Objective To explore the efficacy of closed reduction and inter na l fixation of cannulated screws by minimally invasive procedure in management of tibial plateau fractures. Methods From October 1999 to January 2002, 42 patient s with tibial plateau fractures, which were 29 males and 13 females with an aver age age of 41 years ranging from 26 to 67 years, were treated surgically in our hospital. According to Schatzker system, the fractures were diagnosed as type Ⅰ in 9, type Ⅱ in 5, type Ⅲ in 13, type Ⅳ in 3, type Ⅴ in 6 and type Ⅵ in 6. There was open fracture in 5, and closed fracture in 37. The fracture fragments of tibial plateau were reduced with closed manipulation or reduced assisted by minimally invasive procedure. The later by minimally invasive procedure included two kinds of reductions, one of which was reduction assisted by Kirschner pin t hat was introduced percutaneously into the larger fragment; the other was reduct ion assisted by a bone tamper that was introduced through a small incision into the cortical window beneath the depressed articular surface. Fixation was achiev ed using percutaneous 6.5 mm cannulated screws or combination of the cannulated screws and Bastiani external frame in unstable fractures. Results Of 42 patients , 37 were followed up from 6 to 30 months (average, 15 months). All 37 fractures were united within 12 weeks postoperatively. The mechanical axis of affected li mb and the stability of affected knee joint were restored in the patients. Accor ding to Sanders score for functional results of knee joint, 13 patients were rat ed as excellent, 20 good, and 4 fair. Anatomical reduction was identified while the stepping of articular surface after reduction was less than 2 mm. In 21 pati ents with anatomical reduction, the functional results were excellent in 8, good in 11, and fair in 2. However, in 16 patients without anatomical reduction, the functional results were excellent in 5, good in 9, and fair in 2. There was sig nificant difference between the two groups on functional results. There were no postoperative complications such as infections and neurovascular bundle. Conclus ion Closed reduction and fixation through minimally invasive procedure has provi ded satisfied results in tibial plateau fractures such as less complications, ex cellent mechanical axis restoration, and ideal functional recovery.

The application of four kinds of hemostatic tools in tactical combat casualty care (TCCC) of foreign armies was introduced,including extremity tourniquet,junctional tourniquet,hemostatic dressing.and elastic bandage as well as tranexamic acid.The above hemostatic tools were described from the aspects of structure,operating process,application range and technical points,and the histories of some tourniquet were also expounded.The problems of Chinese PLA were analyzed in designing and developing hemostatic tool.Some suggestions were put forward such as enhancing the practicability and portability of hemostatic tool,rational allocation of TCCC drugs and instruments and etc.

Leucine zipper tumor suppressor 2 (LZTS2) is a novel tumor suppressor gene that has been increasingly recognized in recent years. Currently, many studies illustrate that LZTS2 gene, the important candidate tumor suppressor gene, is already involved in the inhibition of tumorigenesis and aberrant proliferation of tumor cells, and other functions of tumor cells. Information from these stud-ies can contribute to the formulation of new strategies for the treatment of tumors.

ObjectiveTo evaluate the diagnostic value of ultrasound or CT guided percutaneous Trucut needle biopsy on the diagnosis of pancreatic tumors.Methods One hundred and twenty-four patients clinically diagnosed as pancreatic cancer without pathological diagnosis underwent percutaneous pancreatic biopsy by using Trucut needle under ultrasound or CT guidance.ResultsOne hundred and nine procedures of ultrasound-guided biopsy and 15 procedures of CT-guided biopsy were performed,and one patient received 2.3times of punctures.Tissue samples were obtained in all 124 patients,the diagnostic accuracy was 95.2％,among them 115 were adenocarcinoma,5 were cystadenoma,2 were metastasis cancer,1 was cancer of unknown origin and 1 was normal.The sensitivity,specificity,and accuracy were 99.2％ 100％,and 99.2％,respectively.Transient serum amylase increase was observed in 3 patients; 5 patients' abdominal pain aggravated,but all recovered with conservative management.One patient was found to have tumor seeding on the spot of insertion after 34 days.No other major complications occurred.ConclusionsUltrasound or CTguided percutaneous pancreatic 16 ～ 18G Trucut needle biopsy is a safe and simple procedure with excellent diagnostic value for pancreatic cancer.

Objective:To explore the correlation among childhood trauma, obsessive-compulsive symptoms, and implicit and explicit memory in patients with obsessive-compulsive disorder(OCD).Methods:Fifty-two OCD patients were enrolled, and the childhood trauma was investigated by using the childhood trauma questionnaire short-form(CTQ-SF). The degree of obsessive-compulsive symptoms was assessed by using the Yale-Brown obsessive symptoms scale (Y-BOCS). In addition, the abilities of implicit memory and explicit memory were tested by vocabulary perception speed tasks and vocabulary recognition tasks.According to the scores of CTQ-SF, the patients were divided into abuse group( n=26) and neglect group( n=26). SPSS 22.0 software was used for t-test and Pearson correlation analysis. Results:Results of obsessive-compulsive symptoms, implicit memory, and explicit memory showed no differences between the abuse group and the neglect group( t=-1.959-1.839, P>0.05). The scores of obsessions symptoms(12.52±4.61) were positively correlated with the total scores of CTQ-SF (40.10±10.20)( r=0.331, P<0.05). On the subscale, the scores of obsessions were positively correlated with the scores of physical abuse(7.89±3.02), sexual abuse(6.47±2.28)( r=0.373, P<0.01, r=0.356, P<0.05). There was a negative correlation between the scores of physical abuse and the accuracy of explicit memory(68.75±13.33)( r=-0.281, P<0.05). The scores of physical neglect(8.98±2.67) was positively correlated with implicit memory response time(4 285.94±2 067.42)( r=0.314, P<0.05). Conclusion:Obsessions in patients with OCD are related to traumatic childhood experiences, especially physical abuse and sexual abuse.Physical trauma may influence the level of implicit and explicit memory in patients with OCD.

AIM: In order to investigate the change of CD36 expression in atherosclerosis. METHODS: Chinese minipigs were fed a normal control diet (CD) or a high fat/high cholesterol diet (HFHC) for 12 months after common carotid artery injury induced by balloon denudation. Plasma total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) were determined by commercially enzymatic methods. CD36 mRNA and protein levels were determined by reverse transcriptase-polymerase chain reaction (RT-PCR), Western blotting and immunohistochemistry, respectively. RESULTS: After HFHC for 12 months, plasma total cholesterol, HDL cholesterol and triglyceride in HFHC minipigs were increased compared with the control. CD36 expression and aorta PPAR? in HFHC minipigs were upregulated. CONCLUSION: HFHC may induce hyper cholesterolemia, hypertriglyceridemia and upregulation of CD36 and aortic PPAR? expression.

Objective To explore the characteristics of emotional memory in adolescent with anxiety disorders.Methods Totally 40 adolescent patients with anxiety disorders who met the DSM-5 diagnostic criteria were selected as the anxiety disorder group,40 normal adolescents matched with anxiety disorder group in terms of gender,age and education level served as the control group.All subjects of the two groups were implemented by emotional memory test task.Results (1) In emotional memory test,the negative picture score of adolescent anxiety disorder group(2.10±0.75)was significantly lower than that of control group (2.76±0.92) (t=-3.29,P＜0.05).There were no significant difference in positive and neutral picture scores between the two groups(P＞0.05).(2)Compared with control group,the positive picture,neutral picture and total recognition accuracy of adolescent anxiety disorder group both were significantly decreased ((0.24±0.09) vs (0.33±0.08),(0.22±0.10) vs (0.32±0.14),(0.25±0.08) vs (0.33±0.09)) (t=-4.28,-4.28,-3.85,all P＜0.05).There was no significant difference in negative picture recognition accuracy between the two groups (P＞0.05).In adolescent anxiety disorder group,there were significant differences in the correct recognition rates of negative pictures,positive pictures and neutral pictures in anxiety disorder group (F=3.39,P＜0.05),while there was no significant difference in the control group (F=0.04,P＞0.05).(3) The positive picture recognition accuracy and total recognition accuracy in adolescent anxiety disorder group were negatively correlated with Hamilton Anxiety Scale (HAMA) (F=0.04,P＜ 0.05).Conclusion Adolescent anxiety disorders exist in emotional memory defects,and its positive emotional memory deficit is negatively correlated with the severity of anxiety.

Objective:To investigate the characteristics of attentional bias in adolescents with anxiety disorder.Methods:Totally 40 adolescents with anxiety disorder who met the DSM-5 diagnostic criteria were recruited as the case group, 40 normal adolescents matched with the case group in terms of gender, age and education level were served as the control group.Symptom was assessed by the screen for child anxiety related emotional disorders (SCARED), and attention bias was assessed by attention bias test on both groups.All data were analyzed using SPSS 21.0.Results:(1) In the test of attentional bias, the negative reaction of the case group was lower than the neutral response((647.14±94.44)ms, (661.08±112.07)ms), and the attention bias value of the case group was higher than the control group((13.93±33.27)ms, (-0.13±18.49)ms), the differences were statistically significant (both P<0.05). (2) In the total score and each factor score of SCARED, total score of SCARED was negatively correlated with the negative accuracy rate ( r=-0.38), and the separation anxiety score was negatively correlated with the negative accuracy rate ( r=-0.52), social terrorism scores were negatively correlated with negative accuracy ( r=-0.45) and neutral accuracy ( r=-0.43) (all P<0.05). The correlation between somatization, generalized anxiety and school terror with attention bias test were not significant( P>0.05). Conclusion:Adolescents with anxiety disorder are more concerned with negative stimuli, and it is difficult to shift attention from negative stimuli to others.The avoidance to neutral stimuli may be a risk factor for the severity of symptoms in adolescents with anxiety disorders.

ObjectiveTo analyze the coping style and its relationship with anxiety status among middle school students aged 13 to 18 in Anhui province during the COVID-19 epidemic. MethodsFrom February 13 to 19， 2020， a cross-sectional survey was conducted among middle school students in Anhui province by using convenience sampling method and network questionnaire. The assessment tools included the Coping Style Scale for Middle School Students （CSSMSS） and the Screen for Child Anxiety Related Emotional Disorders （SCARED）. ResultsThe results of the CSSMSS evaluation showed that female students scored higher in emotion abreaction than male students ［（8.27±2.98） vs. （7.84±2.91）］. The scores of tolerance ［（9.74±2.73） vs. （9.11±2.60）］， escape ［（7.82±2.79） vs. （7.26±2.44）］， emotion abreaction ［（8.48±2.97） vs. （7.91±2.93）］ and fantasy/denial ［（9.79±3.56） vs. （9.26±3.47）］ of senior high school students were higher than those of junior high school students， and the score of problem solving ［（19.38±4.07） vs. （20.33±4.54）］ was lower than that of junior high school students， with statistical significance （P<0.05 or 0.01）. Correlation analysis results showed that the scores of tolerance， escape， emotion abreaction and fantasy/deny in CSSMSS were positively correlated with the scores of SCARED of middle school students in Anhui province （r=0.348， 0.287， 0.390， 0.501， P<0.01）. ConclusionDuring COVID-19 epidemic， students of different genders and grades in Anhui province have different coping styles， and some coping styles may induce anxiety status.

BackgroundPatients demonstrating depressive disorder with psychotic symptoms often have increased risk of death and poor prognosis. A large amount of research has explored the factors influencing psychotic symptoms in adult patients with depressive disorder， but few has focused on adolescent patients. ObjectiveTo explore the influencing factors of psychotic symptoms in adolescent patients with depressive disorder， so as to provide references for early screening and intervention in clinic. MethodsA total of 96 adolescent patients who met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） for depressive disorder and were seen in the psychiatry departments of Chaohu Hospital of Anhui Medical University and The Fourth People's Hospital of Hefei from September 2022 to January 2023 were included. Another 56 healthy individuals from the health examination center of Chaohu Hospital of Anhui Medical University were concurrently recruited as control group. Patients were assigned into psychotic group （n=32） and non-psychotic group （n=64） according to the presence or absence of psychotic symptoms. Hamilton Depression Scale-24 item （HAMD-24）， Positive and Negative Syndrome Scale （PANSS）， Positive and Negative Suicide Ideation （PANSI） and Childhood Trauma Questionnaire-Short Form （CTQ-SF） were used for evaluation. Plasma brain-derived neurotrophic factor （BDNF） concentration was obtained using Meso Scale Discovery electrochemiluminescence assay. Pearson and Spearman correlation analysis were adopted to determine the correlation of PANSS positive symptom subscale score with plasma BDNF concentration and clinical characteristics of adolescent depression patients with psychotic symptoms. Binary Logistic regression analysis was used to identify the factors influencing the presence of psychotic symptoms in adolescent patients with depressive disorder， and multiple linear regression analysis was utilized to screen the factors affecting the severity of psychotic symptoms. ResultsThe plasma BDNF concentration of adolescent patients with depressive disorder was lower than that of control group （t=-3.080， P<0.01）.The plasma BDNF concentration of psychotic group was lower than that of non-psychotic group （t=2.418， P<0.05）， while the body mass index （BMI） PANSI scores， CTQ-SF scores and HAMD-24 total scores were all higher than those of non-psychotic group （t=-2.024， -2.530， -2.187， -4.977， P<0.05 or 0.01）. Correlation analysis showed that PANSS positive symptom subscale scores were negatively correlated with anxiety/somatization factor score and weight factor score in HAMD-24 of psychotic group （r=-0.438， -0.498， P<0.05 or 0.01）. Binary Logistic regression showed that BMI， plasma BDNF concentration， HAMD-24 total scores and cognitive dysfunction factor score were the influencing factors of psychotic symptoms in adolescent patients with depressive disorder. Multiple linear regression analysis demonstrated that weight factor scores （β=-0.349， P<0.05） and anxiety/somatization factor score （β=-0.433， P<0.05） in HAMD-24 were the factors influencing the severity of psychotic symptoms. ConclusionHigh BMI， low plasma BDNF concentration， severe depressive symptoms and cognitive dysfunction may be the risk factors of psychotic symptoms in adolescent patients with depressive disorder， furthermore， BMI and anxiety symptoms are found to be associated with the severity of psychotic symptoms. ［Funded by Scientific Research Fund Project of Anhui Institute of Translational Medicine （number， 2022zhyx-B01）； Central Finance Supported Provincial Key Clinical Specialty Construction Project of Anhui Province in 2019］