ObjectiveTo unmask the psychological gaps related to suicide ideation in the elderly based on Social Reference Theory， so as to put forward countermeasures for psychological crisis intervention and management. MethodsFrom 2018 to 2019， purposive sampling was adopted to select 19 elderly people with history of suicidal ideation and suicide attempt from 37 geriatric nursing institutions in Ji'nan， Shandong province. Semi-structured interviews were conducted with the elderly， and the collected data were processed by Colaizzi seven-step analysis method. ResultsThe qualitative analysis showed that the elderly with suicidal ideation often experienced strong psychological gaps， including physical condition and function gap， family role gap， socially isolated and lonely gap， filial expectation gap and the gap between the real self and ideal self. ConclusionThe psychological gaps serve as the main psychological motivator for suicidal ideation in the elderly， therefore， reducing the psychological gaps can be a new approach for the suicide intervention among the elderly.

Objective To investigate the prevalence and risk factors of restless leg syndrome (RLS) in hemodialysis patients after kidney transplantation failure.Methods Patients of hemodialysis after kidney transplantation failure were investigated by face-to-face interviews,from March to July,2015,at four dialysis units in Beijing.RLS was diagnosed according to the International RLS Study Group (IRLSSG) criteria.The severity of RLS was assessed using International RLS Rating scale.Besides,three validated sleep disorder questionnaires (Hamilton anxiety and depression scale,Epworth sleepiness scale and Pittsburgh sleep quality index) were completed by the patients at the same time.Results Ninety-four hemodialysis patients after kidney transplantation failure were enrolled;46 patients (48.94％) met the diagnosis of RLS,the average age was 53.44±l 1.89 years,and the median time of RLS onset after kidney transplantation failure was 46 months.The International RLS Rating scale scores of the patients were 17.26±7.81;76.0％ patients were above moderate.As compared with the non-RLS patients,patients with RLS used more erythropoietin (44/48 vs.46/46),less ferrila (30/48 vs.19/46),and few hypnotic medicine (10/48 vs.3/46),with significant differences (P＜0.05).The serum ion,serum ferritin and serum Vitamin B12 of patients with RLS were significantly lower as compared with non-RLS patients (P＜0.05);and poorer sleep quality and higher depression scale scores in the patients with RLS were noted as compared with those in the non-RLS patients (P＜0.05).Conclusion The prevalence of RLS in hemodialysis patients after kidney transplantation failure is high,low iron protein content,low serum iron content and low vitamin B12 levels may be risk factors for RLS.

BACKGROUNDLaparoendoscopic single-site (LESS) surgery through the retroperitoneal approach has been seldom reported. We aimed to evaluate the outcomes of LESS and conventional laparoscopic surgery via the retroperitoneal approach in the management of large, impacted ureteral calculi.

METHODSBetween November 2011 and July 2013, retroperitoneal LESS ureterolithotomy was performed in 12 patients using a homemade single-port device comprising a surgical glove and several strips of tape. Another 16 patients underwent conventional retroperitoneal laparoscopic ureterolithotomy. We compared the operative time, complications, and surgical outcomes, retrospectively.

RESULTSAll patients were completed without conversion to conventional laparoscopic or open surgery. The operative time of the LESS group and of the conventional laparoscopic group were (125.3 ± 12.8) minutes and (116.9 ± 14.4) minutes, respectively (P = 0.119). The intraoperative blood loss was (42.9 ± 8.9) and (43.4 ± 14.7) ml, respectively (P = 0.914). Postoperative radiologic evaluation revealed that the stones had been removed completely. Cosmetic results were superior in the LESS group (P = 0.001).

CONCLUSIONRetroperitoneal LESS ureterolithotomy using a homemade single-port device can be considered a feasible and safe alternative to conventional laparoscopic ureterolithotomy.

Adult ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Retroperitoneal Space ; surgery ; Ureteral Calculi ; surgery ; Urologic Surgical Procedures ; methods

Objective To evaluate the safety and efficacy of intra-arterial infusion neoadiuvant chemotherapy in local advanced bladder cancer. Methods Nineteen cases with T2-T4a bladder cancer were enrolled in this study.Intra-arterial infusion chemotherapy with Gemcitabine and Cisplatin (GC)were performed for 1 to 3 cycles before radical cystectomy.Postoperative values of hematological parameters,maximum diameter of tumors,TNM(tumor,node and metastasis)stages and pathological grades were compared with preoperative parameters of the same case. Results Compared to the values before GC chemotherapy,WBC count showed no significant change post-operative,(6.63±2.58)×109/L vs(5.12±2.91)×109/L(P=0.13);RBC(4.41+0.52)×1012/L vs(3.92±0.42)×1012/L(P=0.00)and platelet count(220.50±59.86)×109/L vs(157.05±56.72)×109/L(P=0.001)showed significant decrease;ALT did not show significant decrease(20.00±8.31 vs 26.88±17.04 U/L,P=0.08);Creatltme also showed no significant change(95.82±14.57 vs 88.04±17.76μmol/L,P=0.06);Maximum diameter of tumors decreased significantly(3.72±1.23 vs 2.80±1.29 cm,P=0.02).Compared with clinical TNM stages,pathological TNM stages demonstrated significant decrease in 9 cases;While cell differentiation did not show decrease. Conclusions Intra-arterial infusion with GC regimen can reduce tumor size,decrease TNM stages,while not causing significant adverse impact to radical cystectomy.Bladder-spare treatment is an option for chemotherapy-sensitive cases.

Objective Through the conversion of civil passenger cars, to develop mobile psychological counseling and treatment centre that can afford field operation for our pilot. Methods The internal structure of 28-Seat-MQ6798 type King Dragon bus was rebuilt by installation of equipment related to psychological intervention, the development of psychological intervention plans, the broad participation of military exercises, force of mental health and education, the actual of sudden catastrophic events, and according to the verification results, field psychological counseling and treatment vehicle and psychological intervention plans were verified. Results The field psychological counseling and treatment centre exclusively includes anterior cabin, hinder cabin, storage rooms and psychological testing and psychological intervention equipment, which can be constituted not only the exchange platform of psychological block aid and information exchange on wartime, popularizing mental health knowledge for officers and soldiers at ordinary times, but also the intervention platform of catastrophic events, anti-terrorism and appeasing confusion and violence. Conclusion The field ambulance is necessary for keeping the mentality health of pilots under the wartime in the future.