The core pathogenesis of attention deficit hyperactivity disorder （ADHD） lies in deficiency， stasis and stagnation. Deficiency arises from kidney essence depletion and spleen dysfunction in transportation and transformation， leading to inadequate nourishment of the marrow sea. Stasis caused by qi deficiency leads to obstruction in channels and collaterals， resulting in obstructed marrow transport. Stagnation is associated with the excess of the five minds transforming into fire， which scorches the brain orifices and leads to loss of control over marrow utilisation. Based on this， a "supplementation-unblocking-regulation" therapeutic approach is proposed. For deficiency， the focus is on supplementing kidney and fortifying spleen， and replenishing the marrow sea. For stasis， the priority is to unblock and open the orifices， and clear the marrow channels. For stagnation， the core is to clear fire and contain the mind， regulate and restore vital activity. In clinical practice， it is necessary to identify the primary and secondary pathogenic mechanisms and apply dynamic， combined treatment， integrating Chinese herbal medicine， acupuncture， and guiding exercises throughout the process， aiming to provide a reference for the diagnosis and treatment of ADHD with traditional Chinese medical.

BackgroundSuicide ideation in adolescent inpatients with depression is a multi-factorial problem， and perceived stress is considered to be closely related to suicide ideation， while its mediating role in suicide ideation among adolescent inpatients with depression remains unclear. ObjectiveTo explore the mediating effect of psychological capital on the relationship between perceived stress and suicide ideation among adolescent inpatients with depression， so as to provide references for preventing the onset of suicide ideation in adolescent inpatients with depression. MethodsA sample of 585 adolescent patients who were hospitalized in Beijing Huilongguan Hospital from June 2021 to March 2023 and fulfilling the International Classification of Diseases， 10th edition （ICD-10） diagnostic criteria for depression were enrolled. All patients were evaluated using self-designed questionnaire， Chinese Perceived Stress Scale （CPSS）， Positive Psychological Capital Questionnaire （PPQ） and Beck Scale for Suicide Ideation-Chinese Version （BSI-CV）. Pearson correlation was used to assess the correlation among the scores of the above scales. Bootstrap method was employed to verify the mediating effect of psychological capital on the relationship between perceived stress and suicide ideation. ResultsCPSS score in adolescent inpatients with depression was positively correlated with BSI-CV score （r=0.375， P<0.01）， and CPSS score and BSI-CV score were negatively correlated with PPQ score （r=-0.481， -0.436， P<0.01）. Psychological capital played a significant yet a partial role in mediating the link between perceived stress and suicide ideation， with an indirect mediating effect value of 0.160 （95% CI： 0.178~0.373）， accounting for 30.42% of the total effect. ConclusionThe perceived stress of adolescent inpatients with depression can affect the onset of suicide ideation both directly and indirectly through psychological capital.

Based on the practical issues discovered in the long-duration teaching practice for the course of Engineering Drawing, our teaching team has proposed the "four combinations" reform concept for the Engineering Drawing course of the biomedical engineering major in military medical universities. A distinguished course closely related with biomedical engineering, clinical medicine, and military medicine was successfully established by performing the course teaching reforms from multiple dimensions, including optimizing the curriculum system, improving teaching methods, innovating assessment models, improving textbook construction, promoting teaching condition construction, and strengthening the teaching team competitiveness. We have demonstrated a significant improvement in teaching effectiveness from multiple perspectives, including student classroom enthusiasm, graduation exam scores, student satisfaction with evaluations, and the use of learned knowledge in practical design work. The teaching reform of this course is expected to significantly enhance the interest of biomedical engineering students in the major at military medical universities, and provide practical experience for other related universities to perform subsequent reforms in Engineering Drawing teaching.

Based on the practical issues discovered in the long-duration teaching practice for the course of Engineering Drawing, our teaching team has proposed the "four combinations" reform concept for the Engineering Drawing course of the biomedical engineering major in military medical universities. A distinguished course closely related with biomedical engineering, clinical medicine, and military medicine was successfully established by performing the course teaching reforms from multiple dimensions, including optimizing the curriculum system, improving teaching methods, innovating assessment models, improving textbook construction, promoting teaching condition construction, and strengthening the teaching team competitiveness. We have demonstrated a significant improvement in teaching effectiveness from multiple perspectives, including student classroom enthusiasm, graduation exam scores, student satisfaction with evaluations, and the use of learned knowledge in practical design work. The teaching reform of this course is expected to significantly enhance the interest of biomedical engineering students in the major at military medical universities, and provide practical experience for other related universities to perform subsequent reforms in Engineering Drawing teaching.

BackgroundThere are differences in executive function between major depressive episode patients with or without psychotic symptoms， and childhood trauma may affect the executive function of patients with major depressive episode. Previous research studies predominantly focused on adult patients with major depressive episode， with a lack of studies specifically focusing on adolescent patients with major depressive episode. ObjectiveTo investigate the differences in executive function among adolescent patients with major depressive episode， with or without psychotic symptoms and childhood trauma. MethodsA total of 112 hospitalized adolescent patients with major depressive episode who met the criteria of the International Classification of Diseases， tenth edition （ICD-10） were included in the study. The participants were recruited from the Department of Child and Adolescent Psychiatry， Shenzhen Kangning Hospital during the period from August 2020 to November 2021. Additionally， 27 healthy controls were recruited through public advertisements. The Cambridge Neuropsychological Test Automated Battery （CANTAB） was used to assess executive function through the administration of the Motor Screening Task （MOT）， Spatial Working Memory（SWM） and Rapid Visual Information Processing （RVP） modules. Childhood Trauma Questionnaire-Short Form （CTQ-SF） was used to assess the trauma type. ResultsCompared with healthy controls， adolescent patients with major depressive episode had a longer mean delay （Z=-3.407， P=0.001） in the MOT task. In the SWM task， the patients had a higher total number of intergroup error responses （Z=-3.291， P=0.001）， a higher total number of intragroup error responses （Z=-3.461， P=0.001）， more total number of double error responses （Z=-3.218， P=0.001）， a higher total error responses （Z=-3.312， P=0.001）， higher strategy scores （Z=-2.437， P=0.015） and longer average delay time （Z=-2.055， P=0.040）. In the RVP task， the patients had fewer hits （Z=-3.196， P=0.001）， more misses （Z=-3.179， P=0.001）， fewer rejections （Z=-2.772， P=0.006）， lower hit probability （Z=-3.187， P=0.001） and lower A´ scores （Z=-3.070， P=0.002）.Compared with adolescent patients with major depressive episode without psychotic symptoms， those with psychotic symptoms had a lower total number of double error responses （Z=-2.566， P=0.010） in SWM task. Compared with adolescent patients with major depressive episode who did not experience emotional neglect， those who experienced emotional neglect had longer average delay time （Z=-3.183， P=0.001） in MOT task， fewer total hits （Z=-2.445， P=0.014）， more total missed reports （Z=-2.467， P=0.014）， lower hit probability （Z=-2.445， P=0.014） and lower A´scores （Z=-2.089， P=0.037） in RVP task. Adolescent patients with major depressive episode who had experienced emotional abuse had longer average delay time in MOT task than those who had not experienced emotional abuse （Z=-2.552， P=0.011）. ConclusionAdolescent patients with major depressive episode exhibit abnormalities in a majority of executive function domains. Specifically， those without psychotic symptoms and with childhood trauma demonstrate significantly impaired executive function. ［Funded by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties （number， SZGS013）， Basic and Applied Basic Research Fund of Guangdong Province （number， 2019A1515110047）， Shenzhen Science and Technology Planning Project （number， JCYJ20190809155019338）］

OBJECTIVES: To investigate the differences in non-suicidal self-injury (NSSI) behaviors between only-child and non-only-child adolescents with mood disorders. METHODS: A three-stage sampling method was used to perform a cross-sectional survey of 529 adolescents, aged 12-18 years, who had mood disorders and NSSI behaviors. These adolescents were sampled from the outpatient service of 20 mental hospitals in 9 provinces of China from August to November 2020. A self-made questionnaire was used to collect general demographic data. The Functional Assessment of Self-Mutilation, Beck Scale for Suicide Ideation, Kessler Psychological Distress Scale, Stress Mindset Measure-General, Multidimensional Scale of Perceived Social Support, Multidimensional Students' Life Satisfaction Scales, and Rosenberg Self-Esteem Scale were used to collect the information on self-injury behaviors and psychological factors in these adolescents. RESULTS: A total of 529 adolescents with mood disorders and NSSI behaviors were surveyed, among whom 375 were only-child adolescents and 154 were non-only-child adolescents. Compared with the non-only-child group, the only-child group had a significantly higher total score of Functional Assessment of Self-Mutilation (P<0.05) .The type and frequency of self-injury in the only-child group were significantly higher than those in the non-only-child group (P<0.05). Psychological analysis showed that compared with the non-only-child group, the only-child group had a significantly lower score of self-esteem (P<0.05) and significantly higher scores of psychological distress and depressive symptoms (P<0.05). The multiple linear regression analysis showed that the score of suicidal ideation was positively correlated with the frequency of NSSI behaviors in both only-child and non-only-child adolescents with mood disorders (P<0.05); in the only-child adolescents, the level of self-esteem was negatively correlated with the frequency of NSSI behaviors (P<0.05), and the score of stress perception was positively correlated with the frequency of NSSI behaviors (P<0.05); in the non-only-child adolescents, the score of anxious emotion was positively correlated with the frequency of NSSI behaviors (P<0.05). CONCLUSIONS Among the adolescents with mood disorders and NSSI behaviors, the only-child adolescents tend to have a higher frequency of self-injury and poorer mental health, and therefore, the only-child adolescents with mood disorders and NSSI behaviors need more attention.
Adolescent ; Cross-Sectional Studies ; Humans ; Mood Disorders ; Risk Factors ; Self Mutilation ; Self-Injurious Behavior/psychology* ; Suicide, Attempted/psychology*

Objective: To investigate the clinical effect of amitriptyline combined with Xiaoyao Powder in the treatment of postpartum depression. Methods: From January 2018 to February 2018, 128 patients with postpartum depression in the Second People's Hospital of Lishui were selected.The patients were randomly divided into observation group and control group according to the digital table, with 64 cases in each group.The observation group was treated with Chinese and western medicine (amitriptyline combined with Xiaoyao Powder), and the control group was treated with amitriptyline alone.The self-rating anxiety scale (SAS), self-rating depression scale (SDS) score, and the concise health survey scale (SF-36) score before and after treatment were compared between the two groups. Results: The SDS scores of the two groups were decreased after treatment (t=4.564, 3.656, P=0.012, 0.027), and the SDS score of the observation group was lower than that of the control group, the difference was statistically significant (P=0.035). The SDS scores had no statistically significant difference between the two groups before treatment (P=0.961). The SAS scores in the two groups were decreased after treatment (t=4.352, 3.432, P=0.015, 0.029). The SAS score of the observation group was lower than that of the control group, and the difference was statistically significant (t=3.021, P=0.038). After treatment, the scores of SF-36 in the observation group were significantly increased (all P<0.05), and the comparison of various indicators: emotional function (t=2.951, P=0.048), vitality (t=3.012, P=0.042), mental health (t=3.131, P=0.043), social function (t=2.967, P=0.048), physical pain (3.320, P=0.039), physiological function (t=3.467, P=0.038), physiological function (t=3.986, P=0.035), overall health (t=4.045, P=0.021), which had statistically significant differences compared with the control group. Conclusion Amitriptyline combined with Xiaoyao Powder in the treatment of postpartum depression can significantly improve the quality of life and improve the anxiety and depressive symptoms of patients, which is better than amitriptyline alone.

China ; Depressive Disorder, Major ; genetics ; Humans ; Polymorphism, Single Nucleotide ; Sirtuin 1 ; genetics

Objective To develop a novel stress fracture animal model system based on dynamic cyclic mechanical loading.Methods Ulnae and tibiae of rats were respectively fixed using differently shaped fixtures (including a fixed holder and a movable holder).The axial mechanical loading was applied via a linear actuator based on LabVIEW control program.During the loading process,a load cell and a laser displacement transducer were used to detect the force and displacement changes in the limbs,respectively.The two signals were sampled at real time by PC-based LabVIEW data acquisition program.A compressive loading test (peak force of 50 N) was conducted to examine the consistency and reliability of cyclic loads after completing the loading system.The loading system and an ElectroForce 3220 mechanical testing machine were respectively used to measure and compare the Young's modulus of a standard ultra-high molecular weight polyethylene (UHMWPE)cylinder to calibrate the loading system.Results The compressive loading test (peak force of 50 N) demonstrated that the mechanical loading system was able to apply consistent loads with controllable intensity and time.The calibration experiment indicated the accuracy of the loading system.Conclusion The novel mechanical loading device has characteristics of precision,scientificity and reliability,and it is approaching the real development situation of stress fracture,which may provide a reliable experimental base for exploring the precautionary measures of stress fracture.

OBJECTIVETo evaluate the outcomes of arthroscopy-assisted treatment of severe comminuted distal radial fracture with external fixators and kirschner wire fixation.

METHODSTwenty-seven cases of severe comminuted distal radial fracture treated between March, 2010 and January, 2012 were reviewed. During the operation, the carpal joint space was expanded with the external fixator, and the fracture was fixed by Kirschner wire after open reduction. The carpal joint was observed intraoperatively with arthroscopy to ensure full reduction, and the distal posterior interosseous nerve was then severed. The results of postoperative X-ray and wrist functional status of the carpal joints were recorded. Another 27 cases of severe comminuted distal radial fracture treated by conventional surgical approach served as the control group.

RESULTSThe patients were followed up for a mean of 13.2 (5-27) months. Compared with the conventional surgical approach, arthroscopy-assisted treatment resulted in a significantly shorter operative time with better appearance of the articular surface and also better wrist function assessed using the Krimmer system (P<0.05).

CONCLUSIONArthroscopy-assisted external fixator treatment is effective for management of severe comminuted distal radial fracture and avoids the stair-like appearance of the articular surface to achieve the maximal functional recovery of the carpal joints and reduce traumatic arthritis.

Adult ; Arthroscopy ; External Fixators ; Female ; Fracture Fixation ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Radius Fractures ; surgery ; Treatment Outcome