BackgroundExecutive function deficits constitute a core problem in attention-deficit/hyperactivity disorder （ADHD）. Previous assessments of executive function in children with ADHD have predominantly relied on performance-based neuropsychological tests conducted in laboratory settings， though their predictive validity for real-world functional outcomes remains limited. In contrast， ecological executive function emphasizes the evaluation of complex task management in naturalistic contexts， demonstrating a stronger predictive power for functional adaptation in daily living among children with ADHD， such as multitasking performance， social interactions and so on. However， current empirical evidence regarding ecological executive function in this population remains insufficient. ObjectiveTo investigate the executive function characteristics of children with ADHD from an ecological perspective， thereby providing references for developing targeted interventions. MethodsA case control study was conducted， including 277 ADHD children who met the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） criteria and were selected at the Child Health Care and Mental Health Center of Shenzhen Children's Hospital from June 2017 to December 2020， as well as 98 healthy controls were recruited from primary and secondary schools in Shenzhen. All participants were assessed using Wechsler Intelligence Scale for Children， fourth edition （WISC-IV） and Behavior Rating Inventory of Executive Function （BRIEF）. Differences in WISC-IV and BRIEF scores were compared between ADHD group and control groups， followed by the comparison of BRIEF scores by gender and ADHD subtypes. ResultsAmong the 277 children with ADHD， 136 cases （49.10%） had predominantly inattentive type （ADHD-I）， 6 cases （2.17%） had predominantly hyperactive-impulsive type （ADHD-HI）， and 135 cases （48.73%） had combined type （ADHD-C）. ADHD group demonstrated significantly lower scores on both the WISC-IV total IQ and four index scores （verbal comprehension， perceptual reasoning， working memory and processing speed） than control group （t=3.698~9.335， P<0.01）. After controlling for WISC-IV total IQ as a covariate， the scores of each factor in the dimensions of behavioral regulation index （inhibition， shifting， emotional control） and metacognition index （task initiation， working memory， planning， monitoring and organization） were all higher in ADHD group than in control group， and the differences were statistically significant （F=46.563~290.475， P<0.01）. In terms of gender， no statistically significant difference was found in BRIEF composite scores （behavioral regulation index or metacognition index） of children with ADHD （t=0.105~1.190， P>0.05）. In terms of ADHD subtypes， children with ADHD-C reported significantly higher scores than those with ADHD-I on the scores of inhibition， emotional control， organization and monitoring in BRIEF （t=2.481~7.343， P<0.05 or 0.01）. ConclusionChildren with ADHD have multidimensional deficits in ecological executive function， which vary across different subtypes. ［Funded by Shenzhen Excellent Science and Technology Innovation Talent Training Project （number， RCYX20221008092849069）； the Sanming Project of Medicine in Shenzhen］

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Objective:To explore the parenting characteristics of children with attention deficit hyperactivity disorder (ADHD) and conduct problems.Methods:This was a cross-sectional study involving 84 ADHD children with conduct problems and 75 ADHD children without conduct problems treated in the Outpatient Department of Children′s Health and Mental Health Center, Shenzhen Children′s Hospital from September 2017 to December 2019, and 54 healthy control children (healthy children in ordinary primary and secondary schools in Shenzhen) were included.The Egna Minnen av Barndoms Uppfostran (EMBU) scale was used to access the parenting styles of participants. ANCOVA was used to compare the different score of all factors in EMBU among these 3 groups and Tukey′s post-hoc comparisons were also performed.All comparisons were corrected for age and sex. Results:Among the factor scores of EMBU scale, ADHD children with conduct problems scored significantly higher on parental and maternal harsh/punishment [Parental (22.10±4.92) scores vs.(19.40±4.01) scores vs.(17.40±2.51) scores; Maternal (15.10±3.54) scores vs.(13.70±2.78) scores vs.(12.40±1.97) scores] and the reject/deny factors [Parental(10.60±2.49)scores vs.(9.40±2.06)scores vs.(8.90±1.61)scores, Maternal(13.90±3.28)scores vs.(12.40±2.64)scores vs.(11.60±2.19)scores] than ADHD children without conduct problems and the healthy control group (all P<0.001). On parental overprotection factors, both ADHD groups scored higher than the healthy control group [(10.30±2.03) scores vs.(9.80±2.13) scores vs.(8.70±1.92) scores, P<0.001], while on maternal over-interference factor, ADHD children with conduct problem scored significantly higher than ADHD children without conduct problems and the healthy controls [(36.00±4.64) scores vs.(34.60±4.38) scores vs.(33.30±4.92) scores, P=0.009]. Conclusions:Parents of ADHD children with conduct problems tend to use more negative parenting skills like punishment, over-interference, rejection and denial.This kind of negative parenting style, to some extent, causes the conduct problems in children with ADHD.

We have adopted various smart tools and applied multiple teaching models to smoothly carry out our on-line teaching. Aiming at encouraging students' self-learning and independent thinking, the first task is to cultivate students' self-learning ability and independent thinking way of clinical microbiology. Our online teaching model is based on the asynchronous small private online course (SPOC) of the Chinese University MOOC, the core part of our teaching model, and supplemented by the Sojump questionnaire test and WeChat, the inter-action channels among teachers and students. All of these build up an integrated teaching system which fully embodies the "student-oriented" teaching concept and pushes forward the promotion and application of online teaching in college specialized courses.

Objective:To determine the effects of cognitive-behavioral therapy (CBT) on resting-state brain functional changes in adults with attention-deficit/hyperactivity disorder (ADHD).Methods:Participants including 10 adults with ADHD aged 18-65 years,diagnosed with the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ) and 12 age-and gender-matched healthy controls.The ADHD symptoms and executives functions were assessed using the ADHD Rating Scale (ADHD-RS) and Behavior Rating Inventory of Executive Function (BRIEF) respectively and resting-state functional magnetic resonance imaging were acquired before and after 12-session,CBT for ADHD patients.The healthy controls were also scanned.We used the regional homogeneity (ReHo) to capture the changes of regional brain function between pre-and post-CBT in ADHD for measuring the effects of CBT.Results:After CBT,the total scores of ADHD-RS [(43 ± 7) vs.(31 ± 7),P ＜ 0.01],the subscale of inattention and subscale of hyperactivity/impulsivity were decreased in ADHD adults.As for the executive functions,the subs cales of monitor [(15 ± 2) vs.(11 ± 2),P ＜ 0.01] and organization [(19 ± 5) vs.(14 ± 4),P ＜ 0.01] in BRIEF were reduced significantly in adults with ADHD after CBT training.The ReHo was increased in the regions involved in default mode network and fronto-parietal network,i.e.,right parahippocampa gyrus,fight precentral gyms,fight postcentral gyms and left postcentral gyrus (Voxels with P ＜ 0.05 and cluster size ＞3051mm3,which resulted in a corrected threshold of P ＜ 0.01 determined by AlphaSim).Conclusion:These findings support that CBT could selectively modulate the regional brain function in the default mode network and fronto-parietal network which may contribute to the improvement of ADHD symptoms and executive functions.

Computational fluid dynamics (CFD) was used to numerically investigate the blood flow in 3-D models of human preoperative and posteroperative of cerebral aneurysm clip, and the feasibility of surgical operation was evaluated by the calculated hemodynamics parameters. Mimics software was used to reconstruct the models from CT angiograms, and numerical simulation of blood flow at different time in a cardiac circle was performed. Comparison analysis of blood flow in three models of human preoperative and posteroperative of cerebral aneurysm clip was conducted in terms of blood velocity distribution, wall shear stress (WSS) distribution and pressure distribution. The results demonstrated that blood velocity and WSS were significantly increased, and pressure was obviously decreased.
Blood Flow Velocity ; Cerebrovascular Circulation ; Computer Simulation ; Hemodynamics ; Humans ; Imaging, Three-Dimensional ; Intracranial Aneurysm ; diagnostic imaging ; physiopathology ; surgery ; Models, Cardiovascular ; Stress, Mechanical ; Tomography, X-Ray Computed