The social communication impairment is one of the core impairments of children with autism spec-trum disorder(ASD).This paper introduced five play-based intervention models that can improve social communica-tion skills of children with ASD.Guided by the concept of precision rehabilitation,practitioners who master these methods may effectively tailor interventions to different cases,by integrating personalized therapy for prescriptive treatment,may ensure healthy mind and body development of children with ASD while solving social communication problems,thus provide practice reference for parents of children with ASD,researchers and clinical educators in China.

Objective To explore the effect of sleep duration and body mass index(BMI)on hypertension.Methods The data was collected from the database of the China Health and Retirement Longitudinal Study(CHARLS),and the data of the 2015 National Longitudinal Study were selected.A total of 8,889 subjects were included in this study.Questionnaires,health status,physical examination and laboratory information were collect-ed.The interactive effect of sleep duration and BMI on hypertension was analyzed by multiplicative model and addi-tive model.Results The prevalence rate of hypertension was 28.86%.Logistic regression results showed that night sleep duration＜6 h(OR=1.138,95%CI:1.024-1.265)and＞8 h(OR=1.1365,95%CI:1.167-1.598);overweight(OR=1.736,95%CI:1.557-1.936)and obesity(OR=2.076,95%CI:1.973-2.710)were all risk factors for hypertension(P＜0.05).Stratified results showed that the risk of hypertension in the normal group was 1.193(95%CI:1.023-1.393)times and 1.555(95%CI:1.244-1.943)times of those with sleep du-ration 6-8 h,respectively.The risk of hypertension was 1.392(95%CI:1.066-1.818)times higher than that of sleep duration 6-8 h.The interaction showed that night sleep duration and BMI had a multiplicative interaction(OR=2.120,95%CI:1.767-2.543)and a additive interaction on hypertension[RERI=1.242(95%CI:0.326-2.157),SI=3.697(95%CI:2.658-5.143),AP=0.460(95%CI:0.324-0.595)].Conclusions Insufficient and excessive sleep duration at night and BMI both increase the risk of hypertension,and have a mul-tiplicative and additive interaction.Reasonable adjustment of nighttime sleep duration and BMI may prevent the occurrence of hypertension.

Objective To analyze the safety of laparoscopic splenectomy for traumatic splenic rupture.Methods The clinical data of 62 patients with traumatic splenic rupture treated by laparoscopic splenectomy in our hospital from Jan 2013 to Jan 2018 were retrospectively analyzed.Results All 62 patients successfully underwent laparoscopic surgery except for 1 case who was converted to open surgery.One case suffered from postoperative bleeding.There was no infection,serious pancreatic leakage and other major complications.The total amount of intraoperative bleeding was 1 600 ml on average,the average operation time was 135 min,the average splenectomy time was 55 min,and the average hospital stay was 12.5 d.Conclusion Laparoscopic splenectomy is a safe and reliable minimally invasive operation for traumatic splenic rupture.

Objective To investigate the related factors of clinical stage and prognosis in the patients with endometrial carcinoma and their relation with proto-oncogene Wip1 expression level.Methods The paraffin samples of resected endometrial carcinoma in 120 cases of endometrial carcinoma in our hospital from January 2002 to January 2012 were collected as the experimental group,the samples were verified by pathology.Contemporaneous 120 samples of biopsy normal endometrial tissue served as the control group.The expression leve of Wipl were detected in turo groups.Results (1) In the Wip1 immunohistochemical staining results:Wip1 immunohistochemical staining was negative or weak in normal endometrial tissue cells,while showed pale yellow to yellowish-brown in endometrial cancer tissue.The positive expression rate of Wip1 protein in endometrial carcinoma tissue was 77.5%(93/120),which was higher than 22.5%(27/120) in normal endometrial tissue,the difference was statistically significant (P<0.05).(2)In the Western blot results of Wip1 protein in endometrial cancer tissue and normal endometrial tissue:the relative amount of Wip1 protein in endometrial carcinoma tissue was 0.635±0.023,which was significantly higher than 0.325±0.018 in normal endometrial tissue,the difference between the two groups was statistically significant (P<0.05).(3)In the real time quantitative qRT-PCR results of various samples:Wip1 mRNA expression level was higher than that in normal endometrial tissue,which were 0.628±0.053 and 0.191±0.009 respectively,the difference between the two groups was statistically significant(P<0.05).(4) The expression level of Wip1 had no correlation with age,estrogen and progesterone status,HER2,lymph node status and TNM stage,but had correlation with P53 expression level.Conclusion (1) The Wip1 expression amount is high in endometrial carcinoma and low in normal endometrial tissue.(2)The Wip1 expression level has no relation with age,estrogen and progesterone status,HER2,lymph node status and TNM stage,while has association with P53 expression level.

Objective To compare the effects of different extracts of Rheum palmatum on weight and tissue structure of hypothalamusand and pituitary of adult female rats,and screen the main reproductive toxicity extract.Methods The water,chloroform,ethyl acetate,and n-butanol extracts and water-soluble substance of R.palmatum were prepared by polarity gradient extraction method.Female adult rats were randomly divided into blank control group,rhubarb water extract group,and different extracts groups.The dosage of all the groups was equivalent to 4.00 g/kg crude rhubarb.Rats were administered with extracts by gavage for 60 d.Body mass growth rate of rats were calculated before and after administration.The pathological changes of hypothalamic arcuate nucleus neurons and pituitary gonadal cell were observed with light microscope.Results Compared with the blank control group,the body mass growth rate of rhubarb water extract group was decreased (P ＜ 0.05),while those in the different extracts groups were increased (P ＜ 0.01);The hypothalamic arcuate nucleus neurons of rhubarb water extract group showed chromatin marginalization,nissl substance dissolving,fuzzy boundary of nuclear membrane,as well as hell cells,and the total number of adenohypophysis cells reduced and the cells arranged in irregular.However,there were no apparent pathologic changes in different extracts groups.Conclusion Rhubarb water extract administration by long-term dose can reduce weight growth rate and result in pathologic changes of hypothalamic arcuate nucleus and adenohypophysis,while the different extracts can increase weight growth rate significantly and have little effects on the organizational structure ofhypothalamic arcuate nucleus and adenohypophysis.

Abscess ; pathology ; Breast ; pathology ; Esophagus ; pathology ; surgery ; Foreign Bodies ; surgery ; Humans ; Neck ; pathology ; Otorhinolaryngologic Surgical Procedures ; Recurrence

Objective To investigate the inhibitory effects of docosahexaenoic acid (DHA)and 5-fluorouracil (5-FU)in combination on human gastric cancer cell line AGS in vitro .Methods Human gastric cancer line AGS was treated with different concentrations of DHA and 5-FU alone or in combination.The inhibition of cell proliferation was evaluated by MTT assay.Dose of median (IC50 )of drugs (alone or in combination)and the combination index (CI)were calculated using the median-effect equation and the combination index equation of Chou-Talalay.Flow cytometry was used to detect the cell cycle distribution.The expression of mitochondrial respiratory membrane protein complex in AGS cells was analyzed with Western blot.Results DHA and 5-FU alone or in combination could markedly suppress the proliferation of AGS in significantly time-dependent and dose-dependent manners (P <0.05).IC50 values with DHA or 5-FU administered for 24 h and 48 h were 5 1.60 μg/mL (DHA:24 h),34.82 μg/mL (DHA:48 h),45.90 μg/mL (5-FU:24 h),and 1 6.86 μg/mL (5-FU:48 h), respectively.DHA remarkably strengthened the inhibitory effect of 5-FU and decreased IC50 of 5-FU by 3.56 -2.1 5 folds.The combination of DHA and 5-FU showed synergism.Flow cytometry showed that AGS cells treated with DHA and 5-FU were arrested in G0/G1 phase and the proportion of AGS cells in G0/G1 phase increased compared with that in the control group,DHA group and 5-FU group,while the proportion of the cells in S phase decreased significantly (P < 0.05 ).Western blot showed after treatment with DHA and 5-FU for 48 h,the expression of mitochondrial respiratory membrane protein complex was significantly decreased compared with control group,DHA group and 5-FU group (P <0.05).Conclusion DHA could act synergistically with 5-FU in inhibiting the growth of gastric carcinoma cells,and meanwhile decrease the dose of 5-FU.The mechanism may be associated with cell cycle arrest in G0/G1 phase and interference in the energy metabolism of AGS cells due to inhibition of the expression of mitochondrial oxidative respiratory chain complexes by the two compounds.

ABSTRACT:Objective To investigate the effects of ω-3 polyunsaturated fatty acids on the proliferation of human gastric cancer cell line AGS and the possible mechanisms.Methods Human gastric cancer line AGS and human microvascular epithelial cell HMEC-1 were treated with different concentrations of docosdhexaenoic acid (DHA)and eicosapentaenoic acid (EPA).The inhibition of cell proliferation was evaluated by MTT assay and cell morphology.Flow cytometry was used to detect the cell cycle change.The expressions of mitochondrial respiratory membrane protein complex Ⅰ,Ⅱ and V were analyzed with Western blot.Results DHA and EPA could markedly inhibit the proliferation of AGS in significant time-dependent and concentration-dependent manners (P < 0.05 ). The inhibitory effect of DHA was stronger than that of EPA under the same concentration gradient (P <0.05).The morphological changes of cells were characterized by cell shrinkage and weak adhesion.Flow cytometry showed that AGS cells treated with DHA and EPA were arrested in G0/G1 phase and the proportion of AGS cells in G0/G1 phase increased compared with that of the control group while the proportion of the cells in S phase decreased significantly (P <0.05).Western blot showed after treatment with DHA for 24 h and 48 h,compared with control group,the expressions of mitochondrial respiratory membrane protein complex Ⅰ,Ⅱ and Ⅴ were obviously decreased.The longer effect of DHA,the lower expression of membrane protein complex (P <0.05).DHA had little effect on cell proliferation,morphology or mitochondrial membrane protein complex in HMEC-1 (P >0.05).Conclusion ω-3 PUFAs can selectively inhibit the growth and proliferation of human gastric cancer cell line AGS.These effects may be as-sociated with arresting cell cycle in G0/G1 phase and inhibiting the energy metabolism of AGS cells.

Objective To observe the outcomes of the modified multiple nerve transfer s combined with the late hand function reconstruction to restore the active pick-up function of the paralyzed upper extremity in patients with total brachial plexus avulsion injuries (TBPAI).Methods 33 patients suffered with TBPAI firstly underwent multiple nerve transfers,which including accessory nerve transfers to neurotize the suprascapular nerve to recover the shoulder abduction,contralateral C7 (CC7) nerve transfers via the modified pre-spinal route with direct coaptation to restore lower trunk function and the musculocutaneous nerve was also neurotized by the transferred CC7 nerve via a cutaneous nerve graft to restore the function of elbow flexion,as well as the phrenic nerve transfers to neurotize the posterior division of lower trunk to restore the function of elbow and finger extension.The patients with muscle recovery were selected to perform the hand function reconstruction at the second stage for restoring the active pick-up function.The patients were chosen as followcriterias:the degree of shoulder abduction attained 30°or more,the motor power of elbow,wrist,and finger flexion attained grade M4 or more,elbow and finger extension attained M3 or more.The methods of hand function reconstruction included wrist fusion and flexor carpal ulnaris opponensplasty,in addition to palmar capsulodesis of the metacarpophalangeal joint.Results The mean follow up was 41±7.7 (range,36-73 months) after the first procedure of multiple nerve transfers,the muscle strength of elbow and finger and wrist flexion attained M 4 as well as the elbow and finger extension achieved M3 or more in 10 patients,all of 10 patients achieved 40°-80°shoulder abduction.8 out of 10 patients had performed the second surgical procedure for hand functional reconstruction.6 of them had successfully recovered the active pick-up function.Conclusions The newly designed procedure of multiple nerve transfers could effectively restore the function of shoulder abduction,elbow,wrist,and finger flexion,as well as elbows and finger extension in patients with TBPAI,combined with the hand functional reconstruction,active pick-up function could be successfully reconstructed.

Objective To explore the effect of ilomastat combined with chemotherapeutic drug capecitabine on human laryngeal cancer hep-2 cell .Methods hep-2 cells were treated by ilomastat and capecitabine alone and their combination .The untreated group was taken as the control group .The proliferation activity of the hep-2 cells was analyzed by MTT assay ,and the Jin′s Q was adopt-ed to assess the characters of combination medication of ilomastat and capecitabine ;the expression level of MMP-9mRNA in hep-2 cell was detected by RT-PCR;the apoptosis rate of hep-2 cell was detected by the flow cytometry .Results Both ilomastat and capecitabine had the inhibiting effect on the proliferation of hep-2 cell ,and the combination of ilomastat and capecitabine increased the cell inhibitory rate(P<0 .05) ,the interaction between ilomastat and capecitabine was the synergistic effect when the combined concentration was (8+100)μg/mL ,while the interaction between ilomastat and capecitabine was the additive action when the com-bined concentration was (40+ 400)μg/mL ;RT-PCR analysis showed that compared with control group ,the expression level of MMP-9mRNA in the single ilomastat group and the combination group were both decreased (P< 0 .05) ,and the expression of MMP-9mRNA in the combination group was lower than that in the single ilomastat group (P<0 .05);the flow cytometry indicated that the apoptosis rate of hep-2 cell in the single ilomastat group and the single capecitabine group were both higher than that in the control group(P<0 .05) ,and the apoptosis rate in the combination group was higher than that in the other groups (P<0 .05) .Con-clusion Ilomastat combined with capecitabine can obviously enhance the inhibition and apoptosis-induced ability of single drug on laryngeal cancer hep-2 cell ,the action mechanism of ilomastst is down-regulation of the expression level of the MMP-9 mRNA .