Objective:To explore the effect of personalized training based on early start Denver model (ESDM) combined with applied behavior analysis (ABA) in children with autism spectrum disorder (ASD) .Methods:From January 2021 to January 2023, convenience sampling was used to select 90 children with ASD who received treatment at the Shaoxing Seventh People's Hospital and their caregivers as research subjects. The children were divided into two groups using a random number table method in a 1∶1 ratio. The control group received routine rehabilitation, while the observation group was treated with personalized training based on ESDM combined with ABA. Both groups were intervened for six months. Children's Autism Rating Scale (CARS), Autism Behavior Checklist (ABC), Gesell Developmental Schedule (GDS), Sign-Significate Relation (S-S) Language Development Delay Assessment, Social Life Ability Scale for Infant-Junior Middle School Students (S-M), and Modified Barthel Index (MBI) were used to evaluated the effects of intervention on two groups of ASD children before and after intervention.Results:After six months of intervention, the CARS and ABC scores of ASD children in the observation group were lower than those in the control group, and the scores of GDS dimensions and total developmental quotient, S-S Language Development Delay Assessment score, S-M score, and MBI score were higher than those in the control group, and the differences were statistically significant (all P<0.05) . Conclusions:Personalized training based on ESDM combined with ABA has a good effect, which can improve loneliness symptoms of children with ASD, alleviate cognitive, language, and behavioral dysfunction, enhance social adaptation ability and activities of daily living.

The Danggui Yinzi, as one of the classic prescriptions, was first recorded in Yan's Jisheng Prescription and is mainly used to treat various skin diseases with blood deficiency and wind dryness. By referring to ancient books and modern literature researches, this study analyzed and summarized the literature of Danggui Yinzi from the aspects of prescription origin, composition, addition and subtractive changes of flavor, dosage and decocting and taking method, discrimination of prescription and efficacy, raw material and processing of medicinal materials, and modern clinical application. Textual researches explored more than 80 ancient literature and 170 modern literature and showed its content included Angelicae Sinensis Radix, Paeoniae Radix Alba, Chuanxiong Rhizoma, Rehmannia Radix, Tribuli Fructus, Saposhnikoviae Radix, Schizonepetae Spica, Polygoni Multiflora Radix, Astragali Radix, Glycyrrhizae Radix et Rhizoma. It was cooked by water. It was used for the patients with skin diseases and Chinese pattern of blood deficiency wind drying. It has showed a wide range of applications, and similar application in ancient and modern time. This paper provides a more comprehensive reference for the research and development of compound preparation of Danggui Yinzi.

Objective:To investigate the clinical efficacy of radical resection of rectal cancer with different surgical approaches and influencing factors of postoperative complications.Methods:The retrospective study was conducted. The clinicopathological data of 3 418 patients who underwent radical resection of rectal cancer in the Second Affiliated Hospital of Harbin Medical University from July 2011 to September 2020 were collected. There were 2 060 males and 1 358 females, aged (61±11)years. Patients meeting the requirements of radical resection and surgical indications underwent surgeries choosing from open radical colorectal cancer surgery, laparoscopic radical colorectal cancer surgery, and natural orifice specimen extraction surgery (NOSES). Observation indicators: (1) intraoperative and postoperative conditions of patients undergoing different surgical approaches; (2) comparison of preoperative clinical characteristics in patients undergoing different surgical approaches; (3) comparison of postoperative histopathological characteristics in patients undergoing different surgical approaches; (4) postoperative complications of patients undergoing different surgical approaches; (5) analysis of influencing factors of postoperative complications. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M(range), and comparisons between groups was analyzed using the Kruskal-Wallis rank test. Comparison of ordinal data was analyzed using the non-parameter rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Multivariate analysis was conducted using the Logistic regression model. Results:(1) Intraoperative and postoperative conditions of patients undergoing different surgical approaches. Of the 3 418 patients, 1 978 cases underwent open radical colorectal cancer sur-gery, 1 028 cases underwent laparoscopic radical colorectal cancer surgery and 412 cases underwent NOSES, respectively. The operation time, volume of intraoperative blood loss, cases with permanent stoma, preventive stoma or without fistula, time to postoperative first flatus, time to postoperative liquid food intake, cases transferred to intensive care unit after surgery, duration of postoperative hospital stay were 145(range, 55?460)minutes, 100(range, 30?1 000)mL, 435, 88, 1 455, 72(range, 10?220)hours, 96(range, 16?296)hours, 158, 10(range, 6?60)days, respectively, in patients undergoing open radical colorectal cancer surgery. The above indicators were 175(range, 80?450)minutes, 50(range, 10?800)mL, 172, 112, 744, 48(range, 14?120)hours, 72(range, 38?140)hours, 17, 9(range, 4?40)days, respectively, in patients undergoing laparoscopic radical colorectal cancer surgery and 180(range, 80?400)minutes, 30(range, 5?500)mL, 0, 45, 367, 48 (range, 14?144)hours, 72(range, 15?148)hours, 1, 6(range, 3?30)days, respectively, in patients undergoing NOSES. There were significant differences in the above indicators among the patients undergoing different surgical approaches ( H=291.38, 518.56, χ2=153.82, H=408.86, 282.97, χ2=78.66, H=332.30, P<0.05). (2) Com-parison of preoperative clinical characteristics in patients undergoing different surgical approaches. The gender, age, body mass index, cases with diabetes, cases with hypertension, cases with coronary heart disease, cases with anemia, cases with hypoproteinemia, cases with intestinal obstruction, tumor location, preoperative carcinoembryonic antigen, preoperative CA19-9 showed significant differences among patients undergoing open radical colorectal cancer surgery, laparoscopic radical colorectal cancer surgery and NOSES ( P<0.05). (3) Comparison of postoperative histopathological characteris-tics in patients undergoing different surgical approaches. Tumor histological type, tumor differentiation degree, tumor diameter, number of lymph node detected, nerve invasion, vascular invasion, lymph node invasion, tumor T staging, tumor N staging, tumor M staging, tumor TNM staging showed significant differences among patients undergoing open radical colorectal cancer surgery, laparos-copic radical colorectal cancer surgery and NOSES ( P<0.05). (4) Postoperative complications of patients undergoing different surgical approaches. Cases with postoperative complications as anastomotic leakage, abdominal infection, intestinal obstruction, anastomotic bleeding, incision complications, pulmonary infection, other complications were 52, 21, 309, 8, 130, 51, 59, respectively, in patients undergoing open radical colorectal cancer surgery. The above indicators were 33, 17, 75, 3, 45, 58, 9, respectively, in patients undergoing laparoscopic radical colorectal cancer surgery and 13, 4, 8, 0, 11, 10, 15, respectively, in patients undergoing NOSES. There were significant differences in the intes-tinal obstruction, incision complications, pulmonary infection, other complications among patients undergoing different surgical approaches ( χ2=122.56, 13.33, 20.44, 15.59, P<0.05) and there was no significant difference in the anastomotic leakage, abdominal infection, anastomotic bleeding among patients undergoing different surgical approaches ( χ2=0.96, 2.21, 3.08, P>0.05). (5) Analysis of influencing factors of postoperative complications. ① Analysis of influencing factors of intestinal obstruction in patients with radical resection of rectal cancer. Age as 20?39 years and 40?59 years, surgical approach as laparoscopic radical colorectal cancer surgery and NOSES were independent protective factors of intestinal obstruction in patients with radical resection of rectal cancer ( odds ratio=0.46, 0.59, 0.43, 0.13, 95% confidence interval as 0.21?1.00, 0.36?0.96, 0.33?0.56, 0.06?0.27, P<0.05). ② Analysis of influencing factors of incision complications in patients with radical resection of rectal cancer. Body mass index as 24.0?26.9 kg/m 2, surgical approach as laparoscopic radical colorectal cancer surgery and NOSES were independent protective factors of incision complications in patients with radical resection of rectal cancer ( odds ratio=0.24, 0.63, 0.46, 95% confidence interval as 0.11?0.51, 0.44?0.89, 0.24?0.87, P<0.05). ③ Analysis of influencing factors of pulmonary infection in patients with radical resection of rectal cancer. The surgical approach as laparoscopic radical colorectal cancer surgery was an independent risk factor of pulmonary infection in patients with radical resection of rectal cancer ( odds ratio=2.15, 95% confidence interval as 1.46?3.18, P<0.05), and tumor TNM staging as 0?Ⅰ stage was an independent protective factor ( odds ratio=0.10, 95% confidence interval as 0.01?0.88, P<0.05). ④ Analysis of influencing factors of other complica-tions in patients with radical resection of rectal cancer. Age as 20?39 years, 40?59 years, 60?79 years, body mass index as <18.5 kg/m 2, 18.5?23.9 kg/m 2, 24.0?26.9 kg/m 2, 27.0?29.9 kg/m 2, surgical approach as laparoscopic radical colorectal cancer surgery were independent protective factors of other complications in patients with radical resection of rectal cancer ( odds ratio=0.10, 0.29, 0.37, 0.08, 0.22, 0.35, 0.32, 0.29, 95% confidence interval as 0.01?0.81, 0.13?0.64, 0.17?0.78, 0.02?0.40, 0.09?0.52, 0.15?0.83, 0.12?0.89, 0.14?0.59, P<0.05). Conclusions:Compared to laparoscopic radical colorectal cancer surgery and NOSES, open radical colorectal cancer surgery has wide indication and short operation time, but less perioperative treatment effect. Laparoscopic radical colorectal cancer surgery and NOSES can achieve better surgical result and less postoperative complication when patients meeting surgical indications.

Objective:To investigate the drug resistance of Yersinia pestis to 11 kinds of antibiotics in the natural foci of plague in Inner Mongolia Autonomous Region, and to provide a theoretical basis for scientifically and effectively selecting antibiotics for treatment of the plague. Methods:A total of 137 strains of Yersinia pestis isolated from the natural foci of plague in Inner Mongolia Autonomous Region at different times, regions, hosts and vectors were collected. According to Clinical and Laboratory Standard Institute (CLSI), the agar plate dilution method was used to determine the minimum inhibitory concentration (MIC) of the 11 kinds of antibiotics against 137 strains of Yersinia pestis, including ofloxacin, ciprofloxacin, kanamycin, streptomycin, ceftriaxone, ampicillin, chloramphenicol, spectinomycin, cefuroxime, tetracycline and sulfamethoxazole-trimethoprim. The MIC 50 and MIC 90 (the minimum concentration of drug which could inhibit 50% and 90% of bacterial growth) were calculated, and their sensitivity was determined according to CLSI standards. Results:Among 137 strains of Yersinia pestis tested, no strains of Yersinia pestis had single or multiple resistance to ofloxacin, ciprofloxacin, kanamycin, streptomycin, ceftriaxone, ampicillin, chloramphenicol, spectinomycin, cefuroxime, tetracycline and sulfamethoxazole-trimethoprim. According to CLSI standards, 137 strains of Yersinia pestis were all sensitive to the 11 kinds of antibiotics; among them, ofloxacin, ciprofloxacin, ceftriaxone and sulfamethoxazole-trimethoprim had higher antibacterial activity, with MIC 90 < 0.250 μg/ ml; the antibacterial activity of spectinomycin was the lowest, with MIC 90 of 16.000 μg/ml. Conclusions:The Yersinia pestis isolated from the natural foci of plague in Inner Mongolia Autonomous Region is not found to have single or multiple resistance to the 11 kinds of antibiotics. Continuous drug resistance monitoring of Yersinia pestis should be carried out to provide a basis for clinical medication.

Objective In order to acquaint with the prevalence of Tibetan sheep plague in this area, we conducted a serum epidemiological investigation of Tibetan sheep plague in Qinghai Province. Methods Indirect hemagglutination assay (IHA) and colloidal gold immunochromatography (GICA) were applied to test serum samples of Tibetan sheep and whole blood samples from jugular vein of Tibetan sheep were collected in 8 Prefectures of Qinghai Province from 2013 to 2016. Results A total of 86 positive Tibetan sheep serum samples with plague F1 antibody were detected by both methods, and the positive rate was 0.68％ (86/12710), the samples collected in Xinghai County Hainan Prefecture had the highest positive rate, which was 5.20％ (27/519). The Haixi Prefecture and Yushu Prefecture were historical epidemic areas, the positive rates were 0.65％(15/2313) and 0.26％(6/2293), respectively. Hainan Prefecture, Guoluo Prefacture and Huangnan Prefecture were newly confirmed epidemic areas, the positive rates were 1.61％ (28/1741), 1.01％ (15/1481), and 1.44％(19/1316), respectively. The antibody titers were 1:20 to 1:5120, the samples collected in Maqin County Guoluo Prefecture had the highest titer, namely 1 :5120. Conclusions In Qinghai Province, Tibetan sheep plague is endemic, and there are outbreaks in some regions. So we have to enhance the Tibetan sheep plague monitoring especially in Marmot plague epidemic area.

Objective To understand the epidemic trend of Tibetan sheep plague in Guoluo Prefecture,Qinghai Province,we detected the plague F1 antibody in Tibetan sheep serum in this area.Methods Indirect hemagglutination test (IHA) and colloidal gold immunochromatography (GICA) were applied to test serum samples of Tibetan sheep which were separated from 5 ml whole blood drew from jugular vein in Maqin County,Maduo County,Gande County,Banma County,Jiuzhi County and Dari County in 2014 and 2015.Results We collected 1 481 serum samples,566 from Maqin County,315 from Maduo County,150 from Gande County,150 from Banma County,150 from Jiuzhi County and 150 from Dari County.Totally 14 serum samples showed F1 antibody positive,the positive rate was 0.95％ (14/1 481),and they were all from Maqin County.Conclusions This area has the prevalence of Tibetan sheep plague.Therefore,the monitoring work of Tibetan sheep plague should be strengthened.

Objective To evaluate the mechanism of external branch of the superior laryngeal nerve (EBSLN) injury during thyroid surgery as showed by intraoperative neuromonitoring.Methods 70 patients with 109 nerves at risk were enrolled in this study from March 2011 to October 2011.A positive signal is determined by observing contractions of the cricothyroid muscle.The relationship between EBSLN and the upper pole of the thyroid or the inferior constrictor muscle was studied.Results 108 nerves (99.1％) were located successfully,42 of which were visualized (38.9％).55 nerves (50.9％) crossed the superior thyroid artery more than 1 cm apart,while the other 53 nerves (49.1％) went less than 1 cm including 24 nerves(more than 0.5 cm,less than 1 cm) and 29 nerves (less than 0.5 cm) or coursed below the superior pole of the thyroid.The rate of the latter type was significantly elevated in patients with the top to botton diameter of the gland more than 5 cm.One patient suffered from impairing in the production of high tones postoperatively.Conclusions Intraoperative neuromonitoring is useful and helpful in providing instructive information for operations by locating EBSLN.

In order to get more pulse diagram valuable information, we summarized the traditional acceleration in the pulse chart based on the calculation of a new high-precision calculation of the acceleration pulse graph algorithms, being suitable for a large amount of data to adapt to requirements of high-resolution digital pulse diagram analysis, optimizing the acceleration pulse mapping process, reducing the impact of noise on data analysis, and improving the ability to distinguish details of the image. In addition, we used the spectrum analysis diagram for high-precision acceleration pulse. By doing so, we overcomed the traditional acceleration noise in the pulse data as the large loss, we found flat pulse, slippery pulse, taut pulse acceleration spectrum of feature points in the new Chinese medical traditional pulses. We then were able to recognize the pulse diagram calculated at the acceleration level to identify the frequency domain.
Algorithms ; Equipment Design ; Humans ; Medicine, Chinese Traditional ; instrumentation ; methods ; Pulse

ObjectiveTo evaluate the intraoperative neuromonitoring of the external branch of the superior laryngeal nerve (EBSLN) during Micooli's endoscopic thyroidectomy in order to avoid nerve injury.MethodsIn this study,36 patients with 56 nerves at risk were enrolled from February 2011 to September 2011.A positive signal is determined by observing contractions of the cricothyroid muscle to locate the EBSLN.The relationship between EBSLN and the upper pole of the thyroid or the inferior constrictor muscle was studied.The VHI-10 table was used for evaluation pre- and postoperatively. ResultsAll 56 nerves were located successfully,26 nerves(46.4％ ) crossed the superior thyroid artery more than 1 cm apart from the upper pole of the thyroid gland,while the other 30 nerves(53.6％ ) did less than 1 cm.In cases where the diameter was longer than 5 cm,the nerves crossed the artery at less than 1.0 cm from the upper pole in 73％ cases(P =0.006).There was no significant difference between VHI-10 results before and after surgery (P ＞ 0.05). ConclusionsIntraoperative neuromonitoring is useful and helpful in avoiding nerve injury by locating EBSLN.

ObjectiveTo rapidly detect the mutation frequency of DBC2 gene 7776C ＞ T in breast cancer and breast fibroadenoma by applying the mutation-sensitive molecular switch ( comprised of high-fidelity DNA polymerase and phosphorothioate-modified allele-specific primers) and agarose gel electrophoresis.Methods Allelic specific primers targeting mutation type and wild type were designed with the primers'3'terminal phosphorothioate modification.When the primers matched with the tissue DNA,the primers could be extended with highfidelity polymerase; when they mismatched with the tissue DNA,the primers could not be extended.DNA samples from 85 cases of breast cancer and 10 cases of breast fibroadenoma tissues were chosen and analyzed by PCR amplifications mediated by high-fidelity DNA polymerase.Gel imaging system was employed to make analysis of PCT products.ResultsThe mutation-sensitive molecular switch system showed that the mutation rate of 7776C ＞ T was 2.4％ ( 2/85 ) in the 85 cases of breast cancer,and no mutation was found in the 10 cases of breast fibroadenoma.ConclusionsThe mutation-sensitive molecular switch combined with agarose gel electrophoresis can rapidly detect the mutation of breast cancer DBC2 gene 7776C ＞ T.It is applicable in single nucleotide polymorphisms assay and has enormous application value in detecting gene mutation.