Based on practice of video-cases teaching,this paper put forwards four sorts of contradictions,which are the contradiction between time limitation of classroom and expressing limi-tation of video cases,the contradiction between relative independence of video cases (part)and con-sistency of teaching objective (entirety),the contradiction between apparentness of video cases (phe-nomenon)and depth of teaching content (essence)and the contradiction between variability of video case class and control of class by teachers. This paper suggested teaching principle of part conforming to entirety. Meanwhile,it indicated that classroom video case teaching should have strict design, closely coordinated class discussion and teachers should be good at guiding and summarizing. Through these efforts,the above four contradictions can be resolved and designed video case teaching obtained good effect.

Objective:To investigate the current situation of network ethics among the college students , to pro-vide evidence for cultivating correct network ethics .Methods:A survey was conducted in 1200 students with a self-designed questionnaire .Results:College students in the network ethics exist conflicts .They eager to trust but face a crisis of confidence , tool enhancements but responsibility fall , network security but network open , virtual but reality.Conclusion:The government should strengthen the network legislation and network credit system , should increase the development of network security technology so as to build networks ethical norms .Colleges should pay attention to culture the social responsibility , and promote the quality level of network ethics among the college students .

Objective To explore the value of digital mammography in diagnosis of the negative palpable breast cancer in rural ar-eas.Methods 6 754 women randomly selected among 13 700 female outpatients (range,30-83 years)in rural areas underwent dig-ital mammography no matter they had breast palpable masses or not.Results 72 cases with breast cancer were diagnosed by digital mammography (72/6 754).Clinical palpation showed positive in 59 cases (59/72)and negative in 13 cases (13/72)with aged 35-77 years.Among 13 cases with negative palpable breast cancer,6 cases were carcinomas in situ,3 cases were intraductal carcinomas,and 4 cases were infiltrating ductal carcinomas.Conclusion Digital mammography may help in detection of the negative palpable breast cancer in early time.

As important Internet users, college students need to establish good cyber ethics to promote healthy development of the Internet and meet the needs of their own growth. The characteristics of college students' cyber ethics include hierarchy, self-discipline, orientation and particularity. Self-respect and respect for others;hon-est and trustworthy;fair and mutual benefit;attention to public welfare and participation;patriotic, studious, cre-ate a harmonious network should be college students' network moral norms.

Obiecrive:To investigate the social support condition and its influencing factors of the rural elderly in Shandong province.Methods:With multi-stage stratified random sampling method,a questionnaire survey was conducted among 2200 elderly people aged over 60 years using self-developed questionnaire and Social Support Rating Scale (SSRS).Results:Total score of social support in 1115 rural elderly people was (38.01 ±8.39),higher than the national norm.Multiple factor analysis showed that marital status (P ＜ 0.01) and self-care ability (P ＜0.01) had significant effect on the social support of the rural elderly in Shandong Province.Conclusion:The social support condition of the rural elderly in Shandong province is good.We should pay more attention to the spir-itual demands of the rural elderly and further improve the social support of the rural elderly,and thusto promote the development of the rural elderly physical and mental health.

Objective:To explore the subjective well-being and its influencing factors of female elderly in ur-ban community in Shandong province. Methods: Used the multi-stage stratified sampling method to extract 449 elderly women in 6 communities of 18 cities in Shandong Province. The basic situation and Subjective well-being of their were investigated by using the self-designed questionnaire and Memorial University of Newfoundland Scale of Happiness ( MUNSH) . Results:The economic situation, the number of children, living conditions, self-care ability, chronic disease severity, and other variables have a significant effect on the subjective well-being of fe-male elderly. Conclusions:To improve the economic situation of the urban community elderly women, pay atten-tion to their physical and mental health level, improve the pension and health insurance system, intensify the con-struction of old-age care institutions, playing the roles of family, children, society in the network to support the community elderly women society, can significantly improve the community elderly women′s subjective well-be-ing.

Objective:To study the mental health of old people who live in endowment institutions in Shandong Province and its influencing factors. Methods: A sample of 2200 old people over 60 years old was selected with the stratified random sampling method. They were investigated using the self-designed questionnaires, symptom checklist (SCL-90), and Social Support Rating Scale. A total of 2013 questionnaires were recovered effectively (91. 5%), and 271 questionnaires were analyzed in this study. Results:41. 7% of old people in endowment insti-tutions in Shandong Province is positive in SCL -90 . Multivariate analysis showed that self -care ability ( P =0 . 045 ) and type of chronic disease ( P=0 . 025 ) associated with mental health problems of old people in Shandong Province. Conclusion:The mental health status of old people in endowment institutions in Shandong Province was not optimistic and its influencing factors included self-care ability and the type of chronic disease. It should take measures to promote successful aging in Shandong Province.

Objective:To summarize the situation of dead newborns and their parents after parents gave up treatment, and analyze the reasons and emotional needs of parents who gave up treatment, so as to provide reference for reducing neonatal mortality and negative emotions of parents.Methods:A retrospective study was conducted to collect the data of neonates and mothers who died after giving up treatment reported in Hunan Children′s Hospital from January 2019 to December 2021. The general information, perinatal risk factors, and the incidence of in-hospital diseases were analyzed. Then, semi-structured interviews were conducted with parents of newborns who died after giving up treatment from February to December 2021. Understand why parents give up treatment and their emotional needs.Results:A total of 172 newborns died after giving up were included in the analysis, including 103 males (59.88%) and 74 premature infants (43.02%); Umbilical cord, placenta and amniotic fluid abnormalities were 21 cases (12.21%), 39 cases (22.67%) and 25 cases (14.53%), respectively. Birth asphyxia was 31 cases (18.02%), including severe asphyxia in 18 cases (10.46%); There were 21 (12.21%), 35 (20.35%) and 30 (17.44%) cases of maternal infection in the third trimester, hypertension in pregnancy and diabetes in pregnancy, respectively. The top three causes of death were septicemia (18.02%), congenital malformation (16.86%) and severe pneumonia (10.47%). The main reason why parents give up treatment was that the child′s disease was critical and irreversible, and parents had strong emotional needs for hospice care in their hearts.Conclusions:There are many high risk factors of perinatal death of newborns after giving up treatment. Sepsis is the primary cause of death, and strengthening perinatal health care is fundamental. Parents have a strong demand for hospice care, so it is of practical significance to implement family-centered hospice care model for such special newborns.

Objective:To analyze the significance and factors influencing of CT scan under the modified Valsalva maneuver. Methods:Clinical data of 52 patients with hypopharyngeal carcinoma diagnosed from August 2021 to December 2022 were collected, all patients had calm breathing CT scan and modified Valsalva maneuver CT scan. Compare the exposure effect of the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall, and glottis with each CT scanning method. The effects of age, neck circumference, neck length, BMI, tumor site, and T stage on the exposure effect were analyzed. Results:In 52 patients, 50 patients（96.15%） completed CT scan at once time. The exposure effect of the CT scan under modified Valsalva maneuver in the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall was significantly better than CT scan under calm breathing（Z=-4.002, -8.026, -8.349, -7.781, -8.608, all P<0.01）, while CT scan under modified Valsalva maneuver was significantly worse in glottis than CT scan under calm breathing（Z=-3.625, P<0.01）. In the modified Valsalva CT scan, age had no obvious effect on the exposure effect. The exposure effect was better with long neck length, smaller neck circumference, smaller BMI and smaller T stage. The exposure of postcricoid carcinoma was better than pyriform sinus carcinoma and posterior hypopharyngeal wall carcinoma. But differences were not all statistically significant. Conclusion:The anatomical structure of the hypopharynx was clearly under CT scan with modified Valsalva maneuver, which clinical application is simple, but the effect of glottis was worse. The influence of age, neck circumference, neck length, BMI, and tumor T stage on the exposure effect still needs further investigation.
Humans ; Hypopharynx/diagnostic imaging* ; Valsalva Maneuver ; Hypopharyngeal Neoplasms/surgery* ; Tomography, X-Ray Computed ; Carcinoma