BACKGROUND:In closed fractures, the initial hematoma that is inclined to remove is seldom considered as the important reasons for bone healing. OBJECTIVE:To observe the mechanism and potential role of original fracture hematoma in fracture healing. METHODS:Ninety-six patients with closed fractures of the long bones undergoing open reduction and internal fixation were randomly divided into experimental group (n=48) and control group (n=48). In the experimental group, original fracture hematoma, 1.0-2.0 mL, was first taken out during the internal fixation and placed into a special sterile plastic bag; then, 3-4 pieces of hematomas were filed into the fracture site and sutured layer by layer. On the contrary, original fracture hematomas from the control group were discarded. Blood samples were extracted to detect the biochemical indicators at 1 month after internal fixation. X-ray examination was done at 1, 3, 6 months after internal fixation for observation of fracture healing. RESULTS AND CONCLUSION: X-ray films showed that the healing rate at 3 months after operation was 95% in the experimental group and 78% in the control group, and there was a significant difference between the two groups (P < 0.05). Levels of bone glaprotein, I-type precolagen carboxy terminus peptide and serum bone alkaline phosphatase were significantly higher in the experimental group than the control group (P < 0.01 orP < 0.05). These findings indicate that the original fracture hematoma can accelerate calus formation, promote bone induction, provide nutrition to the fracture site, and participate in revascularization. Therefore, the original fracture hematomas is one of the effectively therapeutic methods for union and nonunion of fractures.

Objeetive: To learn the sleep behaviors of preschool children and their association with behavioral problems,so as to provide reference for improving sleep quality and behaviors in preschool children. Methods: By stratified random sampling method,the children aged 3-6 years were selected from 11 counties in 5 cities of Zhejiang Province. A self-designed questionnaire was used to investigate 19 items of sleep behaviors, and Achenbach children's behavior Scale（CBCL）was used to evaluate behavior problems. Spearman rank correlation was conducted to analyze the relationship between sleep behaviors and behavioral problems in preschool children. Results : Totally 1 865 preschool children were enrolled,1 732 valid questionnaires were collected,with a response rate of 92.86%. The total score of sleep behaviors in preschool children was 5.87±3.38. The prevalence rates of 19 sleep behaviors ranged from 0.69% to 82.85%;the common behaviors were rejecting quilt cover（82.85%）,grinding teeth（53.35%）,sleep-talking（53.23%）,drooling（52.66%）and snoring（43.07%）. The total score of CBCL was 20.01±14.39. There were 229 children with behavioral problems,accounting for 13.22%. The results of Spearman rank correlation showed that except for sleeping posture and apnea,all the other 17 items of sleep behaviors were correlated with the total score of CBCL（P < 0.05）. Conclusion Preschool children generally have problems in sleep, their sleep behaviors are correlated with behavioral problems.

Objective: To investigate the associations of deficits in prepotent response inhibition with attention deficit and impulsive behavior in children with attention deficit hyperactivity disorder (ADHD), so as to provide insights into response inhibition training in ADHD to relieve clinical symptoms. Methods: From March to December 2022, 57 children with ADHD were selected from the clinical psychology department of a tertiary hospital in Hangzhou City as the ADHD group, and 55 normal children matched by age and gender were selected from a primary school as the control group. Prepotent response inhibition, attention deficit and impulsive behavior were assessed by inhibition conflict task, visual continuous performance test (CPT) and matching familiar figures test (MFFT), respectively. The associations of deficits in prepotent response inhibition with attention deficit and impulsive behavior were analyzed using multiple linear regression model, and the predictive value of deficits in prepotent response inhibition on ADHD was evaluated using receiver operating characteristic (ROC) curve. Results: The children included in the ADHD group had a mean age of (8.77±1.60) years and 44 males (77.19%), and the children included in the control group had a mean age of (9.20±1.77) years and 42 males (76.36%). The error rate of inhibition conflict task, missing report rate of visual CPT and the number of MFFT errors were higher in the ADHD group than in the control group [22.50% (12.50%) vs. 8.75% (7.00%), 24.00% (30.00%) vs. 7.50% (7.00%), 8.67±3.32 vs. 4.47±3.16; all P<0.05]. Multiple linear regression model showed that the error rate of inhibition conflict task was positively associated with the missing report rate of visual CPT (R2=0.135, β=0.091, P<0.001) and the number of MFFT errors (R2=0.092, β=0.009, P<0.001). The area under the ROC curve was 0.891, the sensitivity was 93.00%, the specificity was 80.00%, and the cut-off was 13.13%. Conclusions The deficits in prepotent response inhibition are positively associated with attention deficit and impulsive behavior.

Objective: To examine the relationship between inhibition of ongoing responses deficit with attention deficit and behavior disorder among ADHD children. Methods: Totally 43 children with attention deficit hyperac tivity disorder (ADHD) aged 6-14 years who met the DSM-V criteria for ADHD were recruited. And 38 health children were recruited as the control group. Vision Continuous Performance Task (CPT) and Matching Familiar Figures Test were used to assess attention deficit and behavior disorder feature of the ADHD children. Stop-signal paradigm was used to assess the inhibition of ongoing responses. Results: In the stop-signal paradigm, the ADHD children’s error rate was significantly higher than typically developing children(t=4.34, P<0.01). The ADHD children error rate in the stopsignal task was positively correlated with the wrong number miss rate in CPT task(r=0.45, P<0.01), similar finding was observed in regression analysis,with inhibition of ongoing responses accounted for 20.1% of attention deficit(t=3.21,P<0.01). In ROC curve analysis, the cut-off sore was 15.50 in the task. The error rate in stop-signal task showed no association with miss rate in Matching Familiar Figures Test(r=0.09,P>0.05). Conclusion Inhibition of ongoing responses among ADHD children is associated with attention deficit, but not with existence of behavior disorder.

Objective: To investigate psychological and behavioral responses and the prevalence of acute stress disorder (ASD) among the injured from a serious road traffic accident. Methods: The injured persons at ages of 7 years and older from a serious road traffic accident were enrolled, and individuals with severe injury were exclude. Participants' gender, age, educational level, marital status, injury severity, family member's injury and death during the accident and psychological and behavioral status were collected. The prevalence of ASD was estimated using a semi-structured interview and the ASD Scale, and the factors affecting the development of ASD were identified using a multivariable logistic regression model. Results: A total of 132 survivors participated in psychological crisis assessment, including 82 men (62.12%) and 50 women (37.88%) and with a mean age of (46.50±18.57) years. There were 6 participants without obvious trauma (4.54%), 113 with mild injury (85.61%) and 13 with moderate injury (9.85%), and there were 6 participants with death of their family members during this accident. Insomnia, anxiety, flashback and fear were predominant psychological and behavioral responses, with prevalence rates of 42.42%, 35.58%, 26.52% and 23.48%, respectively. The prevalence of ASD was 30.30% among participants, and a higher rate of ASD was detected among women than among men (52.00% vs. 17.07%; χ2=17.940, P<0.001). The detection of ASD was higher among participants with death of their family members than among those without death of their family members (83.33% vs. 26.98%; χ2=8.370, P=0.004), and a higher detection rate of ASD was seen among participants with moderate injury (61.54%; χ2=6.786, P=0.034). Multivariable logistic regression analysis showed a higher risk of ASD among females (OR=7.764, 95%CI: 3.187-18.915) and those with a high educational level (high school/technical secondary school, OR=6.896, 95%CI: 1.030-46.152; diploma and above, OR=71.583, 95%CI: 4.145-1 236.270). Conclusions Insomnia and anxiety are predominant psychological and behavioral responses following serious road traffic accidents, and women and individuals with a high educational level present a high risk of ASD, which requires to be given timely psychological crisis interventions.