The purpose of this study was to investigate and discuss imaging methods and management strategies for congenital choledochal cyst with co-existing intrahepatic dilation and aberrant bile duct as well as other complicated biliary anomalies. In this study we reviewed and analyzed 72 patients with congenital choledochal cyst, ranging in age from 15 days to 12 years old and who were seen at our hospital during the past 12 years, from January 1993 to October 2005. The image manifestation and clinical significance of patients with co- xisting intrahepatic biliary dilation and aberrant bile duct were carefully examined during operation via MRCP, cholangiography and choledochoscope. Twenty-two cases (30.1%) presented with intrahepatic bile duct dilation and 12 of these were of the cystic type. That is, the orifice of the dilated intrahepatic tract that converged into the common hepatic duct showed membrane or septum-like stenosis. In 10 cases the dilation tapered off from the porta hepatis to the initiating terminals of the intra-hepatic bile ducts and was not accompanied by stenosis. An aberrant bile duct was observed in 2 of the cases. In 3 cases, the right and left hepatic ducts converged at the choledochal cyst. In conclusion, the imaging methods for intrahepatic bile duct dilation possess important clinical significance. Further, for hepatojejunostomy with radical excision of a choledochal cyst, additional operative procedures for intrahepatic stenosis, possible bile duct malformation and pancreaticobiliary common duct calculi can potentially reduce postoperative complications.
Tomography, X-Ray Computed ; Postoperative Complications/ultrasonography ; Male ; Liver Diseases/complications/*radiography/surgery ; Infant, Newborn ; Infant ; Humans ; Female ; Choledochal Cyst/complications/*radiography/surgery ; Cholangiography ; Child, Preschool ; Child ; Bile Ducts/*abnormalities/pathology/surgery

The purpose of this study was to investigate and discuss imaging methods and management strategies for congenital choledochal cyst with co-existing intrahepatic dilation and aberrant bile duct as well as other complicated biliary anomalies. In this study we reviewed and analyzed 72 patients with congenital choledochal cyst, ranging in age from 15 days to 12 years old and who were seen at our hospital during the past 12 years, from January 1993 to October 2005. The image manifestation and clinical significance of patients with co- xisting intrahepatic biliary dilation and aberrant bile duct were carefully examined during operation via MRCP, cholangiography and choledochoscope. Twenty-two cases (30.1%) presented with intrahepatic bile duct dilation and 12 of these were of the cystic type. That is, the orifice of the dilated intrahepatic tract that converged into the common hepatic duct showed membrane or septum-like stenosis. In 10 cases the dilation tapered off from the porta hepatis to the initiating terminals of the intra-hepatic bile ducts and was not accompanied by stenosis. An aberrant bile duct was observed in 2 of the cases. In 3 cases, the right and left hepatic ducts converged at the choledochal cyst. In conclusion, the imaging methods for intrahepatic bile duct dilation possess important clinical significance. Further, for hepatojejunostomy with radical excision of a choledochal cyst, additional operative procedures for intrahepatic stenosis, possible bile duct malformation and pancreaticobiliary common duct calculi can potentially reduce postoperative complications.
Tomography, X-Ray Computed ; Postoperative Complications/ultrasonography ; Male ; Liver Diseases/complications/*radiography/surgery ; Infant, Newborn ; Infant ; Humans ; Female ; Choledochal Cyst/complications/*radiography/surgery ; Cholangiography ; Child, Preschool ; Child ; Bile Ducts/*abnormalities/pathology/surgery

Objective To find out the distribution and status of drinking-water-borne fluorosis in Qinghai,and to provide basic data for prevention and control of the disease.Methods According to the "Action Plan of Endemic Fluorosis and Arsenic Poisoning in Qinghai (2016-2020)",10 counties were selected to carry out the epidemiological study in 2016.The operation of the improvment project was investigated.The fluoride content of water was determined with fluoride ion-selective electrode,and dental fluorosis of 8-12 years old children was diagnosed by the Deans method.Results A total of 97 villages have been investigated,and all water was improved.The range of water fluoride was 0.20-2.13 mg/L.Normal operation rate of water-improving project was 83.33％ (50/60).The pass rate of water fluorine content was 96.67％ (58/60).The prevalence rate of dental fluorosis of the children was 18.70％ (774/4 140),and it was significantly lower than national standards (30％).Conclusions Water has been improved in all of the fluorosis villages.Most of the water-improving engineering projects to control drinking-water fluorosis has played a positive role,and drinking-water-borne fluorosis is under control.

Objective:To study the epidemic status of drinking tea type endemic fluorosis in Qinghai Province.Methods:In 2019, in counties (cities, districts, referred to as counties) that had the habit of drinking brick tea in 8 cities (prefectures) of Qinghai Province, epidemiological investigation of drinking tea type endemic fluorosis was carried out in villages. Ten households were randomly selected from each village, to investigate the demographic data of each household and the drinking situation of brick tea, residents' drinking water and brick tea samples were collected to determine the fluorine content, and calculate the daily per capita tea fluorine intake. At the same time, skeletal fluorosis was examined in all adults over 25 years old, and dental fluorosis was examined in all children aged 8 to 12 years old in survey sites. The content of fluorine in tea and water was detected by ion selective electrode method; the diagnosis of skeletal fluorosis was based on "Diagnostic Criteria for Endemic Skeletal Fluorosis" (WS 192-2008), the diagnosis of dental fluorosis was based on "Diagnosis of Dental Fluorosis" (WS/T 208-2011).Results:The mean (range) of fluorine of the 3 602 water samples was 0.31 (0.20 - 1.00) mg/L. The geometric mean (range) of fluorine of the 31 067 brick tea samples was 646 (40 - 2 295) mg/kg, the fluorine content of the brick tea ≤300 mg/kg accounted for 7.80% (2 422/31 067) of the total samples. The proportion of drinking Fu brick-tea was 89.97% (27 952/31 067); and the daily per capita tea fluorine intake was 1.93 mg, the daily per capita tea fluorine intake in Guoluo, Yushu and Hainan prefectures were higher than the health standard (3.50 mg). The detection rate of skeletal fluorosis in adults was 0.16% (2 357/1 484 907), Yushu Prefecture was the highest [29.23% (592/2 025)], followed by Guoluo Prefecture, which was 8.21% (771/9 393). The detection rate of dental fluorosis in children was 4.79% (8 076/168 623), Yushu Prefecture was the highest [32.61% (1 562/4 790)].Conclusion:Drinking tea type endemic fluorosis is prevalent in Qinghai Province, with obvious regional characteristics, covering a large population. The disease is relatively popular in Yushu Prefecture and Guoluo Prefecture.

Objective To dynamic monitor drinking-water-borne fluorosis in Huzhu County and water improvement projects,to know the trend of the disease,and to evaluate the effect of prevention and control measures.Methods Seven townships in Huzhu County including 60 history drinking-water-borne fluorosis villages were selected as investigation sites in 2017,and demographic data were collected.In the villages of the diseased areas where the water had been changed,the operation of the water improvement project was investigated,and 1 tap water sample was collected to determine the fluorine content;for the villages in the diseased areas where the water had not been changed,one water sample was collected from the drinking water source in accordance with the five directions of east,west,south,north and middle to determine the fluorine content.More than 90％ of the children aged 8-12 years old in the surveyed villages were examined and judged for dental fluorosis.According to historical data,1 village with severe illness of children was selected,50 people were selected who were over 25 years old and lived in the villages for more than 5 years.Clinical and X-ray examinations of skeletal fluorosis were performed.Urine samples from adults surveyed were collected for urinary fluoride detection.Results Six of the 60 villages in the 7 townships had been relocated.By 2017,a total of 54 villages in drinking-water-borne fluorosis areas had changed their water.A total of 16 water improvement project were surveyed,among them,there were small water improvement project 6,accounting for 37.50％,large water improvement project 10,accounting for 62.50％;normal operated project 16,accounting for 100.00％;water fluoride content of qualified project 16,the qualified rate was 100.00％,the water fluoride content ranged 0.10-0.66 mg/L,covering a population of about 160 thousand and 846 people.A total of 2 399 children aged 8-12 were examined,117 cases of dental fluorosis were detected,the detection rate of dental fluorosis was 4.88％,dental fluorosis index was 0.13.Among them,89 cases were extremely mild,accounting for 3.71％ of all the children examined,21 cases were mild,accounting for 0.88％ of all the children examined,7 cases were moderate,accounting for 0.29％ of all the children examined,and no severe cases were found.A total of 68 adults over 25 years old were examined for skeletal fluorosis.Twelve patients were found to have clinical skeletal fluorosis.The detection rate was 17.65％.X-ray radiography was used to examine 46 people,and 1 case was detected,the detection rate was 2.17％.Clinical and X ray examinations showed no more than moderate patients.Fifty samples of adult urine were tested,the level of urine fluorine was 0.72 mg/L.Conclusions Water improvement project is working well in Huzhu County,and no serious children with dental fluorosis and adult skeletal fluorosis are detected.The prevention and control measures of drinking-water-bornefluorosis has achieved remarkable results in Huzhu County.We will continue to strengthen water improvement project and disease monitoring,and thoroughly control the prevalence of drinking water fluorosis.

Objective:To investigate the prevalence of adult skeletal fluorosis caused by drinking tea-type endemic fluorosis in Yushu Tibetan Autonomous Prefecture (hereinafter referred to as Yushu Prefecture), Qinghai Province, and provide scientific basis for prevention and control of the disease.Methods:In August 2021, one village was selected as a survey site in six counties (cities) in Yushu Prefecture, including Nangqian, Chindu, Yushu, Zadoi, Qumarlêb, and Zhiduo. Drinking water samples and 10 brick tea samples were collected from each village to determine the fluoride content in water and brick tea; at least 100 permanent residents aged ≥ 25, who had a habit of drinking brick tea and had lived in the local area for more than 5 years, were selected for X-ray imaging to examine the prevalence of adult skeletal fluorosis.Results:A total of 75 samples of residential drinking water were collected, with a fluoride content of (0.21 ± 0.05) mg/L, ranging from 0.11 to 0.34 mg/L; 60 samples of brick tea, with a fluoride content of (626.70 ± 157.27) mg/kg, ranging from 324.00 to 2 102.00 mg/kg. A total of 1 136 adults were examined, and 318 cases of skeletal fluorosis were diagnosed, with a detection rate of 27.99%. Among them, the detection rates of mild, moderate, and severe skeletal fluorosis were 20.95% (238/1 136), 6.07% (69/1 136), and 0.97% (11/1 136), respectively, with mild symptoms being the main. The detection rates of skeletal fluorosis in males and females were 29.09% (121/416) and 27.36% (197/720), respectively, with no statistically significant difference between the gender (χ 2 = 0.39, P = 0.533). Comparison of the skeletal fluorosis in different gender, the differences were statistically significant (χ 2 = 22.31, P < 0.001). The detection rates of skeletal fluorosis in the age groups of 25 - 35, 36 - 45, 46 - 55, 56 - 65, 66 - 75, and ≥76 years old were 6.86% (7/102), 22.37% (51/228), 24.02% (92/383), 37.44% (73/195), 43.48% (70/161), and 37.31% (25/67), respectively. The differences between the groups were statistically significant (χ 2 = 59.84, P < 0.001). Moreover, there was a statistically significant difference in the composition of skeletal fluorosis among different age groups ( H = 37.66, P < 0.001). The Spearman correlation analysis results showed that the severity of adult skeletal fluorosis was positively correlated with age ( r = 0.34, P < 0.001). Conclusions:There is a certain degree of prevalence of adult skeletal fluorosis in Yushu Prefecture. And as age increases, the condition of skeletal fluorosis becomes more severe.

Objective: To investigate the status quo and influencing factors of work burnout of psychiatric nurses, and to provide theoretical basis for formulating intervention strategies for work burnout of psychiatric nurses. Methods: A questionnaire was conducted on 812 nurses selected from 6 tertiary A psychiatric hospitals in Shandong province as the research object by stratified random sampling, and the questionnaire was conducted by using the Maslach Burnout Inventory (MBI), the Kessler Psychological Distress Scale (K10) and Emotion regulation questionnaire (ERQ). Results: There were significant differences in job burnout among psychiatric nurses with different educational background, age, nurse-patient conflict and income level. There were significant differences in the dimensions of job burnout among psychiatric nurses with different titles (P< 0.05), There were significant differences in emotional exhaustion (F=8.417, P=0.000) and depersonalization level (F=7.918, P=0.000) between psychiatric nurses with different frequency of nurse-patient conflict.There were significant differences in affective exhaustion (F=6.426, P=0.002) and personal accomplishment (F=3.444, P=0.032) between psychiatric nurses with different monthly income levels. Psychiatric nurses' age, working years, psychological distress, cognitive reappraisal, inhibition of expression were associated with job burnout (r=0.075~0.570) . Regression analysis revealed that the factors impacting emotion exhaustion (R²=0.374, F=81.627, P=0.000) and depersonalization (R²=0.240, F=65.014, P=0.000) were psychological distress, inhibition of expression, cognitive reappraisal, conflict between nurses and patients. The factors impacting diminished personal accomplishment (R²=0.199, F=68.332, P=0.000) were psychological distress, cognitive reappraisal and age. Conclusions The work fatigue of psychiatric nurses was at the moderate level. Emotional regulation and psychological distress were the influencing factors of job burnout.Nursing administrators in psychiatric department should pay attention to the improvement of nurses' sense of burnout, improve the ability of nurses' emotional management, cultivate positive mood and behavior pattern, reduce anxiety and depression and so on, so as to effectively improve the mental health level of nurses in psychiatric department.