Objective To conduct a biomechanical evaluation of the four internal fixation methods to treat transverse acetabular fracture and find the b est one. Methods The transverse acetabular fracture models were created by osteo tomy in 12 pairs of embalmed cadaveric hip joints, and fixed with one of the fou r different methods: an anterior column plate (P/N), an anterior column plate w ith a posterior column screw (P+S), a posterior column plate with an anterior screw (S+P) and two posterior column plates (N/P?2). The biomechanical stabi lity was evaluated on longitudinal displacement, level displacement and stiffnes s measurements for fixed fracture fragments which were under 800 Newton vertical compression load. Results The longitudinal displacement in S+P was 3.99mm, in P+S 4.09mm, in N/P?2 5.07mm and in P/N 5.66mm; the level displacement in S+P was 0.015mm, in P+S 0.016mm, in N/P?2 0.022mm and in P/N 0.025mm; the average stiffness in S+P was 205.77N/mm, in P+S 207.52N/mm, in N/P?2 162.36N/mm and i n P/N 146.67N/mm. There were significant differences between the groups of S+P and P+S and the groups of N/P?2 and P/N (P

Objective To explore the relationship among psychological resilience, self-efficacy and core competence in psychiatric nurses. Methods Totally 237 psychiatric nurses in a psychiatric hospital in Shandong province were recruited and assessed with general information questionnaire, Connor-Davidson Resilience Scale, General Self-Efficacy Scale and Competency Inventory for Registered Nurse. Results The total core competence of psychiatric nurses was (2.59 ± 0.66) points, at a moderate level. Psychological resilience were positively corrected with self- efficacy (r=0.454,P=0.000) and core competence (r=0.647, P=0.000), self-efficacy were positively corrected with core competence (r=0.487, P=0.000). Psychological resilience partially mediate the relationship between self- efficacy and core competence, It′s mediating effect was 44.8%. Conclusions Psychological resilience plays an important role to core competence in psychiatric nurses.Nursing managers should carry out related training, improve the psychological resilience and self-efficacy of psychiatric nurses, and comprehensively improve the level of core competencies.

Blood transfusion is an important resuscitation method for combat casualties with severe hemorrhagic shock.The optimal resuscitation plan directly influences the treatment effect of the wounded.Whole blood,once the main resuscitation fluid,was replaced by blood components for various reasons and became a supplement when there was insufficient blood components supply.With the latest evidence of whole blood application in combat casualties,the development of blood transfusion technology and the deepened clinical and basic research,we realize that the obstacles in the use of whole blood are not insurmountable and that whole blood has the advantages that blood components do not have in the treatment of combat casualties.Therefore,whole blood has once again become a research hotspot in the field of combat casualties treatment.This article reviews the development history,advantages and disadvantages of whole blood application in the resuscitation of hemorrhagic shock after combat casualties,with a view to provide reference for further clinical and basic research.

Objective To investigate the present status and influencing factors of psychological distress among psychiatric nurses, and provide theoretical basis for intervention measures. Methods Totally, 812 psychiatric nurses in six psychiatric hospitals of Shandong province were selected to complete the Kessler Psychological Distress Scale (K10), Perceived Organizational Support(POS), Simplified Coping Style Questionnaire(SCSQ) and Emotion regulation questionnaire(ERQ). Results The mean scores of psychological distress among psychiatric nurse was (21.29±8.11) points,70.3%of psychiatric nurses had psychological distress. There were significant differences in psychological distress among psychiatric nurses with different age (F=6.886,P=0.001), working years (F=4.403,P=0.004), professional title (F=6.597,P=0.000) and experience of nurse-patient conflict (F=7.228,P=0.000).Psychological distress was negatively related to cognitive reappraisal(r =- 0.093), positive coping style (r =- 0.163) and perceived organizational support(r =- 0.379), while psychological distress was positively related to expressive suppression(r=0.160) and negative coping style(r=0.258)(all P<0.01). Regression analysis revealed that the factors impacting psychological distress were positive coping style, perceived organizational support, expressive suppression, negative coping style and nurse-patient conflict (R2=0.224,F=46.611,P=0.000). Conclusions Psychiatric nursing managers should pay attention to the cultivation of emotional management ability of nurses and the ability to deal with conflict,encouraging them apply positive thinking cognition and positive coping style to deal with negative events in the work,creating a supportive work environment in order to improve the level of mental health.

Objective To explore the prenatal ultrasound image features and clinical significance of fetal ductus venosus abormalities . Methods Fifteen fetuses with ductus venosus abormalities diagnosed by prenatal ultrasonography at Peking University T hird Hospital were retrospective review . T he prenatal findings ,umbilical shunting type ,perinatal outcomes ,and autopsy reports were analyzed . Results Fourteen fetuses were found with absence of ductus venosus . In 6 fetuses the umbilical vein connected to the portal vein ,5 fetuses the umbilical vein connected to the inferior vena cava and 3 fetuses the umbilical vein connected to the right atrium . T he remaining 1 fetus was found obliteration of ductus venosus . Absence of ductus venous showed no normal ductus venous and the umbilical vein almost always drained directly into portal vein ,inferior vena cava or right atrium . Obliteration of ductus venous showed normal ductus venous was replaced by a tiny echogenic string without blood flow . T hree cases had intracardiac and extracardiac abnormalities ; 4 cases had extracardiac abnormalities only ; 8 of these ,ductus venosus abormality were isolated . T wo cases had trisomy 21 syndrome . Four patients underwent legal termination of pregnancy ; 2 were intrauterine fetal death ; and 8 carried to term wit normal outcome ; the remaining one underwent operation due to extracardiac abnormality and postoperative course was uneventful . Conclusions Prenatal ultrasound can be used to diagnose fetal ductus venosus abormalities . Hemodynamic depends on umbilical venous drainage site and diameter . T he prognosis for this group of anomalies depends on the chromosomal abnormalities and additional findings . Chromosome and ultrasonic monitoring are suggested for following pregnancy .

Objective:To investigate the situation of nursing handover among psychiatric nurses, and explore the association between perceived organizational support, self-efficacy and quality of nursing handover.Methods:A total of 186 clinical nurses in Shandong Mental Health Center were enrolled by convenience sampling method. They were assessed with handover evaluation scale, perceived organizational support scale and general self-efficacy scale for the evaluation of nursing handover, perceived organizational support and self-efficacy.Results:The average score of quality of nursing handover was 5.85±1.14, and bi-variate correlations were found between perceived organizational support, self-efficacy and quality of nursing handover. Self-efficacy could mediate the relationship between organizational support and nursing handover, and the value of mediating effect was 13.4%.Conclusions:Self-efficacy might mediate the relationship between perceived organizational support and nursing handover among psychiatric nurses.

Sepsis is a common and severe infectious disease, and its associated coagulation dysfunction can cause disseminated intravascular coagulation (DIC) and organ failure, leading to a significant increase in mortality. Pyroptosis is a form of programmed cell death mediated by caspase-1 in the classical pathway and caspase-4/caspase-5/caspase-11 in the non-classical pathway, along with the effector molecule gasdermin (GSDM) family. Recent studies have shown that pyroptosis plays an important role in the development of coagulation disorders in sepsis. Pyroptosis leads to the formation of cytoplasmic membrane pores, cell swelling and membrane rupture, as well as the release and enhanced activity of procoagulant contents, strongly promoting the development of systemic coagulation activation and DIC in sepsis. Therefore, exploring the role and molecular mechanisms of pyroptosis in sepsis-related coagulation disorders is of great significance for the prevention and treatment of sepsis. This article provides a review of the mechanisms involved in pyroptosis and coagulation disorders in sepsis, as well as the role and mechanisms of pyroptosis in sepsis-associated coagulation disorders to provide new ideas for sepsis related research.

Objective To investigate the clinical effect of 125I seeds implantation on bone metastasis from radioactive iodine-refractory differentiated thyroid carcinoma (RAIR-DTC).Methods A total of 9 RAIR-DTC patients with bone metastases (4 males,5 females,age range:42-87 years) between April 2014 and December 2016 were enrolled in this prospective study.Treatment plan was developed through treatment planning system (TPS).125I seeds implantation was performed under CT guidance.After 2 and 4 months,metastasis size,serum thyroglobulin (Tg) and verbal rating scale (VRS) pain score changes were recorded.Paired t test and two-sample t test were used for data analysis.Results VRS pain score decreased 2 months post-treatment comparing with that before treatment (2.56±0.88 vs 5.22±2.44;t =4.28,P＜0.01).VRS pain score at 4 months post-treatment was 1.78±0.83,which was lower than that at 2 months post-treatment (t =3.48,P＜0.01).The maximum tumor diameters before the implantation and 2 months post-treatment were (6.47± 1.84) cm and (5.08±2.11) cm,respectively (t =9.14,P＜0.01).The maximum tumor diameter at 4 months post-treatment showed a decreasing trend but it was not statistically different compared to that at 2 months post-treatment:((4.52±2.16) cm;t =2.19,P＞0.05).Serum Tg level reduced 2 months after the implantation (lgTg:2.71±0.85 vs 2.94±0.82;t =4.82,P＜0.01).Serum Tg level at 4 months post-treatment (lgTg:2.56±0.81) was lower than that at 2 months post-treatment (t =2.69,P＜0.05).Conclusions 125I seeds implantation is an effective method for treating bone metastasis from RAIR-DTC.It can help to shrink bone metastasis,alleviate pain and improve patients' quality of life.

Objective To study the stability of lumbar spine after transforaminal lumbar interbody fusion (TLIF) surgery combined with a novel articular process fixation system (APFS). Methods Based on the validated finite element model of L3-S1 intact segment (Model A), TLIF surgery was simulated to establish bilateral pedicle screw TLIF model (Model B), right unilateral pedicle screw TLIF model (Model C), APFS combined with right pedicle screw fixation TLIF model (Model D). The range of motion (ROM) of the lumbar spine model and stress distributions on pedicle screws, APFS and interbody fusion cages under different working conditions were observed. Results The overall ROMs of Models B, C, and D under different working conditions were comparable, which were all smaller than those of the physiological model. Compared with Models B and C, the maximum compressive stress of the right pedicle screw and the interbody fusion cage in Model D was the smallest or between Models B and C under different working conditions. Model D had the largest peak stress of APFS and right pedicle screw during anterior flexion. Conclusions APFS combined with contralateral pedicle screw fixation can be used as a novel fixation method for TLIF surgery of lumbar spine.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.