The modified Valsalva maneuver in hypopharynx CT scan / 临床耳鼻咽喉头颈外科杂志

Objective:To analyze the significance and factors influencing of CT scan under the modified Valsalva maneuver. Methods:Clinical data of 52 patients with hypopharyngeal carcinoma diagnosed from August 2021 to December 2022 were collected, all patients had calm breathing CT scan and modified Valsalva maneuver CT scan. Compare the exposure effect of the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall, and glottis with each CT scanning method. The effects of age, neck circumference, neck length, BMI, tumor site, and T stage on the exposure effect were analyzed. Results:In 52 patients, 50 patients（96.15%） completed CT scan at once time. The exposure effect of the CT scan under modified Valsalva maneuver in the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall was significantly better than CT scan under calm breathing（Z=-4.002, -8.026, -8.349, -7.781, -8.608, all P<0.01）, while CT scan under modified Valsalva maneuver was significantly worse in glottis than CT scan under calm breathing（Z=-3.625, P<0.01）. In the modified Valsalva CT scan, age had no obvious effect on the exposure effect. The exposure effect was better with long neck length, smaller neck circumference, smaller BMI and smaller T stage. The exposure of postcricoid carcinoma was better than pyriform sinus carcinoma and posterior hypopharyngeal wall carcinoma. But differences were not all statistically significant. Conclusion:The anatomical structure of the hypopharynx was clearly under CT scan with modified Valsalva maneuver, which clinical application is simple, but the effect of glottis was worse. The influence of age, neck circumference, neck length, BMI, and tumor T stage on the exposure effect still needs further investigation.

Analysis of Social Support Conditionand Influencing Factors of Rural Elderly in Shandong Province / 中国医学伦理学

Obiecrive:To investigate the social support condition and its influencing factors of the rural elderly in Shandong province.Methods:With multi-stage stratified random sampling method,a questionnaire survey was conducted among 2200 elderly people aged over 60 years using self-developed questionnaire and Social Support Rating Scale (SSRS).Results:Total score of social support in 1115 rural elderly people was (38.01 ±8.39),higher than the national norm.Multiple factor analysis showed that marital status (P ＜ 0.01) and self-care ability (P ＜0.01) had significant effect on the social support of the rural elderly in Shandong Province.Conclusion:The social support condition of the rural elderly in Shandong province is good.We should pay more attention to the spir-itual demands of the rural elderly and further improve the social support of the rural elderly,and thusto promote the development of the rural elderly physical and mental health.

Mental Health Status of Old People in Endowment Institutions and the Influencing Factors in Shandong Province / 中国医学伦理学

Objective:To study the mental health of old people who live in endowment institutions in Shandong Province and its influencing factors. Methods: A sample of 2200 old people over 60 years old was selected with the stratified random sampling method. They were investigated using the self-designed questionnaires, symptom checklist (SCL-90), and Social Support Rating Scale. A total of 2013 questionnaires were recovered effectively (91. 5%), and 271 questionnaires were analyzed in this study. Results:41. 7% of old people in endowment insti-tutions in Shandong Province is positive in SCL -90 . Multivariate analysis showed that self -care ability ( P =0 . 045 ) and type of chronic disease ( P=0 . 025 ) associated with mental health problems of old people in Shandong Province. Conclusion:The mental health status of old people in endowment institutions in Shandong Province was not optimistic and its influencing factors included self-care ability and the type of chronic disease. It should take measures to promote successful aging in Shandong Province.

Analysis of the Influencing Factors and Countermeasures on the Subjective Well-being of Female Elderly in Urban Community / 中国医学伦理学

Objective:To explore the subjective well-being and its influencing factors of female elderly in ur-ban community in Shandong province. Methods: Used the multi-stage stratified sampling method to extract 449 elderly women in 6 communities of 18 cities in Shandong Province. The basic situation and Subjective well-being of their were investigated by using the self-designed questionnaire and Memorial University of Newfoundland Scale of Happiness ( MUNSH) . Results:The economic situation, the number of children, living conditions, self-care ability, chronic disease severity, and other variables have a significant effect on the subjective well-being of fe-male elderly. Conclusions:To improve the economic situation of the urban community elderly women, pay atten-tion to their physical and mental health level, improve the pension and health insurance system, intensify the con-struction of old-age care institutions, playing the roles of family, children, society in the network to support the community elderly women society, can significantly improve the community elderly women′s subjective well-be-ing.

Network Ethics of College Students / 中国医学伦理学

As important Internet users, college students need to establish good cyber ethics to promote healthy development of the Internet and meet the needs of their own growth. The characteristics of college students' cyber ethics include hierarchy, self-discipline, orientation and particularity. Self-respect and respect for others;hon-est and trustworthy;fair and mutual benefit;attention to public welfare and participation;patriotic, studious, cre-ate a harmonious network should be college students' network moral norms.

Analysis on Conflict of Contemporary College Students'Network Ethics / 中国医学伦理学

Objective:To investigate the current situation of network ethics among the college students , to pro-vide evidence for cultivating correct network ethics .Methods:A survey was conducted in 1200 students with a self-designed questionnaire .Results:College students in the network ethics exist conflicts .They eager to trust but face a crisis of confidence , tool enhancements but responsibility fall , network security but network open , virtual but reality.Conclusion:The government should strengthen the network legislation and network credit system , should increase the development of network security technology so as to build networks ethical norms .Colleges should pay attention to culture the social responsibility , and promote the quality level of network ethics among the college students .

Analyzing contradictions of video-case teaching in social medicine classroom / 中华医学教育探索杂志

Based on practice of video-cases teaching,this paper put forwards four sorts of contradictions,which are the contradiction between time limitation of classroom and expressing limi-tation of video cases,the contradiction between relative independence of video cases (part)and con-sistency of teaching objective (entirety),the contradiction between apparentness of video cases (phe-nomenon)and depth of teaching content (essence)and the contradiction between variability of video case class and control of class by teachers. This paper suggested teaching principle of part conforming to entirety. Meanwhile,it indicated that classroom video case teaching should have strict design, closely coordinated class discussion and teachers should be good at guiding and summarizing. Through these efforts,the above four contradictions can be resolved and designed video case teaching obtained good effect.