Objective To explore the difference in early symptoms between 2-3 years old autism spectrum disorder (ASD) children and healthy children through video analysis,in order to provide evidence for the identification and screening of ASD children.Methods The study involved 25 cases of ASD children who were admitted to Children Development and Behavior Center,the Third Affiliated Hospital,Sun Y at-Sen University,and confirmed with diagnosis standards of Diagnosis and Statistical Manual of Medical Disorder 5th edition (DSM-5) and 21 healthy children recruited in community.Three-minute videos of children in standard procedure were collected.Mter that,all the videos were scored on 5 items by 2 professional evaluators,unaware of diagnostic status.Comparison analysis of video scores between ASD and the healthy controls was made,and the sensitivity and specificity of video analysis were evaluated.Results Response to roll-call score was higher in ASD children [2 (2) scores] than that of the healthy children [0 (0) scores],response to audible object score was higher in ASD children [0(1) scores] than that of the healthy children [0(0) scores],social smiling score was higher in ASD children [1 (1) scores] than that of the healthy children [0 (1) scores],and total score was higher in ASD children [4 (2) scores] than that of the healthy children [2 (0) scores],and the differences were statistically significant (Z =2.272,P =0.000;Z =0.976,P =0.010;Z =1.763,P =0.001;Z =2.355,P =0.000).But,no difference was found in speech and finger pointing (all P ＞ 0.05).The consistency between three-minute video analysis and standard diagnosis was 0.652 (P =0.000),with 80.0％ of sensitivity and 85.7％ of specificity.Conclusions The ASD children perform worse than the healthy children in response to roll-call,response to audible object and social smiling.Three-minute standard video analysis can help to detect the early symptoms of ASD children.This result also demonstrates the potential of video-based analysis used as a ASD screening instrument in 2-3 years old children.

Objective To explore sex differences in cognitive and behavioral characteristics in children with autism spectrum disorder (ASD) in different age.Methods The study involved 621 children(503 boys,118 girls) diagnosed with ASD from June 2013 to June 2015.Using raw scores to examine cognitive and behavioral characteristics in children with ASD based on the Psycho-Educational Profile-3rd Edition (PEP-3).The subjects were divided into two groups according age:＜4Y group and ≥ 4Y group.The sex differences of cognitive and behavioral characteristics were analyzed in different age groups.Results No sex differences were found in characteristic motor behaviors (CMB) and characteristic verbal behaviors (CVB) raw scores in ＜4Y group(P＞0.05),while girls with ASD had lower raw scores on CMB and CVB raw scores in ＞4Y group((21.56±7.33) vs (24.09±4.80),(9.79±7.05) vs (13.27±5.75) ; P＜0.05)).Girls with ASD had lower raw scores on cognitive verbal/preverbal (CVP),CMB and CVB in ～ 4Y,～5Y,and ～6Y group (P＜0.05).However,there was no sex difference on CVP,CMB and CVB in ～ 3Y and ～ 7Y group (P＞0.05).Conclusions Characteristic verbal and motor behaviors may not be obvious in girls with ASD in early childhood,which may increase the difficulties of early clinical identification.The development of cognitive ability in girls with ASD is far behind that in boys in the crucial 3-5 years old,as well as social reciprocity and characteristic behaviors.It suggests that the behavior characteristics are closely related to cognitive development.

Objective To improve the prognosis of children with autism spectrum disorder (ASD), a model of structure-based outpatient training course was conducted to explore the intervention effect for children with ASD. Methods 154 children with ASD were included in the present study (aged 1.6-5.5 years). All children were received the inpatient training course. The training course included individual coaching, game, motor, music courses etc. The training course lasted 1 month, 8 hours per day. All children were also received the Psycho-educational Profile-3rd Edition(PEP-3) assessment at the beginning and ending of training. Results Children with ASD scored significant raw scores in cognitive verbal/preverbal (29.08 ± 13.23 vs. 43.27 ± 11.62), expressive language (13.33 ± 10.55 vs. 25.38 ± 11.82), receptive language (15.77 ± 10.64 vs. 27.48 ± 8.42), fine motor (25.97 ± 6.10 vs. 32.64 ± 5.07), gross motor (23.03 ± 5.52 vs. 27.72 ± 2.95), visual-motor imitation (10.65 ± 5.31 vs. 15.44 ± 3.76), affective expression (14.34 ± 4.31 vs. 16.36 ± 3.85), social reciprocity (11.90 ± 4.01 vs. 16.08 ± 4.13), personal self-care (13.39 ± 4.70 vs. 16.98 ± 4.30) and adaptive behaviors (17.8 ± 4.95 vs. 20.33 ± 5.37) (t=5.43-20.70, all P<0.05). Conclusions The model of structure-based inpatient training course is effective program to improve the prognosis of children with ASD .

Objective To explore the clinical pathway teaching method application effection end-stage renal disease( ESRD) teaching practice. Methods From May 2013 to July 2014, a total of 80 nursing intern students in Nephrology Department, the Fifth Hospital of Wuhan, were divided into observation group (40 cases) and control group (40 cases) according to a random number table method. Conventional teaching method was applied in the control group whereas the observation group used clinical pathway teaching method. Four weeks after the internship,the quality of clinical teaching programs scores, nursing students theoretical knowledge, skills assessment excellent rates and patient satisfaction levels of both groups were compared. Results Statistical analysis of the quality of clinical teaching programs filled by nursing intern students showed that the observation group nursing students in the teachers′ teaching management, teaching attitude, knowledge level and teaching skill level four aspects were higher than those in the control group (P<0. 05). The average total score of the observation group was (91. 3 ± 4. 1) while the control group was (79. 6 ± 3. 2), and the difference was statistically significant (P <0. 01). Nursing students theoretical knowledge and skills excellent rates of the observation group were 55. 0% and 57. 5%, significantly higher than those ofthe control group ( 22. 5%, 17. 5%). Patients in the observation group of nursing students satisfaction rate was 76. 58%, significantly higher than these of the control group which was 51. 89% (P<0. 05). Patients′ nursing students satisfaction rate in the observation group was 76. 58%, higher than that of the control group (51. 90%), and the difference was statistically significant (P <0. 01). Conclusions Clinical pathway teaching method which can promote effective communication between teachers and students, strengthen teacher-student communication, and improve the learning efficiency of nursing intern students is also conducive to nursing intern students′ practice, improve their theoretical knowledge, operation skills, and comprehensive ability. Satisfaction of patients with end-stage renal disease can be improved as well.

To investigate the effect of multiple factors, including breast-feeding and modes of birth, on gastrointestinal (GI) symptoms of children with autism spectrum disorder (ASD). Methods This was a cross-sectional study. A total of 92 children, aged 2 to 10 years, with a diagnosis of ASD by DSM-5 criteria, along with 84 age-matched typical developing (TD) children as control, were enrolled in this study. The six-item gastrointestinal symptom index (6-GSI) was used for symptomatic survey. The self-made questionnaires were used to collect information on dietary preferences, sleep problems and breast-feeding. Results Constipation from 6-GSI was higher in ASD group than in TD group (P＜0.01). Stratified analysis revealed that total GI symptom scores (P=0.030), fecal odor (P=0.028) and abdominal pain (P=0.022) were higher in ASD children born by c-section than ASD children born vaginally whereas only abdominal pain was higher in TD children born by C-section than TD children born vaginally (P=0.016). ASD children with pick eating had higher scores in diarrhea (P=0.048) and abdominal pain (P=0.013) than those without. ASD children with sleep disorders had higher scores in constipation (P=0.008), diarrhea (P=0.020) and fecal odor (P=0.027) than those without. There was also a significant difference in constipation from 6-GSI between mainly breast-fed children and mainly formula-fed children among all subjects (P=0.026). Conclusion ASD children have more severe constipation than TD children. ASD children with pick eating or with sleep disorders tend to have more GI symptoms, including diarrhea, fecal odor, and abdominal pain, while breastfeeding can alleviate these symptoms.