Nonalcoholic fatty liver disease(NAFLD)has become one of the great risks for children′s development and health, while its pathogenesis and progression characteristics are still not clear.The establishment of NAFLD specific research model can help to explore and reveal the role of related pathways in the occurrence and development of NAFLD.The existing models for the study of NAFLD in children mainly include diet-induced animal models and in vitro hepatocyte culture models.In recent years, organoids cultured from stem cells have similar spatial tissues of corresponding organs and can reproduce some functions of corresponding organs, which can be used to simulate liver inflammation and fibrosis process.In this paper, we will introduce these models and methods, focus on the construction and application of organoids, and look forward to the application of models for children NAFLD in the future.

Objective:To investigate the medical narrative competence of pediatric staff, and analyze its influencing factors and correlation with psychological resilience, and to discuss strategies to improve narrative competence.Methods:From January 11 to February 25, 2022, by convenience sampling, we sampled pediatric personnel and those on refresher training at Children's Hospital, Zhejiang University School of Medicine for a questionnaire survey involving general information, the narrative competence scale, and the 14-item resilience scale. With the use of SPSS 26.0, the narrative competence of different populations was compared, and factors affecting narrative competence were determined through Pearson correlation analysis and multiple regression analysis.Results:A total of 361 valid questionnaires were included in this study, and there was significant differences in the narrative competence score between different ages, professional titles, working years, income levels, and whether they wrote parallel charts ( P<0.05). The total score of narrative competence of pediatric staffs was (147.13±18.76), and positively correlated with the total resilience score and the score of each dimension ( P≤0.001). The regression analysis showed that writing parallel charts and resilience could explain 53.10% of the variation in narrative competence ( P<0.001). Conclusions:Pediatric staff's narrative competence is at low or intermediate levels. Parallel chart writing and resilience training can improve narrative competence and promote a harmonious doctor-patient relationship.

OBJECTIVETo observe the effects of electroacupuncture (EA) at"Changqiang"(GV 1) on expression of nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) in rats after acute spinal cord injury (ASCI), and to explore the mechanism of EA at"Changqiang"(GV 1) on ASCI.

METHODSTwenty-four adult female SD rats were randomly divided into an EA group, a model group and a sham operation group, 8 rats in each one. The rats in the sham operation group were treated with laminectomy to expose the spinal cord without any strike. The rats in the model group and EA group were treated with modified Allen's method to establish ASCI model. After model was established, the rats in the EA group were treated with EA at"Changqiang"(GV 1), once a day for continuous 7 days. The rats in the sham operation group and model group were treated with immobilization, once a day, without any other interventions. The basso beattie bresnahan (BBB) was evaluated 1, 3, 5, 7 days after operation. 7 days after operation, the rats were sacrificed with perfusion and the spinal cord was embedded with paraffin. The morphological changes of spinal cord and neuron were observed by Nissl's staining method; the expressions of NGF and BDNF were detected by immune fluorescence method.

RESULTS3 days, 5 days and 7 days after operation, the BBB scores in the EA group were higher than those in the model group (<0.05, <0.01). The Nissl's staining indicated the gray matter of spinal cord was butterfly-shaped with complete structure and clear boundaries between the gray and white matter; the tabby-shaped Nissl bodies were observed in cytoplasm. There were incomplete gray nucleus, big and saturate local stasis plaque. Compared with the model group, the smallerarea of blood stasis, less severity of neuron edema, better morphology of neuron and no vacuole change were observed in the EA group. The immune fluorescence results indicated the expressions of NGF and BDNF in the model group and EA group were higher than those in the sham operation group (all <0.01); the expressions of NGF and BDNF in the EA group were higher than those in the model group (both <0.01).

CONCLUSIONEA at"Changqiang"(GV 1) could improve the expression of NGF and BDNF and increase the score of BBB in rats with ASCI, which is beneficial to the repair of ASCI.

Animals ; Brain-Derived Neurotrophic Factor ; metabolism ; Electroacupuncture ; Female ; Nerve Growth Factor ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; metabolism ; Spinal Cord Injuries ; therapy

OBJECTIVEBased on rehabilitation training, to observe the clinical effect difference between pricking combined with cupping and western medication for elbow flexion spasticity of upper limb of stroke patients.

METHODSSixty patients were randomly assigned by SPSS software random number generator into a comprehension group and a western medication group, 30 cases in each one. Rehabilitation was used in the two groups. Pricking and cupping were applied at the affected abdominal center of biceps brachii muscle on Tuesday and Friday continuously for 4 weeks in the comprehensive group. Baclofen was prescribed orally continuously for 4 weeks, once 10 mg and 3 times a day in the western medication group. The indexes were observed before and after 4-week treatment as well as at immediate treatment, immediately after the first treatment in the comprehension group and 24 h after treatment in the western medication group, including the affected elbow joint activity, modified Ashworth scale (MAS), simple Fugl-Meyer assessment (FMA), integrated electromyogram (IEMG) of the affected biceps brachii and triceps brachii. The clinical effects were evaluated.

RESULTSAfter treatment, the elbow joint activity in the two groups was improved compared with that before treatment (both＜0.05), with better result in the comprehension group (＜0.05). There was no statistical significance for MAS and FMA scores at immediate treatment between the two groups (both＞0.05). After treatment, the MAS score decreased and the FMA score increased in the two groups (both＜0.05), with better results in the comprehension group (both＜0.05). At immediate treatment and after treatment, biceps brachii IEMG decreased in the two groups (all＜0.05). The biceps brachii IEMG in the comprehension group at the immediate treatment was higher and that after treatment was lower compared with those in the western medication group (both＜0.05). The triceps brachii IEMG at immediate treatment was not statistically different from that before treatment in the comprehension group (＞0.05) and that in the western medication group decreased (＜0.05). After treatment, the triceps brachii IEMG increased in the two groups (both＜0.05), with higher IEMG in the comprehension group (＜0.05). The total effective rate was 83.3% (25/30) in the comprehensive group, which was higher than 60.0% (18/30) in the western medication group (＜0.05). .

CONCLUSIONPricking and cupping combined with rehabilitation training can reduce the IEMG of the biceps brachii muscle in patients with stroke, and improve the spasticity and motor function.