Discussion on Disease Mechanism， Pattern Differentiation， and Treatment of Autoimmune Diseases Based on the Theory of "Transformation of Healthy Qi into Pathogenic Qi" / 中医杂志

Based on the duality of "healthy" and "pathogenic" of the immune system in physiological and pathological states， and combined with the analogy between "immune function" and "healthy qi"， the theory of "transformation of healthy qi into pathogenic qi" was proposed to guide the pattern identification and treatment of autoimmune diseases. The theory of "transformation of healthy qi into pathogenic qi" means that "healthy qi"， which is originally used by the body's original ability to defend and remove harmful factors or normal functional activities， transformed into "pathogenic qi"， which is factors that damage and destroy the human body or abnormal body state. In the pathogenesis of autoimmune diseases， the pathogenic factors and causes of congenital endowment， tissue damage under the influence of external pathogens， abnormal function of zang-fu （脏腑） organs and meridians， abnormal transmission and transformation of qi， blood， body fluids was proposed. Autoimmune diseases have the dynamic mechanism of latent pathogen at early stage， internal and external contraction at the onset stage， and the expansion of the pathogenic qi at the complete period， and also have the characteristics of the specificity， invisibility and contradiction of healthy qi and pathogenic qi. In terms of treatment， it advocates the ideas of treatment with both attack and supplementation throughout the disease， identifying diseases with special prescriptions and formulas for specific diseases， dynamically adjusting treatment by identifying the remission and onsets of the disease， observing the changes in the dynamics of healthy qi transforming into pathogenic qi， and treating disease before it arises with early intervention.

Research Progress and Application Prospect of Facial Micro-Expression Analysis in Forensic Psychiatry / 法医学杂志

Research on facial micro-expression analysis has been going on for decades. Micro-expression can reflect the true emotions of individuals, and it has important application value in assisting auxiliary diagnosis and disease monitoring of mental disorders. In recent years, the development of artificial intelligence and big data technology has made the automatic recognition of micro-expressions possible, which will make micro-expression analysis more convenient and more widely used. This paper reviews the development of facial micro-expression analysis and its application in forensic psychiatry, to look into further application prospects and development direction.

Advances in Basic Studies on Antitumor Effect and Underlying Molecular Mechanisms of Sinomenine / 中国实验方剂学杂志

Tumors are new organisms formed by uncontrollable cell proliferation of local tissues driven by various oncogenic factors. The cause of tumors is unknown with life-threating outcome. Tumors can be classified into benign tumors， borderline tumors， and malignant tumors according to their pathological properties. Among them， malignant tumor is commonly known as cancer， with no specific medicines or reliable cure means， so this is a hot spot and difficult point in current medical research. In ancient literatures， there are many records about the efficacy of Chinese herbal medicine in treating tumor， and modern pharmacological researches have shown that more and more active ingredients of traditional Chinese medicine（TCM） have gradually highlighted their inhibitory effect on various types of tumor. Caulis sinomenii has been used for treatment of rheumatic diseases in TCM for a long history. Sinomenine is a major bioactive alkaloid presented in C. sinomenii， which has demonstrated a wide range of pharmacological activities such as anti-inflammation， immunosuppression， analgesia and sedation， and due to its slightly soluble in water， it is commonly used in clinic in the form of hydrochloride， with its commercial name of Zhengqing Fengtongning. Recent studies show that sinomenine alone or combined with chemoradiotherapy can inhibit growth of several tumors significantly or in a synergistic way， so it is termed as an inhibitor of tumors. Anti-tumor effect of sinomenine involve inhibition of tumor cell proliferation， induction of tumor cell apoptosis， blockade of tumor cell cycle， suppression of tumor invasion and metastasis， induction of autophagy of tumor cells， and reversal of multidrug resistance of tumor cells. Upon combination with nanomaterials， it can enhance efficiency and reduce toxicity. Here we summarized and reviewed recent advances on basic anti-tumor research of sinomenine， and then made a classification and description according to its in vivo and in vitro pharmacological action and mechanism of action， so as to elucidate the great potential of sinomenine as a promising anti-tumor drug， and provide reference for further research on its anti-tumor mechanism.

Research Progress of Rheumatoid Arthritis Treatment with Huangqi Guizhi Wuwutang / 中国实验方剂学杂志

Rheumatoid arthritis （RA） is a common immune-mediated inflammatory autoimmunity disease. Due to its clinical characteristics， RA is classified into the category of "Bi syndrome" in traditional Chinese medicine. Huangqi Guizhi Wuwutang （HGW）， originated from Synopsis of Golden Chamber Jinkui Yaolue， is composed of Astragali Radix， Cinnamomi Ramulus， Paeonial actiflora， Zingiberis Rhizoma Recens， and Jujubae Fructus. It has been used for treatment of blood "Bi syndrome" in clinical practice， and nowadays， it is also widely used for treatment of RA or RA with wind-cold-dampness Bi syndrome or Qi and blood deficiency Bi syndrome. In 2018， HGW was collected in the Catalogue of Ancient Classical Prescriptions （the First Batch）. In order to provide insight for standardized clinical medication and lay a solid foundation for its further development， we herein reviewed literatures of clinical and animal studies on HGW treatment in RA. According to the basic pathogenesis of RA， HGW can be used for treatment of general RA， RA with wind-cold-dampness Bi syndrome or Qi and blood deficiency Bi syndrome alone or in combination with other drugs. The mechanisms of HGW were related to inhibition of inflammatory cytokines expression， inhibition of lipid peroxidation of synovium， and promotion of apoptosis. However， many issues in the current research still needed to be addressed， such as lack of standardization of drug compatibility and dosage， lack of standardization of clinical trial scheme，undefined drug interaction and unclear safety on the combination of Chinese medicine with chemistry drugs， lack of proper syndrome animal model， and limited study about molecular mechanisms. We propose that future research should focus on the standardization of the clinical trial scheme and RA syndrome of HGW， clarify the principle of drug compatibility and dosage， drug interaction and safety. In terms of mechanistic study， the research should focus on animal models of RA syndrome using multiple dimensions such as genetics， transcription， and metabolism.

Working Memory of Patients with Mild Cognitive Impairment due to Brain Trauma Based on fNIRS / 法医学杂志

Objective To discuss the activation characteristics of the prefrontal cortex of people with mild cognitive impairment （MCI） due to brain trauma during working memory tasks. Methods The psychological experiment design software E-prime was used and N-back paradigm was adopted as working memory task. Functional near-infrared spectroscopy （fNIRS） was used to detect changes in cortical oxygenated hemoglobin concentrations of 22 channels within the prefrontal lobe of 24 people with MCI due to brain trauma （study group） and 27 healthy volunteers （control group） with matching gender and age. Behavioral data, such as the number of keystroke errors and reaction time, were recorded simultaneously. Independent samples t test and non-parametric test were used to compare the mean value of oxygenated hemoglobin concentration change, the number of key errors and the mean value of reaction time of the two groups in each task. Results （1） The differences in the number of errors and reaction time between the two groups in 1-back and 2-back tasks had statistical significance （P<0.05）.The main effects of task load and group were both significant （task F=14.11, P=0.001 1; group F=10.39, P=0.001 5）. （2） During the 1-back task, the differences in oxygenated hemoglobin concentration changes of the 22 channels between the two groups had no statistical significance （P>0.05）. During the 2-back task, the differences in oxygenated hemoglobin concentration changes of the two groups in channel 2, 3, 7, 9, 10, 11, 14, 15, 18, 19, 21 and 22 had statistical significance （P<0.05）. （3） In the 1-back task, the left frontal pole and dorsolateral prefrontal area in both groups were activated. In the 2-back task, the activation areas of the control group were the left frontal pole area and the left dorsolateral prefrontal area, while that of the study group almost covered most of the left and right frontal pole areas, which were scattered and the right area was activated, too. Conclusion Patients with MCI due to brain trauma have obvious working memory impairment, and during the 2-back working memory task, the activation of the prefrontal lobe decreased, but the activation range was wider.

Accuracy Analysis of Distinguishing the Cooperation Degree during Image Completion Test by Eye Movement Parameters / 法医学杂志

Objective To analyze the differences in accuracy of different eye movement parameters in distinguishing the cooperation and non-cooperation during image completion test of patients with mental disorders caused by craniocerebral trauma. Methods One hundred and forty cases of patients with mental disorders caused by craniocerebral trauma who took psychiatric impairment assessments were collected. The 21 pictures from "image completion" of Wechsler intelligence test were used as stimulating pictures, then divided into cooperation group and non-cooperation group according to binomial forced-choice digit memory test and expert opinions. The eye movement parameters of research subjects during completion of images were obtained by the SMI eye-tracker. The accuracy of eye movement parameters in distinguishing the cooperation or non-cooperation of patients with mental disorders caused by craniocerebral trauma in psychiatric impairment assessments were evaluated by the ROC curve. Results During the process of the image completion test, the area under curve （AUC） value of frequency of blink, frequency of fixation, pupil size, frequency of saccade, latency of saccade, average acceleration of saccade, the average and peak longitudinal velocity of saccade was above 0.5. When it comed to a specific stimulating picture, the AUC value of frequency of blink in looking at a specific stimulating picture could be above 0.8, and the AUC value of X axis diameter of pupil size could be above 0.7. Conclusion The accuracy of eye movement parameters in distinguishing the cooperation or disguise of patients with mental disorders caused by craniocerebral trauma is related with the stimulating picture. The accuracy of frequency of blink in distinguishing cooperation and non-cooperation is better than that of other eye movement parameters.

Laparoscopic indocyanine green fluorescence imaging combined with ultrasound-guided ablation for liver tumors / 中华肝胆外科杂志

Objective To study the combined use of indocyanine green (ICG) fluorescence imaging and intraoperative ultrasound in laparoscopic tumor ablation.Methods This retrospective study was conducted between May 2016 and December 2017 on 81 patients with primary liver carcinoma,metastatic liver cancer and hepatic hemangioma who underwent laparoscopic tumor ablation using fluorescence imaging combined with intraoperative ultrasound guidance at the Union Hospital,Tongji Medical College,Huazhong University of Science and Technology.Preoperative venous injection of ICG was used to result in detection of intraoperative positive staining.Results Of 36 patients with primary liver carcinoma,the intrabepatic lesions in 20 patients could not be detected under fluorescence imaging.The ablation was performed under intraoperative ultrasound guidance.However,for all the subcapsular lesions in 16 patients,including 15 patients with tumors with non-distinguishing boundaries under the bright-field model,the lesions were captured on fluorescence imaging.Of 18 patients with metastatic liver cancer with 54 lesions,all the intrahepatic and subcapsular lesions were not stained by ICG,but the subcapsular lesions could be distinguished by staining of the surrounding liver tissues.Of 27 patients with subcapsular hepatic hemangiomas,the lesions were not stained but they could be distinguished by staining of the peripheral liver tissues.All laparoscopic treatments for the 81 patients were performed successfully without conversion to laparotomy.The average ablation time for a single lesion was (8.5 ± 3.5) minutes.The intraoperative blood loss was 0～20 ml.Two patients developed intraoperative subcutaneous emphysema and 1 patient hemoglobinuria.There was no postoperative bleeding,postoperative renal insufficiency,bile leakage and significant collateral tissue damage.Conclusions Laparoscopic ultrasound guided tumor ablation resulted in low intra-and post-operative complications.The procedure was safe and effective.Ultrasound combined with fluorescence imaging clearly distinguished tumors from the adjacent normal tissues.This technique is clinically useful.

Molecular Mechanism of Lycii Fructus and Salviae Miltiorrhizae Radix et Rhizoma in Treatment of Retinitis Pigmentosa / 中国实验方剂学杂志

Objective:To explore the molecular mechanism of Lycii Fructus and Salviae Miltiorrhizae Radix et Rhizoma (FLRSM) in the treatment of retinitis pigmentosa (RP) based on network pharmacology and bioinformatics. Method:Possible intake active components and targets of FLRSM were screened out and predicted by traditional Chinese medicine systems pharmacology database and analysis platform(TCMSP). Gene targets related to RP were mined through disease gene databases. Protein-protein interaction (PPI) network of component-targets and disease-targets were mapped by functional protein association networks (STRING), and the intersection of the two networks was obtained. The gene ontology and kyoto encyclopedia of genes and genomes(KEGG) pathway of the intersection network were analyzed by the database for annotation, visualization and integrated discovery(DAVID). CytoHubba analysis was used to screen out the key targets. Result:A total of 390 active ingredients related to FLRSM were retrieved from TCMSP. According to pharmacokinetic parameters, 110 active ingredients were screened out, 19 active ingredients were further screened out, and 208 targets related to these constituents were retrieved. Totally 206 genes directly related to RP were obtained from the disease gene databases. And 79 genes were obtained from the intersection of PPI networks of component targets and disease targets. These genes mainly involved in biological processes, such as protein autophosphorylation, transcriptional regulation and cell proliferation, and the molecular functions mainly involved adenosine triphosphate binding, transcription factor activity, core promoter binding, and were enriched in nuclear, transcription factor complex, nucleus, cytoplasm and other regions. It was mainly related to neurotrophin signaling pathway, cell cycle related pathway and Wnt signaling pathway. And 8 key gene targets for FLRSM treatment of RP were identified by further screening. Conclusion:The material basis of pharmacodynamic action of FLRSM involves 19 active ingredients, such as porous sterol and tanshinone ⅡA. The key targets of FLRSM in the treatment of RP include 8 genes, such as E2F transcription factor 1(E2F1) and retinoblastoma gene1(RB1).The main mechanism is related to the regulation of neurotrophin signaling pathways, cell cycle related pathways and other signaling networks.

Application of Mismatch Negative in Evaluation of Severity of Mental Disorders due to Traumatic Brain Injury / 法医学杂志

Objective To explore the applied value of mismatch negative （MMN） in evaluation of severity of mental disorders due to traumatic brain injury. Methods Thirty-five patients（case group） that conform to the diagnostic criteria of organic （traumatic brain injury） mental disorder in ICD-10 Classification of Mental and Behavioural Disorders criteria were selected. Twenty-four healthy subjects （normal control group） that matched the case group in terms of gender, age composition ratio and educational level were selected. All subjects were evaluated by Activity of Daily Living Scale （ADL） and Social Disability Screening Schedule （SDSS） and then examined by Event-Related Potential （ERP）. A statistical analysis of the data was made by SPSS 22.0 software. Results The 32 patients and 24 normal control subjects completed the study. The scores of ADL and SDSS were significantly higher in the case group than in the normal control group （P<0.05）. The latency of Fz, FCz, Cz and Pz in the case group was significantly longer than that in the normal control group （P<0.05）. In the case group, the latency of Fz, FCz, Cz and Pz was positively correlated with the scores of ADL and SDSS （P<0.05）. The equation can be well fitted with the scores of ADL and SDSS. The latency and amplitude of Fz, FCz, Cz and Pz were used as concomitant variables and whether or not the subjects had mental disorders due to traumatic brain injury as dependent variables. Conclusion The latency of MMN can be used as an indicator in potential evaluation of the severity of mental disorders due to traumatic brain injury, which means that the longer the latency of MMN is, the more severe mental disorders due to traumatic brain injury may be. The combined application of ADL, SDSS and MMN can be an objective indicator in preliminary judgment of mental disorders due to traumatic brain injury.

Application of Activities of Daily Living Scale in Mild Psychiatric Impairment As-sessment / 法医学杂志

Objective To explore the application of activities of daily living(ADL)scale in mild psy-chiatric impairment assessment under the guideline of Classification of Human Body Disability Caused by Injury. Methods A total of 124 subjects with organic mental disorders and mild psychiatric impair-ments(levels 7 to 10), and 106 healthy controls were included in. All participants were assessed by the ADL scale, physical self-maintenance scale(PSMS)and instrumental activities of daily living(IADL) scale. The difference between the scores of control group and study group, and the relationship of im-pairment level and the scores were compared, and the threshold value was determined according to the ROC curve. Results The total scores of ADL, IADL and PSMS were significantly different between the control group and the study group(P<0.05). The scores of ADL,IADL,PSMS were significantly different among the impairment levels(P<0.05), which showed a relativity with impairment level. The scores of ADL corresponding to levels 10, 9, 8 and 7 were 14-17, 18-23, 24-29 and 30-34, respectively, which showed a good correlation between the conclusion according to the scale and the expert's opinion(k=0.914, P<0.05). Conclusion The score of ADL was significantly related to mild psychiatric impairment, and the higher ADL score represents the more severe disability, which can be used as a reference index for preliminarily judging the level of mild psychiatric impairment.

Treatment of intercondylar fracture of the humerus through internal and external elbow approach or elbow posterior olecranon osteotomy approach / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the efficacy, advantages and disadvantages of internal and external elbow joint approach and olecranon osteotomy approach for the treatment of intercondylar fracture of humerus.</p><p><b>METHODS</b>From October 2012 to May 2016, 18 cases of intercondylar fracture of humerus were treated by operation including 12 males and 6 females with a mean age of 33.5 years old (ranged from 4 to 56 years old); 8 cases were operated by internal and external elbow joint approach, 10 cases were operated by olecranon osteotomy approach. According to AO classification, 3 cases were type C1, 8 cases were type C2, 7 cases were type C3. All patients were excluded from neurologic and vascular injuries.</p><p><b>RESULTS</b>All patients were followed up from 12 to 26 months with an average of 15 months. The incision healed well and no heterotopic ossification was found. According to the modified Cassebaum elbow function score, the result was excellence in 14 cases, good in 3 cases, fair in 1 case.</p><p><b>CONCLUSIONS</b>According to the fracture type, the appropriate surgical approach and fixation were selected in order to get anatomic reduction. Rigid fixation, and early functional exercise is important condition for successful operation and satisfactory functional recovery in intercondylar fracture of the humerus.</p>

Characterization of serum metabolite profile in patients with rheumatoid arthritis / 中国医师杂志

Objective To investigate and characterize the serum metabolite profile of patients with rheumatoid arthritis (RA),a common autoimmune disease,which will be of help for early diagnosis in clinic.Methods Serum specimens from 26 patients with RA and 19 age-matched healthy volunteers were collected from the First Affiliated Hospital of Hunan University of Chinese Medicine from January through April 2015.Samples were detected on the gas chromatography-mass spectrometry (GC-MS),and serum metabolites were identified by the chemometric methods.Discriminative model of RA and healthy volunteers was established using partial least squares-linear discriminant analysis (PLS-LDA),and furthermore the established model was evaluated with double cross validation (DCV) for predicting ability.Finally,differential metabolites with clinical diagnostic potential were screened out by using subwindow permutation analysis (SPA).Results The established PLS-LDA discriminative model identified 48 metabolites.The total accuracy of the model approached 97.73％,in which the accuracy of the model for predicting RA and healthy volunteers was 96.15％ and 100％,respectively.Our studies screened out 3-hydroxy butyric acid,phosphoric acid,isoleucine,mannose and hexadecanoic acid with clinical diagnostic potential based on the SPA.Conclusions Metabolomics with the application of GC-MS combined with the PLS-LDA method can distinguish patients with RA and healthy volunteers,and can aid in potential early diagnosis of RA.

Eye Movement Characteristics of Cooperation Degree during Image Completion Test in Psychiatric Impairment Assessment / 法医学杂志

OBJECTIVES@#To explore the difference of eye movement characteristics between uncooperative and cooperative subjects with mental disorder after cerebral trauma.@*METHODS@#Thirty-nine subjects which needed psychiatric impairment assessment were selected. According to the binomial forced-choice digit memory test （BFDMT）, all subjects were divided into cooperative and uncooperative groups. The subjects were asked to take the image completion test from Wechsler adult intelligence scale. Meanwhile, the data of eye movement track, fixation, saccade, pupil and blink were recorded by the track system of eye movement.@*RESULTS@#There were significantly differences （P<0.05） in the data of saccade between cooperative （10 cases） and uncooperative groups （29 cases）. The frequency, time, amplitude, acceleration of saccadic in uncooperative group were significantly higher than cooperation group. The saccade latencies of cooperation group increased more than uncooperative group. There was a significant difference （P<0.05） in total discrete distance, average distance and total time of fixation between two groups, while the average duration time, number and frequency of fixation had no significantly difference （P>0.05） between two groups. And the blink frequency of cooperation group was higher than uncooperative group.@*CONCLUSIONS@#Eye movement can be an objective index for the primary judgment of cooperation level.

Tujia ethnomedicine Xuetong suppresses onset and progression of adjuvant-induced arthritis in rats / 中国药理学通报

Aim Kadsuraheteroclita ( Roxb ) Craib ( Schizandraceae) is a medicinal plant termed Xuetong in Chinese Tujia ethnomedicine. Xuetong possesses therapeutic effects of, in the terms of Chinese medical theories, reinforcing vital energy, promoting blood cir-culation, expelling wind-evil, and removing damp-e-vil, and has been long used for the prevention and treatment of rheumatic and arthritic diseases, especial-ly in the southern China. The HPLC analysis has iden-tified that the ethanol extract of Xuetong contains large-ly biologically active lignans and triterpenoids. Our previous studies have shown that KHS exhibits very fa-vorable safety profile and potent anti-inflammatory and analgesic activities. In the present study, we investiga-ted anti-arthritic effects and the possible mechanisms of Xuetongon adjuvant-induced arthritis ( AIA ) in rats. Methods AIA was established in male Sprague-Daw-ley ( SD ) rats as described previously, and animals were daily treated by gavage with Xuetong ethanol ex-tract ( 1. 0 g · kg-1 ) or vehicle ( 0. 3% CMC-Na ) throughout the 30-day experiment. The incidence and severity of arthritis were evaluated using clinical pa-rameters. On day 30, bone destruction of the arthritic joints was assessed by computed tomography( CT) and histopathological analyses. The serum levels of pro-in-flammatory cytokines TNF-α, IL-1β, and IL-6 were measured by ELISA. Results Treatment with 1. 0 g/kg Xuetong significantly inhibited the onset and pro-gression of AIA. The vehicle-treated rats all developed severe arthritis, while the incidence of AIA in the Xue-tong-treated rats was as low as 55%( P=0. 035 ) . The Xuetong -treated rats exhibited 1. 8 to 2. 3 fold reduc-tion of paw swelling, and gained 10 to 20% more body weight than the vehicle-treated AIA rats throughout the experiment. CT and histopathological examinations re-vealed that Xuetong markedly protected AIA rats from cartilage and bone destruction of joints. Moreover, the serum levels of TNF-α, IL-1β, and IL-6 were signifi-cantly decreased in the Xuetong-treated rats than the vehicle-treated AIA rats. Conclusions These data strongly support the clinical use of Xuetong for rheu-matic and arthritic diseases, and suggest that Xuetong is a valuable candidate for further investigation to be a new anti-arthritic drug with favorable safety profile.

Impact of four anesthetic drugs commonly used in animal experiments on the cardiovascular system in rats / 中国实验动物学报

Objective To explore the impact of four different anesthetic drugs commonly used in animal experi-ments on cardiovascular system in rats.Methods Electrocardiogram ( ECG) and blood pressure were dynamically recor-ded by a BioPac MP150 system after anesthesia.In addition, the blood glucose at different time points and hepatic func-tion, kidney function, cardiac enzymes and electrolytes at the end of the test were collected.Rusults Chloral hydrate caused severe ventricular arrhythmia.Isoflurane had inhibitory effect on the heart rate.Pentobarbital sodium induced a in-crease of ECG P wave.Urethane caused J point elevation of ECG.Blood pressure in the urethane-and pentobarbital sodi-um-treated groups were increased.Chloral hydrate caused CK to be raised, while isoflurane showed the opposite effect on CK and CKMB.Alanine aminotransferase and aspartate aminotransferase in the pentobarbitol sodium and isoflurane groups were decreased.Creatinine in the chloral hydrate, pentobarbital sodium and isoflurane groups were lower, and the serum sodium and potassium were decreased in the four groups.Conclusions Chloral hydrate has obvious effect on the cardio-vascular system, and is not suitable for animal studies on cardiovascular diseases.Pentobarbital sodium, urethane, isoflu-rane can be chosen for animal studies on cardiovascular diseases.

Personality Change due to Brain Trauma Caused by Traffic Accidents and Its Assessment of Psychiatric Impairment / 法医学杂志

OBJECTIVE@#To explore the main performance of personality change in people with mild psychiatric impairments which due to the brain trauma caused by traffic accidents and its value in assessment of psychiatric impairment.@*METHODS@#The condition of personality change of patients with traumatic brain injury caused by traffic accident was evaluated by the Scale of Personality Change Post-traumatic Brain Injury (SPCPTBI). Furthermore, the correlation between the personality change and the degrees of traumatic brain injury and psychiatric impairment were explored. Results In 271 samples, 239 (88.2%) with personality changes. Among these 239 samples, 178 (65.7%), 46 (17.0%), 15 (5.5%) with mild, moderate and severe personality changes, respectively. The ratio based on the extent of personality changes to the degree of brain trauma was not significant (P > 0.05), but the total score difference between the groups was significant (P < 0.05). There was no statistical significance between the medium and high severity brain trauma groups. The higher degree of personality changes, the higher rank of mental disabilities. The total score difference of the scale of personality change among the different mild psychiatric impairment group was significant (P<0.05). The difference between other psychiatric impairment levels had statistical significance (P < 0.05) except level 7 and 8.@*CONCLUSION@#The occurrence of personality change due to traumatic brain injury caused by traffic accident was high. Correlations exist between the personality change and the degree of psychiatric impairment. Personality change due to brain trauma caused by traffic accident can be assessed effectively by means of SPCPTBI, and the correlation between the total score and the extent of traumatic brain injury can be found.

Case-control study on the treatment of humerus supracondylar fracture of Gartland III in children by manipulative reduction and Kirschner wire percataneous internal fixation / 中国骨伤

<p><b>OBJECTIVE</b>To study the clinical effect of the Gartland III humerus supracondylar fractures in children by manipulative reduction and Kirschner wire percataneous internal fixation.</p><p><b>METHODS</b>From July 2010 and July 2013, 60 patients with Gartland III humerus supracondylar fracture were selected and divided into treatment group and control group. In the treatment group 32 patients were treated with traditional bone setting tetradeca-manipulative reduction and percataneous Kirschner wire internal fixation,included 18 males and 14 females with an average age of (7.8 +/- 2.7) years old ranging from 5 to 11; in the control group 28 patients were treated with open reduction and Kirschner wire internal fixation,included 16 males and 12 females with an average age of (7.2 +/- 3.0) years old ranging from 4 to 12. The motion range of the elbow joint,the time of fracture clinical healing, and the effect after 6 months of Flynm clinical functional assessment standards were observed and compared.</p><p><b>RESULTS</b>The average fracture healing time of the control group (5.01 +/- 0.43) weeks was longer than that of the treatment group (4.29 +/- 0.29) weeks (t = 7.49, P = 0.00). At 6 months after treatment,the elbow motion range of the treatment group (146.02 +/- 2.28) was more than that of the control group (140.76 +/- 4.42) (t = -5.67, P = 0.00). At 6 months after treatment, according to Flynn evaluation, in the control group,there were 7 cases as excellent, 16 as good, 4 fair, 1 poor; in the treatment group, excellent in 21, good in 9, fair in 2 (U = 3.09, P = 0.002).</p><p><b>CONCLUSION</b>Manipulative reduction and Kirschner wire percataneous internal fixation for treatment of children's Gartland III humerus condyle fractures can shorten fracture clinical healing time and the clinical curative effect is better.</p>

Relevance between writing characteristic and therapeutic effect in schizophrenia / 法医学杂志

OBJECTIVE@#To explore the relevance between writing characteristic and therapeutic effect in schizophrenia and to discuss the influence of aggressive behavior on writing characteristic.@*METHODS@#Recoding the casual and fixed writing in admission, one week, two weeks, four weeks, eight weeks after treatment and rating Positive and Negative Syndrome Scale (PANSS) and Modified Overt Aggression Scale (MOAS). Choosing two characteristics, "relationship between font and grid lines" and "having big strokes or not", and comparing before and after treatment.@*RESULTS@#Eight weeks after treatment, the score of PANSS decreased. The condition of patients and the writing characteristic improved as well. The differences of writing characteristics were statistically significant in patients with aggressive behavior before and after treatment (P < 0.05).@*CONCLUSION@#The writing characteristic has relation with therapeutic effects and improved with therapeutic effects in aggressive patients.

Development of competency to stand trial rating scale in offenders with mental disorders / 法医学杂志

OBJECTIVE@#According with Chinese legal system, to develop a competency to stand trial rating scale in offenders with mental disorders.@*METHODS@#Proceeding from the juristical elements, 15 items were extracted and formulated a preliminary instrument named the competency to stand trial rating scale in offenders with mental disorders. The item analysis included six aspects, which were critical ratio, item-total correlation, corrected item-total correlation, alpha value if item deleted, communalities of items, and factor loading. The Logistic regression equation and cut-off score of ROC curve were used to explore the diagnostic efficiency.@*RESULTS@#The data of critical ratio of extreme group were 18.390-46.763; item-total correlation, 0.639-0.952; corrected item-total correlation, 0.582-0.944; communalities of items, 0.377-0.916; and factor loadings, 0.614-0.957. Seven items were included in the regression equation and the accuracy of back substitution test was 96.0%. The score of 33 was ascertained as the cut-off score by ROC fitting curve, the overlapping ratio compared with the expertise was 95.8%. The sensibility and the specificity were 0.938 and 0.966, respectively, while the positive and negative likelihood ratios were 27.67 and 0.06, respectively.@*CONCLUSION@#With all items satisfied the requirement of homogeneity test, the rating scale has a reasonable construct and excellent diagnostic efficiency.

Applicability of capacity of sexual self-defense assessment scale in psychiatric patients without mental retardation / 法医学杂志

OBJECTIVE@#To explore the applicability of Capacity of Sexual Self-defense Assessment Scale (CSSAS) in psychiatric patients without mental retardation.@*METHODS@#Eighty-seven cases required for assessment of the capacity of sexual self-defense were collected and evaluated by trained professionals according to CSSAS, and the results were compared to the experts' opinions.@*RESULTS@#The scores of three grades of capacity of sexual self-defense (none, limited and whole) were 5.97 +/- 5.83, 32.22 +/- 10.15 and 61.60 +/- 13.02, respectively, which were statistically significant among them (P < 0.01). The correlation coefficients between items and total score were 0.59 to 0.91, the Cronbach's alpha value was 0.96, the spilt half Cronbach's alpha value were 0.94 and 0.91, respectively, and the relation coefficient between them was 0.94. According to the original cut off scores, the Kappa value between scale results and experts' opinions was 0.32 (P < 0.01). By redefining the cut off scores, the Kappa value was improved to 0.84 (P < 0.01). Two factors were extracted by means of the factor analysis. The explanation rates of variance were 46.15% and 28.93%, respectively. The accuracy of retrospective cumulative square was 94.30%.@*CONCLUSION@#The CSSAS could be applied in the psychiatric expertise of the capacity of sexual self-defense in psychiatric patients without mental retardation; however, the cut off scores and the factor weight should be redefined.