Autism spectrum disorder （ASD）， also known as autism， is a series of neurodevelopmental disorders characterized by social disorders and repetitive stereotyped behaviors/narrow interests. Its pathogenesis is complex， and there is a lack of effective treatment drugs， with some cases having adverse outcomes. Recent studies have consistently revealed that individuals with autism spectrum disorder （ASD） commonly exhibit characteristics such as gut microbiota dysbiosis （abnormal Bacteroidetes/Firmicutes ratio）， impaired intestinal barrier function （elevated serum levels of zonulin and LPS）， and intestinal immune dysregulation （increased pro-inflammatory cytokines including IL-6 and TNF-α）， suggesting that gastrointestinal abnormalities may influence central nervous system development through neuroendocrine， immunoregulatory， and metabolic pathways. Consequently， growing scholarly attention has focused on dietary interventions as potential approaches to alleviate clinical symptoms in children with ASD. This review systematically summarizes the role of gut microbiota and their metabolite alterations in ASD pathogenesis， along with recent advancements in understanding the microbiota-gut-brain axis mechanisms. Additionally， it elaborates on the therapeutic effects and underlying biological basis of restrictive diet therapy， modified diet therapy， and nutritional supplementation therapy in promoting the health of children with ASD. This systematic review reveals that children with ASD exhibit significant gut microbiota dysbiosis （e.g.， increased Clostridium， decreased Faecalibacterium） and abnormal metabolite profiles （e.g.， altered short-chain fatty acid spectra， elevated 4EPS levels）. These alterations exacerbate neuroinflammation and immune dysregulation through the microbiota-gut-brain axis， thereby impacting nervous system development and function. Furthermore， interventions such as ketogenic diets， camel milk， and specific nutritional supplements can alleviate certain ASD symptoms by modulating gut microbiota， restoring intestinal barrier function， and improving metabolic pathways. Future investigations should aim to create multi-omics evaluation systems for pinpointing potential beneficiaries， devise individualized intervention strategies rooted in microbiome characteristics， and verify their therapeutic value and safety in large-scale randomized controlled trials. These efforts are crucial to transitioning ASD treatment from symptomatic control to address disease etiology， thereby paving the way for improving prognoses.

ObjectiveTo construct a stable monoclonal human embryonic kidney 293 （HEK293） cell line expressing recombinant human coagulation factor Ⅶ （rhFⅦ） and evaluate the expression level and procoagulant bioactivity of rhFⅦ. MethodsThe plasmid pCDNA3.1-EGFP-FⅦ was transfected into HEK293 cells to verify the effectiveness of the transfection system. The plasmid pCDNA3.1-FⅦ was transfected into HEK293 cells， and monoclonal stable transfected cell lines were selected using geneticin （G418）. The transcription of the FⅦ gene was identified by reverse transcription polymerase chain reaction （RT-PCR）. The expression level of rhFⅦ in the supernatant of the monoclonal stable transfected cell line was detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot. The concentration of rhFⅦ was determined by enzyme-linked immunosorbent assay （ELISA）， and the procoagulant activity of rhFⅦ was measured by human coagulation factor Ⅶ potency assay. ResultsHEK293 cells transfected with pcDNA3.1-EGFP-FⅦ showed green fluorescence， indicating that rhFⅦ was successfully expressed in the supernatant of HEK293 cells after transient transfection with pcDNA3.1-FⅦ. The monoclonal stable transfected cell line was obtained by G418 screening. RT-PCR identified that the FⅦ gene was integrated into the genome of the monoclonal stable transfected cell line. The cell viability was good as detected by Cell Counting Kit-8， and a single band of rhFⅦ was obtained by purification of the cell supernatant. The highest rhFⅦ expression was （1.27±0.09） mg/L， and the highest procoagulant activity was （380.29±13.80）%. ConclusionThe monoclonal HEK293 cell lines which can express rhFⅦ protein efficiently and stably with excellent procoagulant bioactivity is successfully screened.

Objective: To characterize longitudinal trajectories of testicular development in boys and breast development in girls, so as to provide reference data for understanding patterns of pubertal sexual maturation. Methods: Based on the Shanghai Pudong New Area Cohort Study on Growth, Development and Health in Children and Adolescents, a baseline survey was conducted in 2020 using a mult stage cluster random sampling method. A total of 2 184 children who completed all follow ups during the primary school period from 13 elementary schools in Pudong New Area,Shanghai,with annual follow ups during 2021-2025. Testicular volume and Tanner stage of breast development were assessed by professional physicians using standardized visual inspection and palpation. The age distribution of testicular volume and breast development was fitted by using cumulative link mixed models and Turnbull s nonparametric maximum likelihood estimation method. Results: Median ages for testicular volumes of 2, 3, 4 and 5 mL in boys were 7.07, 9.24, 10.29, and 11.57 years old, respectively. Median ages for Tanner breast stages Ⅱ, Ⅲ, Ⅳ, and Ⅴ in girls were 8.55 , 10.17, 11.18, and 13.78 years old, respectively. Based on overweight and obesity, stratified analysis showed that earlier pubertal onset among overweight/obesity children, and the key milestones for pubertal initiation were testicular volume reaching 4 mL in boys and breast Tanner II in girls for 10.29, 10.83; 8.18, 9.00 years. Conclusion Overweight and obesity are associated with earlier pubertal initiation,but there are certain gender and developmental stage specific patterns.

[Objective]To analyze the prescriptions for the differentiation,treatment and application in the Treatise on Three Categories of Pathogenic Factors regarding low back pain by using data mining technology,and to explore CHEN Wuze's understanding of low back pain as well as the rules for prescribing medications.[Methods]Prescriptions that met the inclusion criteria were screened to establish a database.The IBM SPSS Modeler 18.0 software was used for association rule analysis,and the SPSS statistics 26.0 software was adopted for drug frequency statistics and cluster analysis.Combined with ancient literature records,CHEN's understanding of low back pain,treatment ideas and medication rules were analyzed.[Results]A total of 63 prescriptions were included,involving 143 types of Chinese medicinal herbs with a total frequency of 581 applications.Seventeen high-frequency herbs were identified,primarily including roasted licorice(Glycyrrhiza uralensis),poria(Poria cocos),ginger(Zingiber officinale),aconite(Aconitum carmichaelii),white peony root(Paeonia lactiflora),and cinnamon bark(Cinnamomum cassia).Common herb pairs included"Atractylodes macrocephala-Poria cocos","Poria cocos-Cinnamomum cassia"and"Cinnamomum cassia-Angelica sinensis".The predominant therapeutic effects involved tonifying and deficiency-replenishing medicinals.Medicinal properties were mainly warm,neutral and cold,with sweet,pungent and bitter flavors predominating.Herbs primarily entered the spleen,kidney and lung meridians.Cluster analysis categorized high-frequency herbs into three groups associated with functions such as dispelling wind and eliminating dampness,tonifying the liver and kidney,relaxing tendons and nourishing blood and warming Yang to resolve dampness.[Conclusion]CHEN's approach to treating low back pain emphasizes differentiation and treatment based on the three etiological factors(internal,external and non-internal/external causes),and a spleen-stomach-focused treatment strategy.Core therapeutic principles included strengthening the spleen to eliminate dampness,warming Yang to resolve dampness and warming/unblocking blood vessels.This article summarizes and extracts the medication rules and academic thoughts of CHEN from the Yongjia medical school in treating lumbago,which has reference value for the clinical treatment of lumbago.

Objective:To investigate the application effect of smart wearable device in the postoperative rehabilitation of patients with glioma and its influence on postoperative recovery.Methods:Eighty patients with glioma who underwent surgical treatment at the First Affiliated Hospital of Harbin Medical University between January 2022 and September 2024 were selected,and they were randomly divided into an observation group and a control group using a random number table,with 40 cases in each group.Patients in the control group received routine follow-up and rehabilitation management after surgery.Patients in the observation group received smart wearable devices to monitor their postoperative recovery on the basis of the management for control group.The study evaluated the scores of the Cancer-Related Fatigue Scale(CFS),exercise amount(steps and activity time),sleep quality(total sleep time and sleep efficiency),and vital signs(heart rate and blood oxygen saturation)at the 1st week,1st month,and 3rd month after surgery for both groups.Results:At the 1st week after surgery,the differences of CFS scores,daily steps and activity time between two groups were not significant(P>0.05).At the 1st month and 3rd month after surgery,the CFS score of observation group was lower than that of control group,and the differences were significant(t=8.914,11.268,P<0.05).Additionally,the daily average steps of observation group were higher than that of control group,and the differences were significant(t=15.259,20.024,P<0.05).Furthermore,the activity time of observation group was significantly longer than that of control group,and the difference was significant(t=8.994,10.667,P<0.05).In the observation group,the heart rate and amplitude of blood oxygen fluctuation at the 1st month and 3rd month after surgery were less than them at the 1st week after surgery,and the recovery after surgery in patients was more stability,while the difference was not significant among them(P>0.05).Conclusion:Smart wearable device can effectively monitor the postoperative rehabilitation of patients with glioma,and help patients to improve fatigue,and increase physical activity,and enhance sleep quality,and stabilize vital signs by real-time feedback.

Objective To Investigate the efficacy of modified electroconvulsive therapy(MECT)in patients with schizophrenia across different genders.Methods From May 2018 to August 2022,481 patients with schizophrenia were recruited from three psychiatric hospitals in Luzhou,Zigong,and Yibin.According to gender grouping,both groups received adjunctive MECT treatment for two consecutive weeks for a total of six treatments.The differences in positive and negative syndrome scale(PANSS)scores before and after treatment,UKU adverse reaction rating scale(UKU),and gastrointestinal symptom rating scale(GSRS)scores were compared between the two groups.Results After quality control,463 cases were followed up for analysis including 246 males and 217 females.Compared with pre-treatment,the total PANSS score and scores on each subscale were significantly reduced in both genders after treatment(P<0.001).When comparing the reduction rates between the groups,the male patients showed a higher reduction rate in negative symptoms than the female patients(31.24%±30.24%vs.25.80%±33.96%,P<0.05).However,there were no significant differences between the two groups in the reduction rates of the total score,positive symptoms,and general psychopathology(P>0.05).The comparison of adverse reactions showed that the frequency of other types of adverse reactions was higher in female patients than in male patients(47.47%vs.37.80%,P<0.05).However,no significant differences were observed in the adverse reactions related to the mental,neurological,autonomic nervous system,and gastrointestinal systems(P>0.05).Correlation analysis revealed that the reduction rate of the PANSS total score was positively correlated with smoking history(r=0.135,P=0.034)and alcohol history(r=0.160,P=0.012)in male patients,while the reduction rate of the PANSS total score was negatively correlated with the disease duration(r=-0.210,P=0.002)and positively correlated with the age of onset(r=0.145,P=0.032)in female patients.Conclusion MECT is significantly effective for both male and female patients with schizophrenia.Compared to female patients,MECT shows a more pronounced effect on negative symptoms in male patients.Additionally,the factors related to the efficacy of MECT differ between genders,indicating that it is necessary to consider the clinical characteristics of patients comprehensively when selecting an MECT treatment plan.

As the main body of scientific research and innovation in hospitals,timely understanding of medical person-nel's scientific research outputs and its influencing factors has practical guiding significance for hospital management to identify scientific research talents,formulate targeted training programs,customize relevant science and technology policies,etc.This ar-ticle will comprehensively elaborate the concept of scientific research outputs,evaluation methods and influencing factors of scien-tific research outputs among medical personnel.Meanwhile,the article will provide suggestions for influencing factors,in order to provide references for the hospital management in the future.

Objective:To analyze by bioinformatics the association between the expression of membrane-associated tyrosine/threonine protein kinase 1(PKMYT1)in glioma with its prognostic value,biological function,drug sensitivity,gene mutation,and immune infiltration.Methods:The differential expression of PKMYT1 was analyzed based on the Chinese Glioma Genome Atlas database(CGGA)and the Cancer Genome Atlas database(TCGA).Pathways likely to be enriched for PKMYT1 were predicted by gene ontology analysis(GO)and gene set enrichment analysis(GSEA).PKMYT1 was subjected to Pearson correlation and gene set variation analysis(GSVA)with cell cycle-related genes and gene sets.The survival prognosis,gene mutation,drug sensitivity and immune infiltration were further analyzed for PKMYT1 high and low expression groups of glioma patients.Results:PKMYT1 was significantly highly expressed in WHO high-grade glioma(P<0.000 1),IDH wild-type glioma(P<0.05),and glioblastoma(P<0.000 1).Overall survival(OS)of patients in the PKMYT1 low expression group was significantly higher than that of the high expression group(P<0.05).Cox regression analysis showed that PKMYT1 expression level was an independent prognostic factor for OS(P<0.05).GO and GSEA analyses showed that the gene sets co-expressed with PKMYT1 were mainly enriched in signaling pathways such as cell cycle,DNA replication and DNA damage repair.Pearson correlation and GSVA analyses showed that the expression of PKMYT1 was significantly and positively correlated with the cell cycle-related genes,gene sets and cell cycle checkpoint genes(P<0.01).Drug sensitivity analysis revealed that patients in the PKMYT1 high expression group had high sensitivity osimertinib,dabrafenib,carmustine and cediranib(P<0.05).Mutation analysis revealed that the IDH1 gene had a higher mutation frequency in the PKMYT1 low expression group.The results of immune infiltration analysis showed that PKMYT1 expression was significantly positively correlated with glioma stroma score(r=0.13,P<0.001),immune score(r=0.11,P<0.01)and ESTIMATE score(r=0.13,P<0.001);and was significantly positively correlated with immune cell infiltration level of regulatory T(Treg)cells and M2-type macrophages(P<0.05).Conclusion:Patients with high PKMYT1 expression have a poorer prognosis,and the mechanism may be related to tumor immune infiltration and cell cycle regulation.PKMYT1 is expected to be a potential target for the diagnosis and treatment of glioma.

Objective To study the level of fall-related self-awareness among the elderly in community and to explore the influence of cognitive reserve and social cohesion on fall-related self-awareness,thereby providing a reference for developing targeted interventions.Methods Toally 500 old people in communities were recruited by convenience sampling in Hengyang between August and September 2024.Data were collected with the general information questionnaire,neighbourhood cohesion scale,self-awareness of falls in elderly scale,and cognitive reserve index questionnaire.Hierarchical multiple linear regression analysis was employed to explore the effects of cognitive reserve and social cohesion on fall-related self-awareness while controlling for demographic variables.Results A total of 467 valid questionnaires were returned.The score of fall-related self-awareness was 54.60±6.64(moderate level).Social cohesion scores was 29.84±5.52(moderate level),and cognitive reserve score was 93.27±10.83(moderate level).The cognitive reserve and social cohesion were both positively correlated with fall-related self-awareness(all P<0.01).Community integration accounted for 9.10%of its total variability,and cognitive reserve accounted for 5.70%of the total variability of fall vigilance,while controlling for variables such as body mass index(BMI),sleep quality,sedentary habits,fear of falling and financial resources.Conclusion The elderly in communities exhibit a low level of fall-related self-awareness.More attention to risk of falling is required along with developing targeted and individualised training programs aiming at improvement of cognitive reserve and social cohesion,thereby reducing the incidence of falls.

Objective To summarize and evaluate the treatment strategies and clinical outcomes of bladder inflammatory myofibroblastic tumor(IMT),so as to provide reference for the diagnosis and treatment of this rare entity.Methods A retrospective analysis was conducted on the clinical data of two patients with bladder IMT treated at Shandong Provincial Hospital Affiliated to Shandong First Medical University.In combination with literature analysis,the clinical characteristics,treatment methods and prognosis of this disease were analyzed.Results Both patients presented with painless terminal macroscopic hematuria.Patient 1 was a 42-year-old male with a 6 cm bladder mass detected by cystoscopy,with no muscular involvement.Transurethral en bloc resection with a 1470 nm diode laser was performed,followed by a second transurethral resection.Patient 2 was a 21-year-old male with a 5 cm bladder mass visualized on cystoscopy,with no muscular invasion.Transurethral en bloc resection using a 1470 nm diode laser was conducted,followed by transurethral laser marking the margin of the wound and laparoscopic partial cystectomy.Preoperative cystoscopic biopsy and postoperative pathology diagnosed it as IMT,which invaded the superficial muscular layer and the margin was negative.Patient 1 was followed for 40 months and patient 2 for 15 months.Follow-up cystoscopy performed every 3 months showed no evidence of recurrence.This article also summarized the relevant literature on bladder IMT over the past five years.Conclusion Bladder IMT is an extremely rare neoplasm with nonspecific clinical manifestations,posing challenges in both diagnosis and treatment.However,early recognition and definitive pathological diagnosis,combined with bladder-sparing surgical strategies such as en bloc resection,often result in favorable outcomes,with reduced risk of recurrence and improved quality of life.