Visuospatial Bias in Children with Autism Spectrum Disorder: Evidence from Line Bisection Tasks

Journal of Autism and Developmental Disorders - Previous studies have found reduced leftward bias of facial processing in individuals with Autism Spectrum Disorder (ASD). However, it is not clear...     

High-Frequency Transcranial Magnetic Stimulation Combined With Functional Magnetic Resonance Imaging Reveals Distinct Activation Patterns Associated With Different Dorsolateral Prefrontal Cortex Stimulation Sites

ObjectivesTranscranial magnetic stimulation (TMS) has been extensively used for the treatment of depression, obsessive-compulsive disorder, and certain neurologic disorders. Despite having promising treatment efficacy, the fundamental neural mechanisms of TMS remain understudied.Materials and MethodsIn this study, 15 healthy adult participants received simultaneous TMS and functional magnetic resonance imaging to map the modulatory effect of TMS when it was applied over three different sites in the dorsolateral prefrontal cortex. Independent component analysis (ICA) was used to identify the networks affected by TMS when applied over the different sites. The standard general linear model (GLM) analysis was used for comparison.ResultsICA showed that TMS affected the stimulation sites as well as remote brain areas, some areas/networks common across all TMS sites, and other areas/networks specific to each TMS site. In particular, TMS site and laterality differences were observed at the left executive control network. In addition, laterality differences also were observed at the dorsal anterior cingulate cortex and dorsolateral/dorsomedial prefrontal cortex. In contrast with the ICA findings, the GLM-based results mainly showed activation of auditory cortices regardless of the TMS sites.ConclusionsOur findings support the notion that TMS could act through a top-down mechanism, indirectly modulating deep subcortical nodes by directly stimulating cortical regions.Clinical Trial RegistrationThe Clinicaltrials.gov registration number for the study is NCT03394066.     

The efficacy of hemodialysis in interventional therapy in coronary artery disease patients with chronic renal insufficiency

The aim of this study was to explore the efficacy and safety of hemodialysis in interventional therapy for patients with coronary artery disease combined with chronic renal insufficiency. With the aging and social development, the number of coronary artery disease patients with chronic renal insufficiency gradually increased. Total 58 coronary heart disease patients with chronic renal dysfunction were selected. These patients were characterized with typical angina symptoms and typical electrocardiogram (ECG) changes of onset angina. Continuous oral administration of sodium bicarbonate tablets 1?g 3/day?×?3 days and slow intravenous input sodium chloride 1000 ～1500 mL 3–12?h before operation were given. By this way, all patients were treated by hydration and alkalization. After percutaneous coronary intervention (PCI) treatment, patients were immediately transferred to undergo 4?h of dialysis treatment without removing indwelling of femoral artery puncture sheath tube to protect renal function. Changes in renal function including serum creatinine, glomerular filtration rate, and urine were observed and recorded. All patients were successfully underwent PCI treatment. Within one month after PCI, there were no obvious complication and no stent thrombosis occurred. Among of 58 patients, 56 cases showed no significant increase in serum creatinine levels compared with those before operation. However, serum creatinine level of one patient increased to 251?umol/L and one patient still required permanent dialysis. Using hemodialysis in interventional therapy in coronary artery disease patients with chronic renal insufficiency could significantly improve the prognosis of the patients.     

高频焊接仪闭合动脉血管的安全性与可靠性研究

目的:探讨高频焊接仪(HFWD)闭合动脉血管的安全性与可靠性。方法:将6头西藏小型猪均随机分为HFWD组与超声刀组(HS组),全麻后分离裸化颈、股动脉,分别采用HFWD与HS闭合离断血管。比较两组血管闭合后的爆破压、闭合时间、闭合过程中的最高温度及闭合处病理热损伤。结果:不区分血管管径大小时,HFWD组平均爆破压高于HS组(489.64 mm Hg vs.439.88 mm Hg,P0.05),当血管直径≤3 mm时,HFWD组与HS组爆破压无明显差异(593.40 mm Hg vs.572.48 mm Hg,P0.05),对于直径3~5 mm、5~7 mm的血管,HFWD组爆破压均大于HS组(457.02 mm Hg vs.404.32 mm Hg;418.51 mm Hg vs.342.84 mm Hg,均P0.05);无论血管直径大小,HFWD组闭合血管所需时间均少于超声刀(均P0.05)。HFWD组闭合处的平均最高温度低于HS组(65.91℃vs.105.25℃,P0.05);HFWD组闭合处血管壁胶原变性及血管平滑肌损伤程度轻于HS组。结论:HFWD闭合动脉血管是安全可靠的。     

Preparation and Quality Evaluation of Salvianolic Acids and Tanshinones Dry Powder Inhalation

Salvianolic acids and tanshinones both exhibit efficacy in treating idiopathic pulmonary fibrosis (IPF), but their formulation limits their clinical use. This study aimed to prepare the salvianolic acids and tanshinones dry powder for inhalation (SPI) to achieve pulmonary delivery for the treatment of IPF. The variable quantities of salvianolic acids and tanshinones composite powder were optimized using the central composite design-response surface method. Different carriers with various drug-carrier ratios were optimized to prepare SPI. The final optimized formulation of SPI was as follows: InhaLac 230^® was selected as the carrier with drug:carrier = 1:6, and the milled lactose InhaLac 400^® was added at 5%. The developed SPI characterized with an angle of repose 52.46 ± 1.04°, Carr's index of 34.00 ± 0.50% and showed high lung deposition in vitro, indicating the potential of pulmonary delivery for the treatment of IPF.     

Glioma targeting peptide modified apoferritin nanocage

Therapeutic outcome for the treatment of glioma was often limited due to the non-targeted nature of drugs and the physiological barriers, including the blood-brain barrier (BBB) and the blood-brain tumor barrier (BBTB). An ideal glioma-targeted delivery system must be sufficiently potent to cross the BBB and BBTB and then target glioma cells with adequate optimized physiochemical properties and biocompatibility. However, it is an enormous challenge to the researchers to engineer the above-mentioned features into a single nanocarrier particle. New frontiers in nanomedicine are advancing the research of new biomaterials. In this study, we demonstrate a strategy for glioma targeting by encapsulating vincristine sulfate (VCR) into a naturally available apoferritin nanocage-based drug delivery system with the modification of GKRK peptide ligand (GKRK-APO). Apoferritin (APO), an endogenous nanosize spherical protein, can specifically bind to brain endothelial cells and glioma cells via interacting with the transferrin receptor 1 (TfR1). GKRK is a peptide ligand of heparan sulfate proteoglycan (HSPG) over-expressed on angiogenesis and glioma, presenting excellent glioma-homing property. By combining the dual-targeting delivery effect of GKRK peptide and parent APO, GKRK-APO displayed higher glioma localization than that of parent APO. After loading with VCR, GKRK-APO showed the most favorable antiglioma effect in vitro and in vivo. These results demonstrated that GKRK-APO is an important potential drug delivery system for glioma-targeted therapy.     

上海某医院护理人员离职意愿与满意度调查

目的：探讨改善护理人力配置,降低护理人员离职率,提高在职护理员工满意度,为部队医院提升优化护理人力资源管理提供科学依据和决策建议。方法：以问卷调查的形式评估该院304名护理人员的满意度和离职意愿现状,通过统计学处理和因子分析研究其满意度和离职意愿。结果：该院护理人员离职意愿较高（离职意愿处于较高以上等级占72%）,满意度较低（满意度处于不满意等级为33.3%）,满意度中工资福利、管理和工作被认可三个影响因子与离职意愿有显著相关性。结论：通过完善薪酬福利体系,创新管理方式,改善工作环境,提高护理工作社会认可度,以提高部队医院护理人力资源管理水平。     

两种QCT骨密度测量软件检测腰椎骨密度的比较

目的 探讨飞利浦工作站IntelliSpace (IP) （无体模）和Mindways (MW) QCT Pro（有体模）两种骨密度测量软件测量腰椎BMD值的重复性、相关性、一致性及其在临床中的应用价值。方法 临床需要进行腹部扫描患者222例,将扫描数据分别传到IP和MW骨密度测量软件进行测量,应用 Pearson 相关性检验分析两种软件测量结果的相关性,应用配对样本 t 检验分析两种方法测量结果平均值是否有差异,应用Bland-Altman 图分析二者的一致性。自222例数据中随机抽取30例,由 2 名测量者在不同时间分别在各自软件上测量2 次椎体BMD 值,评价两个软件测量重复性。结果 重复性研究：IP及MW 对于所选 30 例 2 次测量结果之间均具有显著相关性(r=0.977,P＜0.01) 。2次测量结果之间差异均无统计学意义 (P>0.05) 。IP测量BMD值（92.93±36.16 mg/cm3）显著低于MW测量BMD值（112.78±41.36 mg/ cm3）,但两者测量值之间成正相关（r=0.911,P＜0.01）,对原始数据进行Bland-Altman 分析,差值大部分位于差值平均值±1. 96 标准差范围内,提示两种测量一致性好。结论 IP骨密度测量软件不能直接采用QCT诊断标准,但其与MW骨密度测量软件的一致性及相关性好,可用于对临床患者骨密度的评价及随访。     

Mid-term follow-up surgical results in 284 cases of clival chordomas: the risk factors for outcome and tumor recurrence

Objective

Skull base chordoma (SBC) is rare and one of the most challenging diseases to treat. We aimed to assess the optimal timing of adjuvant radiation therapy (RT) and to evaluate the factors that influence resection and long-term outcomes.

Methods

In total, 284 patients with 382 surgeries were enrolled in this retrospective study. Postsurgically, 64 patients underwent RT before recurrence (pre-recurrence RT), and 47 patients underwent RT after recurrence. During the first attempt to achieve gross-total resection (GTR), when the entire tumor was resected, 268 patients were treated with an endoscopic midline approach, and 16 patients were treated with microscopic lateral approaches. Factors associated with the success of GTR were identified using χ² and logistic regression analyses. Risk factors associated with chordoma-specific survival (CSS) and progression-free survival (PFS) were evaluated with the Cox proportional hazards model.

Results

In total, 74.6% of tumors were marginally resected [GTR (40.1%), near-total resection (34.5%)]. History of surgery, large tumor volumes, and tumor locations in the lower clivus were associated with a lower GTR rate. The mean follow-up period was 43.9 months. At the last follow-up, 181 (63.7%) patients were alive. RT history, histologic subtype (dedifferentiated and sarcomatoid), non-GTR, no postsurgical RT, and the presence of metastasis were associated with poorer CSS. Patients with pre-recurrence RT had the longest PFS and CSS, while patients without postsurgical RT had the worst outcome.

Conclusion

GTR is the goal of initial surgical treatment. Pre-recurrence RT would improve outcome regardless of GTR.