Autism spectrum disorder (ASD), a representative disease of children's neurodevelopmental disorders, brings huge pressure and financial burden to families and society. It is of great significance to explore its etiology and pathogenesis. Therefore, we established an ASD Cohort based on the existing China National Birth Cohort (CNBC), which applied parallel design to recruit and follow up families who achieved pregnancy after receiving assisted reproductive technologies (ART) and families with spontaneous conception. The main aims of this study are to compare the incidence of ASD among children born after ART with those born under spontaneous pregnancy, and to evaluate the impact of ART on the neurobehavioral development of offspring. Additionally, with a variety of clinical and behavioral related information collected during pregnancy and at early life of offspring, we are able to investigate the risk factors associated with ASD comprehensively. This article briefly introduces the objectives, contents, preliminary progress, strength and limitations, as well as further prospects of the ASD cohort study, mainly focusing on the overall design and current progress.

The importance of gut microbes to human health has gradually attracted attention. With the use of animal models, it has been revealed that maternal microbes during pregnancy could influence their children's health outcomes through shaping their microbial composition and regulating the development of their metabolic and immune system. However, the physiological mechanism of the human body is more complex and is affected by the interaction of multiple factors. The research results obtained from animal models are often inconsistent with human studies. At present, the influence of maternal intestinal microbes during pregnancy on the microbial colonization in their offspring and on a series of children's health outcomes is still unclear. Establishing a sub-cohort to detect the microbiome of the women across pregnancy and of their offspring, and further to integrate with variety of environmental and behavioral exposures can better provide reliable support for the research on the mechanism of children's health and diseases. This paper briefly introduces the research objectives, content, progress, strength and limitations of the sub-cohort study.

Objective To investigate the effect of sarcopenia on the skeletal muscle and cardiac function in elderly patients with chronic heart failure (CHF).Methods Sixty patients with CHF and sarcopenia and 60 sex and age-matched CHF patients without sarcopenia were enrolled from September 2014 to December 2015.The skeletal mass was evaluated by fat-free mass index (FFMI) and muscle function was evaluated by gait speed (GS),hand strength (HS) and the simple physical performance battery (SPPB).The cardiac function was accessed by a 6-min walk distance (6-MWD) and left ventricular ejection fraction (LVEF).Furthermore,the serum inflammation cytokines IL-6,TNF-α,and skeletal muscle biomarker C 1q were measured.Results The CHF patients with sarcopenia had lower values for skeletal muscle mass:FFMI [(17.68±0.74) vs.(18.34±0.54)kg/m2,F=33.696,P＜0.05] and lower muscle function:HS [(17.26±4.20)vs.(28.85±6.43)kg,F=136.54,P＜0.05],GS [(0.65±0.11) vs.(0.90±0.10)m/s,F=-12.922,P＜0.05],SPPB [(6.45±2.07) vs.(7.65± 1.76),t=-3.452,P＜0.05].And the cardiac function decreased significantly in patients with sarcopenia:6-MWD [(253.76 ± 72.62) vs.(340.91 ± 55.78)m,F=54.350,P＜0.05],LVEF [(39.12 ± 7.02)vs.(43.83±5.81)％,t=16.060,P＜0.05].Serum IL-6/TNF-α/C1q levels were significantly elevated:IL-6[(14.12± 1.40) vs.(13.46±1.06) ng/L,F=8.513,P＜0.05],TNF-α [(443.43±28.06) vs.(299.37±21.53)ng/L,t=31.556,P＜0.05],C1q[(578.92±23.63) vs.(504.1 1±41.77)ng/L,F=145.78,P＜0.05].Conclusion The CHF patients with sarcopenia present less skeletal muscle mass,poorer skeletal function and reduced cardiac function,and higher inflammation levels.

Objective To study the effect of rhBNP on serum chemerin and IL-37 levels in acute myocardial infarction (AMI) patients undergoing emergency PCI.Methods Eighty AMI patients who underwent emergency PCI were randomly divided into cortrol group (n =40) and rhBNP treatment group (n=40).The patients in control group were treated with conventional drugs and those in rhBNP treatment group were treated with intravenous rhBNP.Their serum chemerin and IL-37 levels were measured by ELISA.Their LVEDD and LVEF were compared.Results The serum level of chemerin was significantly lower while that of IL-37 was significantly higher in two groups at 72 h and on day 7 after PCI than before PCI (P＜0.05).The serum level of chemerin was significantly lower while that of IL-37 was significantly higher in rhBNP group than in control group at 72 h and on day 7 after PCI (P＜0.05).The LVEDD was significantly shorter while the LVEF was significantly higher in two groups on day 7 and month 1 after PCI than before PCI (P＜0.05).The LVEDD was significantly shorter in rhBNP group than in control group on day 7 and month 1 after PCI (P＜0.05).Conclusion rhBNP can effectively reduce the serum chemerin level,increase the serum IL-37 level,and improve the cardiac function in AMI patients following emergency PCI.The effect of rhBNP is better than that of conventional drugs in AMI patients after emergency PCI.

Objective To evaluate the role of laparoscopic ultrasonography (LUS) in difficult place laparoscopic hepatectomy of the right liver.Methods The data of 7 patients undergoing laparoscopic hepatectomy with tumor in the difficult location of the right liver in our hospital between Jun 2015 and Aug 2017 were retrospectively analyzed.LUS was used during all the operations in order to investigate the anatomy of the operations,determine the tumor stage and guide the incision margin of tumor.It was conventionally used to detect the relationship between the lesions and peripheral intrahepatic vessels and ducts.Results Seven cases underwent successful laparoscopic hepatectomy.The mean operative time was (121 ± 50) min,average intraoperative blood loss was (301 ± 122) ml,and there was no operative mortality.Mean hospital stay was (7.1 ± 1.2) d.One suffered biliary leakage and was cured by conservative treatment.Conclusions Laparoscopic ultrasound can determine tumor location and guide the operative route,increasing safety of laparoscopic hepatectomy.

Objective To investigate the effect and mechanism of decorin (DCN) on invasion of colorectal cancer cell line HCT116 in vitro.Methods Transwell assay was employed to detect the invasion of HCT116 cells;Real-time PCR was used to detect the expression of CD133 and TIMP-2 mRNA of HCT116 cells;Western blot method was used to detect the expression of HIF-1α, CD133 and TIMP-2 protein of HCT116 cells.Results 1) When the concentrations of DCN was 0, 1 and 3 mg/L, under the conditions of normal oxygen and hypoxia, the numbers of invasive cells were (241±46), (168±46), (51±17) fields in each well (P<0.01) and (207±61), (213±64), (156±54), (44±17) fields in each well (P<0.01).2) Under the normoxic conditions, the TIMP-2 mRNA and protein in HCT116 cells were increased by DCN (3 mg/L) (P<0.01), but that of CD133 were not affected.3) DCN (3 mg/L) significantly decreased the expression of HIF-1α/CD133/TIMP-2 protein in HCT116 cells under hypoxia (P<0.01), but had no significant effect on the expression of CD133 mRNA.ConclusionsUnder the conditions of hypoxia and normal oxygen, DCN may function through different mechanisms to inhibit the invasion of colorectal adenocarcinoma cell line HCT116 in vitro.

Objective To discuss task-based learning and team-based learning methods and lecture-based learning method in the class of ethnic medicine.Method 50 students in clinic medicine (general practice) of grade 2012 were selected as D-TBL group and 54 students in clinic medicine of grade 2013 were selected as LBL group.Both groups have teaching content,textbook,teachers,class hours in common.Effect of teaching was valued by tests,evaluation in students,questionnaires.SPSS was used to analyze scores of tests.T test was used.Results The correct answer rate?of subject items in D-TBL group was higher than that of LBL group and the difference had statistical significance [(94.56 ± 4.95)％ vs.(29.26 ± 12.15)％,t=36.382,P=0.000).There was no significant difference between the correct answer rate of personal test in D-TBL group and objective item in the LBL group[(75.20 ± 11.82)％ vs.(68.61 ± 14.65)％,t=2.512,P=0.374].There was no statistically significant difference between the correct answer rate of group test in D-TBL group and objective item in the LBL group[(84.25 ± 13.08)％ vs.(68.61 ± 14.65)％,t=5.727,P=0.961].In Score table for members in every division,41(85.42％) students got straight A,7(14.58％) students got B and nobody got C.Feedback questionnaire showed 40(83.33％) students like D-TBL while 26(50.00％) students like LBL.Conclusion Most of students in D-TBL group like D-TBL.D-TBL and LBL cannot take the place of each other.In the future teaching,both methods should be used in different teaching periods according to their merits.

Objective To investigate the criteria of hemodynamic parameters for diagnosis of intracranial segment vertebral artery stenosis with transcranial color-coded sonography (TCCS ). Methods A total of 622 outpatients or inpatients with suspected posterior circulation ischemia were enrolled retrospectively,from which 216 patients were selected with TCCS,color Doppler flow imaging (CDFI)screen,and digital subtraction angiography (DSA)examination,including 33 patients (15. 3%) had normal intracranial vertebral arteries,the stenosis rates<50% were 45 cases (20. 8%),50%-69%were 44 cases (20. 4%),and 70%-99% were 94 cases (43. 5%). The mean velocity (MV)of intracranial segment,the ratios SPRP (PSV1/PSV2 ),SPRE (EDV1/EDV2 )of the systolic and end diastolic flow velocity between the intracranial segment and the intervertebral space segment were calculated respectively by detecting the intracranial segment of vertebral artery,the intervertebral space segment peak systolic velocity (PSV1 ,PSV2 )and end diastolic velocity (EDV2 ,EDV1 ). The DSA findings were used as the criteria,the area under the receiver operating characteristic (ROC ) curve was calculated and the optimal cut-off points were obtained. Results The optimal cut-off points of TCCS diagnosis of intracranial vertebral artery stenosis were as follows:the parameter standards of stenosis rate <50% were 110 cm/s≤PSV1≤145 cm/s and 65 cm/s≤MV≤85 cm/s,the parameter standards of stenosis rate 50%-69%were 145 cm/s≤PSV1≤190 cm/s and 85 cm/s≤MV≤115 cm/s,and the parameter standards of stenosis rate 70%-99% were PSV1≥190 cm/s and MV≥115 cm/s. Conclusion TCCS may effectively evaluate the hemodynamic changes of intracranial vertebral artery stenosis and provide reference for the ultrasound evaluation criteria of intracranial vertebral artery stenosis.

Objective To investigate color Doppler flow imaging (CDFI)and transcranial color-coded sonography (TCCS)for detection and evaluation of severe stenosis of intracranial vertebral artery (IVA) before and after stenting,as well as the hemodynamic changes of restenosis and their clinical value. Methods A total of 102 patients with severe stenosis of IVA confirmed by CDFI plus TCCS and DSA from November 2011 to November 2013 were analyzed retrospectively. Extra- and intracranial segments peak systolic velocity (PSV),end-diastolic velocity (EDV),IVA pulsatility index (PI),extracranial resistance index (RI),tube diameter,spectrum morphology,and hemodynamic parameters before stenting and 1 week, 3,6 and 12 months after stenting were compared. According to the results of TCCS,they were further divided into either a restnosis group (n=16 )or a non-restnosis group (n=86 ). Results (1 )The results of TCCS detection showed:PSV,EDV,and PI of the stenotic segments were improved significantly at 1 week after stenting,they were 109 ± 40 cm/s vs. 258 ± 63 cm/s,47 ± 18 cm/s vs. 132 ± 45 cm/s,0. 91 ± 0. 15 vs. 0.75 ± 0. 18,respectively. There were significant differences (all P<0. 01). PSV and EDV of the restenosis group were increased gradually from 3 to 12 months after procedure. There were significant differences between 12 months after procedure and one week after procedure (all P<0. 01). There were no significant differences in PSV,EDV,and PI of the non-restenosis group between the 12-month observation period after procedure and one week after procedure (P>0. 05). (2)The results of CDFI showed:PSV and EDV of the ipsilateral extracranial segment were improved significantly after procedure compare with those before procedure, they were 64 ± 15 cm/s vs. 51 ± 15 cm/s and 24 ± 6 cm/s vs. 19 ± 7 cm/s (all P<0. 05). The RI value and vertebral artery diameter of the extracranial segment were improved gradually,and they reached the peak at 12 months after procedure (0. 61 ± 0. 07 vs. 0. 63 ± 0. 12,P=0. 038;3. 6 ± 0. 4 mm vs. 3. 4 ± 0.5 mm,P=0. 009). Conclusion CDFI in combination with TCCS can objectively evaluate the extra-and intracranial hemodynamic changes before and after IVA stenting,and provide reference information for the effectiveness of stenting and the imaging evaluation of restenosis.

Teachers applied task-based learning and Team-based learning methods in the course of ethnic medicine.Teaching contents were classified according to relations of different herbs and quantity of herbs in each chapter.7-9 students formed a learning group which was also called team.Learning groups prepared lessons before class,debated on different tasks such as herb identification and treatment prescription of clinical cases in class,and drew a conclusion after debates.Learning groups expounded their viewpoints and debated with other learning groups about different views.Teachers recorded and commented on viewpoints from each learning group.After class,through a questionnaire,teachers understood the students' feedback to the whole teaching process,and the effect of application of task driven and cooperative team learning got students' recognition.In the future,we will make some improvement by increasing the classroom comment,improving the preparation before class,increasing the efficiency of learning group presentation and debate time,enriching teachers' academic knowledge and improving their teaching skills.