Objective To investigate the potential relationship among brain vessels,hippocampus tissue and cell morphology in depressive rat model.Methods According to the weight-atching principle,thirty SD rats were randomly divided into control group (n =15) and depressive group (n =15).Compared with the control group,the depressive group was handled according to the demand of depressive rat model.After rats were scanned by 3.0 magnetic resonance on the 0th,2nd,4th,6th,8th week,respectively,hippocampus was picked out,taken photos and stained by HE.Microscopeat was used to observe hippocampus cell morphology and brain vessels,and hippocampus was described and analysed by Mimics software.Results Diameter and length of the middle cerebral arteries of the model group decreased with time increasing.Compared with the control group,these changes in the model group were significantly different on the 8th week (left:control group (0.31 ± 0.04),(5.53 ± 0.62) mm,depressive group (0.25±0.02),(4.64±0.61) mm,t =5.20,5.48 respectively,both P＜0.01;right:control group (0.30±0.03),(5.59 ±0.64) mm,depressive group (0.24 ±0.03),(4.72 ±0.67) mm,t =3.96,4.85 respectively,both P ＜ 0.01).The cells morphology of hippocampus was also changed with stimulation time increasing.The numbers of cell in DG area,CA1 area and CA3 area were decreased,with cell shrank,cells nuclear stained strongly and arranged loosely.Besides,the volume of hippocampus tissue in the depressive group also changed correspondingly with time.On the 8th week,it was significantly different (left:control group (40.62 ±2.32) mm3,depressive group (34.18 ±2.25) mm3,t =7.72,P＜0.01;right:control group (40.47 ±2.25) mm3,depressive group (35.63 ±2.48) mm3,t =5.60,P ＜0.01).Conclusion With stress time increasing,brain vessels,hippocampus tissue and cell morphology in depressive rats change obviously,indicating certain correlation among them.

ObjectiveTo explore the particular inner world of the children with attention deficit hyperactivity disorder (ADHD)with the sandplay therapy and the initial sandtray's clinical diagnosis role and value on the ADHD.MethodsThe differences of the initial sandtrays between 28 children with ADHD and 24 normal children were compared.Results 1.On the use of toys,the experimental group was significantly higher in transports ((5.04 ±6.60),(1.38 ±2.12),t=2.73) and lower in stones((0.00 ±0.00),(8.00 ± 12.33),t=-3.18).2.On the scene of sandtrays,the experimental group was significantly higher in the fight( x2 =12.96,P ＜ 0.01 ),dynamic scenes ( x2 =13.37,P ＜ 0.01 ).3.On the use of self-images,the experimental group was lower than the normal children,and the differences were significant ( x2 =4.75,P ＜ 0.05 ).4.There were no significant differences in the use of sand between two groups( x2 =3.46,P ＞ 0.05).ConclusionThe results show that the children with ADHD have significantly characteristics in sandtrays.Initial sandtray is valuable to be an aid to clinical diagnosis and intervention means.

Objective To investigate the risk factors which indicate behavior problems and degree of conflict function defects in different subtypes of attention deficit hyperactivity disorder( ADHD),and to compare behavioral problems,family environment and conflict function in children with and without ADHD.Methods 87children with ADHD and 38 matched controls performed Simon-Stroop task while questionnaires (Parent Symptom Questionnaire and Family environment Scale)were acquired from their parents.Results Questionnaire indicated that children with ADHD-combined(ADHD-C) had the highest score of conduct problem( 1.05 ± 0.44),learning problem ( 1.97 ± 0.52 ),hyperactivity-impulsion ( 1.56 ± 0.60) and hyperactivity index ( 1.45 ± 0.40 ) than ADHDⅠ(0.65±0.32,1.58 ±0.58,1.06 ±0.46,1.01 ±0.31) and matched controls ( 0.42 ±0.24,0.77 ±0.49,0.58±0.40,0.55 ±0.34) in PSQ.ADHD-Ⅰ and ADHD-C had higher score of contradiction(3.28 ± 1.70,4.61 ±2.56 ) and lower score of family cohesion (6.75 ± 2.27,6.61 ± 2.03 ),emotional expression (5.03 ± 1.54,5.06 ±1.91 ),knowledge (3.83 ± 2.30,3.61 ± 1.81 ) and entertainment (3.70 ± 2.12,3.47 ± 2.32 ) than matched controls (2.36 ± 1.44,8.06 ± 1.71,6.03 ± 1.54,4.86 ± 1.91,4.83 ± 2.29) in FES-CV.Behavior data indicated that the correct rate of children with ADHD-Ⅰ and ADHD-C in Simon-incongruent trials( Siin:0.76 ± 0.13,0.69 ±0.13 ) and Stroop-inconsistent trials( Stin:0.82 ± 0.10,0.78 ± 0.08 )were lower and reaction time of children with ADHD-Ⅰ and ADHD-C in the Siin ( (876.4 ± 97.34) ms,( 893.8 ± 130.1 ) ms) and Stin ( ( 864.4 ± 91.82 ) ms,(860.2 ± 125.0) ms) were longer than matched controls ( (Siin (0.81 ± 0.11 ) ms,(810.4 ± 136.1 ) ms; Stin (0.87 ± 0.08 ) ms,(797.4 ± 136.1 ) ms).Pearson correlation analysis suggested that some factors in the FES-CV had correlation with behavioral problems.Conclusion This finding indicates that poor family environment is the risk factor that indicate behavioral problems in children with ADHD and behavioral problems,conflict function defeet of ADHD-C are more serious than ADHD-Ⅰ and matched controls.

Objective To explore the potential categories of fatigue trajectory in patients with diabetic peripheral neuropathy and analyze the influencing factors.Methods Convenience sampling method was used to select 426 patients with diabetic peripheral neuropathy who were hospitalized in a tertiary hospital in Jiangsu Province from April 2022 to April 2023.General information and disease related data of the patients were collected,and the Chinese version of Multi-dimensional Fatigue Scale,Pittsburgh Sleep Quality Index Scale,Social support Rating Scale,pain number rating scale and Tampa scale of kinetophobia were used to investigate at discharge(T1).The Chinese version of multi-dimensional fatigue scale was used to investigate 3 months after discharge(T2),6 months after discharge(T3),and 12 months after discharge(T4).A mixed growth model was used to identify the potential categories of fatigue trajectory and logistic regression were employed to analyze the influencing factors of fatigue.Results 414 patients finished the study.Three categories of fatigue trajectory in the patients with diabetic peripheral neuropathy were identified:significantly increasing group(19.6%),slowly increasing group(47.8%),and decreasing group(32.6%).Logistic regression analysis showed that age,sleep,social support,number of comorbidities,body mass index(BMI),pain and fear of exercise were the factors influencing the potential categories of fatigue trajectory in the DPN patients.Conclusions There are three potential categories of fatigue trajectories in DPN patients.Age,sleep disorders,social support,comorbidities,BMI,pain score,and exercise fear were influencing factors of fatigue in patients with DPN.

Objective:To investigate the mid-to-long term therapeutic effects of allogeneic bone composite prosthesis reconstruction in patients with large bone defects after the resection of distal femoral tumors.Methods:From June 2013 to December 2018, a total of 19 patients with malignant tumors of the distal femur who underwent reconstruction with allogeneic bone composite prosthesis in the Department of Bone Tumor, Shanghai General Hospital were retrospectively collected. There were 10 males and 9 females, aged 22.3±11 years (range, 11-42 years). The mean body mass index was 19.3±3.4 kg/m 2 (range, 14-27 kg/m 2). There were 18 cases of osteosarcoma and 1 case of Ewing's sarcoma. According to Ennecking staging, there were 17 cases of stage IIB and 2 cases of stage III. The intraoperative blood loss and operation time were recorded, and the prosthesis and patient survival conditions and postoperative complications were observed. The limb function was evaluated by the Musculoskeletal Tumor Society (MSTS) 93 function score. Results:All patients successfully completed the operation. The operation time was 187.3±39.8 min (range, 110-260 min), the intraoperative blood loss was 284.9±87.0 ml (range, 200-500 ml), and the blood transfusion volume was 327±213 ml (range, 100-800 ml). The remaining length of the proximal femur was 153.7±26.6 mm (range, 93-190 mm), and the length of allogeneic bone was 84.1±24.6 mm (range, 39-134 mm). Among the 19 patients, 9 patients (47%) achieved bony union with an average healing time of 16.7±4.8 months (range, 10-25 months), and 7 patients had delayed healing with an average healing time of 18.4±4.0 months (range, 15-25 months). The remaining 10 cases were nonunion between allogeneic bone and host bone. All patients were followed up for 80.7±20.2 months (range, 56-121 months). During the follow-up, 3 cases died due to pulmonary metastasis of bone tumors, and the time of death was 57 months, 63 months, and 59 months after surgery, respectively. At the last follow-up, the patient survival rate was 84% (16/19), and the MSTS 93 function score of the 16 patients was (24.3±2.4) points (range, 21-28 points), with an excellent rate of 100% (16/16). Seven patients underwent revision surgery, 3 cases were aseptic loosening, 3 cases were prosthesis stem fracture at the junction of the allograft bone and the host bone, and 1 case was periprosthetic infection, among which the patient with periprosthetic infection had poor local soft tissue conditions due to preoperative radiotherapy, and the infection was controlled after two revision surgeries. Five cases were revised with allogeneic bone composite prosthesis, and 2 cases were revised with short-stem giant prosthesis with cortical steel plate or locking nail. After revision, the remaining length of the proximal femur was 143.4±31 mm (range, 91-175 mm), and the length of the allograft bone was 92.6±26.6 mm (range, 61-123 mm). The 7 revised patients were still in follow-up. There were no cases of pulmonary infection, nerve injury, deep vein thrombosis or other complications after surgery.Conclusion:The survival period of patients after the surgery to reconstruct large bone defects following the resection of malignant tumors at the distal end of the femur using allogeneic bone composite prosthesis is satisfactory, and the limb function is good. However, the incidence of prosthesis complications is high, which can be reconstructed through revision.

Objective:Limb salvage treatment for osteosarcoma in the distal tibiais challenging and the incidence of postoperative complications is high. To prove that the use of autologous bone inactivation to replant the ankle joint has a satisfactory clinical effect.Methods:This study retrospectively studied 6 cases (4 males and 2 females) of the osteosarcoma of the distal tibia from June 2018 to April 2019 in our center. The average case age was 16.8 years. All cases were first diagnosed in the center, and classic osteosarcoma was confirmed by biopsy. Before the operation, he received 4 courses of neoadjuvant chemotherapy. The tumor was resected under general anesthesia, and the tumor bone was inactivated and replanted for internal fixation and reconstruction. During the operation, the tumor segment was completely removed, and after a series of treatments, it was immersed in hypertonic saline at 65 °C for 45 min. After removal, the bone defect was filled with bone cement, and internal fixation materials such as plate screws and anchors were placed. Finally, soft tissue was rebuilt after the inactivated bone internal fixation complex (autograft-fixation composite, AFC) was replanted. Patients were treated with plaster for 3 months after surgery. Chemotherapy continued 2 weeks after surgery. Follow-up X-ray of the lower tibia were taken at 3 months, 6 months, and 12 months after the operation to evaluate the MSTS score and ankle function score (AOFAS) to evaluate the ankle function.Results:The patients were followed up for an average of 20 months. At 12 months after operation, no complications such as deep infection, mechanical failure of internal fixation, or local tumor recurrence occurred. The MSTS score averaged 26.7±2.6 points. The AOFAS average was 82.3±8.5 points. The VAS average is 2.7 points. Boneunionwasobserved in 5 cases during follow-up. All cases were satisfied with the treatment results.Conclusion:Limb salvage treatment of distal tibia osteosarcoma is more difficult. This study proves that the use of tumor bone inactivation and internal fixation to reconstruct the ankle joint can not only cure the tumor, but also has satisfactory limb function. It is an ideal strategy for limb salvage reconstruction.

Objective To explore the related factors and clinical significance of the effect of irrigation on infant with dacryocystitis. Methods A total of 318 eyes of 262 infant were treated with dacryocystitis, and their overall curative effect was observed. Single factor correlation analysis and multivariate Logistic regression were used to analyze 8 factors related to efficacy, such as age of children, length of medical history, severity of symptoms, degree of operation of nurses, degree of parental cooperation, compliance with medication, massage therapy and treatment methods. The effect of each factor on the curative effect. Results It was found that the total effective rate was 90.56 percent of the lacrimal passage in children with 318 tear channel obstruction and dacryocystitis.Single factor analysis results show that the factors influencing the curative effect of single in treatment (χ2= 88.984, P < 0.01), symptom severity (χ2=14.185,P < 0.05) length of history (χ2=18.783, P < 0.05) difference and massage therapy (χ2=10.081, P < 0.05) was statistically significant, the three factors of multiariable Logistic regression analysis results showed that the treatment (P=0.000, OR=0.148,95％ CI 0.052- 0.419) and massage therapy (P=0.012, OR=3.390, 95％ CI 1.309- 8.777) affected infant lacrimal duct flushing out main factors influencing the efficacy of tong. Conclusions The main influencing factors are the different treatment modalities, severity of symptoms the length of medical history and massage therapy in the related factors that affect the effect of infantwith dacryocystitis.

To report the short-term clinical outcome of three cases of distal tibial osteosarcoma treated with a novel 3D-printed ankle fusion prosthesis for limb preservation. The patients were admitted to the Department of Bone Tumor, Shanghai General Hospital from January 2020 to June 2021, with one male and two female cases, aged 18, 12, and 14 years, respectively, all diagnosed with distal tibial osteosarcoma (Ennecking stage IIb). A new self-designed ankle fusion prosthesis was used to perform osteosarcoma resection and prosthetic reconstruction of the distal tibia. The operation time, blood loss, postoperative American Orthopedic Foot and Ankle Society Score (AOFAS) and ankle range of motion were recorded. All the 3 patients successfully completed the operation and were followed up for 22 months, 18 months and 12 months, respectively. The operation time was 140 min, 110 min and 200 min, and the blood loss was 200 ml, 200 ml and 350 ml, respectively. At the last follow-up, the AOFAS were 86, 90 and 95 points, and the range of motion of ankle flexion and extension were 30°, 15° and 30°. There was no local recurrence or lung metastasis at the last follow-up. The novel 3D-printed ankle fusion prosthesis in the distal tibia is safe and effective for the reconstruction of bone defects after resection of osteosarcoma in the distal tibia, and the early postoperative function is satisfactory.

Objective To explore the potential categories of self-management behavior in prediabetes patients and analyze the influencing factors of different potential categories.Methods A convenient sampling method was used to select pre-diabetic patients treated in physical examination centers and endocrinology outpatient clinics in 2 tertiary A hospitals in Jiangsu Province from September 2022 to June 2023.General data questionnaire,Prediabetic Disease Knowledge Questionnaire,Prediabetes Self-management Scale,Diabetes Self-efficacy Scale and Social Support Rating Scale were used for investigation.Results A total of 445 subjects were included in this study,with an average age of(44.92±4.98)years.4 potential categories of self-management behavior were identified,namely low self-management(16.4％),static self-management(19.1％),dynamic self-management(25.6％)and high self-management(38.9％).Occupational status,marital status,family per capita monthly income,family history of diabetes,disease knowledge,self-efficacy and social support were the influencing factors of self-management behavior in prediabetes patients(P＜0.05).Conclusion There are significant category characteristics of self-management behavior in patients with prediabetes.Medical staff can identify the category characteristics and influencing factors early,and provide bases for medical staff to formulate targeted clinical intervention measures to help patients improve their self-management level.

Objective:To explore the construction and application methods of multicenter bone tumor-specific database.Methods:Experts from multiple centers including Shanghai General Hospital, Shanghai Changzheng Hospital, Zhongshan Hospital, Shanghai Sixth People's Hospital, Ruijin Hospital, Fudan University Shanghai Cancer Center and Shanghai Ninth People's Hospital established a standard dataset for bone tumors through research and discussion. Clinical data will be automatically collected and standardized according to standard fields. A database will be built and a users' interface will be developed to ensure secure data storage, while providing services such as exporting raw data, visualizing statistical analysis, establishing clinical queue research projects, et al. Finally, the bone tumor database will be shared by integrating with the Shenkang's Big Data Platform to achieve multi-center data integration.Results:A standard data set for bone tumors containing 603 fields has been established and published. An automated data collection system for bone tumors has been established, including complete data collection, data collation and visualization functions. The data categories include modules such as patients' electronic case information, laboratory information on blood routine, biochemistry and tumor markers, imaging information, surgery information, pathology information and radiotherapy records. Personal information such as patients' names and ID numbers are desensitized and encrypted and can be exported for further research. From 2015 to 2023, the total number of bone tumor cases collected in the database was 10,789. From 2015 to 2019, 112 cases of the osteosarcoma cohort were retrospectively analyzed for admission, with a statistical 5-year survival rate of 68%.Conclusion:A regional bone tumor specialty big data network and data sharing platform has been established, along with data sharing mechanisms and standards including data standards, security standards, and quality evaluation standards. This provides data and efficient new solutions for the construction of China's bone tumor database, as well as a research and development platform for standardized diagnosis and treatment of bone tumors and new technologies.