A review of healthcare service and education provision of Autism Spectrum Condition in mainland China

Little is known about the current situation regarding Autism Spectrum Conditions in mainland China. Electronic databases and bibliographies were searched to identify literature on service provision for ASC in both English and Chinese databases. 14 studies and 6 reports were reviewed. The findings of identified papers on service provision were summarized according to four settings for ASC including healthcare, mainstream education, private special education, and state-run special education. The literature on the situation of the healthcare system and educational services for children with ASC in China was profoundly limited. There were great financial problems faced by the parents of autistic children which were partly due to the under-developed healthcare and educational system for ASC.     

Suicide attempt and suicidal ideation and their associations with demographic and clinical correlates and quality of life in Chinese schizophrenia patients

Objectives

This study aimed to examine the prevalence and correlates of lifetime suicide attempts and current suicidal ideation in community-dwelling schizophrenia patients in China.

Method

A sample of 540 schizophrenia patients was randomly selected in Beijing, China. All subjects were interviewed using standardized assessment instruments and their basic socio-demographic and clinical data including history of suicide attempts were collected.

Results

The prevalence of lifetime suicide attempts and the point prevalence of suicidal ideation were 12.0 %, and 21.1 %, respectively. In multiple logistic regression analyses, the presence of lifetime suicide attempt was independently associated with rural residence, having major medical conditions and better social functioning, while higher likelihood of current suicidal ideation was associated with past suicide attempt, the severity of overall psychopathology and depressive symptoms and lower psychological quality of life (QOL).

Conclusion

Among Chinese outpatients with schizophrenia, increased current symptoms and poorer QOL were correlated with current suicidal ideation, while demographic factors and indicators of greater social support were mostly correlated with lifetime suicide attempts. This study may help to identify important subgroups of patients with schizophrenia at particularly high risk of suicidal behavior.     

Expression patterns and potential roles of SIRT1 in human medulloblastoma cells in vivo and in vitro

Medulloblastoma is a primitive neuroectodermal tumor, which originates in the cerebellum, presumably due to the alterations of some neurogenetic elements. Sirtuin 1 (SIRT1), a class III histone deacetylase (HDAC), regulates differentiation of neuronal stem cells but its status in medulloblastomas remains largely unknown. The current study aimed to address this issue by checking SIRT1 expression in noncancerous cerebellar tissues, medulloblastoma tissues and established cell lines. The roles of SIRT1 in proliferation and survival of UW228‐3 medulloblastoma cells were analyzed by SIRT1 small interfering RNA (siRNA) transfection and SIRT1 inhibitor nicotinamide treatment. The results revealed that the frequency of SIRT1 expression in medulloblastoma tissues was 64.17% (77/120), while only one out of seven tumor‐surrounding noncancerous cerebellar tissues showed restricted SIRT1 expression in the cells within the granule layer. Of the three morphological subtypes, the rates of SIRT1 detection in the large cell/anaplastic cell (79.07%; 34/43) and the classic medulloblastomas (60.29%; 41/68) are higher than that (22.22%; 2/9) in nodular/desmoplastic medulloblastomas (P < 0.01 and P < 0.05, respectively). Heterogeneous SIRT1 expression was commonly observed in classic medulloblastoma. Inhibition of SIRT1 expression by siRNA arrested 64.96% of UW228‐3 medulloblastoma cells in the gap 1 (G1) phase and induced 14.53% of cells to apoptosis at the 48‐h time point. Similarly, inhibition of SIRT1 enzymatic activity with nicotinamide brought about G1 arrest and apoptosis in a dose‐related fashion. Our data thus indicate: (i) that SIRT1 may act as a G1‐phase promoter and a survival factor in medulloblastoma cells; and (ii) that SIRT1 expression is correlated with the formation and prognosis of human medulloblastomas. In this context, SIRT1 would be a potential therapeutic target of medulloblastomas.     

前纵裂入路显微手术切除鞍上脑室内外型颅咽管瘤

目的 探讨前纵裂入路在鞍上脑室内外型颅咽管瘤显微手术切除中的应用,并比较与其他手术入路的优缺点.方法 回顾性分析22例采用前纵裂入路显微手术切除鞍上脑室内外型大型颅咽管瘤患者,分析手术技巧及术后效果.结果 肿瘤全切20例,次全切除2例,无手术死亡病例.术后发生电解质紊乱15例,尿量增多17例,2-7周后好转,术后1周内视力好转15例.随访6-60个月,肿瘤复发2例,均为12个月内复发.结论 前纵裂入路可直视下处理肿瘤在垂体漏斗部位的粘连,是鞍上脑室内外型颅咽管瘤较好的手术入路.     

Guided bone regeneration using collagen membranes for sinus augmentation

We investigated the effect of guided bony regeneration using collagen membranes for sinus augmentation in the first maxillary molars of 18 adult female beagle dogs. The teeth were extracted bilaterally and the sinus floors were lifted with simultaneous implantation. The grafted material composed of a combination of autografts and Bio-oss in a 2:1 ratio. On the experimental side in each dog, collagen membrane was folded at the lateral osteotomy window, at the apex of the implants, and at a certain part of the palatal bone. On the opposite (control) side, the collagen membrane covered the osteotomy window. Six animals were killed at each of 4, 12, and 24 weeks postoperatively. Gross observation, biomechanical testing, and histological examinations were made. On the experimental side, grafted materials showed no obvious resorption or subsidence, and a new bone had formed at the apex of the implants. On the control side, the grafted materials had been shifted and absorbed. Histological examination showed increased formation of a new bone in the experimental group, which matured over time. At 4 weeks, inflammatory cells were present in the control group, which showed less maturation of the new bone. The pull-out force increased with time and, at week 24, there was a significant difference in pull-out force between the two groups (p<0.01). Guided bony regeneration with the enfolded coverage of membrane can effectively reduce resorption of grafted bone on the apical surface of implants and stimulate formation of the new bone in sinus augmentation.     

Assessment of silk fibroin for the repair of buccal mucosa in a rat model

This study evaluated the effectiveness of silk fibroin materials for wound repair confined to the buccal mucosa in a rat model by assessing several key clinical parameters and the associated local and systemic immune response. Ninety male SD rats were subjected to microscopic oral surgery to establish a full thickness wound on the buccal mucosa. Rats were randomly divided into three groups based on the treatments received: group A, covered with polyporous silk fibroin scaffold; group B, repaired with crosslinking silk fibroin film; and group C, control. Visual observation of the wounds suggests that wound shrinkage 5 days after the operation was significantly lower in both silk fibroin repaired groups (A and B) than that in the controls. The distribution of inflammatory neutrophils in group A was significantly lower than those in the control group throughout the entire study. The percentage of fibroblasts and capillary endothelia (CD34(+)), and the subgroups of peripheral lymphocytes (CD3(+), CD4(+), CD8(+)) were similar amongst the groups. The results revealed that placement of silk fibroin in an oral buccal defect can reduce the degree of wound shrinkage and enhance the growth of mucosal epithelial cells without any local or systemic immunological incompatibility.     

Autophagy inhibits the mesenchymal stem cell aging induced by D-galactose through ROS/JNK/p38 signalling

Autophagy and cellular senescence are two critical responses of mammalian cells to stress and may have a direct relationship given that they respond to the same set of stimuli, including oxidative stress, DNA damage, and telomere shortening. Mesenchymal stem cells (MSCs) have emerged as reliable cell sources for stem cell transplantation and are currently being tested in numerous clinical trials. However, the effects of autophagy on MSC senescence and corresponding mechanisms have not been fully evaluated. Several studies demonstrated that autophagy level increases in aging MSCs and the downregulation of autophagy can delay MSC senescence, which is inconsistent with most studies that showed autophagy could play a protective role in stem cell senescence. To further study the relationship between autophagy and MSC senescence and explore the effects and mechanisms of premodulated autophagy on MSC senescence, we induced the up- or down-regulation of autophagy by using rapamycin (Rapa) or 3-methyladenine, respectively, before MSC senescence induced by D-galactose (D-gal). Results showed that pretreatment with Rapa for 24 hours remarkably alleviated MSC aging induced by D-gal and inhibited ROS generation. p-Jun N-terminal kinases (JNK) and p-38 expression were also clearly decreased in the Rapa group. Moreover, the protective effect of Rapa on MSC senescence can be abolished by enhancing the level of ROS, and p38 inhibitor can reverse the promoting effect of H₂O₂ on MSC senescence. In summary, the present study indicates that autophagy plays a protective role in MSC senescence induced by D-gal, and ROS/JNK/p38 signalling plays an important mediating role in autophagy-delaying MSC senescence.     

ACR TI-RADS分类联合剪切波弹性成像对甲状腺结节的诊断价值

目的探讨美国放射学会(ACR)甲状腺影像报告与数据系统(TI-RADS)联合剪切波弹性成像(SWE)对甲状腺结节的诊断价值。方法回顾性分析167例患者的甲状腺结节(共243个)的ACRTI-RADS分类和SWE图像特征,以手术病理结果为金标准,绘制受试者工作特征(ROC)曲线,得出SWE诊断甲状腺结节良恶性的最佳阈值。分析ACRTI-RADS分类、SWE以及两者联合应用对甲状腺结节良恶性诊断的结果,绘制ROC曲线,将三种方法的诊断结果与病理结果进行一致性分析。结果243个甲状腺结节中,病理诊断恶性结节183个,良性结节60个。当选择最佳阈值SWE_max=38.6kPa,SWE_mean=27.5kPa时,两种方法联合诊断甲状腺结节良恶性的敏感性、特异性为96.72%、88.33%,曲线下面积(0.925)明显大于ACRTI-RADS分类(0.793)或SWE(0.843)单独诊断,差异有统计学意义(P<0.01)。结论ACRTI-RADS分类联合SWE应用可进一步提高甲状腺结节的诊断水平。     

过伸型胫骨平台骨折的临床治疗

目的探讨过伸型胫骨平台骨折的临床治疗。方法回顾性分析2013年11月—2017年12月南京医科大学第一附属医院治疗的12例过伸型胫骨平台骨折。其中男性4例,女性8例;年龄24～65岁,平均53.6岁;致伤原因均为道路交通伤。患者采用屈曲位复位,植骨后使用内外侧钢板固定。观察患者术后平台后倾角、美国特种外科医院膝关节功能评分(HSS评分)、关节屈曲度以及并发症情况。结果术后X线片显示均获得解剖复位。术后均无膝关节反曲,患者均得到随访6～18个月,平均9.7个月。骨折愈合时间8～12周,平均10.0周。所有患者术后测量后倾角5°～9°(平均7.9°),术后半年5°～10°(平均7.7°)。HSS评分90～98分(平均93.6分)。术后半年关节屈曲度120°～145°(平均131°),伸直均为0°。术后无一例发生钢板及螺钉断裂现象。结论通过恢复正常后倾角及关节面平整,充分植骨及锁定钢板固定治疗过伸型胫骨平台骨折,效果良好,值得临床推荐。