Objective:To investigate the effect of ultrasound-guided sciatic nerve block via lateral suprapopliteal approach on postoperative pain and motor function in elderly patients undergoing total knee arthroplasty(TKA).Methods:A retrospective analysis was conducted on 83 patients who underwent TKA at our hospital from December 2021 to November 2024.Patients were divided into two groups based on postoperative analgesia methods:the control group(n=41)and the observation group(n=42).Both groups received the combined spinal-epidural.The observation group received the ultrasound-guided sciatic nerve block via lateral suprapopliteal approach combined with intravenous analgesics,and the control group only adopted intravenous analgesics.The general data,Visual Analog Scale(VAS)scores at different time points,first press time and number of the analgesic pump on vein,the time to first ambulation,Fugl-Meyer Assessment(FMA)score of lower limb and the incidence of adverse reactions between two groups were analyzed.Results:The VAS scores at the rests of 12 h,24 h,36 h,and 48 h,and at the motion after surgery in observation group were significantly lower than those in the control group,with statistically significant differences(t=3.124,11.617,12.886,4.474,5.235,12.187,5.028,5.119,P<0.05).The number of first press of the analgesic pump,the time to first ambulation,and the adverse reactions in observation group were significantly lower than those in control group,and the differences were significant(t=65.134,39.193,2.162,P<0.05).The time of first press of the analgesic pump at the 48th h after surgery,and the FMA scores at the 2nd week and 4th week after surgery in the observation group were significantly higher than those in the control group(t=21.192,3.786,3.626,P<0.05).Conclusion:The ultrasound-guided sciatic nerve block via lateral suprapopliteal approach combined with intravenous analgesics can effectively relieve the pain levels in elderly TKA patients,and decreases the medication usage of analgesic pump,and reduce the incidence of adverse reactions.

Objective: To explore the interactive mechanisms of middle school students lifestyle with depressive and anxiety symptoms, so as to provide a basis for constructing a precise prevention system of middle school students mental health. Methods: From October to December in 2024, a stratified cluster random sampling method was used to select 6 251 middle school students from Guangxi. The Lifestyle Questionnaire, Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 ( GAD- 7) were used to investigate middle school students lifestyle, depressive symptoms and anxiety symptoms. The relationship of adolescent lifestyle with depressive and anxiety symptoms was analyzed through binary Logistic regression. The network analysis method was used to construct the network of middle school students lifestyle with depressive and anxiety symptoms. Results: A total of 1 690 individuals (27.0%) exhibited depressive symptoms, and 1 071 individuals (17.1%) exhibited anxiety symptoms. Binary Logistic regression analysis revealed that smoking, alcohol consumption, excessive intake of sugary drinks, insufficient vegetable intake, not eating breakfast daily, frequent consumption of fast food, prolonged sedentary time on both weekdays and weekends, insufficient sleep duration on weekdays and weekends, and excessive screen time on weekdays were all associated with depressive symptom ( OR =1.19-2.07) and anxiety symptom ( OR =1.20-1.91) in middle school students(all P ＜0.05). Additionally, excessive screen time on weekends was associated only with depressive symptoms ( OR =1.35, P <0.05). The connection between the lifestyle-depressive symptom cluster was mainly through "breakfast" and "suicidal ideation" (weight=0.31); the connection between the lifestyle-anxiety symptom cluster was mainly through "sedentary time on weekdays" and "uncontrollable worry" (weight=0.34). In the depressive symptom network, "depressed mood" had the highest node strength; in the anxiety symptom network, "uncontrollable worry" had the highest node strength. "Suicidal ideation" was a key bridge node between lifestyle and depressive and anxiety symptoms. Conclusions Unhealthy lifestyles are significant modifiable risk factors for depressive and anxiety symptoms among middle school students. Regular breakfast intake and management of sedentary behavior should be prioritized as important intervention entry points.

Objective:To investigate the effect of ultrasound-guided sciatic nerve block via lateral suprapopliteal approach on postoperative pain and motor function in elderly patients undergoing total knee arthroplasty(TKA).Methods:A retrospective analysis was conducted on 83 patients who underwent TKA at our hospital from December 2021 to November 2024.Patients were divided into two groups based on postoperative analgesia methods:the control group(n=41)and the observation group(n=42).Both groups received the combined spinal-epidural.The observation group received the ultrasound-guided sciatic nerve block via lateral suprapopliteal approach combined with intravenous analgesics,and the control group only adopted intravenous analgesics.The general data,Visual Analog Scale(VAS)scores at different time points,first press time and number of the analgesic pump on vein,the time to first ambulation,Fugl-Meyer Assessment(FMA)score of lower limb and the incidence of adverse reactions between two groups were analyzed.Results:The VAS scores at the rests of 12 h,24 h,36 h,and 48 h,and at the motion after surgery in observation group were significantly lower than those in the control group,with statistically significant differences(t=3.124,11.617,12.886,4.474,5.235,12.187,5.028,5.119,P<0.05).The number of first press of the analgesic pump,the time to first ambulation,and the adverse reactions in observation group were significantly lower than those in control group,and the differences were significant(t=65.134,39.193,2.162,P<0.05).The time of first press of the analgesic pump at the 48th h after surgery,and the FMA scores at the 2nd week and 4th week after surgery in the observation group were significantly higher than those in the control group(t=21.192,3.786,3.626,P<0.05).Conclusion:The ultrasound-guided sciatic nerve block via lateral suprapopliteal approach combined with intravenous analgesics can effectively relieve the pain levels in elderly TKA patients,and decreases the medication usage of analgesic pump,and reduce the incidence of adverse reactions.

Donation related vasovagal reaction(DRVR) is the most common adverse reaction during blood donation. It is very important for blood banks to identify, treat and prevent DRVR accurately. At present, it is generally believed that psychological factors are the first major inducement of DRVR. Applied muscle tension (AMT) and salt supplementation have been proved to be effective interventions for vasovagal response; the identification methods of high-risk groups such as State Trait Anxiety Inventory, Medical Fear Inventory and Blood Donor Response Scale have been relatively mature, but the utilization rate is relatively low in China. In this paper, the main clinical manifestations, pathogenesis, research methods, related factors, management and prevention measures of DRVR, as well as the identification of high-risk groups before blood donation are reviewed.

OBJECTIVE: To investigate the expression of Wilms'tumor 1 () gene in patients with acute myeloid leukemia (AML), and to explore its application in predicting prognosis of AML in patients with wild or mutated nucleophosmin 1() and Fms-like tyrosine kinase 3-internal tandem duplication (). METHODS: One hundred and sixty-seven newly diagnosed AML patients(exclued M3 type) were enrolled in this study. The survival of patients were analyzed with Kaplan-Meier method. The clinical data, laboratory findings and the survival of patients were analyzed and compared between patients with high expression (high- group) and those with low expression (low- group), as well as among the patients with or wild type and mutants. RESULTS: The overall response rates (ORR) in high- and low- groups were 65.9% (83/126) and 95.1% (39/41), respectively (<0.01). Compared with the low- group, the high- group had lower 2-y overall survival (OS) rate (46.1% vs. 75.2%, <0.05) and 2-y disease free survival (DFS) rate (43.5% vs. 68.5%, <0.05). After induction chemotherapy, the patients with decreased gene expression ≥ 1log was associated with higher ORR and 2-y OS rate (all <0.05), but the advantage of 2-y DFS rate was not shown (>0.05). In patients with wild type, the high- group had inferior ORR and 2-y OS rate (all <0.05), while in the patients with wild type, the high- group had inferior ORR, 2-y OS rate and 2-y DFS rate (all <0.05). In patients with or FLT3 -ITD mutations, the expression had no significantly predicting values in treatment efficacy and survival (all >0.05). CONCLUSIONS gene overexpression indicated poor prognosis of AML patients; the patients with decreased gene expression ≥ 1 log after the first induction therapy show better prognosis than those with<1 log. The gene expression level at diagnosis can be used as an unfavorable prognostic factor for AML patients with or wild types.
Disease-Free Survival ; Gene Expression Profiling ; Humans ; Kaplan-Meier Estimate ; Leukemia, Myeloid, Acute ; diagnosis ; genetics ; mortality ; Mutation ; Nuclear Proteins ; genetics ; Prognosis ; WT1 Proteins ; genetics ; fms-Like Tyrosine Kinase 3 ; genetics

Objective: To determine the value of hyperextension MRI evaluation in determining whether to perform decompression therapy after reduction of reducible atlantoaxial dislocation as well as assess the decompression effect. Methods: A retrospective case series study was conducted to analyze 24 patients with atlantoaxial dislocation admitted to Honghui Hospital affiliated to Xi'an Jiaotong University from May 2015 to May 2017. There were 10 males and 14 females, aged 40-74 years, with an average age of 52 years. There were 14 patients with os odontoideum, four patients with odontoid fracture, and six patients with transverse atlantal ligament rupture. Hyperextension MRI was performed to assess spinal cord compression for all patients. Eight patients with anterior spinal cord compression (Group A) underwent posterior atlantoaxial arch decompression plus atlantoaxial internal fixation reduction and bone graft fusion; 16 patients without anterior compression of the spinal cord (Group B) underwent only atlantoaxial internal fixation reduction and bone graft fusion. Intraoperative and postoperative complications were recorded. Spinal cord compression index and improvement rate of spinal cord decompression were evaluated by routine cervical spine MRI. Japanese Orthopedic Association (JOA) score was used to evaluate the clinical effect. Results: All patients were followed up for 3-24 months, with an average of 9.3 months. There was no nerve or vertebral artery injury during the operation, and no screw loosening occurred after surgery. The spinal cord compression index (0.37±0.18) in Group A at the last follow-up was significantly lower than that before operation (0.73±0.22) (P<0.05), while the index in Group B (0.19±0.20) at the last follow-up was also lower than that before operation (0.61±0.25) (P<0.05). The improvement rate of spinal cord decompression was 67.11% in Group A and 70.61% in Group B. The final JOA score of Group A was (13.29±3.68)points, which was significantly better than the preoperative JOA [(5.61±2.74)points] (P<0.05). The final JOA score in Group B [(14.13±3.45)points] was also significantly better than the preoperative JOA [(7.32±2.90)points] (P<0.05). Improvement rate of JOA was 57.31% in Group A and 59.91% in Group B. Conclusions Hyperextension MRI of cervical vertebra can effectively judge whether the anterior spinal cord is compressed after reduction of atlantoaxial dislocation. It has important clinical significance for decompression treatment during reduction and internal fixation of reducible atlantoaxial dislocation. At the same time, posterior atlantoaxial arch resection and decompression can effectively relieve the compression of the spinal cord after reduction of atlantoaxial dislocation.

Objective To improve patient postoperative comfort of vitrectomy with tamponnade in the prone position, design a new prone position headrest to reduce complications caused by improper body position and observe its clinical effect. Methods According to the postoperative position of the patients, 360 cases were collected. The patients were divided into the control group and the observation group with 180 cases of each group. Observation group was treated with the new prone position headrest nursing, control group were treated with routine prone position. The comfort of patients, postoperative adverse reactions, success rate of retina reattachment were observed. Results According to simplified comfortable situation scale, physiological, psychological, social culture and environment of each individual score respectively was (2.74±0.21), (3.54±0.29) , (3.25±0.23), (3.36±0.27) points in observation group and (2.30± 0.19), (2.92±0.31), (2.93±0.26), (2.79±0.30) points in control group, and there were significant differences (t=12.368-20.845, all P<0.05). The daily posture duration in postoperative first time and 5 days was respectively (220.00±25.08), (1008.00 ± 20.32) min in observation group and (85.00±28.07), (650.00± 30.12) min in control group, and there were significant differences(t=48.117, 133.194, all P<0.01). The incidence of corneal edema, conjunctival congestion, water turbidity in observation group were lower than those in control group at 4 weeks after surgery, and there were statistically significant difference (U=6.308,8.130, 6.875, P < 0.01). The incidence of high intraocular pressure, recurrent retinal detachment rate and reduction rate in observation group were lower than those in control group at 4 weeks after surgery, and there were statistically significant difference (χ2=9.000, 10.540, 11.770, P < 0.01). Conclusions The new prone headrest can effectively improve the resection of vitreous body with tamponade patients in comfort, ensure the operation effect.

Objective To explore the importance of high-quality nursing in the process of wavefront aberration test. Methods This study retrospectively analyzed the nursing cooperation in 16 patients (32 eyes) during their wavefront aberration test. Results The uncorrected visual acuity ( UCVA ) in 15 patients of 16 patients reached more than 1. 0 both in one month and 6 months after the surgery; the post-operation refraction were less than 0. 5D with expected refraction; none of the 16 patients′ best corrected visual acuity ( BCVA) reduced after surgery. Conclusions The accuracy of data collection of wavefront aberration test is the foundation for excimer laser and high-quality nursing plays an important role in the test.

Objective To observe the nursing efficacy for myopic patients with high cornea curvature undergoing laser-assisted insight keratomileusis ( LASIK ) . Methods We retrospectively analyzed the nursing experience and surgery cooperation during LASIK for 35 myopic patients with pure high cornea curvature, including pre-operation examination, pre-operation preparation, cooperativeness during surgery, and post-operative nursing instruction. We also compared the pre-operation and post-operation anterior corneal surface elevation and posterior corneal surface elevation. Results All 35 patients had achieved their pre-operation best corrected visual acuity, without cornea staphyloma. The long-term efficacy needed to be follow-up in further study. Conclusions LASIK has shown safety and efficacy for myopic patients with high cornea curvature, and the success of which not only depended on the skill of the surgeon, but also on the peri-op nursing.

[Abstrict] Objective To explore the effect of systemic family dynamics,egma minnen bardndom on the psychological traits,treatment efficacy of the first onset schizophrenia.Methods 53 schizophrenia patients with first onset were assessed by Self-rating Scale of Systemic Family Dynamics (SSFD),Egma Minnen Bardndom Uppforstran (EMBU),Neurotism Scale (Nf),Psychoticism (PSY),Paranoia Scale (Pa),Psychopathic Deviate Scale (Pd),Tolerance Scale(To) of MMPI-2,and lie Scale (L) was used to control assessment effectiveness.40 normal control cases were assessed by SSFD and EMBU.The scale scores between study group and control groupwere compared,and correlation and regression of study group were analyzed.Results Scores of family atmosphere,individuation,system logic of SSFD were higher in study group than those in control group (t=4.04,3.295,2.44,all P＜0.05),scores of emotional warmth and understand of EMBU in father and mother were lower in study group than those in control group (t=2.925,3.45,all P＜0.01),scores of refused and deny and punishment and stern of EMBU in father and mother were higher in study group than those in control group((t=4.715,4.971,4.331,4.067,all P＜0.01)).And correlation analysis showed that refused and deny of EMBU of father and mother,punishment and stern of EMBU of mother and PSY had significantly positive correlation(r=0.3378,0.4677,0.2895,all P＜0.05),refused and deny and punishment and stern of EMBU of father and mother and Pa had significantly negative correlation (r=-0.2913,-0.3254,-0.5003,-0.3242,all P＜0.05),punishment and stern and excessive interference of EMBU of father and Pd had significant positive correlation (r=0.3417,0.2958,all P＜0.05),PSY of MMPI-2 and treatment effect had significant negative correlation (r=-0.3194,P＜0.05).Regression analysis showed that psychoticism to forecast the poor treatment effect the rate was 10.2％,father and mother the refused and deny to forecast psychoticism high mark the rate respectively were 11.41％ and 21.87％,mother the severe punishment to forecast the psychoticism high mark the rate was 8.13％,Conclusion Father and mother the refused and deny,mother severe punishment have effects on psychological traits of the first onset schizophrenia,psychoticism of psychological traits has an affect on treatment efficacy,the psychoticism high mark presages the poor treatment efficacy.