BACKGROUND: Severe acute respiratory syndrome (SARS) is a kind of very strong infective respiratory system diseases. Due to rapid development of disease course, severe symptoms, forced isolation, being away the supports from relatives and friends, many patients with SARS presented extremely anxiety and panic, even depression and despair, and they are in the crisis state and need mental support and help.OBJECTIVE: To evaluate the therapeutic effect of mental crisis intervention in patients with SARS.DESIGN: Controlled observation.SETTING: Xiaotangshan Hospital of Chinese PLA.PARTICIPANTS: Totally 680 patients with SARS who received the mental intervention in the Psychological Counseling Center, Xiaotangshan Hospital of Chinese PLA in May 2003. The patients, 379 male (55.74%)and 301 female (44.26%), were aged (35±7) years. Degree of education:34.5% of patients received education below junior high school, 31.5% senior high school and 34.0% college. 100% of the patients had family member or colleague-infected life events, and 14.4% of the patients lost their family members. Degree of disease: 6.9% of patients were in the severe period, 67.5% in the stable period and 25.6% in the rehabilitation period.METHODS: ① Totally 489 patients who received telephone counseling,and attended telephone mutual-help group, group debugging, individual counseling and group counseling were chosen, serving as intervention group, and the other 191 patients served as control group. ②The mental health state of patients in the 2 groups was evaluated at admission with symptom checklist 90 (SCL-90), which consisted of somatization, obsessive compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism 9 factors. The grading scoring was used. The higher grades, the more severe symptoms. ③ The patients of intervention group were given comprehensive mental intervention, which included handing out materials(self-debugging propagandist manual), care from staff, mental counseling by telephone, group debugging, individual counseling, guidance by mental doctor, etc. Patients in the control group only received handed materials (self-debugging propagandist manual) and the care from staff. SCL-90 was used to re-evaluate the patients of intervention group and control group before discharge. ④Intervention therapeutic effect of patients in 2 groups were evaluated with comprehensive mental intervention questionnaires, which were mainly about self and social cognition, feeling and emotion, life behavior styles, physiological and body symptoms 4 dimensions. Grading scoring was used. The higher points, the better intervention effect. Self-rating and rating by others were used in each question. If the results in self-rating are the same as those in rating by others, questionnaire is valid, otherwise, it is invalid). ⑤ The scoring of all the patients at admission was compared with that of Beijing norm by using SCL-90.The mental health of patients of 2 groups after intervention was measured, evaluated and compared with SCL-90.MAIN OUTCOME MEASURES: Difference in scoring of SCL-90 between all the patients and Beijing norm; Changes in the scoring of SCL-90 between intervention group and control group at admission and after intervention.RESULTS: Totally 680 comprehensive mental intervention questionnaires were handed out, and 669 of them were retrieved, among which 483 from intervention group and 186 from control group. Altogether 669 patients participated in the result analysis. ① Points of each factor in SCL-90 of patients at admission were significantly higher than norm, especially in anxiety and phobic anxiety. 45.5% and 50.1% of the investigated patients had more than 3 points in anxiety and phobic anxiety respectively. 86.5% of the investigated patients had mental problems to different degrees. ②There was no significant difference in the points of various factors in SCL-90 at admission between intervention group and control group (P＞0.05).In the various factors of SCL-90, no significant difference in the points of various factors in SCL-90 at admission between intervention group and control group (P＞0.05).In the various factors of SCL-90,no significant difference exists in phobic anxiety and paranoid ideation and psychoticism between two groups (P＞0.05),but the points of the other factors of intervention group were significantly lower than those of control group (P＜0.05-0.01).CONCLUSION: Mental crisis intervention can remarkably lighten the somatization, obsessive-compulsive, anxiety and depression, lower interpersonal sensitivity and improve hostility.

Objective:To evaluate the practicability and effectiveness of nursing plan for elderly patients with urinary incontinence after operation.Methods:The patients admitted to the Department of Urology and Gynecology in a Grade 3A general hospital from September to October 2019 were selected as the control group, and the patients admitted from December 2019 to January 2020 as the intervention group. In the quasi-experimental study, the control group was given routine discharge guidance, and the intervention group was given a nursing plan for elderly patients with urinary incontinence to observe the preliminary effect of the nursing program for a period of 2 months.Results:Two months after implementation, the total scores of discharge preparation, quality of life and satisfaction of urinary incontinence in the intervention group was (125.08 ±17.64), (58.79 ±5.52) and (96.09 ±2.53) respectively, which were significantly different from those in the control group ( P<0.05). Conclusion:The preliminary verification of the scheme has a certain feasibility, has a certain guiding significance for nurses, and is helpful to improve the discharge preparation of elderly surgical patients with urinary incontinence and improve their satisfaction and quality of life when they are discharged.

Objective To evaluate the efficacy of Disposcope endoscope(DE)-guided nasotrache-al intubation in patients with difficult airway by comparing with fiberoptic bronchoscope(FOB). Methods One hundred and twenty American Society of Anesthesiologists physical statusⅠ-Ⅲ patients of both se-xes, with body mass index<25 kg∕m2, aged 18-64 yr, with mouth opening<3 cm, of Mallampati classifi-cation Ⅲ or Ⅳ, undergoing maxillofacial surgery requiring nasotracheal intubation were divided into DE group(n=60)and FOB group(n=60)using a random number table.Nasotracheal intubation was per-formed under the guidance of DE or FOB after induction of anesthesia.Glottis exposure was evaluated using Cormack-Lehane grade.Epistaxis during intubation, successful intubation, time and degree of glottis expo-sure, intubation time and development of tachycardia and hypertension and requirement for assisted ventila-tion with face mask during intubation were recorded.The patients were followed up postoperatively, and the development of intubation-related complications was also recorded.Results Compared with group FOB, glottis exposure time and incubation time were significantly shortened(P<0.05), and no significant change was found in Cormack-Lehane grade, rate of successful incubation, rate of successful intubation at first attempt or intubation-related complications in group DE(P>0.05). Hypertension and tachycardia were not found and no patients required assisted ventilation with face mask during intubation in the two groups.Conclusion DE-guided nasotracheal intubation provides similar efficacy to that of FOB with shorter time and is an optimal selection for the patients with difficult airway.

Objective: By comparing different repairing effects of different methods on articular cartilage defects in rabbit model, the ability of a new bioactive glass scaffold to repair cartilage defect was studied. Methods: We prepared the PSC/CS bone cement by mixing the bioactive glass (BG) powder composed of 10.8%P₂O₅-54.2%SiO₂-35%CaO (PSC), chitosan solution (CS) and calcium sulfate hemihydrate (CSH), then the bone cement was sized by a mold to form cylindrical scaffold. In vivo experiment, 18 male rabbits were divided into three groups randomly, including blank group, BG group and TGF-β1 group, which was added TGF-β1 into BG scaffold. Both knees of each rabbit were made cartilage defect for the same group, and no intervention was applied in B group, then implanted scaffolds into defects in both experimental groups. At 6 and 12 weeks after surgery, observed the macroscopic growth, histologic staining and collagen II immunohistochemistry (IHC), and the International Cartilage Repair Society (ICRS) and Wakitani score were used to analyze the experimental results quantitatively. Results: At 6 weeks after surgery, there was no obvious difference between blank group and BG groups, but the macroscopic result of TGF-β1 group was better than the other two groups and its ICRS score 4.67±0.52 points was statistically higher than BG group 2.83±0.75 points (t=-2.817, P=0.015). As to the comparison of histologic staining and Wakitani socre among three groups, no statistical difference was observed (blank group=13.67±0.52, BG group=13.83±0.41, TGF-β1 group=13.33±1.03). At 12 weeks after surgery, there was still no obvious difference between blank and BG groups, while the results of macroscopic observation and ICRS score in TGF-β1 group were significantly higher than them 9.01±0.63 points (blank group vs TGF-β1 group: t=-2.289, P=0.022; BG group vs TGF-β1 group: t=-2.326, P=0.020). More importantly, much deeper positive staining were observed in TGF-β1 group, and the Wakitani score was higher than the other two groups (blank group=9.83±1.33, BG group=9.51±1.05, TGF-β1 group=6.50±1.38, blank group vs TGF-β1 group: t=-2.771, P=0.007; BG group vs TGF-β1 group: t=-2.756, P=0.006). By comparing the degree of histologic staining and Col II expression with normal cartilage, the regenerated tissue in TGF-β1 group was similar. Conclusion Single PSC/CS scaffold doesn’t possess excellent ability to repair cartilage defect. When TGF-β1 was added into PSC/CS bioactive glass, the scaffold was able to promote cartilage defect repair, and the regenerated tissue was similar to normal cartilage.

Objective:To search, evaluate and integrate the best evidence of exercise rehabilitation intervention after PCI in patients with acute myocardial infarction, so as to provide evidence-based basis for clinical doctors and nurses to intervene in exercise rehabilitation of patients.Methods:We searched PubMed, China National Knowledge Infrastructure, Wanfang Data and other domestic and foreign databases, guide websites and professional association websites about the evidence of exercise rehabilitation intervention in patients with acute myocardial infarction after PCI. The search period is from January 2010 to June 2021. The quality of the included literature was evaluated by two researchers, and the literature evidence in accordance with the quality standard was extracted.Results:A total of 20 articles were included, and 39 pieces of evidence were summarized from 11 aspects, such as the establishment of multidisciplinary team, evaluation, exercise prescription, exercise monitoring and so on.Conclusions:This study summarized the best evidence of exercise rehabilitation intervention in patients with acute myocardial infarction after PCI, and provided theoretical support for clinical practice. It is suggested to combine the clinical situation and patients' wishes to promote the transformation of the best evidence to clinical practice.

Objective:To evaluate the efficacy of levonorgestrel-releasing intrauterine system (LNG-IUS) (mirena) versus mifepristone therapy for adenomyosis.Methods:We retrived the Cochrane library, the Pubmed, EMbase, China National Knowledge Infrastructure (CNKI), WanFang Data, VIP, China Biomedical Literatue Database (CBM) and other databases to identify randomized controlled trials (RCTs) involving the comparison of levonorgestrel-releasing intrauterine system and mifepristone up to October 2018. The quality assessment and data extraction for RCTs were conducted by two reviewers independently. Then data were analyzed with Stata 11.0 software.Results:A total of 17 RCTs involving 1 772 patients were included. The results indicated that mirena was more effective than mifepristone [RR=1.25, 95% CI(1.19, 1.32), P<0.01]. The decrease in endometrial thickness [MD=-1.94, 95% CI(-2.19, -1.70), P<0.01], uterine volume [MD=-18.99, 95% CI(-19.90, -18.07), P<0.01] and the incidence of adverse reactions [RR=0.67, 95% CI(0.47, 0.95), P=0.026] in mirena group were significantly different compared with the mifepristone group. Also the dysmenorrhea score and menstrual blood volume of mirena group were lower than mifepristone group ( P<0.05). Conclusions:Current evidence shows that the efficacy and safety of mirena was better than mifepristone in the treatment for adenomyosis patients. Since the limitation of quantity and quality of included studies, large-scale high-quality RCTs are needed to verify the above conclusion.

Objective:To investigate the associations between small diffusion-weighted imaging (DWI) hyperintensities lesions and total cerebral small vessel disease (cSVD) burden and the influence on prognosis in patients with acute intracerebral hemorrhage (ICH).Methods:Consecutive patients with acute spontaneous ICH from January 2018 to June 2021 were recruited in the Stroke Center of Zhengzhou People′s Hospital. Magnetic resonance imaging was performed to quantify DWI hyperintensities lesions and cSVD imaging markers, including white matter hyperintensities, enlarged perivascular spaces, lacunes and cerebral microbleeds, which were calculated for the total cSVD burden (0-4 points). The prognosis was assessed with the modified Rankin Scale (mRS) at discharge and 90-day. Multivariable Logistic regression models were adopted to explore the associations between DWI lesions and total cSVD burden and clinical outcome.Results:Of 283 included patients, 59 (20.8%) had small DWI lesions, 32 (11.3%) had multiple lesions. They were mostly punctate, mainly located in the cortical and subcortical regions, and scattered in multiple vascular territories. With the increase of cSVD burden, the number of DWI lesions gradually increased. Spearman correlation analysis showed that the total cSVD burden was positively correlated with the number of DWI lesions ( r=0.21, P<0.001). In multivariable regression analyses, the total cSVD burden was independently associated with DWI lesions ( OR=1.63, 95% CI 1.23-2.15, P=0.001). The 90-day poor outcome (mRS scores≥4) in patients with DWI lesions was significantly higher than those without DWI lesions (39.3% vs 16.3%, χ 2=14.38, P<0.001), while there was no statistically significant difference in the poor outcome of discharge between the two groups (26.5% vs 17.7%, χ 2=3.06, P=0.080). With the increase in the number of DWI lesions, the 90-day poor outcome increased significantly (trend chi-squared test χ 2=11.50, P=0.001). Multivariable analyses showed that DWI lesions ( OR=4.39, 95% CI 1.92-10.03, P<0.001) and their number ( OR=1.42, 95% CI 1.06-1.90, P=0.018) were independently associated with the 90-day poor outcome. Conclusions:Higher total cSVD burden is an independent risk factor for small DWI lesions in patients with ICH. Small DWI lesions were independently associated with the 90-day poor outcome, but not with the discharge outcome.

Objective:To investigate the value of a nomogram predicting the outcome of intracerebral hemorrhage (ICH) based on clinical characteristics and diffusion-weighted imaging (DWI) of hyperintense lesions.Methods:A case-control study. Consecutive patients, aged 30-88(59±13) years old, with ICH were recruited at the Stroke Center of Zhengzhou People′s Hospital from January 2018 to August 2021. Patients were divided into a group with DWI lesions and a group without DWI lesions depending on whether there were DWI hyperintense lesions distant from the hematoma. Prognosis was evaluated at 90 days via the modified Rankin Scale (mRS). Univariate and multivariable logistic regression models were used to identify independent predictors of a poor ICH outcome (mRS score≥4), and a nomogram model was developed. The performance of the nomogram was validated via the area under the receiver operating characteristic curve (AUC) and a calibration chart.Results:Of the 303 patients included in the study, 24.8% presented with DWI lesions; 17.5% with asymptomatic DWI lesions and 7.3% with symptomatic DWI lesions. Poor outcomes were significantly more frequent in the group with DWI lesions than in the group without DWI lesions ( χ2=21.32, P<0.001). In multivariable regression analysis, age [odds ratio ( OR)=1.032, 95% confidence interval ( CI) 1.002-1.063, P=0.035], hematoma volume ( OR=1.050, 95% CI 1.011-1.090, P=0.012), hematoma location ( OR=3.839, 95% CI 1.248-11.805, P=0.019), DWI lesions ( OR=3.955, 95% CI 1.906-8.206, P<0.001), and baseline NIHSS scores ( OR=1.102, 95% CI 1.038-1.170, P=0.001) were independent predictors of a poor outcome. In subgroup analysis patients with asymptomatic DWI lesions had a 3-fold greater risk of a poor outcome compared to those without DWI lesions ( OR=3.135, 95% CI 1.382-7.112, P=0.006), and patients with symptomatic DWI lesions had a 7-fold greater risk of a poor outcome compared to those without DWI lesions ( OR=7.126, 95% CI 2.279-22.277, P=0.001). A nomogram model was established based on the independent predictors for a poor outcome. The AUC of the nomogram was 0.846 (95% CI 0.795-0.898), and a calibration chart indicated good consistency between values predicted by the nomogram and actual observed values. Conclusions:DWI lesions are an independent risk factor for a poor outcome in patients with ICH-particularly symptomatic DWI lesions. A nomogram model based on clinical characteristics and DWI lesions exhibited good efficacy when predicting the outcome of ICH.

ObjectiveTo analyze the epidemiological distribution and temporal trends of liver cancer incidence among Luzhou residents from 2016‒2022， and to provide a theoretical basis for improving liver cancer prevention and treatment strategies in Luzhou. MethodsData on liver cancer incidence among Luzhou residents from 2016 to 2022 were collected， and the incidence rate， age-specific incidence rate， and annual percentage change （APC） were calculated. A Joinpoint regression model was used to fit a time series segment to the monthly number of new cases in each district and county of Luzhou to explore the trend of liver cancer incidence rate. ResultsThe incidence rate of liver cancer in Luzhou increased from 22.96/10⁵ in 2016 to 32.31/10⁵ in 2022. The incidence rate of liver cancer in men was higher than that in women in both 2016 and 2022， and the incidence rate of liver cancer in men increased from 34.83/10⁵ in 2016 to 47.95/10⁵ in 2022， with an APC of 3.3%； the incidence rate of liver cancer in women increased from 10.50/10⁵ in 2016 to 15.95/10⁵ in 2022， with an APC of 3.0%， and the differences in the change trends were not statistically significant （P>0.05）.The incidence of liver cancer was low in the age group of 0‒<40 years from 2016 to 2022 and increased with age； the incidence of liver cancer in the age group of 55 years and above was increasing at an average annual rate of 16.4%. ConclusionThe overall incidence of liver cancer in Luzhou is on the rise， and the incidence of liver cancer in men is higher than that in women. Middle-aged and elderly men are the key population for liver cancer prevention and treatment， and liver cancer prevention and treatment should be carried out in a targeted manner， taking into account regional development differences.