Rumination is a core cognitive symptom of post-traumatic stress disorder(PTSD),which significantly exacerbates difficulties in emotional regulation and impedes symptom recovery.Its occurrence is closely associated with gray matter structural impairments and abnormal white matter connectivity in the prefrontal-limbic system,including the hippocampus,amygdala,and prefrontal cortex.Functional neuroimaging studies indicate that the neural basis of rumination involves hyperactivation of the default mode network and the salience network,coupled with reduced functionality of the executive control network.Neurochemical research suggests that metabolic imbalances in the glutamate/γ-aminobutyric acid system may further contribute to the maintenance and reinforcement of rumination.Systematically elucidating the neural mechanisms of rumination in PTSD patients based on multimodal neuroimaging evidence will facilitate a deeper understanding of its neuropathological mechanisms and help expand future research directions.

BACKGROUND:The development of calcium phosphate bone cement is limited due to its poor mechanical properties and weak osteogenic ability.Silicate bioactive glass is highly favored due to its excellent biological activity and osteogenic ability.Simultaneously,fiber structures can enhance the mechanical strength of materials.OBJECTIVE:To investigate the mechanical properties,biocompatibility,and osteogenic effect of silicate bioactive glass fiber composite calcium phosphate bone cement.METHODS:Different mass percentages(0％,10％,and 20％)of silicate bioactive glass fiber were added to the solid phase of calcium phosphate bone cement,mixed with the liquid phase and cured for 48 hours to obtain silicate bioactive glass fiber composite calcium phosphate bone cement.The mechanical properties,setting time,and ion precipitation of the cement were characterized.The three groups of bone cement extracts were co-cultured with MC3T3-E1 cells.The cell compatibility of the materials was evaluated by CCK-8 assay,live/dead staining,and phalloidin staining.After osteogenic induction,the osteogenic induction ability of the materials was evaluated by alkaline phosphatase staining,alizarin red staining,RUNX2 immunofluorescence staining,and RT-PCR.RESULTS AND CONCLUSION:(1)With the increase of silicate bioactive glass fiber content,the compressive strength and flexural strength of bone cement increased,and the setting time was prolonged.When bone cement was immersed in simulated body fluid,the precipitation of silicon ions,calcium ions,and phosphorus ions could be detected.Moreover,with the increase of silicate bioactive glass fiber content,the mass concentration of silicon ions and phosphorus ions released by bone cement increased,and the mass concentration of calcium ions decreased.(2)Live/dead staining and phalloidin staining results exhibited that silicate bioactive glass fiber composite calcium phosphate bone cement had no toxic effect on MC3T3-E1 cells.CCK-8 assay results showed that silicate bioactive glass fiber composite calcium phosphate bone cement could promote the proliferation of MC3T3-E1 cells.(3)With the increase of silicate bioactive glass fiber content in bone cement,the alkaline phosphatase activity and extracellular calcium deposition of MC3T3-E1 cells increased,the expression of RUNX2 protein increased,and the expression of alkaline phosphatase,osteocalcin,osteopontin,and RUNX2 mRNA expression increased.(4)The results indicate that silicate bioactive glass fibers can enhance the mechanical properties and osteogenic induction ability of calcium phosphate bone cement,among which 20％silicate bioactive glass fibers have a more obvious effect.

Objective To compare the quality of liquids dispensed by intelligent dispensing robot and traditional manual in PIVAS,to ensure the safety of clinical infusion.Methods Using omeprazole and ambroxol as the main drugs and 5％glucose injection and 0.9％sodium chloride solution as the solvent,a number of quality indexes including drug residues and the number of insoluble particles were evaluated in the two modes of manual and robotic dispensing,respectively.Results Under the robot dispensing mode and manual dispensing mode,the residual amount of drugs was less than 5％,the insoluble particles were far less than the limit,the pH value was in line with the human infusion range,and the endotoxin and aseptic culture were negative results,with no statistical significance(P＞0.05).Conclusions The quality of liquid dispensed under the robotic dispensing mode is guaranteed,and there is no significant difference in the quality of liquid dispensed with the traditional manual dispensing mode,which provides a reliable guarantee for the large-scale application of robotic dispensing in intravenous admixture service.

BACKGROUND:The development of calcium phosphate bone cement is limited due to its poor mechanical properties and weak osteogenic ability.Silicate bioactive glass is highly favored due to its excellent biological activity and osteogenic ability.Simultaneously,fiber structures can enhance the mechanical strength of materials.OBJECTIVE:To investigate the mechanical properties,biocompatibility,and osteogenic effect of silicate bioactive glass fiber composite calcium phosphate bone cement.METHODS:Different mass percentages(0％,10％,and 20％)of silicate bioactive glass fiber were added to the solid phase of calcium phosphate bone cement,mixed with the liquid phase and cured for 48 hours to obtain silicate bioactive glass fiber composite calcium phosphate bone cement.The mechanical properties,setting time,and ion precipitation of the cement were characterized.The three groups of bone cement extracts were co-cultured with MC3T3-E1 cells.The cell compatibility of the materials was evaluated by CCK-8 assay,live/dead staining,and phalloidin staining.After osteogenic induction,the osteogenic induction ability of the materials was evaluated by alkaline phosphatase staining,alizarin red staining,RUNX2 immunofluorescence staining,and RT-PCR.RESULTS AND CONCLUSION:(1)With the increase of silicate bioactive glass fiber content,the compressive strength and flexural strength of bone cement increased,and the setting time was prolonged.When bone cement was immersed in simulated body fluid,the precipitation of silicon ions,calcium ions,and phosphorus ions could be detected.Moreover,with the increase of silicate bioactive glass fiber content,the mass concentration of silicon ions and phosphorus ions released by bone cement increased,and the mass concentration of calcium ions decreased.(2)Live/dead staining and phalloidin staining results exhibited that silicate bioactive glass fiber composite calcium phosphate bone cement had no toxic effect on MC3T3-E1 cells.CCK-8 assay results showed that silicate bioactive glass fiber composite calcium phosphate bone cement could promote the proliferation of MC3T3-E1 cells.(3)With the increase of silicate bioactive glass fiber content in bone cement,the alkaline phosphatase activity and extracellular calcium deposition of MC3T3-E1 cells increased,the expression of RUNX2 protein increased,and the expression of alkaline phosphatase,osteocalcin,osteopontin,and RUNX2 mRNA expression increased.(4)The results indicate that silicate bioactive glass fibers can enhance the mechanical properties and osteogenic induction ability of calcium phosphate bone cement,among which 20％silicate bioactive glass fibers have a more obvious effect.

Objective:To analyze and summarize clinical phenotypic characteristics and genetic variations in patients with intellectual disability and pathogenic variations of the DYNC1H1 gene across 4 generations within a single family. Methods:Retrospective case analysis.Clinical data of a child with epilepsy and intellectual disability and her family members were collected from the Children′s Medical Center, Peking University First Hospital on December 2019.The child was followed up regularly.DNA was extracted from the peripheral blood of the child′s family members.Then whole-exome sequencing and Sanger sequencing were performed to identify the genetic variation type in the proband and her family members.The relationship between genotype and phenotype was further analyzed.Results:A total of 13 patients across 4 generations in the family had intellectual disability, and the proband also had drug-resistant epilepsy.The variation c. 13556C> A (p.A4519E) of the DYNC1H1 gene was confirmed by gene testing in 8 patients (no blood samples were obtained from the remaining patients). Conclusions:DYNC1H1 gene-related intellectual disability in most previously reported cases are caused by novel variations of this gene.In this study, a large family of 13 intellectual disability patients across 4 generations caused by a pathogenic mutation in the DYNC1H1 gene was summarized.The findings make precise genetic counseling possible for this family and provide a basis for further studies on the relationship between the genotype and phenotype of the DYNC1H1 gene.

Objective:To compare the efficacy of lateral placement of the intramedullary nail guide pin versus that of median placement of the intramedullary nail guide pin in the closed reduction of metaphyseal fracture of the distal tibia.Methods:A retrospective cohort study was conducted to analyze the clinical data of 48 patients with metaphyseal fracture of the distal tibia who had been admitted to Department of Trauma Orthopaedics, The Second General Hospital of Fuzhou from May 2019 to July 2023. There were 37 males and 11 females, aged (46.0±12.4) years. According to the AO classification, 37 patients were classified as type A1, and 11 ones as type A2. The patients were divided into 2 groups according to the distal positioning of the intramedullary nail guide pins during operation. In the lateral placement group of 26 patients, the distal positioning of the guide pins was located at 1/3 lateral to the articular surface of the distal tibia. In the median placement group of 22 patients, the distal positioning of the guide pins was located at the midpoint of the articular surface of the distal tibia. The operation time, intraoperative blood loss, hospital stay, fracture healing time and fracture reduction were recorded and compared between the 2 groups. Moreover, the visual analogue scale (VAS) pain score, American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, and range of motion of the affected ankle were compared between the 2 groups, as well as within the 2 groups. The complications were compared between the 2 groups at the last follow-up.Results:There were no significant differences in the demographic data between the 2 groups, indicating comparability ( P>0.05). All patients were followed up for (19.6±4.4) months. The operation time [(81.7±17.3) min], intraoperative blood loss [(78.4±12.2) mL], hospital stay [(5.7±2.1) d] and fracture healing time [(4.3±1.1) months] in the lateral placement group were significantly less than those in the median placement group [(103.0±13.4) min, (111.4±11.7) ml, (8.6±3.5) d, and (6.1±1.3) months] ( P<0.05). There was no significant difference in the VAS pain score between the 2 groups before operation or at the last follow-up ( P>0.05). At the last follow-up, the AOFAS ankle-hindfoot score [(93.6±1.6) points], ankle dorsiflexion (17.9°±1.6°) and plantar flexion (41.9°±1.9°) in the lateral placement group were significantly better than those in the median placement group [(87.8±3.2) points, 15.1°±1.2°, and 38.5°±2.7°] ( P<0.05). In both groups, significant improvements were achieved at the last follow-up in VAS pain score, the AOFAS ankle-hindfoot score, ankle dorsiflexion and plantar flexion compared with the preoperative period ( P<0.05). The incidence of fracture angulation deformity in the lateral placement group (11.5%, 3/26) was lower than that in the median placement group (31.8%, 7/22) ( P>0.05). There was no significant difference in the incidence of complications between the lateral placement group (3.8%, 1/26) and the central placement group (18.2%, 4/22) ( P>0.05). Conclusion:In the closed reduction of metaphyseal fracture of the distal tibia, compared with median placement of the intramedullary nail guide pin, lateral placement of the intramedullary nail guide pin assisted with a Kirschner wire demonstrates advantages of more rapid and effective closed reduction of the fracture, shortened operation time, reduced intraoperative blood loss and promoted postoperative rehabilitation.

Objective To compare the quality of liquids dispensed by intelligent dispensing robot and traditional manual in PIVAS,to ensure the safety of clinical infusion.Methods Using omeprazole and ambroxol as the main drugs and 5％glucose injection and 0.9％sodium chloride solution as the solvent,a number of quality indexes including drug residues and the number of insoluble particles were evaluated in the two modes of manual and robotic dispensing,respectively.Results Under the robot dispensing mode and manual dispensing mode,the residual amount of drugs was less than 5％,the insoluble particles were far less than the limit,the pH value was in line with the human infusion range,and the endotoxin and aseptic culture were negative results,with no statistical significance(P＞0.05).Conclusions The quality of liquid dispensed under the robotic dispensing mode is guaranteed,and there is no significant difference in the quality of liquid dispensed with the traditional manual dispensing mode,which provides a reliable guarantee for the large-scale application of robotic dispensing in intravenous admixture service.

Rumination is a core cognitive symptom of post-traumatic stress disorder(PTSD),which significantly exacerbates difficulties in emotional regulation and impedes symptom recovery.Its occurrence is closely associated with gray matter structural impairments and abnormal white matter connectivity in the prefrontal-limbic system,including the hippocampus,amygdala,and prefrontal cortex.Functional neuroimaging studies indicate that the neural basis of rumination involves hyperactivation of the default mode network and the salience network,coupled with reduced functionality of the executive control network.Neurochemical research suggests that metabolic imbalances in the glutamate/γ-aminobutyric acid system may further contribute to the maintenance and reinforcement of rumination.Systematically elucidating the neural mechanisms of rumination in PTSD patients based on multimodal neuroimaging evidence will facilitate a deeper understanding of its neuropathological mechanisms and help expand future research directions.

Objective:To analyze and summarize clinical phenotypic characteristics and genetic variations in patients with intellectual disability and pathogenic variations of the DYNC1H1 gene across 4 generations within a single family. Methods:Retrospective case analysis.Clinical data of a child with epilepsy and intellectual disability and her family members were collected from the Children′s Medical Center, Peking University First Hospital on December 2019.The child was followed up regularly.DNA was extracted from the peripheral blood of the child′s family members.Then whole-exome sequencing and Sanger sequencing were performed to identify the genetic variation type in the proband and her family members.The relationship between genotype and phenotype was further analyzed.Results:A total of 13 patients across 4 generations in the family had intellectual disability, and the proband also had drug-resistant epilepsy.The variation c. 13556C> A (p.A4519E) of the DYNC1H1 gene was confirmed by gene testing in 8 patients (no blood samples were obtained from the remaining patients). Conclusions:DYNC1H1 gene-related intellectual disability in most previously reported cases are caused by novel variations of this gene.In this study, a large family of 13 intellectual disability patients across 4 generations caused by a pathogenic mutation in the DYNC1H1 gene was summarized.The findings make precise genetic counseling possible for this family and provide a basis for further studies on the relationship between the genotype and phenotype of the DYNC1H1 gene.

Objective:To compare the efficacy of lateral placement of the intramedullary nail guide pin versus that of median placement of the intramedullary nail guide pin in the closed reduction of metaphyseal fracture of the distal tibia.Methods:A retrospective cohort study was conducted to analyze the clinical data of 48 patients with metaphyseal fracture of the distal tibia who had been admitted to Department of Trauma Orthopaedics, The Second General Hospital of Fuzhou from May 2019 to July 2023. There were 37 males and 11 females, aged (46.0±12.4) years. According to the AO classification, 37 patients were classified as type A1, and 11 ones as type A2. The patients were divided into 2 groups according to the distal positioning of the intramedullary nail guide pins during operation. In the lateral placement group of 26 patients, the distal positioning of the guide pins was located at 1/3 lateral to the articular surface of the distal tibia. In the median placement group of 22 patients, the distal positioning of the guide pins was located at the midpoint of the articular surface of the distal tibia. The operation time, intraoperative blood loss, hospital stay, fracture healing time and fracture reduction were recorded and compared between the 2 groups. Moreover, the visual analogue scale (VAS) pain score, American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, and range of motion of the affected ankle were compared between the 2 groups, as well as within the 2 groups. The complications were compared between the 2 groups at the last follow-up.Results:There were no significant differences in the demographic data between the 2 groups, indicating comparability ( P>0.05). All patients were followed up for (19.6±4.4) months. The operation time [(81.7±17.3) min], intraoperative blood loss [(78.4±12.2) mL], hospital stay [(5.7±2.1) d] and fracture healing time [(4.3±1.1) months] in the lateral placement group were significantly less than those in the median placement group [(103.0±13.4) min, (111.4±11.7) ml, (8.6±3.5) d, and (6.1±1.3) months] ( P<0.05). There was no significant difference in the VAS pain score between the 2 groups before operation or at the last follow-up ( P>0.05). At the last follow-up, the AOFAS ankle-hindfoot score [(93.6±1.6) points], ankle dorsiflexion (17.9°±1.6°) and plantar flexion (41.9°±1.9°) in the lateral placement group were significantly better than those in the median placement group [(87.8±3.2) points, 15.1°±1.2°, and 38.5°±2.7°] ( P<0.05). In both groups, significant improvements were achieved at the last follow-up in VAS pain score, the AOFAS ankle-hindfoot score, ankle dorsiflexion and plantar flexion compared with the preoperative period ( P<0.05). The incidence of fracture angulation deformity in the lateral placement group (11.5%, 3/26) was lower than that in the median placement group (31.8%, 7/22) ( P>0.05). There was no significant difference in the incidence of complications between the lateral placement group (3.8%, 1/26) and the central placement group (18.2%, 4/22) ( P>0.05). Conclusion:In the closed reduction of metaphyseal fracture of the distal tibia, compared with median placement of the intramedullary nail guide pin, lateral placement of the intramedullary nail guide pin assisted with a Kirschner wire demonstrates advantages of more rapid and effective closed reduction of the fracture, shortened operation time, reduced intraoperative blood loss and promoted postoperative rehabilitation.