Structured physical activity programs for children with autism spectrum disorders and their health benefits: a systematic review / 中国康复理论与实践

ObjectiveTo systematically analyze the content and health benefits of structured physical activity programs for children with autism spectrum disorders (ASD). MethodsPublished literature related to structured physical activity for children with ASD and its health benefits were searched in Wanfang database, CNKI, Embase, EBSCO and PubMed from January, 2013 to July, 2023. A systematic review was conducted using the PRISMA guidelines. ResultsSeven literatures were finally included, from China, USA, Germany, Italy and Turkey. The publication dates concentrated after 2019. The study designs were all randomised controlled trials with 193 children with ASD, aged three to 14 years. Structured physical activity intervention sites included community sports halls, special education schools, rehabilitation wards of children's hospitals, and rehabilitation centers for children with disabilities. The intervention attributes were generally treatment, rehabilitation and health promotion. The content of physical activity mainly included motor skill-based activities (e.g., running, jumping, kicking, hitting, throwing), traditional yoga activities (e.g., breathing, mimicking postures and relaxation, as well as appropriate socialization activities such as encouragement of greeting/farewell songs, touch/contact games and expressive games), and a combination of multiple types of exercises integrated with school-based curricula such as aerobic exercises (walking), endurance exercises (jumping) and neuromuscular exercises (throwing paper airplanes), mindfulness for emotions and body, and judo. The frequency of the intervention ranged from 40 to 90 minutes, one to four times a week; the intensity ranged from mild to vigorous; and the duration ranged from eight to 40 weeks. The physical and behavioral health benefits were reflected in three aspects. In terms of body composition, it could reduce fat and body mass, increase muscle strength, and improve cardiorespiratory function. In terms of function, it could improve children's language and communication function, cognitive and executive function, and motor function. In terms of physical activity-related health behaviors, it could enhance children's motivation to exercise, reduce sedentary behavior, increase social and interactive behavior, improve emotional regulation, and reduce the risk of problematic behaviors. ConclusionThe physical and behavioral health benefits of structured physical activity for children with ASD can be reflected in the areas of body composition, function, and physical activity-related health behaviors.

Influences of Different Stop Modes on Gait Stability of the Elderly Carrying Heavy Objects / 医用生物力学

Objective To analyze characteristics of muscle activity and changes of corresponding kinematic parameters of the lower limbs for the elderly carrying heavy objects under synchronous stop modes, and explore the effects of hand weight-bearing and stop modes on gait stability and body balance of the elderly. Methods The ankle, knee, hip joint angles and surface electromyography (EMG) signals of bilateral lower limbs were collected under the condition of emergency stop and planned stop by loading 0 kg, 2.5 kg on both hands and 5 kg on right hand. Results Under different weight-bearing modes, the ankle and hip angles of bilateral lower limbs were significantly different (P<0.05), while the knee angles did not change significantly, and different stop modes significantly affected the angle changes in each joint (P <0.001); the average EMG of tibia anterior muscle, lateral femoral muscle, and biceps femoris in braking leg showed higher muscle activity during emergency stop. Conclusions In order to cope with the instability caused by weight-bearing and emergency stop, the elderly will have a corresponding balance mechanism in the lower limbs. During an emergency stop, braking the tibialis anterior muscle of the leg requires a higher muscle activity level to control flexion angle of the ankle joint, thereby reducing amplitude of the ankle joint fluctuation. The single-handed load increases the muscle performance differences between the braking leg and trailing leg, resulting in the lateral instability.

Fall Risk Analysis of Elderly People with Different Load Distributions during Obstacle Crossing Based on Surface Electromyography / 医用生物力学

Objective To study the factors leading to the increased risk of falls when the elderly cross obstacles with different load distributions in their hands, and to explore the gait strategies to prevent falls for elderly people with different load distributions during obstacle crossing. Methods Twelve young healthy (control group) and 12 elderly healthy participants performed walking tasks with or without obstacle crossing at their daily speed under different load distributions. Surface electromyography (sEMG) signals were collected from both sides of the lateral femoris, rectus femoris and medial femoris. Then the average sEMG was analyzed and compared. The numbers of contact incident during obstacle touching were also recorded. Results Age, weight carrying and obstacle all had significant influences on the activity level of lower limb muscles in elderly people. A total of 9 contact incidents occurred in 1 152 obstacle crossing tests. In addition, the contribution of right vastus medialis muscle was the greatest in the elderly and young adults when they completed the weight carrying and obstacle crossing tasks. Conclusions The elderly people had the lowest risk of falling down by taking advantage of the dominant side of the leg to take the lead in obstacle crossing under the uniform distributions of load. The research findings provide references for systematic assessment of fall risk in the elderly and have certain guiding significance for lower limb exercise or rehabilitation training in the elderly.

Non-suicidal self-injury and exposure to suicidal behaviors among Chinese adolescents: a longitudinal study / 中华流行病学杂志

Objective@#Non-suicidal self-injury (NSSI) in adolescents appeared prevalent and multifactorial. This study was to examine the associations between exposure to suicidal behaviors and NSSI in the Chinese adolescents.@*Methods@#Participants included for analyses were 5 154 adolescent students who participated in the baseline survey in 2015 and the first follow-up survey in 2016 of the Shandong Adolescent Behavior and Health Cohort, but with no history of NSSI at the baseline survey. A self-administered structured questionnaire was used to collect data on demographics, behavioral and emotional problems, lifetime and last-year NSSI. Data on the history of exposure to suicide attempt or death of a family member, friend, or close acquaintance were also collected. Multivariate logistic regression methods were used to examine the associations between exposure to suicidal behaviors and NSSI.@*Results@#In the baseline survey, mean age of the 5 154 participants was (14.49±1.48) years, with 48.5% of the participants as girls. Of the participants, 9.0% reported having been exposed to suicidal behaviors, including 6.0% reported to suicide attempt, 4.9% to suicide death, 7.3% to suicidal behaviors of friends/close acquaintances, and 3.1% to suicidal behaviors of relatives. The prevalence rates of NSSI in the last year were significantly higher in adolescents who had been exposed to suicidal behaviors than those who had not (P<0.05). Results from the multivariate logistic regressions showed that exposure to suicide death (OR=1.91, 95%CI: 1.22-3.01) or to suicidal behaviors of relatives (OR=1.79, 95%CI: 1.02-3.12) were both significantly associated with the increased risk of NSSI.@*Conclusions@#Experiences related to exposure to suicide-death or suicidal behaviors of relatives were associated with increased risk of NSSI in adolescents. After the suicide events, psychological counseling and health education programs set for high-risk groups were helpful in promoting physical and mental health and preventing the attempt of self-injury in teenagers.

The relationship between mental stimulation level of life events and suicide attempt of rural residents in Shandong Province / 中华预防医学杂志

Objective@#To explore the relationship between the level of mental stimulation and the suicide attempts of rural residents in Shandong Province.@*Methods@#A 1:1 matched case-control study was designed to collect 1 200 cases from a survey of three suicide attempts in rural areas of Shandong Province. Controls were selected according to the following matched factors: age difference within 3 years, same gender, same village or neighboring village, no blood relationship, no suicide history. The basic characteristics of all subjects were collected through the questionnaire, and the level of mental stimulation of life events was measured. Multivariate conditional logistic regression model was used to analyze the relationship between the level of mental stimulation of life events and suicide attempts.@*Results@#The mean age of the case group and the control group was both (36.6±0.3) years old, and 35.8% (430/1 200) were males in each group. The low-medium level of mental stimulation of negative life events in the case group was 16.7% (200/1 200) and 61.7% (740/1 200), respectively, which was higher than that in the control group, about 2.5% (30/1 200) and 29.3% (352/1 200) (all P values <0.05), respectively. A total of 11.1% (133/1 200) of the case group had positive life events, which was lower than that of the control group [16.8% (201/1 200)] (all P values<0.05). Multivariate logistic regression model analysis showed that after the adjustment of gender, age, place of residence, education level, marital status, occupation, family income, somatic disease, mental disorders, family history of suicide, and opposite life events, the low-medium and high level of mental stimulation of negative life events were risk factors for suicide attempts, with OR (95%CI) as 5.88 (4.53-7.64) and 13.94 (8.15-23.86), respectively. Mental stimulation of positive life events was protective factor of suicide attempts, with OR (95%CI) as 0.58 (0.41-0.82).@*Conclusion@#Mental stimulation of negative and positive life events were risk and protective factors for suicide attempts.

Effects of dexamethasone on proliferation, differentiation and apoptosis of adult human osteoblasts in vitro / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To observe the effects of dexamethasone on proliferation, differentiation and apoptosis of adult human osteoblasts in vitro.</p><p><b>METHODS</b>Iliac trabecular bone specimens were obtained from adult patients undergoing necessary surgery. After the bone pieces were digested with collagenase-trypsin, osteoblasts were released and incubated at 37 degrees C in a relative humidity of 95% and 5% CO2. Then, the cells were purified, and their passages were given DMEM-F12 and fetal bovine serum medium. Subsequently, 10(-8) mol/L dexamethasone was added into the culture medium to incubate the osteoblasts for three days, and the cells from control groups were incubated without any drugs. All cells were observed continually with phase contrast microscope and transmission electron microscope. Finally, apoptosis was detected by the use of terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) and biochemical indices, alkaline phosphatase (ALP) and osteocalcin (OCN) were used to determine the effects of dexamethasone on proliferation, differentiation and apoptosis of adult osteoblasts in vitro.</p><p><b>RESULTS</b>In the adult osteoblasts obtained by collagenase-trypsin digestion, it achieved high survival, stable biochemical indices and excellent purification. Under the condition of dexamethasone 10(-8) mol/L and osteoblasts 10,000/ml, there was significant promotion of ALP and OCN secretion without cell apoptosis.</p><p><b>CONCLUSIONS</b>Dexamethasone has a significant effect on the proliferation and differentiation of adult osteoblasts in vitro without apoptosis, and dexamethasone at the suggested concentration can be used as positive control in drug studies for osteoporosis treatment.</p>

INNERVATION IN THE RAT THYMUS——AN INVESTIGATION BY SILVER STAIN AND ACETYLCHOLINESTERASE HISTOCHEMICAL METHOD / 解剖学报

The innervation in the thymus was observed by silver stain and acetylcho linesterase (AChE) histochemical method. It was shown by silver stain that nerve fibers constituted a complex network in the thymic medulla. In the cortex and medulla there were AChE-containing nerve fibers. which terminated near or encircled the thymocytes. AChE-containing nerve fibers contacted with mast cells. Some mast cells had AChE-containing substance. This study suggests that the cortex and medulla of thymus are innervated by parasympathetic cholinergic nerve fibers, which may regulate the thymocytes and mast cells.

THE INFLUENCE OF EXPERIMENTAL DIABETES ON THE EPITHELIAL CELLS IN RAT THYMIC CORTEX / 解剖学报

Objective To explore the morphologic changes of the epithelial cells in the thymic cortex in diabetes rats, and its possible mechanism of thymocyte apoptosis and thymus involution. Methods The ultrastructure changes of the epithelial cells in the thymic cortex in diabetes rats were observed under electron microscope. Results The type 2 epithelial cells had four kinds of the changes on ultrastructure:1 the endocrine disorder like changes with a large number of the degenerative cystic vacuoles;2 the degenerative like changes with lots of the abnormal secretory vacuoles and myelin like bodies and bulky tonofilament bundles; 3 the phagocyte like changes with a great number of the dense lysosome like granulae and the phagocytosed apoptotic cells and bodies; 4 the apoptosis like changes with the early morphologic changes of apoptosis. The type 3 epithelial cells had two kinds of the changes on ultrastructure:1 degenerative like changes with groups of dense granulae which secrete peptide hormones;2 the proliferative like changes with numerous collage fibrils in the vicivity of their perikarya. In addition, a lot of the apoptotic thymocytes and the reduction of thymocyte number were found in thymic cortex.Conclusion The varied ultrastructure changes of the epithelial cells in rat thymic cortex could be induced by diabetes, which might be the one of major mechanisms on influencing the thymocyte development and causing the thymocyte apoptosis and thymus involution.\;[