Attention deficit hyperactivity disorder(ADHD) is one of the most common psychiatric disorders among school-age children.The diagnosis and treatment of ADHD rely on a comprehensive evaluation of symptom,functional impairment and comorbidity.Therefore the standardized rating scales is widely used clinically.The standardized rating scales can be categorized into: Broad-band scales,evaluating the general misbehavior and sociopsychological functions andNarrow-band scales,evaluating ADHD specific symptoms,and also functional impairment rating scales.Useful comorbidity and functional impairment rating scales are in need domestically.This paper reviewed the published literature about the clinical application and progression of frequently-used rating scales for school-age ADHD evaluation,at home and abroad.

Objective To investigate the clinical outcome of large decompressive craniectomy in treatment of severe traumatic brain injury combined with herniation of brain.Methods A retrospective analysis was carried out to assess the clinical outcome of large decompressive craniectomy for 98 patients with severe traumatic brain injury combined with herniation of brain enrolled from Jan.2007 to Sep.2010.Results According to the Glasgow outcome scale,there were 27 patients ( GOS 5 points) with good recovery,23 ( GOS 4 points) with moderate deficit,28 (GOS 3 points) with severe deficit,6 (GOS 2 points) under persistent vegetative status and 14 (GOS1 points) deaths at the end of 6 month post injury.We observed a good prognosis rate (good recovery and moderate deficit) of 51％ and a poor prognosis of 49％.Conclusion Large decompressive craniectomy can significanty improve the outcome and reduce complications of patients with severe traumatic brain injury combined with herniation of brain.

Objective To explore the role of improved cranioplasty plus ventriculoperitoneal shunt in early treatment of hydrocephalus secondary to decompressive craniectomy for patients with severe craniocerebral injury. Methods A retrospective study was performed on 45 patients complicated by hydrocephalus after decompressive craniectomy for severe craniocerebral injury treated with early stage improved cranioplasty plus ventriculoperitoneal shunt from January 2006 to December 2010.Then,the clinical data,complications and outcomes were summarized. Results All operations were carried out 38-80 days after injury.The postoperative complications were distal obstruction of ventriculoperitoneal shunt in two patients and intracranial infection in one.The clinical symptoms were obviously improved in 36 patients (80％) and the cerebral ventricle was diminished in 34 (76％) one month postoperatively.The Glasgow Outcome Scale (GOS) at discharge was good in eight patients,moderate disability in 19,severe disability in 13 and prolonged coma in five,where better recovery (good recovery and moderate disability) in 27 patients (60％) showed significant improvement compared with preoperation ( x2 =23.47,P ＜0.01 ). Conclusion Early cranioplasty plus ventriculoperitoneal shunt is an effective and safe method for treatment of the complicated hydrocephalus after decompressive craniectomy for severe craniocerebral injury.

Objective To investigate the clinical outcome of modified large decompressive craniectomy in treatment of severe traumatic brain injury combined with acute subdural hematoma. Methods A retrospective analysis was carried out to compare the clinical outcome of large decompressive craniectomy (treatment group) for 81 patients with severe traumatic brain injury combined with acute subdural hematoma from July 2007 to June 2010 and that of standard large trauma decompressive craniectomy (control group) for 65 patients with same injuries from July 2004 to June 2007. Results According to the Glasgow outcome scale at the end of month 6 after injury, there were 21 patients (GCS 5 points) with good recovery, 19 (GCS4 points) with moderate deficit, 24 (GCS 3 points) with severe deficit, five (GCS 2 points) under persistent vegetative status and 12 (GCS 1 points) deaths in the treatment group,with good prognosis rate (good recovery and moderate deficit) of 49% (P ＜ 0.05) and poor prognosis rate of 51%. However, only 21 patients got favorable outcome, including 12 patients (GCS 5 points)with good recovery and nine (GCS 4 points) with moderate deficit; 44 patients got unfavorable outcome (68%), including 22 patients (GCS 3 points) with severe deficit, three (GCS 2 points) under persistent vegetative status and 19 (GCS 1 points) deaths in the control group (P ＜0.05). Furthermore, the incidences of delayed intracranial hematomas and subdural collection of fluid in the treatment group were significantly lower than those in the control group (P ＜ 0.05). Conclusion Modified large decompressive craniectomy can significantly improve the outcome and reduce complications of patients with severe traumatic brain injury combined with acute subdural hematoma.

Objective To investigate the clinical application of anti-β2 glyeoprotein Ⅰ antibodies (IgG, IgM, IgA)in systemic lupus erythematosus(SLE). Methods The anti-β2-GP Ⅰ antibodies and anti-cardiolipin antibodies(ACL) level were measured by ELISA in 100 SLE patients, 39 other rheumatoid arthri-tis patients and 30 healthy control people. Their clinical application was analyzed in SLE diagnose and thera-py. Results The level of anti-β2-GP Ⅰ (IgG, IgM, IgA)were significantly higher in SLE than that in healthy (P < 0. 01 ). Sensitivity, specificity, positive predictive value and negative predictive value were 17.2%, 95.7%, 85.0% and 44. 6%, respectively. There was a significant and positive correlation be-tween anti-β2-GP Ⅰ antibodies and ACL antibodies ( IgG, IgM, IgA) (r = 0.418, 0. 624, 0.518, 0. 583, P <0.01). In multivariate analysis the factors(anti-β2-GP Ⅰ antibodies, ACL antibodies, dsDAN, u1-RNP, Sm, SSA, SSB, Jo-1, Scl-70, P-protein, PT, APTT) associated with SLE disease activity index(SLEDAI) were anti-β2-GP Ⅰ (IgG) and dsDNA. Conclusion anti-β2-GP Ⅰ antibody has high specificity and positive predict value, also is associated with SLE's thrombosis. It has some values in the clinical application.

Objective:To explore the relationship between social anxiety and sex role in college students,and to analyze the mediating effect of self-acceptance between them.Methods:Data came from a sample of 2000 col-lege students in Daqing,who were selected by stratified random cluster sampling method according to the constitu-ent ratio of the college students.We used the Interaction Anxiety Scale (IAS)to assess subjective experience of so-cial anxiety,Bem Sex-Role Inventory (BSRI)to evaluate sex-role classification and Self-Acceptance Questionnaire (SAQ)to measure characteristics of self-acceptance.Results:In the college,the distribution of sex-role classifica-tion were androgynous 656 (34.9%),undifferentiated 650 (34.6%),masculine 287 (15.3%),feminine 284 (15.1%).The differences of gender in scores of IAS and SAQ were not significant (Ps >0.05),but there were significant differences among sex roles (P <0.001).IAS scores of feminine were significantly higher than the oth-ers,and the scores of androgyny and masculine were both lower than the other two significantly.SAQ scores offeminine and undifferentiated were both significantly lower than the other two respectively (Ps <0.05).By Boot-strap test,masculine,undifferentiated and feminine (vs.androgynous)could mediate IAS through self-acceptance, the mediating effects were 0.76 (95%CI:0.09 -1.42),4.14 (95%CI:3.43 -4.93),and 4.03 (95%CI:3.47 -4.64) respectively.There was a mediating effect.Both undifferentiated (vs.androgynous ) and feminine (vs.androgynous)directly influenced IAS significantly (Ps <0.05).Conclusion:Social anxiety may be related to sex role but not gender,social anxiety level of feminine students is higher,the sex-role types could influence social anxiety through self-concept indirectly.

Objective To investigate the effects of glutamine (Gln) supplementation on neurologica severity score,brain edema,neuron apoptosis,and endoplasmic reticulum stress (ERS) response after traumatic brain injury (TBI) in rats.Methods TBI rat models were established using modified Feeney's method.Eighty Sprague-Dawley rats were divided into 4 groups with a random number table:sham operation group (Sham group),TBI group,Gln supplementation group (TBI + Gln group) and ERS inducer 2-deoxy-D-glucose group (TBI +Gln + 2-DG group).We measured the rats' neurobehavioral outcomes by modified neurologic severity score (mNSS) on day 1,3,7 and 14 after TBI.Neuron apoptosis was detected using TUNEL staining.Brain water content was measured with wet-dry weight method.The apoptosis-related protein (caspase-12,caspase3,and Bcl-2) and ERS-related cytokines [inositol-requiring enzyme 1 (IRE-1),C/EBP homologous protein (CHOP)] expressions in TBI cerebral cortex were determined by immunohistochemistry staining and Western blot.Results Compared with the Sham group,the levels of brain edema,mNSS,apoptosis-related protein (caspase-12,caspase-3,Bcl-2) and ERS-related proteins (IRE-1,CHOP) were significantly increased in the other three groups (all P =0.00).Compared with the TB1 group,the TBI +Gln group showed significant lower brain water content [3 d:(81.39±0.59)％ vs.(83.54±0.52)％,P=0.04;7 d:(74.86±0.38)％ vs.(77.32±0.66)％,P=0.03],improved mNSS (8.63 ±0.22 vs.10.37±0.29,P=0.03),suppressed expressions of apoptosis-and ERS-related proteins (caspase-12,caspase-3,IRE-1,and CHOP)(P =0.01,P ＜ 0.01),and increased expression of anti-apoptotic protein Bcl-2 (P =0.02).Compared withthe TBI + Gln group,the expression of ERS-related factors (IRE-1 and CHOP),brain edema level,and neurological severity were increased in the TBI + Glu + 2-DG group.Conclusion Glutamine supplementation may have neuroprotection function,demonstrated as reducing brain edema and neuron apoptosis,and improving neurobehaviroal outcomes after TBI,possibly mediated by inhibiting TBI-induced ERS response.

Objective To investigate the effects of omega-3 polyunsaturated fatty acids (ω-3 PUFA)supplementation on brain edema,autophagy response and neurobehavioral outcome after traumatic brain injury (TBI) in rats and the related mechanisms.Methods TBI rat models were established using Feeney's method.Seventy-two SD rats were divided into 4 groups using random number table:sham operation group,TBI group,ω-3 PUFA supplementation group (TBI + ω-3 group) and autophagy inhibitor 3-methyladenine group (TBI + 3-MA group) (all n =18),each group was further divided into 3 sub-groups (n =6) corresponding to 3 time points (days 1,3,and 7 after TBI).On each of the 3 time points,we measured rat behavioral outcomes with modified neurologic severity score (mNSS) tests;brain water content was measured with wet-dry weight method.The mRNA and protein expressions of autophagy-related factors (LC3-Ⅱ and Beclin-1) in TBI cerebral cortex were determined by immunohistochemistry staining,reverse transcription-polymerase chain reaction and Western blot on day 3 after TBI.Results Compared with the sham group,on days 1,3,and 7 after injuary,the TBI group,the TBI + ω-3 group,and the TBI + 3-MA group had significantly higher mNSS scores (TBI group:12.42±0.27vs.1.34±0.32,12.07±0.27vs.1.16±0.29,10.22±0.39vs.1.22±0.30;TBI+ω-3 group:12.05 ±0.23 vs.1.34 ±0.32,11.38 ±0.21 vs.1.16±0.29,8.20 ±0.21 vs.1.22±0.30;TBI +3-MA group:11.93 ±0.20 vs.1.34 ±0.32,11.09 ±0.19 vs.1.16 ±0.29,7.93 ±0.17 vs.1.22 ± 0.30;all P =0.00) and brain water content [TBI group:(79.82 ± 0.61) ％ vs.(71.87 ± 0.43) ％,(83.04±0.42)％ vs.(72.13 ±0.53)％,(75.12 ±0.72)％ vs.(71.78 ±0.38)％;TBI+ω-3 group:(76.81 ±0.63)％ vs.(71.87 ±0.43)％,(79.39 ±0.59)％ vs.(72.13 ±0.53)％,(73.86 ±0.38)％ vs.(71.78 ±0.38)％;TBI+3-MAgroup:(75.98 ±0.49)％ vs.(71.87 ±0.43)％,(77.14 ±0.46)％ vs.(72.13 ±0.53)％,(72.24 ±0.37)％ vs.(71.78 ±0.38)％;all P =0.00].The mRNA and protein expressions of LC3-Ⅱ and Beclin-1 in the brain were also significantly higher on day 3 in the TBI group,the TBI + ω-3 group,and the TBI + 3-MA group (all P =0.00).Compared with the TB1 group,on day 3 and day 7 after injury,the TBI + ω-3 group and the TBI + 3-MA group had significantly lower mNSS scores (TBI + ω-3 group:11.38±0.21 vs.12.07±0.27,P=0.04,8.20±0.21 vs.10.22±0.39,P=0.01;TBI+3-MA group:11.09±0.19vs.12.07 ± 0.27,P=0.01,7.93 ± 0.17 vs.10.22±0.39,P=0.00).Ondays1,3,and 7,compared with the TBI group,the TBI + ω-3 group and the TBI + 3-MA group had significantly lower brain water content [TBI + ω-3 group:(76.81 ± 0.63) ％ vs.(79.82 ± 0.61) ％,P =0.04,(79.39 ±0.59)％ vs.(83.04±0.42)％,P=0.01,(73.86±0.38)％ vs.(75.12±0.72)％,P=0.03;TBI+3-MAgroup:(75.98 ±0.49)％ vs.(79.82 ±0.61)％,P=0.01,(77.14 ±0.46)％ vs.(83.04 ±0.42)％,P =0.00,(72.24 ± 0.37) ％ vs.(75.12 ± 0.72) ％,P =0.02].On day 3,the TBI + ω-3 group and the TBI + 3-MA group had significantly reduced LC3-Ⅱ and Beclin-1 mRNA expression compared with the TBI group (TBI +ω-3 group:P=0.04,P =0.01;TBI +3-MA group:P =0.01,P =0.00) and protein expression (TBI+ω-3 group:P=0.01,P=0.03;TBI +3-MA group:both P=0.00).Conclusion ω-3 PUFA supplementation could markedly reduce brain edema and improve neurological functions after TBI,showing a neuroprotective effect,possibly through inhibiting TBI-induced autophagy responses.

Purpose To study the clinicopathological features of lymphangiomyomatosis (LAM) of pelvis lymph node.Methods A patient with endometrial endometrioid adenocarcinoma and LAM was analyzed including clinical data and pathological features.HE and immunohistoehemistry of EnVision stainings were used,and the literatures were reviewed.Results Well-moderately differentiated endometrioid adenocarcinoma could be observed in the endometrium.Proloferation of LAM cells were seen in the capsule and medulla of the pelvic lymph node.The LAM cell was spindle,epitheliod and polygonal cells with oxyphilic or clear cytoplasm which arranged surrounding lacunes.The LAM cells showed no atypia and mitosis could not seen.The tumor cells showed diffusely positive for SMA,Caldesmon,desmin,vimentin,ER and PR,the cells lining the lacunes were positive for CD34 and D2-40.The epitheliod cells were positive for HMB-45 and negative for Melan-A.The Ki-67 immunostaining showed a proliferation index of ＜ 1％.Conclusion LAM is an uncommon neoplastic multisystem disease that affects the lungs mostly.Endometrial endometrioid adenocarcinoma with LAM of pelvic lymph node is extremely rare.The diagnosis can be made according to the histological characteristics and immunohistochemical features.Moreover this conclusion will provide the clinicopathological materials for the future study about LAM.

Objective To investigate the prevalence of malnutrition in human immunodeficiency virus ( HIV )‐infected children in China , and to explore and analyze the factors associated with malnutrition .Methods A cross‐sectional study was conducted by the antiretroviral treatment database of children .HIV‐infected children aged between 0 - 15 years old who initiated antiretroviral treatment were collected between January 1st , 2010 and December 31st , 2014 . Z‐score of height and weight were calculated by WHO Anthro (plus) software .Univariate and multivariate Logistic model analyses were performed to determine the factors associated with acute /chronic/mixed malnutrition .Results Baseline data of the 3 138 HIV‐infected children showed that 1 645 patients (52 .42% ) had malnutrition before antiretroviral treatment ,with acute ,chronic and mixed malnutrition of 8 .76% (275) ,39 .77% (1 248) and 3 .89% (122) ,respectively according to the type of malnutrition .Multivariate analysis showed that baseline CD4 + cell count < 200 cells/μL was the risk factor associated with acute malnutrition (aOR =2 .27 ,95% CI :1 .68 - 3 .06) ;rural settings (aOR = 1 .30 ,95% CI :1 .11 - 1 .53) ,baseline CD4 + cell count < 200 cells/μL (aOR = 1 .98 ,95% CI :1 .65 - 2 .38) ,baseline CD4 + cell count between 200 to 350 cells/μL (aOR = 1 .38 ,95% CI :1 .13 - 1 .69) and having AIDS‐related diseases (aOR = 1 .34 ,95%CI :1 .13 - 1 .59) were risk factors associated with chronic malnutrition ;and age of 11 - 15 years (aOR =2 .38 ,95% CI :1 .46 - 3 .88) ,baseline CD4 + cell count < 200 cells/μL (aOR = 4 .99 ,95% CI :3 .04 -8 .21) and having AIDS‐related diseases (aOR = 2 .45 ,95% CI :1 .65 - 3 .66) were risk factors associated with mixed malnutrition .Conclusions The prevalence of malnutrition in untreated HIV‐infected children remains high .All three types of malnutrition are associated with immunodeficiency .Early diagnosis and early treatment should be improved in HIV‐infected children through antiviral therapy to reduce the destruction of HIV to immune system .At the same time ,intensified monitoring of the nutritional status and nourishing undernourished children should be strengthened to reduce the prevalence of malnutrition .