Objective To investigate the correlation between self-injurious and suicidal behavior in adolescents with depressive disorder and their non-enzymatic antioxidants and thyroid hormones.Methods A total of 93 adolescent patients with depressive disorder who were hospitalized at the Qingdao Mental Health Center from August 2023 to May 2024 were selected as the research subjects.The patients were divided into three groups:depression group(n=33),self-injurious behavior group(n=30)and a suicidal behavior.Plasma levels of non-enzymatic antioxidants and thyroid hormones were measured at admission and after 8 weeks of treatment,and their clinical symptoms were assessed by the Hamilton depression scale(HAMD)and the Hamilton anxiety scale(HAMA).Differences in plasma non-enzymatic antioxidants and thyroid function levels and scale scores were compared among three groups.Results Compared with depression group,baseline UA levels were lower in self-injurious and suicidal behavior groups.After 8 weeks of treatment,FT3 levels were higher in self-injurious group than in the suicidal behavior group,and both HAMD and HAMA scores decreased in all patients.After correction,HAMA scores were higher in suicidal behavior group than in depression group(P=0.047).Compared to baseline levels,TSH levels increased,and HAMD and HAMA scores decreased in all groups after treatment(P＜0.001).In suicidal behavior group,TBIL and FT3 levels decreased,and UA levels increased after treatment,while in depression group,FT4 levels decreased after treatment.Conclusion Non-enzymatic antioxidants may serve as potential biological markers for adolescents with depressive disorder who exhibit self-injurious and suicidal behavior.

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection，with immune dysregulation serving as the central mechanism. Interleukin-10，a pivotal cytokine in the immunopathological cascade of sepsis，plays dual roles in balancing inflammatory and anti-inflammatory responses. This article provided a concise review of the latest research advances regarding the role of interleukin-10 in the pathogenesis，early diagnosis，prognostic evaluation，and therapeutic strategies of sepsis，aiming to enhance clinical understanding of its diagnostic，therapeutic，and prognostic implications in sepsis management.

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection，with immune dysregulation serving as the central mechanism. Interleukin-10，a pivotal cytokine in the immunopathological cascade of sepsis，plays dual roles in balancing inflammatory and anti-inflammatory responses. This article provided a concise review of the latest research advances regarding the role of interleukin-10 in the pathogenesis，early diagnosis，prognostic evaluation，and therapeutic strategies of sepsis，aiming to enhance clinical understanding of its diagnostic，therapeutic，and prognostic implications in sepsis management.

Objective To investigate the correlation between self-injurious and suicidal behavior in adolescents with depressive disorder and their non-enzymatic antioxidants and thyroid hormones.Methods A total of 93 adolescent patients with depressive disorder who were hospitalized at the Qingdao Mental Health Center from August 2023 to May 2024 were selected as the research subjects.The patients were divided into three groups:depression group(n=33),self-injurious behavior group(n=30)and a suicidal behavior.Plasma levels of non-enzymatic antioxidants and thyroid hormones were measured at admission and after 8 weeks of treatment,and their clinical symptoms were assessed by the Hamilton depression scale(HAMD)and the Hamilton anxiety scale(HAMA).Differences in plasma non-enzymatic antioxidants and thyroid function levels and scale scores were compared among three groups.Results Compared with depression group,baseline UA levels were lower in self-injurious and suicidal behavior groups.After 8 weeks of treatment,FT3 levels were higher in self-injurious group than in the suicidal behavior group,and both HAMD and HAMA scores decreased in all patients.After correction,HAMA scores were higher in suicidal behavior group than in depression group(P=0.047).Compared to baseline levels,TSH levels increased,and HAMD and HAMA scores decreased in all groups after treatment(P＜0.001).In suicidal behavior group,TBIL and FT3 levels decreased,and UA levels increased after treatment,while in depression group,FT4 levels decreased after treatment.Conclusion Non-enzymatic antioxidants may serve as potential biological markers for adolescents with depressive disorder who exhibit self-injurious and suicidal behavior.

Objective:To investigate the safety and feasibility of modified pararectus abdominis approach in the anterior plate fixation of sacral fractures.Methods:In 5 fresh adult cadavers (3 males and 2 females), gross anatomy was performed on one pelvic side using a modified pararectus abdominis approach to clarify the anatomical structures around the approach. On the other side of the pelvis, the anterior structures of the sacrum were exposed in simulated anterior plate fixation of sacral fracture via the modified pararectus abdominis approach. The exposed anatomic range of the approach, and the locations and courses of lumbosacral trunk nerve and iliac vessels were observed and recorded.Results:(1) The modified pararectus abdominis approach exposed the whole S1 vertebral body from the sacroiliac joint to the medial side, the L5 vertebral body cephalally, the S1 foramina in the true pelvis, and the same structures laterally as a traditional pararectus abdominis approach did. (2) Via the modified pararectus abdominis approach, exploration and decompression of the lumbosacral plexus (from L4 to S1) (including S1 foraminoplasty) were performed under direct vision to decompress the nerve entrapment from anterior compressed fracture fragments and hyperplastic callus. (3) There was a safe surgical area in anterior L5 and S1 where a plate could be safely fixed to the S1 vertebral body. (4) Since the maximum vertical distance from the lumbosacral trunk nerve lifted above the periost to the sacral ala was 1.4 cm (range, from 1.2 to 1.5 cm), a plate could be safely placed from the subperiosteum to the S1 vertebral body to fix the fracture.Conclusions:The modified pararectus abdominis approach is safe and feasible for exploration and decompression of lumbosacral nerves in the anterior sacral region (from L4 to S1) because it has significant advantages in vision and operation. It also broadens the range of anterior sacral plate fixation because a sacral fracture displacement can be reduced under direct vision and a plate can be fixated to the S1 vertebral body along the alae sacralis and across the sacroiliac joint to the iliac bone.

Some questions like the hardship of treatment and lacking of standard on diagnosis are existing in steroid-resistant nephritic syndrome(SRNS).This article make an ethical analysis on these questions and assumes that we should persist in treating the patients carefully with humanism,carry on informed consent principle,implement the optimal treatment and perfect the standard of diagnosis and treatment,carry on clinical ethics education and promote the judgment level of clinical ethics.

With the development of the neonatal intensive care technology,the livability of premature infants arises greatly.But the evidently increased handicap and unknowable prognosis have brought series of social problems.The author assumed that!abandoning or ending treatment of premature infants who have no social value after cure and who are about to die soon after born correspond to ethics principle.Hospital ethics committee should play role in the decision making of cure.