Autism spectrum disorder(ASD),characterized by unknown etiology and high heterogeneity,ne-cessitates precise diagnostic and intervention strategies.Neuroimaging techniques have shown great promise in un-covering the neural mechanisms of ASD,providing a foundation for aided diagnosis and transcranial magnetic stim-ulation(TMS)interventions.This review highlights that integrating multimodal neuroimaging and developing indi-vidualized indices with developmental specificity can significantly improve the accuracy of ASD diagnosis and clas-sification.Furthermore,TMS interventions guided by functional connectivity derived from functional magnetic reso-nance imaging(fMRI)offer a personalized approach to ASD treatment.

Autism spectrum disorder(ASD),characterized by unknown etiology and high heterogeneity,ne-cessitates precise diagnostic and intervention strategies.Neuroimaging techniques have shown great promise in un-covering the neural mechanisms of ASD,providing a foundation for aided diagnosis and transcranial magnetic stim-ulation(TMS)interventions.This review highlights that integrating multimodal neuroimaging and developing indi-vidualized indices with developmental specificity can significantly improve the accuracy of ASD diagnosis and clas-sification.Furthermore,TMS interventions guided by functional connectivity derived from functional magnetic reso-nance imaging(fMRI)offer a personalized approach to ASD treatment.

Objective:To explore the impact of postoperative extracorporeal membrane oxygenation (ECMO) support on neurodevelopment of neonatal patients with complex congenital heart disease (CHD) and its early neurorehabilitation intervention effect.Methods:A retrospective analysis was performed; 17 neonates who underwent complex CHD corrective surgery with ECMO support in Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University from January 1, 2019 to December 31, 2021 were chosen. Neurological injury of the neonates was observed during ECMO support period. At 12 months old, the neonates underwent head MRI; and Griffiths Developmental Scale-Chinese version (GDS-C) were performed on the neonates to evaluate the neurodevelopment. A systematic neurorehabilitation intervention program was implemented for neonates with abnormal neurodevelopment as indicated by GDS-C, and GDS-C was performed again to assess the neurodevelopmental changes of the neonates at 36 months old.Results:(1) During ECMO support period, 13 neonates (76.47%) suffered from neurological damage, including 8 with simple intracranial hemorrhage, 2 with intracranial hemorrhage combined with ischemic hypoxic changes, 1 with intracranial hemorrhage combined with white matter injury, and 2 with white matter injury. (2) At 12 months old, head MRI revealed hemorrhagic foci or softening foci in 2 neonates; GDS-C indicated 12 neonates with delayed neurodevelopment, 4 with borderline status, and only 1 with normal development. (3) Among the 16 neonates with abnormal neurodevelopment who received systematic neurorehabilitation, 11 achieved normal neurodevelopment, 4 remained borderline, and 1 still had delayed development at 36 months old indicated by GDS-C. Compared with those before the neurorehabilitation intervention, the neonates after neuro-rehabilitation intervention had better neurodevelopmental rating (average ranks: 9.630 and 23.380, respectively), and significantly improved neurodevelopmental quotients in the 4 major dimensions of motor, personal-social, language, and hand-eye coordination ( P<0.05). Conclusion:Neonates accepted CHD surgery face high risks of postoperative neurological complications during ECMO support period; incidence of neurodevelopmental abnormalities is high in neonates at 12 months old; by implementing a systematic neurorehabilitation intervention, the outcomes of neonates with neurodevelopmental abnormalities can be effectively improved.

Objective:To explore the impact of postoperative extracorporeal membrane oxygenation (ECMO) support on neurodevelopment of neonatal patients with complex congenital heart disease (CHD) and its early neurorehabilitation intervention effect.Methods:A retrospective analysis was performed; 17 neonates who underwent complex CHD corrective surgery with ECMO support in Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University from January 1, 2019 to December 31, 2021 were chosen. Neurological injury of the neonates was observed during ECMO support period. At 12 months old, the neonates underwent head MRI; and Griffiths Developmental Scale-Chinese version (GDS-C) were performed on the neonates to evaluate the neurodevelopment. A systematic neurorehabilitation intervention program was implemented for neonates with abnormal neurodevelopment as indicated by GDS-C, and GDS-C was performed again to assess the neurodevelopmental changes of the neonates at 36 months old.Results:(1) During ECMO support period, 13 neonates (76.47%) suffered from neurological damage, including 8 with simple intracranial hemorrhage, 2 with intracranial hemorrhage combined with ischemic hypoxic changes, 1 with intracranial hemorrhage combined with white matter injury, and 2 with white matter injury. (2) At 12 months old, head MRI revealed hemorrhagic foci or softening foci in 2 neonates; GDS-C indicated 12 neonates with delayed neurodevelopment, 4 with borderline status, and only 1 with normal development. (3) Among the 16 neonates with abnormal neurodevelopment who received systematic neurorehabilitation, 11 achieved normal neurodevelopment, 4 remained borderline, and 1 still had delayed development at 36 months old indicated by GDS-C. Compared with those before the neurorehabilitation intervention, the neonates after neuro-rehabilitation intervention had better neurodevelopmental rating (average ranks: 9.630 and 23.380, respectively), and significantly improved neurodevelopmental quotients in the 4 major dimensions of motor, personal-social, language, and hand-eye coordination ( P<0.05). Conclusion:Neonates accepted CHD surgery face high risks of postoperative neurological complications during ECMO support period; incidence of neurodevelopmental abnormalities is high in neonates at 12 months old; by implementing a systematic neurorehabilitation intervention, the outcomes of neonates with neurodevelopmental abnormalities can be effectively improved.

Objective To evaluate the efficacy of Jianpi Yang'er Ointment for children with anorexia of spleen deficiency type in Lingnan area;To analyze its effects on children's intestinal flora and functional information by means of metagenome sequencing.Methods Totolly 144 children with anorexia in Guangzhou Women and Children Medical Center of Guangzhou Medical University from August 2022 to January 2023 were orally treated with Jianpi Yang'er Ointment,one bag per time,twice a day,after meal,for 28 d.Visits were conducted at 0 and 28 days,respectively,to measure height and body mass,record symptoms and signs,observe adverse reactions,collect feces,and fill out the"Clinical Index Scoring Table for Children with Spleen Deficiency Type Anorexia in Lingnan Area".Clinically cured children were included in the anorexia group,with healthy children as a healthy control group(HC group),perform metagenomic analysis on feces of HC group and anorexia group 0 and 28 days of treatment.Results Compared with 0 d of treatment,there was no significant difference in the height of children(P>0.05),while there was a significant difference in body mass(P<0.05),the total syndrome score,main symptom score,and secondary symptom score decreased at 28 d of treatment(P<0.05).The efficacy index was 57.03%,and the total effective rate was 99.31%(143/144).All patients did not experience symptoms such as allergies,vomiting,or diarrhea.7 clinically cured children and 6 healthy children were included in metagenome analysis on feces.PCoA showed that the structure of intestinal flora in anorexia group with 28 d treatment(JP2 group)was more similar to that in HC group at the phylum and genus levels;at the phylum level,there was no significant difference in the distribution of intestinal flora between anorexia group with 0 d treatment(JP1)group and JP2 group and HC group.At the genus level,compared with JP1 group,the abundance of Bacteroides in JP2 group decreased,but the difference was not statistically significant(P>0.05);at the species level,both JP1 and JP2 groups were mainly composed of Phocaeicola plebeius et al.and Bifidobacterium pseudocatenatum et al.The biomarker with significant differences between the two groups was s_Phascolarctobacterium_faecium,while the HC group was mainly composed of Prevotella copri and Bifidobacterium pseudocatenatum.The functional annotation results indicated that a significant change in microbial functional genes related to carbohydrate metabolism occurred after the treatment with Jianpi Yang'er Ointment.Conclusion Jianpi Yang'er Ointment can effectively improve the clinical symptoms of children with spleen deficiency anorexia in Lingnan area,adjust the structure of intestinal flora,increase the content of key probiotics,and regulate the production of intestinal microbiota short-chain fatty acids.

The bromodomain and extraterminal (BET) family member BRD4 is pivotal in the pathogenesis of cardiac hypertrophy. BRD4 induces hypertrophic gene expression by binding to the acetylated chromatin, facilitating the phosphorylation of RNA polymerases II (Pol II) and leading to transcription elongation. The present study identified a novel post-translational modification of BRD4: poly(ADP-ribosyl)ation (PARylation), that was mediated by poly(ADP-ribose)polymerase-1 (PARP1) in cardiac hypertrophy. BRD4 silencing or BET inhibitors JQ1 and MS417 prevented cardiac hypertrophic responses induced by isoproterenol (ISO), whereas overexpression of BRD4 promoted cardiac hypertrophy, confirming the critical role of BRD4 in pathological cardiac hypertrophy. PARP1 was activated in ISO-induced cardiac hypertrophy and facilitated the development of cardiac hypertrophy. BRD4 was involved in the prohypertrophic effect of PARP1, as implied by the observations that BRD4 inhibition or silencing reversed PARP1-induced hypertrophic responses, and that BRD4 overexpression suppressed the anti-hypertrophic effect of PARP1 inhibitors. Interactions of BRD4 and PARP1 were observed by co-immunoprecipitation and immunofluorescence. PARylation of BRD4 induced by PARP1 was investigated by PARylation assays. In response to hypertrophic stimuli like ISO, PARylation level of BRD4 was elevated, along with enhanced interactions between BRD4 and PARP1. By investigating the PARylation of truncation mutants of BRD4, the C-terminal domain (CTD) was identified as the PARylation modification sites of BRD4. PARylation of BRD4 facilitated its binding to the transcription start sites (TSS) of hypertrophic genes, resulting in enhanced phosphorylation of RNA Pol II and transcription activation of hypertrophic genes. The present findings suggest that strategies targeting inhibition of PARP1-BRD4 might have therapeutic potential for pathological cardiac hypertrophy.

Objective: To investigate the relationship between classroom lighting and poor vision of primary and middle school students of poor vision with classroom natural light selecting and artificial lighting, so as to provide reference and basis for the prevention and control of eyesight of primary and middle school students. Methods: A total of 1 734 students from 45 classrooms in 7 primary and secondary schools (2 in primary school, 2 in junior high school, and 1 in vocational school) in Baiyun District, Guangzhou were selected by stratified cluster sampling method for research. The classroom lighting environment was monitored by the illuminometer, the naked eye vision of students was detected by 5 m standard logarithmic vision light box, and the basic information and myopia-related behaviors of students were investigated by questionnaire. And the correlation between poor vision of primary and middle school students and classroom lighting was analyzed. Results: The poor vision rate of primary and middle school students in Baiyun District of Guangzhou was 74.2%(1 286), the girls’ rate(79.7%) was higher than boys’(69.4%), the rate of senior high school students(63.4%) was higher than that of middle school students(81.1%), the rate of vocational school students(82.8%) was higher that of primary school students(60.2%), the rate of resident students(78.5%) was higher than that of non-resident students(69.6%). The results of multivariate analysis after controlling for confangulation factors showed that average illumination on the blackboard, and uneven illumination on the desk were associated with higher risk of poor vision[OR(OR95%CI)=1.51(1.01-2.25), 1.42(1.02-1.98),P<0.05)]. Conclusion Poor eyesight of primary and middle school students in Baiyun District of Guangzhou city is serious, especially that of female students, senior high school students and resident students. There is a significant correlation between classroom lighting and poor vision in primary and middle school students. The blackboard and desk lighting are associated with higher risk of poor vision in primary and middle school students.

Objective:To observe the pronunciation of consonants among children with developmental speech sound disorder and explore the correlation between mispronounced consonants and short-term memory so as to determine the pathogenesis of the disorder.Methods:Thirty-six children with developmental speech sound disorder and aged 4 to 13 years were evaluated. Their pronunciation of consonants at the phoneme and lexical levels was tested to record the error types and error rate. Twelve of the children were then randomly chosen to form a voice disorder group. Another 10 healthy counterparts constituted a control group. The short-term memory of both groups was assessed and any correlation between pronunciation and short-term memory was analyzed.Results:The children with a developmental speech sound disorder differed significantly from the controls in terms of the numbers of errors in articulating blade-alveolar, blade-palatal and velar consonants. On the phoneme level, the highest substitution error rate occurred when pronouncing lingua-palatal consonants (42.86%), followed by supradental consonants (32%). The highest distortion and non-acquisition error rates were with blade-palatal consonants (14%) and lingua-palatal consonants (9.5%). On the vocabulary level, the highest substitution, distortion, ellipsis and non-acquisition error rates appeared when pronouncing lingua-palatal and velar consonants, velar and blade-palatal consonants, supradental consonants as well as blade-palatal consonants. Significant differences were found between the phoneme and lexical levels in the substitution of supradental and blade-palatal consonants as well as in the ellipsis of blade-alveolar consonants. They were moderately associated with pronunciation level. There was, however, no significant difference in working memory span between the two groups, and no significant correlation was observed between working memory span and pronunciation level.Conclusion:The mispronunciation of consonants by children with developmental speech disorders is higher at the lexical than at the phoneme level. They mainly substitute lingua-palatal and velar consonants and elide supradental consonants, which may be related to short-term memory span.

Objective To explore the efficacy of conventional physical therapy,acupuncture and hormone intervention for treating Bell's palsy so as to suggest an optimal treatment in clinical practice.Methods Clinical data on 1170 patients with Bell's palsy (BP) treated at the First Affiliated Hospital of Jinan University between October 2012 and November 2015 were collected and analyzed retrospectively.The Kruskal-Wallis test was used to compare the differences in disease course and in total cost among the patients.Seasons of the year,age,treatments,as well as the presence of immune-related diseases were the covariates studied.Multivariate logistic regression equation was used to test for any significant relationships.Results Physical therapy and hormones were found to have shortened the average course of treatment,but immune-related complicating diseases were shown to be risk factors.Patients receiving acupuncture for more than 1 month had longer courses of the disease than those without.Patients whose treatment combined hormones with physical therapy had the shortest disease course and lower total cost on average.Conclusion Early hormone intervention combined with physical therapy can shorten the course of BP and lower the cost of treatment.

In recent years, the relationship between working memory and language comprehension received more and more attention by many researchers, especially those of psychology and pedagogy. This article reviewed the researches on the working memory and language comprehension disorder in aphasia, including the theoretical model of working memory, assessment and brain positioning, etc., and discussed the process of working memory and comprehension disorder in rehabilitation.