Objective:To investigate the main manifestation of broader autism phenotype (BAP) in autism family, find the rate of BAP.Method:Exploring the BAP in 75 autism family with Family Investigation Schedule and Bolton's BAP operating definition.Result:There were 42 cases that met the criteria of BAP in the 75 families. They mainly presented as reciprocal social interaction deficits and language developing disorder.Conclusion:BAP do exit in Chinese autism families.

OBJECTIVEThis study aims to observe and compare the influences of the casting alloy post and cores on magnetic resonance imaging (MRI).

METHODSSix casting alloy post and sores were fabricated for the experimental groups, and zirconia post and core served as the control. The seven types of post and cores were of the same size and shape. Each post and core was orally fastened to a volunteer and then imaged with sequences of T1-weighted spin echo imaging (SE-T1WI), T2-weighted turbo spin-echo imaging (TSE-T2WI), and diffusion weighted imaging (DWI).

RESULTSCobalt chromium alloy post and core generated severe artifacts, whereas gold palladium alloy post and core generated no obvious artifacts, and no difference was observed between the zirconia and the gold palladium alloy post and cores (P > 0.05). The pure titanium alloy post and core produced mild artifacts. The post and cores of the titanium, nickel-cadmium, and gold platinum alloys generated moderate artifacts with no significant differences (P > 0.05).

CONCLUSIONDifferent metal post and cores have different influences on MRI. With the exception of that generated by cobalt chromium alloy, the artifact generated by the single-alloy post and core does not influence the image of the normal head and neck.

Objective To evaluate efficacy,safety and complication of percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture (OVCF) in≥90 years patients.Methods Clinical data of 56 cases aged ≥ 90 years with osteoporotic vertebral compression fracture undergoing percutaneous kyphoplasty were retrospectively analyzed.Visual analog scale (VAS) score,analgesics administration score,locomotor activity score,bone cement leakage and incidence of refracture were evaluated before and 3 days after treatment,and at the last follow-up.Results The mean follow-up was 18.6 months (6-32 months) in all patients.The mean VAS score was (7.1 ±2.1) before treatment,(2.6±1.1) at 3 days after the procedure,and (1.8±0.7) at last follow-up,respectively (F=455.794,P＜0.001).Analgesics administration score were (2.0±1.7),(1.4±0.5) and (1.1±0.7) respectively before and 3 days after treatment,and at the last follow-up (F=9.631,P＜0.001).Locomotor activity score were (2.5±0.6),(1.2±0.5) and (1.0±0.3)before and 3 days after treatment,and at the last follow-up (F=63.254,P＜ 0.001) respectively.Bone cement leakage occurred in 10 cases(17.9％),recurrent fracture in 6 cases(10.7％),cerebrospinal leak in 3 cases (5.3％),and nerve root stimulation in2 cases(3.6％).Total complication rate was 33.9％(19/56),and all complications were transient and well tolerated.Conclusions Kyphoplasty for osteoporotic vertebral compression fracture in the very elderly is effective and safe.It alleviates fracture-induced pain,reduces analgesic drug use and improves spinal activity,and provides a better choice for minimal invasive treatment for nonagenarian OVCF patients.

Objective:To investigate the impact of osteoporosis on clinical outcomes in elderly patients treated with short segment transforaminal lumbar interbody fusion.Methods:From May 2016 to May 2018, elderly patients who had undergone transforaminal lumbar interbody fusion(TLIF)in our hospital were retrospectively analyzed.Based on bone mineral density(BMD), patients were divided into the osteoporosis group(the OP group, n=75, T≤-2.5 in BMD)and the control group(the CO group, n=103, T>-1.0 in BMD). General patient information, clinical data and postoperative follow-up clinical results were compared between the two groups.Results:Eventually 178 cases were enrolled, including 68 with lumbar disc herniation and 110 with lumbar spinal stenosis.Preoperative Visual Analogue Scale(VAS)scores were 7.35±1.30 in the lower back and 7.32±1.30 in the leg for the OP group and 7.35±1.33 and 7.22±1.40, respectively, for the CO group, and there was no significant difference between the two groups( t=0.140 and 0.468, P=0.989 and 0.640). The proportions of cage collapse and internal fixation loosening were 70.7%(53/75)and 37.3%(28/75)in the OP group, which were higher than 22.3%(23/103)and 14.6%(15/103)in the CO group( χ2=41.440 and 12.280, both P=0.000). However, there was no significant difference between the OP group and the CO group in 1-and 2-year postoperative interbody fusion rates(postoperative 1-year rate: 89.3% or 67/75 vs.91.3% or 94/103, χ2=0.187, P=0.666; postoperative 2 year rate: 94.6% or 71/75 vs.95.1% or 98/103), χ2=0.021, P=0.885). There was no significant difference in VAS score and Oswestry disability index(ODI) between the OP group and the CO group at 6 months, 1 year and 2 years after surgery(all P>0.05). Conclusions:Although there are some osteoporosis-related complications such as cage subsidence and screw loosening, short-segment TLIF can still achieve good clinical results in elderly patients with osteoporosis.

Objective To evaluate the quality of life and emotion symptoms (anxiety symptom and depressive symptom) of adolescents with allergic rhinitis (AR) in middle area of Jiangsu province.Methods A case-control study on quality of life and emotion symptoms among 220 AR adolescents and 240 controls was performed.The participants were investigated by questionnaires of RQLQ,ICD,and SCARED.SPSS 13.0 software was used to analyze the data.Results The scores of RQLQ five dimensions with AR were higher than the controlled subjects respectively(all P ＜0.01).The score of SCARED((24.15 ±4.89) vs (19.13 ± 3.17)) but not ICD((20.78 ±4.4) vs (19.97 ±3.45)) in AR was higher than the controlled subjects(t =12.79,P ＜ 0.05;t =2.34,P ＞ 0.05).Furthermore,anxiety symptom was significantly associated with nasal symptoms,other problems and behavior problems.Conclusions The quality of life and emotion symptoms were significantly affected by AR.It is important to pay attention to overall health in AR adolescents.

Objective ??This?study?aims?to?observe?and?compare?the?influences?of?the?casting?alloy?post?and?cores?on?mag-netic?resonance?imaging?(MRI). Methods ??Six?casting?alloy?post?and?cores?were?fabricated?for?the?experimental?groups,?and?zirconia?post?and?core?served?as?the?control.?The?seven?types?of?post?and?cores?were?of?the?same?size?and?shape.?Each?post?and?core?was?orally?fastened?to?a?volunteer?and?then?imaged?with?sequences?of?T1-weighted?spin?echo?imaging?(SE-T1WI),?T2-weighted?turbo?spin-echo?imaging?(TSE-T2WI),?and?diffusion?weighted?imaging?(DWI).?Results ??Cobalt?chromium?alloy?post?and?core?generated?severe?artifacts,?whereas?gold?palladium?alloy?post?and?core?generated?no?obvious?artifacts,?and?no?difference?was?observed?between?the?zirconia?and?the?gold?palladium?alloy?post?and?cores?(P>0.05).?The?pure?titanium?alloy?post?and?core?produced?mild?artifacts.?The?post?and?cores?of?the?titanium,?nickel-cadmium,?and?gold?platinum?alloys?generated?moderate?artifacts?with?no?significant?differences?(P>0.05).?Conclusion ??Different?metal?post?and?cores?have?different?in-fluences?on?MRI.?With?the?exception?of?that?generated?by?cobalt?chromium?alloy,?the?artifact?generated?by?the?single-alloy?post?and?core?does?not?influence?the?image?of?the?normal?head?and?neck.

Objective To observe the value of artificial neural network(ANN)model based on recursive feature elimination-support vector machine(RFE-SVM)for differentiating ductal carcinoma in situ(DCIS)and DCIS complicated with microinvasion(DCISM).Methods Totally 296 female patients with single breast cancer(244 cases of DCIS and 52 cases of DCISM)were retrospectively collected as training set.Then 120 female patients with single breast cancer(87 cases of DCIS and 33 cases of DCISM)were prospectively enrolled as validation set.The general data,mammography and MRI findings were compared between sets.The optimal feature subsets for establishing ANN model were screened.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of ANN model for differentiating DCIS and DCISM.Results Ki-67 index,the minimum apparent diffusion coefficient(ADCmin),nuclear grade,ADCheterogeneity,maximum diameter of lesion,patient's age,P63,lesion enhancement type,calcification status and necrosis were the selected top 10 optimal feature subsets.The accuracy,sensitivity,specificity,positive predictive,negative predictive and AUC of ANN model for differentiating DCIS and DCISM was 91.55％,63.46％,97.54％,84.62％,92.61％and 0.950 in training set,respectively,while was 80.00％,69.70％,83.91％,62.16％,87.95％and 0.896 in validation set,respectively.The calibration curves of ANN model were consistent with the ideal curves in both training and validation set(P=0.355,0.480),which also expressed high clinical net benefit.Conclusion ANN model based on SVM-RFE could be used to differentiate DCIS and DCISM effectively.

Objective To investigate the role and molecular mechanism of Sirt1 in renal injury in diabetic mice under acute inflammatory state.Methods Forty SPF grade C57BL/6J male mice,8 weeks old,weighing 20-25 g were selected.The mice were divided into five groups by random number table meth-od:control group(group C),diabetic group(group D),lipopolysaccharide(LPS)+diabetic group(group L),LPS+diabetic+Sirt1 blocker EX527 group(group E),and LPS+diabetic+Sirt1 agonist ginkgoflavone sapogenins group(group G),8 mice in each group.After successful preparation of the diabet-ic mouse model,group L was injected intraperitoneally with LPS 10 mg/kg.Group E was injected intraper-itoneally with EX527 5 mg/kg(dissolved in DMSO 0.2 ml)1 hour before giving LPS treatment to diabetic mice.Group G was injected intraperitoneally with 200 mg/kg of ginkgoflavone sapogenins(dissolved in DMSO 0.2 ml)1 hour before LPS treatment was given to diabetic mice,groups C and D underwent an in-traperitoneal injection of 2％DMSO 0.15 ml at the same time point.24-hours urine volume was collected and 24-hours urinary protein concentration was determined,and blood was taken from the posterior eyes to detect serum Scr and BUN concentrations.After kidney tissues were removed,IL-1βand IL-18 concentra-tions were measured by ELISA,nitrate reductase assay for nitric oxide(NO)content in kidney,iron ion an-tioxidant capacity assay for total antioxidant capacity(T-AOC),qPCR and Western blot assay for Sirtl,caspase-1,NLRP3,and ASC mRNA expression and protein content.The acetylated FoxO3a protein content was detected by immunoprecipitation,the reactive oxygen species(ROS)content was calculated by di-hydroethidium staining,the pyroptosis rate was calculated by immunofluorescence double staining,HE stai-ning was performed,and the pathological results were observed under light microscope.Results Compared with group C,24-hours urine volume,urine protein concentration,serum Scr and BUN concentration,con-centrations of renal tissue IL-1β,IL-18,and NO,NLRP3,caspase-1,and ASC mRNA expressions and protein contents,ROS content and pyroptosis rate were significantly increased,T-AOC activity was signifi-cantly decreased in groups D,L,E,and G(P＜0.05).Compared with group D,24-hours urine volume,urine protein concentration,serum Scr and BUN concentration,concentrations of renal tissue IL-1 β,IL-18,and NO,NLRP3,caspase-1,and ASC mRNA expressions and protein contents,ROS content and pyroptosis rate were significantly increased,T-AOC activity was significantly decreased in groups L,E,and G(P＜0.05).Compared with group L,24-hours urine volume,urine protein concentration,serum Scr and BUN concentration,concentrations of renal tissue IL-1β,IL-18,and NO,NLRP3,caspase-1,and ASC mRNA expressions and protein contents,acetylated FoxO3a protein content,ROS content,and pyroptosis rate were significantly increased,T-AOC activity,Sirt1 mRNA expression and protein content,and FoxO3a mRNA expression were significantly decreased in group E(P＜0.05),24-hours urine volume,urine pro-tein concentration,serum Scr and BUN concentration,concentrations of renal tissue IL-1β,IL-18,and NO,NLRP3,caspase-1,and ASC mRNA expressions and protein contents,acetylated FoxO3a protein con-tent,ROS content and pyroptosis rate were significantly decreased,T-AOC activity,Sirt1 mRNA expression and protein content were significantly increased in group G(P＜0.05).Compared with group E,24-hours urine volume,urinary protein concentration,serum Scr and BUN concentration,concentrations of renal tissue IL-1β,IL-18,and NO,NLRP3,caspase-1,and ASC mRNA expressions and protein contents,acetylated FoxO3a protein content,ROS content,and pyroptosis rate were significantly decreased,T-AOC activity,Sirt1 mRNA expression and protein content were significantly increased in group G(P＜0.05).Conclusion In diabetic mice under acute inflammatory state,elevated Sirt1 reduces kidney injury by de-creasing acetylated FoxO3a protein content,reduced urine volume,urine protein concentration,serum Scr and BUN concentration,inflammatory factor concentrations and apoptosis levels in renal tissue,and attenua-ted oxidative stress and inflammation levels.

Objective:To investigate the value of stereo-electroencephalography (SEEG)-guided radiofrequency thermocoagulation (RFTC) in patients with focal epilepsy.Methods:Eighteen patients with focal epilepsy admitted to and treated by SEEG-guided RFTC in our hospital from April 2019 to December 2020 were chosen. The clinical data of these patients were retrospectively analyzed, and follow up was performed monthly by telephone and outpatient subsequent visit. The treatment efficacies of these patients were evaluated by Engel grading.Results:(1) The number of electrodes accurately implanted into the intended target in these 18 patients was 4-11 (6.56±2.15 on average); unilateral implantation was noted in 6 patients, and bilateral implantation was noted in 12 patients. SEEG monitoring showed that 7 patients were with frontal lobe epilepsy, 8 were with temporal lobe epilepsy, 2 were with frontotemporal junction epilepsy, and one was with temporal occipital junction epilepsy. (2) Two-9 RFTC electrodes (3.43±1.47 on average), and 9-42 RFTC contacts (17.38±9.20 on average) were given in these 18 patients. One patient developed seizures during the course of RFTC, one had temporary mental symptoms after RFTC, one had diffuse brain edema with intracranial hypertension, and one had asymptomatic regional brain edema. The total complication incidence was 22.2% (4/18) and no permanent neurological impairment occurred. (3) Eleven patients (61.1%) had recurred seizure within 1 year of RFTC: 3 (27.3%) recurred within 1 month, 3 (27.3%) recurred within 1-3 months, 3 (27.3%) recurred within 3-6 months, and 2 (18.2%) recurred within 6-12 months; however, the duration and frequency of seizure were obviously decreased as compared with those before RFTC. Seven patients (38.9%) received craniotomy after RFTC; follow up for 5-24 months showed that 12 patients were with Engel grading I, 4 were with Engel grading II, 2 were with Engel III, and no one was with Engel grading IV.Conclusions:SEEG-guided RFTC has enabled patients with focal epilepsy to achieve complete remission of their seizures with varying durations, and some patients have achieved long-term remission of their seizures. For patients with recurrent epilepsy after SEEG-guided RFTC, further craniotomy of the epileptogenic area is still effective.

Objective:To compare the minimally invasive transforaminal lumbar interbody fusion (MTLIF) with open transforaminal lumbar interbody fusion (OTLIF) in treatment of lumbar degenerative disease.Methods:Clinical data of 63 patients with single segment lumbar degenerative disease treated in Department of Orthopedics of Beijing Hospital from November 2015 to September 2016 were retrospectively analyzed, among whom 30 cases received MTLIF and 33 cases received OTLIF. The operative time, intraoperative X-ray exposure times, intraoperative blood lose, postoperative drainage,perioperative fever, adjacent segment degeneration, loosening of internal fixation and cage collapse were observed in two groups 4 years after operation, and the visual analog scale (VAS) score of the lower back and the leg, the Oswestry disability index (ODI) score were compared between two groups.Results:The operation time [(191.6±50.5) min] and radiation exposure times [(15.5±6.4) times] in MTLIF group were significantly more than those in OTLIF group [(105.8±23.1) min, (7.2±1.4)times, t=17.210, t=10.850,all P<0.01]. The intraoperative blood loss [(150.4±70.4) ml], postoperative drainage [(90.4±30.7)ml], VAS score (2.4±0.7) and ODI score (24.5±3.7) 2 weeks after surgery in MTLIF group were significantly lower than those in OTLIF group [(250.7±43.9)ml,(216.3±67.8)ml,(4.5±1.6),(30.6±4.6), t=-12.830, t=-14.070, t=-6.890, t=-5.805,all P<0.01]. There were no significant differences in the incidence of fever [1 case(3.3%) vs. 4 cases(12.1%),χ2=-1.661, P=0.20], VAS score[(1.2±0.7) vs. (1.3±0.6), t=-0.628, P=0.53], ODI score[(14.2±2.7) vs. (14.7±2.5), t=-0.756, P=0.45], fusion rate of Bridwell grade Ⅰ [86.7%(26/30) vs. 84.8%(28/33),χ2=0.042, P=0.84] 1 year after surgery; and the adjacent segment degeneration [0 case(0) vs. 1 case(3.0%),χ2=0.924, P=0.34], internal fixation loosening [1 case(3.3%) vs. 1 case(3.0%),χ2=0.005, P= 0.95] and cage collapse 4 years after surgery [1 case(3.3%) vs. 1case(3.0%),χ2=0.005, P=0.95] between MTLIF group and OTLIF group. Conclusion:Compared with OTLIF, MTLIF has longer operation time and more radiation exposure, but it can achieve full decompression, the same fusion rate, less bleeding, less trauma, faster recovery, fewer complications and satisfactory long-term effect.