Objective To investigate the sleep status in children with autism spectrum disorder (ASD) and its relationship with executive function and neurodevelopment. Methods The medical records of 346 children with ASD in the hospital from April 2023 to January 2025 were retrospectively collected. The sleep status of children was investigated by Children’ s Sleep Habits Questionnaire (CSHQ). According to the score, the children were divided into good sleep group (CSHQ score<41 points, 189 cases) and sleep disorder group (CSHQ score≥41 points, 157 cases). The general data were compared between groups of children. Chinese version of Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P) and developmental behavior assessment scale of children aged 0-6 years (Children's psychological scale-II) were used to analyze the relationship between sleep status and executive function and neurodevelopment in children with ASD. Results The CSHQ score of 346 children was (39.08±3.24) points, including 157 cases with CSHQ score≥41 points and 189 cases with CSHQ score<41 points. The proportion of severe previous medical history and executive function score in sleep disorder group were significantly higher than those in good sleep group, and the evaluation result of developmental quotient was lower than that in good sleep group (P<0.05). Logistic regression analysis showed that executive ability and neurodevelopment were closely related to sleep status in children with ASD (P<0.05). Spearman correlation analysis showed that sleep status in children with ASD was negatively correlated with executive function (r=-0.456, P<0.05), and was positively correlated with the developmental quotient (r=0.547, P<0.05). Conclusion The incidence rate of sleep disorder is high in children with ASD, and sleep status is closely related to executive function and neurodevelopment. Clinically, it is necessary to pay attention to the sleep problems in children with ASD, and take effective intervention measures to improve the sleep quality of children and promote the training of executive function and neurodevelopment.

Objective To investigate the changes in eosinophil counts and the activation of microglial cells in the brain tissues of mice at different stages of Angiostrongylus cantonensis infection, and to examine the role of microglia in regulating the progression of angiostrongyliasis and unravel the possible molecular mechanisms. Methods Fifty BALB/c mice were randomly divided into the control group and the 7-d, 14-d, 21-day and 25-d infection groups, of 10 mice in each group. All mice in infection groups were infected with 30 stage III A. cantonensis larvae by gavage, and animals in the control group was given an equal amount of physiological saline. Five mice were collected from each of infection groups on days 7, 14, 21 d and 25 d post-infection, and 5 mice were collected from the control group on the day of oral gavage. The general and focal functional impairment was scored using the Clark scoring method to assess the degree of mouse neurological impairment. Five mice from each of infection groups were sacrificed on days 7, 14, 21 d and 25 d post-infection, and 5 mice from the control group were sacrificed on the day of oral gavage. Mouse brain tissues were sampled, and the pathological changes of brain tissues were dynamically observed using hematoxylin and eosin (HE) staining. Immunofluorescence staining with eosinophilic cationic protein (ECP) and ionized calcium binding adaptor molecule 1 (Iba1) was used to assess the degree of eosinophil infiltration and the counts of microglial cells in mouse brain tissues in each group, and the morphological parameters of microglial cells (skeleton analysis and fractal analysis) were quantified by using Image J software to determine the morphological changes of microglial cells. In addition, the expression of M1 microglia markers Fcγ receptor III (Fcgr3), Fcγ receptor IIb (Fcgr2b) and CD86 antigen (Cd86), M2 microglia markers Arginase 1 (Arg1), macrophage mannose receptor C-type 1 (Mrc1), chitinase-like 3 (Chil3), and phagocytosis genes myeloid cell triggering receptor expressed on myeloid cells 2 (Trem2), CD68 antigen (Cd68), and apolipoprotein E (Apoe) was quantified using real-time quantitative reverse transcription PCR (RT-qPCR) assay in the mouse cerebral cortex of mice post-infection. Results A large number of A. cantonensis larvae were seen on the mouse meninges surface post-infection, and many neuronal nuclei were crumpled and deeply stained, with a large number of bleeding points in the meninges. The median Clark scores of mouse general functional impairment were 0 (interquartile range, 0), 0 (interquartile range, 0.5), 6 (interquartile range, 1.0), 14 (interquartile range, 8.5) points and 20 (interquartile range, 9.0) points in the control group and the 7-d, 14-d, 21-d and 25-d groups, respectively (H = 22.45, P < 0.01), and the median Clark scores of mouse focal functional impairment were 0 (interquartile range, 0), 2 (interquartile range, 2.5), 7 (interquartile range, 3.0), 18 (interquartile range, 5.0) points and 25 (interquartile range, 6.5) points in the control group and the 7-d, 14-d, 21-d and 25-d groups, respectively (H = 22.72, P < 0.01). The mean scores of mice general and focal functional impairment were all higher in the infection groups than in the control group (all P values < 0.05). Immunofluorescence staining showed a significant difference in the eosinophil counts in mouse brain tissues among the five groups (F = 40.05, P < 0.000 1), and the eosinophil counts were significantly higher in mouse brain tissues in the 14-d (3.08 ± 0.78) and 21-d infection groups (5.97 ± 1.37) than in the control group (1.00 ± 0.28) (both P values < 0.05). Semi-quantitative analysis of microglia immunofluorescence showed a significant difference in the counts of microglial cells among the five groups (F = 17.66, P < 0.000 1), and higher Iba1 levels were detected in mouse brain tissues in 14-d (5.75 ± 1.28), 21-d (6.23 ± 1.89) and 25-d infection groups (3.70 ± 1.30) than in the control group (1.00 ± 0.30) (all P values < 0.05). Skeleton and fractal analyses showed that the branch length [(162.04 ± 34.10) μm vs. (395.37 ± 64.11) μm; t = 5.566, P < 0.05] and fractal dimension of microglial cells (1.30 ± 0.01 vs. 1.41 ± 0.03; t = 5.266, P < 0.05) were reduced in mouse brain tissues in the 21-d infection group relative to the control group. In addition, there were significant differences among the 5 groups in terms of M1 and M2 microglia markers Fcgr3 (F = 48.34, P < 0.05), Fcgr2b (F = 55.46, P < 0.05), Cd86 (F = 24.44, P < 0.05), Arg1 (F = 31.18, P < 0.05), Mrc1 (F = 15.42, P < 0.05) and Chil3 (F = 24.41, P < 0.05), as well as phagocytosis markers Trem2 (F = 21.19, P < 0.05), Cd68 (F = 43.95, P < 0.05) and Apoe (F = 7.12, P < 0.05) in mice brain tissues. Conclusions A. cantonensis infections may induce severe pathological injuries in mouse brain tissues that are characterized by massive eosinophil infiltration and persistent activation of microglia cells, thereby resulting in progressive deterioration of neurological functions.

Objective:To analyze the clinical characteristics and cytokines expression characteristics in infants with mild and severe respiratory syncytial virus (RSV) infection.Methods:From May 2023 to December 2023, plasma samples and clinical information were collected from 16 infants with RSV infection and 14 control infants. Cytek Aurora flow cytometry (Cytek, America) and Enzyme linked immunosorbent assay (ELISA) were used to detect the expression levels of 25 cytokines after mild and severe RSV infection.Results:Cough and nasal obstruction were the main clinical manifestations in infants with mild RSV infection, accompanied by polypnea, wheezing and other symptoms. The main symptoms of severe RSV infection were cough and rales, accompanied by fever and polypnea. In comparison with the control group, the expression levels of IL-2, IL-4, IL-5, IL-6, IL-9, IL-13, IL-22, TNF-α, IFN-α, IFN-β, MIP-1β, I-TAC, ENA-78, GROα, Eotaxin, and MCP-1 in the RSV infection group all exhibited an upregulation trend. Both IP-10 and MIP-3α demonstrated a downward trend in the RSV infection group; however, there was no statistically significant difference ( P>0.05). The levels of IL-10, IFN-γ, MIP-1α, and IL-8 in the RSV infection group were significantly higher than those in the control group, whereas the levels of MIG, TARC, and RANTES in the RSV infection group were significantly lower than those in the control group ( P<0.05). The levels of IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-13, IL-22, IFN-β, IFN-γ, TNF-α, IL-8, I-TAC, MIP-1β, Eotaxin, and MCP-1 in the mild RSV infection group were significantly higher than those in the severe RSV infection group ( P>0.05). Among these, the levels of MIG, RANTES, TARC, MIP-3α, and ENA-78 in the mild infection group were all lower than those in the severe infection group. The expressions of ENA-78 and MIP-1α in the severe infection group were significantly higher than those in the mild infection group and also higher than those in the control group. There was no significant difference in IP-10 and GROα between the mild and severe RSV infection groups ( P>0.05). Conclusions:The differences in clinical features and cytokines between infants with mild and severe RSV infection provide important data support for the prevention and treatment of RSV infection in infants.

Objective:To observe the changes of retinal and choroidal blood flow density and thickness in macula of different myopic dioptre eyes, and to analyze the correlation between retinal and choroidal blood flow density and axial length (AL).Methods:A retrospective clinical study. From October 2022 to May 2023, 86 eyes of 56 myopic patients scheduled for refractive surgery in Department of Ophthalmology, PLA Central Theater CommandGeneral were included into the study. According to the equivalent spherical specular degree (SE), 19, 21, 27 and 19 eyes of low myopia group (group A), moderate myopia group (group B), high myopia group (group C) and super high myopia group (group D) were observed. Optical coherence tomography angiography (OCTA) and AL measurement were performed in all patients. The diopter was expressed in SE. AL was measured by ultrasonic bio-meter. OCTA scanner was used to scan the macular region in the range of 3 mm × 3 mm. The software automatically divided the macular region into two concentric circles with the fovea as the center, which were 1 mm in diameter respectively, the paracentric fovea of 1-3 mm was divided into 5 regions: superior, nasal, inferior and temporal. The superficial capillary plexus (SCP), deep capillary plexus (DCP), choroidal capillary plexus (CC), choroidal blood flow density, retinal and choroidal thickness were measured. The correlation between AL and blood flow density and thickness was analyzed by Pearson correlation analysis.Results:There was no significant difference in SCP blood density and DCP blood density in the fovea in groups A, B, C and D ( P>0.05) .There were significant differences in DCP flow density among superior, nasal, inferior and temporal areas ( P<0.05), the difference was significant ( P<0.05). There was no significant difference in the fovea area between the four groups ( P>0.05), but there was significant difference in the superior, nasal, inferior and temporal areas ( P<0.05). Different macular regions: there were statistically significant among group A, group B, and group C, group D ( P<0.05). Results of correlation analysis, AL was negatively correlated with DCP blood flow density ( r=-0.504, -0.500, -0.460, -0.465), retinal thickness ( r=-0.348, -0.338, -0.312, -0.230), macular subarea CC ( r=-0.633, -0.666, -0.667, -0.710, -6.82), choroidal layer ( r=-0.635, -0.687, -0.659, -0.703, -0.680) and choroidal thickness ( r=-0.665, -0.605, -0.656, -0.648,-0.643) ( P<0.05). Conclusions:AL is negatively correlated with DCP, CC, CDF, retinal and choroidal thickness in the eyes with myopia. SCP, DCP and retinal thickness in fovea did not change significantly, and temporal choroidal thickness changed earlier than other areas.

This study investigates the clinical differentiation and treatment strategies for bipolar disorder （BD） by analyzing the relationship of its core pathomechanisms including qi stagnation， blood stasis， phlegm turbidity， and heat constraint with bile acid metabolism. The imbalance of "yin in form and yang in function" leads to qi stagnation， blood stasis， phlegm turbidity， and heat constraint， which are critical in the pathogenesis and progression of BD. Bile acids regulate neuroinflammation， neural plasticity， and intestinal flora homeostasis through receptor-mediated pathways. It is believed that the physiological functions of bile acids concretely embody the concept of the "liver is yin in form and yang in function" theory. Clinically， prescriptions such as Sini Powder （四逆散） with the function of venting pathogen and resolving constraint， Wendan Decoction （温胆汤） of drying dampness and resolving phlegm， Longdan Xiegan Decoction （龙胆泻肝汤） of clearing liver and draining fire， and Huanglian Ejiao Decoction （黄连阿胶汤） of nourishing yin and blood can be used to nourish liver yin and restore liver yang function. These strategies may improve BD prognosis by modulating bile acid synthesis and metabolism.

Objective To compare the application values of the Ranson score,Bedside Index for Severity in Acute Pancreatitis(BISAP),CT Severity Index(CTSI)and Oxford Acute Severity of Illness Score(OA-SIS)in forecasting the new onset organ failure in the patients with severe acute pancreatitis(SAP).Methods The study was a retrospective analysis.A total of 126 cases of SAP receiving by the intensive care unit(ICU)and emergency ICU(EICU)of the Second Affiliated Hospital of Chongqing Medical University from January 2015 to June 2023 served as the study subjects.The clinical data of the patients were collected.The first time OASIS score,Ranson score,BISAP score and CTSI score were calculated within 48 h after the patients ente-ring ICU.The new onset organ failure served as the clinical outcome.The random forest and least absolute shrinkage and selection operator(LASSO)regression were used to screen the risk factors for new onset organ failure.The multivariate logistic regression was adopted to analyze the correlation between the four scoring systems and new onset organ failure in the SAP patients.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were adopted to analyze the predictive efficiency of 4 kinds of scoring sys-tems.Results The age in the organ failure group was higher than that in the non-organ failure group(P=0.039).The OASIS,Ranson,BISAP and CTSI scores in the organ failure group all were higher than those in the non-organ failure group(P＜0.05).The random forest and LASSO regression analysis results showed that Lac,Cr and myoglobin were the most important variables affecting the new onset organ failure in SAP pa-tients.The OASIS score(OR=1.27,95％CI:1.06-1.51,P=0.009)and Ranson score(OR=1.88,95％CI:1.03-3.43,P=0.040)were the independent influencing factors for predicting the new onset organ fail-ure in SAP patients.The ROC curve results showed that the area under the curve(AUC)of the OASIS score was the highest(AUC=0.830,95％CI:0.743-0.916).Conclusion The OASIS score is an independent risk factor for predicting the new onset organ failure in SAP patients,moreover has the highest predictive efficiency in predicting the new onset organ failure.

Objective To explore the role of Schlafen4(SLFN4)in acute pneumonia induced by hypervirulent Klebsiella pneumoniae(hvKp)via intratracheal aerosolization.Methods Differential expression gene Slfn4 was identified after infection with hvKp based on RNA sequencing(RNA-seq)and single-cell RNA sequencing(scRNA-seq)data before Slfn4-/-mice were obtained via CRISPR/Cas gene editing technology.Slfn4-/-mice and wild mice were challenged via intratracheal aerosolization.Mortality and weight changes were recorded for 14 d,while pathological changes and expression levels of interleukin-6(IL-6),IL-17A,IL-1β,and tumor necrosis factor-α(TNF-α)were detected at 48 h post-infection.Results SLFN4 expression was significantly increased in wild mice after infection with hvKp.Survival was significantly increased,and weight loss was mitigated before gradual recovery in Slfn4-/-mice after infection.The knockout of SLFN4 attenuated alveolar wall thickening,diminished neutrophil infiltration,and suppressed pro-inflammatory cytokine production(IL-6,IL-17A,IL-1β,TNF-α)in the lung at 48 h post-infection.Conclusion The deletion of SLFN4 may suppress the expression of specific pro-inflammatory cytokines and attenuate neutrophil over-recruitment in the lung,thereby alleviating pneumonia in mice after hvKp infection.

Objective To assess the intervention effect of nicotinamide mononucleotide (NMN) on the mouse model of hematotoxicity induced by subacute benzene exposure. Methods Benzene exposure and NMN intervention were adopted in a 2×2 factorial design, as benzene exposure and non-exposure, and NMN intervention and non-intervention. Male specific pathogen-free C57BL/6J mice were randomly assigned to negative control group, NMN control group, simple benzene exposure group and NMN intervention group, with 12 mice in each group. Benzene exposure of mice in simple benzene exposure group and NMN intervention group was conducted by dynamic inhalation of benzene at a concentration of 325 mg/m³ for six hours per day, five days per week for four weeks (28 days). Mice in the negative control and NMN control group inhaled clean air. During benzene exposure, mice in the NMN control group and NMN intervention group received NMN in drinking water at a dose of 300 mg/kg body weight. Peripheral blood samples of mice were collected for complete blood count analysis and calculation of composite inflammatory indices after 28 days. Results Interaction analysis showed that the counts of peripheral white blood cell, neutrophil, lymphocyte, and platelet of mice in the simple benzene exposure group were lower than those in the negative control group (all P<0.05). Neutrophil and platelet counts in the NMN intervention group were higher than those in the simple benzene exposure group (all P<0.05). The results of main effect analysis showed that the monocyte count of peripheral blood, systemic inflammatory index, systemic inflammatory response index, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio of mice in the benzene exposure group increased (all P<0.05), and the basophil count and lymphocyte/monocyte ratio decreased (all P<0.05), compared with the control group. Conclusion Oral NMN alleviates subacute benzene-induced decreases in peripheral neutrophil and platelet counts in mice. This protective effect may be related to the targeted intervention of NMN on mitochondrial energy metabolism disorder and oxidative damage induced by benzene exposure in male mice.

Objective To assess the clinical efficacy of intravitreal anti-vascular endothelial growth factor(VEGF)agents plus panretinal photocoagulation(PRP)for treating young and middle-aged patients with proliferative diabetic reti-nopathy(PDR).Methods A retrospective case study was conducted on young and middle-aged PDR patients presenting to the Ophthalmology Department of Shaanxi Provincial People's Hospital between January 1,2021 and October 1,2024.The patients were divided into three groups according to Chinese Clinical Guidelines for Diabetic Retinopathy(2022):se-vere non-proliferative diabetic retinopathy(NPDR),early proliferative diabetic retinopathy(E-PDR)and fibrous prolifera-tive diabetic retinopathy(F-PDR).A total of 53 patients(94 eyes)were included in this study,and the mean age was(41.66±10.24)year old.There were 17 cases(31 eyes)in the NPDR group,18 cases(33 eyes)in the E-PDR group,and 18 cases(30 eyes)in the F-PDR group.All the patients were treated with the intravitreal injection of anti-VEGF agents(0.5 mg ranibizumab)about 3.5 mm from the sclerocorneal limbus at the inferior temporal sector,once a month,for three consecutive months.Routine PRP treatment was given 1 week after the first injection.Best-corrected visual acuity[BCVA(logMAR)],intraocular pressure,slit-lamp,slit-lamp fundus,optos fundus photography and OCT examinations were per-formed.The central macular thickness(CMT),average macular thickness(AMT),and the incidence of diabetic vitreous hemorrhage and emerging epiretinal membrane were recorded 1 month and 3 months after the first injection.Results Pa-tients in the F-PDR group were younger than those in NPDR and E-PDR groups(all P＜0.05).The BCVA values of eyes in all the three groups increased to varying degrees after 3 months of treatment,compared with those before treatment(all P＜0.05).The eyes in the F-PDR group had poorer vision than those in NPDR and E-PDR groups after 3 months of treat-ment(all P＜0.05).CMT and AMT decreased in all groups after 3 months of treatment,compared with those before treat-ment(all P＜0.05).No significant difference was found in CMT and AMT among the three groups at the same period(all P＞0.05).Eyes in the F-PDR group had higher risk of diabetic vitreous hemorrhage and emerging epiretinal membrane than those in NPDR and E-PDR groups 3 months after treatment(all P＜0.05).Conclusion Intravitreal anti-VEGF therapy combined with PRP can effectively slow the progression of PDR and improve vision acuity in young and middle-aged pa-tients.PDR patients with fibrovascular proliferation are at higher risk of diabetic vitreous hemorrhage and emerging epireti-nal membrane during the treatment with intravitreal anti-VEGF therapy plus PRP.These patients need a close follow-up,and vitrectomy should be performed in a timely manner to relieve vitreous traction when necessary.

Objective To improve the diagnosis and treatment of Streptococcus liver abscesses by analyzing the clinical presentations,antibiotic susceptibility,and treatment strategies of patients.Methods A retrospective analysis was conducted on 21 patients diagnosed with liver abscess caused by Streptococcus from June 2012 to June 2022.The data included demographic information,clinical characteristics,laboratory tests,imaging findings,treatment strategies,and outcomes.Results The 21 patients were 29 to 77 years of age,and 81.0％were male.Clinical manifestations included fever,chills,fatigue,and abdominal pain.Some patients also had headache and altered consciousness,indicating possible concomitant brain abscess.Hematogenous dissemination and biliary tract origin were the most common routes of infection.The predominant pathogen was Streptococcus anginosus group(76.2％).Single pathogen infection was found in 12 cases and mixed infection in 9 cases.All isolates were sensitive to penicillin,cefotaxime,vancomycin,and levofloxacin,but 36.4％(4/11)of the isolates showed resistance to erythromycin and clindamycin.Four patients developed metastatic abscesses,and two experienced septic shock.The main treatment approach was a combination of antibiotics and percutaneous liver puncture drainage,resulting in improvement in 18 patients.Conclusions Liver abscesses caused by Streptococcus are usually non-specific in terms of symptoms.Streptococcus anginosus group is the primary pathogen.Antibiotics combined with percutaneous drainage is an effective treatment approach.It is crucial for clinicians to be aware of potential brain abscesses and the necessity of early intervention.