Objective To investigate the value of MRI of the sternal end of clavicle in bone age assessment in Chinese population,especially its applicability in the determination of criminal responsible age.Methods A total of 431 patients aged from 10.00 to 29.99 years with neck or chest MRI were retrospectively collected.According to the Schmeling grading method,the epiphyseal development of the clavicle MRI was divided into five grades.The consistency of methods was evaluated.The correlation and general descriptive analysis between MRI grades and age was analyzed.The sex difference was analyzed.Curve fitting was used to establish a nonlinear model between age and grades.Results The grades of clavicle MRI showed a significant age-related trend(Figure 2),and the correlation was 0.861(0.887 in males and 0.840 in females).Except for grade 1,there was no significant difference between males and females in other grades.The minimum age of male grade 3 was greater than 14 years old,and the minimum age of female grade 3 was greater than 16 years old.The minimum age in grade 4 and grade 5 was over 18 years old in both sexes.The best curve fitting model was cubic model for both sexes(R2=0.805 for men and 0.722 for women).Conclusion Clavicle MRI can be used for the assessment of bone age in Chinese population.Complete epiphyseal plate closure can be used as a reliable indicator for the determination of age at 18 years old,and it is expected to achieve radiation-free forensic bone age assessment.

Objective To investigate the value of MRI of the sternal end of clavicle in bone age assessment in Chinese population,especially its applicability in the determination of criminal responsible age.Methods A total of 431 patients aged from 10.00 to 29.99 years with neck or chest MRI were retrospectively collected.According to the Schmeling grading method,the epiphyseal development of the clavicle MRI was divided into five grades.The consistency of methods was evaluated.The correlation and general descriptive analysis between MRI grades and age was analyzed.The sex difference was analyzed.Curve fitting was used to establish a nonlinear model between age and grades.Results The grades of clavicle MRI showed a significant age-related trend(Figure 2),and the correlation was 0.861(0.887 in males and 0.840 in females).Except for grade 1,there was no significant difference between males and females in other grades.The minimum age of male grade 3 was greater than 14 years old,and the minimum age of female grade 3 was greater than 16 years old.The minimum age in grade 4 and grade 5 was over 18 years old in both sexes.The best curve fitting model was cubic model for both sexes(R2=0.805 for men and 0.722 for women).Conclusion Clavicle MRI can be used for the assessment of bone age in Chinese population.Complete epiphyseal plate closure can be used as a reliable indicator for the determination of age at 18 years old,and it is expected to achieve radiation-free forensic bone age assessment.

Objective:To compare the clinical and ultrasonic features of elderly-onset rheumatoid arthritis(EORA)and young-onset rheumatoid arthritis(YORA).Methods:A total of 104 patients diagnosed with rheumatoid arthritis were categorized into two groups based on their age of onset: the EORA group, consisting of 70 patients, and the YORA group, consisting of 34 patients.A comparative analysis was conducted on the clinical manifestations, laboratory findings, and ultrasonic images of patients in these two groups.Results:The male ratio in the EORA group was significantly higher than that in the YORA group(24.3% vs.8.8%, P=0.048).There were no statistical differences in the course of disease, DAS28, ESR, CRP, RF, and anti-CCP antibody positive rates between the two groups( P>0.05)when compared with the YORA group.The incidence of osteoarthritis and osteoporosis in the EORA group was significantly higher than that in the YORA group( P=0.018, P=0.011).Ultrasonic results revealed a significantly higher incidence of phalangeal bone erosion in the EORA group compared to the YORA group(14.9% vs.4.3%, P<0.01).Binary logistic regression analysis indicated that different age groups, disease duration, osteoarthritis, and osteoporosis did not have an effect on the ultrasonic changes of synovial hyperplasia, tendonitis, tenosynovitis, and bone erosion in RA patients. Conclusions:There is no significant difference in the clinical disease activity and disease progression between EORA group and YORA group.Additionally, the pattern of joint inflammation involvement is similar in both groups.Ultrasound examinations revealed a higher incidence of bone erosion in finger joints of EORA patients compared to YORA patients.

Objective:To explore the intervention effect of preventive nursing combined with function training on bladder function recovery in patients after transurethral resection of prostate.Methods:A non-randomized historical control study was used, 29 patients who received benign prostatic hyperplasia surgery and postoperative bladder function training in Lu′an Traditional Chinese Medicine Hospital from January 2021 to July 2022 were classified as control group, and 31 patients with benign prostatic hyperplasia surgery who received postoperative preventive nursing based on summary of influencing factors combined with bladder function training from August 2022 to February 2024 were included in combined group. Bladder function [bladder compliance (BC), maximum bladder storage capacity (VM-CC), maximum urine flow (Qmax), post-void residual urine volume (PVR)], incidence rate of bladder spasm, number of indewelling catheter days,comfort [Kolcaba comfort status scale (GCQ)] and quality of life [benign prostatic hyperplasia quality of life scale (BPHQLS)] were compared between groups at 3 months after surgery.Results:The age of the control group was (71.97 ± 3.99) years, (71.77 ± 2.92) years in the combined group, the baseline data were balanced.Conclusions:Preventive nursing combined with bladder function training can effectively improve the postoperative bladder function, reduce the risk of bladder spasm, and enhance the comfort and quality of life in patients with benign prostatic hyperplasia surgery, and it has application value.

Objective:To explore the effects of multidisciplinary pain management in patients with cesarean scar pregnancy (CSP) undergoing uterine artery embolization (UAE) .Methods:Totally 140 CSP patients who underwent UAE in Nantong Maternity and Child Health Care Hospital, Nantong University from January 2019 to March 2021 were selected by convenient sampling and divided into the observation group and control group according to the random number table, with 70 patients in each group. Patients in the control group received routine care, while patients in the observation group underwent multidisciplinary pain management. The stress response-related indicators, complication rates, and pain control satisfaction were compared between the two groups.Results:The heart rate, systolic blood pressure, visual analog pain score, and anxiety score of the observation group were lower than those of the control group, and the Brinell comfort score was higher than that of the control group, with statistically significant differences ( P<0.05) . The total incidence of complications in the observation group was 8.57% (6/70) , which was lower than 21.43% (15/70) in the control group, and the difference was statistically significant ( P<0.05) . The total satisfaction with pain control in the observation group was 91.43% (64/70) , which was higher than 75.71% (53/70) in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The multidisciplinary pain management is beneficial to relieve the degree of stress response of patients, reduce the occurrence of complications, and improve the satisfaction with pain control.

Objective:To evaluate the effects of comprehensive rehabilitation nursing based on guided education and training on rehabilitation treatment in school-age children with drug-resistant epilepsy undergoing epileptogenic focus resection.Methods:Fifty movement disorders school-age children with drug-resistant epilepsy undergoing epileptogenic focus resection in Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University from January 2017 to December 2019 were enrolled in this study. The child patients were divided into the control group and the observation group according to the order of admission, with 25 cases in each group, and the control group was from January 2017 to June 2018 while the observation group was from July 2018 to December 2019. In the control group, routine nursing after epileptogenic focus resection and functional exercise were conducted. The observation group was treated with comprehensive rehabilitation nursing based on guided education and training. On the third day after operation, the day of discharge respectively, the motor function and activity of daily living of the two groups were evaluated. The satisfaction of children′s parents on nursing was compared between the two groups.Results:The scores of motor function on the third day after operation and the day of discharge were (57.0 ± 6.8), (73.0 ± 5.4) points respectively in the observation group, and those in the control group were (55.0 ± 5.6), (65.6 ± 5.9) points. There were significant differences intra group comparison ( t=-9.26, -6.48, both P<0.05). The activity of daily living scores on the third day after operation and the day of discharge were (45.2 ± 5.9), (74.2 ± 8.3) points respectively in the observation group, and those in the control group were (44.0 ± 5.8), (60.2 ± 7.6) points. There were significant differences intra group comparison ( t=-14.33, -8.51, both P<0.05). There were significant differences between the scores of motor function and the ability of daily living scores on the day of discharge in the observation group and the control group ( t values were -4.65, -6.25, both P<0.05). The satisfaction of children′s parents on nursing in the observation group and the control group were 96.0% (24/25), 72.0% (18/25) respectively. There was significant difference between the two groups ( χ 2=8.78, P<0.05). Conclusions:Rehabilitation nursing based on guided education and training can improve motor function and ability of daily living in movement disorders school-age children with drug-resistant epilepsy undergoing epileptogenic focus resection, promote the functional recovery of children after surgery and increase the satisfaction of children′s parents on nursing.

Objective To investigate the epidemiological characteristics of outpatients exposed to rabies and to analyze the post-exposure prophylaxis in Weinan City in 2017 in order to provide a scientific basis for the prevention of rabies. Methods Clinical data of all outpatients with exposure to rabies in Wei-nan were collected. Ecxcel 2007 was used for data entry and SPSS13. 0 for Chi-square test. Results A total of 32 094 cases were reported with an annual exposure rate of 625. 64/100 000 in Weinan in 2017. Animal bites mainly occurred in spring and summer,accounting for 47. 47% of the total cases in 2017. There were statistically differences in exposure rate among different age groups (χ2=15. 858,P=0. 003). Farmers ac-counted for the largest proportion of the outpatients exposed to rabies (52. 34% ). Among 31 435 outpatients, 28 181(89. 65% ) received wound care and rabies vaccination. The vaccination rate of rabies immunoglobu-lin for patients with gradeⅢ exposure was 46. 93%. Conclusion Comprehensive measures with focuses on compulsory vaccination for domestic dogs and adoption of stray dogs should be implemented to prevent human rabies. Meanwhile,health education rabieson prevention and control should also be strengthened.

Objective To assess the effects of different doses of oxycodone hydrochloride on spontaneous breathing and consciousness level of patients,so as to provide theoretical basis for its clinical application.Sixty patients undergoing elective surgery were randomly divided into 3 groups:0.05 mg · kg-1 oxycodone group (group P1),0.1 mg· kg-1 oxycodone group (group P2),0.2 mg· kg-1 oxycodone group (group P3).Changes of respiratory rate (RR),end tidal carbon dioxide partial pressure (PETCO2),saturation of blood oxygen (SpO2) and bispectral index (BIS) were recorded in patients before injection (t0) and 1-15 min after injection (once per min);the Observer's Assessment of Alertness/Sedation Scale (OAA/S) were recorded.At the same time,the adverse reactions were observed after drug injection in each group.Results In 10 min after injection there were no significant differences in the RR,SpO2,PETCO2,BIS and OAA/S in group P1 as compared with those before injection (P＞0.05).The patients had no respiratory depression in group P1.In group P2,RR had a significant decrease (P＜0.05),BIS had decreased but were greater than 85;there were no significant differences in the SpO2,PETCO2 and OAA/S (P＞0.05).The P2 group had 3 cases with respiratory frequency＜10 per min,but SpO2 were all greater than 94％.In group P3,There were significant differences in the RR,SpO2,PETCO2,BIS and OAA/S (P＜0.05).The P3 group had 12 cases of respiratory frequency ＜10 per min,at the same time there were 8 patients with SpO2 less than 94％.With the increasing dose,the frequency of respiratory inhibition increased,and there were statistical differences (P＜ 0.05).In 15 min after injection,RR,SpO2,PETCO2,BIS and OAA/S were not significantly different in group P1 and P2 as compared with those before injection (P＞0.05).In group P3,RR was significantly different after injection (P＜0.05).There were no significant differences in the SpO2,PETCO2,BIS and OAA/S in group P3 after injection (P＞0.05).No patients complained with chest wall stiffness,nausea and vomiting,cough and other adverse reactions in group P 1 and P2.In group P3,three patients had nausea 5 min after injection,two patients complained of chest skin itching but no skin flushing.Conclusion With the increasing dose,effect of oxycodone hydrochloride on breathing and consciousness level of patients gradually increased.Injection of oxycodone hydrochloride 0.05 mg · kg-1 had no obvious effect on breathing and consciousness.After injection of oxycodone hydrochloride 0.1 and 0.2 mg · kg-1 for 5 to 10 min,respiration inhibition and sedative effect were the most obvious.Fifteen min after injection,the 0.1 mg · kg-1 dose group recovered to the level before,the respiratory rate of the 0.2 mg · kg-1 dose group was still lower than that before the injection.

Objective To observe the therapeutic effect of ear-acupuncture therapy for intractable hiccups in the patients treated with endovascular embolization for bleeding from spontaneous rupture of liver cancer. Methods A total of 60 patients with intractable hiccups after endovascular embolization for bleeding from spontaneous rupture of liver cancer were randomly divided two groups using a random digit table, 30 in each group. The patients in the control group were treated breath holding combined with oral baclofen, and those in the observation group with ear-acupuncture therapy for 5 days, and then both groups were followed up for 1 week. The Karnofsky Performance Status Scale (KPS) was used for quality of life evaluation. The adverse events and recurrence during the treatment and the followed up were recorded. The therapeutic effect was evaluated. Results Total effective rate (100% vs. 76.7%; χ2=5.822, P=0.016)in the observation group was significantly higher than that in the control group. The rate of adverse events (6.7% vs. 33.3%; χ2=5.104, P=0.024)in the observation group were significantly lower than that in the control group. There was no significant difference in the KPS scores after treatment between the observation group and the control group (82.1 ± 12.6 vs. 76.5 ± 17.8; t=1.407, P=0.165). Conclusions Ear-acupuncture therapy may efficiently alleviate intractable hiccups in patients treated with endovascular embolization for bleeding from spontaneous rupture of liver cancer, and superior to breath holding combined with oral baclofen.

Objective:To figure out the development status of group psychotherapy and its problems and trends in China.Methods:Properties and contents,intervention programs and methods of 386 chosen articles from key journals of psychology and Doctor & Master Thesis in the group psychotherapy area were examined with bibliometric analyses and content analysis.Result:It showed a fast increase in properties and contents for the last 15 years.The proportion of clinical and sub-clinical study was 1 ∶ 4.Totally 53.9％ of studies focused on anxiety and depression,89.4％ were quantitative studies and 86.9％ were effect studies.As for the intervention programs,36.5％ were CBT,90.0％ were short-term treatment group below 12 times,35.6％ were lack of details in introductions and 67.8％ had other missing descriptions of group leader.As for the methods,34.9％ of participants were undergraduates,experimental (34.9％) and comprehensive (44.6％) methods were dominant,and difference test (58.3％) was most widely used statistical analysis.The self-report effect evaluation accounted for about 91.4％,and the follow-up studies were less than 22％.Totally 42.9％ of studies were lack of ethical consideration.Conclusion:The status of group psychotherapy in China is still in its early developmental phase,which need further standardization and improvement.