Objective: To understand the impact of left behind experience on the mental health of secondary vocational school students, so as to provide theoretical basis for the psychological health education of secondary vocational school students. Methods: From September to December in 2019, a total of 3 401 students from Duyun, Guiding and Pingtang County were selected by multi stage cluster random sampling method. Self designed questionnaire and Symptom Check List-90(SCL-90) were used to investigate mental health status. A total of 1 415 left behind students and 1 415 non left behind students were matched by using propensity score matching (PSM). Wilcoxon test and Logistic regression analysis were conducted. Results: Before the matching of propensity score, there were statistically significant differences in the distribution of family structure, mother s educational level, family residence,family harmony and children s past health among the students with or without left behind experience ( χ 2=28.17, 52.40, 96.31, 29.75 , 19.10, P <0.05). After the matching, there were no statistically significant differences in the distribution of the above variables among the students with or without left behind experience ( χ 2=0.02-4.32, P >0.05). Before the matching of propensity scores, there were significant differences in the scores of 10 dimensions of SCL-90, including somatization (1.67,1.58), interpersonal sensitivity (2.00,1.89), anxiety (1.90,1.70), obsessive compulsive symptoms (2.20, 2.10), depression (2.00, 1.85), hostility (1.83, 1.67), terror (1.85, 1.71), paranoia (1.83, 1.67), psychotic (1.70, 1.60) and other (1.85, 1.71) dimensions among secondary vocational school students with or without left behind experience ( Z=-5.15 to -2.84, P <0.05). After propensity score matching, there were significant differences in scores remained only in three factors for interpersonal sensitivity [(2.00(1.56,2.67)，2.00(1.44,2.56)], paranoia [1.83(1.33,2.50)，1.83(1.33,2.33)] and psychoticism [1.70(1.30,2.30)，1.70(1.20,2.20)] in SCL- 90 among secondary vocational students with or without left behind experience ( Z=-2.45, -2.12, -2.23, P <0.05). Conclusion The impact of left behind experience on the mental health of vocational school students is mainly reflected in interpersonal sensitivity, paranoia, and psychoticism, which should be identified as key areas of psychological education for secondary vocational school students.

First metatarsophalangeal joint arthrodesis, as a corrective measure for severe hallux valgus deformity, has a long history and remains in use today. Indications for the first metatarsophalangeal joint arthrodesis include severe hallux valgus deformity, recurrent hallux valgus, hallux deformity in rheumatoid arthritis, severe hallux rigidus, joint infection, primary or secondary osteoarthritis, hallux valgus deformity due to neuromuscular disorders, and severe gouty arthritis. Innovative research continues to emerge in biomechanics and materials science related to the first metatarsophalangeal joint arthrodesis. Surgical fixation options are diverse and evolving, encompassing traditional screws and plates alongside novel intramedullary fixation systems and shape-memory alloy implants. Biomechanical studies, gait analysis research, and clinical trials consistently demonstrate minimal postoperative impact on gait and no significant impairment of functional mobility. When performed with proper technique, complications are rare. The first metatarsophalangeal joint arthrodesis is an effective and reliable method for treating severe hallux valgus deformity.
Humans ; Hallux Valgus/surgery* ; Arthrodesis/instrumentation* ; Metatarsophalangeal Joint/surgery* ; Bone Screws ; Treatment Outcome

OBJECTIVE: To compare effectiveness of multiple metatarsal osteotomy versus first metatarsophalangeal arthrodesis in treating severe metatarsal adductus hallux valgus deformity. METHODS: A retrospective analysis was conducted on the clinical data of 25 patients with severe metatarsal adductus hallux valgus deformity admitted between June 2010 and May 2014 who met the selective criteria. Among them, 15 patients underwent multiple metatarsal osteotomy (osteotomy group), while 10 patients underwent first metatarsophalangeal arthrodesis (fusion group). There was no significant difference between groups ( P>0.05) in gender, age, disease duration, affected side, preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS) score for pain, intermetatarsal angle (IMA), hallux valgus angle (HVA), or metatarsal adduction angle (MAA). The osteotomy group underwent fixation with screws and/or staples fixation, while the fusion group utilized anatomic fusion plates and trans-articular compression screws. The study compared the following outcome indicators between groups: operation time, pre- and post-operative differences (change values) in AOFAS scores, VAS scores, and radiographic parameters (HVA, MAA), osteotomy healing outcomes, and recurrence of hallux valgus deformity. RESULTS: Both surgical procedures were completed successfully. The operation time was significantly shorter in the fusion group than in the osteotomy group ( P<0.05). All patients were followed up 96-144 months (mean, 116 months). The follow-up time was (129.1±7.2) months in the osteotomy group and (104.4±8.0) months in the fusion group, with no significant difference between groups ( P>0.05). X-ray films revealed the radiographic union in two groups, and the fusion time was significantly shorter in the fusion group than in the osteotomy group ( P<0.05). At last follow-up, both groups demonstrated significant improvements in AOFAS and VAS scores compared to preoperative levels ( P<0.05). However, the differences in the change values of AOFAS and VAS scores between groups were not significant ( P>0.05). During follow-up, 3 cases (20%) of deformity recurrence occurred in the osteotomy group, while no recurrence was observed in the fusion group. There was no significant difference in the incidences of deformity recurrence between groups ( P>0.05). CONCLUSION For severe metatarsus adductus hallux valgus deformities, both multiple metatarsal osteotomy and first metatarsophalangeal arthrodesis can correct the deformity. The former preserves metatarsophalangeal joint mobility but demands high technical proficiency from the surgeon, involves relatively longer operation times, extended bone healing periods, and higher complication incidences. The latter procedure is relatively simpler, facilitates faster postoperative recovery, allows early weight-bearing, and yields more reliable outcomes, though it sacrifices first metatarsophalangeal joint mobility.
Humans ; Osteotomy/methods* ; Hallux Valgus/diagnostic imaging* ; Retrospective Studies ; Arthrodesis/instrumentation* ; Treatment Outcome ; Metatarsal Bones/diagnostic imaging* ; Metatarsophalangeal Joint/diagnostic imaging* ; Male ; Female ; Bone Screws ; Adult ; Middle Aged ; Bone Plates ; Pain Measurement

The high incidence of bleeding after peripherally inserted central catheter (PICC) catheterization increases the risk of puncture site infection and unplanned extubation. Hemostatic dressings should be used in the early stages of catheterization to reduce blood infiltration. However, new hemostatic dressings have various types and advantages, which makes them difficult to choose dressings for medical staff. This paper introduces the types and hemostatic characteristics of novel functional hemostatic dressings, reviews the hemostatic mechanism and hemostatic effect of chitosan, cyanoacrylate gum, alginate, gelatin sponge and oxycellulose dressings in PICC puncture respectively, and prospects the development of new functional hemostatic dressings. It is expected that future hemostatic dressings will move towards multifunctionality and compositeness.
Humans ; Bandages ; Catheterization, Peripheral/instrumentation* ; Hemorrhage/prevention & control* ; Hemostatics/therapeutic use*

Retained products of conception (RPOC) represent a common pregnancy-related condition that may lead to complications such as abnormal uterine bleeding, infection, secondary arteriovenous fistula, intrauterine adhesions, and infertility. Currently, the main clinical treatments for RPOC include surgical intervention, medical therapy, and expectant management, sometimes supplemented by high-intensity focused ultrasound or uterine artery embolization when necessary. However, no standardized treatment guidelines exist. Medical and expectant management may help some patients avoid or reduce the need for surgery, though these approaches often involve a prolonged disease course. While surgery yields rapid results, patients with large lesions may require multiple procedures, increasing the risk of endometrial damage and intrauterine adhesions. There is still a lack of robust evidence-based guidance for selecting the optimal or individualized treatment approach. This review explores recent advances in the management of RPOC, with an emphasis on strategies that effectively preserve the endometrium, safeguard fertility, and support more precise, minimally invasive, and efficient personalized treatment.
Humans ; Female ; Pregnancy ; Placenta, Retained/surgery* ; Uterine Artery Embolization/methods* ; Tissue Adhesions ; Endometrium ; High-Intensity Focused Ultrasound Ablation

Humans ; Prognosis ; Treatment Outcome ; Pulmonary Disease, Chronic Obstructive

Background Regional differences in economic development, natural environment, health care level, and social structure may lead to differences in the provincial distribution of the health status of the elderly population. Objective To explore the provincial distribution characteristics, regional differences, and influencing factors of the self-assessed health of the elderly population, with the aim of providing a policy basis for improving the health of the elderly population and promoting healthy aging according to local conditions. Methods Using 31 provinces (municipalities and autonomous regions) in China as the basicstudy unit and based on the method of Wagstaff, the self-rated health data of the elderly population (aged 60 years and above) in each province from the 2010 and 2020 national censuses and the 2015 1% National Population Sample Survey were converted into ill-health scores as a measure of self-assessed health, and higher scores represented worse health status perception. Global Moran's I was used to evaluate spatial autocorrelation, range [−1, 1], with a value of 1 as a perfect clustered pattern. Local Moran's I was used to evaluate the tendency of local autocorrelation, and high-high aggregation/low-low aggregation indicated that both target province and its neighboring provinces showed higher/lower ill-health scores. Spatial econometric models were selected by Lagrange multiplier test and Hausman test to explore influencing factors of the self-assessed health of the elderly population. Results In 2010, 2015, and 2020, the national ill-health scores of the elderly population were 1.831, 1.873, and 1.547, respectively, and the corresponding Global Moran's I statistics were 0.347, 0.482, and 0.511, respectively (P<0.01), indicating that the ill-health scores of the elderly population showed a significant spatial positive autocorrelation, and the degree of spatial aggregation was increasing gradually. From 2010 to 2020, the high-high aggregation of ill-health scores among the elderly population was concentrated in the inland northwest, while the low-low aggregation was concentrated in the southeast coast, gradually showing a "southeast-central-northwest" stepped incremental pattern of differentiation. The Lagrange multiplier test and Hausman test suggested that the fixed-effects spatial lagged model was a better choice, and the regression model showed a spatial autocorrelation in the ill-health scores of the elderly population, with an autocorrelation coefficient of 0.3969 (P<0.001); the ill-health scores of the elderly population were negatively correlated with the natural logarithms of gross regional product per capita, and the number of beds in health care facilities per 1000 population, with regression coefficients of −0.8297 and −0.0454 (P<0.05) respectively, and positively correlated with the annual average concentration of PM_2.5, illiteracy rate, and the number of health technicians per 1000 population, with regression coefficients of 0.0033, 0.0297, and 0.0765 (P<0.05), respectively. Conclusion From 2010 to 2020, the overall self-assessed health level of China's elderly population showed an upward trend and a spatial positive autocorrelation, with better self-assessed health in the southeast coast and poorer ratings in the northwestern inland. Additionally, there was a gradual decline in self-assessed health of the elderly population from the southeast to the central regions and further to the northwest in terms of spatial distribution. Economic development level, environmental pollution, health resource allocation, and education level are important factors influencing the self-assessed health of the elderly population.

Objective To analyze the postoperative therapeutic effect of prokinetic agents in patients after tricuspid valve replacement （TVR） under cardiopulmonary bypass. Methods Patients received TVR under cardiopulmonary bypass （during June 2010 to December 2021） in the department of Cardiovascular Surgery of the First Affiliated Hospital of Naval Medical University were selected as the subjects of our study. The data of basic characteristics, first postoperative defecation time and postoperative recovery condition were collected and retrospectively analyzed in the patients taking prokinetic agents within three days after surgery （prevention group） and patients not taking prokinetic agents within three days after surgery （control group）. Results A total of 184 patients were selected, including 101 in the prevention group and 83 in the control group. The first defecation time of patients in the prevention group was significantly earlier than that in the control group （P<0.05）. The incidences of abdominal distension and pulmonary infection in the prevention group were significantly lower than that in the control group. The length of time in ICU, postoperative mechanical ventilation and nasogastric tube decompression in the prevention group were significantly shorter than that in the control group （P<0.05）. Conclusion Taking prokinetic agents within three days after TVR under cardiopulmonary bypass could effectively improve the prognosis of patients.

Objective:To investigate associations of serum peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) with cerebral microbleeds (CMBs) and their severity in patients with cerebral small vessel disease (CSVD).Methods:Consecutive patients with CSVD admitted to the Department of Neurology, the Second Affiliated Hospital of Nantong University and the Eighth People's Hospital of Tongzhou District, Nantong from August 2022 to August 2023 were prospectively included. According to the MRI findings, patients were divided into non-CMB group and CMB group, with the latter further divided into mild CMB group (1-2), moderate CMB group (3-10), and severe CMB group (>10). Multivariate logistic regression analysis was used to identify the independent correlation factors of CMBs. Multiple linear regression analysis was used to identify the correlation between serum PGC-1α and the number of CMBs. Results:A total of 158 patients with CSVD were included, of which 96 (60.8%) had CMBs; among them, 55 patients had mild CMBs, 24 had moderate CMBs, and 17 had severe CMBs. The PGC-1α and white blood cell count in the CMB group were significantly lower than those in the non-CMB group, while age, platelet count, triglycerides, fasting blood glucose, and glycated hemoglobin were significantly higher than those in the non-CMB group (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for the confounding variables such as age, fasting blood glucose, and white blood cell count, PGC-1α was an independent protective factor for CMBs in patients with CSVD (odds ratio 0.588, 95% confidence interval 0.415-0.833; P=0.003). Multiple linear regression analysis showed a significant negative correlation between serum PGC-1α and the number of CMBs ( β=-0.566, P<0.001). Conclusion:Serum PGC-1α is associated with CMBs and their severity in patients with CSVD; the higher the serum PGC-1α, the lower the likelihood of the presence of CMBs.

Objective To explore the clinical application of the Shikani optical style(SOS)in guiding nasal tracheal intubation.Methods A retrospective analysis was made on clinical data of 60 patients who underwent selective operation under general anesthesia through nasal tracheal intubation from January 2017 to December 2022.According to the guidance methods of nasal tracheal intubation,the patients were divided into three groups with 20 cases in each group:video laryngoscope guided nasal tracheal intubation group(group V),fiberoptic bronchoscopy guided nasal tracheal intubation group(group F),and SOS guided nasal tracheal intubation group(group S).The grading of glottis exposure and epistaxis during tracheal intubation were recorded,as well as the success rate,completion time,and incidence of postoperative complications related to nasal tracheal intubation.Results The glottis exposure in the group F and group S were both grade Ⅰ.Among the group V,there were 7 cases of gradeⅠ,10 cases of gradeⅡ,and 3 cases of grade Ⅲ.The glottis exposure effect of patients in the group F and S was significantly better than that of the group V(Z =-4.274,P = 0.000;Z =-4.274,P = 0.000).There were 15 and 14 patients in the group F and the group S without epistaxis,and 5 and 6 patients with mild epistaxis,respectively.There were no patients with severe epistaxis in the group F and the group S.In the group V,there were 7 patients without epistaxis,10 patients with mild epistaxis,and 3 patients with severe epistaxis.The degree of epistaxis in the group F and the group S was significantly less than that in the group V(Z =-2.678,P =0.007;Z =-2.402,P =0.016).The median time for tracheal intubation in the group S was 37.5(34.3,41.5)s,significantly shorter than 45.0(39.8,72.5)s in the group V and 89.0(76.0,102.5)s in the group F(Z =15.703,P =0.013;Z =32.050,P =0.000),with the group V being significantly shorter than the group F(Z =-16.347,P =0.009).The nasal tracheal intubation failed in 2 cases in the group V,while was all successfully completed in the group F and the group S.The difference of success rate was not statistically significant among the three groups(P>0.05).There were no statistically significant differences in the rates of postoperative nasopharyngeal pain and nasal congestion among the three groups(P>0.05).Conclusion The method of SOS-guided nasal tracheal intubation can provide good glottis exposure and achieve a satisfactory success rate of tracheal intubation without increasing the risk of adverse reactions,which can be regarded as a safe and effective method of nasal tracheal intubation.