T(4-TMAP) P [?,?,?,?-tetrakis-(4-trimethylammoniunphenyl)Por-phine] has been used for the colorimetric determination of copper in grain. The results of this method are in agreement with those of atomic-absorption spectrophotometry and the ordinary spectrophotometry. The method is very simple, accurate and rapid. The recovery is 94.2%-105.8% and the coefficient of variation is 1.6%-4.9%.

BACKGROUND: The incidence of mental problems in adolescents is increasingly higher and has gradually become an important factor affecting their health and growth.OBJECTIVE: To probe into the mental health status and its influencing factors in adolescents in some cities and rural areas in Hubei Province.DESIGN: Clustering stratified random sampling, cross-sectional survey.SETTING: Department of Maternal, Child and Adolescent Health, Tongji Medical College, Huazhong University of Science and Technology.PARTICIPANTS: According to the selected investigation spots of National Surveillance of Constitution and Health of Students, we selected representative urban areas (Wuhan City and Huangshi City) and rural areas (Yun County, Xiantao City, and Xiaogan City) in Hubei Province as sample spots. Totally 1 498 adolescents, aged 16-18 years, were surveyed by clustering stratified random sampling. There were 605 adolescents in urban group and 893 in rural group.METHODS: The self-made survey scale was used to investigate general conditions, such as age, parents' occupation and educational level, family type, social atmosphere, school type and atmosphere, and interpersonal relationship. Symptom Checklist-90 (SCL-90) was used to determine the adolescents' mentalhealth status; 9 subscales (somatization, obsessivecompulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychosis) were set as the observation indexes. SCL-90 is an inventory which is rated on a 5-point scale. Factor score of SCL-90 ≥ 3 or total score ≥ 160 was considered mental disorders. The family educational pattern was investigated through Egma Minnen av Bardndosnaupporstran(EMBU) by questionnaires. It contained positive rearing pattern and negative rearing pattern. Positive rearing pattern (namely, affectional warmth and understanding) contributes to mental health, while negative rearing pattern (e.g. punishment, firm control, excessive interference, partialism or rejection, denial and excessive protection) is adverse to mental health. The family environment was investigated with Family Environment Scale(FES). Four subscales (intimacy, conflict, intellectual-cultural orientation, and positive-recreational orientation) with high reliability and validity were set as indexes. All participants were given unified instructions and required to fill in anonymous questionnaires. The questionnaires were then collected by the teacher in charge of the class.Some indexes of adolescents in the urban and rural areas were observed including the score of SCL-90 and its relation with general conditions,parental rearing pattern and family environment quality. The total scores of symptom checklist 90 were set as dependent variables for stepwise regression analysis of related factors.MAIN OUTCOME MEASURES:①The incidence of mental health ,gender and regional difference of adolescents in some cities and rural areas in Hubei province; ②The score of SCL-90 and its comparison with national norm;③Correlation analysis of the total scores of SCL-90 with general condition and parents' educational type.RESULTS: ① The general incidence of mental disorders was 18.13 ％ in the 1 498 adolescents in Hubei province. It was 18.20% in boys and 18.04% in girls with no significant difference (P ＞ 0.05). Regional differences: The incidence in rural areas [23.74% (212/893)] was significantly higher than that in urban areas [16.69% (101/605), P ＜ 0.05]. Among all kinds of mental disorders, compulsion, interpersonal sensitivity, hostility,paranoid ideation, and depression were more common. ② Comparison with the national norm: The factor scores of SCL-90 and family environmentalquality were significantly lower that those of the national norm.③ Single factor analysis: The total score of SCL-90 was obviously correlated with age, gender, parents' educational level and expectation, and school atmosphere (P ＞ 0.01). It was negatively correlated with positive rearing pattern (affectional warm, understanding) (P ＞ 0.01), but positively correlated with negative rearing pattern (punishment, firm control, excessive interference,partialism or rejection, and denial). It had significant positive correlation with conflict and significant negative correlation with intimacy, intellectualcultural orientation and positive-recreational orientation(P ＞ 0.01).④Multiple factor analysis: The mental health status of the students was closely related to age, gender, parents' educational level and expectation, interpersonal sensitivity as well as school atmosphere, parental rearing pattern,and quality of family environment.CONCLUSION: The incidence of mental problems in adolescents in some urban and rural areas in Hubei Province is relatively high. Score factors of SCL-90 are all higher than those of the national norm and the mental health level is poor. This has obvious correlation with family factors including age, gender, parents' educational level and expectation, and school atmosphere. Moreover, the quality of family environment and parental rearing pattern are the major factors affecting their mental health.

Plasma HDL, HDL2 and HDL3 were determined in 95 untreated and 87 treated patients with NIDDM and 86 cases with IGT using Eder's modified method.The result showed that HDL, HDL2 and HDL3 were all reduced in these three groups in comparison with control group, but the average concentrations of all 3 subfractions of HDL showed no significant difference among these three groups. It also indicated that HDL abnormality may appear quite early in cases with abnormal glucose tolerance, such as in patients with IGT.

In order to identify family factors obviously relevant to aggression, and offer a theoretical foundation for the prevention of aggression, 4010 students from primary and secondary schools in 5 different areas in Hubei province were surveyed. The Child Behavior Checklist " parents' form" (Chinese version) and the four scales of Family Environment Scale were used. A multiple logistic regression was used to identify risk factors of children's and adolescents' aggressive behavior. The results showed that maternal education, paternal occupation, family type, parental child-rearing attitude and patterns, students' interpersonal relationship were significantly associated with the children's and adolescents' aggression. The risk factors of aggression were parental child-rearing patterns, peer relationship, teacher-student relationship, and family conflicts.

Objective To explore new treatment methods for old acromioclavicular dislocation. Methods Twenty-nine cases of old acromioclavicular dislocation were treated with augmenting reconstruction of acromioclavicular ligament by coracoacromial ligament and augmenting reconstruction of coracoclavicular ligament by conjoining tendon with biceps brachii muscle and coracobrachialis muscle in coracoid. Twenty-five cases were followed up with follow-up period of 3-36 months. There were 10 cases in grade Ⅱ and 15 in grade Ⅲ according to classification of Allman. Results Of 25 cases with follow-up, 16 were excellent and 9 satisfactory according to the Lazzcano standard. There were no other complications or dislocations. Conclusions Reconstruction of acromioclavicular and coracoclavicular ligaments for treatment of old acromioclavicular dislocation is an efficient method with advantage of rigid fixation and accords with micro-motion physiological function of acromioclavicular joint.

Objective:To explore the development characteristics of empathy in adolescents and the relations with aggression.Methods:With multistage stratified random sampling method,15 738 middle school students were selected from 5 provinces across China.The Buss-Warren Aggression Questionnaire Revised in China (BWAQ-RC) and Interactional Reactivity Index (IRI-C)was used to measure adolescents'aggression and empathy.Results:Girls had higher level of empathy than boys (P <0.001).Age and gender were interacted in predicting empathetic con-cern (P <0.001).Perspective taking was significant negative predictor of indirect aggression,physical aggression, hostile and angry (P <0.001),while empathetic concern was significant positive predictor of indirect aggression, verbal aggression,hostile and angry (P <0.001).Empathy was divided into 4 class used the K-Means clustering a-nalysis,namely,low empathy class,high perspective taking class,high empathetic concern class,high perspective taking and empathetic concern class.In contrast to other classes,individuals in low empathy class were more likely to involve in physical aggression (P <0.05),and individuals in high level of perspective taking and empathetic con-cern class were related with less physical aggression and elevated verbal aggression (P <0.05).Individuals in high empathetic concern class exhibited more indirect aggression,hostile and anger than other subgroups (P <0.05). Conclusion:The unbalance development of the two components of empathy may be closely correlated with different conduction of aggressive behaviors.

Objective To assess the patient enablement level in a general hospital and its related factors,to investigate the relationship of patient enablement with patient's overall satisfaction and doctor's empathy levels.Methods Patients attending the Family Medicine Clinic of HKU-Shenzhen Hospital in September 2014 and met the inclusion criteria were asked to complete a questionnaire survey which included general characteristics,overall satisfaction;the Patient Enablement Instrument (PEI) and the Consultation and Relational Empathy Measure Scale (CARE) after the consultation.Results Total 2 326 questionnaires were issued and 1 818 were retrieved,of which 1 478 were qualified questionnaires.The qualified rate of PEI was 81.3％ and the qualified rate of patient overall satisfaction was 96.28％.The positive rate of patient enablement was 97.70％ (1 444/1 478),and the mean score of PEI was 8.21 ±3.33.Multivariate linear regression analysis showed that the PEI scores were not influenced by gender and education level of the patients,gender of the consulting doctors and initial/follow up consultation.The PEI scores were influenced by the age of the patients,the types of clinic (general practice/chronic practice clinic) and the reasons for consulting (P ＜ 0.05).There were correlations between PEI score and overall satisfaction of patients (r =0.383,P ＜ 0.001),patient's recommendation of the clinic (r =0.595,P ＜ 0.001) and CARE scores (r =0.546,P ＜ 0.001).Conclusion The results show that the PEI scores of patients visiting family medicine clinic of this hospital are higher than those reported in other studies.The PEI score may be influenced by the age of the patients,the types of clinic and the reasons for consulting.Positive correlations between patient enablement and the overall satisfaction,patient's recommendation and doctor empathy were observed.

In order to identify family factors obviously relevant to aggression, and offer a theoretical foundation for the prevention of aggression, 4010 students from primary and secondary schools in 5 different areas in Hubei province were surveyed. The Child Behavior Checklist "parents' form"(Chinese version) and the four scales of Family Environment Scale were used. A multiple logistic regression was used to identify risk factors of children's and adolescents' aggressive behavior. The results showed that maternal education, paternal occupation, family type, parental child-rearing attitude and patterns, students' interpersonal relationship were significantly associated with the children's and adolescents' aggression. The risk factors of aggression were parental child-rearing patterns, peer relationship, teacher-student relationship, and family conflicts.

Clinical research design is the beginning and the cornerstone for clinical research,and it functions as the preliminary step of translational research.In order to improve clinical research ability,foster quality research talents team,and to promote the development of translational research,Peking Union Medical College Hospital (PUMCH) started to provide the online course Designing Clinical Research (DCR),which has greatly contributed to enhancing clinical research capacity.The management of DCR online course serves as a great exploration on training junior medical professionals and international research collaboration.This study aims at sharing the management experiences of clinical research design and junior talents training.

Objective: To analyze clinical characteristics and wound repair methods and effects of patients with upper limb electric burns. Methods: Medical records of 136 patients with upper limb electric burn who met the inclusion criteria and hospitalized in our unit from January 2015 to March 2019 were retrospectively analyzed. Proportion in patients with electric burns in the same period, gender, age, admission time, categories, injury causes, injury voltage, burn area and depth of upper limb, simultaneous injury of both upper limbs, and early wound treatment measure of patients with upper limb electric burn were recorded. The main repair methods of each affected limb were classified and recorded. The overall efficacy of the patients was recorded, including postoperative wound complications and healing condition. The patients repaired with distal pedicled flaps and those with free flaps were followed up for 3 to 6 months. The survival rate of flaps were recorded, the function of affected limbs after operation was evaluated, and the satisfaction degree of patients was investigated by Curative Effect Score Table. The amputation rate, age, and burn area of upper limbs of patients caused by high-voltage and low-voltage electricity were compared. Data were processed with Wilcoxon rank sum test, chi-square test, or Fisher′s exact probability test. Results: (1) The number of upper limb electric burn patients accounted for 88.3% of 154 patients with electric burns hospitalized in the same period, including 117 males and 19 females, aged 1 year and 2 months to 72 years [(34±18) years], admitted 1 h to 48 d after injury, including 51 electricians, 32 rural migrant workers, 31 students and preschool children, and 22 patients belonging to other categories. Patients of the first two categories were mainly injured by work accidents, and those of the latter two categories mainly suffered from touching power source or power leakage. Among all the patients, 75 cases were injured by high-voltage electric burn, and 61 cases were injured by low-voltage electric burn, with burn area of upper limb from 0.2% to 16.0% [2% (1%, 5%)] total body surface area (TBSA) and area of wounds deep to bone from 0.2% to 15.0% [2% (1%, 5%)] TBSA. Two upper limbs in 54 cases were simultaneously injured, accounting for 39.7%. Early fasciotomy was performed for 73 limbs. (2) Thirteen affected limbs were treated with dressing change, 2 affected limbs were sutured directly after debridement, 56 affected limbs were repaired by skin grafting, 12 affected limbs were repaired by local flap, 45 affected limbs were repaired by distal pedicled flap, 22 affected limbs were repaired by free flap, and 40 affected limbs were amputated (accounting for 21.1%). (3) One case died of pulmonary infection, sepsis, and multiple organ failure after operation, and the rest patients were all cured. One case with avulsion of abdominal flap was repaired by skin grafting after dressing change. The anterolateral thigh flap in one case necrotized after transplantation, which was replaced by pedicled abdominal flap. Seven cases had small erosion on the pedicle or margin after transplantation of abdominal flap and were healed by dressing change. Six cases had local bruising at the distal end after transplantation of abdominal flap and were healed after conservative treatment such as hyperbaric oxygen. The other flaps survived well. (4) The survival rate of distal pedicled flap grafting was 97.8% (44/45), which was close to that of free flap grafting (95.5%, 21/22, P>0.05). The function recovery of affected limb after free flap grafting was better than that of distal pedicled flap grafting (Z=-3.054, P<0.01), but their satisfaction degree of patients was similar (Z=-0.474, P>0.05). (5) Patients with high-voltage electric burn had higher amputation rate, older age, and larger upper limb burn area than those with low-voltage electric burn (χ²=4.743, Z=-2.801, -6.469, P<0.05 or P<0.01). Conclusions Upper extremity electric burn often occurs in children, electricians, and rural migrant workers with high rate of amputation. Teachers and parents should strengthen safety education for children and manage power source of life well. Workers should improve safety awareness and operate standardly. Fasciotomy for relaxation should be performed for electric burn wound as soon as possible, and flap grafting can effectively repair wound after early debridement. The function recovery of affected upper limb repaired with free flap grafting is better.