Humans ; Artificial Intelligence ; Algorithms ; Brain ; Head

Objective To investigate the effects of Tuina targeting different body parts on the behaviors and gut microflora of rat models with valproic acid(VPA)-induced autistic spectrum disorder(ASD). Methods Twenty female Sprague Dawley(SD)rats with 12.5 d of pregnancy were randomly divided into VPA model group[intraperitoneal injection of VPA(600 mg/kg),n=15]and saline group(intraperitoneal injection of equal amount of normal saline,n=5).The offspring male rats injected with saline were secleted as control group.The offspring male rats injected with VPA were randomly divided into VPA,dorsal,and abdominal groups(n=7 in each group).On the 21st day after birth,three-chamber social test,open field test,and marble-burying test were carried out to observe the social abilities,anxiety behaviors,and stereotypi-cal behaviors of rats in the four groups.Rats in dorsal and abdominal groups underwent Tuina for 14 d,twice a day.On the 35th day,behavioral tests were conducted again,and in-testinal contents were taken for species composition and structural analysis,as well as mark-er and differential species analysis. Results(i)According to behavioral observations,compared with VPA group,the social and movement time in the central open field of rats in dorsal group increased significantly(P<0.05),and the number of buried marbles decreased markedly(P<0.01),indicating improve-ment on their social abilities,anxiety behaviors,and stereotypical behaviors as consequences of dorsal Tuina;and the number of buried marbles was reduced as well in abdominal group when compared with VPA group(P<0.05),suggesting the improvement on their stereotypi-cal behaviors following abdominal Tuina.In the marble-burying test,the number of marbles buried in dorsal group was less than in abdominal group,and the stereotypical behaviors were improved more significantly(P<0.05),and there were no significant differences in the three-chamber social and open field tests between the two groups(P>0.05).(ii)In accor-dance with intestinal microflora detection results,compared with VPA group,both dorsal and abdominal groups showed increased richness(P<0.05)and elevated diversity(P<0.05 in dorsal group and P<0.01 in abdominal group)in intestinal microflora.The results of differen-tial analysis indicated that at the phylum level,compared with VPA group,the relative abun-dance of Firmicutes in rats in abdominal group showed a significant reduction trend(P<0.05);at the genus level,compared with VPA group,the relative abundance of Lactobacillus in rats in dorsal and abdominal groups decreased significantly(P<0.05).Dorsal group also showed significant increase in the genus Blautia in the analysis of marker species compared with VPA group(P<0.05). Conclusion Tuina impacted the behavior and gut microflora structure of ASD model rats.Dorsal intervention had a significant effect on social abilities,anxiety behaviors,and stereo-typical behaviors of ASD model rats,while abdominal intervention only had an obvious effect on stereotypical behaviors.Both dorsal and abdominal interventions increased the richness and diversity of gut microflora of ASD model rats,with abdominal intervention improving the intestinal microbial diversity more significantly and resulting in a more uniform species dis-tribution.

【Objective】 To detect the expressions of microRNA（miR）-362 and histone deacetylase 6 （HDAC6） in bone cancer pain （BCP） rats and investigate the analgesic effect of miR-362 and its potential analgesic mechanism. 【Methods】 The BCP model was developed by injecting Walker 256 mammary gland carcinoma cells into bone marrow cavity. Plasmid transfection was used to regulate the expressions of miR-362 and HDAC6. The Van Frey filaments and radiant heat instrument were used to detect the paw withdrawal threshold （PWT） and paw withdrawal latency （PWL）. qRT-PCR was used to detect mRNA expression levels of miR-362 and HDAC6， and Western blotting was used to detect protein expression of HDAC6 and nuclear factor kappa-B p65 （NF-κB p65）. ELISA assay was used to detect the protein levels of interleukin （IL）-1β， IL-6 and tumor necrosis factor α （TNF-α）. Luciferase activity assay was used to determine the relationship between miR-362 and HDAC6. 【Results】 Compared to sham group， the significant decrease of PWT and PWL， decrease of miR-362 and the increase of HDAC6 mRNA and protein in the spinal were detected in BCP group （P<0.05）. Compared to BCP group， the significantly increase of PWT and PWL and decrease of HDAC6 mRNA and protein in the spinal were detected in BCP+LV-miR-362 group （P<0.05）. Compared to BCP+LV-miR-362 group， PWT and PWL significantly decreased in BCP+LV-miR-362+LV-HDAC6 group （P<0.05）. In addition， compared to BCP group， significant decreases of NF-κB p65， IL-1β， IL-6 and TNF-α in spinal were detected in BCP+LV-HDAC6 siRNA group （P<0.05）. Moreover， compared to mimic miR-362+HDAC6 3’UTR^MUT group， the luciferase activity significantly decreased in mimic miR-362+HDAC6 3’UTR^WT group （P<0.05）. 【Conclusion】 As a key factor regulating the mechanism of BCP through “HDAC6-NF-κB p65” signal pathway in rats， targeting miR-362 may be a novel therapeutic method for BCP.

OBJECTIVE:To provide reference for improving rational drug use in undergraduates from non-medical college. METHODS:By questionnaire survey,9 non-medical colleges were collected according to college entrance examination admission batches and school types stratification sampling. The questionnaires were issued among 860 college students by encounter sampling. The survey included medication knowledge,medication behavior,personal basic information three aspects. Single factor analysis and Logistic regression analysis were conducted for their influential factors. RESULTS:A total of 860 questionnaires were sent out, and 812 valid questionnaires were collected with effective recovery rate of 94.4%. In respect of medication knowledge,4.2% of college students answered all of the five questions correctly,the correlation of correct rate with monthly disposable income was maximal(P=0.007);correct rate of the minority students with monthly disposable income more than 6 000 yuan was higher. In respect of medication behavior,14.4% of college students answered all of the seven questions correctly,the correlation of correct rate with whether the family had long-term(more than half a year)medication experience was maximal(P=0.035);the students whose family had no long-term(more than half a year)medication experience member and had medical personnel used drugs more standardly. CONCLUSIONS:The non-medical college students in Beijing lack of medication knowledge and have poor compliance;medication behavior is also unreasonable. Society,universities and families should strengthen the health education of students,and guide students to standardize the self-medicine therapy.

The objective is to deal with brain effective connectivity among epilepsy electroencephalogram (EEG) signals recorded by use of depth electrodes in the cerebral cortex of patients suffering from refractory epilepsy during their epileptic seizures. The Wiener-Granger Causality Index (WGCI) is a well-known effective measure that can be useful to detect causal relations of interdependence in these kinds of EEG signals. It is based on the linear autoregressive model, and the issue of the estimation of the model parameters plays an important role in the calculation accuracy and robustness of WGCI to do research on brain effective connectivity. Focusing on this issue, a modified Akaike's information criterion algorithm is introduced in the computation of the WGCI to estimate the orders involved in the underlying models and in order to advance the performance of WGCI to detect brain effective connectivity. Experimental results support the interesting performance of the proposed algorithm to characterize the information flow both in a linear stochastic system and a physiology-based model.

OBJECTIVETo investigate the associated high risk factors of postoperative relapse and metastasis for patients with confined tumors (grade pT1b-4a) without lymph-node metastases (pN0) in thoracic esophageal squamous cell carcinoma (ESCC).

METHODSClinicopathological and follow up data of ESCC patients undergoing radical surgical resection as primary treatment in the Department of Thoracic Surgery, Shanghai Chest Hospital between January 2004 and December 2012 from Hospital Database were retrospectively collected. The inclusion criteria were as follows: (1) the first development of ESCC confirmed by histopathology without lymphatic and distant metastasis; (2) pathological stage of pT1bN0M0 to pT4aN0M0 according to the Union for International Cancer Control (UICC) in 2009; (3) curative trans-thoracic esophagectomy with R0 (tumor-free surgical margin) resection, using the Ivor-Lewis or McKeown procedure; two-field lymphadenectomy or three-field lymph node dissection based on the positive results of preoperative cervical ultrasonography examination or CT scan; (4) without adjuvant chemotherapy and/or radiotherapy before and after operation; (5) complete follow-up data. Logistic regression analysis was employed to identify the clinicopathological factors affecting the postoperative relapse and metastasis.

RESULTSA total of 112 patients were eligible, including 94 male cases and 18 female cases; age of (58.6±7.7) years; squamous carcinoma of upper thorax in 25 cases, of middle thorax in 67 cases and of lower thorax segment in 20 cases; 12 cases of high-differentiated ESCC, 49 cases of moderate-differentiated ESCC, poorly-differentiated ESCC in 48 cases; 4 cases of I(a stage, 9 cases of I(b, 24 cases of II(a, 62 cases of II(b, 13 cases of III(a; the tumor length >4 cm in 43 cases, ≤4 cm in 69 cases. Forty-three (38.4%) patients presented relapse or metastasis during the follow-up, including 24 (21.4%) of loco-regional relapse, 13 (11.6%) of distant metastasis, and 6(5.4%) of both above. Multivariate regression analysis revealed that poorly-differentiated tumor (OR=1.899, 95%CI:1.233-2.925, P=0.004), upper-middle location (OR=2.351, 95%CI:1.188-4.653, P=0.014), and tumor length >4 cm (OR=2.381, 95%CI:1.009-5.618, P=0.048) were independent risk factors of overall postoperative relapse and metastasis for thoracic ESCC with stage pT1b N0M0-T4aN0M0. Further stratified analysis identified that only poorly-differentiated tumor (OR=1.730, 95%CI:1.121-2.671, P=0.013) was an independent risk factor of loco-regional relapse, whereas pathological stage II(b-III(a (OR=3.372, 95%CI:1.206-9.428, P=0.021) was an independent risk factor of distant metastasis.

CONCLUSIONSPoorly-differentiated tumor, tumor length >4 cm, and upper-middle location may be regarded as high risk factors for predicting overall relapse and metastasis of pN0 thoracic ESCC patients after esophagectomy. Moreover, poorly-differentiated tumor is the only independent risk factor of postoperative loco-regional relapse, meanwhile it should be noted that pathological stage II(b-III(a is closely related to postoperative distant metastasis.

OBJECTIVE To analyze impulsive-like behaviors of SD rats induced by pramipexole in Y-maze avoidance tasks. METHODS Behaviors of SD rats in Y-maze avoidance tasks were recorded with a camera and analyzed by Noldus Etho Vision XT8 software after acute subcutaneous injection of pramipexole(0.1,1 and 10 mg · kg-1),including right reaction numbers of 20 consecutive avoidance tasks,shuttle number of times between the three arms of Y-maze, distance covered in Y-maze and time spent in safe arms during 20 consecutive avoidance tasks. Then,the prepulse inhibition(PPI)of the startle reflex test was used to assess the effect of pramipexole on sensorimotor gating (SG). Effects of pramipexole on the dialyzed content of monoamine neurotransmitter and its metabolites in the striatum and amygdala of SD rats were measured by microdialysis in vivo. RESULTS Compared with normal control group,the rats of pramipexole group showed a significant increase in the shuttle number of times and distance covered in Y-maze between Y-maze avoidance tasks(P<0.01),but a statistically significant decrease in the time spent in safe arms(P<0.01),while the number of right reactions in Y-maze avoidance tasks was not changed. Such premature responses were quite similar to certain impulsive-compulsive behaviors in rodent models,such as five-choice serial reaction time tasks. In the PPI test,pramipexole displayed an impairing effect on SG(P<0.01). The microdialysis results showed that there was an increase of dopamine and 5-hydroxytryptamine in the striatum of pramipexole group, but not statistically significant. Monoamine neurotransmitters and their metabolites were not significantly changed in the amygdala. CONCLUSION Pramipexole can induce impulsive-compulsive behaviors in Y-maze avoidance tasks,which might be attributed to impaired SG.

Objective The aim of this study is to evaluate the safety and efficacy of partial pancreatectomy as part of primary cytoreductive surgery in advanced epithelial ovarian cancer (EOC). Methods A total of 8 patients were recruited in this study who underwent partial pancreatectomy during the primary cytoreductive surgeries for advanced EOC in Fudan University Shanghai Cancer Center from April 2009 to July 2015. Their clinicopathological characteristics, diameter of metastatic tumors, the scope of cytoreductive surgeries, residual diseases after cytoreductive surgeries, postoperative complications and survival situation were retrospective analyzed. Results (1) Clinicopathological characteristics:the median age of these patients was 58 years old(range: 39-63 years old). The median value of preoperative serum CA125 was 1 688 kU/L(range: 119-5 000 kU/L). The median diameter of metastatic tumors involved in pancreatic body or tail was 4.5 cm (range:3-10 cm). All the tumors from the 8 patients were confirmed to be high-grade serous carcinoma. Four patients were staged as International Federation of Gynecology and Obstetrics (FIGO)Ⅳ, and the other 4 patients were staged as FIGOⅢc. (2) Tumor metastases and the scope of cytoreductive surgeries:all of these 8 patients had widely disseminated ovarian cancer, with involvement of upper abdominal, middle abdominal and pelvic cavity. Each patient underwent extensive intra-abdominal cytoreductive surgeries, including hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic periton-ectomy, splenectomy, partial pancreatectomy. Each patient had cytoreductive surgeries of 9.6 different sites on average. Of all 8 patients who underwent partial pancreatectomy, 7 patients had pancreatic tails removed;the other 1 patient had pancreatic body and tail removed. The median volume of blood loss during surgery was 1 350 ml(range:300-3 500 ml), blood transfusion was performed in 7 patients with the median volume of 1 150 ml (range: 500-1 800 ml). (3) Residual diseases after cytoreductive surgeries: optimal cytoreduction was achieved in all patients, with microscopic residual disease in 3 patients, residual tumors diameter < 0.5 cm in 3 patients, and residual tumors diameter between 0.5 and 1 cm in 2 patients. (4) Postoperative complications: 4 patients suffered from complications including pancreatic leakage (2/8), intraperitoneal hemorrhage (1/8) and pancreatic pseudocyst accompanied by infection (1/8). These complications were treated successfully by conservative managements. (5) Survival situation: during the median follow-up duration of 17 months (ranged from 2 to 46 months), 5 patients were still alive until the end of follow-up, including 4 cases under treatment and 1 case survived 29 months without relapse after treatment. Three patients were respectively died in 5, 20 and 46 months after surgery. Conclusion There is a higher risk of postoperative complications of pancreas resection as part of primary cytoreductive surgery in advanced epithelial ovarian cancer, but the resection of pancreatic metastases and part of the pancreas is feasible and necessary.

ObjectiveTo summarize the operative experiences and postoperative complications of pediatric liver transplantation (LT).MethodsClinical data of 88 child patients undergoing LT in West China Hospital, Sichuan University between January 2000 and October 2015 were retrospectively analyzed. Among the patients, 38 were males and 50 were females, with the age ranging from 3 months to 17 years and 7 months old and the median of 2 years and 3 months old. Seventy-seven cases underwent living donor LT and 11 underwent cadaver LT. Thirty-nine cases underwent left lobe transplantation and 49 underwent left lateral lobe transplantation. The main immunosuppressive regimen after operation was adrenocortical hormone + tacrolimus (FK506) or cyclosporin. And heparin was used after operation for anticoagulation. The informed consents of all patients and their families were obtained and the local ethical committee approval was received. The intraoperative conditions and postoperative complications of the patients were observed.ResultsThe average operation time was (7.5±2.4) h, the median intraoperative blood loss was 475(100-2 000) ml, the transfusion of red blood cells was 1.8(0-6.5) U, the warm ischemia time was 2.5(1.0-10.0) min, the cold ischemia time was 188(110-590) min and the inferior vena cava occlusion time was 75(35-170) min. Forty-nine cases developed early complications after operation, and the incidence of vascular complications was 11%(10/88), including 4 cases of hepatic artery thrombosis, 5 of portal vein thrombosis and 1 of hepatic vein stenosis. Sixteen cases developed late complications, and the incidence of biliary complications was 12% (11/88), including 9 cases of cholangitis, 1 of bile leakage and 1 of bile duct stricture. The 1-, 3-year survival rate after LT was respectively 81% and 75%.Conclusions The success rate and postoperative survival rate of pediatric LT have increased signiifcantly in recent years. However, the incidence of postoperative vascular and biliary complications are still high. Thus, the operation procedures should be kept improving, and the immunosuppressant and anticoagulant therapy should be individually adjusted in order to obtain better efifcacy.

Background and objectivePostoperative radiotherapy (PORT) for thymic tumor is still controversial. The object of the study is to evaluate the role of PORT for stage I/II/III thymic tumor.MethodsThe database of Chinese Al-liance of Research for Thymomas (ChART) was retrieved for patients with stage I/II/III thymic tumor who underwent surgi-cal therapy without neoajuvant therapy between 1994 and 2012. Univariate and multivariate survival analyses were performed. Cox proportional hazard model was used to determine the hazard ratio for death.Results 1,546 stage I/II/III patients were identiifed from ChART database. Among these patients, 649 (41.98%) underwent PORT. PORT was associated with gender, histologic type (World Health Organization, WHO), surgical extent, complete resection, Masaoka stage and adjuvant che-motherapy. The 5-yr and 10-yr overall survival (OS) rates and disease-free survival (DFS) rate for patients underwent surgery followed by PORT were 90% and 80%, 81% and 63%, comparing with 96% and 95%, 92% and 90% for patients underwent surgery alone (P=0.001,P<0.001) respectively. In univariate analysis, age, histologic type (WHO), Masaoka stage, complete-ness of resection, and PORT were associated with OS. Multivariable analysis showed that histologic type (WHO)(P=0.001), Masaoka stage (P=0.029) and completeness of resection (P=0.003) were independently prognostic factors of OS. In univari-ate analysis, gender, myasthenia gravis, histologic type (WHO), Masaoka stage, surgical approach, PORT and completeness of resection were associated with DFS. Multivariable analysis showed that histologic type (WHO) (P<0.001), Masaoka stage (P=0.005) and completeness of resection (P=0.006) were independently prognostic factors of DFS. Subgroup analysis showed that patients with incomplete resection underwent PORT achieved the better OS and DFS (P=0.010, 0.017, respectively). However, patients with complete resection underwent PORT had the worse OS and DFS (P<0.001,P<0.001, respectively). ConclusionThe current retrospective study indicated that PORT atfer incomplete resection could improve OS and DFS for patients with stage I/II/III thymic tumor. But for those atfer complete resection, PORT may not help improve prognosis on the whole.