Background:Due to the variability in clinical manifestations and the frequent diagnostic delays associated with autism spectrum disorder (ASD), interest in identifying fatty acids as potential biomarkers is increasing. Nonetheless, owing to inconclusive evidence, further investigation is needed. Objective:To explore the relationship between fatty acids and ASD risk and identify distinct fatty acid metabolites in children with ASD. Methods:Plasma fatty acid levels were tested in totally 131 participants (ages 2-6 and male-to-female ratio 2.5:1) with and without ASD using gas chromatography coupled to flame ionization detector and mass spectrometer (GC-FID/MS) technology. Between-group differences in each fatty acid and the omega-3 polyunsaturated fatty acid/arachidonic acid (AA) ratio were explored. We adjusted for covariates via multivariable models. The discriminatory sensitivity of meaningful fatty acids between ASD and control groups was assessed via receiver operating characteristic curve (ROC) analysis. Results:Two of 22 fatty acids significantly differed between children with ASD and typically developing children. Specifically, C20:4ω6 (AA) (457.4 ± 195.3 μmol/L vs. 493.3 ± 111.9 umol/L, P = 0.044) and C24:0 (34.7 ± 7.9 μmol/L vs. 38.3 ± 8.7 μmol/L, P = 0.019) levels were significantly lower in the autism group than in the control group, whereas the alpha-linolenic acid (ALA)/AA ratio [0.13(0.10, 0.18) vs. 0.10(0.08, 0.15)] was significantly greater in children with autism than in those without. Potential interactive effects between AA, C24:0, ALA/AA and gastrointestinal syndromes were further observed. Biomarkers were assessed via ROC analysis, which revealed AA, C24:0 and ALA/AA AUC values of 0.60(0.50~0.70), 0.62(0.52~0.72) and 0.62 (0.52~0.71), respectively. Conclusions:Fatty acid disturbance was observed among children with ASD, particularly in terms of AA, C24:0 and the ALA/AA ratio. These findings provide valuable insights into the underlying mechanisms of ASD and suggest that modulating fatty acid levels could serve as an intervention strategy.

Background:Children with autism often exhibit atypical eating behaviors, which may significantly impact their nutritional status and overall well-being. However, research on the dietary habits of Chinese children with autism remains limited. Objective:This study primarily assesses the applicability of Brief Autism Mealtime Behavior Inventory (BAMBI) for Chinese children with autism, while further exploring the unique dietary behavior characteristics within this population. Methods:In total, 103 children with autism aged 3-6 years and 331 typically developing preschoolers were recruited. All participants' parents completed the Brief Autism Mealtime Behavior Inventory (BAMBI) and the Six-item Gastrointestinal Severity Index (6-GSI). The reliability and validity of the Chinese version of the BAMBI were analyzed, and differences in dietary behavior were tested between cases and controls. Results:The item reliability (Cronbach's alpha) was 0.849 for total BAMBI. Pearson correlation analyses of the full BAMBI scale scores and subscales revealed significant correlations (r values ranging from 0.580 to 0.912, P < 0.01). The confirmatory factor analysis result shows that BAMBI 18 items have an acceptable fit to the data (GFI = 0.901, CFI = 0.819, ILI = 0.821, RMSEA = 0.074). Although the value of average variance extra (AVE) of the main scale is slightly below 0.5, the composite reliability (CR) is both above 0.7. The ASD group scored significantly higher than the typically developing group in terms of the BAMBI total score and subscales. The top problematic dietary behaviors reported by parents were inflexible about mealtime routines (79.61%), unwilling to try new foods (75.73%) and not accepts or prefers a variety of foods (71.84%). The positive association between BAMBI total scores and 6-GSI scores was observed. Conclusion:BAMBI is a validated tool for assessing dietary behaviors in autistic children in China. Compared with their typically developing peers, ASD children presented more dietary behavior problems. This study emphasizes early attention to dietary behavior problems in children with autism.

目的 为营造良好的社会风气,杜绝收受回扣现象的发生,规范医疗设备购销秩序,优化公立医院医疗设备招标采购监管机制.方法 基于演化博弈理论,对医疗设备招标采购阶段利益相关者进行识别,构建演化博弈模型,通过模型求解得到各方主体的行为选择演化稳定策略,并运用Matlab仿真模拟,探讨影响参与主体行为的因素.结果 根据模型分析可知,当合谋的额外收益小于合谋被查处所受处罚及合谋成本之和、监管机构严格监管的成本较小时,能实现良好的均衡状态.结论 通过模型仿真分析发现,监管机构只加强一方的监管力度并不能实现监管目标,加强对合谋体的监管与处罚可预防腐败合谋的发生,同时审计机关对监管机构过高的问责力度不利于双方策略行为向理想的平衡状态转化.

[目的]通过对医院内部资产管理部门和医院内部监督组织的行为博弈分析,为医院应对资产管理风险提供决策理论参考.[方法]围绕医院资产安全与效率2个主要问题,以医院资产管理部门和医院内部监督组织为博弈主体,进行演化博弈分析,并运用Matlab计算机仿真,分析不同情况下双方的博弈行为.[结果]当医院资产管理部门追求自利的成本高于其收益时,会选择追求医院价值最大化;反之,惩罚较低或额外收益较高时,会偏向于追求自利行为.当内部监督组织的认真监督的成本低于其不认真监督受到上级的处罚时,会选择认真监督;反之,会选择不认真监督.[结论]当医院资产管理部门追求自利行为的成本高于其期望收益且内部监督组织认真监督成本低于所受上级处罚时,其双方博弈结果将会达到理想的状态,且医院内部监督组织对其资产管理部门实施较重处罚时将会加快这一过程的收敛.

从信息化视角出发,基于委托代理理论,分析公立医院固定资产管理存在的问题,提出利用机器人流程自动化技术实现对医院固定资产业务流程的自动化管理,利用全过程动态数据,加强信息化建设,推进业财融合,优化内部控制方法,从而提升医院固定资产信息化管理水平.

Currently available drugs for complex diseases have such limitations as unsatisfactory efficacy, drug resistance, and toxic side effects. Complexity of biological systems is a determinant of drug efficacy. It is not an effective approach to find disturbance strategies for the complicated biological network for complex diseases based on the static topological structures, as biological systems undergo dynamic changes all the time. Supported by profound theoretical basis and rich clinical experience, traditional Chinese medicine(TCM) emphasizes systematic and dynamic treatment depending on changes. Guided by TCM theory in practical treatment, Chinese medicine dynamically and comprehensively regulates the overall state. Therefore, if the dynamic factors are taken into consideration in design, the resultant drugs will be more effective. This study proposes state-regulating(SR) medicine from the perspective of system dynamics, elaborating the concept in terms of the connotations and principle and verifying the feasibility of SR medicine design with the attractor method. Thus, SR medicine is a new concept for drug discovery and design from the aspect of system dynamics, which integrates the TCM focusing on holistic dynamic regulation with biomedicine that features local microscopic research such as molecular mechanisms. The attractor method is a feasible techinical way for SR medicine design.

目的:挖掘并分析益智方剂药性组合层面的配伍规律.方法:以《中医方剂大辞典》中90首益智方剂为数据源,采用频数分析和关联规则Apriori算法进行定性分析,挖掘使用频率较高的药性组合模式与药物组合,并基于"药性组合权值"对益智方剂进行定量分析.结果:90首益智方剂中人参、远志、石菖蒲、茯苓、茯神等中药用药频率最高;置信度为100％,支持度>83％时,得到6条核心药性组合模式"温苦肾+温苦肺+温苦心""温苦肾+平甘肾""温苦肺+平甘肾""平甘心+平甘肾""平甘肾+平甘脾""平甘肾+温苦心";方剂用药组成上,置信度为100％,支持度>30％时,得到8条频繁项集.通过药性组合权值定量得出权重较高的药性组合为平甘肾、温苦心、平甘心、平甘脾、温苦肾、温甘肾、温苦肺、温辛心、温甘脾等.结论:药性组合模式能在一定程度上体现方剂配伍规律,益智类方剂多有开窍醒神、益肝补脾、解郁安神、补气健脾等功效.采用的方法对临床用药和经典方剂的传承有一定的指导作用.

卒中后认知障碍(PSCI)在我国卒中患者中发病率高,寻求能够有效预防、治疗PSCI的疗法迫在眉睫.现代研究表明针刺在改善卒中患者认知功能方面取得了较好的疗效,但存在对研究成果的总结与探究不够深入的问题.该文通过检索PubMed、The Cochrane Library、 CNKI、WanFang Data、VIP、CBM数据库,对近10年(2010年1月-2020年1月)国内外相关研究进行分析.结果 表明:(1)PSCI存在知晓率低、缺乏系统性筛查、药物治疗证据不足等现状;(2)针刺治疗PSCI取穴方面以百会、神庭、四神聪为主,但仍缺乏有高级别证据支持的、较为统一的穴位组方;(3)针刺或针刺联合其他疗法均具有改善认知功能的疗效,但仍存在研究中评价疗效指标过于单一、缺乏手法量学研究等问题,且部分研究存在概念混淆、干预措施过于复杂、难以评价疗效等问题.该文主要阐述PSCI的诊疗现状及针刺治疗PSCI的研究概况,并进行总结与思考.

Background: Pulmonary Fibrosis (PF) is an interstitial lung disease characterized by excessive accumulation of extracellular matrix in the lungs, which disrupts the structure and gas exchange of the alveoli. There are only two approved therapies for PF, nintedanib (Nib) and pirfenidone. Therefore, the use of Chinese medicine for PF is attracting attention. Tianlongkechuanling (TL) is an effective Chinese formula that has been applied clinically to alleviate PF, which can enhance lung function and quality of life.Purpose: The potential effects and specific mechanisms of TL have not been fully explored, yet. In the present study, proteomics was performed to explore the therapeutic protein targets of TL on Bleomycin (BLM)-induced Pulmonary Fibrosis.Method: BLM-induced PF mice models were established. Hematoxylineosin staining and Masson staining were used to analyze histopathological changes and collagen deposition. To screen the differential proteins expression between the Control, BLM, BLM + TL and BLM + Nib (BLM + nintedanib) groups, quantitative proteomics was performed using tandem mass tag (TMT) labeling with nanoLC-MS/MS [nano liquid chromatographymass spectrometry]). Changes in the profiles of the expressed proteins were analyzed using the bioinformatics tools Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG). The protein–protein interactions (PPI) were established by STRING. Expressions of α-smooth muscle actin (α-SMA), Collagen I (Col1a1), Fibronectin (Fn1) and enzymes in arginase-ornithine pathway were detected by Western blot or RT-PCR.Result: TL treatments significantly ameliorated BLM-induced collagen deposition in lung tissues. Moreover, TL can inhibit the protein expressions of α-SMA and the mRNA expressions of Col1a1 and Fn1. Using TMT technology, we observed 253 differentially expressed proteins related to PPI networks and involved different KEGG pathways. Arginase-ornithine pathway is highly significant. The expression of arginase1 (Arg1), carbamoyltransferase (OTC), carbamoy-phosphate synthase (CPS1), argininosuccinate synthase (ASS1), ornithine aminotransferase (OAT) argininosuccinate lyase (ASL) and inducible nitric oxide synthase (iNOS) was significantly decreased after TL treatments.Conclusion: Administration of TL in BLM-induced mice resulted in decreasing pulmonary fibrosis. Our findings propose that the down regulation of arginase-ornithine pathway expression with the reduction of arginase biosynthesis is a central mechanism and potential treatment for pulmonary fibrosis with the prevention of TL.

中药是中医治病的重要手段,随着大数据、传感器、人工智能等各种技术的成熟,其与中药的结合形成了新兴的中药智能产业,成为中药新兴产业的发展方向.本研究从中药质量追溯、中药设计、中药智能制造3个方面概述了中药智能产业的当前进展.结合中药产业面临的资源高度分散、质量影响因素众多、难以实现连续自动、需求个体差异明显等产业难题,指出未来中药智能产业在种植与炮制、煎煮与制剂、应用与推广的发展趋势和具体形式,以期对目前中药智能产业的发展方向提供参考.

This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder (ASD) in Chinese children. We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling. The Modified Chinese Autism Spectrum Rating Scale was used for the screening process. Of the target population of 142,086 children, 88.5% ( n = 125,806) participated in the study. A total of 363 children were confirmed as having ASD. The observed ASD prevalence rate was 0.29% (95% CI: 0.26%–0.32%) for the overall population. After adjustment for response rates, the estimated number of ASD cases was 867 in the target population sample, thereby achieving an estimated prevalence of 0.70% (95% CI: 0.64%–0.74%). The prevalence was significantly higher in boys than in girls (0.95%; 95% CI: 0.87%–1.02% versus 0.30%; 95% CI: 0.26%–0.34%; P < 0.001). Of the 363 confirmed ASD cases, 43.3% were newly diagnosed, and most of those (90.4%) were attending regular schools, and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity. Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.

Objective This study intends to explore the effect of parent-training program on the rehabilitation intervention in children with autism spectrum disorder (ASD) in Chinese-speaking areas of China by offering parent skill training and psychology counseling. Methods From January 2018 to June 2019, a total of 80 children diagnosed with ASD from the Department of Children Healthcare of Wuxi Children’s Hospital were randomly grouped into the parent training groups and control groups. Parents in the training group received 12 weeks of skill training, including 8 group and 2 individual training sessions, as well as psychology counseling. This enabled them to give their children >2 h of intervention training daily in a natural environment. Children in the control group were placed on a rehabilitation waiting list or received general community training. Before grouping and after the intervention, all children underwent neuropsychological evaluations with Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Gesell Developmental Schedule (GDS). GDS covers five sectors, namely adaptive behavior, gross motor, fine motor, language, and personal-social behavior. Results Statistically significant differences were not detected between the two groups in ABC, CARS, and GDS scoring at baseline evaluation. And significant differences were detected between the two groups in ABC, CARS, adaptive behavior, and personal-social behavior scoring at endpoint evaluation. Furthermore, the re-evaluation results of ABC scoring and CARS scoring of the children in the parent training group decreased significantly from the preliminary evaluation results when compared before and after the intervention. Moreover, the intragroup comparison of adaptive behavior scoring, language scoring, and personal-social behavior scoring of the experiment group increased significantly from the preliminary evaluation results, while the difference of the same of the children in the control group between re-evaluation and preliminary evaluation did not differ significantly. Conclusions In China, the parent-training program enables parents to train ASD children in a natural environment, which would markedly improve behavioral problems, core symptoms, adaptability, language competence, and social development capability.

Background: Alzheimer’s disease (AD) is a neurodegenerative disease that primarily manifests as progressive memory loss and cognitive impairment. Traditional herbal medicines may be helpful in the discovery of new anti-AD drugs. Studies have shown that Ferula assafoetida has neuroprotective and memory-enhancing effects, which may be beneficial for the treatment of AD. However, the combination of active ingredients and their mechanisms remain unclear. Therefore, we aimed to identify potential active ingredients in F. assafoetida and their mechanisms of action against AD by using network pharmacology. Methods: In our study, an integrated network pharmacological approach, that included adsorption, distribution, metabolism and excretion screening, target identification, network construction, topological analysis, gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis, and molecular docking, was used to predict the pharmacological material basis and potential mechanisms through which these ingredients may treat and prevent AD. Results: The results indicated that 12 key active ingredients, obtained by topological analysis (including farnesiferol a, conferol, farnesiferol b, ferulic acid, etc.), may be the primary pharmacological components that may ameliorate AD. The 2 key significant pathways identified are the cholinergic synapse signaling pathway (critical targets include ACHE, CHRM1, CHRM2, MAPK1, PIK3CA, PIK3CB, PIK3CD, and PIK3CG) and the AD signaling pathway (critical targets include APP, BACE1, GSK3B, MAPK1, NCSTN, NOS1, PSEN1). These critical targets are closely related to the regulation of three typical pathological features of AD [central nervous system (CNS) cholinergic hypofunction, amyloid-β (Aβ) plaques, and hyperphosphorylated tau proteins]. Finally, 14 critical targets in the 2 key significant pathways were validated by molecular docking analysis. Conclusion: F. assafoetida may be effective for alleviating AD symptoms, through multi-component, multi-target, and multi-pathway synergistic effects, associated with the multiple pathogenesis hypotheses of AD. Our study may provide certain clues for the further development and utilization of this natural herbal medicine.

目的:构建科学合理的收支管理风险量化评价指标体系,为识别公立医院收支管理环节存在的风险提供依据.方法:分别采用传统描述性统计方法和熵值法对收支风险指标进行赋权.结果:"备用金年底是否及时收回""支出申请与内部审批是否分离"等风险点在两种方法下其权重排序差异较大.结论:在传统医院收支风险管理领域,实务界关注收入支出的数量真实性、合法合规性,而以差异化为导向的熵值法更关注的是不同被试之间的差异性,即易被忽视的风险点,这与近几年审计实务中发现的问题基本吻合,医院财务管理人员应予以重点关注.

BACKGROUND Solitary rectal ulcer syndrome (SRUS) is a rare rectal disorder characterized by bloody mucus in the stool, difficulty in defecation, pain, and anal swelling. To date, the etiology of this syndrome remains not well understood and the diagnosis is frequently confused with other disorders, making treatment a clinical challenge. CASE SUMMARY A 50-year-old woman presented to our hospital with a 40-d history of bloody mucus in the stool and anal swelling. SRUS was suspected. Rectoscopy revealed a large, severe ulcerous lesion. Histologically, the lesion was characterized as chronic ulcer without clear tumor cells, and the final diagnosis of SRUS was made. The patient was treated with Chinese medicine therapy, with administration of Tong Xie Yao Fang. After 3 wk of treatment, the symptoms improved significantly. At 2-mo follow-up, rectoscopy in a local hospital showed healed ulcer scars without obvious protrusion 3 cm from the anal verge. CONCLUSION Chinese medicine therapy represents a potential treatment of SRUS with predominant rectal bleeding, mucinous discharge, and anal swelling pain.

Zuojinwan (ZJW), a classic herbal formula, has been extensively used to treat gastric symptoms in clinical practice in China for centuries. However, the pharmacological mechanisms of ZJW still remain vague to date.

Stimulated Raman scattering (SRS) microscopy is an emerging label-free imaging technique. It is a nonlinear version of Raman scattering, with the advantages of high chemical selectivity and rapid imaging. We have applied SRS microcopy for brain tumor detection on both in vivo mouse models and ex vivo human surgical specimens, based on the spectral differences between normal and tumor tissues. We further developed dual-phase parallel imaging technique for real-time two color SRS imaging, which provides a key advance for intraoperative virtual histology.

Northeastern China is one of the largest industrial and agricultural bases in China, but frequent flooding brings huge losses to the people and country. To forecast floods in northeastern China, we used commensurability forecasting techniques and ordered a network structure chart and butterfly structure diagram. The prediction selected extraordinary flooding years that have occurred in the region since 1856, and it used ternary, quinary, and septenary commensurability calculation models for forecasting. It verified the inevitability of flooding in 2013 and showed that northeastern China would be highly prone to flooding in 2017. The specific locations of flooding would be the second Songhua River or Liaohe River. The ordered network structure and butterfly structure diagram are the extension of commensurability, both of which showed perfect symmetry neatly and orderly, and indicated the great possibility of flooding in northeastern China in 2017. Because of spatial distribution in the region, we also picked up four representative sites in the region to subsidiarily forecast the runoff qualitatively. Except for a site that did not have a significant year, the other three sites showed that the runoff in the second Songhua River would be wet in 2017. The idea of this paper is good in the data-starved area and helpful for improving judgment regarding flood trends.

This study aimed to establish norms for the modified Chinese version of the Autism Spectrum Rating Scale (ASRS). Participants were recruited from Shanghai, Harbin, Guangzhou, and Changsha, China, and their parents and teachers were invited to complete the Chinese Parent version and the Teacher version of the ASRS. In both versions, boys had significantly higher sub-scale scores and total score (T-score) by 1-3 and 4-5 points respectively, than girls (both P < 0.001). Age had weak correlations with some sub-scores and the T-score (r ranged from -0.1859 to 0.0738), and some reached significance (P < 0.03). The correlations appeared stronger and were more common in females. The T-score based on Chinese norms ideally correlated with the score based on the United States norms in boys and girls for both versions. Norms for the Chinese version of the ASRS for children aged 6-12 years are proposed and may be helpful for screening individuals with autism spectrum disorders from the general population of children.

The purpose of this study was to explore the psychometric properties of the Chinese version of the autism spectrum rating scale (ASRS). We recruited 1,625 community-based children and 211 autism spectrum disorder (ASD) cases from 4 sites, and the parents of all participants completed the Chinese version of the ASRS. A robust weighted least squares means and variance adjusted estimator was used for exploratory factor analysis. The 3-factor structure included 59 items suitable for the current sample. The item reliability for the modified Chinese version of the ASRS (MC-ASRS) was excellent. Moreover, with 60 as the cut-off point, receiver operating characteristic analysis showed that the MC-ASRS had excellent discriminate validity, comparable to that of the unmodified Chinese version (UC-ASRS), with area under the curve values of 0.952 (95% CI: 0.936–0.967) and 0.948 (95% CI: 0.930–0.965), respectively. Meanwhile, the confirm factor analysis revealed that MC-ASRS had a better construct validity than UC-ASRS based on the above factor solution in another children sample. In conclusion, the MC-ASRS shows better efficacy in epidemiological screening for ASD in Chinese children.