Objective To investigate the differences of language abilities between children with developmental delay(DD)and those with autism spectrum disorder(ASD)aged 3-6 years,and to provide references for clinical differential diagnosis and subsequent rehabilitation therapy.Methods In this study,61 cases of DD children and 61 cases of ASD chil-dren were selected.The language ability of children was assessed using the"Children's Language Ability Assessment Stand-ards and Methods",which evaluated grammar,comprehension,expression and communication abilities.Results Children with DD showed better comprehension and social skills but weaker grammar and expressive abilities.Children with ASD generally had lower levels in all language areas.There was no significant difference in the average language ability or expres-sive ability the two groups(P＞0.05),but the language comprehension ability and communication ability of the ASD group were significantly lower than those of the DD group(P＜0.05).The grammar ability of the ASD group was higher than that of the DD group(P＜0.05).Conclusion The levels of different language areas of children with DD and ASD children are significantly different.Language ability tests can assist in the differential diagnosis of DD and ASD children,and provide reference for language rehabilitation training.

Objective To investigate the differences of language abilities between children with developmental delay(DD)and those with autism spectrum disorder(ASD)aged 3-6 years,and to provide references for clinical differential diagnosis and subsequent rehabilitation therapy.Methods In this study,61 cases of DD children and 61 cases of ASD chil-dren were selected.The language ability of children was assessed using the"Children's Language Ability Assessment Stand-ards and Methods",which evaluated grammar,comprehension,expression and communication abilities.Results Children with DD showed better comprehension and social skills but weaker grammar and expressive abilities.Children with ASD generally had lower levels in all language areas.There was no significant difference in the average language ability or expres-sive ability the two groups(P＞0.05),but the language comprehension ability and communication ability of the ASD group were significantly lower than those of the DD group(P＜0.05).The grammar ability of the ASD group was higher than that of the DD group(P＜0.05).Conclusion The levels of different language areas of children with DD and ASD children are significantly different.Language ability tests can assist in the differential diagnosis of DD and ASD children,and provide reference for language rehabilitation training.

Objective To analyze the risk factors of short-term re-obstruction after plastic stent placement by endoscopic retrograde cholangiopancreatography(ERCP)in patients with hilar malignant biliary obstruction.Methods A retrospective study was performed on clinical data of 93 patients with hilar malignant biliary obstruction who underwent ERCP biliary plastic stent placement from January 2015 to January 2024.Understanding the effects of general information,clinical characteristics,operative-related factors,and laboratory-related indicators on postoperative short-term re-obstruction.The dependent variable was whether biliary stent re-obstruction in short-term after operation,univariate and multivariate Logistic regression analysis were used to analyze the risk factors for the patients with hilar malignant biliary obstruction occurred re-obstruction in short-term after ERCP plastic stent placement.Results Among the 93 patients,49 patients had short-term recurrent biliary stent obstruction after plastic stent placement by ERCP and the recurrence rate was 52.7%.Univariate analysis showed that gender,types of malignant biliary strictures,preoperative cholangitis,no drainage before operation and endoscopic sphincterotomy(EST)during ERCP plastic stent placement,location of stent placement,fever within 24 h after ERCP plastic stent placement,the decrease less than 50%of total bilirubin(TBiL)at 2 weeks after operation,the decrease less than＜50%of γ-glutamyl transpeptidase(GGT)at 2 weeks after operation,GGT and alkaline phosphatase(ALP)by less than 50%at 2 weeks after operation were potential risk factors affecting for short-term re-obstruction after ERCP plastic stent placement in patients with hilar malignant biliary obstruction.Multivariate analysis showed that,no drainage before operation(O＾R=5.738,P=0.013),preoperative cholangitis(O＾R=5.347,P=0.025)and place stents on the left or on the right(O＾R=6.739,P=0.014;O＾R=9.719,P=0.005)were independent risk factors for short-term re-obstruction after ERCP plastic stent placement.Conclusion No drainage before operation,preoperative cholangitis,place stents on the left or on the right are independent risk factors for short-term re-obstruction after ERCP plastic stent placement in patients with hilar malignant biliary obstruction.Early identification of risk groups and timely intervention of risk factors in clinical practice are of great significance for the prevention of short-term re-obstruction after ERCP plastic stent placement in such patients.

Objective To investigate the clinical efficacy of different stents placement under endoscopic retrograde cholangiopancreatography(ERCP)in patients with malignant biliary obstruction(MBO)and the effect on patient survival time.Methods Clinical data of MBO patients treated with ERCP stent placement between January 2020 and March 2024 were collected,divided into recyclable stent group(33 cases),metal stent group(42 cases),and ordinary stent group(34 cases).Comparation of the three groups of preoperative and postoperative changes in liver function,complications of long-term cholangitis and pancreatitis,stent patency time,success rate of stent removal with a single clamping,survival time,monitoring follow-up situation.Results There was no statistically significant difference in the liver function of the three groups of patients before stent placement(P>0.05);One week after stent placement,the difference compared with preoperative between direct bilirubin(DBiL)and total bilirubin(TBiL)in the recyclable stent group and the metal stent group was significantly higher than that in the ordinary stent group,and the difference between the ordinary stent group and other two groups was statistically significant(P<0.05).The incidence of cholangitis in the recyclable stent group was the lowest,followed by the ordinary plastic biliary stent,and the metal biliary stent had the highest incidence of cholangitis,the incidence of cholangitis in the long term after stent placement was compared among the three groups of patients with a statistically significant difference(P<0.05).The incidence of postoperative pancreatitis in the three groups was not statistically significant(P>0.05).The success rate of stent removal with a single clamping was higher in the recyclable stent group than the ordinary stent group.Comparison of median stent patency time among the three groups,the difference was statistically significant(P<0.05).The metal stent group had the longest median patency time of 194.0 d,recyclable plastic stent had the second longest median patency time of 126.0 d,and ordinary plastic biliary stent had the shortest median patency time of 92.0 d.Median survival time among the three groups was statistically significant(P<0.05).The recyclable plastic biliary stent had the longest median survival time of 590.0 d,metal biliary stent had the second longest median survival time of 476.0 d,and ordinary plastic biliary stent had the shortest median survival time of 453.0 d.Conclusion Recyclable plastic biliary stent has a faster decrease in bilirubin index compared with the ordinary stent group after operation.And the recyclable plastic stent group has lower incidence of long-term cholangitis,higher success rate of one-time clamping of the stent,and more advantages in time to stent patency and survival time compared with ordinary plastic biliary stent,which is an effective choice of stenting modality for ERCP stent placement in patients with MBO.

Objective To investigate the protective effect of berberine (BBR) against ionizing radiation injury in rats and its mechanism of action. Methods Sprague-Dawley rats were divided into seven groups: normal control group, 1-Gy radiation group, 1-Gy radiation plus low-dose BBR (50 mg/kg) group, 1-Gy radiation plus high-dose BBR (150 mg/kg) group, 3-Gy radiation group, 3-Gy radiation plus low-dose BBR (50 mg/kg) group, and 3-Gy radiation plus high-dose BBR (150 mg/kg) group. All the groups except the normal control group were exposed to external irradiation with a medical electron linear accelerator, followed by BBR administration by gavage for consecutive ten days. The serum levels of superoxide dismutase (SOD), reduced glutathione (GSH), and malondialdehyde (MDA) were measured by using the micromethod. The pathological changes of the bone marrow and small intestine were observed with HE staining. Results Compared with the normal control group, the radiation groups showed significantly increased MDA levels (P < 0.05), significantly decreased SOD and GSH levels (P < 0.05), and more severe pathological damage of the bone marrow and small intestine. Compared with the radiation groups, the BBR groups showed significantly decreased MDA levels (P < 0.05), significantly increased SOD and GSH levels (P < 0.05), and reduced pathological damage to the bone marrow and small intestine, which were more marked in the high-dose BBR group. Conclusion BBR has a certain protective effect against radiation injury in rats, which may be through increasing the activity of antioxidant substances, enhancing free radical clearance, and thereby alleviating free radicals-caused oxidative damage.

A patient with scalp laceration suspected of radioactive waste water contamination had the wound ruled out of radioactive contamination, psychological fear eliminated, and well-healed wound, through rapid emergency medical response and scientific and effective disposal. The treatment process and psychological intervention for batch wounded after a nuclear accident are still applicable to patients with a small amount of sudden radioactive contamination. This article summarizes the relevant disposal process for reference.

Nuclear accidents and nuclear terrorist attacks are characterized by extensive impact，severe destruction，many casualties，and great difficulties in rescue and treatment. Therefore，it is necessary to establish a highly-skilled，well-trained and quick response medical rescue team for nuclear accidents. This paper discusses the construction of the second-tier hospital for nuclear accident medical rescue from eight aspects：specialized medical treatment，hospital layout，staffing，cultivation and incubation mechanism，integration of military and local departments，maintenance of equipment and facilities，radioactive waste management，and team building，so as to improve the quality of medical rescue for nuclear accidents.

Nuclear accidents and nuclear terrorist attacks are characterized by extensive impact，severe destruction，many casualties，and great difficulties in rescue and treatment. Therefore，it is necessary to establish a highly-skilled，well-trained and quick response medical rescue team for nuclear accidents. This paper discusses the construction of the second-tier hospital for nuclear accident medical rescue from eight aspects：specialized medical treatment，hospital layout，staffing，cultivation and incubation mechanism，integration of military and local departments，maintenance of equipment and facilities，radioactive waste management，and team building，so as to improve the quality of medical rescue for nuclear accidents.

Objective To explore routes for the optimization of casualty triage flow in urgent medical support of nuclear acci -dents.Methods The present working procedures were reorganized and redesigned in accordance with the feature and pattern of the medi -cal mission , as well as the practical organization of medical support teams in case of nuclear accidents .Results Through optimized proce-dures, the casualties were integrated from multiple types to simpler types:i.e.the A1 casualty type that would go through 3 steps and A2 would go through 4 steps;B1 casualty type would go through 3 steps and B2 casualty type would go through only 2 steps.The triage work flow was optimized to 2 steps, and treatment work flow was also optimized and clarified .Conclusion Casualty triage was permeated in the whole process of medical rescue mission , for this reason, the responsibilities and divisions of work for various teams should be elaborated and clarified on the basis of optimized work procedures , and they should be demonstrated and further rectified in practical work .

Objective:To monitor the dynamic changes in coagulation function and assess their clinical significance in patients with gas-tric cancer by using thromboelas to gram (TEG). Methods:A total of 178 patients with gastric cancer from March 2014 to May 2015 in Xinxiang Central Hospital were selected as the experimental group. The patients were grouped based on different tumor stages, inva-sion depths, and lymph node metastasis. The TEG results of all patients were dynamically monitored before and after operation, and 60 healthy persons were selected as normal control group. Blood coagulation change was analyzed by comparing the TEG test results. Results:Compared with those of the control group, the TEG parameters of the experimental group showed significantly decreased R and K values, as well as significantly increased Angle, CI, and MA values, and the differences were statistically significant (P<0.05). In the experimental group, the K values were significantly decreased after operation, whereas Angle, MA, and CI were significantly in-creased (P<0.05). No significant changes were observed in R, LY30, and others. TEG values were significantly different in the compari-son of values for tumor patients with different stages, different tumor infiltration degrees, and with or without lymphatic metastasis. Conclusion:Blood hypercoagulability in the perioperative period was observed in patients with gastric cancer and was positively corre-lated with tumor stages, tumor infiltration degrees, and lymphatic metastasis. Dynamic monitoring of gastric cancer perioperative TEG can provide valuable information for clinical treatment, improve the safety of gastric cancer surgery, and reduce postoperative compli-cations associated with active clinical significance.