF-α-TRAF2 signal activation in mediating abnormal proliferation of RA synovial cells.

Progress on the role of the RARα regulating homeostatic synaptic plasticity in the pathogenesis of autism spectrum disorders / 国际儿科学杂志

Autism spectrum disorders(ASD)is an important disease in children′s neuropsychic development disorder.The incidence rate is increasing now, which brings heavy burden to family and society.Functional studies of ASD related different single gene mutation models have showed that these overlapping phenotypes shared the common mechanism of the homeostatic synaptic plasticity impairment.Retinoic acid receptor α(RARα)regulate synaptic plasticity of the nervous system in both directions, through glutamate receptor subunit 1(GluR1)translation and RARα/mTOR signaling pathway, and affect the integration of sensory information and situational adaptive learning, and then affect the learning and memory function and neural synaptic signal network through the growth of dendritic spines.These researches suggest that RARα may work as a potential drug target for ASD, playing an important role in stable regulation of homeostatic synaptic plasticity, which is helpful for molecular typing accurate diagnosis and treatment of ASD.

Role of Nrf2/HO-1 signaling pathway in reduction of endotoxin-induced acute lung injury by esketamine in mice: relationship with NLRP3 inflammasome-mediated pyroptosis / 中华麻醉学杂志

Objective:To evaluate the role of NF-E2-related factor 2 (Nrf2)/heme oxygenase (HO-1) signaling pathway in reduction of endotoxin-induced acute lung injury (ALI) by esketamine and the relationship with NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome-mediated pyroptosis in mice.Methods:SPF male wild-type (WT) and Nrf2 knockout (KO) C57BL/6J mice, aged 6-8 weeks, weighing 20-25 g, were divided into 3 groups ( n=6 each) using a random number table method: control group (WT+ C group, KO+ C group), ALI group (WT+ ALI group, KO+ ALI group) and ALI+ esketamine group (WT+ ALI+ E group, KO+ ALI+ E group). ALI model was developed by injection of lipopolysaccharide (LPS) 15 mg/kg via the tail vein. Esketamine 10 mg/kg was intraperitoneally injected at 30 min after LPS injection, and 6 h later the medication was repeated for one time in WT+ ALI+ E and KO+ ALI+ E groups, while the equal volume of normal saline was given in the other groups. The mice were anesthetized at 12 h after LPS injection, and blood samples were obtained by cardiac puncture for determination of serum interleukin-1beta (IL-1β) and IL-18 concentrations, and bilateral lung tissues were also obtained for examination of the pathological changes of lung tissues(with the light microscope) which were scored and for determination of the content of reduced glutathione (GSH) and expression of Nrf2, HO-1 and NLRP3 inflammasome-mediated pyroptosis-related proteins (NLRP3, apoptosis-associated speck-like protein containing a CARD[ASC], pro-caspase-1, cleaved-caspase-1, gasdermin D[GSDMD]) (by Western blot). Results:Compared with the corresponding C group (WT+ C group or KO+ C group), the lung injury score and concentrations of IL-1β and IL-18 were significantly increased, the content of GSH in lung tissues was decreased, and the expression of NLRP3, ASC, pro-caspase-1, cleved-caspase-1 and GSDMD was up-regulated in WT+ ALI group and KO+ ALI group ( P<0.05), and the expression of Nrf2 and HO-1 was significantly up-regulated in WT+ ALI group( P<0.05). Compared with the corresponding ALI group (WT+ ALI group or KO+ ALI group), the lung injury score and concentrations of IL-1β and IL-18 were significantly decreased, the content of GSH in lung tissues was increased, and the expression of NLRP3, ASC, pro-caspase-1, cleved-caspase-1 and GSDMD was down-regulated in WT+ ALI+ E group and KO+ ALI+ E group ( P<0.05), and Nrf2 and HO-1 expression was significantly up-regulated in WT+ ALI+ E group( P<0.05). Compared with WT+ ALI+ E group, the lung injury score and concentrations of IL-1β and IL-18 were significantly increased, the content of GSH in lung tissues was decreased, the expression of Nrf2 and HO-1 was down-regulated, and the expression of NLRP3, ASC, pro-caspase-1, cleved-caspase-1 and GSDMD was up-regulated in KO+ ALI+ E group ( P<0.05). Conclusions:The mechanism by which esketamine reduces endotoxin-induced ALI may be related to activation of Nrf2/HO-1 signaling pathway, thus inhibiting NLRP3 inflammasome-mediated pyroptosis in mice.

Development of parenting behavior scale for caregivers of children aged 2 to 6 years and analysis for its reliability and validity / 中华预防医学杂志

To develop a caregiver parenting behavior scale for children aged 2 to 6 years, and to verify its reliability and validity. This study recruited 1 350 caregivers of children aged 2 to 6 years. The item discrimination analysis and exploratory factor analysis were used to analyze the structure, dimensions and items of the scale. Homogeneity reliability, split-half reliability and test-retest reliability were used to analyze the reliability of the scale. Content validity and construct validity were used to analyze the validity of the scale. The results showed that the final scale contained 7 dimensions and 45 items. Cronbach's α coefficient of the total scale was 0.945; the coefficient of split half was 0.899; the test-retest reliability analysis showed that the correlation coefficients between the two tests were 0.893 (total score), 0.854 (social), 0.832 (language), 0.871 (gross motor), 0.893 (fine motor), 0.862 (cognitive), 0.832 (self-care), and 0.872 (sensory). The content validity analysis was carried out by two rounds of expert argumentation using Delphi expert consultation method. The Kendall coefficient of the items score in two rounds of Delphi expert consultation was 0.813 (P<0.01). The structure validity analysis showed that there were significant correlations between each dimension and the total scale, also between each dimension of the scale, and the extracted average variance values of each dimension was greater than the correlation coefficients between this dimension and other dimensions. In conclusion, the reliability and validity of the scale are qualified. It can be used as a tool to evaluate and guide the parenting behavior of caregivers of children aged 2 to 6 years.

Congenital pulmonary alveolar proteinosis in a neonate / 中国当代儿科杂志

The male patient was referred to the hospital at 44 days old due to dyspnea after birth and inability to wean off oxygen. His brother died three days after birth due to respiratory failure. The main symptoms observed were respiratory failure, dyspnea, and hypoxemia. A chest CT scan revealed characteristic reduced opacity in both lungs with a "crazy-paving" appearance. The bronchoalveolar lavage fluid (BALF) showed periodic acid-Schiff positive proteinaceous deposits. Genetic testing indicated a compound heterozygous mutation in the ABCA3 gene. The diagnosis for the infant was congenital pulmonary alveolar proteinosis (PAP). Congenital PAP is a significant cause of challenging-to-treat respiratory failure in full-term infants. Therefore, congenital PAP should be considered in infants experiencing persistently difficult-to-treat dyspnea shortly after birth. Early utilization of chest CT scans, BALF pathological examination, and genetic testing may aid in early diagnosis.

Predictive validation of existing bleeding and thromboembolic scores in elderly patients with comorbid atrial fibrillation and acute coronary syndrome / 老年心脏病学杂志（英文版）

BACKGROUND@#The validation of various risk scores in elderly patients with comorbid atrial fibrillation (AF) and acute coronary syndrome (ACS) has not been reported. The present study compared the predictive performance of existing risk scores in these patients.@*METHODS@#A total of 1252 elderly patients with AF and ACS comorbidities (≥ 65 years old) were consecutively enrolled from January 2015 to December 2019. All patients were followed up for one year. The predictive performance of risk scores in predicting bleeding and thromboembolic events was calculated and compared.@*RESULTS@#During the 1-year follow-up, 183 (14.6%) patients had thromboembolic events, 198 (15.8%) patients had BARC class ≥ 2 bleeding events, and 61 (4.9%) patients had BARC class ≥ 3 bleeding events. For the BARC class ≥ 3 bleeding events, discrimination of the existing risk scores was low to moderate, PRECISE-DAPT (C-statistic: 0.638, 95% CI: 0.611-0.665), ATRIA (C-statistic: 0.615, 95% CI: 0.587-0.642), PARIS-MB (C-statistic: 0.612, 95% CI: 0.584-0.639), HAS-BLED (C-statistic: 0.597, 95% CI: 0.569-0.624) and CRUSADE (C-statistic: 0.595, 95% CI: 0.567-0.622). However, the calibration was good. PRECISE-DAPT showed a higher integrated discrimination improvement (IDI) than PARIS-MB, HAS-BLED, ATRIA, and CRUSADE (P < 0.05) and the best decision curve analysis (DCA). For thromboembolic events, the discrimination of GRACE (C-statistic: 0.636, 95% CI: 0.608-0.662) was higher than CHA2DS2-VASc (C-statistic: 0.612, 95% CI: 0.584-0.639), OPT-CAD (C-statistic: 0.602, 95% CI: 0.574-0.629) and PARIS-CTE (C-statistic: 0.595, 95% CI: 0.567-0.622). The calibration was good. Compared to OPT-CAD and PARIS-CTE, the IDI of the GRACE score slightly improved (P < 0.05). However, NRI analysis showed no significant difference. DCA showed that the clinical practicability of thromboembolic risk scores was similar.@*CONCLUSIONS@#The discrimination and calibration of existing risk scores in predicting 1-year thromboembolic and bleeding events were unsatisfactory in elderly patients with comorbid AF and ACS. PRECISE-DAPT showed higher IDI and DCA than other risk scores in predicting BARC class ≥ 3 bleeding events. The GRACE score showed a slight advantage in predicting thrombotic events.

The recognition significance of pointing gestures in children with autism spectrum disorder and its relationship with functional development / 中华行为医学与脑科学杂志

Objective:To understand the identification value of pointing gestures in children with autism spectrum disorder(ASD) and its relationship with functional development.Methods:From December 2020 to November 2021, 1 099 children from Children’s Health Care Center of Beijing Children’s Hospital were tested by pointing gestures test, including 942 ASD children and 157 typical developed children.And the data of children's neuropsychological development scale from 800 children aged 1.0-5.9 were collected.SPSS 20.0 was used for statistical analysis. Trend test was used to analyze the distribution of pointing gestures test sensitivity in autistic children, and ANOVA was used to analyze the relationship between pointing gestures test scores and functional development fields.Results:The sensitivity of pointing gestures was 83.5% in children aged 1.0-10.0 years, 76.3%-93.1% in children aged 1.0-4.9 years, and 93.1%-95.1% in children aged 1.0-2.9.With the increase of age, the sensitivity of pointing gestures in autistic children (linear-by-linear association =164.889, P<0.001) and the Yoden index had a decreasing trend. The positive predictive value (91.53%-100.00%) and negative predictive value (75.36%-91.84%) were found in the children aged 1.0-10.0 years.The sensitivity of pointing gestures test was 44.9% in children with mild autism aged 1.0-10.0 years and 46.5%-65.9% in children with mild autism aged from 1.0-3.9 years. The sensitivity of pointing gestures test was 81.5% in children with moderate autism aged from 1.0-10.0 years and 87.3%-97.8% in children with moderate autism aged 1.0-3.9 years. The sensitivity of the pointing gestures test was 97.2% in children with severe autism aged 1.0-10.0 years, and 100.0% in children with severe autism aged 1.0-3.9 years. The sensitivity of the pointing gestures in mild, moderate and severe autism children decreased with age (linear-by-linear association values were 16.725, 64.232, 66.732 respectively, all P<0.001). The children with severe autism mainly scored 2 points (80.3%, 419/522) on the pointing gestures test , and children with moderate autism mainly scored 1 point(64.2%, 170/265) on the pointing gestures test. There were significant differences in functional development among different pointing gestures test groups.Functional development score in the autism children with 0 score of pointing gestures test was significantly higher than those with 1 score and 2 scores of pointing gestures test (all P<0.05). Conclusion:Pointing gestures has good sensitivity in children with autism (especially 1.0-4.9 years of age), and may serve as an objectively observable screening method. The better children with autism score on the pointing gestures, the better their functional development.

Eukaryotic expression，purification and activity identification of human His-GRK2 recombinant protein / 安徽医科大学学报

Objective@#To construct a human G protein-coupled receptor kinase 2 ( GRK2) eukaryotic expression system．@*Methods@#The primers were designed ，and the His-GRK2 target gene was amplified by PCR using the Pans-EGFP-GrK2 (full-length) gene as the template．The His-GRK2 target gene was connected to the pcDNA3．1EGFP eukaryotic expression vector． The pcDNA3. 1-EGFP-His-GRK2 plasmid was transfected into HEK 293T cells．48 h later，the expression of GRK2 protein was detected by Western blot，and the GRK2 protein was purified by nickel chelated magnetic bead method．The purification of GRK2 protein was detected by Coomassie bright blue staining and Western blot，and the activity of GRK2 protein was detected by His pull down. @*Results @#The results of double enzyme digestion and sequencing showed that pcDNA3. 1-EGFP-His-GRK2 eukaryotic expression plasmid was successfully constructed．Western blot analysis showed that the molecular weight of GRK2 protein was about 80 ku，indicating that GRK2 protein was successfully expressed in HEK 293T cells (t = 6. 433，P = 0. 003) ．GRK2 protein was purified by nickel chelated magnetic beads．His pull down experiment results showed that GRK2 was bound to prostaglandin E2 receptor 4 (EP4) ，suggesting that GRK2 protein had biological activity (t = 13. 5，P = 0. 000 2) ．@*Conclusion@#The pcDNA3．1-EGFP-His-GRK2 eukaryotic expression plasmid was correctly sequenced and the GRK2 recombinant plasmid was successfully constructed．The GRK2 recombinant plasmid was successfully expressed in eukaryotic cells HEK 293T and the protein expressed was biologically active.

Diffuse midline gliomas with H3K27 alteration in children: a clinicopathological analysis of forty-one cases / 中华病理学杂志

Objective: To investigate the clinicopathological features of pediatric diffuse midline glioma with H3K27 alteration and to analyze their relationship with prognosis. Methods: Forty-one cases of childhood diffuse midline glioma with H3K27 alteration were collected at Children's Hospital of Fudan University (39 cases) and Xi'an Children's Hospital (2 cases), from July 2016 to July 2020. The clinical manifestations, imaging data, histopathology, immunohistochemical phenotype and molecular genetics features, tumor size, site and histological grading were evaluated. Results: Among the 41 cases, 21 were males and 20 females, the age of onset was 3-14 years, the average and median age was 7.6 years and 7.0 years, respectively. The tumor sites were brain stem (n=36) and other locations (n=5). The clinical manifestations were dizziness, gait disturbance, and limb weakness, etc. The MRI features were variable. The histology varied from low-grade to high-grade glioma with neuron differentiation. Immunohistochemistry showed that the tumor cells expressed H3K27M, GFAP, and Olig2. Genetic study showed that 76% (16/21) of tumors had H3F3A gene mutation, mostly accompanied by TP53 (62%, 13/21) missense mutation; five tumors (24%, 5/21) had HIST1H3B gene mutation, accompanied by missense mutations in ACVR1 and PI3K pathway-related gene PIK3CA (4/5) and PIK3R1 (1/5) mutations. The prognosis was dismal with only one alive and others died. The average and median overall survival time was 7 months and 4 months, respectively. Cox multivariate regression analysis showed that age, tumor location, radiologically maximum tumor diameter, histologic grading, and surgical methods were not significantly associated with overall survival rate (P>0.05). Conclusions: Pediatric diffuse midline gliomas with H3K27 alteration have unique clinicopathological and genetic characteristics. The prognosis is poor. The tumor location and histopathologic grading are not related to prognosis. New specific drugs and comprehensive treatment are needed to improve the prognosis.

Progress in the study of intracranial arterial dolichoectasia / 中华神经科杂志

Intracranial arterial dolichoectasia (IADE), also known as dilated cerebral artery disease, is manifested as an increase in the length and diameter of one or more intracranial arteries, the affected arteries being enlarged and dilated significantly, or even with winding and tortuosity. The diagnosis and prognostic evaluation of IADE are mainly based on the diameter and curvature of the intracranial artery. IADE can be manifested as ischemic stroke, transient ischemic attack, hydrocephalus, and hemorrhagic stroke. The review focuses on IADE, including the concept, diagnostic criteria, etiology, pathogenesis, pathology, clinical manifestations, treatment, and prognosis.

Intracranial arterial dolichoectasia and cerebral small vessel disease / 国际脑血管病杂志

Intracranial arterial dolichoectasia (IADE), also known as dilated cerebral artery disease, is a kind of disease in which the diseased arteries are lengthened, enlarged, and tortuous due to various reasons. Cerebral small vessel disease (CSVD) refers to a series of clinical, imaging and pathological syndromes caused by various etiologies affecting cerebral arterioles, venules and capillaries. Its main imaging manifestations include lacunar infarction, cerebral microbleeds, enlargement of perivascular space, white matter hyperintensities, and brain atrophy. In recent years, more and more studies have shown that IADE is closely associated with the occurrence and development of CSVD. This article reviews the correlation between IADE and CSVD.

Murine models of primary biliary cholangitis and its role in disease research / 中国药理学通报

Primary biliary cholangitis (PBC) is an autoimmune liver disease characterized by destructive cholangitis affecting the small intrahepatic bile ducts, and the presence of antimitochondrial antibodies (AMA). At present, there has been limited progress in exploring the pathogenesis of the disease, because of difficulty in obtaining human tissue samples and lack of suitable animal models. In recent years, some murine models have been reported, which showed serological, biochemical, and histological characteristics similar to those of humans with PBC. In this review, various murine models of PBC are reviewed, and the characteristics and mechanism of PBC in mice are introduced. Besides, their advantages and limitations in the study of PBC are discussed. It hopes to provide an important theoretical basis for studying the pathogenesis of PBC and developing therapeutic drugs for PBC.

Associations between floods and bacillary dysentery cases in main urban areas of Chongqing, China, 2005-2016: a retrospective study

BACKGROUND@#Understanding the association between floods and bacillary dysentery (BD) incidence is necessary for us to assess the health risk of extreme weather events. This study aims at exploring the association between floods and daily bacillary dysentery cases in main urban areas of Chongqing between 2005 and 2016 as well as evaluating the attributable risk from floods.@*METHODS@#The association between floods and daily bacillary dysentery cases was evaluated by using distributed lag non-linear model, controlling for meteorological factors, long-term trend, seasonality, and day of week. The fraction and number of bacillary dysentery cases attributable to floods was calculated. Subgroup analyses were conducted to explore the association across age, gender, and occupation.@*RESULTS@#After controlling the impact of temperature, precipitation, relative humidity, long-term trend, and seasonality, a significant lag effect of floods on bacillary dysentery cases was found at 0-day, 3-day, and 4-day lag, and the cumulative relative risk (CRR) over a 7-lag day period was 1.393 (95%CI 1.216-1.596). Male had higher risk than female. People under 5 years old and people aged 15-64 years old had significantly higher risk. Students, workers, and children had significantly higher risk. During the study period, based on 7-lag days, the attributable fraction of bacillary dysentery cases due to floods was 1.10% and the attributable number was 497 persons.@*CONCLUSIONS@#This study confirms that floods can increase the risk of bacillary dysentery incidence in main urban areas of Chongqing within an accurate time scale, the risk of bacillary dysentery caused by floods is still serious. The key population includes male, people under 5 years old, students, workers, and children. Considering the lag effect of floods on bacillary dysentery, the government and public health emergency departments should advance to the emergency health response in order to minimize the potential risk of floods on public.

Targeted inhibition of GRK2 kinase domain by CP-25 to reverse fibroblast-like synoviocytes dysfunction and improve collagen-induced arthritis in rats

Rheumatoid arthritis (RA) is an autoimmune disease and is mainly characterized by abnormal proliferation of fibroblast-like synoviocytes (FLS). The up-regulated cellular membrane expression of G protein coupled receptor kinase 2 (GRK2) of FLS plays a critical role in RA progression, the increase of GRK2 translocation activity promotes dysfunctional prostaglandin E4 receptor (EP4) signaling and FLS abnormal proliferation. Recently, although our group found that paeoniflorin-6'-

The correlation of developing capability of autistic children with social and linguistic parenting behaviors / 中华行为医学与脑科学杂志

Objective:To investigate the correlation between social and linguistic parenting behaviors and developing capability of children with autism.Methods:From August 2020 to December 2020, the social and linguistic parenting behaviors of 302 parents of children diagnosed with autism were investigated in the outpatient department of the hospital.Meanwhile, the data of Gesell scale for children, the social life competence scale for infant and junior middle school students, the autism behavior checklist and the Cancy autism behavior scale were collected.SPSS 20.0 software was used for statistical analysis.Independent sample t test and analysis of variance were used to compare the social and linguistic parenting behaviors of different parents.Pearson correlation analysis was used to analyze the correlation between the social and linguistic parenting behaviors of parents and children's developmental ability and symptom severity. Results:There were no statistically significant differences in children's social and language development parenting behavior between father and mother ( t=1.033, P=0.303; t=-0.312, P=0.756). There were no statistically significant differences in children's social and linguistic parenting behaviors between fathers of different age groups ( F=1.425, P=0.244; F=1.127, P=0.345). Among mothers of different age groups, the social parenting behaviors of <30 years old and 30-34 years old groups were significantly better than those of 35-39 years old group ( F=3.374, P=0.019; LSD: P=0.010, P=0.006). Among fathers, the social parenting behavior( F=4.346, P=0.008; LSD: P=0.020, P=0.001) and social + linguistic parenting behavior in the graduate group and college group were significantly better than those in the high school/vocational group( F=3.965, P=0.012; LSD: P=0.020, P=0.002). Among mothers, the social parenting behavior ( F=2.812, P=0.040; LSD: P=0.008, P=0.023, P=0.009), linguistic parenting behavior ( F=3.769, P=0.011; LSD: P=0.010, P=0.025, P=0.001), social + linguistic parenting behavior ( F=3.654, P=0.013; LSD: P=0.005, P=0.015, P=0.002) in graduate and above groups were significantly better than those in college group, high school/vocational group, junior high school and below groups.The scores of social parenting behavior(40.72±6.80), linguistic parenting behavior(27.20±5.22), and social + linguistic parenting behavior(67.92±11.10) were significantly correlated with children’s fine motor(61.75±16.41)( r=0.193, P=0.001; r=0.153, P=0.009; r=0.190, P=0.001), cognition(68.28±16.83)( r=0.231, P=0.000; r=0.186, P=0.001; r=0.229, P=0.000), language(53.01±18.55) ( r=0.262, P=0.000; r=0.305, P=0.000; r=0.304, P=0.000) and social self-care(61.44±17.85) ( r=0.264, P=0.000; r=0.238, P=0.000; r=0.274, P=0.000). The scores of linguistic parenting behavior and social + linguistic parenting behavior were correlated with children's social life ability (8.65±0.89) ( r=0.142, P=0.046; r=0.140, P=0.049). There was no significant correlation between social parenting behavior, linguistic parenting behavior, social + linguistic parenting behavior and the scores of ABC scale (50.53±21.39) ( r=-0.089, P=0.336; r=-0.115, P=0.215; r=-0.107, P=0.250) and CABS scale (13.96±4.54) ( r=-0.050, P=0.490; r=-0.059, P=0.411; r=-0.058, P=0.421). Conclusions:The social and linguistic parenting behaviors are related to their age and educational level, and are significantly correlated to developing capability of children with autism, but have nothing to do with the severity of children's symptoms.

Expression of p-AKT and p-mTOR in pediatric Burkitt lymphoma and their correlation with prognosis / 中华病理学杂志

To evaluate the expression of p-AKT and p-mTOR, the key proteins in PI3K/AKT/mTOR pathway in pediatric Burkitt lymphoma (BL), and to investigate the clinical and prognostic significance. Fifty-eight cases of pediatric BL and thirty cases of reactive hyperplastic lymphadenitis (RH) were collected at Children's Hospital of Fudan University from September 2011 to July 2018. Paraffin sections of tissues were immune stained for p-AKT and p-mTOR, and the expression was assessed and correlated with the clinical features and prognosis. A total of 58 cases were diagnosed and 6 cases lost the follow-up. Of the remaining 52 BL patients including 43 males and 9 females, the median age was 5 years (range: 2 to 14 years). Regarding to the correlation between the two biomarkers, Spearman test showed that p-mTOR was positively associated with the expression of p-AKT (0.759, 0.001). Of all BL patients, the positive rates of p-AKT and p-mTOR were 62.1% (36/58) and 60.3%(35/58) respectively, both significantly higher than control group (0.011, 0.035 respectively). The presence of p-AKT was significantly associated with higher lactate dehydrogenase (LDH≥573 IU/L) level in patients of the disease (0.006), while p-mTOR was increased both in the higher LDH and lower ratio of albumin to globulin (A/G) group (0.006, 0.034 respectively). Expression of p-AKT and p-mTOR did not show any statistical correlation with sex, age, St.jude stage, tumor size, B-symptom present or not, number of extra-nodal sites or international prognostic index (IPI) (0.05). Fifty-two patients had a median follow-up of 40 months (range: 5-87 months). Univariate analysis showed that p-AKT expression was significant in predicting both inferior OS (5-year estimate, 72.7% . 94.7%, (2)=4.123, 0.042) and PFS (5-year estimate, 66.7% . 94.7%, (2)=5.822, 0.016). The 5-year OS rate was 71.0% (22/31) for the p-mTOR positive cohort of patients compared to 95.2% (17/21) for p-mTOR negative group ((2)=4.881, 0.027); however, there was no statistical significance in 5-year PFS rate (0.05). Especially, the 5-year OS and PFS rate of p-AKT/p-mTOR double-positive group were significantly lower than negative control group (including absence of single p-AKT or p-mTOR expression, and absence of both) (OS: 69.0% . 95.7%, (2)=6.285, 0.012; PFS: 65.5% . 91.3%, (2)=5.405, 0.020). The results of multivariate COX proportional risk regression analysis indicated that p-AKT/p-mTOR double-positive, higher LDH and IPI score 3-5 were independent prognostic factors for both OS and PFS, and the bulky tumor (>10 cm) for PFS of pediatric BL. The expression of p-AKT and p-mTOR may be a potential reference for diagnosis and the independent prognostic indicators of pediatric BL.

Analysis of string-overalls-suture pancreaticojejunostomy in preventing of postoperative pancreatic fistula / 中华内分泌外科杂志

Objective:To investigate the influence of string-overalls-suture pancreaticojejunostomy on the incidence of postoperative pancreatic fistula (POPF) in pancreaticoduodenectomy (PD) .Methods:Clinical data of 70 cases receiving PD in the Affiliated Zhongshan Hospital of Dalian University from Jan. 2011 to Dec. 2018 were retrospectively studied. All cases were divided into experimental group and control group according to the different ways of pancreaticojejunostomy. Patients in experimental group received string-overalls-suture pancreaticojejunostomy, and those in control group received pancreatic duct jejunal mucosa pancreaticojejunostomy. The 70 cases were performed by the same team. Operative time and the incidence of postoperative complications between the two groups were compared and analyzed.Results:There was no statistical differences between the two groups in general data and intraoperative observations. The total operative time was (4.28±1.10) hours in the control group and (3.62±0.76) hours in the experimental group. It was significantly different between the two groups ( t=2.942, P=0.004) . There were 7 (28.0%) cases of POPF including 6 cases of grade B, and 1 case of grade C in the control group, and 3 (6.7%) cases of grade B in the experimental group. 6 (24.0%) cases had postoperative bleeding in the control group, 7 (15.6%) cases in the experimental group, 8 (32.0%) cases with abdominal infection in control group, and 8 (17.8%) cases in the experimental group. Delayed gastric emptying occurred in 3 (12.0%) cases in the control group, and 4 (8.9%) cases in the experimental group. It was significantly different for POPF between the two groups (χ 2=4.358, P=0.037) . And there were no significant differences for other postoperative complications between the two groups (all P>0.05) . Conclusion:The string-overalls-suture pancreaticojejunostomy has the advantages of simple and quick manipulation, wide indication, safe and reliable pancreaticojejunostomy, and has certain superiorities in shortening operation times and reducing POPF.

Investigation on college students' acceptance of flipped classroom and analysis of its influencing factors / 中华医学教育探索杂志

Objective:To investigate college students' acceptance of flipped classroom and its influencing factors, so as to provide basis and suggestions for the promotion of flipped classroom in colleges and universities.Methods:A structured quantitative questionnaire was used to investigate the learning status of 876 students in Chongqing Medical University and their cognition and acceptance of flipped classroom. The influencing factors were analyzed by multiple linear regression.Results:According to the questionnaire, 77.9% of the students did not know about flipped classroom, 32.3% of them had high acceptance to it and 62.0% of them accepted it moderately. The stronger the learning ability and motivation, the higher levels of understanding and acceptance of the flipped classroom.Conclusion:Undergraduates have a certain degree of acceptance to flipped classroom. In daily education, attention should be paid to stimulating students' learning motivation, cultivating their learning ability in various aspects, widely spreading teaching concept of flipped classroom, and actively trying the teaching mode of flipped classroom.

Effects of Acupuncture on Alzheimer's Disease: Evidence from Neuroimaging Studies / 中国结合医学杂志

As the worldwide population ages, the prevalence of Alzheimer's disease (AD) increases. However, the results of promising medications have been unsatisfactory. Chinese acupuncture has a long history of treating dementia, but lack of evidence from well-designed randomized controlled trials that validate its efficacy and safety, as well as its lack of clear underlying mechanisms, contribute to its limited application in clinical practice. In recent years, brain imaging technologies, such as functional magnetic resonance imaging and positron emission tomography, have been used to assess brain responses to acupuncture in a dynamic, visual, and objective way. These techniques are frequently used to explore neurological mechanisms of responses to acupuncture in AD and provide neuroimaging evidence as well as starting points to elucidate the possible mechanisms. This review summarizes the existing brain imaging evidence that explains the effects of acupuncture for AD and analyzes brain responses to acupuncture at cognitive-related acupoints [Baihui (GV 20), Shenmen (HT 7), Zusanli (ST 36), Neiguan (PC 6), and Taixi (KI 3)] from perspectives of acupoint specificity and acupoint combinations. Key issues and directions to consider in future studies are also put forward. This review should deepen our understanding of how brain imaging studies can be used to explore the underlying mechanisms of acupuncture in AD.

Expert consensus on biomechanical research of dental implant / 华西口腔医学杂志

Current biomechanical research of dental implants focuses on the mechanical damage and enhancement mechanism of the implant-abutment interface as well as how to obtain better mechanical strength and longer fatigue life of dental implants. The mechanical properties of implants can be comprehensively evaluated by strain gauge analysis, photo elastic stress analysis, digital image correlation, finite element analysis, implant bone bonding strength test, and measurement of mechanical properties. Finite element analysis is the most common method for evaluating stress distribution in dental implants, and static pressure and fatigue tests are commonly used in mechanical strength test. This article reviews biomechanical research methods and evaluation indices of dental implants. Results provide methodology guidelines in the field of biomechanics by introducing principles, ranges of application, advantages, and limitations, thereby benefitting researchers in selecting suitable methods. The influencing factors of the experimental results are presented and discussed to provide implant design ideas for researchers.