ObjectiveTo explore the incidence, characteristics, and influencing factors of non-suicidal self-injury behavior (NSSI) in adolescent patients with mental disorders in Wenzhou City, and to provide a basis for proposing effective preventive intervention strategies. MethodsA total of 500 adolescent patients with mental disorders admitted to the Seventh People’s Hospital of Wenzhou City from June 2022 to June 2023 were selected as the research subjects. Based on the definitions in the Third Edition of the Chinese Classification Scheme and Diagnostic Standards for Mental Disorders (CCMD-3), whether the patients had experienced NSSI within the past year was evaluated. Patients were divided into two groups based on the presence of NSSI: the occurrence group and the non-occurrence group. A logistic regression model was used to analyze the influencing factors of NSSI in adolescent patients with mental disorders. ResultsAmong the 500 adolescent patients with mental disorders, the incidence of NSSI was 39.40%. Among the adolescent patients with mental disorders who experienced NSSI, the main areas of self-injury were the forearm and wrist, hand, accounting for 36.54% and 23.86%, respectively. The main methods of self-injury were cutting and collision, accounting for 50.25% and 29.44%, respectively. Childhood family dysfunction, academic pressure, childhood abuse experiences, campus violence, mother’s education level, and Loneliness Scale (LRS) scores were related factors for the occurrence of NSSI in adolescent patients with mental disorders, and the differences were statistically significant (P<0.05). Multivariate logistic regression analysis showed that having a mother with a junior college education or above, experiencing campus violence, childhood abuse experiences, childhood family dysfunction, high academic pressure and an LRS score >11 points were risk factors for NSSI in adolescent patients with mental disorders (all P<0.05). ConclusionThe occurrence of NSSI in adolescent patients with mental disorders is closely related to factors such as having a mother with a junior college education or above, high academic pressure, exposure to campus violence, childhood abuse experiences, childhood family dysfunction, and an LRS score >11 points.

Objective:Molecular mechanisms underlying compound heterozygous mutations in a patient with inherited antithrombin (AT) deficiency.Methods:The proband was admitted to the First Affiliated Hospital of Wenzhou Medical University in November 2018 with a one-day history of sudden syncope and limb twitching. Peripheral venous blood was collected from the proband and members of his lineages, totaling nine persons across three generations, and a family lineage survey was conducted. AT activity (AT:A) was measured using a chromogenic substrate assay, while AT antigen (AT:Ag) was detected through an immunoturbidimetric assay. Mutation sites were identified by means of Sanger sequencing of the SERPINC1 gene, and silico tools were applied to predict the mutational conservation and hydrophobicity changes. Recombinant plasmid expression vectors were constructed and transfected into HEK293T cells for in vitro overexpression studies. The recombinant AT protein was characterized using Western Blotting, ELISA, and cellular immunofluorescence assays.Results:The proband was a 21-year-old man with type Ⅰ AT deficiency. His AT:A was 33%, along with a corresponding reduction in AT:Ag. The genetic analysis revealed there was a heterozygous insertion mutation at c.318_319insT (p.Asn107*) and a heterozygous missense mutation at c.922G>T (p.Gly308Cys) in exons 2 and 5, respectively. These mutation sites were entirely conserved among the homologous species. Additionally, hydrophobicity studies showed that the p.Gly308Cys mutation will decrease the hydrophilicity of amino acid residues 307-313. The in vitro expression studies indicated a reduction of approximately 46.98%±2.94% and 41.35%±1.48% in the amount of recombinant protein AT-G308C in transfected cell lysates and culture supernatants, respectively. Treatment with the proteasome inhibitor (MG132) restored the cytoplasmic levels of AT-G308C protein to a level similar to that of wild-type protein. However, neither cell lysate nor culture supernatant demonstrated the presence of the recombinant protein AT-N107*. Conclusions:The heterozygous insertion mutation of p.Asn107* and the heterozygous missense mutation of p.Gly308Cys have been associated with reduced AT levels in proband. The p.Asn107* heterozygous insertion mutation may initiate the degradation of mRNA via nonsense mutation-mediated mechanisms, which would remove the defective transcripts, as well as the p.The Gly308Cys heterozygous missense mutation may cause the AT protein to undergo proteasome-dependent degradation by modifying the hydrophobicity of nearby residues in the cytoplasm.

Objective To investigate the predictive value of serum lipoprotein-associated phospho-lipase A2(Lp-PLA2)for long-term prognosis of elderly patients with stable coronary heart dis-ease(CHD).Methods A retrospective trial was conducted on 198 patients with stable CHD ad-mitted to our hospital from January 2016 to December 2018.All of them were followed up for 5 years,and divided into adverse cardiovascular event group(n=42)and control group(n=156)according to whether adverse cardiovascular events occurred during follow-up.Clinical features and Lp-PLA2 level were compared between the two groups.The predictive value of Lp-PLA2 for adverse cardiovascular events was analyzed in elderly patients with stable CHD within 5 years.Re-sults The adverse cardiovascular event group had significantly older age(74.95±7.02 vs 70.17±6.30 years,P=0.000),larger proportions of diabetes(54.76％vs 27.56％,P=0.001),of coronary artery stenosis ≥75％(69.05％vs 47.44％,P=0.013)and of left ventricular ejection fraction(LVEF)＜50％(50.00％vs 28.21％,P=0.008),and higher Lp-PLA2 level(478.38±187.54 U/L vs 308.17±126.73 U/L,P=0.000)when compared with the control group.The AUC value of age and Lp-PLA2 was 0.683(95％CI:0.590--0.776,P＜0.001)and 0.763(95％CI:0.677--0.848,P=0.763),respectively,in predicting the long-term prognosis in elderly patients with stable CHD.Multivariate logistic regression analysis showed that age,diabetes,coronary artery stenosis ≥75％,LVEF＜50％and Lp-PLA2 were independent influencing factors for adverse cardiovascular events within 5 years in elderly patients with stable CHD(P＜0.05,P＜0.01).Con-clusion Increased Lp-PLA2 level is associated with adverse cardiovascular events within 5 years in patients with stable CHD.

[Objective]To discuss Professor LIN Shangzhu's experience in treating chronic atrophic gastritis (CAG).[Methods]Through clinical follow-up learning,analyzing related medical cases and summarizing Professor LIN Shangzhu's clinical experience in treating CAG from the aspects of etiology and pathogenesis,treatment characteristics,and therapeutic methods and prescriptions,with a medical case for substantiating it.[Results]Professor LIN Shangzhu thought that the pathogenesis of CAG was related to deficient root and excessive superficial.It was based on spleen and stomach of asthenia of healthy energy,and Qi stagnation,phlegm dampness stagnation,blood stasis and residual heat toxin are the temporary solutions.He proposed that "Qi deficiency and collateral stasis syndrome" was a common clinical syndrome of CAG.The treatment should be based on invigorating the spleen and replenishing Qi,supplemented by products for promoting blood circulation and removing blood stasis,taking into account the methods of warming Yang,nourishing Yin,regulating Qi and dispelling dampness.In the medical record,the patient was of deficiency of spleen Qi and functional activities of Qi would be obstructed.Combining with symptoms,tongue,pulse and applying syndrome differentiation and treatment,the case was treated with modified Liujunzi Decoction to invigorate the spleen and replenish Qi,promote blood circulation and remove blood stasis,eliminate phlegm and descend inverse,dissipate dampness and promote appetite,clear residual heat toxin in order to tackle both symptoms and root causes for the exact clinical effect.[Conclusion]Professor LIN Shangzhu treats CAG from deficiency,stagnation,phlegm and blood stasis,it has certain reference significance in the prevention and treatment of the disease with traditional Chinese medicine.

[Objective]To discuss Professor LIN Shangzhu's experience in treating chronic atrophic gastritis (CAG).[Methods]Through clinical follow-up learning,analyzing related medical cases and summarizing Professor LIN Shangzhu's clinical experience in treating CAG from the aspects of etiology and pathogenesis,treatment characteristics,and therapeutic methods and prescriptions,with a medical case for substantiating it.[Results]Professor LIN Shangzhu thought that the pathogenesis of CAG was related to deficient root and excessive superficial.It was based on spleen and stomach of asthenia of healthy energy,and Qi stagnation,phlegm dampness stagnation,blood stasis and residual heat toxin are the temporary solutions.He proposed that "Qi deficiency and collateral stasis syndrome" was a common clinical syndrome of CAG.The treatment should be based on invigorating the spleen and replenishing Qi,supplemented by products for promoting blood circulation and removing blood stasis,taking into account the methods of warming Yang,nourishing Yin,regulating Qi and dispelling dampness.In the medical record,the patient was of deficiency of spleen Qi and functional activities of Qi would be obstructed.Combining with symptoms,tongue,pulse and applying syndrome differentiation and treatment,the case was treated with modified Liujunzi Decoction to invigorate the spleen and replenish Qi,promote blood circulation and remove blood stasis,eliminate phlegm and descend inverse,dissipate dampness and promote appetite,clear residual heat toxin in order to tackle both symptoms and root causes for the exact clinical effect.[Conclusion]Professor LIN Shangzhu treats CAG from deficiency,stagnation,phlegm and blood stasis,it has certain reference significance in the prevention and treatment of the disease with traditional Chinese medicine.

Objective:To evaluate the various wire tension belt ventral compression wiring technologiesfor treating several types of femoral greater trochanter fractures in total hip replacement, according to the different types of greater trochanter of femur fractures.Methods:From March 2013 to June 2019, a total of 1 280 cases of primary total hip arthroplasty were completed in our hospital, 21 patients with greater trochanter fractures were identified in total hip replacement. There were 11 males and 10 females with an average age of 65.81±6.45 years (range 42-76 years). All of them were unilateral. There were 11 cases on the left and 10 cases on the right. There were 11 cases of osteoarthritis secondary to hip dysplasia, 4 cases of hip osteoarthritis, 4 cases of aseptic necrosis of femoral head and 2 cases of femoral neck fracture. Different wire tension belt ventral compression wiring technologies were used for each fracture type. Harris hip function score, Parker activity score, and visual analogue scale (VAS) score of hip pain were evaluated during follow-up. X-ray films were taken to evaluate the fracture healing, prosthesis position, loosening and dislocation.Results:Three new fracture types were proposed: A transverse fracture from the greater trochanter tip to the base (4 cases); B oblique fracture from the greater trochanter tip to the base (according to the fracture line direction, type B was further divided into types B1 (4 cases) and B2 (6 cases); and C fracture line from the greater trochanter to subtrochanteric plane (7 cases). Among the 21 patients, one died at an early stage, two were lost during follow-up, and 18 were followed up for an average of 30.7±7.6 months. In 18 patients, the mean operation time was 110.0±20.0 min, and the mean intraoperative blood loss was 356.9±115.7 ml. The patients' Harris score was 35.26±5.52 at the preoperative, 65.7±6.42 at the 3 months after operation, and 87.75±6.21 at the final follow-up. The difference was statistically significant ( F=377.23, P<0.001). The patients' Parker score was 2.17±0.98 at the preoperative, 5.94±1.11 at the 3 months after operation,and 8.01±0.77 at the final follow-up. The difference was statistically significant ( F=170.96, P<0.001). The patients' VAS score was 6.22±1.11 at the preoperative, 2.61±0.92 at the 3 months after operation, and 1.28±0.67 at the final follow-up. The difference was statistically significant ( F=139.71, P<0.001). Deep vein embolism, heterotopic ossification was noted in one and another patient, respectively. The patient with non-union refused reoperation and had a broken steel wire, lower-limb limp, and no notable pain at the 12-month follow-up examination. Radiographs of 17 patients showed good location of the femoral prosthesis and no chronic pain. Conclusion:Different types of greater trochanter fractures in total hip arthroplasty were proposed, using different wire tension belt ventral compression wiring technologies for the various types of femoral greater trochanter fractures during total hip replacement can improve clinical outcomes.

Scientific and technological innovation is a vital support for emergency response assurance for public health security, and it is imperative to improve the emergency-oriented research management mechanism in hospitals. In view of elements in emergency-oriented research management as well as centralized resources management and associated platform construction, the authors explored to build an emergency-oriented research model applicable to municipal hospitals, so as to better serve regional science-based epidemic prevention and elevate the capacity of scientific and technological innovation in clinical subjects.

Objective: To explore the clinical effect of reduction and reconstruction of the removed bony structure after one-stage posterior resection of high cervical tumors. Methods: From October 2009 to March 2018, 17 patients including 10 males and 7 females of high cervical tumors who underwent one-stage posterior resection with an average age of 57 years (26~84 years) were reviewed. There were 11 shwannomas, 3 meningiomas and 3 concurrent shwannoma and meningioma arising in the same level, respectively. Reduction with (14 cases) or without internal fixation (3 cases) were performed for the removed C1 posterior arch or C2 laminar and spinous process. The clinical effects were compared with Visual analogue score (VAS), Japanese Orthopaedic Association scores (JOA) and American Spinal Injury Association (ASIA) grade. The cervical lordosis and range of motion were measured with the X-ray before the operation and at the last follow-up. Results: There were no vertebral artery injury or massive hemorrhage during the surgeries. The operation time was 184±43 min, blood loss was 203±223 ml, and mean follow-up period was 29.1±28.2 months. No recurrence was found during the follow-up, and the motor and sensory were significant recovered in all patients after surgery. VAS score and JOA score were significantly improved at the last follow-up. ASIA grade was C for 1 case, D for 11 cases and E for 5 cases before surgery. After surgeries, C improved to D, 8 cases of D improved to E and 3 cases of D failed improved to E. Although the cervical lordosis and range of motion was decreased significantly in the last follow-up in X-ray, no patients complained stiffness and discomfort in rotation or flexion and extension of the neck. Cardiac arrest during operation was occurred in 1 case, and heartbeat recovered after stopping the manipulation. CSF leakage was found in 9 cases and no surgical site infection was occurred. Conclusion Resection of high cervical dumbbell-shape tumors is a demanding surgery with high incidence of complications. The reduction and reconstruction of removed bony structure without fusion could rebuild the stability of high cervical spine and preserve the cervical range of motion as much as possible which improves clinical effect.