[Objective] Domestic literatures on misdiagnosis of osteonecrosis of femoral head(OFH)in the past 15 years are reviewed to distinguish OFH from other 9 similar diseases.The symptoms in early,middle and late stages of OFH are similar to other diseases,which is easy to be misdiagnosed as OFH.Pathological changes in different hip joint diseases have different specific performances.Careful and discriminative diagnosis is important in clinical practice.

ve To explore the methods for sanitary safety test of water purifier. Methods The water purifiers using active carbon, KDF and molecular sieve as absorptive materials and hollow fibers as filter materials were collected for sanitary safety test. The water purifiers were irrigated by pure water continuously for 15, 30, 45 and 60 min respectively first, and then were immersed continuously for 24 h by pure water, the variations of turbid-ity, pH value, total dissolved solid and chemical oxygen demand (COD), etc, of the immersing water were observed. The water purifiers were also irrigated continuously for 1 h at first, and then were immersed continuously for 5, 15, 24, 48, 72 h and 1 week by pure water respectively, in the end, the variations of those 4 sanitary indexes mentioned above were also detected. Results Significant differences were observed in those 4 indexes between the immering water samples obtained after 15 min-irrigation and 30 min-irrigation, 30 min-irrigation and 45 min-irrigation (P

Objective To observe the curative effects of malignant brain swelling after brain injury by using the operations of standard large Craniotomy decompression and removal of necrotic brain tissues. Methods 80 cases of malignant brain swelling after severe brain injury were observed. The standard decompression surgery of large era-niotomy routine were used in 40 cases,while the operations of standard large craniotomy decompression and removal of necrotic brain tissues were used in the other 40 cases. The curative effects of the results after 15 days and six mon-ths were analyzed. Results The incidence of intracranial hypertension (37.5%, 15/40 ) and brain tissue incisional hernia (32.5% ,13/40)of the group using standard large craniotomy decompression and removal of nee-rotic brain tissues treatment was significantly lower than that of simple standard large craniotomy decompression treat-ment group [15.0% (6/40) vs 10.0% (4/40)] after 15 days (P<0.05 ). The prognosis excellent rate ( good + re-sidual) of the group using standard large Craniotomy decompression and removal of necrotic brain tissues treatment was significantly higher (60.0%) than that of simple standard large craniotomy decompression treatment group (40.0%) after six months (P<0.05 ). Conclusion The operations of standard large craniotomy decompression and removal of necrotic brain tissues can effectively reduce the intracranial hypertension of malignant brain swelling after trauma injury,and reduce mortality and morbidity of severe brain injury.

Objective To study the pathogenesis and the effect of early drugs therapy of symptoms after concussion.Methods One-hundred and thirteen patients with symptoms after suffered concussion enrolled in the study and divided randomly into three groups.The patients of different groups were treated respectively with drugs,i.e.erigeron breviscapus,nimodipine,energy mixture.Symptom Check-List 90 ( SCL-90 ) and electroencephalogram(EEG) and cerebral blood flow of trancranial Doppler(TCD) were examined in the early and late stage of post-concussion.Normal population were recruited as control.All examination results and the effect of treatment were compared between treatment group and control group.Results In the scores of SCL-90,the factor scores of somatization symptom,compulsion,depressive disorder,anxiety disorders,and hostile symptom in 113 post-concussion patients in early stage were all higher than those in the normal( t =10.78,2.08,9.53,11.09 and 2.52,P ＜0.01or P ＜0.05),and as well as that of somatization symptom,depressive disorder,anxiety disorders,terror and mental disorder symptom in 12 post-concussion patients in late stage compared to normal( t =3.21,6.85,3.07,3.14 and 4.73,Ps ＜ 0.01 ).The test of EEG was abnormal in 57.4 ％ of patients in early stage and in 33.3％ in the late stage.Of all TCD results,67.0 ％ was abnormal in the early stage and 25.0％ in the late stage,The disappearance rate of post-concussion symptoms in the 14th day was significantly higher in the erigeron breviscapus group ( 45.0％ ) than in the nimodipine group ( 23.7％ ) ( x2 =3.91,P ＜0.05 ) and in the energy mixture group ( 20.0％ ) ( x2 =5.25,P ＜ 0.05 ).The disappearance rate of postconcussion symptoms in the 30th day in the energy mixture group(40.0％ ) was significantly lower than those in nimodipine group( 68.4％ )( x2 =5.94,P ＜ 0.05 ) and in erigeron breviscapus group( 75.0％ )( x2 =9.43,P ＜ 0.01 ).The occurrence rate of post-concussion sequelae was higher in the energy mixture group ( 22.9％ )than in the nimodipine group ( 5.2％ ) ( x2 =4.77,P ＜ 0.05 ) and in the erigeron breviscapus group (5.0％ )( x2 =5.15,P ＜ 0.05 ) three month after injuries.Conclusion The occurrence of symptoms originated from the organic damage of brain tissue.However,its changes were influenced by psychologic factors after concussion.Early vasodilative drugs therapy could improve the recovery of patients with post-concussion symptoms in time and decrease the occurrence of post-concussion sequelae.

BACKGROUND:Transfusion of bone marrow mesenchymal stem cells may become a novel and effective biological therapy for inflammatory bowel disease in clinical practice. Nevertheless, the oncological safety of the treatment is worrisome, and is a key to determine whether mesenchymal stem cells can be widely used in treatment of inflammatory bowel disease, and deserves further investigation. OBJECTIVE:To evaluate the therapeutic effect of bone marrow mesenchymal stem celltransfusion against inflammatory bowel disease in mouse models, and to clarify the effects of mesenchymal stem cells on tumorigenesis of inflammatory bowel disease. METHODS:Mouse model of colitis was established using Balb/c (H-2d) mice exposed to dextran sulfate sodium. Syngeneic bone marrow mesenchymal stem cells were transfused into mouse model through caudal vein. The therapeutic effect of mesenchymal stem cells was compared and observed, and pathological remission of colitis was evaluated. Mouse model of colitis-driven colon carcinogenesis was established using Balb/c (H-2d) mice exposed to dextran sulfate sodium and azoxymethane. Tumor formation within the murine colon was compared and observed after transfusion of mesenchymal stem cells. RESULTS AND CONCLUSION:In models of dextran sulfate sodium-induced colitis, weight loss and fecal occult blood were lessened in the bone marrow mesenchymal stem cellgroup compared with the phosphate buffered saline group. Histological damage score of colitis was less in the bone marrow mesenchymal stem cellgroup:mucosal structure of distal colon was almost intact under microscope, and there was smal area of epithelial defects and cryptal defects. Inflammatory cellinfiltration, proliferation of capil ary and smal vessels could be observed in mucosa and submucosa. Homing and colonization of mesenchymal stem cells in submucosa of inflamed colon could also be observed by in vivo tracing. In the dextran sulfate sodium/azoxymethane model of colitis-driven colon carcinogenesis, the number of intestinal tumors and tumor load were obviously less in the bone marrow mesenchymal stem cellgroup than in the control group. Results indicated that transfusion of bone marrow mesenchymal stem cells can apparently improve colitis lesions of mice with inflammatory bowel disease and inhibit carcinogenesis of colitis, which may provide theoretical support for the biological safety of mesenchymal stem cells transplantation for inflammatory bowel disease.

Lymphoblastic lymphoma (LBL) is a rare aggressive neoplasm of T-/B-precursors resembling acute lymphoblastic leukemia,which develops very fast with high morbidity.T-lymphoblastic lymphoma (T-LBL),accounting for 85％-90％ of LBL,develops more frequently in children and young adults and is typically characterized by a grossly enlarged mediastinum,whose diagnostic hallmark is the expression of a T-precursor cell immunophenotype.Recently many new diagnostic technologies,such as polymerase chain reaction,flow cytometry,fluorescence in situ hybridization and so on,have been used for the dignosis of LBL,which lay the foundation of the precision therapy for LBL.The adoption of pediatric-derived,intensive lymphoblastic leukemia-like protocols leads to significantly improved results,with event free survival about 75％-90％ in children.New clinical trials will introduce and confirm the value of new drugs and targeting agents,which may have more good effects.New minimal residual disease assessment methods(eg,next generation sequencing,NGS) make it possible to detect MRD in different subtype of childhood lymphomas.Now,the new advances in diagnosis and treatment of T-LBL were reviewed.

Objective: To explore the association between mothers reactions to adolescents exposure to intimate shots and pornography use of junior high school students, and to provide references for family communications on sexual topics in similar scenarios. Methods: A total of 1 760 students from grade 6 to 8 in three junior high schools in a certain district of Shanghai were selected by cluster sampling. Self-filled questionnaires on tablets were used to collect data. Results: The proportion of junior high school students who watched pornography was 26.36%(464), and that of boys (29.83%，270/905) was higher than of girls (22.69%，194/855). Most junior high school students believed that mothers reactions to adolescents exposure to intimate shots would be “taking the opportunity to educate teenagers not to do this” (30.54%) or “avoiding adolescents watching intimate shots” (42.24%). The results of multivariable analysis showed that comparing with junior high school students who believed that mothers would “watch together without making any comments ”, students who believed that mothers would “take the opportunity to educate teenagers not to do this”(OR=0.43, 95%CI=0.29-0.64) and “avoid adolescents watching intimate shots”(OR=0.56, 95%CI=0.39-0.80) were at lower risk of viewing pornography (P<0.01). Conclusion There is a significant correlation between junior high school students pornography use and mothers possible reactions to adolescents exposure to intimate shots. Family sex education and parental monitoring should be emphasized, and parents awareness of communicating sexual issues with adolescents should be strengthened.

Objective: To evaluate adolescents’ self-esteem and explore its influencing factors in order to provide basic evidence for improving self-esteem level and mental health of adolescents. Methods: A total of 5 709 adolescents of different characteristics from both urban and rural areas in six provinces were investigated anonymously with the method of computer-assisted self-interview (CASI). Self-esteem was evaluated by Self-Esteem Scale (SES, scored 10-40 points). Results: The average score of self-esteem was 28.15,28.40, 28.97 and 27.45 point for junior high students, senior high students, college students and out-of-school adolescents, respectively. The difference of the scores among the four groups was statistically significant(F=27.64, 14.41, P<0.01). More than 80% adolescents felt they were people of worth, were able to do things as most other people, took a positive attitude toward themselves and were satisfied with themselves. About 50% of adolescents thought they were no good at all at times. Less than 20% adolescents thought they had enough respect for themselves. About 11.57% to 22.22% of adolescents felt sad about their own gender, about 37.56% to 61.49% of adolescents often or sometimes felt sad about their body image. The multiple linear regression analysis showed that those who had a good overall feeling of family, satisfied with their own gender, and less worried about their body image tended to have a higher self-esteem scores among 4 groups(P<0.01). Other related influencing factors included parental education level, family economic status, only-child or not, birth place and parental preference for gender of their child. Conclusion Adolescents’ self-esteem was fair, and many factors were associated with it. It is necessary to strengthen the education on gender equality among parents and adolescents and to pay more attention to mental health of the adolescents, who were in rural areas, with poor family atmosphere and economic status.

Objective: To explore the relationship between Adverse childhood experiences(ACEs) and depression in early adolescence, and to provide scientific basis for effectively coping with the impact of ACEs on adolescents’ mental health. Methods: Stratified cluster sampling method was used to select adolescents in grade 6-8 in three middle schools of Shanghai during November and December of 2017. Adolescents were investigated anonymously using computer assisted self-interview approach via the tablets. Information including demographic characteristics, ACEs, and depression was collected. The chi-square test and multivariate logistic regression were used to explore the relationship between ACEs and depression, after controlling potential confounders. Results: Totally 1 629 eligible records were obtained. 65.25% of the respondents had experienced of neglect, followed by those abused(61.26%), and the incidence of family dysfunction was relatively low(20.81%). About 79.01% of the respondents had experienced at least one ACE, and more than half(61.45%) of the respondents had experienced at least two ACEs, and 10.01% of the respondents had experienced five or more ACEs. Multivariate logistic regression analysis showed that abuse and neglect experienced by male and female adolescents was associated with depression severity, with the OR values ranging from 2.62 to 3.60. Family dysfunction was found to be associated with depression only in male adolescents, with the OR of 1.91. The cumulative effect of ACE score on depression was observed. Conclusion Different types of ACEs in early adolescents are associated with depression, and ACEs have cumulative effects on depression severity.

Objective: To explore the relationship between gender role attitudes (GRA) and adolescent depression to provide evidence for the promotion of mental health among adolescents. Methods: A total of 1 549 students from grades 6 to 8 in three public middle schools in Jing an District of Shanghai were selected by stratified cluster sampling. The baseline and follow up surveys were conducted by anonymous electronic questionnaire on mobile tablets from November to December in 2017 and 2018, respectively. The GRA Scale and the Depression Scale were used to collect subjects attitudes towards traditional role assignment and power inequality between men and woman and depression in family and sexual relationships. The multivariate Generalized Estimating Equations (GEE) model was adopted to examine the relationship between GRA and depression. Results: The mean score of the GRA Scale was (2.52±0.83) and (2.29±0.86), while the score of Depression Scale was (15.92±5.08) and (16.48±5.29), in the baseline and follow up survey, respectively ( P <0.05). After controlling the covariates of age, bullied experience, body image, social cohesion, etc., the multivariate GEE model indicated traditional GRA was significantly associated with a higher risk of depression among both boys and girls ( β boys =0.38, β girls =0.41, P <0.05). Conclusion Traditional GRA may increase the risk of depression in adolescents, suggesting that cultivating a positive and equal GRA among this population group may help to prevent depression.