Autism spectrum disorder(ASD)is a highly heterogeneous neurodevelopmental disorder with a complex underlying genetic structure.Current preclinical trials,however,mainly rely on rodent models to test the effects of non-pharmacological and pharmacological interventions on the core and related symptoms of ASD.This paper considers the brain regions that affect social interaction behaviors from the perspective of cognitive neural mechanisms,and reviews behavioral testing experiments,such as the three-chamber social interaction test,visible burrow system,and eco-HAB system.We also summarize effective non-pharmacological and pharmacological interventions,such as baclofen,oxytocin,and metformin,in the core and related symptom areas of ASD.This review aims to provide reference directions to promote the development of preclinical trials using rodent models.

Objective:To construct a knowledge graph,to design an intelligent risk assessment model for adverse events and a risk factor analysis control system for the disinfection supply of stomatological medical devices,and improve the quality of disinfection supply of stomatology instruments through system application.Methods:The automatic collection,conversion and loading of stomatological medical devices disinfection supply data were realized by constructing data access services,the knowledge graph of adverse events of stomatology disinfection supply was constructed by using failure mode and effect analysis(FMEA)and dynamic risk assessment theory,and the risk prediction model and root cause analysis method of adverse events of disinfection supply were constructed by using recurrent neural network(RNN),and the risk assessment and root cause analysis of adverse events of stomatology medical devices disinfection supply were carried out.Results:The top four risk factors of the adverse events of"cleaning"in disinfection supply were incorrect cleaning parameter settings,stains on the instrument after cleaning,substandard lumen cleaning after cleaning,failure to meet the standard of luminal cleaning after cleaning,and scale presence in the instrument after cleaning,respectively,and the systematic prediction probabilities were 4.67%,2.33%,1.50%,and 1.39%,respectively,which were consistent with the actual probability of occurrence of 2.14%,1.85%,0.75%,and 0.50%.The top four risk factors for the adverse event of"water stains on the surface of disinfection equipment"were too high temperature setting of disinfection equipment,too long disinfection time of disinfection equipment,residual dirt on the surface of disinfection equipment and scale residue of heating pipe,which were consistent with the composition order of the first four risk factors in the actual statistical results.Conclusion:The application of the risk assessment model of adverse events and the risk factor analysis and control system of intelligent stomatological medical device disinfection supply can timely discover the quality hidden dangers in the operation of stomatology device disinfection supply and implement risk control,and provide reference for the construction of related business systems.

Objective    To evaluate the data of preoperative aortic root CT angiography (CTA), compare it with two-dimensional transthoracic echocardiography and investigate the correlation of the two measurements with the actual intraoperative measurement data. Methods    Clinical data of 53 patients with aortic valve diseases who underwent aortic valve repair in our hospital from January 2018 to August 2020 were retrospectively analyzed, including 38 males and 15 females with an average age of 42.9±18.3 years ranging from 10 to 77 years. Preoperative two-dimensional transthoracic echocardiography (TTE) and aortic root CTA measurements were collected, including aortic valve annulus (AVA), aortic sinus (Sinus) and sino-tubular junction (STJ). In comparison with the intraoperative measurements during the aortic valve repair surgery, the consistency analysis was performed. Results    Both the preoperative echocardiography AVA measurements and the CT AVA measurements were positively correlated with the intraoperative AVA measurements (P<0.001). Compared with the echocardiography AVA data [correlation coefficient (ρ)=0.74, mean squared error (MSE)=12.78], the CT AVA data were more accurate and consistent with the intraoperative AVA measurements (ρ=0.95, MSE=2.72). CT AVA data had a higher correlation coefficient with the intraoperative measurements, compared to that of  the echocardiography AVA data (P<0.001). Conclusion    In comparison with two-dimensional transthoracic echocardiography, preoperative morphological evaluation of aortic root CTA is more consistent with the actual intraoperative measurements during aortic valve repair surgery.

Confusional arousal (CA) is a rare non-rapid eye movement sleep-related parasomnia and rarely reported in China, leading to misdiagnosis and mistreatment in clinic. A detailed collection of clinical symptoms and simultaneous video polysomnography is very important for diagnosis and differential diagnosis of CA. A elderly patient with CA was diagnosed according to the International classification of sleep disorders, third edition diagnostic criteria. The summary and analysis of the patient is conducted to improve the understanding of CA, meanwhile to avoid misdiagnosis and mistreatment.

Objective:To compare the survival rate of secondary hyperparathyroidism (SHPT) patients with different dialysis modalities after parathyroidectomy (PTX), and analyze the influencing factors of survival prognosis.Methods:Clinical data of dialysis patients diagnosed with SHPT and treated with PTX in the First People′s Hospital of Foshan from April 2014 to May 2019 were retrospectively collected and analyzed. The patients were divided into hemodialysis (HD) group and peritoneal dialysis (PD) group according to preoperative dialysis modalities, and the differences in baseline clinical data and cardiac ultrasound results were compared between the two groups. Kaplan-Meier survival analysis was used to compare the difference in cumulative survival rate between the two groups. Multivariate Cox regression model was used to analyze the influencing factors of all-cause death. Receiver operating characteristic curve (ROC curve) was used to predict the risk of all-cause death.Results:A total of 99 patients were enrolled in this study, and 94 patients completed follow-up, including 23 patients who died. Compared with PD group ( n=45), HD group ( n=54) had higher dialysis age, blood pressure, intact parathyroid hormone, alkaline phosphatase, total heart valve calcification rate, mitral valve calcification proportion, interventricular septal thickness (IVST) and left ventricular mass index (all P<0.05). The median follow-up time was 46.00(32.75, 60.25) months. Kaplan-Meier survival analysis showed that there was no significant difference in cumulative survival rate between HD group and PD group (Log-rank test χ2=0.414, P=0.520). Multivariate Cox regression analysis showed that increasing age ( HR=1.066, 95% CI 1.017-1.118, P=0.008), systolic blood pressure>140 mmHg ( HR=2.601, 95% CI 1.002-6.752, P=0.049) and increasing IVST ( HR=1.269, 95% CI 1.036-1.554, P=0.021) were independent influencing factors for all-cause death in dialysis patients after PTX. ROC curve analysis results showed that the cut-off values of age, dialysis age and IVST for predicting all-cause death after PTX were 51.5 years old ( AUC=0.673, 95% CI 0.545-0.802, P=0.013) and 75.0 months ( AUC=0.654, 95% CI 0.528-0.780, P=0.027) and 13.5 mm ( AUC=0.680, 95% CI 0.557-0.803, P=0.010) respectively. The area under the ROC curve for age, dialysis age, IVST, left ventricular hypertrophy in combination with systolic blood pressure>140 mmHg in the prediction of all-cause death after PTX was 0.776(95% CI 0.677-0.875, P<0.001). Conclusions:There is no significant difference in cumulative survival rate between HD and PD patients with SHPT after PTX. Increasing age, systolic blood pressure>140 mmHg and increasing IVST are independent risk factors for all-cause death in dialysis patients with SHPT after PTX.

Objective    To evaluate the midterm effect of valve-sparing aortic root replacement (VSRR) on aortic root aneurysm and moderate to severe aortic regurgitation (AR). Methods    The clinical data of patients with aortic root aneurysm and moderate to severe AR undergoing VSRR and surviving from the operation from October 2013 to May 2020 were retrospectively analyzed. There were 31 males and 9 females, with an average age of 47.1±13.4 years. There were 30 patients with true aneurysm of aortic root and 10 patients with dissecting aneurysm of aortic root. There were 3 patients with bicuspid aortic valve, and 12 patients with Marfan syndrome. The AR measured by the echocardiogram was moderate in 18 patients and severe in 22 patients. The average diameter of aortic annulus was 27.0±3.9 mm, and the mean largest diameter of aortic sinus was 52.3±6.1 mm. Results    A total of 32 patients underwent David technique and 8 patients underwent Yacoub technique, and 10 patients underwent aortic cusp repair simultaneously. All 40 patients  completed the follow-up, and the follow-up period was 12-86 (45.7±18.9) months. During the period, 1 patient died of heart failure, 2 had reoperation due to new-onset Stanford B aortic dissection, and no patients had reoperation related to aortic valve. The postoperative New York Heart Association cardiac function classification (1.6±0.5 vs. 2.8±0.8), left ventricular end-diastolic dimension (52.2±7.8 mm vs. 61.4±10.6 mm) and left ventricular end-diastolic volume (136.0±58.8 mL vs. 193.3±83.9 mL) of the patients were significantly improved compared with preoperative ones (P<0.05). By echocardiography, 19 patients had no AR, 18 patients had mild AR, 3 patients had mild-moderate AR, and no patients had moderate or higher AR. Conclusion    In patients with aortic root aneurysm and moderate to severe AR, VSRR technique avoids prosthetic valves and anticoagulation-related complications, has lower rate of AR recurrence and reoperation, and improves the quality of life in the midterm period.

Objective    To evaluate the short and mid-term outcomes of valve repair in patients with insufficient bicuspid aortic valves (BAV). Methods    The clinical data of 27 consecutive patients with insufficient BAV undergoing valve repair in Shanghai Chest Hospital from September 2016 to January 2020 were retrospectively reviewed. There were 24 males and 3 females with a mean age of 38.5±14.6 years (range: 20-68 years). BAV of all patients was type 1 in Seviers' classification. There were 23 patients with left-right fusion and 4 patients with right-noncoronary fusion. There was aortic regurgitation in the patients measured by the echocardiogram, including moderate regurgitation in 3 patients, moderate-severe in 18 patients, and severe in 6 patients. The diameter of aortic annular base was 27.9±3.4 mm, and the largest diameter of aortic sinus was 39.9±7.6 mm. Left ventricular end diastolic diameter was 62.7±6.5 mm, and the volume was 197.9±53.6 mL. Results    All 27 patients completed the follow-up, and the mean time was 24.2±12.5 months (range: 12-51 months). No patient died or required aortic valve-related reoperation during the follow-up. The cardiac function of the patients significantly improved postoperatively (P<0.05). By echocardiography, 11 patients had no aortic regurgitation, 13 had mild aortic regurgitation, and 3 had moderate aortic regurgitation, and no patient had severe aortic regurgitation. Postoperative left ventricular end diastolic diameter and volume decreased, compared to preoperative ones (P<0.05). Conclusion    In patients with insufficient BAV, valve repair is safe and effective, and has excellent short and mid-term outcomes.

Objective:To explore the changes of serum levels of copeptin and α-amylase and their correlations with sleep and cognition in patients with chronic insomnia (CI).Methods:From September 1, 2018 to May 31, 2019, fifty CI outpatients or inpatients from the Department of Sleep Disorder, Affiliated Chaohu Hospital of Anhui Medical University, were enrolled continuously, and thirty good sleepers from the Physical Examination Center of the hospital, were also enrolled to serve as controls. Pittsburgh Sleep Quality Index (PSQI), polysomnography (PSG) and Pre-Sleep Arousal Scale (PSAS) were used to assess the insomnia severity and sleep disorder susceptibility. Montreal Cognitive Assessment scale (MoCA) and Nine-Box Maze were used to respectively assess general cognition and memories. The serum levels of copeptin and α-amylase were detected using enzyme linked immunosorbent assay.Results:Compared to the controls, the CI patients had increased PSQI score (16.0 (15.0, 17.0) vs 4.0 (2.8, 6.0); Z=-7.678, P<0.001) and PSAS score (33.0 (30.0, 37.5) vs 17.0 (16.0, 18.5); Z=-7.350, P<0.001), decreased MoCA score (24.1±2.5 vs 26.7±1.9, t=-4.625, P<0.001), increased numbers of errors in the object working (1.0 (0, 1.0) vs 0 (0, 1.0), Z=-2.099, P=0.036), spatial working (2.0 (1.0, 4.0) vs 1.0 (0, 2.0), Z=-3.935, P<0.001) and object recognition (1.0 (0, 2.0) vs 0 (0, 0), Z=-2.266, P=0.023) memories, and elevated serum levels of copeptin ((35.1±19.9) pg/ml vs (14.8±6.9) pg/ml, t=5.414, P<0.001) and α-amylase ((990.1±193.7) U/L vs (728.9±230.5) U/L, t=5.597, P<0.001). In the CI patients, the level of copeptin was positively correlated with PSQI score ( r=0.338, P=0.013), PSAS score ( r=0.316, P=0.021), sleep latency ( r=0.324, P=0.018), number of awake ( r=0.325, P=0.017) and stage 1 percent of non-rapid eye movement sleep ( r=0.278, P=0.044), and negatively correlated with stage 2 percent of non-rapid eye movement sleep ( r=-0.279, P=0.043); α-amylase was positively correlated with numbers of awake in PSG ( r=0.293, P=0.033). Multiple linear regression analysis showed that copeptin level affected PSQI score (β=0.255, P=0.043) and sleep latency (β=0.254, P=0.043). Conclusion:The levels of copeptin and α-amylase in CI patients elevate, and copeptin may be associated with initial sleep difficulties, but not with cognitive ability, in patients with CI.

Objective: To explore serum levels of brain-derived neurotrophic factor (BDNF) and glial-derived neurotrophic factor (GDNF), and whether changes of BDNF and GDNF are correlated with sleep quality and cognitive function in patients with chronic insomnia disorder (CID). Methods: Fifty-seven CID patients in the Department of Sleep Disorders, Chaohu Hospital of Anhui Medical University and 30 healthy controls were enrolled from May 2017 to July 2018. Pittsburgh Sleep Quality Index (PSQI) was used to assess the degree of insomnia severity (some CID patients were monitored by overnight polysomnography). Montreal Cognitive Assessment (MoCA) scale and Nine-Box Maze were used to assess general cognitive function and specific memory function, respectively. The serum levels of BDNF and GDNF were detected using ELISA. Results: Compared to the controls, CID patients had significantly higher PSQI scores (CID patients: 14.0±2.2, healthy controls: 3.9±1.1; t=28.093, P<0.01), lower MoCA scores (CID patients: 24.5±3.6, healthy controls: 26.5±0.9; t=-2.985, P<0.01), more errors in object working memory (CID patients: 1.0 (0, 1.0), healthy controls: 0 (0, 0.3)), spatial working memory (CID patients: 3.0 (2.0, 4.0), healthy controls: 1.0 (1.0, 2.0)) and object recognition memory (CID patients: 0 (0, 0), healthy controls: 0 (0, 0); Z=-2.896、-5.007、-2.306, P<0.05), and lower serum BDNF (CID patients: (19.48±7.50) ng/ml, healthy controls: (46.49±13.33) ng/ml; t=-10.274, P<0.01) and GDNF (CID patients: (32.76±14.04) pg/ml, healthy controls: (59.63±20.30) pg/ml; t=-7.240, P<0.01). The partial correlation analysis showed that in the CID patients, the levels of BDNF and GDNF were correlated with PSQI scores negatively (r=-0.293, -0.320, P<0.05) and MoCA scores positively (r=0.331, 0.295, P<0.05). The BDNF level was also correlated with the duration of disease and the errors in the spatial working memory test negatively (r=-0.319, -0.393, P<0.05), and the GDNF level was correlated with the total sleep time detected with polysomnogram positively (r=0.520, P<0.05). Conclusion Serum BDNF and GDNF levels in CID patients were lower than those in healthy controls, and correlated with sleep quality and cognitive impairment.

Boron neutron capture therapy(BNCT)is an advanced radiotherapy combined with targeted therapy and heavy ion therapy. BNCT is based on the nuclear reaction 10B (n, α) 7Li that occurs when boron-10 isotopes is irradiated with neutrons of the appropriate energy to produce high-energy recoiling 7Li nuclei and α particles. The released high linear energy transfer (LET) particles have path lengths of approximately one cell diameter (5-9 μm) and deposit most of their energy within the boron-containing tumor cells. BNCT has the advantages of precise tumor targeting, less damage to normal tissue and fewer irradiation fractionations (1-3 fractionations) than conventional radiotherapy (30 fractionation). The neutrons used in BNCT are produced by reactors or accelerators. The boron drugs used in clinical trials include BPA and BSH. In this paper, we review the clinical trial status and the significant progress of BNCT for head and neck tumors. The clinical data have approved the effectiveness of BNCT in the treatment of head and neck cancer. With the technical improvement of accelerator neutron source and the development of new boron drugs, BNCT will play a more important role in the field of clinical radiotherapy in the future.