Objective To summarize the imaging characteristics of occult rib fracture(ORF),analyze the causes of missed diagnosis and misdiagnosis of ORF,and explore strategies to improve the detection rate of ORF.Methods A total of 142 patients with rib fractures who underwent multi spiral computed tomography(MSCT)were selected.The initial examination was conducted within 1 week after the injury,and follow-up examinations were performed at multiple time points after 1 week post-injury.A retrospective analysis was conducted to review the fracture detection and locations during the follow-up period.The time of fracture edge sclerosis or callus growth was observed in the young group(17 cases),middle-aged group(64 cases),and elderly group(61 cases).Results The anterior segment of the ribs was the predilection site for occult fractures,with 199 cases(53.4％).The missed diagnosis rates of fracture were higher for fractures near the costal cartilage segment and the posterior segment of the ribs,with missed diagnosis rates of 49.4％and 58.8％,respectively.Compared with the number of rib fractures identified in the initial examination,there was a statistically significant difference in the number of rib fractures at 3-6 weeks after injury(P＜0.05).The time of local sclerosis or callus growth in the young,middle-aged and elderly groups was(18.76±3.849)d,(26.14±6.597)d,and(37.69±5.726)d,respectively,with statistically significantl differences between the groups(P＜0.05).Conclusion MSCT has certain limits in diagnosing ORF in the short term after injury.Primarily observing the predilection sites and missed sites of occult fractures,systematically recognizing the imaging characteristics of ORF,and adopting the optimal detection-time window for patients of different age groups can reduce the missed diagnosis rate and misdiagnosis rate of ORF and improve the detection rate of fractures.This provides accurate and objective basis for clinical and forensic identification,with significant clinical importance and application value.

Objective:To explore the influence of value orientation brief therapy (VBT) on anxiety and depression symptoms, social function, coping style and self-acceptance level of major depressive disorder adolescents with anxious distress.Methods:From June 2021 to June 2022, seventy adolescent major depressive disorder patients with anxious distress were included in the study, who were randomly divided into study group(35 people, 31 people completed)and control group (35 people, 30 people completed). The study group was given routine treatment combined with VBT, while the control group was given routine treatment only. Before and after treatment, Hamilton anxiety scale(HAMA), Hamilton depression scale (HAMD), social disability screening schedule (SDSS), coping style questionnaire(CSQ) and self-acceptance questionnaire (SAQ) were used to evaluate the two groups, and SPSS 26.0 software was used to statistically analyze the data of the two groups. Paired sample t-test was used for intra-group comparison, and independent sample t-test was used for inter-group comparison. Results:After 6 weeks of treatment, the scores of HAMA((6.03±3.58) vs (14.03±7.06), t=5.55, P<0.01), HAMD((8.77±5.52 ) vs (16.50±7.59), t=4.56, P<0.01)and SDSS((4.23±1.50) vs (6.63±0.96), t=7.43, P<0.01)in the study group were significantly lower than those in the control group, the differences were statistically significant. The scores of self-acceptance((19.23±1.33) vs (13.47±1.46), t=-16.12, P<0.01)and self-evaluation ((19.87±2.87) vs (12.77±1.68), t=-11.75, P<0.01) in the SAQ scale and the scores of problem-solving((8.71±2.30) vs (6.23±3.45), t=3.31, P<0.05) and rationalization ((6.20±3.11) vs (4.67±2.43), t=2.13, P<0.05) in the CSQ questionnaire were significantly higher than those in the control group, the differences were statistically significant. The total effective rate of the study group(90.3%(28/31) vs 66.7%(20/30), χ2=5.09, P<0.05) was significantly higher than that of the control group, the difference was statistically significant. Conclusion:The effect of routine treatment combined with VBT is better, which can effectively improve anxiety and depression symptoms, social function and coping style, and enhance self-acceptance and self-evaluation in adolescent major depressive disorder patients, which is worthy of clinical application.

Objective:To explore the influence of value orientation brief therapy (VBT) on anxiety and depression symptoms, social function, coping style and self-acceptance level of major depressive disorder adolescents with anxious distress.Methods:From June 2021 to June 2022, seventy adolescent major depressive disorder patients with anxious distress were included in the study, who were randomly divided into study group(35 people, 31 people completed)and control group (35 people, 30 people completed). The study group was given routine treatment combined with VBT, while the control group was given routine treatment only. Before and after treatment, Hamilton anxiety scale(HAMA), Hamilton depression scale (HAMD), social disability screening schedule (SDSS), coping style questionnaire(CSQ) and self-acceptance questionnaire (SAQ) were used to evaluate the two groups, and SPSS 26.0 software was used to statistically analyze the data of the two groups. Paired sample t-test was used for intra-group comparison, and independent sample t-test was used for inter-group comparison. Results:After 6 weeks of treatment, the scores of HAMA((6.03±3.58) vs (14.03±7.06), t=5.55, P<0.01), HAMD((8.77±5.52 ) vs (16.50±7.59), t=4.56, P<0.01)and SDSS((4.23±1.50) vs (6.63±0.96), t=7.43, P<0.01)in the study group were significantly lower than those in the control group, the differences were statistically significant. The scores of self-acceptance((19.23±1.33) vs (13.47±1.46), t=-16.12, P<0.01)and self-evaluation ((19.87±2.87) vs (12.77±1.68), t=-11.75, P<0.01) in the SAQ scale and the scores of problem-solving((8.71±2.30) vs (6.23±3.45), t=3.31, P<0.05) and rationalization ((6.20±3.11) vs (4.67±2.43), t=2.13, P<0.05) in the CSQ questionnaire were significantly higher than those in the control group, the differences were statistically significant. The total effective rate of the study group(90.3%(28/31) vs 66.7%(20/30), χ2=5.09, P<0.05) was significantly higher than that of the control group, the difference was statistically significant. Conclusion:The effect of routine treatment combined with VBT is better, which can effectively improve anxiety and depression symptoms, social function and coping style, and enhance self-acceptance and self-evaluation in adolescent major depressive disorder patients, which is worthy of clinical application.

Objective:To explore the current status and influencing factors of intrinsic capacity in elderly patients with Parkinson's disease.Methods:Convenience sampling was used to select 306 elderly patients with Parkinson's disease who attended Xuanwu Hospital of Capital Medical University from March to September 2024 for the study. Influencing factors were screened based on the health ecology model. Elderly patients with Parkinson's disease were surveyed using the General Information Questionnaire, Connor-Davidson Resilience Scale, Family APGAR Scale, Social Support Rating Scale, and Intrinsic Capacity Assessment Tool. Multiple linear regression was used to analyze the factors influencing the total score and the scores of each dimension of intrinsic capacity in elderly patients with Parkinson's disease.Results:A total of 306 questionnaires were distributed and 301 valid questionnaires were recovered, with a valid recovery rate of 98.37% (301/306). The total intrinsic capacity score of 301 elderly patients with Parkinson's disease was (67.21±11.47), of which 297 elderly patients with Parkinson's disease had impaired intrinsic capacity, and the rate of impaired intrinsic capacity was 98.7% (297/301). The dimensions in descending order of impairment were motor [89.7% (270/301) ], mental [76.1% (229/301) ], sensory [70.4% (212/301) ], vitality [38.2% (115/301) ], and cognitive [25.6% (77/301) ]. Multiple linear regression analysis showed that age, Hoehn-Yahr staging, levodopa equivalent dosage, activity of daily living, history of falls, regular exercise, psychological resilience, social support, and monthly income were the factors influencing the total intrinsic capacity score of elderly patients with Parkinson's disease ( P<0.05) and heterogeneity of influencing factors in each dimension. Conclusions:Elderly patients with Parkinson's disease have a high rate of impaired intrinsic capacity, with the motor dimension being the most severely impaired. Healthcare professionals should pay attention to the assessment of the intrinsic capacity of elderly patients with Parkinson's disease, and customize interventions according to the influencing factors to promote the functioning of elderly patients so as to reduce the burden of care on families and society.

Objective To summarize the imaging characteristics of occult rib fracture(ORF),analyze the causes of missed diagnosis and misdiagnosis of ORF,and explore strategies to improve the detection rate of ORF.Methods A total of 142 patients with rib fractures who underwent multi spiral computed tomography(MSCT)were selected.The initial examination was conducted within 1 week after the injury,and follow-up examinations were performed at multiple time points after 1 week post-injury.A retrospective analysis was conducted to review the fracture detection and locations during the follow-up period.The time of fracture edge sclerosis or callus growth was observed in the young group(17 cases),middle-aged group(64 cases),and elderly group(61 cases).Results The anterior segment of the ribs was the predilection site for occult fractures,with 199 cases(53.4％).The missed diagnosis rates of fracture were higher for fractures near the costal cartilage segment and the posterior segment of the ribs,with missed diagnosis rates of 49.4％and 58.8％,respectively.Compared with the number of rib fractures identified in the initial examination,there was a statistically significant difference in the number of rib fractures at 3-6 weeks after injury(P＜0.05).The time of local sclerosis or callus growth in the young,middle-aged and elderly groups was(18.76±3.849)d,(26.14±6.597)d,and(37.69±5.726)d,respectively,with statistically significantl differences between the groups(P＜0.05).Conclusion MSCT has certain limits in diagnosing ORF in the short term after injury.Primarily observing the predilection sites and missed sites of occult fractures,systematically recognizing the imaging characteristics of ORF,and adopting the optimal detection-time window for patients of different age groups can reduce the missed diagnosis rate and misdiagnosis rate of ORF and improve the detection rate of fractures.This provides accurate and objective basis for clinical and forensic identification,with significant clinical importance and application value.

Objective:To explore the current status and influencing factors of intrinsic capacity in elderly patients with Parkinson's disease.Methods:Convenience sampling was used to select 306 elderly patients with Parkinson's disease who attended Xuanwu Hospital of Capital Medical University from March to September 2024 for the study. Influencing factors were screened based on the health ecology model. Elderly patients with Parkinson's disease were surveyed using the General Information Questionnaire, Connor-Davidson Resilience Scale, Family APGAR Scale, Social Support Rating Scale, and Intrinsic Capacity Assessment Tool. Multiple linear regression was used to analyze the factors influencing the total score and the scores of each dimension of intrinsic capacity in elderly patients with Parkinson's disease.Results:A total of 306 questionnaires were distributed and 301 valid questionnaires were recovered, with a valid recovery rate of 98.37% (301/306). The total intrinsic capacity score of 301 elderly patients with Parkinson's disease was (67.21±11.47), of which 297 elderly patients with Parkinson's disease had impaired intrinsic capacity, and the rate of impaired intrinsic capacity was 98.7% (297/301). The dimensions in descending order of impairment were motor [89.7% (270/301) ], mental [76.1% (229/301) ], sensory [70.4% (212/301) ], vitality [38.2% (115/301) ], and cognitive [25.6% (77/301) ]. Multiple linear regression analysis showed that age, Hoehn-Yahr staging, levodopa equivalent dosage, activity of daily living, history of falls, regular exercise, psychological resilience, social support, and monthly income were the factors influencing the total intrinsic capacity score of elderly patients with Parkinson's disease ( P<0.05) and heterogeneity of influencing factors in each dimension. Conclusions:Elderly patients with Parkinson's disease have a high rate of impaired intrinsic capacity, with the motor dimension being the most severely impaired. Healthcare professionals should pay attention to the assessment of the intrinsic capacity of elderly patients with Parkinson's disease, and customize interventions according to the influencing factors to promote the functioning of elderly patients so as to reduce the burden of care on families and society.

【Objective】 To investigate the effect of two different oral calcium supplementation methods(method 1: bone health basic supplements in the interval plus routine calcium supplement; method 2: only routine calcium supplement on the day of donation)on platelet donors, to improve some biochemical indexes of the body caused by citrate anticoagulant. 【Methods】 A total of 252 long-term regular platelet donors in our station from January 2019 to December 2020 were selected and randomly divided into two groups: experimental group (n=126) were given 10% calcium gluconate oral solution 20 mL before platelet collection, orally. Oral caltrate D3 (containing 600 mg calcium carbonate and 125 international units of vitamin D3) was administered in the interval (20±2 days), 1 tablet per day. Oral alfacalcidol soft capsule (containing alfacalcidol 0.25 μg), 1 tablet per day; control group (n=126) were given routine administration of 10% calcium gluconate oral solution 20 mL before platelet collection. Serum PTH and serum concentrations of calcium, magnesium, phosphorus and 25 hydroxyvitamin D of the two groups were detected at 0 min after injection and 0 min after the end of the last circulation, respectively. Meanwhile, the occurrence of blood donation reactions was observed in the two groups. 【Results】 In the experimental group and control group, serum PTH concentration both increased significantly after donation, while serum calcium, inorganic phosphorus, magnesium and 25 hydroxyvitamin D decreased significantly(P<0.01). After donation, 4 donors in the experimental group and 8 in the control group showed citrate reaction, with the incidence of adverse reactions at 3.17%(4/126)and 6.34%(8/126), respectively. Before blood collection, serum calcium concentration in the experimental group was higher than that in the control group, while PTH concentration was lower than that in the control group (P<0.01), but no significant differences were noticed in serum magnesium, inorganic phosphorus and 25 hydroxyl vitamin D concentrations (P>0.05), and so was in the control group after blood collection. 【Conclusion】 Method 1 can further slow down the increase of serum PTH and the decrease of serum calcium, and can effectively reduce the citrate response of blood donors compared with method 2, which is of great significance to prevent osteoporosis in long-term regular blood donors.