ObjectiveAutism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties with communication and social interaction, restricted and repetitive behaviors. Previous studies have indicated that individuals with ASD exhibit early and lifelong attention deficits, which are closely related to the core symptoms of ASD. Basic visual attention processes may provide a critical foundation for their social communication and interaction abilities. Therefore, this study explores the behavior of children with ASD in capturing attention to changes in topological properties. MethodsOur study recruited twenty-seven ASD children diagnosed by professional clinicians according to DSM-5 and twenty-eight typically developing (TD) age-matched controls. In an attention capture task, we recorded the saccadic behaviors of children with ASD and TD in response to topological change (TC) and non-topological change (nTC) stimuli. Saccadic reaction time (SRT), visual search time (VS), and first fixation dwell time (FFDT) were used as indicators of attentional bias. Pearson correlation tests between the clinical assessment scales and attentional bias were conducted. ResultsThis study found that TD children had significantly faster SRT (P<0.05) and VS (P<0.05) for the TC stimuli compared to the nTC stimuli, while the children with ASD did not exhibit significant differences in either measure (P>0.05). Additionally, ASD children demonstrated significantly less attention towards the TC targets (measured by FFDT), in comparison to TD children (P<0.05). Furthermore, ASD children exhibited a significant negative linear correlation between their attentional bias (measured by VS) and their scores on the compulsive subscale (P<0.05). ConclusionThe results suggest that children with ASD have difficulty shifting their attention to objects with topological changes during change detection. This atypical attention may affect the child’s cognitive and behavioral development, thereby impacting their social communication and interaction. In sum, our findings indicate that difficulties in attentional capture by TC may be a key feature of ASD.

Objective To clarify the differences in the effects of bupivacaine liposome and ropivacaine on quadratus lumborum block in patients undergoing laparoscopic total hysterectomy.Methods A total of 70 patients who underwent laparoscopic total hysterectomy at Suqian First People's Hospital Affiliated to Nanjing Medical University from January 2023 to October 2024 were selected as the research subjects.The patients were randomly divided into the control group and the observation group,with 35 cases in each group.Before general anesthesia,patients of the control group were given ropivacaine quadratus lumborum block,while patients of the observation group were given bupivacaine liposome quadratus lumborum block.The general conditions before and after operation,visual analogue scale(VAS)scores at different time points after operation,rescue analgesia,mini-mental state examination(MMSE)scores at different time points after operation,postoperative rehabilitation and analgesic adverse reactions were compared between the two groups.Results There was no statistically significant difference in the general conditions of patients in the two groups before and after the operation(P>0.05).At 24 hours,48 hours,and 72 hours after surgery,the abdominal resting VAS scores of patients in the observation group were significantly lower than those in the control group(P<0.05).The time of the first self-controlled use of the intravenous analgesic pump after surgery in the observation group was significantly later than that in the control group(P<0.05).The number of analgesic pump compressions and the rate of oxycodone rescue analgesia in the observation group were significantly fewer/lower than those in the control group within 48 hours after surgery(P<0.05).At 24 hours,48 hours,and 72 hours after surgery,the MMSE scores of patients in the observation group were significantly higher than those in the control group(P<0.05).The time for patients to get out of bed and move around after surgery and the recovery time of anal exhaust in the observation group were significantly earlier than those in the control group(P<0.05).There was no statistically significant difference in the incidence of postoperative analgesic adverse reactions between the two groups of patients(P>0.05).Conclusion Compared with the use of ropivacaine for quadratus lumborum block in patients undergoing laparoscopic total hysterectomy,bupivacaine liposome can provide a longer-lasting analgesic effect,reduce patients'dependence on intravenous analgesia,be conducive to protecting patients'cognitive function,accelerate the recovery of patients without increasing the incidence of adverse reactions.

Objective To examine the expression pattern of apoptosis signal-regulating kinase 1(ASK1)in the intestinal tissues of patients with Crohn's disease(CD),and analyze its mechanistic impact on intestinal epithelial barrier function and inflammatory responses.Methods Ileal tissue samples from Crohn's disease patients and healthy controls were collected.ASK1 protein level was assessed by immunohistochemistry,and its relationship with the Crohn's disease activity index(CDAI)was analyzed.A mouse model of acute colitis was constructed using TNBS,and subjected to qRT-PCR,Western blotting and immunohistochemistry for ASK1 expression,and the association between ASK1 expression and the disease activity index was examined.Lentivirus transfection was employed to create stable Caco-2 cell lines with altered ASK1 expression,and the intestinal barrier integrity and inflammation were assessed by measuring transepithelial electrical resistance(TEER),FITC-dextran leakage,and IL-6,IL-1β levels.Furthermore,the effects of ASK1 expression on Krüppel-like factor 4(KLF4)levels was examined using qRT-PCR and Western blotting.Results ASK1 was highly expressed in the ileum of CD patients and positively correlated with CDAI.In a TNBS-induced mouse model of acute colitis,ASK1 expression was up-regulated and positively correlated with DAI.Inflammation-induced ASK1 overexpression weakened the Caco-2 cell intestinal barrier,whereas ASK1 knockdown strengthened it.Moreover,ASK1 had the capability to enhance the expression of inflammatory factors.Additionally,ASK1 knockdown increased KLF4 expression,while overexpression decreased it,indicating a negative correlation between ASK1 and KLF4.Conclusion ASK1 expression is notably higher in CD and positively correlates with disease activity.ASK1 can influence intestinal barrier integrity and inflammatory factor expression,possibly through its impact on KLF4 expression.

In recent years, the rapid development of artificial intelligence (AI) has revolutionized the whole-course nutritional management of elderly patients. AI technologies, including machine learning and natural language processing, are capable of efficiently processing vast amounts of multidimensional information such as clinical data, laboratory test results, and imaging findings. For instance, machine learning algorithms can efficiently identify complex nutritional metabolism patterns and accurately predict malnutrition and its trends in elderly patients. Following the standard pathway of "screening, assessment, diagnosis, treatment, and monitoring", AI technology empowers the whole-course nutritional management for elderly patients, forming a refined, data-driven management model, and shows great potential in improving the nutritional status of elderly patients, enhancing treatment outcomes, and promoting elderly health.

Objective:To investigate the relationship between dynamic alterations in serum albumin (ALB) concentrations and clinical outcomes in hospitalized surgical patients, thus providing a basis for optimizing clinical management strategies.Methods:This study utilized data from a prospective observational cohort study on nutritional status among 7 122 elderly hospitalized patients across 34 tertiary hospitals in 18 Chinese cities. A total of 1 714 surgical patients hospitalized for 7-30 days with complete data were included. Standardized protocols were used to collect demographic data, clinical outcomes, and a range of laboratory results, including nutritional and hematological parameters. Heterogeneous effects of ALB on clinical outcomes were explored. Receiver operating characteristic (ROC) curves were used to determine cutoff values for infection-related complications. Correlation analyses and multiple linear regression models were used to identify independent predictors of the absolute change in ALB (?ALB).Results:Among the surgical patients, 69.7% (1 195/1 714) experienced a decline in ALB levels during their hospital stay, which was significantly associated with the occurrence of both infection- and non-infection-related complications. Simultaneously, a marked decrease in ALB was also significantly correlated with changes in nutritional and inflammatory status during hospitalization, worsening of gastrointestinal symptoms at discharge, and functional activity abnormalities (all P<0.05). ?ALB exhibited a close association with outcome variables such as infection-related complications. Based on the incidence of infection-related complications, a cutoff value for ALB was calculated, dividing patients into a high-risk group ( n=179) and a low-risk group ( n=1 535), and a statistically significant difference in the incidence of infection-related complications was found between these two groups ( P<0.05). Correlation analysis and multiple linear regression modeling revealed that female gender, a higher baseline ALB level, a poorer baseline inflammatory status, an exacerbation of inflammatory status, larger alterations in platelet-to-lymphocyte ratio, and the presence of infection-related complications were predictive factors for a decline in ALB levels among surgical patients during their hospital stay. Conclusions:?ALB serves as a critical indicator of the inflammatory-nutritional interplay, with its magnitude of decline effectively predicting clinical outcomes and nutritional status changes and guiding multidisciplinary interventions in surgical patients.

The high prevalence of frailty in older adults and its close link to adverse outcomes make it a critical public health challenge in the aging global population. Frailty, characterized by multisystem functional decline, significantly increases the risk of falls, disability, and even death, yet its underlying mechanisms remain poorly understood. While the role of gut microbiota as the "second genome" in disease regulation has been widely recognized, its specific mechanisms in the development of frailty syndrome remain to be systematically investigated. This review synthesizes findings from the last decade of international literature to analyze the mechanisms by which gut microbiota dysbiosis contributes to frailty syndrome. We focus on pathways including metabolic disorders, chronic inflammation, oxidative stress, and the oral-gut microbiota axis, aiming to provide insights for clinical diagnosis and treatment.

Objective To take text analysis of the mental health promotion policies for Chinese medical staff,and provide guidance for the optimization and improvement of subsequent policies.Methods Two-dimensional analysis framework composed of policy tools and two-factor theory were established,and external attribute analysis and content analysis of 19 mental health promotion policies issued by the central level were conducted.Among the policy text types,the most notifications,followed by opinions and the least work plan.A total of 368 policy codes were selected in the included policy texts.Among the 180 codes in the dimension of policy tool,authority,incentive,capacity building,guidance and organizational change accounted for 19.44％,15.56％,28.89％,31.11％and 5.00％respectively.Among the 188 codes in the two-factor theoretical dimension,health care factors and incentives accounted for 63.83％and 36.17％,respectively.There are rich types of policy tools for mental health promotion of Chinese staff workers,but they show an unbalanced state and pay less attention to the motivation of medical staff.

Objective:To verify the efficacy of VELscope autofluorescence examination technology in the early warning of potential oral malignant diseases.Methods:80 patients with suspected dysplasia were included and underwent oral examination,visually en-hanced lesion scope(VELscope)autofluorescence examination and histopathology examination respectively,the fluorescence imaging results were compared with the histopathological results.Results:Pathological reports showed 64 cases with mild or no dysplasia,9 cases with moderate or severe dysplasia,1 case with moderate dysplasia without malignant transformation and 6 cases with cancer.The results of VELscope showed that there were 73 positive cases and negative 7 cases of fluorescence deletion.The sensitivity and specificity of VELscope were 93.75％and 9.37％respectively,and the sensitivity could reach 100％in the cancerous tissue.Con-clusion:As a non-invasive examination method,VELscope is highly sensitive but lowly specific.

Objective To explore a nomogram model based on clinical characteristics and immune indicators for predicting the efficacy of tyrosine kinase inhibitor(TKI)against chronic myeloid leukemia(CML).Methods Clinical data was retrospectively collected from 100 patients with CML treated with TKI between January 2021 and January 2023 in Tangshan Gongren Hospital.Patients were divided into the best response and warning/treatment failure groups according to therapeutic efficacy.Factors affecting therapeutic efficacy were analyzed using logistic regression analysis,and a nomogram model was constructed.Results The best response and warning/treatment failure groups showed significant differences in red blood cell distribution width(RDW),platelet count(PLT),ELTS score,Th 1/CD4+,Treg/CD4+ratio,white blood cell count,and absolute value of natural killer cells(P＜0.05).Logistic regression confirmed that the above indicators were influencing factors(P＜0.05),indicating that the model was meaningful,and had a high goodness of fit as well as high predictive value.Conclusion The nomogram model constructed based on RDW,PLT,and other factors can effectively predict the thera-peutic efficacy of AKI in treating CML.

Objective:Invasive pulmonary mucormycosis(PM)is a rare but highly lethal opportunistic infection.COVID-19 associated mucormycosis(CAM)is difficult to diagnose,often leading to misdiagnosis or missed diagnosis,and has poor treatment outcomes.This study reports a case of successfully treated CAM and explores optimized diagnostic and therapeutic strategies.Methods:A retrospective analysis of the diagnosis and treatment process in a 50-year-old female patient with COVID-19 associated with diabetic ketoacidosis(DKA)and invasive pulmonary mucormycosis was conducted.Combined with a literature review,the therapeutic efficacy of local bronchoscopic instillation in conjunction with systemic treatment using liposomal Amphotericin B(L-AmB)was specifically evaluated.Results:The patient was rapidly diagnosed with Rhizopus microsporus infection through metagenomic next-generation sequencing(mNGS).She subsequently received antifungal treatment with intravenous L-AmB combined with local bronchoscopic instillation.After treatment,the patient was significantly improved,with imaging studies showing gradual absorption of the lesions.Follow-up at six months revealed no recurrence.A literature review suggests that early diagnosis and multimodal therapy are key to improving survival rates in patients with CAM.Conclusion:mNGS can significantly improve the early diagnosis rate of CAM.The combination of local and systemic treatment with L-AmB is valuable in improving prognosis.Early diagnosis,multimodal antifungal therapy,and individualized management are key to increasing the survival rate of patients with CAM.