Objective:To analyze the etiological characteristics of Clostridium ramosum DZS3717106 isolated from the blood of a patient with septic shock secondary to perianal abscess and the immunological characteristics of the patient. Methods:The isolate was subjected to morphological observation, mass spectrometry, antibiotic susceptibility testing, and 16S rRNA sequencing. Biochemical and cytological test results of the patient were collected. Flow cytometry was used to detect T cell subsets. Impacts of the virulence factors of the isolate on the host immune system were evaluated.Results:DZS3717106 was an anaerobic Clostridium with pleomorphic rod-shaped cells and spores. It was sensitive to penicillin G, piperacillin/tazobactam, and metronidazole, but resistant to clindamycin. It carried various virulence and resistance genes. The patient was immunocompromised with abnormal IL-6, IL-8, and IL-10 levels. Conclusions:Septic shock caused by Clostridium ramosum is rare, and more research is needed on the causes and epidemiology. DZS3717106 infection triggers over-activated inflammatory response in the patient, which may be closely related to the occurrence and development of septic shock.

Objective:To evaluate the efficacy and safety of modified endoscopic submucosal dissection (ESD) utilizing a mushroom extraction method for gastric ectopic pancreas.Methods:From June 1, 2009 to June 30, 2023, data of 190 patients (191 lesions) with pathologically confirmed heterotopic pancreas who underwent resection using modified ESD with mushroom extraction method in Shandong Second Provincial General Hospital ( n=99) and the 960th Hospital of the PLA Joint Logistics Support Force ( n=91) were retrospectively analyzed. The clinical characteristics and endoscopic and endoscopic ultrasonography (EUS) features were summarized and the treatment effects of the modified ESD was evaluated. The complications and follow-up recurrence were analyzed. Results:Preoperative EUS showed that most lesions originated from the submucosa and often involved multiple layers, invading the muscularis propria in 12 cases. A total of 191 gastric lesions included 174 in the gastric antrum, 2 pyloric canal, 6 gastric body, 7 gastric angle and 2 gastric fundus. The long diameter of the lesions ranged from 0.5-4.0 cm. All patients underwent modified ESD with the mushroom extraction method, and the complete removal rate of specimens was 99.5% (190/191). The operation time was 0.5-2.5 h. There were 10 cases of intraoperative perforation; 1 case of postoperative delayed perforation, 1 case of delayed hemorrhage, and 3 cases of short-term fever. Patients were followed up for 3-5 years after the operation, and no recurrence or metastasis was found.Conclusion:The modified ESD technique incorporating mushroom extraction proves to be a safe and effective approach for the complete removal of gastric ectopic pancreas, minimizing the risk of recurrence and residual pancreatic tissue.

Objective:To evaluate the efficacy and safety of modified endoscopic submucosal dissection (ESD) utilizing a mushroom extraction method for gastric ectopic pancreas.Methods:From June 1, 2009 to June 30, 2023, data of 190 patients (191 lesions) with pathologically confirmed heterotopic pancreas who underwent resection using modified ESD with mushroom extraction method in Shandong Second Provincial General Hospital ( n=99) and the 960th Hospital of the PLA Joint Logistics Support Force ( n=91) were retrospectively analyzed. The clinical characteristics and endoscopic and endoscopic ultrasonography (EUS) features were summarized and the treatment effects of the modified ESD was evaluated. The complications and follow-up recurrence were analyzed. Results:Preoperative EUS showed that most lesions originated from the submucosa and often involved multiple layers, invading the muscularis propria in 12 cases. A total of 191 gastric lesions included 174 in the gastric antrum, 2 pyloric canal, 6 gastric body, 7 gastric angle and 2 gastric fundus. The long diameter of the lesions ranged from 0.5-4.0 cm. All patients underwent modified ESD with the mushroom extraction method, and the complete removal rate of specimens was 99.5% (190/191). The operation time was 0.5-2.5 h. There were 10 cases of intraoperative perforation; 1 case of postoperative delayed perforation, 1 case of delayed hemorrhage, and 3 cases of short-term fever. Patients were followed up for 3-5 years after the operation, and no recurrence or metastasis was found.Conclusion:The modified ESD technique incorporating mushroom extraction proves to be a safe and effective approach for the complete removal of gastric ectopic pancreas, minimizing the risk of recurrence and residual pancreatic tissue.

Objective:To analyze the etiological characteristics of Clostridium ramosum DZS3717106 isolated from the blood of a patient with septic shock secondary to perianal abscess and the immunological characteristics of the patient. Methods:The isolate was subjected to morphological observation, mass spectrometry, antibiotic susceptibility testing, and 16S rRNA sequencing. Biochemical and cytological test results of the patient were collected. Flow cytometry was used to detect T cell subsets. Impacts of the virulence factors of the isolate on the host immune system were evaluated.Results:DZS3717106 was an anaerobic Clostridium with pleomorphic rod-shaped cells and spores. It was sensitive to penicillin G, piperacillin/tazobactam, and metronidazole, but resistant to clindamycin. It carried various virulence and resistance genes. The patient was immunocompromised with abnormal IL-6, IL-8, and IL-10 levels. Conclusions:Septic shock caused by Clostridium ramosum is rare, and more research is needed on the causes and epidemiology. DZS3717106 infection triggers over-activated inflammatory response in the patient, which may be closely related to the occurrence and development of septic shock.

Objective To explore the effect of head acupuncturing therapy combined with massaging key head acupoints on language and cognitive function in children with autism.Methods 60 children with autism who visited the Department of Pediatric Rehabilitation of our hospital from January 2021 to June 2022 were selected as subjects,who were then randomly divided into the conventional group treated with the conventional rehabilitation training and the combination group treated with head acupuncturing therapy combined with massaging the key acu-points,apart from conventional rehabilitation training 30 cases in each group.The cognitive function,developmental status,and parental quality of life before and after the treatment were compared between the two groups,and so were the language function and safety.Results There were no significant differences in the scores by Autism Behavior Checklist(ABC)and Childhood Autism Rating Scale(CARS),adaptability scores,language scores,and individual-social interaction scores between the conventional group and the combination group before the treatment(P>0.05).After the treatment,the scores by ABC and CARS were significantly decreased in both groups,and the scores of the combination group were significantly lower than those in the conventional group(P<0.05);The adaptability scores,language,individual-social interaction scores were significantly increased in both groups,and the scores of the combined group were significantly higher than those of the conventional group(P<0.05).The abnormal rates of symbolic expression,language comprehension,action-oriented subjects,and language development delay in the combined group were all significantly lower than those in the conventional group(P<0.05).There was no significant difference in the scores by the QL-Index between the conventional group and the combined group before the treatment(P>0.05),but after the treatment,the QL-Index scores of the conventional group and the combination group were increased,and the score of the combination group was significantly higher than that of the conventional group(P<0.05).The results of blood routine,urine routine,stool routine,liver function,and kidney function in both groups were not significantly abnormal.There was one case of mild swelling and pain at the acupunctured site in the combination group,which was improved without intervention.Conclusion Head acupuncturing therapy combined with massaging the key head acupoints can improve language function,cognitive function,and development of autis-tic children.In addition,it can enhance parental quality of life and have a high level of safety.

Objective:To explore the eye movement characteristics of gaze following in children with autism spectrum disorder (ASD) guided by three cues: non-sociality (arrow), high level sociality (eye) and low level sociality (head turning).Methods:Total of 23 ASD children with a developmental age of 2-3 years old and 23 typical development (TD) children with a physiological age of 2-3 years old were included from April to October 2022. The children were guided to follow gaze with three types of cues, namely arrow, eye and head turning, and the eye tracking features were collected with the Tobbi Pro X3-120 eye tracker. SPSS 17.0 was used to analyze the data. A generalized linear model was used to analyze the differences of different score (DS), time to first fixation( TFF), first fixation duration(FFD) and total fixation duration (TFD) between the two groups.Results:(1) The interaction of DS between the groups and cue types was significant (χ 2=11.22, P<0.01), the main effect of groups was significant (χ 2=3.95, P<0.05), and the main effect of cue types was significant (χ 2=31.43, P<0.001). Further simple effect analysis showed that under eye contact conditions, the DS of the ASD group was lower than that of the TD group ( P<0.001). There was no statistically significant difference between the two groups under arrow conditions and head turning conditions (both P>0.05). The DS of the ASD group under eye contact conditions was lower than those under arrow and head turning conditions (both P<0.05), and the DS under arrow conditions was lower than that under head turning conditions ( P<0.001). (2)The interaction of TFF between the groups and the cue type was not significant (χ 2=5.53, P>0.05), and the main effect of groups was not significant (χ 2=3.04, P>0.05). The main effect of cue type was not significant (χ 2=3.19, P>0.05). (3)The interaction of FFD between the groups and cue types was not significant (χ 2=0.29, P>0.05), and the main effect of groups was not significant (χ 2=0.66, P>0.05). The main effect of cue types was not significant (χ 2=3.93, P>0.05). (4)The interaction of TFD between the groups and cue types was not significant (χ 2=2.33, P>0.05). The main effect of groups was significant (χ 2=18.35, P<0.001), and the TFD of the ASD group (1.30 (0.91, 1.58)s) was lower than that of the TD group (1.59(1.31, 1.72)s). The main effect of cue types was significant (χ 2=32.22, P<0.001), and the TFD under arrow condition (1.18 (0.85, 1.40)s) was lower than that under eye contact condition (1.61 (1.29, 1.73)s) and head turning condition (1.62 (1.18, 1.74)s) ( P<0.05). There was no statistically significant difference in TFD under eye contact and head turning conditions (both P>0.05). Conclusion:Under the guidance of non-social and low-level social stimuli, children with ASD exhibit gaze following abilities comparable to TD children when communication development is age matched. Under the guidance of high-level social stimuli, children with ASD have poorer gaze following ability, manifested as lower accuracy in responding to cues. The level of social information in cues is an important factor affecting the gaze following ability of children with ASD.

Objective:To discuss the executive function (EF) characteristics of preschool aged male children diagnosed as high-functioning autism (HFA), and to compare the EF differences between HFA and typically developing (TD) children.Methods:Twenty-six preschool male HFA children aged 4-5 years old and chronological age and gender matched TD children were recruited respectively. Parent questionnaire behavior rating scale of executive function-preschool version (BRIEF-P) and executive function battery EF-TOUCH were adopted to explore the EF characteristics and the differences between the two groups. SPSS 22.0 software was used for statistical analysis, including descriptive statistics, χ2 test, t-test and Mann-Whitney U test. Results:EF-TOUCH results demonstrated significant differences with correct proportions of inhibition tasks (Arrow, Pig, silly sounds game (SSG)), working memory task (pick the picture (PTP)) and cognitive flexibility task (something′s the same (STS)) between groups (Arrow: Z=-2.278, P=0.023; Pig: Z=-2.599, P=0.009; SSG: Z=-1.985, P=0.047; PTP: t=2.635, P=0.011; STS: Z=-3.556, P=0.000). The accuracy rate in HFA group were significantly lower than TD group (HFA group: Arrow: 0.76 (0.57, 0.92), Pig: 0.95 (0.90, 1.00), SSG: 0.85 (0.57, 0.94), PTP: 0.74±0.11, STS: 0.77 (0.62, 0.90); TD group: Arrow: 0.92 (0.78, 0.95), Pig: 1.00 (0.98, 1.00), SSG: 0.94 (0.82, 1.00), PTP: 0.81±0.09, STS: 0.93 (0.82, 0.97)). Reaction time(RT) of Pig task was longer in HFA group than TD group (HFA: (1 624.29±234.33)ms; TD: (1 481.39±220.78)ms, t=-2.263, P=0.028). RTs of Arrow and SSG for both groups were not significantly different ( P>0.05). Children of HFA group exhibited worse inhibition and working memory(WM) than TD children in BRIEF-P(inhibition: HFA group (60.73±10.47), TD group (54.73±6.87); WM: HFA group (68.04±11.51), TD group (61.69±8.44))( t=-2.443, P=0.018; t=-2.267, P=0.028 respectively). No significant differences were found in the rest factors and domains for both groups (all P>0.05). Conclusions:Apparent inhibition control, working memory and cognitive flexibility deficiencies were found in preschool aged male HFA children. There are significant EF differences between preschool aged male HFA and typically developing children.

Objective To explore the difference of serum oxytocin levels between autistic children and healthy children at the age of 3-5,and the relationship between serum oxytocin levels and social competence in children with autism.Methods Twenty-five autistic children and twenty healthy children were tested by an enzyme-linked immunosorbent assay to evaluate the oxytocin levels;the SRS was used to evaluate social competence of children with autism.Results Mann-Whitney test showed there were significantly differences in oxytocin level between autistic children and healthy children(P<0.05).The social competence of autistic children was negatively correlated to oxytocin levels(r=-0.735,P<0.01).Multiple liner regression analyses showed that oxytocin level was an impact factor of the social competence of autistic children(F=11.931,P<0.01).Conclusion This study indicates that the serum oxytocin level maybe a factor which influence the social competence of autistic children.