Objective To investigate the value of multiple sequential MRI in the differential diagnosis of vater ampulla carcinoma (VPC).Methods MRI data of 53 patients with VPC confirmed by surgery and pathology were analyzed retrospectively,which included 17ampullary carcinomas,15 pancreatic head carcinomas,10 duodenal papillary carcinomas and 11 distal common bile duct carcinomas.All patients underwent routine MRI plain scan,MRCP and multi-phase dynamic enhancement scan for the upper abdomen.The morphological characteristics and model of multi-phase dynamic enhancement of the tumor,and the morphological changes of pancreaticobiliary duct were focused,and relevant data were also measured.Results The differences of tumor size,central location,and signal homogeneity among the four different histological types showed statistical significance(P＜0.05),and their patterns of multi-phase dynamic enhancement also had differences.Double-segment sign was most found in VPC (26/53),four-segment sign was easy showed in pancreatic head carcinoma (8/15)and three-segment sign in distal common bile duct carcinoma (8/11).Beak sign was common seen in ampullary carcinoma(10/17),rat-tail sign was easy discovered in pancreatic head carcinoma (7/15) and truncated sign in distal common bile duct carcinoma(10/11).Diameter of major pancreatic duct in pancreatic head carcinoma was maximum and minimum in distal common bile duct carcinoma,and their difference had statistical significance(P＜0.05).Distance between obstructive end of bile common duct and major papilla of duodenum,and between obstructive end of major pancreatic duct and major papilla of duodenum as well as the pancreaticobiliary conjunction angle in pancreatic head carcinoma and distal common bile duct carcinoma were greater than that in ampullary carcinoma and duodenal papillary carcinoma.Conclusion MRI can prominently demonstrate various imaging characteristics of VPC with different histological origins.It is very valuable in the differential diagnosis of VPC with different histological types by comprehensive analysis of these findings.

Objective:To systematically evaluate and integrate qualitative research on the real experience of moral distress among Intensive Care Unit (ICU) nurses.Methods:Qualitative researches on the moral distress of ICU nurses were searched through computers in PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure, WanFang Database, VIP, and China Biology Medicine disc. The search period was from the establishment of the database to April 15, 2023. The quality evaluation of the included studies was conducted using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center (2017) in Australian. The aggregation integration method was used to integrate the results.Results:A total of 13 articles were included, and 42 main results were extracted and categorized into 9 categories. Three integrated results were synthesized, namely the generation and experience of moral distress among ICU nurses, the impact of moral distress on ICU nurses, and the coping styles to moral distress among ICU nurses.Conclusions:Nursing managers should attach importance to the moral distress experience of ICU nurses, reduce the negative impact of moral distress on ICU nurses, and enhance their moral resilience.

Objective:To evaluate the methodological quality and measurement characteristics of children's needs assessment tools.Methods:Literature on children's needs assessment tools was searched in Cochrane Library, PubMed, Embase, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), WanFang Data, VIP, and China Biology Medicine disc. The search period was from database establishment to April 2, 2023. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guideline was used to evaluate the methodological quality and measurement characteristics of assessment tools, and integrate the evaluation results to form recommendations.Results:Six studies were included in total. The recommended opinions for the two evaluation tools (Needs of Children Questionnaire and Male Adolescent Health Needs-Assessment Scale) were A level. The recommended opinions for the four evaluation tools were B level. The Male Adolescent Health Needs-Assessment Scale had high cultural specificity.Conclusions:The evidence quality of the Needs of Children Questionnaire is relatively high and can be temporarily recommended for use, but other measurement characteristics still need further verification.

Objective To systematically evaluate qualitative studies on the experience of transition from adolescent to adult medical care for patients with congenital heart disease(CHD),and to provide a reference for exploring CHD transition management options and developing intervention strategies.Methods A computerized search of PubMed,Embase,Web of Science,Cochrane Library,EBSCO,CINAHL,China Knowledge Network,Wanfang database,Vipshop database,and China Biomedical Literature Database for qualitative studies on the transition experience of CHD patients from adolescence to adult medical care was conducted for the period from the establishment of the database to April 2023.The quality of the literature was evaluated using the Joanna Briggs Institute(JBI)Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research(2016),and the results were integrated using meta-integration methods.Results A total of 9 studies were included,and 49 research results were extracted,and 11 categories were summarized.The final synthesis included 4 integrated results:①Complex attitudes towards healthcare transition,with both attachment and expectation:attachment to paediatric healthcare providers,expectation of transition to adult healthcare providers.(2)Facing multiple healthcare transition challenges:lack of adequate preparation for healthcare transition,parents withdrawing from the role of disease manager,large differences in services between paediatric and adult healthcare providers.③Expect to receive multiple supports:expect to receive comprehensive health education from healthcare personnel,expect healthcare institutions to set up healthcare transition counselling clinics and achieve handover of illness,expect to receive companionship and support from parents,expect to receive understanding and help from peers.④ Per-ceived benefits of medical transition:increased ability to manage illness,role change and personal growth.Conclusion Adolescents with CHD have a complex experience of transitioning to adult healthcare,and healthcare professionals should be attentive to their feelings,encourage them to deal with challenges positively,and provide adequate information and joint parental and peer support to facilitate a smooth transition to adult healthcare for adolescents.

Objective:To summarize and analyze the real experience of conscious patients in Intensive Care Unit (ICU) during hospitalization.Methods:Qualitative researches on the real experience of conscious patients in ICU during hospitalization were searched through computer on China National Knowledge Infrastructure, WanFang Data, VIP, China Biology Medicine disc, PubMed, Embase, Web of Science, CINAHL, Cochrane Library and so on. The search period was from the establishment of the database to April 30, 2022. The quality evaluation was conducted using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center in Australia. The aggregation integration method was used to summarize and integrate the results.Results:A total of 12 articles were included, and 54 results were extracted and categorized into 11 categories. Four integrated outcomes were formed, including physiological discomfort, psychological discomfort, desire for support, active response and self-reflection.Conclusions:ICU conscious patients experience severe physiological and psychological discomfort during hospitalization. While patients themselves actively respond, medical and nursing staff should further provide high-quality nursing care and psychological counseling to patients, optimize their support system, improve the hospitalization experience of ICU patients, and promote disease recovery.

Objective:To systematically synthesize qualitative research on the emotional experience of fathers of premature infants hospitalized in neonatal intensive care unit (NICU), so as to provide a basis for the care guidance and psychological care of fathers of premature infants.Methods:The articles on the qualitative study of emotional experience of fathers of premature infants in NICU were systematically searched through computers in PubMed, Embase, Web of Science, CINAHL, Cochrane Library, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biomedical Medline Disc. The search period was from the establishment of the database to May 15, 2022. The article quality evaluation was conducted using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center in Australia. The aggregation integration method was used to summarize and synthesize the results.Results:A total of 9 articles were included, 33 research results were extracted, summarized into 9 categories, and ultimately integrated into 3 synthesized results, namely facing multiple pressures and challenges, craving support, actively responding and reflecting on growth.Conclusions:The fathers of NICU premature infants have heavy physical and mental burdens, and hope to receive support from multiple parties. It is recommended that medical and nursing staff pay attention to the inner experiences and needs of fathers of NICU premature infants, optimize the support system, and improve their coping ability and promote their mental health.

This paper reviews the current status, evaluation tools, influencing factors, and intervention measures of social alienation in colorectal cancer patients with enterostomy, in order to provide reference for the research on social alienation in colorectal cancer patients with enterostomy in China.

Objective To conduct a scoping review of virtual reality motor sensing exercise in the elderly with dementia,so as to identify the types of intervention,outcome indicators,evaluation tools and application effects of virtual reality motor sensing exercise and provide guidance for future research.Methods A literature search was performed in the PubMed,Embase,CINAHL,Web of Science,Cochrane Library,CNKI,Wanfang,VIP,and CMB databases to identify relevant studies.The search period is from the establishment of databases to October 15,2023.The included studies were summarized and analyzed.Results A total of 18 articles were included in this study,including 14 randomised controlled trials,one class-experimental study and three mixed studies involving a total of 1,054 elderly dementia patients.The types of virtual reality motor sensing exercise included motor sensing interactive games,interactive bicycle riding,remote game exercise,Wii Fit exercise and virtual reality environment exercise.The outcome indicators involve 4 aspects of physical indicators,psychological indicators,cognitive function and quality of life.Conclusion Virtual reality motor sensing exercise is feasible and effective in the elderly with dementia.However,large sample and high-quality randomized controlled trials are still needed in the future to verify the feasibility and application effect of virtual reality exercise in the elderly with dementia,so as to provide evidence-based basis for formulating the best exercise intervention program for the elderly with dementia.

Objective To evaluate and integrate the facilitators and barriers to adherence to diet or exercise interventions in patients with overweight or obesity.Methods PubMed,Web of Science,Embase,CINAHL,Cochrane Library,China National Knowledge Infrastructure,Wanfang,and VIP Chinese Biomedical Literature Database were searched by computer from the establishment of the database to October 14,2023.The 2016 edition of the Joanna Briggs Institute(JBI)evidence-based health care center qualitative research evaluation criteria was used to evaluate and integrate the included literature.Results A total of 19 studies were included,and 38 outcomes were distilled into 12 categories,and the results were consolidated into facilitators(disease threat perception,self-body perception,self-adjustment,sense of responsibility,social support)and barriers to intervention adherence(poor treatment benefit,low self-efficacy,lack of knowledge,competitive priorities,extemal environmental constraints,economic conditions,poor intervention design).Conclusion There are many facilitators and barriers of diet or exercise intervention perceived by patients.It is suggested that follow-up intervention research should be used as a reference to improve the treatment compliance of patients.

Objective To explore the diagnostic value of ultrasound for thyroid nodules with a spoke-wheel blood flow pattern.Methods The clinical data of the patients with thyroid nodules presenting a spoke-wheel blood flow pattern examined by ultrasound were collected,and the gray-scale ultrasound features of the nodules were recorded.The diagnostic performance of the Thyroid Imaging Reporting and Data System by American College of Radiology(ACR TI-RADS),Chinese Thyroid Imaging Reporting and Data System(C-TIRADS),and combined specific indicators for the thyroid nodules with a spoke-wheel blood flow pattern was evaluated by comparison with the pathological results,which was regarded as the gold standard.Results A total of 64 patients with thyroid nodules were finally included,including 47 patients with malignant nodules and 17 patients with benign nodules.In addition to the general ultrasound features,central scar mostly appeared in malignant nodules(x2=5.968,P=0.015),while central coarse calcification was more common in benign nodules(x2=10.899,P=0.001).After the combination of central scar and central gross calcification,the diagnostic performance of ACR TI-RADS and C-TIRADS was improved(both P＜0.001).Conclusions When the thyroid nodule shows a spoke-wheel blood flow pattern,one should be cautious of the possibility of malignancy.Combining central scar and central coarse calcification can improve the accuracy of ultrasonic diagnosis.