Objective:To develop a maternal assessment scale integrating both positive (affirmation, optimism, self-confidence) and negative psychological states (fear, anxiety, depression) throughout the entire pregnancy cycle and evaluate its reliability and validity.Methods:In December 2020, the scale items were preliminarily identified through a literature review, forming a 55-item questionnaire for pilot survey and expert interviews. A pilot survey was conducted among registered pregnant women at the Obstetrics and Gynecology Hospital of Fudan University from April to May 2021. The feasibility and reliability of the questionnaire was validated through reliability and validity analysis, and revisions were made based on the feedback. The finalized version comprised 43 items, categorized into four key event dimensions (pregnancy, childbirth, transition to motherhood, and complications) and six psychological state dimensions (affirmation, fear, anxiety, depression, optimism, and self-confidence). Among these psychological states, affirmation, self-confidence, and optimism represent positive states, while fear, anxiety, and depression reflect negative states. A formal survey was conducted from December 2021 to November 2022. The normality, multicollinearity, reliability, construct validity, convergent validity, and discriminant validity of each item were analyzed.Results:(1) General information: A total of 625 participants were involved in the pilot survey. For the formal survey, 8 045 questionnaires were distributed, with 6 273 valid responses (78.0%). Among the valid questionnaires, 5 694 (90.8%) reported positive psychological states and 579 (9.2%) negative states. All of the psychological state dimensions were correlated (all P<0.01), with no multicollinearity detected [variance inflation factor (VIF)<10]. The four key event dimensions were also correlated (all P<0.01), with no multicollinearity (VIF<10). (2) Reliability: The overall Cronbach's α coefficient of the questionnaire was 0.830, and removing any single item resulted in the value remaining>0.6. Cronbach's α coefficient values for affirmation, fear, anxiety, depression, optimism, and self-confidence were 0.772, 0.724, 0.648, 0.551, 0.257, and 0.740, respectively. The values for the key event dimensions were as follows: 0.722 for pregnancy, 0.554 for childbirth, 0.621 for transition to motherhood, and 0.568 for complications. (3) Model fit: For the psychological states, the Chi-square to degrees of freedom ratio ( χ2/df) was 19.979 (>3), and the root mean square error of approximation (RMSEA) was 0.055 (<0.08). The model of key event dimensions had a χ2/df of 48.557, RMSEA of 0.087, comparative fit index of 0.400 (<0.9), and incremental fit index of 0.400 (<0.9). (4) Convergent and discriminant validity: The average variance extraction (AVE) values for affirmation, fear, anxiety, depression, optimism, and self-confidence were 0.407, 0.099, 0.188, 0.223, 0.419, and 0.362, with composite reliability (CR) values of 0.822, 0.730, 0.655, 0.584, 0.627, and 0.786, respectively. In the model of key event dimensions, the AVE values for pregnancy, childbirth, transition to motherhood, and complications were 0.167, 0.287, 0.328, and 0.166, with CR values of 0.555, 0.832, 0.746, and 0.633, respectively. Significant correlations were observed between all psychological dimensions except optimism-depression and self-confidence-anxiety pairs (all P<0.05). All four key event dimensions were significantly correlated (all P<0.05). Conclusions:This study preliminarily develops a maternal psychological status assessment scale with satisfactory reliability and validity. This scale can be used to evaluate the comprehensive psychological states of pregnant women during critical pregnancy-related events.

Fetal lingual lesion is a rare category of embryological anomalies, characterized by distinctive anatomical positioning, which may precipitate mechanical airway obstruction to unfavorable perinatal outcomes. There is a lack of comprehensive prenatal diagnostic strategies and effective treatments. This review has conducted a systematic literature overview of the clinical classification of fetal lingual anomalies, prenatal diagnosis, and perinatal treatment, including prenatal ultrasonography and magnetic resonance imaging, for optimizing perinatal care and obtaining an improved pregnancy outcome. Utilizing a multidisciplinary team framework, individualized peripartum management strategies are developed, contingent upon the presence or absence of airway compromise, with selective application of the ex-utero intrapartum treatment procedure as clinically warranted. By refining diagnostic accuracy and advancing therapeutic protocols, this review aims to elevate clinical management standards for congenital lingual lesions, thereby enhancing both short-term perinatal outcomes and long-term developmental prognoses.

Fetal lingual lesion is a rare category of embryological anomalies, characterized by distinctive anatomical positioning, which may precipitate mechanical airway obstruction to unfavorable perinatal outcomes. There is a lack of comprehensive prenatal diagnostic strategies and effective treatments. This review has conducted a systematic literature overview of the clinical classification of fetal lingual anomalies, prenatal diagnosis, and perinatal treatment, including prenatal ultrasonography and magnetic resonance imaging, for optimizing perinatal care and obtaining an improved pregnancy outcome. Utilizing a multidisciplinary team framework, individualized peripartum management strategies are developed, contingent upon the presence or absence of airway compromise, with selective application of the ex-utero intrapartum treatment procedure as clinically warranted. By refining diagnostic accuracy and advancing therapeutic protocols, this review aims to elevate clinical management standards for congenital lingual lesions, thereby enhancing both short-term perinatal outcomes and long-term developmental prognoses.

Objective:To develop a maternal assessment scale integrating both positive (affirmation, optimism, self-confidence) and negative psychological states (fear, anxiety, depression) throughout the entire pregnancy cycle and evaluate its reliability and validity.Methods:In December 2020, the scale items were preliminarily identified through a literature review, forming a 55-item questionnaire for pilot survey and expert interviews. A pilot survey was conducted among registered pregnant women at the Obstetrics and Gynecology Hospital of Fudan University from April to May 2021. The feasibility and reliability of the questionnaire was validated through reliability and validity analysis, and revisions were made based on the feedback. The finalized version comprised 43 items, categorized into four key event dimensions (pregnancy, childbirth, transition to motherhood, and complications) and six psychological state dimensions (affirmation, fear, anxiety, depression, optimism, and self-confidence). Among these psychological states, affirmation, self-confidence, and optimism represent positive states, while fear, anxiety, and depression reflect negative states. A formal survey was conducted from December 2021 to November 2022. The normality, multicollinearity, reliability, construct validity, convergent validity, and discriminant validity of each item were analyzed.Results:(1) General information: A total of 625 participants were involved in the pilot survey. For the formal survey, 8 045 questionnaires were distributed, with 6 273 valid responses (78.0%). Among the valid questionnaires, 5 694 (90.8%) reported positive psychological states and 579 (9.2%) negative states. All of the psychological state dimensions were correlated (all P<0.01), with no multicollinearity detected [variance inflation factor (VIF)<10]. The four key event dimensions were also correlated (all P<0.01), with no multicollinearity (VIF<10). (2) Reliability: The overall Cronbach's α coefficient of the questionnaire was 0.830, and removing any single item resulted in the value remaining>0.6. Cronbach's α coefficient values for affirmation, fear, anxiety, depression, optimism, and self-confidence were 0.772, 0.724, 0.648, 0.551, 0.257, and 0.740, respectively. The values for the key event dimensions were as follows: 0.722 for pregnancy, 0.554 for childbirth, 0.621 for transition to motherhood, and 0.568 for complications. (3) Model fit: For the psychological states, the Chi-square to degrees of freedom ratio ( χ2/df) was 19.979 (>3), and the root mean square error of approximation (RMSEA) was 0.055 (<0.08). The model of key event dimensions had a χ2/df of 48.557, RMSEA of 0.087, comparative fit index of 0.400 (<0.9), and incremental fit index of 0.400 (<0.9). (4) Convergent and discriminant validity: The average variance extraction (AVE) values for affirmation, fear, anxiety, depression, optimism, and self-confidence were 0.407, 0.099, 0.188, 0.223, 0.419, and 0.362, with composite reliability (CR) values of 0.822, 0.730, 0.655, 0.584, 0.627, and 0.786, respectively. In the model of key event dimensions, the AVE values for pregnancy, childbirth, transition to motherhood, and complications were 0.167, 0.287, 0.328, and 0.166, with CR values of 0.555, 0.832, 0.746, and 0.633, respectively. Significant correlations were observed between all psychological dimensions except optimism-depression and self-confidence-anxiety pairs (all P<0.05). All four key event dimensions were significantly correlated (all P<0.05). Conclusions:This study preliminarily develops a maternal psychological status assessment scale with satisfactory reliability and validity. This scale can be used to evaluate the comprehensive psychological states of pregnant women during critical pregnancy-related events.

Objective:To explore the application effect of slope adjustment mattresses in the position management of pediatric intensive care unit (PICU) mechanically ventilated children, in order to seek methods for maintaining effective posture in clinical practice.Methods:This was a quasi-experimental study. In this study, the mechanically ventilated children in PICU of Hunan Children′s Hospital from January 1 to December 31, 2022 were selected by convenient sampling method and divided into control group ( n=21) and experimental group ( n=21) according to random number table. Children in control group used the hospital bed and the traditional posture management, and children in experimental group used the slope adjustment mattress for posture management. The comfort scores, mechanical ventilation time, PICU length of stay, postural decline, unplanned extubation and blood gas analysis index were compared between the two groups. Results:There were 21 cases were admitted in each group ultimately. In the control group, there were 10 males and 11 females, the age was (31.43 ± 27.01) months. There were 11 males and 10 females in the experimental group, the age was (24.57 ± 24.20) months. The comfort scores of the experimental group were (13.57 ± 0.93) and (12.52 ± 0.60) points at the 24 hour and 72 hour respectively; while the comfort scores of the control group were (16.05 ± 1.72) and (15.81 ± 1.66) points at the 24 hour and 72 hour respectively. There were significant differences between the two groups ( t=5.82, 8.52, both P<0.05). The mechanical ventilation time was (5.43 ± 2.48) d, the PICU length of stay was (9.29 ± 3.04) d, and the number of postural decline was (7.52 ± 2.06) times in the experimental group which was superior to control group (8.52 ± 4.65) d, (12.71 ± 6.76) d, (14.95 ± 6.86) times, the differences were significant ( t=2.69, 2.12, 4.75, all P<0.05). There were 0 case of unplanned extubation in the experimental group and 4 cases of unplanned extubation in the control group .The difference was significant ( χ2=5.97, P<0.05). For blood gas analysis, PaCO 2 on the second day were (56.90 ± 6.77) mmHg (1 mmHg=0.133 kPa) in the control group, and (48.67 ± 8.13) mmHg in the experimental group; PaO 2, oxygenation index, PaCO 2 on the third day were (91.19 ± 16.27), (278.19 ± 71.54), (51.62 ± 4.73) mmHg in the control group, and (110.43 ± 21.73), (347.33 ± 90.95), (40.24 ± 5.57) mmHg in the experimental group, the differences were significant ( t values were 7.50-51.00, all P<0.05). There were significant differences about blood gas analysis of time interaction, inter-group interaction, time and inter-group interaction were compared between the two groups ( F values were 3.62-66.38, all P<0.05). Conclusions:Slope adjustment mattresses can maintain effective posture, improve comfort, shorten PICU hospital stay and mechanical ventilation time, significantly reduce posture decline and the risk of unplanned tube withdrawal adverse events in PICU mechanically ventilated children. Improving ventilation and ventilation disorders to enhance blood gas analysis indicators.This appliance can be used as an optimized choice for posture management and expected to effectively improve the quality of nursing care.

Objective To investigate the clinical value of ultrasound examination of carpal canal structure in patients with mild hand-arm vibration disease.Methods A total of 29 patients (58 wrists) with mild hand-arm vibration disease who were treated in Shenzhen Prevention and Treatment Center for Occupational Diseases from May to December,2015 were enrolled as observation group,and 20 healthy volunteers (40 wrists) were enrolled as the control group.Color Doppler ultrasound was used to observe the morphology and echo of the median nerve in the carpal canal and 9 muscle tendons and transverse carpal ligament.The thickness of transverse carpal ligament and diameter of the median nerve at the level of the hamulus of hamate bone were measured,as well as the cross-sectional area of the median nerve at the level of pisiform bone.Results In the 29 patients with hand-arm vibration disease patients in the observation group,8 experienced entrapment of the median nerve in the carpal canal,among whom 5 had entrapment in both wrists;there were 13 wrists (23％) with nerve entrapment and 45 wrists (77％) without nerve entrapment.Compared with the control group,the patients with hand-arm vibration disease and nerve entrapment in the observation group showed significant thickening of the transverse carpal ligament at the level of the hamulus of hamate bone and a significant increase in the crosssectional area of the median nerve at the level of pisiform bone (P＜0.05),while there were no significant differences in the thickness of transverse carpal ligament at the level of the hamulus of hamate bone and the crosssectional area of the median nerve at the level of pisiform bone (t=-9.397 and-4.385,both P＞0.05).Conclusion Ultrasound examination can clearly show the radiological changes of carpal canal contents in patients with mild hand-arm vibration disease and has a certain diagnostic value in nerve damage in patients with hand-arm vibration disease.

Objective To investigate the clinical value of ultrasound examination of carpal canal structure in patients with mild hand-arm vibration disease.Methods A total of 29 patients (58 wrists) with mild hand-arm vibration disease who were treated in Shenzhen Prevention and Treatment Center for Occupational Diseases from May to December,2015 were enrolled as observation group,and 20 healthy volunteers (40 wrists) were enrolled as the control group.Color Doppler ultrasound was used to observe the morphology and echo of the median nerve in the carpal canal and 9 muscle tendons and transverse carpal ligament.The thickness of transverse carpal ligament and diameter of the median nerve at the level of the hamulus of hamate bone were measured,as well as the cross-sectional area of the median nerve at the level of pisiform bone.Results In the 29 patients with hand-arm vibration disease patients in the observation group,8 experienced entrapment of the median nerve in the carpal canal,among whom 5 had entrapment in both wrists;there were 13 wrists (23％) with nerve entrapment and 45 wrists (77％) without nerve entrapment.Compared with the control group,the patients with hand-arm vibration disease and nerve entrapment in the observation group showed significant thickening of the transverse carpal ligament at the level of the hamulus of hamate bone and a significant increase in the crosssectional area of the median nerve at the level of pisiform bone (P＜0.05),while there were no significant differences in the thickness of transverse carpal ligament at the level of the hamulus of hamate bone and the crosssectional area of the median nerve at the level of pisiform bone (t=-9.397 and-4.385,both P＞0.05).Conclusion Ultrasound examination can clearly show the radiological changes of carpal canal contents in patients with mild hand-arm vibration disease and has a certain diagnostic value in nerve damage in patients with hand-arm vibration disease.

“Mechanical memory” approach was commonly used in the knowledge learning of traditional Chinese medicine, which makes students often feel that the knowledge is too abstract, and this method is thus ineffective. “Qihuang the way” using Unity 3D game development platform inte-grates the elements of medical knowledge of the Chinese medical history, and combines TCM theoretical knowledge learning with serious games , which can help invoke students' enthusiasm and improve learning efficiency in an entertaining way.

Objective To analyze the ultrasonographic features of fetal palate in the second and third trimester. Methods Two-dimensional ultrasound was performed in 1 885 fetuses during 21 to 36 gestational weeks of pregnancy, including 1 023 cases in 2nd trimester and 862 cases in 3nd trimester. The normal fetal palate ultrasound images were conifrmed by postnatal examination. In the ultrasound examination, fetal palate coronary plane was scanned through submandibular region, oral ifssure and prootic region;longitudinal plane was scanned through oral ifssure. The detection rate of completely and continuously displayed fetal palate was calculated. Results In prenatal ultrasonography, the normal fetal hard palate was shown as a bright band and the normal soft palate as a hypoechoic band in coronary section through fetal submandibular region, oral ifssure and prootic region. The detection rate was 76%(777/1 023)in 2nd trimester group and 53%(458/862) in 3rd trimester group. The normal fetal palate was shown as continuous camber echogenic band in longitudinal plane through oral ifssure. The detection rate was 49%(501/1 023) in 2nd trimester group and 13%(113/862) in 3rd trimester group. The detection rate was 94%(961/1 023) in 2nd trimester group and 56%(483/862) in 3rd trimester group by the combination of two scanning approaches. Conclusions There is usually an obvious gap between mandible gristles in 2nd trimester fetus. Fetal palate is accessible regardless of fetal head position by coronary scanning through submandibular region, oral ifssure and prootic region and longitudinal scanning through oral ifssure. These planes could display fetal palate well, and might be useful in detecting isolated secondary cleft palate. But these scanning approaches and planes might not suitable for routine screening due to operator dependence.

Objective To investigate the clinical effect of different fixed way of tumor chemotherapy patients with PICC .Methods Totals of 90 patients during June 2009 to June 2012 were randomly divided into experimental group and control group , with 45 cases in each group .Experimental group used the puncture vascular direction fixing way ,while control group used the “S” shape traditional fixed method .The breakage of catheter, catheter-related complications, patients ’ satisfaction and comfort of two groups were observed . Results In experimental group , catheter fracture rate was significantly lower than that in control group , and the difference was statistically significant (4.4% vs 20.0%, χ2 =5.075, P=0.024).Local bleeding occurred cases in experimental group were significantly less than that in control group (1 vs 9,χ2 =7.200,P=0.007). While phlebitis , catheter related infection , catheter obstruction , the complications such as tube out between two groups, no statistically significant difference was found (P>0.05).Experimental group had lower patients ’ satisfaction and comfort scores than control group , and the difference was statistically significant [(1.02 ±0.27) vs (2.16 ±0.35),(1.32 ±0.61) vs (2.45 ±0.67), t =1.173,1.528,respectively; P <0.05]. Conclusions Using the puncture vascular direction fixing way can reduce the local bleeding of PICC application and maintenance process , at the same time can prevent the PICC catheter fracture and increase patients ’ satisfaction and comfort in clinic .It is worth promoting clinically .