Dialectical behavior therapy （DBT） is one of the empirically supported therapeutic approaches for borderline personality disorder （BPD）. By integrating behaviorism， dialectical philosophy， biosocial theory and Zen principles， DBT aims to enhance patients' emotional regulation， interpersonal effectiveness and distress tolerance， thereby alleviating BPD symptoms. This article systematically reviews the theoretical foundations of DBT and its research progress in BPD treatment， to Delve into the intervention effects of DBT， as well as the adjuvant role of pharmacotherapy and physiotherapy in enhancing DBT for BPD， and analyzes the challenges faced in DBT research and clinical application. The findings are expected to provide new insights for the localization and theoretical research of DBT in China.

Objective: To establish and validate a whole blood (WB) supply model, thereby providing practical experience for the clinical application of WB in domestic trauma emergency care and informing the development of a wartime blood supply system for the military. Methods: A “10×24” WB supply model was established by formulating blood collection protocols, storage standards, and transfusion criteria. Multiple WB samples were tested under specific storage conditions to assess key indicators at different time points, including red blood cell (RBC), white blood cell (WBC), and platelet counts, hemoglobin concentration, coagulation parameters (PT, APTT, TT, FIB), coagulation factor activity, thromboelastography (TEG) parameters, and electrolyte levels. Additionally, clinical data from hemorrhagic patients who met the criteria for WB transfusion and were admitted between March and July 2024 were analyzed to evaluate WB transfusion volume. Results: RBC counts and hemoglobin levels remained stable in WB stored at 4℃ for up to 10 days. However, platelet counts and coagulation function (PT, APTT) significantly declined with prolonged storage, while potassium levels increased. From March to July 2024, the model was successfully applied to 23 patients with acute hemorrhage, with a median WB transfusion volume of 543 mL. A detailed case study of a severe traumatic hemorrhagic shock patient was reported, who was successfully treated with 5.5 units of refrigerated WB combined with component blood. Conclusion: The “10×24” WB supply model demonstrated acceptable changes in critical quality parameters under strict management and a 10-day rotation cycle. This model effectively supports the treatment of acute hemorrhage and holds promise for integration into the future wartime blood supply system of the military.

The in-depth research of artificial intelligence in the medical field has greatly improved the workflow and diagnostic ability of diagnostic radiology.This article focuses on artificial intelligence technology in the field of interventional medicine,and enumerates its potential application scenarios,including improving image analysis capabilities to assist diagnosis and predict treatment response.It also describes the challenges that need to be overcome for practical application.Finally,with the continuous development of artificial intelligence in interventional medicine,artificial intelligence will further optimize the channels of interventional medicine and bring revolutionary changes to the clinical practice of interventional medicine.

Depression, a mental health disorder, has emerged as one of the significant challenges in the global public health domain. Investigating the pathogenesis of depression and accurately assessing the symptomatic changes are fundamental to formulating effective clinical diagnosis and treatment strategies. Utilizing non-invasive brain imaging technologies such as functional magnetic resonance imaging and scalp electroencephalography, existing studies have confirmed that the onset of depression is closely associated with abnormal neural activities and altered functional connectivity in multiple brain regions. Magnetoencephalography, unaffected by tissue conductivity and skull thickness, boasts high spatial resolution and signal-to-noise ratio, offering unique advantages and significant value in revealing the abnormal brain mechanisms and neural characteristics of depression. This review, starting from the rhythmic characteristics, nonlinear dynamic features, and connectivity characteristics of magnetoencephalography in depression patients, revisits the research progress on magnetoencephalography features related to depression, discusses current issues and future development trends, and provides insights for the study of pathophysiological mechanisms, as well as for clinical diagnosis and treatment of depression.
Humans ; Magnetoencephalography/methods* ; Brain/physiopathology* ; Depression/diagnosis* ; Electroencephalography ; Magnetic Resonance Imaging

Objective:To explore the clinical and genetic characteristics of a child with autosomal recessive primary microcephaly (MCPH).Methods:A case study has been carried out on a boy who had presented at the Inner Mongolia Maternity and Child Health Care Hospital for microcephaly and mental deficiency in September 2022. Prenatal ultrasound images were retrospectively analyzed, and whole exome sequencing and Sanger sequencing were carried out for his family. A literature review was also carried out using keywords such as " ASPM gene", "microcephaly", "prenatal diagnosis", "primary microcephaly", " ASPM", "MCPH5", "MCPH", "autosomal recessive microcephaly", and "prenatal diagnosis on ultrasonography" on the PubMed database, Wanfang Data and China National Knowledge until September 2023. This study was approved by Medical Ethics Committee of the Inner Mongolia Maternity and Child Health Care Hospital (Ethics No. 2021-093-1). Results:The proband had shown progressive reduction in biparietal diameter (BPD) and head circumference (HC) during the fetal period. He was found to harbor compound heterozygous variants of the ASPM gene, which included a paternally derived c. 8044C>T (p.R2682X) and a maternally derived c.8652dup (p.A2885Sfs*35). Both variants were classified as pathogenic (PVS1+ PM2_Supporting+ PP4; PVS1+ PM2_Supporting+ PM3) based on the guidelines from the American College of Medical Genetics and Genomics (ACMG). For other fetuses in his family, prenatal ultrasound and genetic testing were all normal. Literature research has identified 11 relevant articles, which included 14 MCPH cases. All of the MCPH5 cases had shown various degrees of reduced BPD/HC on fetal imaging (100%, 15/15). Developmental delay, intellectual disability, and attention deficits were noted in all survived cases, with one case having seizures (12.5%, 1/8). Their genotypes had included homozygotes (46.2%, 6/13) and compound heterozygotes (53.8%, 7/13) for nonsense variants (45%, 9/20) and frameshifting variants (55%, 11/20). Conclusion:The compound heterozygous variants c. 8044C>T (p.R2682X) and c. 8652dup (p.A2885Sfs*35) of the ASPM gene probably underlay the reduced BPD and HC in this proband with MCPH.

Objective The purpose of this study was to investigate the application value of Chromosomal microarray analysis(CMA)in prenatal diagnosis of nuchal translucency(NT)thickening and nasal bone dyscalci-fication.Methods The fetuses diagnosed with NT thickening and nasal bone dyscalcification at the Prenatal Diagnosis Center of Meizhou People's Hospital from September 2022 to April 2024,who underwent CMA and karyotype analysis were collected to analyze the relationship between NT thickening and nasal bone dyscalcification and chromosome abnormalities.The detection of chromosomal abnormalities in fetuses with NT thickening,nasal bone dyscalcification and the value of ultrasound combined with CMA in prenatal diagnosis were analyzed.Results In 75 fetuses with NT thickening and/or nasal bone dyscalcification,11 cases of chromosome aneuploidy were detected by karyotype analysis,and 5 cases of pathogenic copy number variations(CNV)were detected by CMA,with an additional detection rate of 6.7%.The additional diagnosis rates of CMA were 6.0%and 5.0%in fetuses with simple NT thickening and nasal bone dyscalcification,respectively.Conclusion CMA technique is of high value in prenatal diagnosis of fetuses with NT thickening and nasal bone dyscalcification,it can improve the detec-tion rate of fetal chromosomal abnormalities,and the combined application of multiple techniques can provide a more comprehensive evaluation of the fetuses.

To establish a simple,convenient,sensitive,and specific method for rapid detection of Zi-ka virus(ZIKV),the whole genome sequences of ZIKV isolated from different times and regions were analyzed.The specific primers and probes were designed based on the screened target se-quences located in the conserved region of the ZIKV NS5 gene.By combining RT-LAMP isother-mal amplification technology and immunochromatography technology,a reverse transcription loop mediated isothermal amplification nucleic acid and flow visualization strip(RT-LAMP-VF)detec-tion method for ZIKV was established.The results showed that the method had good specificity and sensitivity.When the ratio of inner,outer,and ring primers(FIP∶LF∶F3)was 4∶2∶1,the detection method can specifically detect 102 copies/pL RNA transcripts or 2.15 pfu ZIKV at 61 ℃for 45 minutes,with no cross reaction with other flaviviruses such as Japanese encephalitis virus and classical swine fever virus.Other RNAs in blood tissue samples did not affect the sensitivity and specificity of RT-LAMP-VF,indicating that the method can be applied to clinical practice.The ZIKV RT-LAMP-VF detection method established in this study is easy to perform and does not require special instruments and equipment.It is particularly suitable for the rapid detection of ZIKV in grassroots units,providing technical support and material support for the establishment of on-site rapid detection and early warning and prediction systems for ZIKV disease.

Objective:To compare the efficacy of reduction and internal fixation of flexion-inversion tibial plateau fractures with a modified two-window and conventional single-window posteromedial inverted L-shaped approach.Methods:A retrospective cohort study was used to analyze the clinical data of 44 patients with flexion-inversion tibial plateau fractures admitted to the Affiliated Changzhou No.2 People′s Hospital of Nanjing Medical University from January 2018 to December 2022, including 22 males and 22 females, aged 31-58 years [(44.4±9.1)years]. Among them, 25 patients were injured on the left side and 19 on the right. A total of 23 patients were treated with the conventional single-window posteromedial inverted L-shaped approach (conventional single-window approach group), while the other 21 with the modified two-window posteromedial inverted L-shaped approach (modified two-window approach group). The length of surgical incision, operation time, intraoperative blood loss, postoperative drainage volume, and postoperative hospital stay were compared between the two groups. The articular step-offs, medial tibial plateau angles (mTPA), tibial posterior slope angles (PSA), and Rasmussen radiological scores at 3 days, 3 months after surgery and at the last follow-up were evaluated in the two groups. The visual analogue scale (VAS) scores before surgery, at 7 days and 3 months after surgery, data of extension-flexion motion of the knee joint at 7 days after surgery and Hospital for Special Surgery (HSS) knee function scores at 3 and 6 months after surgery and at the last follow-up were compared between the two groups. At the last follow-up, the fracture healing was observed. The postoperative incidence of complications such as thrombosis and poor wound healing was compared between the two groups.Results:All the patients were followed up for 12-18 months [(15.7±3.2)months]. The operation time of the modified two-window approach group was (121.6±19.2)minutes, significantly shorter than (149.5±22.4)minutes of the conventional single-window approach group ( P<0.01). There were no statistically significant differences in the length of surgical incision, intraoperative blood loss, postoperative drainage volume, or postoperative hospital stay between the two groups ( P>0.05). At 3 days, 3 months after surgery and at the last follow-up, the articular step-offs of the modified two-window approach group were 0.7(0.5, 0.9)mm, 1.0(0.8, 1.1)mm and 0.9(0.8, 1.0)mm respectively, significantly shorter than 1.0(0.7, 1.2)mm, 1.1(1.0, 1.3)mm and 1.1(0.9, 1.2)mm of the conventional single-window approach group ( P<0.05 or 0.01); the mTPA of the modified two-window approach group was 87.0(86.0, 87.0)°, 87.0(86.0, 87.0)° and 86.0(85.5, 87.0)° respectively, significantly larger than 85.0(84.0, 86.0)°, 85.0(84.0, 86.0)°and 85.0(84.0, 86.0)°of the conventional single-window approach group ( P<0.01); the Rasmussen radiological scores of the modified two-window approach group were (17.0±0.9)points, 16.0(15.0, 17.0)points and 16.0(15.0, 16.0)points respectively, significantly higher than (16.4±1.1)points, 13.0(13.0, 15.0)points and 14.0(13.0, 15.0)points of the conventional single-window approach group ( P<0.05 or 0.01); no significant differences in the PSA were found between the two groups ( P>0.05). There were no significant differences in VAS scores between the two groups before surgery and at 3 months after surgery ( P>0.05), while the VAS score at 7 days after surgery was 3.0(3.0, 3.0)points in the modified two-window approach group, significantly lower than 3.0(3.0, 4.0)points of the conventional single-window approach group ( P<0.05). There was no significant difference in the VAS score at 3 months after surgery between the two groups ( P>0.05). The extension-flexion motion of the knee joint at 7 days after surgery was 90.0(85.0, 95.0)° in the modified two-window approach group, higher than 80.0(75.0, 85.0)° of the conventional single-window approach group ( P<0.01). The HSS knee function score at 3 months after surgery was (67.9±2.8)points in the modified two-window approach group, higher than (66.1±2.7)points of the conventional one-window approach group ( P<0.05). There were no significant differences in the HSS knee function scores at 6 months after surgery and at the last follow-up between the two groups ( P>0.05). At the last follow-up, bone union was observed in both groups. One patient in the conventional single-window approach group developed partial popliteal vein thrombosis, with a complication rate of 4.4% (1/23); while one patient in the modified two-window approach group had poor healing of the incision postoperatively, with a complication rate of 4.8%(1/21) ( P>0.05). Conclusion:Compared with the conventional single-window approach, the modified two-window posteromedial inverted L-shaped approach has the advantages of shorter operation time, better reduction quality, early pain relief, and better restoration of knee joint extension-flexion motion and joint function in the reduction and internal fixation of flexion-inversion tibial plateau fractures.

Objective To explore the clinical efficacy of fluoxetine hydrochloride capsules and escitalopram oxalate tablets in the treatment of first-episode depression disorder.Methods Eighty patients with first-episode depression disorder who were hospitalized in the 14th district of Integrated Traditional Chinese and Western Medicine of Xiamen Xianyue Hospital from February to November 2023 were selected,and divided into fluoxetine hydrochloride capsules group(n=40)and escitalopram oxalate tablets group(n=40)according to random number method;Conducted the Hamilton depression scale(HAMD)estimates before treatment and four weeks after treatment,to analyze and compare the clinical efficacy of two groups.Results After four weeks of treatment,the HAMD scores of all patients significantly decreased compared to before treatment in this group(P＜0.01);There was no statistically significant difference between two groups(P＞0.05).There was no statistically significant difference in the total effective rate between two groups(P＞0.05).Conclusion Escitalopram oxalate tablets and fluoxetine hydrochloride capsules were both effective in treatment of the first-episode depression disorder patients,and the total effective rates of them were similar.

OBJECTIVE: A prospective randomized controlled study was conducted to investigate the early postoperative analgesic effectiveness of using liposomal bupivacaine (LB) for local infiltration anesthesia (LIA) in unicompartmental knee arthroplasty (UKA). METHODS: Between January 2024 and July 2024, a total of 80 patients with knee osteoarthritis (KOA) who met the selection criteria were enrolled in the study. Patients were randomly assigned to either the LB group or the "cocktail" group in a 1∶1 ratio using a random number table, with 40 patients in each group. Baseline characteristics, including gender, age, body mass index, operated side, Kellgren-Lawrence grade, and preoperative American Society of Anesthesiologists (ASA) classification, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and knee joint range of motion, showed no significant difference between the two groups ( P>0.05). Both groups received LIA and comprehensive pain management. The surgical duration, incision length, pain-related indicators [resting and activity visual analogue scale (VAS) scores, total dosage of oral morphine, WOMAC scores], knee joint range of motion, first ambulation time after operation, length of hospital stay, and postoperative adverse events. RESULTS: There was no significant difference between the two groups in surgical duration, incision length, first ambulation time after operation, length of hospital stay, total dosage of oral morphine, and pre-discharge satisfaction with surgery and WOMAC scores ( P>0.05). At 4, 12, and 24 hours after operation, the resting and activity VAS scores in the "cocktail" group were lower than those in the LB group; at 60 and 72 hours postoperatively, the resting VAS scores in the LB group were lower than those in the "cocktail" group, with the activity VAS scores also being lower at 60 hours; all showing significant differences ( P<0.05). There was no significant difference in the above indicators between the two groups at other time points ( P>0.05). On the second postoperative day, the sleep scores of the LB group were significantly higher than those of the "cocktail" group ( P<0.05), while there was no significant difference in sleep scores on the day of surgery and the first postoperative day ( P>0.05). Additionally, the incidence of complications showed no significant difference between the two groups ( P>0.05). CONCLUSION The use of LB for LIA in UKA can provide prolonged postoperative pain relief; however, it does not demonstrate a significant advantage over the "cocktail" method in terms of short-term analgesic effects or reducing opioid consumption and early functional recovery after UKA. Nevertheless, LB may help reduce postoperative sleep disturbances, making it a recommended option for UKA patients with cardiovascular diseases and insomnia or other mental health issues.
Aged ; Female ; Humans ; Male ; Middle Aged ; Anesthesia, Local/methods* ; Anesthetics, Local/administration & dosage* ; Arthroplasty, Replacement, Knee/methods* ; Bupivacaine/administration & dosage* ; Liposomes ; Osteoarthritis, Knee/surgery* ; Pain Measurement ; Pain, Postoperative/prevention & control* ; Prospective Studies ; Treatment Outcome