Objective: To explore the influence of group psychological counseling on the mental health of children with mother s authoritarian parenting. Methods: From November 2022 to February 2023, 76 students from grades 4 to 6 whose mother showed authoritarian parenting style, while fathers adopted no authoritative, authoritarian or democratic parenting style and who scored ≥65 on the total MHT were selected using the Parenting Style Questionnaire (PBI) and the Mental Health Diagnostic Test (MHT). All the participants and their mothers were randomly assigned to the intervention and control groups. Before and after the intervention, participants filled out questionnaires on parental bonding instrument and mental health test. Control group: regular delivery of mental health education information, 2 times per week, for 8 weeks, without any other intervention. Intervention group: group counseling activities were conducted once a week. Each intervention lasted 1.5-2 hours and lasts for 8 weeks. Before and after the intervention, participants filled in the family parenting style and mental health screening questionnaires. Results: After the intervention, compared with the control group, students in the intervention group showed a significant decrease in the total scale score of the MHT, learning anxiety, social anxiety, allergic tendency, physical symptoms, fear tendency, and impulsive tendency ( t=-0.43, -1.04 , -0.81, P >0.05). After intervention, the intervention group students showed a significant decrease in psychological diagnosis test scores, learning anxiety, anxiety towards others, allergic tendencies, physical symptoms, phobic tendencies, and impulsive tendencies compared to the control group students ( t=-20.00, -5.06, -2.09, -3.36, -6.15, -4.76, -5.15, P <0.05). Conclusion Rregular group psychological counseling can effectively improve the academic anxiety, social anxiety, allergic tendencies, physical symptoms, fearful and impulsive tendencies of students whose mothers with authoritarian parenting style, and greatly improve their mental health.

Objective:To observe the clinical effect of retrograde distal tibial intramedullary nail fixation in the treatment of proximal ankle fracture of the distal tibia.Methods:A three-dimensional CT examination of 40 adult tibias was performed to measure anatomical indicators such as the posterior medial posterior torsion angle of the distal tibia, the height of torsion, and the height of the safety zone for nail placement. Based on the anatomy database of the human skeleton model, a retrograde distal tibial nail and its supporting instruments were developed in accordance with the anatomical characteristics of the distal tibia and the proximal ankle of Chinese people. From June 2019 to June 2023, a total of 25 patients with distal tibial proximal ankle fractures treated with retrograde intramedullary nail internal fixation in the 909th Hospital were retrospectively analyzed. There were 18 males and 7 females, aged 41.3±10.8 years (range, 22-65 years). The sample size was 1∶1 matched according to gender and age. Twenty-five patients with distal tibial proximal ankle fractures who underwent antegrade intramedullary nail fixation during the same period were matched, including 20 males and 5 females, aged 41.2±9.4 years (range 19-60 years). The reduction quality, postoperative Baird-Jackson score, American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score, ankle range of motion and complications were observed.Results:All patients were successfully operated and followed up for 14.4±3.5 months (range, 12-24 months). The intraoperative blood loss and hospitalization time in retrograde intramedullary nail group were 33.12±7.38 ml and 10.32±1.75 d, less than 49.04±10.22 ml and 13.16±2.69 d in antegrade intramedullary nail group, and the difference was statistically significant ( P<0.05). The reduction quality was excellent in 23 cases and good in 2 cases in the retrograde intramedullary nail group, and was excellent in 17 cases and good in 8 cases in the anterograde intramedullary nail group. The proportion of excellent reduction quality in the retrograde intramedullary nail group was higher than that in the anterograde intramedullary nail group, and the difference was statistically significant (χ 2=4.500, P=0.034). The Baird-Jackson score and AOFAS ankle and hindfoot score in the retrograde intramedullary nail group were 85.6±2.5 and 85.8±3.3 at 3 months after operation, lower than those at 1 year after operation 95.3±3.1 and 95.8±3.6, and the difference was statistically significant ( P<0.05). The Baird-Jackson score and AOFAS ankle and hindfoot score of the antegrade intramedullary nail group were 85.1±3.3 and 86.1±2.5 at 3 months after operation, lower than 95.2±2.7 and 94.9±3.5 at 1 year after operation, and the difference was statistically significant ( P<0.05). There was no significant difference in Baird-Jackson score and AOFAS ankle and hindfoot score between the two groups at 3 months and 1 year after operation ( P>0.05). At the last follow-up, there was no ankle stiffness, neurovascular injury, deep vein thrombosis, infection or breakage of internal fixation in the two groups. Conclusion:The treatment of distal tibial proximal ankle fractures with retrograde intramedullary nail fixation has satisfactory reduction quality, good postoperative function recovery, and is helpful for early postoperative rehabilitation.

Objective: To determine the relationship between dengue virus load and clinical characteristics, so as to provide basis for dengue fever prevention and treatment. Methods : The dengue viral load and typing of 120 patients in Gongshu District of Hangzhou from June to November 2017 were detected by real-time fluorescent quantitative RT-PCR;the clinical indicators of these dengue patients were collected and their correlation with the viral load was analyzed. Results: The DNA detection of dengue virus in 120 patients showed that they were all typeⅡ. The median dengue virus load was 3.91×104 copies/mL. All the patients had fever, the average peak temperature was（38.96 ± 0.69）℃. There were 102（85.00%）cases with asthenia;116（96.67%）cases with white blood cell count（WBC）less than 4× 109/L;119（99.17%）cases with platelet count（PLT）less than 100×109/L;114（95.00%）cases with glutamic oxaloacetate transaminase（GOT）more than 40 U/L;81（67.50%）cases with glutamic pyruvate transaminase（GPT）more than 52 U/L;58（48.33%）cases with creatine kinase（CK）more than 210 U/L. There was no significant correlation of dengue virus load with length of hospitalization, peak temperature,duration of fever, WBC,PLT, GOT, GPT and CK（P>0.05）. There were 75（62.50%）severe patients, and their median viral load was 9.29×104copies/mL, which was higher than 5.33×103copies/mL in non-severe patients（P<0.05）. Conclusion The dengue virus load is not related with length of hospitalization,peak temperature,WBC,PLT,GOT,GPT and CK,but with the severity of the disease.

Hypercalcemic crisis (HC) is a rare but critical electrolyte disorder, which may result in death if rapid correct management is not given due to the injury of the neurologic, cardiovascular and renal systems. Severe primary hyperthyroidism (PHPT) is listed as the most common cause of hypercalcemic crisis. Prompt surgical removal of the parathyroid glands is the most effective cure for HC. Nevertheless, hypercalcemic crisis after a successful parathyroidectomy is infrequent. Now, we report a case admitted to the Department of General Surgery of the Shanghai Jiao Tong University Affiliated Sixth People’s Hospital about a successful therapy of hypercalcemic crisis postparathyroidectomy in Sep. 2019, aiming to remind clinicians of the individualized program of calcium supplement after surgery of hyperparathyroidism and emphasize the value of renal dialysis in HC.

Objective    To summarize the clinical experience in the treatment of high-risk patients with severe aortic valve disease by transcatheter aortic valve implantation (TAVI) via heart apex approach and to evaluate the early efficacy. Method    Five patients who underwent TAVI via heart apex approach from September 2017 to February 2019 in Henan Thoracic Hospital were retrospectively analyzed, including 3 males and 2 females, aged 65-84 (74.6±4.5) years. Result    All operations were performed through a small left incision into the thoracic cavity (3-5 cm), and then through the J-Valve transport system, the aortic valve was successfully released via heart apex after precise positioning under digital subtraction angiography. One patient developed ventricular fibrillation during the operation, and the operation was completed with the assistance of emergency femoral arteriovenous catheterization cardiopulmonary bypass; one patient underwent percutaneous coronary intervention first because of severe coronary stenosis; one patient had paroxysmal atrial fibrillation during the perioperative period, and had hepatorenal insufficiency and thrombocytopenia after the operation, and was improved after medical treatment; one patient had perivalvular leak during the operation, and was improved after re-implantation of the valve; one patient was in stable condition during operation and recovered smoothly after operation. Surgery was successful in all 5 patients. The follow-up time was 2-19 months, and the early clinical effect was good. Conclusion    The short-term clinical efficacy of TAVI via heart apex approach in the treatment of high-risk severe aortic valve disease is definite and safe, but the long-term and medium-term effects need to be further evaluated.

Inflammatory bowel disease (IBD)is an autoimmune disease leading to diarrhea,abdominal pain,and weight loss. The pathogenesis of diarrhea remains unclear,however,increasing evidence has shown that the epithelial sodium channel (ENaC)is associated with diarrhea. ENaC is crucial in the control of sodium homeostasis,extracellular fluid volume,blood pressure. This article reviewed advances in study on relationship between ENaC and IBD.

Objective To investigate the different characteristics of vertebral basilar artery between isolated vertigo and dizziness with ischemic stroke history by magnetic resonance angiography (MRA) information,and find the independent risk factors of isolated vertigo.Methods From January 2015 to January 2016,isolated vertigo patients from our department were enrolled in study group (vertigo group),and dizzy patients with ischemic stroke history in control group (dizziness group).The patient's general information,and the relevant vascula data of the MRA were statistically analyzed to find the risk factors.Results A total of 118 patients with isolated vertigo was enrolled in the vertigo group,and 74 patients with dizziness after ischemic stroke were used as a control group.There were significant statistical differences in mean diameter of the right vertebral artery,rate of stenosis of basilar artery,vertigo history,the left vertebral artery hypoplasia,basilar artery skewing,and basilar artery hypoplasia between two groups (P ＜ 0.05).Multivariate logistic regression analysis showed that vertigo history (P =0.049,OR =3.822,95％ CI =1.004 ～ 14.548),the right vertebral artery hypoplasia (P =0.001,OR =6.083,95％ C1 =2.193 ～ 16.876),the left vertebral artery hypoplasia (P =0.006,OR =5.110,95 ％ CI =1.615 ～ 16.170),and mean diameter of the right vertebral artery (P =O.000,OR =3.143,95％ CI =1.724 ～ 5.730) were independent risk factors for isolated vertigo,and basilar artery skewing (P =0.018,OR =O.436,95％ CI =0.219 ～ O.866),and degree of basilar artery stenosis (P =0.006,0R =0.634,95％ CI =0.459 ～0.877) were the protective factors.Conclusions The right vertebral artery hypoplasia,the left vertebral artery hypoplasia,and mean diameter of the right vertebral artery are independent risk factors for isolated vertigo.Basilar artery skewing and degree of basilar artery stenosis may be the protective factors.

Cancer pain is the most important factor affecting the cancer patients' quality of life, and the approach to relieve and control cancer pain is becoming the focus. Pain mechanism research can offer solutions to pain treatment, such as blocking the happening and conduction of analgesia. The earliest μ, κ, σopioid receptors were found in the research of morphine and opioid peptides, especially μ receptor's leading role in pain treatment. Currently, μ opioid agonist is basically used in clinical pain treatment. Morphine, the third level drug, is still the classic pain therapy drugs. Novel drugs such as fentanyl transdermal and controlled-release oxycodone provide new ideas for the pain ease. Opioid combined with non-opioid drugs, the change of opioid drugs delivery way and joint application of controlled release drug and relievers, have dramatically reduced opioid drugs' side effects.

Objective To investigate the correlation between the morphological characteristics of vertebrobasilar artery on magnetic resonance angiography (MRA) and isolated vertigo. Methods The patients with isolated vertigo were enrolled retrospectively as a case group. Other patients without vertigo were selected over the same period as a control group. The clinical data and MRA data were collected. Univariate analysis and multivariate logistic regression analysis were used to identify the independent risk factors for isolated vertigo. Results A total of 118 patients with isolated vertigo and 179 controls were enrolled. Univariate analysis showed that there were significant differences in left vertebral artery bending degree, basilar artery stenosis rate, previous stroke, dolichoec tatic basilar artery, and left and right vertebral artery hypoplasia between the two groups (all P < 0.05). Multivariate logistic regression analysis showed that previous vertigo (odds ratio [OR] 6.177, 95%confidence interval [CI] 1.945-19.620; P = 0.002), more serious left vertebral artery bending (OR 1.860, 95% CI 1.127-3.069; P =0.015), and left vertebral artery hypoplasia (OR 4.543,95% CI 1.761-11.721; P = 0.002) were the independent risk factors for isolated vertigo, and previous stroke ( OR 0.377, 95% CI 0.162-0.877; P = 0.024), basal artery hypoplasia ( OR 0.401, 95% CI 0.193-0.830; P = 0.014) were its protective factors. Conclusions Previous vertigo, more serious left vertebral artery bending, and left vertebral artery hypoplasia are the independent risk factors for isolated vertigo, and previous stroke and basal artery hypoplasia may be its protective factors.

Objective To investigate the blood-saving effect of tranexamic acid in patients undergoing Stanford type A aortic dissection surgery.Methods Fifty-six patients of both sexes with acute Stanford type A aortic dissection, aged 34-58 yr, weighing 62-84 kg, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ , with their left ventricular ejection fraction ＞ 40％, undergoing emergency surgery, were randomly divided into 2 groups: control group (group C, n=26) and tranexamic acid group (group TA, n=30).Tranexamic acid was infused as a bolus of 10 mg/kg over 30 min before skin incision followed by an infusion of 10 mg · kg-1 · h-1 throughout the surgery in group TA.The equal volume of normal saline was given instead in group C.The total volume of drainage at 24 h after operation, the postoperative requirement of allogeneic red blood cells, fresh frozen plasma and platelets, and re-thoracotomy for bleeding were recorded.The postoperative mechanical ventilation time, duration of intensive care unit stay, and complications after operation were also recorded.Results Compared with group C, the total volume of drainage at 24 h after operation, and the requirement of allogeneic red blood cells, fresh frozen plasma and platelets were significantly reduced, the incidence of rethoracotomy for bleeding was decreased, the postoperative mechanical ventilation time, and duration of intensive care unit stay were shortened, and the incidence of postoperative acute lung injury and transient neurological dysfunction were decreased in group TA.Conclusion Tranexamic acid has blood-saving effect and can reduce postoperative bleeding and allogeneic blood transfusion in patients undergoing Stanford type A aortic dissection surgery.