Influence of group psychological counseling on mental health of children with authoritarian mothers / 中国学校卫生

Objective@#To explore the influence of group psychological counseling on the mental health of children with mother s authoritarian parenting.@*Methods@#From November 2022 to February 2023, 76 students from grades 4 to 6 whose mother showed authoritarian parenting style, while fathers adopted no authoritative, authoritarian or democratic parenting style and who scored ≥65 on the total MHT were selected using the Parenting Style Questionnaire (PBI) and the Mental Health Diagnostic Test (MHT). All the participants and their mothers were randomly assigned to the intervention and control groups. Before and after the intervention, participants filled out questionnaires on parental bonding instrument and mental health test. Control group: regular delivery of mental health education information, 2 times per week, for 8 weeks, without any other intervention. Intervention group: group counseling activities were conducted once a week. Each intervention lasted 1.5-2 hours and lasts for 8 weeks. Before and after the intervention, participants filled in the family parenting style and mental health screening questionnaires.@*Results@#After the intervention, compared with the control group, students in the intervention group showed a significant decrease in the total scale score of the MHT, learning anxiety, social anxiety, allergic tendency, physical symptoms, fear tendency, and impulsive tendency ( t=-0.43, -1.04 , -0.81, P >0.05). After intervention, the intervention group students showed a significant decrease in psychological diagnosis test scores, learning anxiety, anxiety towards others, allergic tendencies, physical symptoms, phobic tendencies, and impulsive tendencies compared to the control group students ( t=-20.00, -5.06, -2.09, -3.36, -6.15, -4.76, -5.15, P <0.05).@*Conclusion@#Rregular group psychological counseling can effectively improve the academic anxiety, social anxiety, allergic tendencies, physical symptoms, fearful and impulsive tendencies of students whose mothers with authoritarian parenting style, and greatly improve their mental health.

Application research of segmented teaching combined with Kirkpatrick model evaluation in the teaching of PICC specialized nurses / 中华医学教育探索杂志

Objective:To explore the application effect of segmented teaching combined with Kirkpatrick model evaluation in the teaching of specialized nurses of peripherally implanted central venous catheter (PICC).Methods:A total of 60 trainees in the PICC specialized nurse training class in PICC Clinic of Cancer Hospital Affiliated to Nantong University from June 2020 to September 2020 were selected in the study, and they were randomly divided into a control group and a study group, with 30 nurses in each group. The control group conducted traditional training for PICC specialized nurses, and the research group used segmented teaching. After training, the Kirkpatrick model was used to evaluate the response level, learning level, behavior level and result level of the training effect of the two groups of PICC specialized nurses. SPSS 22.0 was used for t test and chi-square test. Results:Through the segmented teaching training, the evaluation results of the Kirkpatrick model showed that the effect of the PICC specialized nurse training was significantly better in the study group than that in the control group in terms of response level, learning level, behavior level and result level. The study group's satisfaction with the training program and teaching content scored higher than that of the control group, with statistically significance ( P<0.001). The research group nurses' mastery of theoretical knowledge and practical skills and humanistic care scores were higher than those of the control group, with significant differences ( P<0.001). After the training, the self-behavior assessment scores of the two groups increased, and the improvement of the research group was more obvious. When the nurses of the research group returned to the hospital clinical work after training, their professional identity, PICC teaching and guidance ability, treatment, nursing service quality, the recognition of patient and family members and the effectiveness of the department were improved to varying degrees, the corresponding measures could be carried out in the hospital, and the development of PICC technology was promoted. Conclusion:The combination of segmented teaching and Kirkpatrick model evaluation can effectively meet the training needs of PICC specialized nurses and make a full range of effect evaluations to improve the quality of PICC specialized nursing services.

Fairness of Urban and Rural Basic Medical Insurance Reform---Based on the Investigation of Hunan Province / 中国医学伦理学

Based on the Hunan province research site, from the egalitarian concrete analysis of the province since the new reform of basic medical insurance of urban and rural reform and the fairness of the situation, think the current reform of insurance of primary medical treatment to a certain extent, promote the economy of the basic medical service accessibility and equity, but rural population and urban population in the benefit of insurance of primary medical treatment is still a gap, should be by advancing the basic medical insurance system of urban and rural integration manage-ment, gradually promote the fairness of health care among different populations.

Application of improved thoracic closed drainage tube vacuum aspiration in treatment of elderly patients with trachea foreign body / 中国基层医药

Objective To explore the clinical application of improved thoracic closed drainage tube vacuum aspiration in treatment of elderly patients with trachea foreign body.Methods 32 elderly patients with trachea foreign body were divided evenly into group A and group B.Group A received treatment of improved thoracic closed drainage tube aspiration,while group B received treatment of bronchoscopy.One-time success rate of removing foreign body,operation duration,length of stay and occurrence of complications were compared between group A and group B.Results One-time success rate of removing foreign body in group A was significantly higher than group B (100.00％ vs 81.25 ％,x2 =6.720,P ＜ 0.05) ;operation time of group A was (1.79 ± 1.25)min,which was significantly shorter than (13.18 ± 4.37) min of group B (t =4.31,P ＜ 0.05).Conclusion The clinical effect of improved thoracic closed drainage tube vacuum aapiration in treatment of elderly patients with trachea foreign body was positive and better than treatment with bronchoscopy,it is worthy of clinical application.

Observation on clinical effect of auricular acupoint sticking plus music therapy for post-stroke insomnia / 针灸推拿医学（英文版）

Objective:To observe the clinical effect of auricular acupoint sticking plus music therapy for post-stroke insomnia. Methods:A total of 154 cases with post-stroke insomnia were randomly divided into a control group and an observation group by the random digital table, 77 cases in each group. The control group was treated by auricular acupoint sticking, while the observation group was treated by auricular acupoint sticking plus music therapy, to compare the clinical effects at the end of the treatment and three months after the treatment between the two groups. Results:At the end of treatment, the total effective rate was 98.7% in the observation group, remarkably higher than 89.6% in the control group, with a statistically significant difference between the two groups (P Conclusion:Auricular acupoint sticking plus music therapy was affirmative in the clinical effects for post-stroke insomnia, providing a new idea to design a best nursing and rehabilitative plan for the patients with post-stroke insomnia.

Imaging and pathologic study of intravertebral vacuum phenomenon in vertebral compression fracture / 中华放射学杂志

Objective To investigate the features of intravertebral vacuum phenomenon (IVP)in vertebral compression fractures (VCFs). Methods Two hundred and nine patients with VCFs underwent percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP). The biopsies and the images of X-ray, CT, MRI of VCFs were obtained. The consistency between IVP and osteonecrosis on histology and the positive predictive value (PPV), negative predictive value (NPV), sensitivity, specificity and Youden index of IVP for diagnosing local osteonecrosis in VCFs were analyzed. Fisher exact probability test was used to analyze the coherence between IVP and osteonecrosis. Results Histological examination revealed 146(69.9%) osteoporoses, 10 (4.8%) osteonecroses with osteoporoses, 53 (25.4%) neoplasms. Prior to surgery,10 cases of IVP were found. Plain radiograph showed horizontally oriented lucent cleft in the vertebral body;CT further confirmed the location of gas;T_1-weighted MR image appeared hypointensity,while the signal intensity of T_2-weighted MR image differed, depending on the duration of recumbency. Nine of 10 patients with IVP showed osteonecrosis on histology, while 9 of 10 patients with osteonecrosis contained IVP. The association of osteonecrosis on histology and the IVP was statistically significant(P <0.01). The PPV, NPV, sensitivity, specificity, and Youden index for diagnosing local osteonecrosis was 90% (9/10), 99.5% (198/199), 90.0% (9/10), 99.5% (198/199), and 0.9, respectively. Conclusion The IVP is stongly suggestive of local osteonecrosis in vertebral compression fracture.

Percutaneous vertebroplasty for treatment of metastatic tumor in axis / 中华放射学杂志

Objective To explore the safety and effectiveness of percutaneous vertebrophasty(PVP)in the treatment of the metastatic tumor involved axis.Methods Ten patients(8 male,2 female)with osteolytic metastases involved axis were treated with PVPs.The anterolateral approach with fluoroscopy guidance was selected in 9 cases,while the posterolateral approach with CT guidance was selected in 1 case.Results Successful unilateral-paracentesis for PVP were achieved in all patients without intervention related complications such as bleeding and symptomatic polymethylmethacrylate(PMMA)leakage.CT scan taken following PVP showed that over 70% of the osteolytic metastatic area was well filled with PMMA in all cases.Varying degrees of pain relief were observed(CR in 7 cases,PR in 3 cases)within 7 days.All patients could support their heads without brackets.During a 3 to 24 months follow up after the procedures,No aggravated pain was found in the group.Two patients died in 4 months,3 Patients died in 8 to 11 months 4 patients died in 13 to 15 months,and 1 patient still was alive after 24 months.Conclusion Anterolateral or posterolateral approach to Aixs in PVP is safe and effective in treating osteolytic metastatic tumors.

The preliminary study on a single balloon cross-medline expansion using unipedicular approach in kyphoplasty / 中华放射学杂志

Objective To evaluate the clinical efficacy and safety of kyphoplasty with single balloon cross-midline expansion using unipedicular approach for osteoporotic vertebral body compressive fracture (OVCF).Methods Thirty six cases of painful OVCF were included in the study,with 61 vertebrae involved.Under X-ray fluoroscopy monitoring,kyphoplasty was performed using a unilateral,single,balloon via a unilateral transpedicular approach.A final balloon position was in the midline of the vertebral body with the balloon cross-midline expansions and bone cement filled. Clinical outcomes were determined by comparison of preoperative and postoperative VAS and ODI scores.Radiographic assessment included vertebral height restoration and correction of kyphosis.Follow-up was conducted for 6.0-12.0 months(mean 9.2 months).Results Thirty-six consecutive patients with 61 vertebrae were successfully operated with an operative time of(37.4±9.6)rain per vertebra.All patients had significant pain relief and functional recovery within 96 h after the procedure with no surgery-and device-related complications.VAS score improved from(7.3±1.0)preoperatively to(2.7±0.8)postoperatively(t=19.53,P＜0.01).ODI score was decreased from(71.1±10.9)%preoperatively to(26.6±6.4)%postoperatively(t=18.54,P＜0.01).The average anterior body height loss was(14.3±2.8)mm before procedure and(10.0±1.8)mm after procedure(t=14.68,P＜0.01).The average middle body height loss was(10.2±2.7)mm before procedure and(5.9±1.8)mm after procedure(t=16.44,P＜0.01).The Cobb's angle was corrected from 23.4°±5.0° to 16.2°±2.8°(t=15.60,P＜0.01).Some leakages of cement around the anterior margin of vertebra and inter-vertebral space were found in 2 patients,but there were no clinical symptoms.X-ray examination indicated there were no cement leakages in other vertebra.The pain relief and functional recovery were substantial and maintained to the last follow up without any re-collapse or adjacent level fracture.Conclusions A single-balloon cross-midline expansion using unipedicular approach in kyphoplasty for OVCF is effective and safety,less operation time,less radiation exposure compared to the conventional kyphoplasty technique.

Kyphoplasty with single balloon inflation followed by cement filling for osteoporotic vertebral compression fractures / 中国组织工程研究

BACKGROUND: In kyphoplasty procedure, two balloons are inserted into the vertebral body and inflated simultaneously for height symmetric restoration of the vertebral body. However, the expensive cost of balloon of kyphoplasty limits the extensive development of this procedure in developing countries. In this study, we try to inflate single balloon with bilateral transpedicular routes alternatively to achieve vertebral body height balanced restoration and reduce operation expenditure. But biocompatibility of bone cement and effect of kyphoplasty still need further observation.OBJECTIVE: To investigate the biocompatibility of bone cement and the clinical efficacy of bipedicular kyphoplasty for osteoporotic vertebral compression fractures by inserting single inflatable balloon into injured vertebral body and filling bone cement in the cavity caused by inflating balloon via bipedicular approach.DESIGN: Controlled observation.SETTING: Department of Medical Imaging, General Hospital of Jinan Military Area Command of Chinese PLA.PARTICIPANTS: Twenty-two patients (31 vertebral bodies) undergoing kyphoplasty with single balloon in Department of Medical Imaging, General Hospital of Ji'nan Military Area Command of Chinese PLA from May 2004 to May 2005 were selected, including 5 males and 17 females aged 68-85 years. Patients with painful compression fractures caused by osteoporosis were enrolled, and confirmed by CT and MRI with complete vertebral posterior wall but no spine deformity. The informed consent was obtained from all subjects, and the experiment and treatment were approved by Ethics Committee. METHODS: The especial instrument for kyphoplasty including puncturing device and balloon were provided by Shandong Guanlong Medical Utensils Co., Ltd. [LDAI (T) 2004 No. 2150017]; bone cement (Polymethymethacrylate) was made in China [MAIT 2005(T) No. 3650267]. Under X-ray fluoroscopy monitoring, single inflatable balloon was inserted into fractured vertebral body by puncturing needle and inflated via bipedicular approach to restore vertebral height. MAIN OUTCOME MEASURES: ①Bone cement biocompatibility during and after surgery; ②pain relief within 72 hours after surgery, restoration of vertebral height and correction of kyphotic deformity.RESULTS: ①Bone cement biocompatibility: Little cement leakage was observed at one intervertebral space of one patient by X-ray film, but no clinical symptoms, inflammatory reaction or rejection were found. ②Obvious pain relief was found in 22 cases with within 72 hours after kyphoplasty. ③The height loss of the anterior and middle vertebral body reduced from (14.70±4.21) mm and (10.62±4.11) mm preoperatively to (10.38±4.23) mm and (6.45±4.04) mm postoperatively after single balloon inflation and cement filling. Cobb angle was corrected averagely from (21.15±6.33)° preoperatively to (11.64±4.33)° postoperatively. CONCLUSION:Biocompatibility of bone cement is good, and no specific adverse effects are found in despite of cement leakage. Bipedicular kyphoplasty with single balloon for painful osteoporotic vertebral compression fractures effectively restores vertebral heights and relieves pain.

Percutaneous vertebroplasty using instruments and drugs made in China for vertebral metastases / 中华医学杂志(英文版)

<p><b>OBJECTIVES</b>To evaluate the effect of percutaneous vertebroplasty on vertebral tumor metastasis using instruments and drugs made in China and to explore the technique of percutaneous vertebroplasty.</p><p><b>METHODS</b>Thirty-two patients with vertebral metastasis were treated with percutaneous vertebroplasty with instruments and drugs made in China. Anterolateral approach for cervical vertebrae and transpedicular approach for thoracic and lumbar vertebrae were used. The volume of disease focus and the amount of polymethy methacrylate (PMMA) injected were calculated with formula V = 4/3pi (D/2)(3) preoperatively. PMMA with contrast was mixed according to the ratio of powder/liquid/contrast of 3:2:1. The procedures were monitored under fluoroscopy. PMMA was injected in the polymerization time. CT scanning was performed before and after the operation.</p><p><b>RESULTS</b>The percentage of lesion PMMA fill was more than 50% as demonstrated by CT. Clinical data were obtained from the cases followed up for 7 - 12 months, and the rate of pain relief was 90.6% (29/32) at one week, 71.8% (23/32) at six months, and 58.6% (17/29) at 12 months after operation. There were no cases of PMMA leakage that affected clinical performance.</p><p><b>CONCLUSIONS</b>Percutaneous vertebroplasty for vertebral tumor metastasis using instruments and drugs made in China was effective. It is important to prevent paravertebral leaks of PMMA and to ensure that PMMA is injected within the polymerization time.</p>

An experimental study of percutaneous vertebroplasty using instruments and drugs made in China / 中华放射学杂志

Objective To evaluate the efficacy of percutaneous vertebroplasty(PVP) using instruments and drugs made in China, and to provide the data for the clinical application Methods Polymethylmethacrylate(PMMA) without adding contrast was classified into 3 groups according to the ratio of powder/liquid as 2∶1,3∶2,1∶1,PMMA with contrast was also classified into 3 groups according to the ratio of powder/liquid/contrast as 2∶1∶1,3∶2∶1,1∶1∶1 There were 6 groups totally The periods and temperature of polymerizing process were measured The PMMA specimens of different group were made,with the diameter of 1 0 cm, height of 3 0 cm The density was determined in X ray pictures and mechanical testing with universal testing machine was performed PVPwas performed in the spines of 3 human cadavers with transpedicular route under fluoroscopic control The PMMA was injected into vertebra at an interval of one vertebra from T4-L4, 7 vertebra were injected on each cadaver The injected volume was recorded The spines were dissected into 42 single vertebrae, with all soft tissues removed Overall,21 pairs of adjacent vertebrae were subjected to axial compression in an universal testing machine The cranial vertebra of each pair was injected with PMMA, the caudal one served as a control Results Lower temperature was observed in the PMMA groups with adding contrast than those without adding contrast during the polymerizing process, the average temperature in the PMMA group with the ratio of powder/liquid/contrast as 3∶2∶1 was 67 4℃ There was significant X ray density difference between the groups with contrast and corresponding groups without contrast ( t = 20 00, t = 20 00, t = 22 86, P 0 05) The group with ratio of power/liquid/contrast 3∶2∶1 was (127? 4 70) s in the period of the paste, and the ultimate compressive strength (mPa) was 47 23 The punctures were successfully reached in all vertebra The injected PMMA average volume was 5 ml in the thoracic vertebra and 7 5 ml in the lumbar vertebra PMMA leaking into adjacent paravertebral tissue was demonstrated in 3 of 21 vertebrae The ultimate compressive strength of the vertebrae without PMMA injection in the 3 groups was 3 28,3 63,and 3 69, respectively The ultimate compressive strength of the injected PMMA vertebrae in the 3 groups was 4 52,4 73,and 4 81, respectively The ultimate compressive strength was significantly higher in the injected PMMA vertebrae than that in the vertebrae without PMMA injection( t =3 17,3 55,3 99, P

The primary report of percutaneous polymethyl methacrylate cementoplasty in osteolytic metastases of the pelvis and peripheral bone / 中华放射学杂志

Objective To propose a technique and treatment of percutaneous polymethyl methacrylate(PMMA) cementoplasty for painful metastatic lesions of the pelvis, humerus, and tibia. Methods Percutaneous PMMA cementoplasty was performed in 24 cases, including the lesions of S1 in 9 cases, acetabulum in 7 cases, ischium in 5 cases, humerus in 2 cases, and tibia in 1 case. There were 26 local lesions. The puncture approach was performed under fluoroscopic guidance. The S1 vertebral body puncture was performed with lateral transsacroiliac joint approach. The needle progression was controlled in the anteroposterior projection with a needle course above the level of the S1 foramen. With the needle adjacent to the S1 vertebral body edge, the needle tip should center just in front of the spinal canal in the lateral fluoroscopic projection. The acetabular roof puncture was performed with lateral approach. The needle progression was controlled in the anteroposterior and lateral projections alternately with a needle course parallel to the body axial plane. The puncture needle arrived directly at the lesions. The puncture to the ischium was from ischium tubercle to the lesions. The puncture progression to the internal compartment of the acetabulum was with the trajectory of the needle from the ischium tubercle to the lesion. The puncture progression to the humerus should avoid conflicting with the radial nerve and upper extremity vessels. The needle course should be from the dorsal upper arm to the lesions. As for the lesions of the tibia, the needle was punctured from the front of tibia to the lesion. After the needle tip placement in the lesions, PMMA in paste condition was injected with the precession injector pressure device under continuous visual control with adequate filling and avoidance of important PMMA leakage. Results Partial or complete pain relief was obtained in all 24 patients (CR in 10 cases, PR in 14 cases) within 7 days after the operation. Clinical improvement was maintained in 23 patients at the follow-up of 2-7 months. One patient with lesion of humerus re-experienced severe pain in local area of PMMA injection 27 days after the operation when he got up by using the treated arm for the support of the body weight. The condition was considered as the fracture at the cement-bone interface, and the gradual pain relief was obtained in 2 days with the external fixation of plaster for limiting the motion of the treated arm, and the complete relief maintained. There was PMMA leakage in 2 cases without corresponding clinical importance. Conclusion The technique and treatment of percutaneous PMMA cementoplasty in osteolytic metastases of the pelvis and peripheral bone was safe and effective. Considering the incidence of the potential fracture, the external fixation for motion limitation should be given after PMMA injection to extremity lesions.

Interventional therapy of renal artery stenosis in kidney transplants / 中华放射学杂志

Objective To evaluate efficacy of percutaneous transluminal angioplasty (PTA) and stenting for treatment of transplanted renal artery stenosis (TRAS). Method Seven patients with TRAS were included in this study. By femoral or axillary approach, balloon angioplasty and /or metallic stents placement at stenostic renal artery were performed. Results Of the seven patients, balloon angioplasty was carried out in 3 (2 cases via femoral artery, 1 via axillary artery), both balloon angioplasty and metallic stents placement were performed in 4 (2 via femoral artery, 2 via axillary artery). After the procedure, blood pressure recovered to normal in 5 cases, controlled with administration of antihypertensive in the other 2 cases. By 9 to 36 month′s follow up, restenosis of renal artery occurred in only 1 case at 9 months after stent implantation. The second balloon angioplasty were taken and better renal artery blood flow was obtained in this case. Other 6 cases showed no restenosis. Conclusion PTA and stents placement were effective and safe approach in treatment of TRAS. Further investigation was needed to prevent and manage restenosis after these procedures.

Interpret the Curriculum of Interpretation of Life and Death / 中国医学伦理学

Since medicine possesses the nature of humanity,life education has remarkable significance for medical students.By interpreting teaching experience in the curriculum of interpretation of life and death,this paper explores the importance of life education in cultivating overall quality of medical graduates.Education should not only answer the questions in life,but also guide us go through the significance of life,and surpass the wonders of life.As for medical students,the curriculum of life and death is also a crucial approach to enhancing educational effect and cultivating their quality of humanistic care,thus much emphasis should be paid to the curriculum of interpretation of life and death.