Objective To explore the content and the psychometric properties of assessment tools used for evaluating functioning and adaptive behavior in school-age children with intellectual and developmental disabilities within educational settings. Methods The most used assessment tools included Vineland Adaptive Behavior Scales(VABS),Supports Intensity Scale for Children(SIS-C),Strengths and Difficulties Questionnaire(SDQ)and Repetitive Behavior Scale-Revised(RBS-R),for assessing functioning and adaptive behavior children with intellectual and developmental disabili-ties.Employing the framework and methods of the International Classification of Functioning,Disability,and Health(ICF),this research encoded and categorized the assessment dimensions and items of the four tools,and explored their psychometric properties. Results VABS's assessment content was solely focused on activities and participation,including speaking(d330),con-versation(d350),toileting(d530),eating(d550),drinking(d560),basic interpersonal interactions(d710),com-plex interpersonal interactions(d720),changing and maintaining body positions(d410-d429),carrying,moving and handing objects(d430-d449),and walking and moving(d450-d469).SIS-C assessed activities and participa-tion,and environmental factors,including washing oneself(d510),caring for body parts(d520),community life(d910),using transportation(d470),school education(d820),basic learning(d130-d159),looking after one's health(d570),basic interpersonal interactions(d710),and products and technology for education(e130).SDQ fo-cused on body functions,and activities and participation,including emotional functions(b152),global psychoso-cial functions(b122),attention functions(b140),and basic interpersonal interactions(d710).RBS-R focused on body functions,and activities and participation,including involuntary movement reaction functions(b755),invol-untary movement functions(b765),looking after one's health(d570),energy and drive functions(b130),under-taking a single task(d210),carrying out daily routine(d230),attention functions(b140),and handling stress and other psychological demands(d240).VABS was characterized by good specificity and excellent sensitivity.SIS-C demonstrated very good internal consistency,reliability and validity.SDQ was good in internal consistency,with excellent credibility and validity.RBS-R showed good internal consistency,reliability and validity. Conclusion SDQ and RBS-R cover both body functions,and activities and participation,SIS-C covers activity and par-ticipation,and environmental factors,while VABS solely assesses activities and participation.In terms of body functions,the assessment items primarily focus on mental functions(b130-b189)and movement functions(b750-b799).For activities and participation,the tools assess content across eight domains of functioning.Regarding en-vironmental factors,the assessment content mainly includes products and technology for education(e130),as well as design,construction and building products and technology of buildings for public use(e150).VABS,SIS-C,SDQ,and RBS-R are all norm-referenced measures,with moderate to excellent internal consistency,and good to excellent reliability and validity.

ObjectiveTo observe the effect of Coptidis Rhizoma and Ophiopogonis Radix on renal tissue injury and epidermal growth factor receptor （EGFR）/phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway in rats with diabetic nephropathy （DN） and explore its possible mechanism of delaying DN. MethodThirty-six male Wistar rats were randomly divided into a normal group （6 rats） and a model group （30 rats）. The model group was fed with a high-fat and high-sugar diet combined with streptozotocin （STZ） to establish a rat model of type 2 diabetes. After the successful preparation of the model， the rats were randomly divided into the model group， low， medium， and high dose groups of Coptidis Rhizoma and Ophiopogonis Radix （100， 200， 400 mg·kg^-1）， and metformin group （200 mg·kg^-1）. After administration， the levels of fasting blood glucose （FBG）， 24 h urine protein （24 h-UTP）， creatinine （SCr）， urea nitrogen （BUN）， and uric acid （UA） were detected. Hematoxylin-eosin （HE） staining and Masson staining were used to observe the pathological changes of renal tissue in rats. Western blot and Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） were used to detect the related protein expression of EGFR， PI3K， and Akt and their mRNA expression levels in the renal tissue of rats in each group. ResultsCompared with the normal group， the levels of FBG， SCr， BUN， UA， 24 h-UTP， and kidney index in the model group were significantly increased （P<0.01）， most renal tubular epithelial cells were necrotic， and the content of collagen in glomeruli was significantly increased （P<0.01）. Compared with the model group， the above indexes of rats in each administration group were improved to varying degrees. The FBG， SCr， BUN， UA， 24 h-UTP， and kidney index of rats in each dose group and metformin group were significantly decreased （P<0.01， P<0.05）. The necrosis degree of renal tubular epithelial cells was reduced， and the fibrosis area was decreased （P<0.01）. There related protein and mRNA expressions of EGFR， PI3K， and Akt were significantly increased （P<0.05， P<0.01）. ConclusionCoptidis Rhizoma and Ophiopogonis Radix can alleviate renal tissue injury in rats with DN， and their mechanism may be related to the regulation of the EGFR/PI3K/Akt signaling pathway.

Objective To explore the intrinsic connectivity alterations of brain-wide functional networks in patient with trigeminal neuralgia(TN)via combining resting-state functional magnetic resonance imaging(rs-fMRI)and graph theory methods.Methods A total of 41 patients with TN(TN group)and 41 healthy controls(HC)(HC group)were recruited,and differences in network topologyat-tributes and correlations with clinical variables were analyzed between the two groups.Results Both groups met the σ standard.The global efficiency(Eg)of TN group was lower than that of HC group(P＜0.05),whereas the λ of TN group was higher than that of HC group(P＜0.05).The node efficiency(Ne)of bilateral rectus gyrus and bilateral pallidum of TN group were significantly higher than those of HC group,while the Ne of left supraparietal gyrus,left angular gyrus,left post-central gyrus,bilateral marginal supraparietal gyrus,and left caudate nucleus of TN group were significantly lower than those of HC group(P＜0.05).The local efficiency(Eloc)of the TN group was negatively correlated with the visual analogue scale(VAS)score(P＜0.05),the clustering coefficient(Cp)of the TN group was negatively correlated with the short-form McGill pain questionnaire(SF-MPQ)sensory score(P＜0.05),and the Ne of right rectus gyrus of the TN group was positively correlated with the disease duration(P＜0.05).Conclusion The TN group retain σ,but the overall information transfer efficiency of the brain is reduced and functional integration is diminished.Several brain regions in the TN group has abnormal Ne,which provide an objective basis for altered brain functional networks in TN.

Objective:To develop an inquiry learning community centered on learning experience in the course of Nursing Clinical Comprehensive Experiment to verify the influence of this teaching mode on the learning gains and practical ability of nursing students. Methods:A total of 132 undergraduate nursing students form grade 3 in Chongqing Medical University were enrolled. The participants were randomly assigned to a learning community group ( n = 69) and a control group ( n = 63) using Minitab 14.0 software. The students in the learning community group adopted the inquiry learning community mode in accordance with the curriculum map for online self-learning, group discussion and skills practice, while the control group received the teacher-led teaching mode for offline theory teaching, operation teaching and skills practice. After the teaching intervention, both groups of students received the assessment questionnaire of learning gains and the comprehensive experimental ability evaluation. Chi-square test or paired t-test was performed using SPSS 23.0. Results:Compared with the control group, students in the learning community group reported that their sense of learning gain was enhanced ( P<0.001, Cohen d=0.97); sub-items showed that the effect size for the understanding of learning content ( P<0.001, Cohen d=1.22), the overall course situation ( P<0.001, Cohen d=0.90), the course activities ( P=0.000, Cohen d=0.83), and the information obtained ( P<0.001, Cohen d=1.16) was significantly different. The total score of practical ability of comprehensive experiment was significantly improved ( P = 0.005, Cohen d=0.51), in which the experimental situation displays ( P=0.002, Cohen d=0.55) and experimental effect ( P=0.006, Cohen d=0.49) were better than the control group. There was no significant difference in the performance of experimental preparation and case analysis between the two groups. Conclusion:Developing an inquiry learning community in nursing clinical comprehensive experiment can effectively enhance student' sense of learning gains and promote the improvement of clinical practical ability.

OBJECTIVE: To investigate the effects of ribonucleotide reductase catalytic subunit M1 (RRM1) gene silencing on drug resistance of human breast cancer cell line MCF-7/R. METHODS: We established a paclitaxel-resistant breast cancer MCF-7 cell line (MCF-7/R) by exposing the cells to high-concentration paclitaxel in a short time. Small interfering RNAs (siRNAs) targeting RRM1 were designed to silence RRM1 expression in human breast cancer MCF-7/R cells. MTT assay was used to detect the IC values and the sensitivity to paclitaxel in the cells with or without siRNA transfection. The changes in the proliferative activity of MCF7 and MCF-7/R cells following RRM1 gene silencing were evaluated using EdU assay. Flow cytometry was used to analyze the cell apoptosis and cell cycle changes. We assessed the effect of RRM1 gene silencing and paclitaxel on the tumor growth in a nude mouse model bearing subcutaneous xenografts with or without siRNA transfection. RESULTS: We detected significantly higher expressions of RRM1 at both the mRNA and protein levels in the drug-resistant MCF- 7/R cells than in the parental MCF-7 cells ( < 0.01). Transfection with the specific siRNAs significantly reduced the expression of RRM1 in MCF-7/R cells ( < 0.05), which showed a significantly lower IC value of paclitaxel than the cells transfected with the negative control siRNA ( < 0.05). RRM1 silencing significantly inhibited the proliferation ( < 0.01) and enhanced the apoptosis-inducing effect of paclitaxel in MCF-7/R cells ( < 0.001); RRM1 silencing also resulted in obviously reduced Akt phosphorylation, suppressed Bcl-2 expression and promoted the expression of p53 protein in MCF-7/R cells. In the tumor-bearing nude mice, the volume of subcutaneously transplanted tumors was significantly smaller in MCF-7/R/siRNA+ PTX group than in the other groups ( < 0.001). CONCLUSIONS RRM1 gene silencing can reverse paclitaxel resistance in human breast cancer cell line MCF-7/R by promoting cell apoptosis.
Animals ; Apoptosis ; Breast Neoplasms ; Drug Resistance, Neoplasm ; Gene Silencing ; Humans ; MCF-7 Cells ; Mice ; Mice, Nude ; Paclitaxel ; RNA, Small Interfering ; Ribonucleotide Reductases ; Tumor Suppressor Proteins

Objective To investigate the mastery of nursing knowledge for diabetic patients with disease deterioration between Chinese and Australian nursing students and possible influencing factors,and to provide a reference for improving nursing teaching method in China.Methods From May to June,2016,a self-designed online knowledge questionnaire was used to investigate the mastery of clinical emergency knowledge among the third-grade nursing students in Chongqing Medical University in China and Hinders University in South Australia.A total of 303 questionnaires were collected,among which 243 valid questionnaires (164 from Chinese students and 79 from Australian students) were included in statistical analysis,with an effective collection rate of 80.20％.SPSS 19.0 software was used for statistical analysis,and the paired t-test or the chi-square test was used for data comparison.Results Australian nursing students had a significantly higher score of clinical emergency knowledge than their Chinese counterparts (t=4.115,P=0.000).Compared with the low-score group (score ＜12),the high-score group (score ≥ 12) had a significantly higher proportion of students with a family/medical history of diabetes,clinical experience in diabetes care,or self-learning as the main method (P＜0.05).As for learning method,Australian nursing students tended to use online self-learning (60 students,75.95％) and do assignments (56 students,70.89％) and participate in class discussion (51 students,64.56％),while Chinese students tended to receive theoretical teaching (138 students,84.15％),consult clinical teachers (138 students,84.15％),and receive simulation/experimental teaching (123 students,75.00％).Conclusion Chinese nursing students have lower degrees of willingness for self-learning and mastery of knowledge for disease deterioration than Australian nursing students.Focus on specialized practice,development of online teaching,and cultivation of the awareness and ability for self-learning may help to improve the mastery of clinical emergency knowledge among nursing students.

Objective To explore the value of intravoxel incoherent motion DWI (IVIM-DWI) combined with single-voxel MRS in distinguishing osteoporotic fractures from metastatic vertebral compression fractures.Methods Totally 70 patients with vertebral compression fractures,who underwent CT scanner were enrolled.The patients were divided into osteoporotic group or metastatic group based on pathological results or clinical follow-up.All patients underwent conventional sagittal T1W,T2W,STIR,IVIM-DWI and single-voxel MRS scanning.Relative peak areas of the signal of water at 4.7 ppm and lipid at 1.3 ppm were determined.IVIM-DWI parameters (diffusion coefficient [D],pseudo diffusion [D*],perfusion fraction [f]) and MRS parameters (lipid water ratio [LWR],fat fraction [FF]) were also recorded.The diagnostic performance of MRS,IVIM-DWI,as well as MRS combined with IVIM-DWI in distinguishing osteoporotic fractures from metastatic vertebral compression fractures were evaluated by using ROC curve,and the area under curve (AUC) was calculated.Results The f,D and FF in metastatic group were significantly lower than those in osteoporotic group,while D* in metastatic group was significantly higher than that in osteoporotic group (all P＜0.05).The sensitivity,specificity and accuracy in differentiating osteoporotic fractures from metastatic vertebral compression fractures was 87.50％ (28/32),57.89 (22/38) and 71.43％ (50/70) of MRS,78.13％ (25/32),89.47％ (34/38) and 84.28％ (59/70) of IVIM-DWI,90.63％ (29/32),97.37％ (37/38) and 94.29％ (66/70) of MRS combining with IVIM-DWI,respectively.AUC of MRS,IVIM-DWI,as well as MRS combined with IVIM-DWI was 0.73,0.88 and 0.94 (all P ＜0.05),respectively.Conclusion Combination of IVIM-DWI and MRS can improve the diagnostic efficiency of differentiating osteoporotic fractures from metastatic vertebral compression fractures.

Objective To analyze clinical distribution and drug resistance of extended-spectrum β-lactamase(ESBLs)-producing and non ESBLs-producing Escherichia coli(E.coli) isolated from 2014 to 2015.Methods Collected 4 721 clinical specimens from January 2014 to December 2015,separated and identified by using VITEK 2-Compact automatic microorganism identification and sensitivity analysis system of Biomerieux,France.Results A total of 1 181 E.coli were isolated from 4 721 clinical specimens,the isolation rate was 25.02%,and the isolation rates of 2014 and 2015 were 17.38% and 19.24% respectively.Meanwhile,the isolation rates of ESBLs-producing E.coli from 2014 and 2015 were 44.46% and 51.71%,increased 7.25%.For the ESBLs-producing E.coli,the main specimens from urine,sputum,blood,appendix content,pus and secreta,and general surgery department,pneumology department,urology,Neurosurgery departments were the main infection departments.For the non ESBLs-producing E.coli,the main specimens from urine,blood,sputum,appendix content,pus and secreta.The drug resistance of E.coli to antibiotics showed increasingly upward trend from 2014 to 2015.However,it showed high sensitive to amikacin,imipenem and meropenem.Conclusion As the isolation rate of E.coli increased in 2015,so does the drug resistance,and it is need combine with the actual situation of medication to regulate the usage of antibiotics.

Objective To study the relationships of alcohol consumption to the prevalence of metabolic syndrome and its re‐lated components in Yichang professional population and provide decision making basis for lifestyle intervention to MS crowd in the city .Methods We examined baseline data from 3 640 participants (2 285 men and 1 355 women) aged 20 to 70 years who under‐went a careful drinking habits survey ,then physical examination and blood chemical examination .They were divided into three groups by average ethanol intake [non ,occasional (<10 g/day) ,moderate (≥10 and <30 g/day) ,and heavy (≥30 g/day) drink‐ers] .Results Compared with no drinking and occasional drinking group ,the prevalence of MS and abnormal rate of BMI ,DBP ,TG , UA increased significantly (P< 0 .05) while SBP decreased significantly in moderate drinking group;compared with moderate drinking group ,the prevalence of MS and abnormal rate of BMI ,DBP and SBP ,GLU ,TCH ,TG ,LDL C ,UA increased significantly (P<0 .05) in heavy alcohol consumption group;whether moderate or heavy drinking ,abnormal rate of CRP and HDL C did not change significantly(P>0 .05) .Conclusion Even moderate drinking has a significant effect to BMI ,DBP ,TG ,LDL C ,UA ,but not obvious to CRP ,GLU ,TCH ,HDL C .Excessive alcohol consumption has a very bad effect on BMI ,DBP ,SBP ,GLU ,TCH ,TG , HDL C ,LDL C ,UA .Both the prevalence of MS and the abnormal rate of its related components are proportional to the alcohol in‐take .Although moderate drinking could lower SBP and GLU ,but can not reduce the incidence of MS .

Objective To explore the functions of phospholipase C (PLC)-independent protein kinase C signaling pathway (PTH/nonPLC/PKC) of parathyroid hormone (PTH) and its role in bone metabolism. Methods Osteoblasts isolated from the calvaria of 2-or 3-day-old C57BL mice, identified by alkaline phosphatase staining and Alizarin red staining, were treated for 4 h with 100 nmol/L[Gly1, Arg19]hPTH(1-28) plus 10 nmol/L RP-cAMP, 10 nmol/L[Gly1, Arg19]hPTH(1-34) plus 10 nmol/L RP-cAMP , 10 nmol/L PTH(1-34), or and 0.1% trifluoroacetic acid (TFA). The total RNA was then isolated for screening differentially expressed genes related to PTH/nonPLC/PKC pathway using Affymetrix mouse 12x135K gene expression profile microarray, and the identified genes were confirmed by real-time quantitative PCR. MC3T3-E1 cells treated with[Gly1, Arg19]hPTH(1-28)+RP-cAMP,[Gly1, Arg19]hPTH(1-34)+RP-cAMP,[Gly1, Arg19]hPTH(1-34)+RP-cAMP+100 nmol/L Go6983, or 0.1%TFA were also examined for GR(1-28)-or GR(1-34)-mediated gene expression changes using real-time quantitative PCR. Results Alizarin red staining visualized red mineralized nodules in the osteoblasts at 28 days of culture. According to the genechip results, we selected 56 target genes related to PTH/nonPLC/PKC pathway, among which CITED1 showed higher expressions in[Gly1, Arg19]hPTH(1-34)+RP-cAMP group than in both the control group and[Gly1, Arg19]hPTH(1-28)+RP-cAMP group (P<0.05), and its expression was the highest in PTH(1-34) group (P<0.05). RT-PCR of MC3T3-E1 cells yielded consist results with those in the primary osteoblasts, and the cells treated with Go6983 (a PKC inhibitor) did not show GR(1-28)- or GR(1-34)-mediated differential expression of CITED1. Conclusion The activation of PLC-independent protein kinase C signaling pathway of PTH enhances the expression of CITED1 in mouse osteoblasts to mediate the effect of PTH on bone metabolism, and this pathway is not dependent on the activation of PLC or PKA signaling.