This study aims to explore whether Guzheng playing training has a positive impact on the brain functional state of children with Autism Spectrum Disorder (ASD) based on power spectral and sample entropy analyses. Eight ASD participants were selected to undergo four months of Guzheng playing training, with one month as a training cycle. Electroencephalogram (EEG) signals and behavioral data were collected for comparative analysis. The results showed that after Guzheng playing training, the relative power of the alpha band in the occipital lobe of ASD children increased, and the relative power of the theta band in the parietal lobe decreased. The differences compared with typically developing (TD) children were narrowed. Moreover, some channels exhibited a gradual increase or decrease in power with the extended training period. Meanwhile, the sample entropy parameter also showed a similar upward trend, which was consistent with the behavioral data representation. The study shows that Guzheng training can enhance the brain function of ASD patients, with better effects from longer training. Guzheng playing training could be used as a daily intervention for autism.
Humans ; Electroencephalography ; Entropy ; Music Therapy ; Child ; Brain/physiopathology* ; Autism Spectrum Disorder/therapy* ; Male ; Female ; Autistic Disorder/therapy*

Objective To explore the predictive value of thromboelastography(TEG)combined with ser-um D-dimer(D-D)and total bilirubin(TBIL)in the risk of postoperative deep vein thrombosis(DVT)in pa-tients with hip fracture.Methods A total of 120 patients with hip fracture who underwent surgical treatment in this hospital from January 2022 to January 2024 were retrospectively selected.According to the occurrence of postoperative DVT,the patients were divided into DVT group(n=34)and non-DVT group(n=86).The TEG parameters[coagulation reaction time(R),blood clot formation time(K),α angle and maximum ampli-tude of thrombus(MA)],D-D and TBIL levels were compared between the two groups before operation.Mul-tivariate Logistic regression was used to analyze the influencing factors of postoperative DVT in patients with hip fracture.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of TBIL,D-D and TEG parameters for postoperative DVT in patients with hip fracture.Results Compared with the non-DVT group,the TBIL level,R value and K value in the DVT group were significantly decreased,while the D-D level,α angle and MA value were significantly increased(P＜0.05).Multivariate Logistic regression anal-ysis showed that TBIL,D-D and TEG parameters were the influencing factors of postoperative DVT in pa-tients with hip fracture(P＜0.05).ROC curve results showed that the area under the curve of TBIL,D-D,TEG parameters combined to predict postoperative DVT in patients with hip fracture was 0.940,the sensitivi-ty was 82.4％,and the specificity was 93.0％.Conclusion TEG combined with D-D and TBIL levels have a high predictive value in postoperative DVT in patients with hip fracture,which can be used in the early evalua-tion of postoperative DVT in patients with hip fracture,and help to improve the prognosis of patients.

Objective To investigate lymphocyte interstitial infiltration condition and the changes of immune checkpoint gene expression in different stages of early esophageal cancer.Methods A ret-rospective analysis was conducted on the clinical data of 90 patients with early esophageal cancer.Based on the pathological depth of infiltration,they were divided into three types:T1a-M1,T1a-M2,and T1a-M3,with 30 cases in each type.Additionally,30 cases of paired normal mucosa tissues adja-cent to the cancer were selected.Hematoxylin-eosin(HE)staining was used to observe tissue morpholo-gy.Immunohistochemistry was employed to detect the expression of CD3,CD4,CD8,and CD20.Real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)was applied to measure the mRNA expression levels of immune checkpoint genes[programmed death ligand-1(PD-L1),cytotoxic T-lym-phocyte-associated protein 4(CTLA4),T-cell immunoglobulin and mucin domain-3(TIM-3),lympho-cyte activation gene 3(LAG3),programmed death receptor-1(PD-1),programmed death ligand-2(PD-L2),and T-cell immunoreceptor with Ig and ITIM domains protein(TIGIT)].Results As the stage of early esophageal cancer progressed,the ratio of tumor cells to lymphocytes increased.The number of CD3+T cells was greater than that of CD20+B cells,and the proportion of CD4+T cells among total T cells was higher than that of CD8+T cells(P＜0.001).The mRNA expression levels of gene in immune checkpoints in patients were elevated(P＜0.05).Compared with normal adja-cent tissues,the expression levels of PD-L1 mRNA,CTLA4 mRNA,TIM-3 mRNA,PD-1 mRNA,and TIGIT mRNA were elevated in patients with T1a-M1,T1a-M2,and T1a-M3 types(P＜0.05).Compared with normal adjacent tissues,the expression levels of LAG3 mRNA and PD-L2 mRNA were increased in patients with T1a-M2 and T1a-M3 types(P＜0.05).Conclusion The progres-sion of early esophageal cancer staging is correlated with increased immune checkpoint gene expres-sion and a decreased lymphocyte ratio,suggesting that changes in the immune microenvironment may be involved in tumor progression.

Objective To explore the risk factors of cardiomyopathy in patients with diabetes and their correlations with the levels of serum fork head box protein O1(FOXO1),growth differentiation factor 11(GDF11),and matrix metalloproteinase-3(MMP3).Methods 200 patients with diabetes complicated with cardiomyopathy and 200 patients with simple diabetes admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from September 2023 to April 2025 were selected to detect serum FOXO1,GDF11 and MMP3 levels,analyze their correlation with cardiac function parameters,screen risk factors through multifactor logistic regression,construct a nomogram model and a receiver operating characteristic(ROC)curve,and evaluate the diagnostic value.Results The duration of diabetes cardiomyopathy group≥10 years,the expression rate of reactive oxygen species(ROS)≥90%,the insulin resistance index and the levels of FOXO1 and MMP3 were significantly higher than those in the simple diabetes group(P<0.05),and the level of GDF11 was lower than that in the simple diabetes group(P<0.05).FOXO1 and MMP3 were positively correlated with E/e'and negatively correlated with LVEF and E/A;GDF11 was negatively correlated with E/e'and positively correlated with LVEF and E/A(P<0.05).The nomogram model showed that the weights of the influencing factors were GDF11,FOXO1,insulin resistance index,MMP3,ROS expression rate,and the course of diabetes.The model calibration was good(χ2=7.336,P=0.719).The combined diagnostic AUC of FOXO1,GDF11,and MMP3 was 0.950,which was better than that of a single indicator(P<0.05).Conclusion GDF11,FOXO1,Insulin resistance index,MMP3,ROS expression rate and the course of diabetes are risk factors for diabetes cardiomyopathy,and the combination of the three is of high diagnostic value.

With the implementation of the Healthy China Strategy, the value of care has become increasingly prominent. It has become an important nursing topic to strengthen the theoretical and practical research of nurse-patient communication, especially to understand the current state, and explore the essential characteristics, the influencing factors and the differences in interdisciplinary perspectives of nurse-patient communication. Through systematic analysis of 100 real clinical nurse-patient communication cases, this paper found that the problem of poor nurse-patient communication still existed widely, which is prominently manifested as the inhibition of communication willingness, the dislocation of communication topics and the lack of communication consensus. The causes of poor nurse-patient communication were nurses’ poor communication skills, negative emotional distress, the lack of humanistic literacy and insufficient energy investment in communication, as well as the patient’s fragile state, the limitation of knowledge and cultural level, and insufficient trust in nurses. The interdisciplinary perspective analysis of ethics, psychology and law is conducive to enriching and developing the theoretical basis and research methods of nurse-patient communication, and can also provide useful suggestions for improving nurse-patient communication in clinical.

Humans ; Adolescent ; Acne Vulgaris/therapy* ; Skin Care ; Surveys and Questionnaires ; Cognition ; China ; Skin

Objective To systematically evaluate the efficacy of β-blocker in pediatric patients with congestive heart failure and congenital heart disease,and to provide evidence for clinician.Methods Before-and-after self-control study and randomized controlled trials were retrieved from PubMed,EMbase,the Cochrane Library,CNKI,WanFang,VIP databases,and the search time was from the establishment of the database to October 31,2023.All outcomes included left ventricular ejection fraction(LVEF),left ventricular fraction shortening,LVFS),left ventricular end-diastolic dimension(LVDD),Left ventricular end-systolic dimension(LVSD),N-terminal proB brain natriuretic peptide(NT-proBNP),heart rate,blood pressure and cardiac function improvement.Results A total of 20 trials involving 1 068 children with heart failure(dilated cardiomyopathy and endocardial fibroelastosis were included.Meta-analysis results showed that the addition of β-blockers(metoprolol succinate,bisoprolol and carvedilol)on the basis of conventional drug therapy for heart failure had significant effects on LVEF[MD=13.06,95%CI(11.67,14.45),P<0.001],LVFS[MD=6.96,95%CI(6.54,7.37),P<0.001],LVDD[MD=-6.43,95%CI(-7.58,-5.28),P<0.001]and LVSD[MD=-8.30,95%CI(-8.83,-7.76),P<0.001]were significantly improved.In addition,blood pressure,heart rate,NT-proBNP and cardiac function could also be improved.Conclusion The combination regimen of β-blockers on the basis of conventional drug therapy for heart failure can improve cardiac function and symptoms of heart failure in children with congestive heart failure.Therefore,it is recommended that β-blockers should be actively used in the conventional treatment regimen for children with congestive heart failure.

Objective To assess inter-observer variations(IOV)in the delineation of target volumes and organs-at-risk(OAR)for intensity-modulated radiotherapy(IMRT)of nasopharyngeal carcinoma(NPC)among physicians from different levels of cancer centers,thereby providing a reference for quality control in multi-center clinical trials.Methods Twelve patients with NPC of different TMN stages were randomly selected.Three physicians from the same municipal cancer center manually delineated the target volume(GTVnx)and OAR for each patient.The manually modified and confirmed target volume(GTVnx)and OAR delineation structures by radiotherapy experts from the regional cancer center were used as the standard delineation.The absolute volume difference ratio(△V_diff),maximum/minimum volume ratio(MMR),coefficient of variation(CV),and Dice similarity coefficient(DSC)were used to compare the differences in organ delineation among physicians from different levels of cancer centers and among the 3 physicians from the same municipal cancer center.Furthermore,the IOV of GTVnx and OAR among physicians from different levels cancer centers were compared across different TMN stages.Results Significant differences in the delineation of GTVnx were observed among physicians from different levels of cancer centers.Among the 3 physicians,the maximum values of △V_diff,MMR,and CV were 97.23%±83.45%,2.19±0.75,and 0.31±0.14,respectively,with an average DSC of less than 0.7.Additionally,there were considerable differences in the delineation of small-volume OAR such as the left and right optic nerves,chiasm,and pituitary,with average MMR>2.8,CV>0.37,and DSC<0.51.However,relatively smaller differences were observed in the delineation of large-volume OAR such as the brainstem,spinal cord,left and right eyeballs,and left and right mandible,with average△V_diff<42%,MMR<1.55,and DSC>0.7.Compared with the differences among physicians from different levels cancer centers,the differences among the 3 physicians from the municipal cancer center were slightly reduced.Furthermore,there were also differences in the delineation of target volumes for NPC among physicians from different levels cancer centers,depending on the staging of the disease.Compared with the delineation of target volumes for earlier stage patients(stages I or II),the differences among physicians in the delineation of target volumes for advanced stage patients(stages III or IV)were smaller,with average △V_diff and DSC of 98.31%±67.36%vs 69.38%±72.61%(P<0.05)and 0.55±0.08 vs 0.72±0.12(P<0.05),respectively.Conclusion There are differences in the delineation of GTVnx and OAR in radiation therapy for NPC among physicians from different levels of cancer centers,especially in the delineation of target volume(GTVnx)and small-volume OAR for early-stage patients.To ensure the accuracy of multicenter clinical trials,it is recommended to provide unified training to physicians from different levels of cancer centers and review their delineation results to reduce the effect of differences on treatment outcomes.

Objective:To analyze the clinical, genetic mutation characteristics, and treatment prognosis of type 2A hereditary hemochromatosis (HH) in China.Methods:Peripheral blood samples and clinical data of patients with primary iron overload were collected through the China Registry of Genetic/Metabolic Liver Disease from June 2015 to November 2023. HH-related genes were detected by Sanger sequencing. Clinical characteristics and gene mutation characteristics of HH patients carrying HJV gene mutations were analyzed.Results:Among the 37 cases with primary iron overload, ten cases (27.0%, 10/37) had detectable HJV gene mutations, which included four homozygous mutations, five compound heterozygous mutations, and one monoheterozygous mutation. p.Q6H and p.C321X (80.0%, 8/10) were the most common mutated sites. The average age of onset was 30.7±14.7 years. The age of diagnosis was 35.7±16.2 years, with male-to-female ratio of 7:3. Ferritin and transferrin saturation were (5 267±905) ng/ml, and 94.3%±1.2%, respectively. Magnetic resonance imaging showed iron overload in the liver, pancreas, and myocardium. Liver biopsy showed diffuse iron deposition within hepatocytes. All ten cases had elevated transaminases; one case (1/10, 10.0%) had liver cirrhosis; four cases (4/10, 40.0%) had heart failure and arrhythmia; five cases (5/10, 50.0%) had diabetes; six cases (6/10, 60.0%) had hypogonadism; six cases (6/10, 60.0%) had skin pigmentation; and six cases (6/10, 60.0%) had fatigue symptoms. All six cases underwent bloodletting therapy, and ferritin levels dropped to about 100 ng/ml. Two cases of oral administration of the iron chelator deferasirox did not meet the ferritin level standard, and one case died from acute heart failure following a confirmed diagnosis during hospitalization.Conclusion:The HJV gene may be one of the main pathogenic genes of HH in China. The p.Q6H and p.C321X mutations were one of the hotspot mutations. The onset age of HJV gene-related HH was between 20 and 30 years old, and their condition was severe. Therefore, early bloodletting treatment can have a favorable outcome.

OBJECTIVE To explore the practicality of the pharmaceutical pathway for prophylactic use of antibiotics during the perioperative period of class Ⅰ neurosurgery incisions. METHODS The previously established pharmaceutical pathway for the prophylactic use of antibiotics in the perioperative period of class Ⅰ neurosurgery incisions was used to retrospectively evaluate the prophylactic use of antibiotics in 127 cases. The “antibiotics prophylactic use scoring system” in the pharmaceutical pathway was used to conduct preoperative scoring， and the patient’s actual antibiotics use was compared and analyzed in combination with existing Guiding Principles for Clinical Application of Antibiotics （2015 Edition） （hereinafter referred to as the Guiding Principles）. The pharmaceutical pathway also innovatively proposes key points for improvement in terms of the frequency of adding antibiotics during surgery and the duration of prophylactic use of antibiotics after surgery. By comparing with the actual medication situation of patients， the direction for updating the Guiding Principles was explored. RESULTS According to the retrospective analysis results， for neurosurgery class Ⅰ incision surgery， in addition to the preoperative prophylactic use of antibacterial drugs for skull mass resection and carotid endarterectomy recommended in the guidelines， endoscopic trigeminal microvascular decompression， arthroscopy and other specific joint examinations， spinal nerve Radical decompression， endoscopic lumbar nucleectomy， dural repair， and spinal canal decompression can also be further explored about the situation of not using antibacterial prophylaxis before surgery； at the same time， for the patients undergoing class Ⅰ neurosurgery incisions， the use of antibiotics during and after surgery may be considered for a second addition of antibiotics， taking into account the surgical time. If cerebrospinal fluid leakage occurred after surgery， it is recommended to extend the duration of prophylactic use of antibiotics appropriately. CONCLUSIONS The application of pharmaceutical pathways can provide more targeted analysis of key points in the prevention of antibiotic use， which promotes the transformation of perioperative antibiotics management for class Ⅰ incisions from “qualitative， empirical” management to “quantitative， scientific” management.