Objective To explore the influence of different training mode on the parenting stress in mothers of children with autism. Methods According to the wishes of parents, 46 children with autism by first diagnosed and their mothers were divided into combination training group (23 cases) and control group (23 cases). The children in combination training group received a family rehabilitation training besides the structured institution-based teaching programme, and the children in control group only received the structured institution-based teaching programme. Comparisons were made between the two groups by the Parenting Stress Index-Short Form score after 1 year teaching. Results Before teaching, the domain score of parental distress, parent-child dysfunctional interaction, difficult child and total score of parenting stress were (37.7 ± 5.6), (35.4 ± 4.1), (38.3 ± 5.4), (111.3 ± 10.5) points in control group, while those were (37.9 ± 5.8), (34.7 ± 4.3), (38.8 ± 4.9), (112.1 ± 9.3) points in combination training group. There was no significant difference between two groups(t=0.155-0.531, all P>0.05). After 1 year teaching, the domain score of parental distress, parent-child dysfunctional interaction, difficult child and total score of parenting stress were (34.0±3.4), (30.7±2.8), (34.3±2.2), (99.0±4.7) points in control group, while those were (34.3±3.7), (28.7±3.1), (31.1±2.4), (94.1±6.8) points in combination training group. The combination training group reported a lower level than control group in the domains score of parent-child dysfunctional interaction, difficult child and total score of parenting stress (t=-2.340,-4.595,-2.890, all P<0.05), while the domain score of parental distress had no significant difference (t= 0.236, P>0.05). Both two groups after 1 year teaching, mothers of children with autism experienced a lower level in all the domains and the total score of parenting stress than before teaching(combination training group: t=3.562-7.925, control group:t=2.534-4.768, all P<0.05). Conclusions Family rehabilitation training combined with institutions could reduce the parenting stress of mothers with autistic children and be worthy of clinical promotion and application.

To explore the effects of long-term treatment of different dietary energy levels on ovarian expression of mRNAs for LHR and FSHR,the present study was performed in nine growth-matched littermate crossbred (Land-race×Large White X Duroc) prepubertal gilts. At approximately 30 kg of body weight and 50 day of age,gilts were housed with individual feeding stalls and placed on a normal level of feeding for 90 days (dl-90) with free ac-cess to water and food throughout the whole research. From d91 ,littermates were divided and randomly assigned to one of the following three treatment lines for 3 weeks till d112:Group H,Group M, and Group L, fed the high energy level diet (n = 3, digestible energy 14.87 MJ/kg), moderate energy level diet (n = 3, digestible energy 12.39 MJ/ kg), and low energy level diet (n = 3, digestible energy 9.98 MJ/kg), respectively. When gilts were slaughtered on d112 after 3 weeks energy treatment, both ovaries of every gilts were collected,snap frozen in liquid nitrogen and re-tained at -80℃ for use to determine and analysis the relative amount of ovarian LHR and FSHR mRNAs using semi-quantitative RT-PCR. Results showed that the effect of dietary energy treatment was notable: the ovarian ex-pression of mRNAs for LHR and FSHR was significantly higher (P<0.05) in gilts treated with high energy diet compared to gilts treated with moderate and low energy diets, while gilts treated with low energy diet had a signifi-cantly lower (P<0.05) ovarian LHR and FSHR expression compared with gilts treated with moderate and high en-ergy diets. These results revealed that ovarian expression of I.HR and FSHR in prepubertal gilts increased as the lev-el of dietary energy intake elevated,i, e. , high energy diet can markedly enhance ovarian expression of mRNAs for LHR and FSHR,whereas energy deficit markedly suppress the expression.

Fourteen neonatal diabetes mellitus(NDM)patients were recruited. 9 patients were treated with glyburide and the other 5 with insulin. ABCC8, KCNJ11, and INS genes were sequenced in 6 of them. Gene mutations were found in 2, 1, and 1 cases in these genes, respectively. One case with 6q24 hypomethylation and another without known mutation were also found. 8 out of 9 patients treated with glyburide reached euglycemia(88.9%). The other 5 patients with insulin therapy either died or lost contact. The results suggest that glyburide therapy is effective in neonatal diabetes mellitus, while insulin therapy may contribute to poor compliance.

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 summarize the clinical feature,gene mutations,diagnosis,treatment,and follow-up data of protein-sensitive hypoglycemia,so as to improve the clinical understanding of the disease.Methods Five patients were diagnosed with protein-sensitive hypoglycemia during June in 2015 and December in 2017 from the Department of Pediatric Endocrinology and Inherited Metabolic Diseases,Children's Hospital of Fudan University.Clinical data of 5 cases were summarized,including clinical manifestations,findings of protein sensitivity test,therapy effect and prognosis.The endocrine and metabolic panel was used to investigate the genetic cause of four patients.Related literatures of protein-sensitive hypoglycemia were reviewed,and the phenotypes,genotypes,and therapy effects were summarized.Results Among the 5 patients diagnosed with positive results of protein-sensitive hypoglycemia,three were found to harbor glutamate dehydrogenase 1 (GLUD 1) mutations (c.965G ＞ A,p.R322H:2 cases;c.943C ＞T,p.H315Y:1 case),and another one had complex heterozygous mutations in L-3-hydroxyacyl-CoA dehydrogenase (HADH,c.29G ＞ C,p.R10P;c.89T＞ A,p.V30E).5 patients were euglycemia without any medical support after low protein diet.In 18 literatures retrieved and this study,there were totally 161 cases of protein-sensitive hypoglycemia (149 cases with GLUD1 mutations and 10 cases with HADH mutations).Conclusions When a child was admitted because of hypoglycemia,the diagnosis of protein-sensitive hypoglycemia should be suspected if he or she also had postprandial hypoglycemia,with or without hyperammonemia.Protein sensitivity test is helpful for us to make the diagnosis of protein-sensitive hypoglycemia.

Objective: To study the feasibility of ¹⁸F-fluoro-L-dihydroxyphenylalanine positron emission tomography/Computed tomography (¹⁸F-DOPA PET/CT) scanning in the localization and differential diagnosing of focal versus diffuse form of pancreas lesions in patients with hyperinsulinemic hypoglycemia (HH). Method: Twenty-four patients were diagnosed with HH between January, 2016 and February, 2017 in the Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children′s Hospital of Fudan University using an integrated clinical and biochemical diagnostic protocol, domestic ¹⁸F-DOPA PET/CT imaging technique were applied after MRI and ultrasound failed to detect pancreas lesions. Pancreas ¹⁸F-DOPA standardized uptake values (SUV) were measured, and pancreas′ lesions were dually analyzed via visual method and pancreas percentage SUV method. Among these patients, 9 patients received surgical pancreatic lesion resections, the correlations among surgical outcomes, histopathological findings and ¹⁸F-DOPA PET/CT scan results were analyzed. Result: Seven patients were detected with focal form of pancreas lesions, the mean peak of SUV was 4.7±1.7(2.6-7.1), and 17 patients were found to have diffuse form lesions after ¹⁸F-DOPA-PET/CT scanning. Among the 24 cases, 9 patients (7 showed focal and 2 showed diffuse ¹⁸F-DOPA PET/CT pancreatic uptake)were euglycemic without any medical support after surgery; the resected pancreatic tissue histopathological results were consistent with that of PET/CT imaging. Only one patient, who responded to medical treatment before surgery, had temporary hyperglycemia after operation. Conclusion Domestic ¹⁸F-DOPA PET/CT could successfully locate and differentiate the pancreatic lesions and thus improve the success of surgery.

Objective To study the infection status of Helicobacter pylori (H. pylori) and sensitivity to commonly used antibiotics in Taizhou district,Zhejiang province. Methods 39 099 cases aged between 5 and 95 years old(mean as 48.42 years)were involved during January 2010 to December,2013 for this study. Sex ratio was 1 ∶ 0.95. Yearly distribution of the number of cases were 5 031,6 709,11 902 and 15 457 in 2010,2011,2012 and 2013,respectively. Gastric mucosal specimens were collected and H. pylori strains were isolated and cultured in the same platform in Zhiyuan Medical Inspection Institute of Hangzhou. Resistance tests of all the H. pylori isolates were performed to 6 commonly used antibiotics:metronidazole,clarithromycin,amoxicillin,gentamicin, levofloxacin and furazolidone with the agar dilution method. The antibiotic resistance rates of H. pylori strains isolated during year 2010-2013 and the changing trends were analyzed. Results Resistance rates to levofloxacin and clarithromycin kept at higher level and the highest was in 2011 and then decreased in both 2012 and 2013 (P<0.01). The resistance rates to both levofloxacin and clarithromycin reached the highest in 2011(P<0.01),and decreased thereafter,with no significant change in 2013 to 2012(P>0.05). Conclusion Antibiotic resistance rate against metronidazole for HP isolate was highest. Resistance rate against amoxicillin and furazolidone,gentamicin was low. Clinical treatment should choose amoxicillin and furazolidone,gentamicin. The resistance rates to levofloxacin and clarithromycin had been seen at a significantly downwarding trend since 2011. However,the combined resistance rates to levofloxacin and clarithromycin did not seem to reduce since 2012.

OBJECTIVETo study the infection status of Helicobacter pylori (H. pylori) and sensitivity to commonly used antibiotics in Taizhou district,Zhejiang province.

METHODS39 099 cases aged between 5 and 95 years old (mean as 48.42 years) were involved during January 2010 to December, 2013 for this study. Sex ratio was 1 : 0.95. Yearly distribution of the number of cases were 5 031, 6 709, 11 902 and 15 457 in 2010, 2011, 2012 and 2013, respectively. Gastric mucosal specimens were collected and H. pylori strains were isolated and cultured in the same platform in Zhiyuan Medical Inspection Institute of Hangzhou. Resistance tests of all the H. pylori isolates were performed to 6 commonly used antibiotics:metronidazole, clarithromycin, amoxicillin, gentamicin, levofloxacin and furazolidone with the agar dilution method. The antibiotic resistance rates of H. pylori strains isolated during year 2010-2013 and the changing trends were analyzed.

RESULTSResistance rates to levofloxacin and clarithromycin kept at higher level and the highest was in 2011 and then decreased in both 2012 and 2013 (P < 0.01). The resistance rates to both levofloxacin and clarithromycin reached the highest in 2011 (P < 0.01), and decreased thereafter, with no significant change in 2013 to 2012 (P > 0.05).

CONCLUSIONAntibiotic resistance rate against metronidazole for HP isolate was highest. Resistance rate against amoxicillin and furazolidone, gentamicin was low. Clinical treatment should choose amoxicillin and furazolidone, gentamicin. The resistance rates to levofloxacin and clarithromycin had been seen at a significantly downward trend since 2011. However, the combined resistance rates to levofloxacin and clarithromycin did not seem to reduce since 2012.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; pharmacology ; Child ; Child, Preschool ; Drug Resistance, Multiple, Bacterial ; Helicobacter pylori ; drug effects ; isolation & purification ; Humans ; Middle Aged ; Young Adult