Objective:To explore the effect of emotional imagery desensitization therapy on posttraumatic stress disorder among school- age children with fracture, to alleviate the adverse psychological state of the children.Methods:By a randomized controlled trials, a total of 78 school- age children with fracture at the Affiliated Hospital of Jining Medical University from July 2021 to July 2023 were divided into experimental group and control group according to the admission time, with 39 cases in each group. Both groups carried out routine care, the control group was given routine psychological intervention, the experimental group implemented emotional imagery desensitization therapy. Before and after 3 months of intervention, the effects was assessed by Post-Traumatic Stress Disorder Self-rating Scale (PTSD-SS) and Medical Coping Modes Questionnaire (MCMQ), respectively.Results:During the research process, there were 2 cases of dropout in the control group due to disconnection, and 4 cases in the experimental group due to disconnection and voluntary withdrawal. 37 children in the control group [20 males and 17 females, age (9.27 ± 1.62) years], and 35 children in the experimental group [21 males and 14 females, age (9.57 ± 1.63) years] completed the intervention. Before intervention, the difference of PTSD-SS and MCMQ scores between two groups was no statistically significant (all P>0.05). After intervention, the subjective assessment, re-experiencing, avoidance symptoms, hypervigilance, functional impairment factor scores and total PTSD-SS scores were (1.51 ± 1.06), (10.74 ± 3.30), (10.86 ± 2.93), (11.94 ± 3.18), (2.31 ± 1.30), (37.37 ± 6.37) in the experimental group, lower than in the control group (2.08 ± 0.80), (12.92 ± 3.63), (12.73 ± 2.99), (14.65 ± 4.23), (2.97 ± 0.87), (45.35 ± 5.86), the differences were statistically significant ( t=2.53-5.54, all P<0.05). After intervention, the confrontation subscale scores were (23.49 ± 2.48), higher than in the control group (21.89 ± 2.38), the avoidance, acceptance- resignation subscale were (10.31 ± 1.89) and (6.83 ± 1.98), lower than in the control group (11.57 ± 1.79) and (7.86 ± 2.12), the differences were statistically significant ( t=2.79, 2.89, 2.14, all P<0.05). Conclusions:Emotional imagery desensitization therapy can effectively alleviate post- traumatic stress disorder and promote positive coping mode in school-age children with fracture.

Humans ; Clavicle ; Fractures, Bone/surgery*

To summarize the reform measures of nursing vertical management in our hospital under the background of diagnosis related groups,including refined performance management,cancellation of nursing main pharmacy classes,implementation of attending nursing working group,establishment of DRGs nursing quality control coder position,head nurse responsible for bed allocation,deepening nursing quality management and other measures,so as to provide references for other hospitals to carry out the reform of nursing vertical management under the background of DRGs.

Humans ; Transcranial Magnetic Stimulation ; Pain Management ; Psychotic Disorders/therapy* ; Depressive Disorder, Major ; Treatment Outcome ; Transcranial Direct Current Stimulation

OBJECTIVE Aim to evaluate the mental level in 4-6 years old children with obstructive sleep apnea hypopnea syndrome(OSAHS). METHODS Children who were diagnosed as OSAHS with a whole night PSG monitor in the sleep center between January 2015 and August 2016, and 30 healthy children were included in the study. Intelligent levels were evaluated at the enrollment day. The following intelligent levels evaluation questionnaires were used: Wechsler Intelligence Scale for children and infants. Intelligent levels were compared between the patient and healthy control groups. RESULTS The 60 children, including 30 children with OSAHS(patient group) and 30 healthy children(control group) were enrolled. Comparison of the patient versus the control groups revealed that total intelligence quotient(FIQ) was 96.59±12.60 vs 102.53±8.44; language capability(VIQ) was 94.00±13.24 vs 101.03±9.41; comprehension test was 5.96±2.5 vs 7.57±2.14; visual analysis was 8.85±2.32 vs 10.3±1.93. All the 4 values in the patient group were significantly lower than those in the control group(all P ＜0.05). The accumulated time of SO2＜90％ correlated with PIQ negatively and significantly. CONCLUSION The intelligent level of children with OSAHS was in the normal range, but lower than that of healthy group. Snoring affects the IQ level of 4-6 years old children, and the influence on PIQ is closely related to the accumulated time of SO2＜90％ in total sleep time.

OBJECTIVE:To establish HPLC fingerprints of taproot and rhizome of Paenoia lactiflora,and to compare the similarity and difference of them.METHODS:The determination was performed on Phenomenex C18 column with mobile phase consisted of acetonitrile-0.1％ phosphoric acid (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set at 230 nm,and column temperature was 30 ℃.The sample size was 10 tL.Using paeoniflorin as reference,HPLC chromatograms of the taproot and rhizome of P lactiflora were established.Common peak identification and similarity evaluation were performed by using TCM Chromatogram Fingerprint Similarity Evaluation System (2012 edition).RESULTS:There were 9 common peaks in HPLC chromatograms of taproot and rhizome of P lactiflora.The similarity of taproot with rhizome of P lactiflora was higher than 0.9.CONCLUSIONS:Established fingerprints can provide reference for identification and quality evaluation of P lactiflora.The effective constituent of taproot and rhizome of P lactiflora are uniform but have small difference.

OBJECTIVETo compare the efficacy difference between acupotomy and acupuncture in the treatment of avascular necrosis of femoral head at the early and middle stages.

METHODSThe randomized controlled prospective study method was adopted. Sixty cases of avascular necrosis of femoral head at Ficat-ArletⅠto Ⅱ stages were randomized into an acupotomy group (32 cases) and an acupuncture group (28 cases) by the third part. In the acupotomy group, the acupotomy was adopted for the loose solution at the treatment sites of hip joint, once every two weeks, totally for 3 times. In the acupuncture group,points around the hip joint were selected and stimulated with warm acupuncture therapy, once every day, for 6 weeks. Harris hip score was observed before and after treatment. The efficacy was evaluated in the two groups.

RESULTSHarris hip score was improved significantly after treatment in the two groups (both<0.05). The result in acupotomy group was better than that in the acupuncture group (<0.05). The effective rate was 90.6% (29/32) in the acupotomy group, better than 75.0% (21/28) in the acupuncture group after treatment (<0.05).

CONCLUSIONSHarris hip score and the effective rate in the acupotomy group are better than those in the treatment with routine acupuncture for avascular necrosis of femoral head at the early and middle stages.

Objective To assess the utility of single source-dual energy CT for distinguishing bladder cancer from hematoma. Methods We retrospectively identified 14 patients with postoperative or follow-up bladder hematoma who had undergone dual energy protocol (40-140 keV)scanning by single source-dual energy CT.The subjective scoring of tumor detection and image quality,the optimal monochrome images and iodine-water images were evaluated by two radiologists who didn’t know the results.The consistency of two observers was analyzed by Kappa test.Mann-Whitney U test was used to compare the difference between the two kinds of diseases and ROC curve was used to analyze the diagnostic efficiency.The statistical differences of image quality scoring among different images were obtained by using Mann-Whitney U test.Results The consistency of the two observers about scoring of lesion detection was good for all groups.There were statistical differences between two groups in non-enhanced phase and arterial phase of mixed-energy images,non-enhanced phase,arterial phase and delayed phase of optimal monochromatic images,and all phase of iodine-water images. The AUC of iodine-water images in the four phases (0.985,1.000,0.955,0.924,respectively)were all higher than that of polychrome unenhanced and arterial phase images (0.909,0.909).The diagnostic efficiency of arterial phase on iodine-water images was the highest.Sensitivity and specificity were both 100% when score was greater than 2.5.There was no statistical difference between two kinds of diseases on non-enhanced phase,delayed phases of mixed-energy or monochromatic images(P >0.05).There were no statistical differences in image quality scoring among the three groups with the same phases (P>0.05).Conclusion Optimal monochromatic images and iodine-water images of single source-dual energy CT are more effective than conventional CT in distinguishing bladder cancer from hematoma.

Objective To evaluate the value of single-source dual-energy CT ( ssDECT ) in differentiating lipid-poor adenomas from metastases in adrenal glands .Methods From August 2011 to Oct 2014,63 patients with 73 adrenal nodules ( 53 metastases proven by 5-6 months follow-up, and 20 histopathologically proven adenomas , CT value >10 HU) underwent ssDECT scanning .The CT values of conventional polychromatic CT and virtual monochromatic images ( 40-140 keV) , fat-water density images and effective atomic number (eff-Z) were reconstructed on an ADW4.5 workstation and ROC curves were then constructed to evaluate the effectiveness of each parameter .The slope of spectral curve was measured and divided into 3 types:increment curve ( K>0.1) , straight curve (-0.1≤K≤0.1) and decrement curve ( K<-0.1) according to the slope ( the value of K ) of spectral curve , and the curve patterns in the two groups were compared statistically .Results There was no statistical difference between the mean CT values of metastases (35.12±5.29)HU and lipid-poor adenomas (32.48±6.94)HU by conventional polychromatic CT (P>0.05).The range of single-energy CT values of metastases [from (53.00±15.12) HU to (33.38± 5.67) HU] was significantly higher than that of lipid-poor adenomas [from (26.90±26.94) HU to (28.77± 10.66) HU] at energy levels ranging from 40 to 80 keV ( P<0.05).There was no significant difference between the single-energy CT value of metastases and lipid-poor adenomas at energy levels ranging from 90 to 140 keV (P>0.05).The median fat-water concentration of metastases was -164.61 μg/cm3, significantly lower than that of lipid-poor adenomas (114.32 μg/cm3, P<0.05).The eff-Z of metastases (7.76±0.15) was also significantly higher than that of lipid-poor adenomas (7.50±0.25, P<0.05).When the threshold of fat-water concentration was -143.89 μg/cm3 , the sensitivity, specificity and accuracy rate of metastasis diagnosis was 70.0%, 66.0%, and 76.7%, respectively.When the threshold of eff-Z was 7.63, the sensitivity , specificity and accuracy rate of metastasis diagnosis was 83.0%, 65.0%, and 80.4%, respectively .The lower the energy , the higher the diagnostic accuracy at energy levels ranging from 40 to 80 keV, and that of 40 keV was the highest .The spectral curves of metastases included 2 ( 3.8%) ascending curves, 9 (17.0%) straight curves and 42 (792.%) descending curves, while in the 20 lipid-poor adenomas, there were 9 ( 45.0%) ascending curves , 4 ( 20.0%) straight curves and 7 ( 35.0%) descending curves , showing significant differences between the two groups ( P<0.05) .Conclu sions Single-source dual-energy CT provides an effective multi-parameter approach for differentiating lipid-poor adrenal adenomas from metastases .

Objective To evaluate the value of single-source dual-energy CT ( ssDECT ) in differentiating lipid-poor adenomas from metastases in adrenal glands .Methods From August 2011 to Oct 2014,63 patients with 73 adrenal nodules ( 53 metastases proven by 5-6 months follow-up, and 20 histopathologically proven adenomas , CT value >10 HU) underwent ssDECT scanning .The CT values of conventional polychromatic CT and virtual monochromatic images ( 40-140 keV) , fat-water density images and effective atomic number (eff-Z) were reconstructed on an ADW4.5 workstation and ROC curves were then constructed to evaluate the effectiveness of each parameter .The slope of spectral curve was measured and divided into 3 types:increment curve ( K>0.1) , straight curve (-0.1≤K≤0.1) and decrement curve ( K<-0.1) according to the slope ( the value of K ) of spectral curve , and the curve patterns in the two groups were compared statistically .Results There was no statistical difference between the mean CT values of metastases (35.12±5.29)HU and lipid-poor adenomas (32.48±6.94)HU by conventional polychromatic CT (P>0.05).The range of single-energy CT values of metastases [from (53.00±15.12) HU to (33.38± 5.67) HU] was significantly higher than that of lipid-poor adenomas [from (26.90±26.94) HU to (28.77± 10.66) HU] at energy levels ranging from 40 to 80 keV ( P<0.05).There was no significant difference between the single-energy CT value of metastases and lipid-poor adenomas at energy levels ranging from 90 to 140 keV (P>0.05).The median fat-water concentration of metastases was -164.61 μg/cm3, significantly lower than that of lipid-poor adenomas (114.32 μg/cm3, P<0.05).The eff-Z of metastases (7.76±0.15) was also significantly higher than that of lipid-poor adenomas (7.50±0.25, P<0.05).When the threshold of fat-water concentration was -143.89 μg/cm3 , the sensitivity, specificity and accuracy rate of metastasis diagnosis was 70.0%, 66.0%, and 76.7%, respectively.When the threshold of eff-Z was 7.63, the sensitivity , specificity and accuracy rate of metastasis diagnosis was 83.0%, 65.0%, and 80.4%, respectively .The lower the energy , the higher the diagnostic accuracy at energy levels ranging from 40 to 80 keV, and that of 40 keV was the highest .The spectral curves of metastases included 2 ( 3.8%) ascending curves, 9 (17.0%) straight curves and 42 (792.%) descending curves, while in the 20 lipid-poor adenomas, there were 9 ( 45.0%) ascending curves , 4 ( 20.0%) straight curves and 7 ( 35.0%) descending curves , showing significant differences between the two groups ( P<0.05) .Conclu sions Single-source dual-energy CT provides an effective multi-parameter approach for differentiating lipid-poor adrenal adenomas from metastases .