ABSTRACT
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is commonly associated with developmental dyslexia (DD), which are both prevalent and complicated pediatric neurodevelopmental disorders that have a significant influence on children's learning and development. Clinically, the comorbidity incidence of DD and ADHD is between 25 and 48%. Children with DD and ADHD may have more severe cognitive deficiencies, a poorer level of schooling, and a higher risk of social and emotional management disorders. Furthermore, patients with this comorbidity are frequently treated for a single condition in clinical settings, and the therapeutic outcome is poor. The development of effective treatment approaches against these diseases is complicated by their comorbidity features. This is often a major problem in diagnosis and treatment. In this study, we developed bioinformatical methodology for the analysis of the comorbidity of these two diseases. As such, the search for candidate genes related to the comorbid conditions of ADHD and DD can help in elucidating the molecular mechanisms underlying the comorbid condition, and can also be useful for genotyping and identifying new drug targets. RESULTS: Using the ANDSystem tool, the reconstruction and analysis of gene networks associated with ADHD and dyslexia was carried out. The gene network of ADHD included 599 genes/proteins and 148,978 interactions, while that of dyslexia included 167 genes/proteins and 27,083 interactions. When the ANDSystem and GeneCards data were combined, a total of 213 genes/proteins for ADHD and dyslexia were found. An approach for ranking genes implicated in the comorbid condition of the two diseases was proposed. The approach is based on ten criteria for ranking genes by their importance, including relevance scores of association between disease and genes, standard methods of gene prioritization, as well as original criteria that take into account the characteristics of an associative gene network and the presence of known polymorphisms in the analyzed genes. Among the top 20 genes with the highest priority DRD2, DRD4, CNTNAP2 and GRIN2B are mentioned in the literature as directly linked with the comorbidity of ADHD and dyslexia. According to the proposed approach, the genes OPRM1, CHRNA4 and SNCA had the highest priority in the development of comorbidity of these two diseases. Additionally, it was revealed that the most relevant genes are involved in biological processes related to signal transduction, positive regulation of transcription from RNA polymerase II promoters, chemical synaptic transmission, response to drugs, ion transmembrane transport, nervous system development, cell adhesion, and neuron migration. CONCLUSIONS: The application of methods of reconstruction and analysis of gene networks is a powerful tool for studying the molecular mechanisms of comorbid conditions. The method put forth to rank genes by their importance for the comorbid condition of ADHD and dyslexia was employed to predict genes that play key roles in the development of the comorbid condition. The results can be utilized to plan experiments for the identification of novel candidate genes and search for novel pharmacological targets.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Dyslexia , Humans , Child , Attention Deficit Disorder with Hyperactivity/complications , Attention Deficit Disorder with Hyperactivity/epidemiology , Attention Deficit Disorder with Hyperactivity/genetics , Gene Regulatory Networks , Dyslexia/complications , Dyslexia/epidemiology , Dyslexia/genetics , Comorbidity , Cell MovementABSTRACT
Objective To study the superiority of severe multiple trauma treatment model based on damage control strategy. Methods In the intergrated injury first-aid mode, the intensive care unit-guided damage control strategy was used to treat severe multiple trauma. Results A total of 789 severe multiple damage patients were treated with damage control strategies in our hospital from December 2018 to December 2018. Sixty-nine patients died and the survival rate was 91.25％. Conclusions The intensive care unit-guided trauma control strategy has a satisfactory clinical effect in the treatment of patients with severe multiple trauma.
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Objective To investigate the potential mechanism that melatonin at higher concentrations inhibits the proliferation of human MG-63 osteosarcoma cells,so as to provide a certain experimental basis for the better application of melatonin in the treatment of diseases in Department of Orthopedics. Methods MG-63 cells cultured in vitro were treated with melatonin at a concentration of 4 mmol/L . Western blotting and real-time PCR method were used to analyze the effect of melatonin on the expression of cyclins and CDKs at protein and mRNA levels ,respectively. Results Western blotting and real-time PCR analyses showed that melatonin's inhibitory effect was possibly through the downregulation of cyclin D1 and CDK4 that related to the G1 phase,and downregulation of cyclin B1 and CDK1 that related to the G2/M phase. However,there was no obvious dif-ference of cyclin E,CDK2,and cyclin A,which were related to G1/S transition and S phase. Conclusion Melatonin may significantly inhibit hu-man osteosarcoma cell proliferation by inducing cell cycle arrest in a time-dependent manner,which is related to the downregulation of cyclin D1, CDK4,cyclin B1 and CDK1.
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Objective To summarize the experience in early diagnosis and emergency treatment for combined thoracoabdominal injury (CTI). Methods Clinical data of 58 cases of CTI admitted to our hospital from June 2001 to August 2009 were analyzed retrospectively.All the patients were treated by closed drainage of thoracic cavity,of which 12 cases were treated with thoracotomy,31 with laparotomy,seven with thoracic and abdominal incisions and three with combined thoracoabdominal incision.Internal fixation for long limb bones was performed in 27 cases,spinal laminectomy and pedicle screw fixation in five and amputation in one. Results After operation,six cases were found to have adult respiratory distress syndrome (ARDS) and 12 cases were complicated with multiple organ dysfunction syndrome (MODS).Fifty-three cases were cured and five died. Conclusions CTI based multiple injuries are severe and complicated.CT scan in the early stage plays a significant role in the diagnosis of CTI and closed drainage of thoracic cavity is an important assurance of the security of abdominal operation.Early diagnosis,correct choice of operation procedures and reasonable handling order of injured organs can improve the successful rescue rate for multiple injury patients.
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Bilingual education refers to applying a kind of foreign language to the non-language class curriculum,and the foreign language and the professional knowledge are gained in synchronization.Using bilingual education has increased students' study difficulty in the medical course.The object of Taskbased Teaching is that the student must grasp the specialized knowledge and the foreign language.
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Objective To evaluate and compare the clinical effects of proximal femoral nail antirotation blade (PFNA) with reverse less invasive stabilization system-distal femur (LISS) in the treatment of proximal femoral fractures associated with coxa vara. Methods From June 2007 to June 2010, A retrospective study with more than 10 months follow-up of 46 patients with proximal femoral fractures associated with coxa vara underwent PFNA or reverse LISS were carried out, including 24 with PFNA and 22 patients with reverse LISS. The physical status of patient was evaluated according to the American Society of Anesthesiologists (ASA) score. After the operation, the operation duration and volume of blood loss were assessed in the two groups, respectively. At the last follow-up, full weight bearing time, fracture healing time, and neck-shaft angle discrepancy related to contralateral side without fracture of the each group were assessed, respectively.Functional recovery was evaluated according to Parker and Palmer mobility score. Results The average follow-up period was 11.2 months (range, 10-12). All the fractures healed successfully and reached bony union.There were no significant differences between PFNA group and reverse LISS group for the average ASA score, the average operating time, the average volume of intraoperative bleeding and Parker and Palmer mobility score. The patients were allowed full weight-bearing from 9.33 weeks after surgery in PFNA group and from 16.95 weeks in reverse LISS group. The patients reached bony union after 17.21 weeks after surgery in PFNA group and from 30.73 weeks in reverse LISS group. Comparing with PFNA group, neck-shaft angle discrepancy decreased in reverse LISS group. Conclusion The results of PFNA and reverse LISS in the treatment of proximal femoral fracture were satisfactory. The fracture treated by PFNA allowed earlier weight bearing. Reverse LISS could provide better support for neck-shaft angle to avoid coxa vara more effectively.
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[Objective]To evaluate the clinical application and results of the anterolateral acromial approach with minimal incision in the treatment of proximal humerus fracture.[Method]From December 2006 to December 2008,42 patients with proximal humeral fracture were treated by the anterorlateral acromial approach using locking plate.There were 25 males and 17 females.All the fractures were classified with AO/OTA classification.There were 5 A2-fractures,11A3-fractures,7 B1-fractures,12 B2-fractures,3 C1-fractures,4 C2-fractures.Anterolateral acromial approach with minimal incision was applied and the deltoid muscle was seperated to expose the fracture fragments.Under direct vision the direct and indirect reduction of the fractures were performed.The locking plate was inserted distally beneath the deltoid muscle and between the distal plate and the humeral shaft was adjusted through another small skin incision on the lateral upper arm.Locking screws were inserted to the proximal and distal plate.Operation time,incision length,blood loss,reduction,Neer scores at 1 year were analyzed in different time points.[Result]All the cases were completed with minimal incision.There were significant differences(P
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[Objective]To explore the clinical effects of titanium plate and morselized hone grafting for the treatment of severe acetabular hone defect.[Method]A total of 27 patients with acetabular defects were treated with this procedure.According to AAOS,the acetabular defects were classified into various types:type Ⅰ in 6 cases,type Ⅱc in 4 and type Ⅲ in 17.The average preoperation Harris score were 37.The postoperative effect should be evaluated by clinical and X-ray manifestations.[Result]All patients were adopted this method to reconstruct the acetabular bone defects.The prosthetic dislocation was found in one case after operation,which was resulted from over-anteverted titanium plate impacted the greater trochanter.The part of trochanteric bone and impact factors were removed to healing.No complications were found in other patients.The average following up was 3 years and average Harris score was 87.The X-ray showed that none of the patients was presented the radiolucent lines in the acetabular mattress,bone transplantation,reconstructive titanium plate and interface of polyethylene liner.[Conclusion]The titanium plate and morselized bone grafting can repair the acetabular bone defects effectively and provide a solid initial fixation for prosthesis and restore the role of rotational center of hip.
