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To study of premature/early death of autistic patients from the perspective of life course can help families, medical institutions and policy makers better deal with the adverse effects of autism. Several studies have shown that autistic patients have a high risk of death, however, the results are still inconsistent. To assess the risk of mortality among the autistic patients, we undertook a comprehensive search of MEDLINE, Web of Science and EMBASE databases. This paper reviewed the studies on the negative disease outcomes of autism spectrum disorders, including the risk of death, causes of death and several research hotspots in this field. Strict inclusion/exclusion criteria were used. Information was extracted from selected papers, tabulated and synthesized. In the study, 15 studies were included, with a total of 216 045 individuals. The main outcome was all-cause mortality in association with autism and the secondary outcome was cause-specific mortality. The results showed that all-cause mortality was higher for the autistic patients (RR=2.32, 95%CI: 1.98-2.72, I2=87.1%, P < 0.001). Risk ratio showed a greater inequality for female than male (male: RR=2.00, 95%CI: 1.57-2.55, I2=93.2%, P < 0.001; female: RR=4.66, 95%CI: 3.30-6.58, I2=92.0%, P < 0.001). Compared with the unnatural death, the risk of natural death was higher (RR=3.44, 95%CI: 1.27-9.26, I2=80.2%, P=0.025). As autism had many comorbidities, which would bring more health risks and natural deaths possibilities. There were some structural differences in unnatural death. Accidental injury death and suicide were two kinds of causes. Lacking social skills would weaken the ability to ask for help when encountering injuries. This paper put forward some suggestions for futures. First, to well study the comorbidity can reduce the risk of death from a medical point of view. Second, the scientists and policymakers should pay attention to the social environment and provide a safer environment for the autistic patients. Third, for women and for adolescents without cognitive impairment, due to their high risk of suicide, the society should provide them with more supportive social networks and improve their life satisfaction. Fourth, it is necessary to balance the rehabilitation resources in various regions in China and provide more high-quality lifelong rehabilitation monitoring and care services.
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Adolescent , Humans , Male , Female , Autism Spectrum Disorder , Cause of Death , Comorbidity , Autistic Disorder , ChinaABSTRACT
Cancer is considered as one of the major diseases endangering human health in the world, it is urgent to find a safer and more efficient treatment for cancer therapy. Gene therapy with ribonucleic acid (RNA) drugs could regulate the expression of tumor related genes, and exhibit good anti-tumor therapeutic potential in preclinical and clinical trials. Based on the differences between tumor tissues and normal tissues in microenvironment signal characteristics such as pH, specific enzyme concentration or redox gradient, various microenvironment responsive nanocarriers had been studied and developed to deliver RNA drugs to tumor tissues and cells, improving the anti-tumor efficacy of RNA drugs and reducing toxic and side effects. This paper reviews the pathophysiological characteristics of tumor microenvironment and various strategies of tumor microenvironment responsive nanocarriers, in order to provide reference for the design of safe and efficient RNA drug delivery system for cancer therapy.
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With the implementation of the two-child policy and the growing demand for child health, pediatric medication has been arousing widespread social concern. To develop the drugs suitable for children, including new compounds, new specifications and new dosage forms, is urgently required for pharmaceutical researchers. In this review, several technical bottlenecks for pediatric oral liquid preparations, as well as the novel strategies involved in drug nanocrystals, self-microemulsion, ion exchange resin and Pickering emulsion were discussed, which may be benefit to play a theoretical guiding role in the research and development of children's oral liquid formulation.
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Objective:To explore the effects of Baduanjin and balancer exercise on motor and non-motor symptoms for patients with mild to moderate Parkinson's disease (PD). Methods:From May, 2017 to September, 2018, 31 patients with PD were collected from the inpatients, outpatients and outside of our hospitals. The patients accepted Baduanjin and balancer exercise successively, three weeks for each exercise, and were assessed with Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part I, II, III and IV, and Non-motor Symptoms Scale (NMSS) before and after each exercise. Results:Four cases dropped out during Baduanjin exercise. The total score, the scores of part I, II and III of MDS-UPDRS, and NMSS score (t > 3.274, P < 0.01) decreased significantly after Baduanjin exercise. Other three cases dropped out during balancer exercise. The total score and the score of part III of MDS-UPDRS decreased significantly after balancer exercise (t > 2.763, P < 0.05). Conclusion:Baduanjin exercise can improve the motor and non-motor symptoms of mild to moderate PD, but not significant for motor complications; while balancer exercise can improve the motor symptoms, but not significant for non-motor symptoms and motor complications.
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Discoidin domain receptor 1(DDR1)is a critical member of the receptor tyrosine kinase family.It may be related to tumor invasion and metastasis,and the abnormal activation of DDR1 can lead to the occurrence and development of malignant tumors,inflammation,and fibrosis.DDR1 are involved in cell adhesion,migration,proliferation,secretion of cytokines,and remodeling of extracellular matrix,thus playing a critical role in various pathophysiological processes of the human body.In this review,we demonstrate the research progress of DDR1 in breast cancer and other malignant tumors,in order to provide a new theoretical basis for the prevention and treatment of breast cancer and other tumors.
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Female , Humans , Breast Neoplasms/genetics , Cell Adhesion , Discoidin Domain Receptor 1 , Fibrosis , Receptor Protein-Tyrosine Kinases/geneticsABSTRACT
OBJECTIVE@#To construct an acute myeloid leukemia cell line stably expressing CD123-CLL1 so as to provide an "in vitro" model for studying the role of CD123 and CLL-1 in leukemia and the treatment targeting CD123 and CLL-1.@*METHODS@#The recombinant plasmid of lentivirus was constructed by synthesizing CD123 and CLL-1 sequences and PCR homologous recombination. The lentivirus vector was packaged by three-plasmid packaging system. After collecting the supernatant of lentivirus, the virus titer was determined by quantitative PCR. K562 leukemia cells were collected and transtected with virus supernatant. Leukemia cell line stably expressing the target gene were screened by purinomycin. The expression levels of CD123 and CLL-1 were detected by RT-PCR and flow cytometry.@*RESULTS@#The lentiviral vector was successfully constructed, and identified by agarose gel electrophoresis and gene sequencing, then the virus titer of the supernatant was up to 5.81×10@*CONCLUSION@#Lentiviral vector expressing CD123-CLL1 has been successfully constructed, and K562 leukemia cell line stably expressing CD123 and CLL-1 has been successfully obtained.
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Humans , Cell Line, Tumor , Genetic Vectors , Interleukin-3 Receptor alpha Subunit , K562 Cells , Lentivirus/genetics , Leukemia, Lymphocytic, Chronic, B-Cell/genetics , Plasmids , TransfectionABSTRACT
OBJECTIVES@#This study aims to investigate awareness of oral health care and health status among elderly people in nursing homes in Taiyuan. Strategies for preventing and treating oral diseases and improving the quality of life of the elderly in nursing homes were formulated on the basis of analyzed data.@*METHODS@#A total of 359 participants from 48 nursing homes in six districts were selected randomly. Awareness, attitude, and behavior with regard to oral health care among the elderly were investigated through a survey using questionnaires and oral health examinations. Data were statistically analyzed with SPSS 20.0.@*RESULTS@#Among the elderly in the nursing homes in Taiyuan, awareness and behavior with regard to oral health care were deficient and inappropriate, and thus professional guidance was needed. In addition to method and time of brushing teeth and bad oral habits, the oral health status of the elderly was statistically affected by age and education. Compared with the data of the Fourth National Oral Epidemiological Investigation, the number of elderly people aged 55-64 or 65-74 years who brush their teeth every day and accept oral diagnosis and treatment was lower. However, the ratios of edentulous and missing teeth without treatment were higher than the national average level for the same age groups.@*CONCLUSIONS@#The awareness and attitude of the elderly in nursing homes with regard to oral health care are unsatisfactory, and their oral health status is poor. Education on oral health care, development of good oral care habits, and regular oral health examination are essential to the maintenance of oral health in elderly people.
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Aged , Humans , Middle Aged , Health Status , Mouth, Edentulous , Nursing Homes , Oral Health , Quality of Life , ToothbrushingABSTRACT
AIM:To investigate the therapeutic and preventive effects of paeoniflorin ( PF) on APP/PS1 mice, and to explore the possible mechanism. METHODS:Fifteen male 5-month-old APP/PS1 non-dominant mice were chosen as normal control group, 15 male 5-month-old APP/PS1 double transgenic mice were used as model group, and 15 male 5-month-old APP/PS1 double transgenic mice treated with 5 mg/kg PF by intraperitoneal injection were allocated in administation group. The learning and memory ability of the mice in each group was detected by Morris water maze. The apoptosis was assessed by TUNEL fluorescence staining. The protein expression of PI3K, Akt, p-PI3K, p-Akt, caspase-3, caspase-9, Bcl-2 and Bax in cerebral cortex and hippocampus was detected by Western Blot. The protein expression levels and distribution of caspase-3 and caspase-9 were detected by immunohistochemistry. RESULTS:(1) Compared with nor-mal control group, the learning and memory ability declined in APP/PS1 model group. Compared with APP/PS1 model group, PF obviously improve the ability of learning and memory in mice. (2) Compared with normal control group, the ap-optosis of nerve cells in APP/PS1 model group significantly increased and distributed in wider areas, while that in PF group was reduced (P<0.05). (3) Compared with APP/PS1 model group, PF could significantly lower pro-apoptotic factors, caspase-3, caspase-9 and Bax (P<0.05), and increase the expression of anti-apoptotic factors, p-PI3K, p-Akt and Bcl-2 (P<0.05). CONCLUSION:PF can up-regulate the expression of Bcl-2 and down-regulate the expression levels of caspase-9, caspase-3 and Bax via the activation of PI3K/Akt pathway, thereby inhibiting the nerve cell apoptosis and pro-tecting the nerve cells, so as to treat neurodegenerative diseases.
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<p><b>OBJECTIVE</b>To investigate the effects of sleep deprivation on intelligence development in primary school students.</p><p><b>METHODS</b>Between June 2009 and April 2010, 316 grade 5 students aged 10-11 years were selected from four primary schools in four administrative districts of Changsha, China by stratified random sampling. The intelligence characteristics of children with varying degrees of sleep deprivation were investigated using the Chinese Wechsler Intelligence Scale for Children.</p><p><b>RESULTS</b>A total of 286 valid questionnaires were received, with a response rate of 90.5%. The survey was comprised of a sleep deprivation group (sleep time <8 hours per night; n=180) and a control group (sleep time ≥8 hours per night; n=106). The sleep deprivation group had significantly lower subtest scores, verbal intelligence quotient (IQ) (VIQ), performance IQ (PIQ) and full scale IQ (P<0.05) and significantly lower verbal comprehension factor score and memory/attention factor score compared with the control group (P<0.05). Compared with the control group, the moderate sleep deprivation subgroup had significantly decreased VIQ and full scale IQ as well as verbal comprehension factor score and memory/attention factor score (P<0.05), and the severe sleep deprivation subgroup showed decreases in all scores (P<0.05). The sleep deprivation group and moderate and severe sleep deprivation subgroups had significantly higher proportions of children with VIQ-PIQ imbalance than the control group.</p><p><b>CONCLUSIONS</b>Sleep deprivation adversely affects intelligence development, especially VIQ, in primary school students, and the adverse effects of sleep deprivation are mainly seen in students with moderate and severe sleep deprivation.</p>
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Child , Female , Humans , Male , Intelligence , Sleep Deprivation , PsychologyABSTRACT
Objective To investigate the related anatomical parameters of single-nostril transsphenoidal approach in adults.Methods Two hundred and ninty-four adults,performed head-neck CTA in our hospital from October 2011 to January 2012,were prospectively collected; and their CT data were collected,and the following anatomical parameters were measured through the multi-planar reconstruction of the CTA images:the angle of sella lowest point-anterior nasal spine root-the bottom of nasal cavity (∠ 1),the angle of the connection of Maxillary central incisors bottom to auditory canal crossing with the bottom of nasal cavity(∠ 2),the angle of tuberculum sellae-anterior nasal spine root-the bottom of nasal cavity(∠3),the angle ofdorsum sellae-anterior nasal spine root-the bottom of nasal cavity (∠4),and the angles of right / left sphenoid sinus mouth-maxillary ridge-the bottom of nasal cavity(∠5 / ∠6).Results ∠1(29.7±3.1°),∠2(29.5±3.1°),∠3(33.6±3.8°),∠4(28.8±3.6°),∠5(33.9±4.2°) and ∠6(33.6±4.5°) were calculated; significant differences were noted between each two angles (P<0.05); ∠ 1 and ∠2 had a positive linear correlation (r=0.78,P<0.05).Conclusion Preoperative multi-planar reconstruction images of CT facilitates safe opening of the anterior wall of spheniodal sinus and the sellar floor,and the operative position refers to the orientation that the virtual plane of Maxillary central incisors bottom to bilateral auditory canal erects the ground.
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Objective To investigate the role of preoperative image information in tumor resection degrees,surgical complications and mortality of patients with meningiomas.Methods One hundred and seventy-two patients with meningiomas,admitted to our hospital from January 2008 to June 2011,were chosen in our study; the complete image informations,including tumor location,tumor size,nerves and vessels wraping around tumor or tumor wraping around nerves and vessels,tumor invasiveness,tumor margin,tumor shape,degrees of tumor enhancement and peritumoral brain edema,were retrospectively analyzed; univariate factor Chi-square test was performed to analyze the factors influencing the extent of tumor resection,surgical complications and death.Binary logistic stepwise regression analysis was performed to analyze statistical significance of the factors.Results Tumor location,tumor size,tumor invasiveness,tumor shape and tumor margin were the five independent risk factors of tumor residual,and tumor invasiveness was the primary risk factor.Tumor location,tumor size,nerves and vessels wraping around tumor or tumor wraping around nerves and vessels,and degrees of tumor enhancement were the four independent risk factors of surgical complications,and tumor location was the primary risk factor.Tumor location and tumor size were two independent risk factors of morbidity,and tumor location was the primary risk factor of mortality.Conclusion Preoperative image information of meningioma,especially the four primary factors (tumor location,tumor size,tumor invasiveness,and nerves and vessels wraping around tumor or tumor wraping around nerves and vessels),may objectively and accurately to estimate and evaluate meningioma resection degree,surgicalcomplications and mortality.
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Objective To develop a three-dimensional visual neurosurgical tool enjoying simple,fast and accurate characteristics at moderate cost for visual positioning and imaging information storage and processing. Methods Seven patients with epidural hematoma or depressed fracture resulted from severe craniocerebral trauma, 8 patients with hypophysoma, 5 with glioma and 3 with meningeoma were chosen in our study; CT three-dimensional reconstruction of their imaging data were performed and used for preoperative planning before surgery assisted by neurosurgical station.According to CT three-dimensional reconstruction results, appropriate neurosurgical approach was planned and patients were treated by surgery. Results Neurosurgical station performed three-dimensional reconstruction could show three-dimensional quantitative relationship between the above lesions and anatomical landmarks directly,which could help direct positioning and designing the best-individualized approach to improve the surgical accuracy and efficacy. Neurosurgical station could improve the efficiency of scientific research and clinical work by managing,storing,editing and using the imaging and video of the patients. Conclusion Neurosurgical station, which can show three-dimensional quantitative relationship between the above lesions and anatomical landmarks directly, is a simple, fast and accurate preoperative planning and information processing tool for clinical neurosurgical practice.
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Objective To explore the correlation between the findings ofbrainstem reflex (BSR)and the prognosis of consciousness in long-term unconscious patients with severe traumatic brain injury (TBI).Methods BSR findings were collected in 60 patients,admitted to our hospital from March 2010 to June 2011 and suffered from severe TBI with a duration of disturbance of consciousness≥2weeks.The patients were divided into conscious and unconscious groups based on whether or not the patients were still with disturbance of consciousness 6 months after the injury.And finally,the significant indicators were chosen in the two groups using chi square test.Results A total of 36 patients (60.0%)retrieved consciousness 6 months after the injury.The abnormality rate of BSR was 23.8%.Significant differences were noted between conscious and unconscious groups in the disappearance of left ciliospinal reflex,left vertical oculo-vestibular reflex,double light reflex and oculocardiac reflex.The unconscious probabilities in patients with abnormal BSR which indexes mentioned above were higher.Conclusion The findings of BSR can objectively and accurately demonstrate the degree of cerebral dysfunction and predict the prognosis of consciousness.
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Objective To observe the anatomical structure via endonasal transsphenoidal approach with virtual endoscopy (VE) and explore the clinical applications of VE in endoscopic pituitary tumor resection through the endonasal transsphenoidal approach. Methods The VE was applied to the reconstruction of the pre-surgical 64-slice CT scanning of the 21 patients with pituitary adenoma received the endoscopic endonasal transsphenoidal surgery. A comparative study and a correlation analysis of cumulative scores of the anatomical structure were performed between the reconstructed VE images and the intraoperative endoscopic ones. Results Preoperative VE images and intraoperative endoscope images are very similar. The correlation of cumulative scores of the anatomical structure between the VE images of anatomical findings and the intraoperative images was positively noted (r=0.923, P=0.001),indicating that VE can be applied to simulately observe the anatomical structure before the endoscopic endonasal transsphenoidal pituitary surgery, and observe the anatomical structure through the endonasal transsphenoidal approach. Conclusion Being able to display the important anatomical structure and its varieties before the endoscopic endonasal transsphenoidal pituitary surgery, VE proves to be a valuable approach to the preoperative planning, increases the surgical efficiency and improves the safety of the surgery.
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Objective To explore the correlation between brainstem auditory evoked potential (BAEP) findings and outcome in long-term unconscious patients with severe traumatic brain injury (TBI).Methods BAEP findings were recorded and analyzed in 63 patients suffering from severe TBI with duration of disturbance of unconsciousness for more than 2 weeks. The peak latency (PL) of wave Ⅰ, Ⅲ and Ⅴ, the interpeak latency (IPL) of wave Ⅰ-Ⅲ and Ⅲ-Ⅴ and the amplitude ratio of wave Ⅰ and Ⅴ were analyzed. Conscious or unconscious at 6 months after the injury was considered as the outcome criterion,and based on these, the patients were divided into conscious and unconscious groups; the significant indicators were chosen in the 2 groups using independent-sample t test. Results The probabilities of awakening in these patients were 34.9% (22/63) with abnormal index of BAEP indicators reaching 66.7%. Sixteen patients were sober at last in 21 patients with normal PL of wave Ⅰ, Ⅲ and Ⅴ, IPL of wave Ⅰ-Ⅲ and Ⅲ-Ⅴ, and amplitude ratio of wave Ⅰ and Ⅴ in bilateral side (the probabilities of awakening were 76.2%); 8 patients having abnormal PL of wave Ⅴ in bilateral side and 7 having abnormal IPL of wave Ⅲ-Ⅴ in bilateral side were unconscious; 2 patients having disappeared wave Ⅴ in unilateral side were unconscious. PL of wave Ⅴ and IPL of wave Ⅲ-Ⅴ in bilateral side were significantly different between the conscious group and the unconscious group. (P<0.05). Conclusion BAEP findings (PL of wave Ⅴ and IPL of wave Ⅲ-Ⅴ in bilateral side) can objectively and accurately demonstrate the cerebral dysfunction and predict the outcome of the patients.
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Objective To develop a simple, fast and accurate preoperative planning method for endoscopic surgery of patients with hypertensive intracerebral hemorrhage (HICH).Methods Eighteen patients with HICH, admitted to our hospital from June 2008 to August 2010, were performed endoscopic minimally invasive surgery; CT three-dimensional reconstruction was employed to locate the intracerebral hematoma and select the appropriate endoscopic approach before the endoscopic surgery.The clinical data and treatmem efficacy were analyzed.Results According to the results of CT three-dimensional reconstruction, our neurosurgeons could design the best endoscopic approach; the three-dimensional relationship between intracerebral hematoma and scalp markers was shown directly and accurate positioning of the location of drilling was achieved; therefore, the time for preoperative preparation, anesthesia and operation was shortened. The mean operating time of these 18 patients was about 1.5 h; the volume of blood loss was only 30-40 mL; and the evacuation ratio was about 89.2%.After the elimination of hematoma, the brain tissues were flabby, so decompressive craniectomy was not needed. Conclusion CT three-dimensional reconstruction is a simple, fast and accurate preoperative planning method for endoscopic surgery of patients with HICH.
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Benign fibrous histiocytomas (BFH) represent a rare group of tumors with a common origin from the tissue histiocytes, often causing pain and space-occupying effect. BFH of bone causes diagnostic difficulties due to its atypical clinical symptoms, radiographic features and cytological characteristics, which can be easily confused with other benign lesions such as non-ossifying fibroma (NOF), giant cell tumor (GCT), and fibrous dysplasia. The lesions are prone to relapse, and the patients often show poor response to radiotherapy and chemotherapy, therefore radical lesion resection should be the therapeutic target of this disease. This paper reported a case of BFH involving the skull and reviewed the associated literatures.
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Humans , Male , Young Adult , Histiocytoma, Benign Fibrous , Pathology , Skull , PathologyABSTRACT
Objective To study the relationship between O6-methylguanine-DNA-methyltransferase(MGMT)expression in gliomas and the efficacy of teniposide(VM-26)combined with somustine(Me-CCNU). Methods A retrospective chart review was performed on 47 patients diagnosed by pathology as having gliomas.The expression of MGMT in all paraffin sections of the patients were determined by immunohistochemical technique.The clinical efficacy was observed and the overall survival rates were analyzed. Results The positive rate of MGMT in all the 47 patients was 40.4%.Three-year survival rate of the negative group was 66.7%and that of the positive group was 52.6%without statistical significance(P>0.05).The average OS of the negative group was 67.861±10.094 and that of the positive group was 47.263±7.983 without statistical significance(P>0.05).Bone marrow suppression of grade I was found in 11 patients with 6 appearing stomach discomfort,vomiting,diarrhea,loss of appetite and digestive symptoms.Conclusions MGMT is one agent of drug resistance of nitrosourea.VM-26 combined with Me-CCNU chemotherapy can overcome the resistance effect of MGMT with little side effects.
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Objective To explore the correlation between magnetic resonance imaging(MRI)manifestations and the prognosis in long-term consciousness disorder patients with severe traumatic brain injury(TBI).Methods MRI data were collected in 66 patients with a duration of disturbance of unconsciousness for more than 2 weeks.These patients suffered from severe TBI and were admitted to our hospital from January 2003 to August 2008.The data about regions of abnormal signal in T2WI in the brain stem,the thalamus,the basal forebrain,the corpus callosum,the cerebral cortex and the subcortical area were recorded and analyzed.The patients were divided into conscious and unconscious groups based on the outcome 6 months after the injury.Logistic regression analysis was used to calculate the OR value between the lesions and the poor outcome of the patients.Results The lesions of the dorsal upper brain stein,the thalamus and the corpus callosum between the conscious and unconscious groups were significantly different.The lesions of the dorsal upper brain stem,the corpus callosum and the thalamic by MRI predict the poor outcomes.Conclusion The MRI manifestations can demonstrate the cerebral dysfunction and probabilities of patients' outcome objectively and accurately.
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Objective To develop a minimally invasive operating technique for the treatment of hypertensive thalamic hemorrhage. Methods The clinical data of 15 patients with hypertensive thalamic hemorrhage performed neuroendoscope-assisted micro-invasive surgical treatment in our hospitals from July 2007 to June 2010 were retrospectively analyzed; their treatment efficacy were also concluded. Results The mean operation time of these patients was (1.5±0.4) h and the amount of blood loss was 30-40 mL; the mean clearance rate of hematoma in the thalamus was (86.2 ±7.9)percentage. Patients were followed up and evaluated by Glasgow outcome scale for at least 3 months.Three patients (21.4%) showed good recovery, 4 (28.6%) moderate disability, 4(28.6%) severe disability and 2 (14.3%) vegetative survival; 1 patient (7.1%) died. Conclusion Neuroendoscope-assisted micro-invasive surgical treatment is a fast and minimally invasive operating technique with little blood loss in the treatment of hypertensive thalamic hemorrhage.