OBJECTIVETo investigate the therapeutic effect of facial artery perforator flap for the soft tissue defects at nose, lip and cheek.

METHODSThe facial artery perforator adjacent to the defect was identified by Doppler ultrasonography. The perforator flap was designed according to the defect location, size and shape. The subcutaneous tissue around the perforator was kept as much as possible to protect the venous drainage.

RESULTSFrom Oct. 2012 to Oct.2013, 26 cases were treated with facial artery perforator flaps, with 9 cases of nasal defects, 10 cases of lip defects and 7 cases of buccal defects. The defects size ranged from 1.5 cm x 2.0 cm to 3.0 cm x 3.0 cm and the flaps size ranged from 2.0 cm x 2.5 cm to 3.5 cm x 3. 5 cm. Superficial necrosis(3mm in width) happened at the end of one flap. All the other 25 flaps survived completely. 16 cases were followed up for 3 months to 2 years with no relapse and satisfactory cosmetic and functional results were achieved.

CONCLUSIONSBoth cosmetic and functional effect can be achieved with facial artery perforator flap for defects at nose, lip and cheek.

Arteries ; Cheek ; surgery ; Graft Survival ; Humans ; Lip ; surgery ; Nose ; surgery ; Perforator Flap ; blood supply ; transplantation ; Rhinoplasty ; methods

Objective To investigate the abnormal brain activity of first-episode depression by rest-ing state functional magnetic resonance imaging ( fMRI) .Methods Twenty-one adolescent participants diag-nosed with depression(AD) and 18 healthy controls ( HC) were recruited.Resting state fMRI brain scans were performed on all participants.Regional homogeneity ( ReHo) approach was applied to preprocess the fMRI datasets.The value of ReHo maps were obtained in the whole brain.Results ReHo values in the AD group were higher than those in the healthy controls in the right inferior temporal gyrus ( MINI:66,-24,-20) ,left upper cingulate cortex (-27,47,-6) ,frontal polar (-24,59,14) ,after upper left cingulate cortex (-1,-16,35),after the bottom left cingulate cortex (-2,-38,32),left praecuneus (-1,-48,65) com-pared with that in the healthy controls (P<0.05) .ReHo in the AD group decreased in the right middle tempo-ral gyrus (45,-34,32) compared with that in the healthy controls (P<0.05).Conclusion Extensive ReHo abnormalities were found in the brains of patients with first-episode,drug-naive depression,and these abnor-malities in spontaneous neural activity may contribute to the neuropathology of adolescent depression.

Objective To study the correlation between 5-serotonin transporter ( 5-HTT) gene pol-ymorphism and the first episode major depressive disorder ( MDD ) and cognitive function in adolescent. Methods 5-HTT genotype and allele were detected by polymerase chain reaction ( PCR) amplification of 76 patients with first episode of MDD and 73 normal controls. Case control method was used to analyze the correlation between different genotypes and the onset, the clinical features, and cognitive function. Result-s There was no significant difference between 5-HTTLPR genotype frequencies for the 41 cases of type S/S (53.9%),27 cases of type L/S(35.5%),8 cases of type L/L(10.5%)of case group and 5-HTTLPR geno-type frequencies for the 38 cases of type S/S(52.1%),18 cases of type L/S(24.7%),17 cases of type L/L (23.3%) of control group(P>0.05).Patients with S/S type,L/S type had significantly higher sleep scores than those of patients with type L/L(P=0.005,P=0.001). Agitation score in patients with S/S type group was significantly higher than that in patients with S/L,L/L(P=0.000,P=0.001);patients with S/S inferior-ity scores were significantly lower than those of patients with S/L,L/L(P=0.002,P=0.006). There was no significant difference in cognitive function among three groups. Conclusions In Chinese Han population, there may be no direct association between 5-HTTLPR gene polymorphism and susceptibility to MDD and its cognitive function in adolescents. S/S and L/S patients may be prone to sleep problems,type S/S patients may be prone to irritability and type L/L patients may be prone to inferiority.

Sexual health is an important part of the overall health of patients.The ability of nurses to carry out sexual health care directly affects the overall level of medical care. This article reviews the concepts of sexual health and sexual health care, the evaluation tools of sexual health care, the practical models and influencing factors of nurses' sexual health care, with a view to providing a reference for improving the practice level of nurses carrying out sexual health care.

Transitional care refers to carrying out related health care services to make discharged patients′nursing activities orderly, coordinated and continuous, so as to meet their various rehabilitation needs. In recent years, it has become a research focus of breast cancer discharged patients. This article reviews the concept of continuous care and its practice and effect in discharged patients with breast cancer, and provides evidence for further improvement of breast cancer patients′continuity of care in China.

Objective: To investigate the posttraumatic growth and emotional regulation strategies of patients with moderate and severe burns at different time points in the rehabilitation period, and to explore the correlation between posttraumatic growth and emotional regulation strategies, so as to provide a basis for targeted nursing intervention. Methods: By convenience sampling method, 115 convalescent patients with moderate and severe burns in Linyi People′s Hospital burn plastic surgery center were investigated by General Information Questionnaire, Chinese Posttraumatic Growth Inventory (C-PTGI), Emotion Regulation Scale (ERQ) respectively on the day of discharge (T1), 3 months and 6 months after hospital discharge (T2, T3) from December 2017 to January 2019. Results: The post-traumatic growth scores of patients T1, T2 and T3 were 58.18±9.51, 48.65±9.31 and 47.43±8.76, respectively. The post-traumatic growth scores showed a downward trend at three time points, and the difference was statistically significant (F=339.732,P<0.01). The scores of T1, T2 and T3 in the cognitive reassessment dimensions of patients′emotion regulation strategies were respectively 27.10±4.13, 26.95±3.76, 26.11±3.60. The scores are going down and the differences were statistically significant (F=27.798, P<0.01). The expression inhibition scores were 14.42±4.39, 15.20±3.30, 15.21±3.56 respectively. The scores are the rise and the differences were statistically significant (F=13.675, P < 0.01). There were positive correlations between cognitive reassessment scores and posttraumatic growth scores、scores of all dimensions (r=0.230-0.555, P<0.05). The expression inhibition scores were negatively correlated with the total post-traumatic growth scores, personal strength, and scores of new possibility dimensions (r=-0.230--0.420, P<0.05). Conclusion Posttraumatic growth of patients with moderate to severe burns is not optimistic in the rehabilitation period. Therefore, it is necessary to pay attention to the guidance of emotional regulation strategies for patients with moderate to severe burns in the rehabilitation period, and carry out targeted interventions to promote the posttraumatic growth of patients.

Objective: To investigate the changes of brain activity in adolescents with first-episode major depressive disorder (MDD) and its significance. Methods: Totally 42 first-episode MDD patients with suicidal ideation (SU group), 17 MDD patients without suicidal ideation (NSU group) and 29 healthy controls (HC group) were examined by psychological assessment and resting-state functional magnetic resonance imaging (fMRI). The differences of brain functional activities between the three groups were compared by amplitude of low frequency fluctuation(ALFF). The relationship between the difference of zALFF value in brain regions and the severity of depression, intensity of suicidal ideation were further analyzed. Results: The zALFF values in the left hippocampus(MNI: x=-21, y=-33, z=0) and left Frontal_Sup_Medial(MNI: x=3, y=33, z=63) of the three groups were significantly abnormal (P<0.001, k>20, uncorrected). The results of Post-hoc test showed that the zALFF value of left hippocampus increased significantly (F=28.931) and decreased significantly in left Frontal_Sup_Medial(F=16.648)in SU group , compared with NSU group and HC group(P<0.001, Bonferroni correction). There was no significant difference in zALFF value between HC group and NSU group(P>0.05). In SU group, the zALFF values of left hippocampus and left Frontal_Sup_Medial were not correlated with total scores of HAMD-24(r=-0.214, -0.103) and suicide ideation intensity factor scores(r=0.115, -0.055)(P>0.05). Conclusion Abnormal autonomic nervous activity exists in left hippocampus and left Frontal_Sup_Medial in adolescent MDD patients with suicidal ideation, which may be the neurological basis and biological index of suicidal ideation.

Objective To sum up nursing experience of cerebrospinal fluid drainage in patients with aortic dissection with paraplegia after sun′s operation. Methods Retrospective analysis of 17 cases of clinical nursing care from January 2014 to December 2016, summing up related nursing experience includingintensive care of cerebrospinal fluid drainage, observation of limb movement and muscle strength, monitoring complications, maintain stable hemodynamics, strengthen the life nursing during hospitalization, in order to ensure the drainage of cerebrospinal fluid. Results 2 deaths, Recovery of different degrees of paraplegia or paresis in 12 and persistent paraplegia in 12 out of the other 15 patients, 9 patients recovered and discharged,6 cases transferred to rehabilitation hospital. Conclusions Careful nursing of cerebrospinal fluid drainage can improve paraplegia or lower extremity paresis caused by spinal cord ischemia,and promote patients′rehabilitation.

Objective To study the resting-state functional connectivity( FC) changes of anterior cingulate cortex(ACC) and amygdala in adolescent patients with medication-naive first-episode major de-pressive disorder(MDD).Methods Medication-naive first-episode MDD adolescents( n＝30) and pair-wise matched healthy controls(HCs,n＝29) underwent resting-state functional magnetic resonance images(fM-RI).To study whether there were different in FC changes between amygdala and ACC and whole brain re-gions,and whether abnormal FC was related to clinical characteristics.Results Compared with HCs,the ado-lescent MDD patients showed decreased FC between the left amygdala and right thalamus( MNI x,y,z:15,－21,18)(t＝－2.85)and increased FC between the left amygdala and the bilateral temporal middle gyrus,left occipital gyrus,right medial prefrontal cortex(MPFC)(MNI x,y,z:9,66,15) ( t＝2.80).The right amygdale showed decreased FC with bilateral middle frontal gyrus,left caudate(MNI x,y,z:－15,－9,21)(t＝－2.53), right thalamus(MNI x,y,z:12,－36,12)(t＝－3.01),right cerebellum(MNI x,y,z:3,－84,－33)(t＝－2.45) and increased FC with right temporal middle gyrus,right MPFC( MNI x,y,z:6,69,12) ( t＝2.41).The left ACC showed decreased FC with left cerebellum( MNI x,y,z:12,－87,－24) ( t＝－2.36),left frontal inferior triangle gyrus,right frontal inferior orbital gyrus and increased FC with right frontal middle orbital gyrus.The right ACC showed decreased FC with left caudate(MNI x,y,z:－15,21,6)(t＝－2.29),right temporal middle gyrus,right MPFC(MNI x,y,z:9,54,36)(t＝－2.29),right frontal inferior orbital gyrus,right angular(MNI x,y,z:45,－51,21)(t＝－3.01),left dorsolateral prefrontal cortex(MNI x,y,z:－21,33,36) ( t＝－2.61).The increased FC between the left amygdale and bilateral temporal middle gyrus showed positive correlation with the score of HAMD(r＝0.50,P＜0.05;r＝0.45,P＜0.05).And the FC between the right amygdale and right middle frontal gyrus was positive correlation with duration of disease( r＝0.63,P＜0.05).Conclusion There is widespread FC disorder in amygdala and ACC in adolescents patients with first-episode depression.Abnor-mal FC changes may be the neuropathological mechanism of depression.

Objective:To investigate the overall clinical performance of nursing students and analyze its influencing factors to provide evidence for the improvement.Methods:A questionnaire survey was carried out among 288 nursing students from Qilu Hospital of Shandong University in March to May 2020. The survey included a general data questionnaire, Holistic Clinical Assessment Tool, Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale, Medical Student Safety Attitudes and Professionalism Survey of nursing students. The factors associated with overall clinical performance of nursing students were analyzed by t test, analysis of variance, Pearson correlation analysis and multiple linear regression. Results:The total score of Holistic Clinical Assessment Tool was 114.95 ± 22.91. The total score of Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale was 156.70 ± 26.98. The total score of Medical Student Safety Attitudes and Professionalism Survey was 123.65 ± 31.00. The influencing factors included social practice experience and clinical learning environment, which accounted for 28.0% of the total variation of overall clinical performance of nursing students.Conclusions:Educators and managers of nursing students' schools and internship hospitals should actively explore the educational reform practice to promote the improvement of clinical ability, so as to promote the improvement of the overall clinical ability of nursing students.