Objective:To explore the risk factors of acute Kemmochi type V anterior talofibular ligament (ATFL) injury in X-ray negative children and their predictive efficacy .Methods:A retrospective cohort study was conducted to analyze the clinical data of 92 children with X-ray negative ATFL injury, who were treated at the outpatient department of Jinan Children′s Hospital from June 2023 to March 2025, including 55 boys and 37 girls, aged 5-14 years [8.8(7.0, 11.0)years]. The cause of injury was low-energy ankle sprain and X-ray examination showed no fracture, ie, X-ray negative. According to the Kemmochi classification for ATFL injury, the injury was classified as type V (Kemmochi type V group) in 42 patients and type I-IV (non-Kemmochi type V group) in 50. Gender, age, side of injury, time from injury to first visit, physical examination at the first visit [positive result of ankle inversion test, weight-bearing ability assessment, visual analogue score (VAS)], X-ray examination at the first visit (presence of os subfibulare), and musculoskeletal ultrasound examination at the first visit (swelling degree of ATFL, ankle joint effusion, enhanced blood flow signal of ATFL) were recorded in both groups. Univariate analysis and binary Logistic regression analysis were used to evaluate and determine the independent risk factors for X-ray negative Kemmochi type V ATFL injury in children. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the predictive efficacy of each independent risk factor for Kemmochi type V ATFL injury. Results:Univariate analysis showed significant differences between the two groups in age, VAS, ATFL swelling degree, and ankle joint effusion ( P<0.05) but no significant differences in gender, side of injury, time from injury to the first visit, positive result of ankle inversion test, weight-bearing ability assessment, presence of os subfibulare or enhanced blood flow of ATFL ( P>0.05). Binary Logistic regression analysis indicated that age ( OR=0.79, 95% CI 0.65, 0.97, P<0.05) and ATFL swelling degree ( OR=6.97, 95% CI 1.38, 35.32, P<0.05) were significantly correlated with Kemmochi type V ATFL injury in X-ray negative children. ROC curve analysis showed that the AUC for age and ATFL swelling degree were 0.65(95% CI 0.54, 0.75) and 0.78(95% CI 0.68, 0.86) and the AUC for age combined with ATFL swelling degree was 0.83(95% CI 0.74, 0.90). The optimal threshold values of age and ATFL swelling degree were 9.3 years and 1.0 mm. Conclusions:Age and ATFL swelling degree are independent risk factors for Kemmochi type V ATFL injury in X-ray negative children. Both age and ATFL swelling degree have relatively high independent predictive efficacy, and the combined predictive efficacy of the two is even higher.

Objective:To explore the risk factors of acute Kemmochi type V anterior talofibular ligament (ATFL) injury in X-ray negative children and their predictive efficacy .Methods:A retrospective cohort study was conducted to analyze the clinical data of 92 children with X-ray negative ATFL injury, who were treated at the outpatient department of Jinan Children′s Hospital from June 2023 to March 2025, including 55 boys and 37 girls, aged 5-14 years [8.8(7.0, 11.0)years]. The cause of injury was low-energy ankle sprain and X-ray examination showed no fracture, ie, X-ray negative. According to the Kemmochi classification for ATFL injury, the injury was classified as type V (Kemmochi type V group) in 42 patients and type I-IV (non-Kemmochi type V group) in 50. Gender, age, side of injury, time from injury to first visit, physical examination at the first visit [positive result of ankle inversion test, weight-bearing ability assessment, visual analogue score (VAS)], X-ray examination at the first visit (presence of os subfibulare), and musculoskeletal ultrasound examination at the first visit (swelling degree of ATFL, ankle joint effusion, enhanced blood flow signal of ATFL) were recorded in both groups. Univariate analysis and binary Logistic regression analysis were used to evaluate and determine the independent risk factors for X-ray negative Kemmochi type V ATFL injury in children. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the predictive efficacy of each independent risk factor for Kemmochi type V ATFL injury. Results:Univariate analysis showed significant differences between the two groups in age, VAS, ATFL swelling degree, and ankle joint effusion ( P<0.05) but no significant differences in gender, side of injury, time from injury to the first visit, positive result of ankle inversion test, weight-bearing ability assessment, presence of os subfibulare or enhanced blood flow of ATFL ( P>0.05). Binary Logistic regression analysis indicated that age ( OR=0.79, 95% CI 0.65, 0.97, P<0.05) and ATFL swelling degree ( OR=6.97, 95% CI 1.38, 35.32, P<0.05) were significantly correlated with Kemmochi type V ATFL injury in X-ray negative children. ROC curve analysis showed that the AUC for age and ATFL swelling degree were 0.65(95% CI 0.54, 0.75) and 0.78(95% CI 0.68, 0.86) and the AUC for age combined with ATFL swelling degree was 0.83(95% CI 0.74, 0.90). The optimal threshold values of age and ATFL swelling degree were 9.3 years and 1.0 mm. Conclusions:Age and ATFL swelling degree are independent risk factors for Kemmochi type V ATFL injury in X-ray negative children. Both age and ATFL swelling degree have relatively high independent predictive efficacy, and the combined predictive efficacy of the two is even higher.

Objective:This study aims to explore the clinical features and electrophysiological mechanism of depression through event-related potential analysis.Method:Temporal Experience of Pleasure Scale (TEPS) was used to evaluate anticipatory (TEPS-A) and consummatory (TEPS-C) pleasurable experience among 53 participants (20 patients with major depressive disorder (MDD), 14 patients with bipolar depression Ⅱ (BD) and 19 health controls (HC)). Hamilton Depression Scale (HAMD) and Brief Screening Scale for Dementia (BSSD) were used to evaluate patients’ clinical characteristics. All subjects completed gambling task according to the instructions. Meanwhile, continuous electroencephalogram （EEG) was recorded, and feedback negativity in event-related potential was analyzed.Results:Firstly, compared with HC group, the scores of TEPS, TEPs-A and TEPs-C in MDD and BD groups were decreased ( P<0.01). Secondly, the FN amplitude wave decreased significantly in MDD group ((-0.138±2.562) μV), compared with HC ((-2.569±2.598) μV) and BD group ((-2.251±0.954) μV), P<0.05. Thirdly, in contrast to HC ((10.778±6.967) μV) and BD ((10.284±5.540) μV), the MDD group ((6.069±4.353) μV) displayed blunted responses to gain feedback; For the loss feedback, no significant difference was shown among the three groups. Moreover, correlation analysis showed that, for the MDD group, consummatory anhedonia measured by TEPS-C were associated with reduction in response to gain feedback ( r=-0.501 ，P=0.024). Conclusions:Patients with depressive episode FN in MDD was negatively correlated with the score of consummatory pleasurable experience by having a lack of pleasure, which was manifested as the decrease of both anticipatory pleasurable experience and consummatory pleasurable experience. Patients with MDD showed decreased reward sensitivity and decreased FN amplitude, while patients with BD Ⅱ showed no similar trend. The changes in EEG indicated underpinning mechanism of anhedonia in depression.

Objective:This study aims to explore the clinical features and electrophysiological mechanism of depression through event-related potential analysis.Method:Temporal Experience of Pleasure Scale (TEPS) was used to evaluate anticipatory (TEPS-A) and consummatory (TEPS-C) pleasurable experience among 53 participants (20 patients with major depressive disorder (MDD), 14 patients with bipolar depression Ⅱ (BD) and 19 health controls (HC)). Hamilton Depression Scale (HAMD) and Brief Screening Scale for Dementia (BSSD) were used to evaluate patients’ clinical characteristics. All subjects completed gambling task according to the instructions. Meanwhile, continuous electroencephalogram （EEG) was recorded, and feedback negativity in event-related potential was analyzed.Results:Firstly, compared with HC group, the scores of TEPS, TEPs-A and TEPs-C in MDD and BD groups were decreased ( P<0.01). Secondly, the FN amplitude wave decreased significantly in MDD group ((-0.138±2.562) μV), compared with HC ((-2.569±2.598) μV) and BD group ((-2.251±0.954) μV), P<0.05. Thirdly, in contrast to HC ((10.778±6.967) μV) and BD ((10.284±5.540) μV), the MDD group ((6.069±4.353) μV) displayed blunted responses to gain feedback; For the loss feedback, no significant difference was shown among the three groups. Moreover, correlation analysis showed that, for the MDD group, consummatory anhedonia measured by TEPS-C were associated with reduction in response to gain feedback ( r=-0.501 ，P=0.024). Conclusions:Patients with depressive episode FN in MDD was negatively correlated with the score of consummatory pleasurable experience by having a lack of pleasure, which was manifested as the decrease of both anticipatory pleasurable experience and consummatory pleasurable experience. Patients with MDD showed decreased reward sensitivity and decreased FN amplitude, while patients with BD Ⅱ showed no similar trend. The changes in EEG indicated underpinning mechanism of anhedonia in depression.

0.5ug/ml in 34 patients(79.1%).Postoperative survival rate and recover of the work ability in group T were significantly higher than those in group C.Conclusions EPTT before RT for the type I diabetes patients with renal disorder can improve the results of RT.

Objective To study the pathogenic features, diagnosis and treatment of aberrant thyroid cancer.Methods A retrospective analysis of clinical and pathological data of 29 cases of aberrant thyroid cancer was made.Results All of the 29 patients underwent operative treatment and postoperative adjuvant radiation therapy and chemotherapy. On postoperative follow up, the 5-year survival rate was 52.0%. The longest survivor patient was alive 24 years after operation.Conclusions The key to increase the survival rate of patients is early detection and timely surgical treatment. Postoperative adjuvant radiation therapy and chemotherapy are conducive to increase survival rate.