Occupational therapy can not only promote the development of motor and cognitive functions in children with developmental or other disabilities, but also improve their self-care ability, learning ability, participation skills and other activities.In 2019, the Aust Occup Ther J published a systematic review on the effects of occupational therapy interventions on disabled children, aiming to summarize the best evidence of occupational therapy and help occupational therapists and families to choose the effective treatment regimens.In this article, the systematic review was interpreted in light of the current status of domestic child occupational therapy, so as to allow clinicians to compare the pros and cons of different treatment methods and improve the efficacy.

Objective To analyze the genotype-phenotype correlation in 5 families with congenital ectopia lentis (CEL) accompanied with cardiovascular abnormal manifestation.Methods Detailed clinical data of 15 family members in 5 families were collected from August 2017 to March 2018 in Zhongshan Ophthalmic Center,including examination of the condition of lens before and after mydriasis by slit-lamp,evaluation of the cardiovascular system using transthoracic echocardiography,and evaluation of the degree of involvement of the subjects' skeletal system using X-ray images.Genomic DNAs were extracted from whole blood sample of the 5 probands and 10 relatives,and screened for FBN1 mutation by targeted exome sequencing.The possible genotype-phenotype correlation was analyzed by reviewing previous literatures into these mutation sites.The study followed the principles of the Helsinki Declaration and written informed consent was obtained from each subject prior to any examination.Results All of the five probands were diagnosed as CEL accompanied with cardiovascular abnormal manifestation.FBN1 gene mutations were identified in all of the five probands,including four missense mutations (c.2741G＞T,c.2585G＞T,c.1633C＞T,c.4260C＞G) and one splicing mutation (c.2114-1G＞C).It was predicted that all of the 5 mutations would alter the protein structure.Conclusions FBN1 gene has a high degree of clinical heterogeneity,and the early detection of ocular phenotypes combined with genetic screening is of great significance in the diagnosis of cardiovascular abnormalities.

Objective:To investigate the correlation between preoperative serum γ-glutamyl transferase (GGT) level and the postoperative survival of patients with renal cell carcinoma.Methods:The clinical data of 235 patients with renal cell carcinoma who underwent nephrectomy from December 2005 to December 2011 in the Affiliated Hospital of China University of Mining and Technology were retrospectively analyzed. According to the preoperative serum GGT level at 1.5 times the upper limit of normal value 90 U/L (the upper limit of normal value of samples in this study was 60 U/L), patients were divided into 2 groups: GGT ≤ 90 U/L group (218 cases) and GGT>90 U/L group (17 cases). The correlation between GGT and clinicopathological characteristics as well as postoperative survival of patient with renal cell carcinoma was also analyzed.Results:There were statistically significant differences in gender, age, the level of the aspartate aminotransferase (AST), the level of alanine aminotransferase (ALT), the neutrpphil-to-lymphocyte ratio (NLR), lymph node metastasis, distant metastasis, neoplasm staging between GGT ≤ 90 U/L group and >90 U/L group (all P < 0.05). Kaplan-Meier survival analysis showed that the median overall survival time was 84 months and 54 months, respectively in GGT ≤ 90 U/L group and GGT > 90 U/L group, and the difference was statistically significant of both groups ( χ2 = 4.334, P = 0.037). Univariate Cox proportional risk regression model showed that pathologic type, pathology T staging, preoperative GGT level, lactate dehydrogenase (LDH) level, ALT level were influencing factors of postoperative overall survival in patient with renal cell carcinoma (all P < 0.05). The multivariate Cox regression model analysis showed that the pathological type ( HR = 2.323, 95% CI 1.228-4.396, P = 0.010), GGT level ( HR = 2.406, 95% CI 1.077-5.376, P = 0.032), LDH level ( HR = 2.320, 95% CI 1.080-4.981, P = 0.031) were independent influencing factors of postoperative overall survival in patient with renal cell carcinoma. Conclusions:Preoperative elevated serum GGT level is associated with poor prognosis of patients with renal cell carcinoma, and the monitoring of it may help to evaluate the prognosis of patients and provide guidelines for individual treatment method.

BACKGROUND:Our previous studies have found that poly(vinylidene fluoride)bionic periosteum prepared by electrospinning has good cytocompatibility,but its biocompatibility is unknown. OBJECTIVE:To evaluate the biocompatibility of poly(vinylidene fluoride)bionic periosteum doped with Zn2+and Mg2+. METHODS:Poly(vinylidene fluoride),poly(vinylidene fluoride)bionic periosteum doped with 1％Zn2+,doped with 1％Mg2+,and doped with 1％(Zn2++Mg2+)were prepared by electrospinning to make bionic periosteum extract.SD rats were selected as the experimental subjects for hemolysis test,short-term systemic toxicity test,and heat source test.Guinea pigs were selected as the experimental subjects for skin sensitization test.The biocompatibility of bionic periosteum of four groups was tested. RESULTS AND CONCLUSION:(1)The hemolysis test results showed that the hemolysis rates of 1％Zn2+poly(vinylidene fluoride),1％Mg2+poly(vinylidene fluoride),1％Zn2++1％Mg2+poly(vinylidene fluoride)bionic periosteum and poly(vinylidene fluoride)extract were(0.130±0.013)％,(0.149±0.020)％,(0.466±0.018)％,and(0.037±0.018)％,respectively,which met the hemocompatibility standard of biomaterials.(2)The results of short-term systemic toxicity test showed that the four groups of bionic periosteal extract had no toxic signs such as body mass reduction,food intake changes,and dyspnea in SD rats,and had no toxic effects on major organs of rats.(3)Heat source test results showed that after intervention with poly(vinylidene fluoride)bionic periosteum doped with 1％Zn2+,doped with 1％Mg2+,and doped with 1％(Zn2++Mg2+),and poly(vinylidene fluoride)bionic periosteum extract,the elevated body temperature values of SD rats were(0.133±0.058),(0.100±0.010),(0.300±0.010),and(0.300±0.017)℃respectively.All were less than 0.6 ℃and the total temperature increase was less than 1.4 ℃.(4)The results of skin sensitization test showed that no erythema or edema was observed under the skin of guinea pigs after the intervention of bionic periosteum extract of four groups.(5)The results showed that poly(vinylidene fluoride)and poly(vinylidene fluoride)bionic periosteum doped with Zn2+and Mg2+had good biocompatibility.

BACKGROUND:Due to the unstable drug release rate of uniaxial bone scaffolds,multi-structure composite printing methods have been sought in and outside China in recent years.Currently,coaxial drug-loaded bone scaffolds,which combine drug-loaded sustained release system with bone transplantation and repair technology,not only replace the defective bone after implantation,but also release drugs slowly,providing a microenvironment conducive to bone formation at the implant site. OBJECTIVE:To explore and assess the in vitro antibacterial properties of uniaxial and coaxial minocycline hydrochloride bone scaffolds. METHODS:Rapid prototyping technology was used to prepare uniaxial hydroxyapatite/silk fibroin-polyvinyl alcohol scaffold,uniaxial hydroxyapatite/silk fibroin-polyvinyl alcohol scaffold,coaxial hydroxyapatite/silk fibroin-polyvinyl alcohol scaffold,and coaxial hydroxyapatite/silk fibroin-polyvinyl alcohol scaffold,respectively,which were named S1,S2,T1 and T2.The morphology,porosity,degradation performance,in vitro sustained-release performance and cytotoxicity of scaffolds were characterized.Four kinds of bone scaffolds were immersed in PBS to prepare the extracts at different time points(1,3,5,7,14,21,and 28 days).The qualitative filter paper was placed into the extract for 24 hours.The filter paper was co-cultured with Porphyromonas gingivalis and Fusobacterium nucleatum for 72 hours.The bacteriostatic effect of four groups of scaffolds was detected by the agar diffusion method. RESULTS AND CONCLUSION:(1)Scaffold characterization:Four groups of scaffolds were well formed.The surface of micro-wires in the S1 and S2 groups was dense and smooth,and the surface of micro-wires in the T1 and T2 groups was rough.Porosity was between 40%-47%and met the requirements of bone scaffolds.Compared with the S2 group,sustained release time was longer in the T2 group.The sustained release concentration of the drug was between 1-10 μg/mL for a long time,which was more conducive to bacteriostasis and osteogenesis.After 10 weeks of immersion in PBS in vitro,the degradation rate of the coaxial printed bone scaffold was faster than that of the corresponding uniaxial printed bone scaffold,and the degradation rate of the coaxial loaded bone scaffold was lower than that of the coaxial non-loaded bone scaffold.The four groups of scaffold extracts were co-cultured with osteoblasts respectively.CCK-8 assay displayed that the cell proliferation rate was greater than 75%,which met the requirements of biocompatibility.(2)In vitro antibacterial effect:S1 and T1 did not have antibacterial activity.S2 and T2 had an obvious antibacterial effect.Under the extraction solution on day 28,the diameter of Porphyromonas gingivalis and Fusobacterium nucleatum inhibition zone in the S2 group was smaller than that in the T2 group(P<0.05).(3)These findings exhibit that hydroxyapatite/silk fibroin-polyvinyl alcohol scaffolds with coaxial minocycline have good physical properties and bacteriostatic properties.

BACKGROUND:Polyvinylidene fluoride(PVDF)with piezoelectric properties,good biocompatibility and nontoxicity make it a suitable candidate for periosteal repair. OBJECTIVE:To evaluate the cytotoxicity of PVDF bionic periosteum by electrospinning with zinc and magnesium ions in vitro. METHODS:Pure PVDF,zinc-doped PVDF,magnesium-doped PVDF and Zinc-magnesium ion PVDF piezoelectric bionic periosteum were prepared by electrospinning technology,respectively.They were named PVDF,PVDF-Zn,PVDF-Mg and PVDF-Zn-Mg,in which the mass fraction of zinc and magnesium ions were all 1%.Osteoblasts and vascular endothelial cells were co-cultured with four groups of bionic periosteum.Cell compatibility of bionic periosteum was determined by alkaline phosphatase staining,CD31 immunofluorescence staining,and scanning electron microscopy. RESULTS AND CONCLUSION:(1)Osteoblasts:Alkaline phosphatase staining after 7 days of culture showed that the PVDF-Zn group secreted more alkaline phosphatase than the other three groups.Under a scanning electron microscopy,after 1 day of culture,the cells had a certain spread on the surface of PVDF-Mg and PVDF-Zn-Mg bionic periosteum,and the pseudopod extended to all sides.On day 3,the cell edge of each group extended pseudopods to the material.By days 5 and 7,the cells were fully spread,well grown and firmly covered the surface of the fibers,and the cellular pseudopods extended around and into the interstitial space of the fibers.CCK-8 assay showed that the cell proliferation on the bionic periosteum of each group showed an increasing trend over time and the relative proliferation rate of cells at 1,3,5,and 7 days was≥75%,and the cytotoxicity was≤grade 1.(2)Vascular endothelial cells:CD31 immunofluorescence staining for 3 days showed that the cells adhered and spread well on the bionic periosteum of each group and connected with each other,and the number of cells in the PVDF-Zn-Mg group was more than that in the other three groups.Under scanning electron microscope,the cells began to adhere to the surface of each group of fibers after 1 and 3 days of culture.On day 5,the cells were well spread on the surface of the fibers and extended obvious pseudopods.On day 7,the cells on the PVDF-Mg and PVDF-Zn-Mg bionic periosteum grew in multiple layers and extended the pseudopod into the fibrous void.CCK-8 assay showed that the cell proliferation on the bionic periosteum of each group showed a downward trend over time,and the relative proliferation rate of cells at 1,3,5 and 7 days was≥125%,and the cytotoxicity was grade 0.(3)The results showed that Zn-Mg electrospun PVDF piezoelectric bionic periosteum had good cytocompatibility.

Peri-implantitis,as a common complication after implant restoration,seriously affects the prognosis of the patients and causes a lot of inconvenience to the normal life of the patients,and its pathogene-sis is not entirely clear.In recent years,laser therapy,photodynamic therapy,local sustained-release drug-load-ed materials and many other emerging technologies have been gradually applied in clinical practice,and have played a positive promoting role in the treatment of peri-implantitis.However,the research on the application of local sustained-release materials in peri-implantitis is still in the initial stage,and there is a lack of systemat-ic induction and summary of relevant research literatures.This article reviews the research status quo,treat-ment status quo and application of emerging local sustained-release drug-loaded materials for peri-implantitis by consulting domestic and foreign literatures,so as to provide reference for clinical research and application.

OBJECTIVE To explore the detoxification mechanism of Terminalia chebula Retz(TCR)soup-processed Euphorbia fischeriana Steud.(EFS)based on LC-MS and simulation processing.METHODS The changes of chemical composition of TCR soup-processed EFS,and dichloromethane extracts of crude EFS after simulation processing with TCR soup were analyzed by LC-MS.Mice were orally administered with alcoholic extracts of crude EFS,alcoholic extracts of water-processed EFS,alcoholic extracts of TCR soup,alcoholic extracts of TCR soup-processed EFS,dichloromethane extracts of crude EFS,dichloromethane extracts of TCR soup-processed EFS,and dichloromethane extracts of crude EFS after simulation processing with TCR soup,respectively.Toxicity changes in TCR soup-processed EFS and dichloromethane extracts of crude EFS after simulation processing with TCR soup were evalu-ated by fecal water contents,release levels of TNF-α and IL-1β,and intestinal pathology.RESULTS A total of 115 and 53 com-pounds were identified in EFS and TCR soup,respectively.The contents of 58 and 12 compounds significantly decreased and signifi-cantly increased respectively in EFS after processing with TCR soup.Compared to the blank control group,the fecal water contents and the release levels of TNF-α and IL-1β significantly increased in both the crude and water-processed EFS groups(P<0.01),and no-table intestinal injury was observed.Compared to the crude EFS group,the fecal water contents and the release levels of TNF-α and IL-1β significantly decreased in both the TCR soup group and the TCR soup-processed EFS group(P<0.01),and repaired intestinal injury was observed.After simulation processing for the dichloromethane extracts of crude EFS with TCR soup,the ion intensity change rates for diterpenoids and tannin phenolic acid compounds ranged from-6.75%to 8.09%and 66.06%to 100.00%,respectively.The ion intensity change rates of diterpenoids in the dichloromethane extracts of TCR soup-processed EFS ranged from-9.92%to 54.72%with almost no tannin phenolic acid compounds.Compared to the blank control group,the fecal water contents and the release levels of TNF-α and IL-1β significantly increased in both the dichloromethane extracts of crude and TCR soup-processed EFS groups(P<0.01),and severe intestinal injury was observed.Compared to the dichloromethane extracts of crude EFS group,the fecal water contents and the release levels of TNF-α and IL-1β significantly decreased in the group of the dichloromethane extracts of crude EFS after simulation processing with TCR soup(P<0.01),with no apparent intestinal injury.CONCLUSION TCR soup pro-cessing can alleviate the intestinal toxicity of EFS.The detoxification mechanism may involve the introduction of a large number of tan-nin phenolic acid compounds in TCR soup during the processing of EFS,which plays a pharmacological antagonistic role in the animal body.

Background Lead (Pb) exposure impairs cognitive functions of children. Whether Pb exposure in different developmental stages induces long-term cognitive impairment, and whether chelation therapy could mitigate the cognitive impairment is rarely reported. Objective This experiment is designed to investigate effects of Pb exposure and chelation therapy during different developmental stages (breastfeeding, weaning, and early puberty periods) on mouse short-term and long-term cognitive functions. Methods C57BL/6 male mice in breastfeeding period, weaning period, and early puberty period (postnatal day 2, 21, and 41; PND 2, PND 21, and PND 41, n=30, respectively) were randomly divided into control, Pb exposure, and Pb+dimercaptosuccinic acid (DMSA) treatment groups (n=10 in each group). The control groups received standard food and deionized water. The Pb exposure mice received standard food and free drinking water containing Pb acetate (0.1% for dams, and 0.05% for pups). After receiving Pb acetate for 19 d, the Pb+DMSA treatment groups were given 1 mmol·kg⁻¹·d⁻¹ DMSA for 6 d with gastric infusion. Whole blood Pb levels were measured after DMSA treatment on experimental day 25. The effects on short-term cognitive function were tested in the Morris Water Maze task by the analyses of escape latency on PND 75−79, as well as target quadrant time and times of platform-crossing on PND 80. Hippocampal long-term potentiation of field excitatory postsynaptic potential (fEPSP) of mice on PND 365 was induced to demonstrate the effects on long-term cognitive function. Results The blood Pb levels among the Pb, Pb+DMSA, and control groups were statistically different for each developmental stage (F_{breastfeeding period}=43.47, F_{weaning period}=228.6, F_{early period of puberty}=274.2, all P<0.001). Compared to the counterpart control groups, blood Pb levels of the pb exposure groups (386.4, 265.0, and 178.1 μg·L⁻¹ in breastfeeding period, weaning period, and early puberty period, respectively) were significantly higher for all stages. After the chelation therapy, the blood Pb significantly decreased for all stages (28.68, 47.29, and 20.93 μg·L⁻¹ in the three periods, respectively, all P<0.001) and the Pb levels of the mice exposed in the breastfeeding period decreased most (by 92.58%, 82.15%, and 88.25% in the three periods, respectively, P<0.01). In the water maze task, the mice exposed to Pb in the breastfeeding period had a gentler decrease in escape latency (from 54.20 s on day 1 to 30.54 s on day 5, by 43.65 % decrease) than the control group (from 32.44 s on day 1 to 15.20 s on day 5, by 53.14 % decrease) (P<0.01) and a significant decrease in target quadrant time (P<0.05). After the chelation therapy, the escape latency of the DMSA-treated mice in the breastfeeding period (from 40.94 s on day 1 to 20.87 s on day 5, by 48.99 % decrease) was steeper than that of the Pb-exposed mice (P<0.05). The differences in the escape latency, target quadrant time, and times of platform-crossing were not significant between the Pb-exposed mice and the control mice in the weaning period and early period of puberty (all P>0.05). After the chelation therapy, such differences were also not significant compared with before therapy. Due to the small sample size, data were merged for different developmental stages in the long-term potentiation test. The amplitudes of fEPSP induced in the control, Pb-exposed, and DMSA treatment groups were significantly different (F_groups=212.2, F_time=11.36. P<0.001). The average fEPSP amplitude induced in the last 10 min recorded in the hippocampal slices in the Pb exposure group was significantly lower than that in the control group (P<0.05). After the DMSA treatment, no significant differences were observed in the fEPSP amplitudes between the Pb exposure group and the DMSA treatment group (P>0.05). When observing the fEPSP data by developmental stages, the fEPSP amplitude in the breastfeeding Pb-exposure group was 27.2% lower than that of the breastfeeding control group, while such changes were not obvious in the weaning period or in the early period of puberty. The fEPSP amplitude in breastfeeding DMSA treatment group was 44.3% higher than that of the breastfeeding Pb exposure group, while such changes were not observed in the weaning period or in early period of puberty. Conclusion Pb exposure during different developmental stages, especially in breastfeeding period, could affect short-term and long-term cognitive functions of mice. The harmful effects may be partially reversed by DMSA chelation therapy, especially being treated in breastfeeding period.