Objective:To evaluate the knowledge of autism among child health care professionals in primary health care institutions.Methods:The study was a cross-sectional survey. An online questionnaire survey was conducted from February to March 2023 in primary health care institutions in Guangzhou to investigate the knowledge on autism among medical staff engaged in children′s health services and the influencing factors.Results:A total of 341 questionnaires were returned and 312 questionnaires were valid with a recovery rate of 91.5%. The age of 312 respondents was (35.9±7.9) years, of which 303 (97.1%) were female. One hundred and fifty-two (48.7%) child health care professionals in primary health care institutions had received specialist training in assessing the psychological and behavioral development of children, and only 139 (44.6%) reported that they were aware of the"five no"principle for early identification of autism. The questionnaire scores were 88.1% pass (275/312) and 53.2% excellent (166/312). The three questions with low accuracy were: autism can be cured with drugs, autism has a genetic basis and rehabilitation training has no effect, and the accuracy for these questions was 42.6% (133/312), 52.2% (163/312) and 70.2% (219/312), respectively. The passing of autism-related knowledge was positively associated with receiving relevant training ( OR=2.585, 95% CI:1.200-5.569), and the excellence was positively associated with the highest education ( OR=1.939, 95% CI:1.220-3.083) and receiving relevant training ( OR=2.016, 95% CI:1.247-3.260). Conclusions:There is a need for more professional training in autism knowledge among child health care professionals in primary health care institutions.

ObjectiveTo investigate the mechanism of neferine（Nef） in promoting vascular regeneration against cerebral ischemia through modulation of mitochondrial calcium uniporter（MCU） ion channel. MethodTaking the area of subintestinal vessels in microvascular deficiency zebrafish as an index， the vascular regenerative efficacy of Nef was evaluated， and the median effective concentration（EC₅₀） was calculated. Rats were randomly divided into a sham operation group， a model group， a positive drug group（butylphthalide， 6 mg·kg^-1）， and Nef low， medium， and high dose groups（0.125， 0.625， 3.125 μg·kg^-1）. Except for the sham operation group， the middle cerebral artery occlusion（MCAO） model was established in other groups. After modeling， the groups were administered the corresponding dose of drugs by gavage， while the sham operation and model groups received equal volumes of saline， once a day for 7 consecutive days. Neurobehavioral scores were assessed for each group of rats， and the infarct rate of ischemic brain tissue was calculated by 2，3，5-triphenyltetrazolium chloride（TTC） staining. The regional cerebral blood flow（rCBF） of each group was measured using a speckle contrast imaging. Immunofluorescence and Western blot were conducted to detect the expression of vascular endothelial growth factor（VEGF）， platelet endothelial cell adhesion molecule-1（CD31）， and hypoxia-inducible factor-1α（HIF-1α） proteins in each group. Human umbilical vein endothelial cells（HUVECs） were divided into the normal group， model group， positive drug group（astragaloside Ⅳ， 10 μmol·L^-1）， and Nef group （32 nmol·L^-1）. In the verification of mitochondrial protection of Nef and its mechanism in promoting vascular regeneration， the spermine（MCU agonist） and Nef+spermine group were added. HUVECs model of oxygen-glucose deprivation（OGD） was established in all groups except the normal group， the cell viability was assessed using 3-（4，5-dimethylthiazol-2-yl）-2，5-diphenyltetrazolium bromide（MTT） assay， and cell migration ability was evaluated through scratch and tube formation assays. Fluorescent probes（Rhod-2 AM， Fluo-3 AM， JC-1， Calcein AM） and a cellular energy metabolism analyzer were used to analyze the mitochondrial protective effects of Nef. Molecular docking was performed to predict the binding ability of Nef with MCU and HIF-1α， and Western blot was used to detect the effects of Nef on the protein expressions of MCU， B-cell lymphoma-2 associated X protein（Bax）， Caspase-3 and HIF-1α in the OGD model HUVECs. ResultThe results of vascular regeneration in microvascular deficiency zebrafish showed that compared to the normal group， the area of subintestinal vessels in the model group significantly decreased（P<0.01）. Compared to the model group， different concentrations of Nef could significantly increase the area of subintestinal vessels（P<0.01）， with the maximum tolerated concentration of 10.24 μmol·L^-1 and the EC₅₀ of 0.23 μmol·L^-1. Anti-cerebral ischemia results on MCAO rats showed that compared to the sham operation group， the model group had a significant decrease in rCBF and a significant increase in infarct rate， while CD31 expression significantly decreased（P<0.01）， and VEGF and HIF-1α protein expressions significantly increased（P<0.05）. Compared to the model group， the treated groups showed significant increases in rCBF， significant reductions in infarct volume， and significant increases in CD31， VEGF， and HIF-1α protein expression（P<0.01）. Cell experiment results showed that compared to the normal group， the model group had decreased cell viability and migration ability， increased intracellular Ca²⁺ and mitochondrial Ca²⁺ levels， reduced mitochondrial permeability transition pore（MPTP） opening， and decreased mitochondrial energy metabolism capability， with increased expressions of MCU， Bax， Caspase-3 and HIF-1α proteins（P<0.05， P<0.01）. Compared to the model group， the Nef group showed increased cell viability and migration ability， decreased intracellular Ca²⁺ and mitochondrial Ca²⁺ levels， increased MPTP opening， enhanced mitochondrial energy metabolism capability， decreased expressions of MCU， Bax and Caspase-3 proteins， and increased HIF-1α protein expression（P<0.05， P<0.01）. ConclusionNef can stabilize mitochondrial membrane potential and inhibit mitochondrial apoptosis. By down-regulating the expression of MCU， it suppresses the activation of intracellular Bax and Caspase-3 while activating the HIF-1α signaling pathway， enhancing the expression of VEGF and CD31， thereby promoting vascular regeneration to treat ischemic brain injury.

OBJECTIVE To evaluate the post-marketing safety of Compound porcine cerebroside and ganglioside injection in patients with ischemic stroke. METHODS A drug-induced， prospective， non-controlled clinical study design was conducted. Using the patients with ischemic stroke who received Compound porcine cerebroside and ganglioside injection at least once in 46 secondary class A and above medical institutions across the country from April 2020 to May 2021 as the monitoring objects， and their basic data， medication information and the occurrence of adverse drug reactions were analyzed. RESULTS Among 13 514 patients with ischemic stroke， the incidence of adverse events was 10.01%， and the incidence of adverse reactions related to Compound porcine cerebroside and ganglioside injection was 0.33%. Drug-related adverse drug reactions were mild or moderate， concentrated in the gastrointestinal system （18 cases）， skin and subcutaneous tissue （10 cases）， nervous system （7 cases） and other systems/organs， mainly including constipation， abdominal pain， diarrhea， rash， pruritus， dizziness and other symptoms. Most of the patients （91.03%） recovered or improved after treatment， and 2 patients died. Among the 45 patients with adverse drug reactions， 84.44% were cured or improved after drug withdrawal or symptomatic treatment， and 15.56% had no significant change. The incidence of adverse drug reactions in tertiary hospitals was significantly higher than that in secondary hospitals， and the incidence of adverse drug reactions in patients with allergic history was significantly higher than that in patients without allergic history （P＜0.05）. Irrational drug use was found in 2.76% of patients， and the incidence of adverse drug reactions（2.95%） was significantly higher than that in patients without irrational drug use（0.26%，P＜0.05）. CONCLUSIONS The adverse drug reaction symptoms of ischemic stroke patients treated with Compound porcine cerebroside and ganglioside injection are relatively common， the incidence rate is generally low， and it is related to the patients’ physique and whether the drug use is standardized.

Objective:To explore the intervention effect of acceptance and commitment therapy on the psychological flexibility, self-compassion, anxiety and depression of the primary caregivers of patients with primary liver cancer, so as to provide reference for the clinical care of the primary caregivers of cancer patients.Methods:This was a prospective study. A total of 80 primary caregivers of patients with primary liver cancer treated in Tianyou Hospital Affiliated to Wuhan University of Science and Technology from July to December 2021 were selected as the observation objects, and they were randomly divided into the control group and the intervention group according to the random drawing method, with 40 cases in each group. The control group was given routine nursing measures, while the intervention group was given acceptance and commitment therapy on the basis of routine nursing. The intervention effect was evaluated by the Acceptance and Action Questionnaire-2nd Edition (AAQ-Ⅱ), Self-Compassion Scale Short-Form (SCS-SF) and Hospital Anxiety and Depression Scale (HADS) before the intervention, on the day of discharge, and one month after discharge.Results:Finally, 71 primary caregivers completed the intervention and follow-up, 36 in the control group and 35 in the intervention group. Before the intervention, there was no statistically significant difference in the scores of AAQ-Ⅱ, SCS-SF, Anxiety subscale of HADS(HADS-A) and Depression subscale of HADS(HADS-D) between the two groups ( P>0.05). The AAQ-Ⅱscores of the intervention group on the day of discharge and one month after discharge were (19.63±2.59), (19.12 ± 2.20) points, which were significantly lower than those of the control group (23.14 ± 2.49), (22.56 ± 2.40) points. The differences were statistically significant ( t=5.83, 6.25, both P<0.01). The SCS-SF scores of the intervention group on the day of discharge and one month after discharge were (39.34 ± 2.68), (39.89 ± 2.81) points, which were significantly higher than those of the control group (36.69 ± 3.08), (37.72 ± 2.41) points, the differences were statistically significant ( t=-3.86, -3.49, both P<0.01). The HADS-A/HADS-D scores of the intervention group on the day of discharge and one month after discharge were (9.31 ± 1.95), (9.09 ± 1.60) points and (8.80 ± 2.15), (8.54 ± 1.75) points,which were significantly lower than those of the control group(11.42 ± 1.50), (11.03 ± 1.70) points and (10.11 ± 1.92), (10.03 ± 1.84) points, the differences were statistically significant( t values were 2.71-5.10, all P<0.01). The scores of AAQ-Ⅱ, SCS-SF, HADS-A and HADS-D of the two groups were analyzed by repeated measures analysis of variance, and there were significant differences in time effect, inter-group effect and interaction effect ( F vaules were 3.42-37.90, all P<0.05). Conclusions:Acceptance and commitment therapy can improve the self-compassion and psychological flexibility, reduce anxiety and depression of the primary caregivers of patients with primary liver cancer.

As an industrial chemical， bisphenol A is widely used in various food packaging materials. However， it is an endocrine disrupting chemical， which has estrogen activity and can cause certain damage to humans. So far， there are few studies on the detection of bisphenol A in self-heating food packaging materials， and there remains a lack of relevant standard. Therefore， it is necessary to establish a simple， sensitive and efficient method for the detection of bisphenol A in self-heating food. This study briefly introduces the pretreatment methods of bisphenol A， such as ultrasonic extraction， solid phase extraction， accelerated solvent extraction， and detection methods， such as gas chromatography-mass spectrometry， high performance liquid chromatography， fluorescent detection， and electrochemical detection.

Objective: To investigate the association between lifestyle risk factors and comorbidity of chronic diseases among male elderly populations in Oroqen Autonomous Banner, Inner Mongolia Autonomous Region, so as to provide insights into improvements of lifestyles and prevention of comorbidity of chronic diseases among male elderly populations. Methods: Male residents at ages of 65 years and older that participated in community healthy examinations were sampled from 16 villages (communities) in Oroqen Autonomous Banner using a multi-stage cluster random sampling method from July to December, 2020. Participants' demographic data, lifestyle risk factors and disease history were collected using questionnaire surveys, and healthy examinations data were collected through the grassroots healthcare service information system for community health service centers, including waist circumference, blood pressure, fasting blood glucose and blood lipid. The correlation between lifestyle risk factors and comorbidity of chronic diseases were examined among males at ages of 65 years and older using a multivariable ordered logistic regression model. Results: Totally 761 male elderly populations were included, with a mean age of (73.61±6.74) years. There were 216 participants with central obesity (28.38%), 179 with smoking (23.52%), 194 with alcohol consumption (25.49%), 412 with a low frequency of physical activities (54.14%), 347 with one type of lifestyle risk factor (45.60%) and 268 with two and more types of lifestyle risk factors (35.22%), 404 with hypertension, 170 with diabetes and 321 with dyslipidemia. There were 347 participants with one type of chronic disease (45.60%), 199 with two types of chronic diseases (26.15%) and 50 with three types of chronic diseases (6.57%), and the prevalence of comorbidity of chronic diseases was 32.72% among the participants. Multivariable ordered logistic regression analysis showed an increased risk of developing comorbidity of chronic diseases among participants with central obesity (OR=2.442, 95%CI: 1.804-3.307), and a reduced risk of comorbidity of chronic diseases among participants with less than two types of lifestyle risk factors (one type, OR=0.607, 95%CI: 0.451-0.820; none, OR=0.675, 95%CI: 0.460-0.990). Conclusions Central obesity and number of lifestyle risk factors are factors affecting comorbidity of chronic diseases among the male elderly populations at ages of 65 years and older in Oroqen Autonomous Banner.

Objective: To carry out the 4^th round of third-party evaluation on the implementation and effect of the 1^st year of the 2^nd Phase National Healthcare Improvement Initiative(abbreviated as Initiative)since 2015. Methods: The 4^th round of the evaluation survey adopted the same methods, organization and execution, and technical roadmap as the former three rounds of evaluations. Results: The 4^th round of evaluation was carried out from 18 March to 9 April, 2019 at 185 public hospitals in 31 provinces(autonomous regions, municipalities directly under the Central Government)and Xinjiang Production and Construction Corps.Facility survey, health professional survey and patient survey were conducted at each of the sample health facilities. A total of 120 782 valid questionnaires were collected from 144 non-psychiatric health facilities, 16 246 valid questionnaires were obtained from 41 psychiatric health facilities, and 252 cases of outstanding departments/hospitals in healthcare improvement were also collected. The average overall scoring of the 12 dimensions to assess Initiative implementation at 144 non-psychiatric health facilities was 84.4%. The overall outpatient satisfaction scoring was 91.1%, 96.7%for the inpatients. The overall inpatient satisfaction(family members inclusive) at 41 psychiatric health facilities was 93%. Areas remaining to be improved include day-surgery, telemedicine and medical social work. Compared with technical services, non-technical care should be further strengthened. The compensation, workload and work environment of the healthcare providers are still to be improved. Conclusions The implementation of the Initiative by health facilities has been greatly improved. The percentage of health facilities and patients who had positive perceptions of improved doctor-patient relationship has been increasing. Patient care experiences at public hospitals have been generally improved, and the implementation of promoting traditional Chinese Medicine practices also made progress. However, work satisfaction of healthcare providers was found to be rather low, compared to the high level of patient satisfaction.

Objective To observe different hypoglycemic treatments on glucagon-like peptide-1 (GLP-1) and its correlation with β cells function in newly diagnosed type 2 diabetes mellitus (T2DM).Methods A total of 76 patients with newly diagnosed T2DM were randomly divided into insulin aspart 30 group and oral drugs group.OGTT test were measured at 0,30,120 min,the serum levels of GLP-1 and corresponding C peptide,and insulin levels were measured,HOMA insulin secretion and insulin resistance index were calculated.Then 30 healthy cases were as the control group,GLP-1 levels were analyzed,and the changes of the index were compared.Results At each time point,blood glucose and glucose area under the curve (AUCg) was significantly decreased (P ＜0.05).Insulin and C-peptide and the AUC (AUCins,AUCc-p) were increased (P ＜ 0.05).HOMA-IR was statistically decreased compared with pre-therapy (P ＜ 0.05),HOMA-IS and △INS30/G30,△ INS120/G120 were significantly increased (P ＜ 0.05).Compared with pre-therapy,GLP-1 levels and AUCglp (area under the curve GLP-1) were significantly increased (P ＜0.05),and reached the peak at 120 min,closed to secretion curve of the control group.Conclusion GLP-1 levels were lower than normal in newly diagnosed T2DM patients,and different hypoglycemic drugs makes GLP-1 levels increase.Insulin,C-peptide and AUCins,AUCc-p,HOMA-IS,HOMA-IR,etc.,suggest that β-cell function is restored and insulin resistance is reduced.

Objective To observe different hypoglycemic treatments on glucagon-like peptide-1 (GLP-1) and its correlation with β cells function in newly diagnosed type 2 diabetes mellitus (T2DM).Methods A total of 76 patients with newly diagnosed T2DM were randomly divided into insulin aspart 30 group and oral drugs group.OGTT test were measured at 0,30,120 min,the serum levels of GLP-1 and corresponding C peptide,and insulin levels were measured,HOMA insulin secretion and insulin resistance index were calculated.Then 30 healthy cases were as the control group,GLP-1 levels were analyzed,and the changes of the index were compared.Results At each time point,blood glucose and glucose area under the curve (AUCg) was significantly decreased (P ＜0.05).Insulin and C-peptide and the AUC (AUCins,AUCc-p) were increased (P ＜ 0.05).HOMA-IR was statistically decreased compared with pre-therapy (P ＜ 0.05),HOMA-IS and △INS30/G30,△ INS120/G120 were significantly increased (P ＜ 0.05).Compared with pre-therapy,GLP-1 levels and AUCglp (area under the curve GLP-1) were significantly increased (P ＜0.05),and reached the peak at 120 min,closed to secretion curve of the control group.Conclusion GLP-1 levels were lower than normal in newly diagnosed T2DM patients,and different hypoglycemic drugs makes GLP-1 levels increase.Insulin,C-peptide and AUCins,AUCc-p,HOMA-IS,HOMA-IR,etc.,suggest that β-cell function is restored and insulin resistance is reduced.

Flap endonuclease 1 (FEN1) is an endonuclease that catalyzes invasive reaction. It can be used in signal-amplification reaction-based nucleic acid assay. However, the application of FEN1 is hampered due to the lack of detailed protocols to express and purify the enzyme, and to quantify the enzyme activity. In this paper, the DNA fragment coding the gene of FEN1 from Archaeoglobus fulgidus was synthesized, and inserted into the plasmid of pET24a(+) to express recombinant FEN1 with His-tag. After optimizing the expression, detailed expression protocol of FEN1 was obtained by culturing the recombinant E. coli at 37 ℃ with 200 r/min of shaking for 8 h, followed by inducing with 0.05 mmol/L IPTG at 37 ℃ for 11 h. The purified recombinant FEN1 with the molecular mass of 38 kDa was obtained by Ni-affinity chromatography. Moreover, we developed a accurate quantification method with fluorescence-labelled probes. Finally, the recombinant FEN1 was used in real-time PCR coupled with high specific invader assay for aldh2 gene genotyping to obtain the correct typing results, indicating that the recombinant FEN1 can be used in gene polymorphism detection. We provide a reliable enzyme for developing invasive reaction-based nucleic acid assay.