Identifying subgroups of attention-deficit/hyperactivity disorder from the psychopathological and neuropsychological profiles.

The Research Domain Criteria (RDoC) advocates the dimensional approach in characterizing mental disorders. We followed RDoC to characterize children with ADHD using profiling based on the cognitive and psychopathological domains. We aimed to identify and validate ADHD subtypes with different clinical characteristics and functional impairments. We recruited 362 drug-naïve children with ADHD and 103 typically developing controls. The cluster analysis was used to identify subgroups based on the Child Behaviour Checklist (CBCL) and the Behaviour Rating Inventory of Executive Function (BRIEF). The subgroups' clinical characteristics and functional impairments were assessed using the WEISS Functional Impairment Rating Scale-Parent Report (WFIRS-P) and the Conners Parent Symptom Questionnaire (PSQ). The cluster analysis yielded four subgroups: (1) ADHD with severe impairment in psychopathology and executive functions (EF), (2) ADHD with mild executive dysfunctions and normal-level psychopathology, (3) ADHD with severe externalizing problems and (4) ADHD with severe executive dysfunctions. These subgroups showed different clinical characteristics and degrees of functional impairment. The EF impairment group displayed more serious learning problems and worse life skills than the externalizing group. The two groups with externalizing problems (i.e. the severe impairment group and the externalizing group) both exhibited higher rates of the combined subtype of ADHD and higher rates of comorbid ODD. Different subtypes of ADHD displayed different profiles of internalizing and externalizing problems and levels of executive dysfunctions. In particular, the subtype with severe impairment in EF exhibited more learning problems and worse life skills, suggesting EF is a critical target for intervention in children with ADHD.

[Intellectual characteristics of children with attention deficit hyperactivity disorder and developmental dyslexia].

OBJECTIVE: To study the intellectual characteristics of children with attention deficit hyperactivity disorder (ADHD) and developmental dyslexia (DD). METHODS: A total of 55 children with ADHD and DD (ADHD+DD group), 150 children with ADHD alone (ADHD group), and 22 children with DD alone (DD group) were enrolled as subjects. Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) was used to evaluate and compare intellectual characteristics among the three groups. RESULTS: There were significant differences in the scores of full-scale intelligence quotient (FSIQ), verbal comprehension index, perceptual reasoning index, and working memory index among the three groups (P < 0.05):the ADHD+DD group had significantly lower scores of FSIQ, verbal comprehension index, perceptual reasoning index, and working memory index than the ADHD group, as well as a significantly lower FSIQ score than the DD group. A comparison of the 10 core subtests in WISC-IV showed that compared with the ADHD group, the ADHD+DD group had significantly lower scores of similarities, vocabulary, comprehension, recitation, picture concepts, matrix reasoning, and letter-number sequencing (P < 0.05). Compared with the DD group, the ADHD+DD group had significantly lower scores of vocabulary, similarities, picture concepts, matrix reasoning, and recitation (P < 0.05). CONCLUSIONS: Compared with the children with ADHD alone, the children with ADHD and DD have more severe impairment of FSIQ, verbal comprehension, perceptual reasoning, and working memory, and therefore, it is suggested to enhance the training on similarities, vocabulary, matrix reasoning, picture concepts, and recitation for children with ADHD and DD in clinical practice.

Continuous Blood Purification Ameliorates Multiple Organ Failure Through Inhibiting the Activation of the P38 MAPK Signaling Pathway in a Rat Model.

BACKGROUND/AIMS: Multiple organ failure (MOF) is a primary threat to the survival of patients with systemic inflammation. Blood purification is employed in the treatment of MOF, as an artificial kidney or artificial liver. This study focuses on the effects of continuous blood purification (CBP) on ameliorating MOF through regulating the p38 mitogen-activated protein kinase (MAPK) signaling pathway in a rat model. METHODS: A rat model of MOF was successfully established by endotoxin injection after hemorrhagic shock resuscitation. The mRNA expressions of inducible nitric oxide synthase (iNOS) and p38 MAPK of liver, kidney, and lung tissues in each group were measured by RT-qPCR at each measuring time point. To evaluate the activation of p38 MAPK signaling pathway, protein levels of phosphorylated p38 (p-p38) MAPK and p38 MAPK was measured by western blot analysis. The serum levels of nitric oxide and TNF-α were determined. RESULTS: After CBP treatment, the levels of SGPT, SGOT, Cr, and BUN were significantly declined, while the PaO2 value was increased. Expressions of p38 MAPK mRNA, iNOS mRNA, p-p38 MAPK protein and p38 MAPK protein, and nitric oxide and TNF-α levels were markedly elevated in MOF, an effect blunted by CPB. Meanwhile, pathological sections of liver, kidney, and lung tissues after CPB treatment ameliorated swelling and inflammation. CONCLUSION: Our study proved that CBP could downregulate the p38 MAPK signaling pathway, suppress iNOS expression, reduced the serum levels of nitric oxide and TNF-α, thus ameliorate symptom of MOF.

MicroRNA-30e promotes hepatocyte proliferation and inhibits apoptosis in cecal ligation and puncture-induced sepsis through the JAK/STAT signaling pathway by binding to FOSL2.

INTRODUCTION: Hepatocyte proliferation and apoptosis are critical cellular behaviors in rat liver as a result of a liver injury. Herein, we performed this study in order to evaluate the role of miR-30e and its target Fos-Related Antigen-2 (FOSL2) in septic rats through the JAK/STAT signaling pathway. METHODS: Rat models of sepsis were induced by cecal ligation and puncture. Enzyme-linked immunosorbent assay (ELISA) was performed to access serum levels of lipopolysaccharide (LPS), inflammatory factors, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) to confirm the successful establishment of the model. The hepatocytes were subject to miR-30e mimics, miR-30e inhibitors or siRNA-FOSL2. The expressions of miR-30e, FOSL2, apoptosis- and, JAK/STAT signaling pathway-related genes in liver tissues and hepatocytes were determined by reverse transcription quantitative polymerase chain reaction (RT-qPCR) and western blot analysis. MTT assay and flow cytometry were performed to evaluate hepatocyte viability and apoptosis, respectively. RESULTS: The results obtained revealed that in the septic rats, serum levels of inflammatory factors, LPS, ALT and AST, as well as the expression of FOSL2 were elevated and the JAK/STAT signaling pathway was activated, while there was a reduction in the expression of miR-30e. An initial bioinformatics prediction followed by a confirmatory dual-luciferase reporter assay determined that miR-30e targeted and negatively regulated FOSL2 expression. MiR-30e inhibited the activation of JSK2/STAT3 signaling pathway by reducing FOSL2 expression, while miR-30e enhanced hepatocyte proliferation and decreased hepatocyte cell apoptosis in septic rats. CONCLUSION: These findings indicated that miR-30e may serve as an independent therapeutic target for sepsis, due to its ability to inhibit apoptosis and induce proliferation of hepatocytes by targeted inhibition of FOSL2 through the JAK/STAT signaling pathway.

Unplanned Reoperations in Neurosurgical Patients Due to Postoperative Bleeding: A Single-Center Experience and Literature Review.

The aim of this study is to investigate the incidence of unplanned reoperations from all causes due to bleeding in neurosurgical patients. The medical records of patients who received neurosurgical procedures at our hospital were retrospectively reviewed and data of patients who received reoperations were extracted and summarized. A literature review was conducted of the Medline, Cochrane, EMBASE, and Google Scholar databases up to November 2013. The main outcome measure was the rate of unplanned reoperations due to bleeding. At our hospital, 68 patients with a mean age of 41.5 ±â€Š21.5 years (range, 7 months to 76 years) received an unplanned reoperation. More than 70% of the patients were older than 18 years, 64.7% were males, and 94.1% had cranial surgery. Almost 60% of the patients received >1 blood transfusion (58.8%) after the first surgery. Of the 68 patients, 35 (51.5%) received a second operation due to bleeding. Univariate logistic regression analysis only showed that an increasing time interval between the first and second surgery was associated with a decreased chance of the reoperation being performed due to bleeding (odds ratio [OR] = 0.843, 95% confidence interval [CI]: 0.720-0.987; P = .033). Of 229 studies identified, 5 retrospective reports with a total of 1375 patients were included in the analysis. The rate of reoperations for bleeding in the 5 studies ranged from 4.2% to 31.5%. Employing measures to reduce postoperative bleeding may help reduce the rate of unplanned neurosurgical reoperations.

The antitumor immune responses induced by nanoemulsion-encapsulated MAGE1-HSP70/SEA complex protein vaccine following peroral administration route.

Previous studies have shown that there are profuse lymphatic tissues under the intestinal mucous membrane. Moreover, vaccine administered orally can elicit both mucous membrane and system immune response simultaneously, accordingly induce tumor-specific cytotoxic T lymphocyte. As a result, the oral route is constituted the preferred immune route for vaccine delivery theoretically. However, numerous vaccines especially protein/peptide vaccines remain poorly available when administered by this route. Nanoemulsion has been shown as a useful vehicle can be developed to enhance the antitumor immune response against antigens encapsulated in it and it is good for the different administration routes. Of particular interest is whether the protein vaccine following peroral route using nanoemulsion as delivery carrier can induce the same, so much as stronger antitumor immune response to following conventional ways such as subcutaneous (sc.) or not. Hence, in the present study, we encapsulated the MAGE1-HSP70 and SEA complex protein in nanoemulsion as nanovaccine NE (MHS) using magnetic ultrasound method. We then immuned C57BL/6 mice with NE (MHS), MHS alone or NE (-) via po. or sc. route and detected the cellular immunocompetence by using ELISpot assay and LDH release assay. The therapeutic and tumor challenge assay were examined then. The results showed that compared with vaccination with MHS or NE (-), the cellular immune responses against MAGE-1 could be elicited fiercely by vaccination with NE (MHS) nanoemulsion. Furthermore, encapsulating MHS in nanoemulsion could delay tumor growth and defer tumor occurrence of mice challenged with B16-MAGE-1 tumor cells. Especially, the peroral administration of NE (MHS) could induce approximately similar antitumor immune responses to the sc. administration, but the MHS unencapsulated with nanoemulsion via po. could induce significantly weaker antitumor immune responses than that via sc., suggesting nanoemulsion as a promising carrier can exert potent antitumor immunity against antigen encapsulated in it and make the tumor protein vaccine immunizing via po. route feasible and effective. It may have a broad application in tumor protein vaccine.

[Novel exploration of cathartic pharmacology induced by rhubarb].

Rhubarb is well-known for its cathartic effect, and this cathartic effect, which is closely correlated with "whter" of traditional Chinese medicine (TCM), is brought into play in colon. Recent researches about the relation between formation and effects have identified that the anthraquinone glycosides with 1,8-dio-hydroxy and without hydroxyl in the 2, 3, 6, 7 location, such as emodin, rhein, chrysophanol, et al, can bring about fairly obvious effects of "Watery Diarrhea". Aquaporins (AQPs) are expressed abundantly in colonic epithelial cells, and the abnormal expression of AQPs can lead to the less absorption of water in colon and/or the more secretion of intestinal juice, which suggest that AQPs might be one kind of the effector molecules, which some drugs playing pharmacologic actions in colon depend on. This assumption provides a novel field of vision. Is this "Watery Diarrhea" effect induced by rhubarb concerned with the location alteration or the expression change of AQPs. We deduce that the regulative effects of AQPs by rhubarb in colon might provide a new pharmacologic explation about the cathartic effect through the exploration of TCM and Chinese herbal drugs, with TCM theory and the analysis of data about efficiency and pharmacologic researches of rhubarb and the researches of AQPs. This deduction might be used to reveal why rhubarb can bring about multi-efficiency.

[Anti-tumor immune responses of nanoemulsion-encapsulated MHS vaccine].

AIM: To prepare nanoemulsion-encapsulated MAGE1-Hsp70/SEA and to evaluate its anti-tumor effects in mouse. METHODS: Nanoemulsion vaccine NE(MHS) was prepared using magnetic ultrasound methods and used to immunize C57BL/6 mice. The cellular immune responses were detected by IFN-gamma ELISPOT and LDH release assay. The tumor challenge assay was performed too. RESULTS: (1) The mean size of NE(MHS) was (20+/-5) nm. The encapsulation rate was 87% and the nanoemulsion vaccine had a good stability. (2) The frequency of MAGE-1 specific CTL and cytotoxicity of CTL to B16-MAGE-1 cells were both greatly enhanced in immunization group than those in control group (P<0.05). NE(MHS) could significantly delay the appearance of tumors and increase the percentage of tumor-free mice. CONCLUSION: The nanoemulsion had excellent physical and chemical characteristics. It could elicit MAGE-1-specific cellular immune response and anti-tumor effects against the MAGE-1-expressing tumor.

[Effect of electroacupuncture on plasma estrin and bone mineral density in ovariectomized rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on plasma estrin (E) 2 and bone mineral density (BMD) in ovariectomized (OVX) rats for studying its underlying mechanism in treating osteoporosis. METHODS: Thirty-two female SD rats were randomized into normal control, model, EA, and medication groups with 8 rats in each group. Postmenopausal osteoporosis model was established by removing the uterus under anesthesia (2% Phenobarbital, 40 mg/kg). In EA group, bilateral "Zusanli" (ST 32) and "Sanyinjiao" (SP 6) were punctured and stimulated electrically for 20 minutes with 1-3 Hz in frequency, 1 ms in duration of waves, and 0.7-1.0 mA in strength, once daily and 8 weeks altogether. Rats of medication group were drenched with 5% Nilestriol, 5 mL/week and for 8 weeks. At the end of experiments, blood samples were collected after removing the rat eyeball, and the left femoral bone tissue was taken. Serum E2 was assayed by using enzyme linked immunosorbent assay (ELISA) and BMD was measured by using double functional X-ray digital bone density meter. RESULTS: Compared with normal group, the body weight of model group was significantly bigger (P < 0.05), and that of model group was also significantly bigger than that of EA and medication groups (P < 0.11). No significant differences were found among the 4 groups before experiments and among normal control and EA groups after treatment (P > 0.05). In comparison with normal group, BMD and serum E2 of model group decreased significantly (P < 0. 01), while compared with model group, BMD and E2 of EA and medication groups increased significantly (P < 0.01, < 0.05). No significant differences were found among normal, EA and medication groups (P > 0.05). CONCLUSION: Both EA and medication can increase BMD and serum E2 in OVX rats, which may be one of the mechanisms of acupuncture in treating osteoporosis.