Objective To investigate the effect of Site-Rite 5 vascular ultrasound on puncturing of grade Ⅱ and Ⅲ veins.Methods Purposive sampling was used and 59 patients with grade Ⅱ and iⅢ veins to receive peripheral intravenous catheteration (PIV) were divided into observation group and control group according to the different wards:30 patients in the observation group and 29 in the control group.The control group received indwelling PIV by routine method and in the observation group,the patients' veins were assessed by Site-Rite 5 ultrasound-guided instrument and marked,followed by puncturing with PIV.The two groups were compared in terms of one-time success rate and incidence of complications.Results The one-time success rate of the observation group was significantly higher than that of the control group.There was no significant difference in the incidence of complications between the two groups (P ＞0.05).Conclusions By the Site-Rite 5 ultrasound-guided instrument,the invisible veins become visible.It is beneficial to improve the success rate of puncturing.

Objective To discuss the effect of Dickkopf-1 (DKK-1) on Wnt singal pathway during the differentiation of osteoblast in vitro.Methods The osteoblasts were obtained from the new rats and cultured in vitro.The 3 passages were divided into control group and DKK-1 group.The cells were cultured in DKK-1 and normal saline for morphogical detection,ALP activity detection and osteoblasts stained at 1 st,6th,12th,21st day.The Wnt was detected by RT-PCR.Results After cultured by the DKK-1 in vitro,the ALP and mineralization of osterblasts staining were prlonged with culture time.Compared with control group,the expression of Wnt was significantly reduced at the 21st day after induction (t =0.278,P ＜ 0.05).Conclusion DKK-1 can regulate the expression of Wnt during osteoblast differentiation,suggests that Wnt may be involved in osteoblast differentiation and can affect bone remodeling process.

Breast cancer has become one of the major factors that threaten women's health. The spouse, as an intimate partner and its main caregiver, has many unmet needs during the care period, which indirectly reflects the quality of life and needs of the patient. This article reviews the measurement tools, content of needs and influencing factors of spouse needs of breast cancer patients, and so as to provide a basis for further exploring spouse needs in China and formulating personalized intervention plans for spouses of patients with different needs at different stages.

Background: Mast cell activation is a characteristic of irritable bowel syndrome (IBS).Study on mast cell and the related inflammatory mediators in colonic mucosa is helpful for the evaluation and treatment of IBS.Aims: To assess the effect of mesalazine combined with trimebutine on colonic mucosal mast cell and related inflammatory mediators in patients with IBS.Methods: Forty patients with diarrhea-predominant IBS (IBS-D) and 40 patients with constipation-predominant IBS (IBS-C) from Oct.2014 to June 2016 at Shanghai Jiading District Central Hospital were enrolled, 20 healthy volunteers were served as controls.Forty patients with IBS-D and 40 patients with IBS-C were randomly divided into mesalazine+trimebutine group and trimebutine group, the treatment courses were all 4 weeks.Number of mast cell was counted by modified toluidine blue staining.Score of related inflammatory mediators were evaluated by immunohistochemistry.Clinical efficacy was assessed.Results: Compared with healthy controls, number of mast cell at baseline was significantly increased both in IBS-D and IBS-C patients (P<0.05).After treatment with mesalazine+trimebutine, number of mast cell was significantly decreased (P<0.05).At baseline, immunohistochemical staining score of 5-HT, IL-1, TNF-α, histamine, tryptase were significantly increased in IBS patients than in healthy controls (P<0.000 1).After treatment with mesalazine+trimebutine, above-mentioned inflammatory mediators were significantly decreased (P<0.05).In IBS-D patients, the total efficacy rate in mesalazine+trimebutine group was significantly increased than that in trimebutine group (85.0% vs.45.0%, P=0.008).In IBS-C patients, no significant difference in total efficacy rate was found between mesalazine+trimebutine group and trimebutine group (55.0% vs.25.0%, P=0.053).Conclusions: Mesalazine combined with trimebutine is an effective and safe approach to reduce mast cell infiltration and release of related inflammatory mediators, and is more efficient for patients with IBS-D.

Objective:To explore the application value of free nail flaps in reconstruction of nail bed and fingertip defect.Methods:From January 2018 to June 2020, nine patients with free nail flap transplantation to treat fingertip injuries in Lishui People′s Hospital were included in this study. According to the Allen classification, 6 patients were characterized as type Ⅱ and 3 were characterized as type Ⅲ. Evaluation was based on the patients′ medical records and follow-up, including postoperative healing of recipient and donor sites, two-point discrimination, the Chinese Medical Association Hand Surgery Society′s evaluation of the function of severed finger replantation, and Michigan Hand Outcomes Questionnaire (MHQ) and Foot Function Index (FFI).Results:All patients successfully completed the operation, the operation time was 3.0-5.0 h (average 4.1 h), the intraoperative blood loss was 100-250 ml (average 178 ml), and the follow-up time was 12-40 months (average 25 months). The nails and flaps of all patients survived with primary healing. No complications were observed after surgery. The appearance of the reconstructed finger of 9 patients was similar to that of the uninfected side; the flap two-point discrimination was 5.0-7.5 mm; the replantation score and MHQ results were satisfactory. The toenail of the donor site grew well, and no deformity or pain with walking was noted.Conclusions:The free toenail flap was used to treat fingertip defects, with satisfactory clinical results in repairing tissue defects, reconstructing nail bed and maintaining finger length.

Objective To observe the effect of removal alcohol with iodine or not in PICC maintenance . Methods Sixty patients who had PICC were randomized into observation group ( n =30 ) and control group ( n=30 ) .Besides routine disinfection method and operation , the observation group used alcohol to remove the iodine.While the control group only received the routine disinfection method and operation .The bacterial cultivation of the skin surface around the PICC insertion site , drying time and time to change the dressing were compared between groups , and observed rolled-up dressing after 7 days of change the dressing .Results The bacterial cultivation of the skin surface around the PICC insertion site were not significantly different between groups (t=6.38,P >0.05).The natural air drying time and the total time of change the dressing of the observation group were (6.41 ±4.80) minutes and (16.60 ±2.71) minutes, which were significantly shorter than those of the control group (t =6.38,2.89, respectively;P <0.05).And the rolled-up dressing was 93.3%in the control group and 10.0%in the observation group .The difference was significant (χ2 =41.72, P<0.05).Conclusions Using alcohol to remove the iodine in PICC maintenance can shorten the nursing time and improve the work efficiency .It can also decrease the rolled-up dressing, reduce the rate of infection of the insertion site and increase the safety of PICC indwelling .What's more, iodine on the skin removed with alcohol makes the patient feel much more comfortable .

Objective To develop the female breast cancer patients' needs assessment scale and test its reliability and validity.Methods Based on extensive literature and Maslow model, the initial assessment scale of female breast cancer patients' needs was established by literature analysis, qualitative interviews and experts consultation. The method of convenience sampling was used to conduct the pilot survey, and evaluate its reliability and validity.Results The initial needs assessment scale of breast cancer patients consists of 37 items. Through item discrimination, correlation analysis, Cronbach's α, factor analysis, 7 items were deleted, and the 30 items scale was eventually formed and consists of 5 dimensions, including physiological needs, safety needs, love and belonging needs, esteem needs and self-actualization needs. The overall Cronbach's α and split half reliability were 0.952 and 0.856 respectively. The content validity ratio (CVI) was 0.99. Construct validity was analyzed by the method of factor analysis. The 5 common factors extracted by orthogonal rotation with principal component method showed consistency with the theoretical conception. The results showed good reliability and validity of the scale.Conclusions Based on Maslow's hierarchy of needs theory, the female breast cancer patients' needs assessment scale has good reliability and validity, and can be used to evaluate the needs of breast cancer patients.

Objective To investigate the effect of human caring ability on job satisfaction of nurses in the oncological department. Method About 215 nurses in the department were enrolled in the study with both caring nurse-patient action scale (CNPI-23) and Minnesota satisfaction questionnaire (MSQ). Results CNPI-23 score on oncology nurses was 88.42±13.54 and MSQ score 44.87±11.34. Nurses' caring ability was associated with age, work experience, marital status and job title. Nurses' humanistic care ability was positively correlated with job satisfaction (r=.433;P<0.001). Job satisfaction was positively related with humanistic care ability (t=6.617, P<0.001), which explained 23.4% variable. Conclusions The oncological nurses' caring ability needs to be improved. It is possible to improve the capability of nurse humanity from the perspective of job satisfaction.

Objective To explore the effects of aripiprazole on clinical symptoms and neurotrophic factor levels in patients with schizophrenia. Methods Forty patients with schizophrenia and 40 normal controls were included in the study. The clinical symptoms of patients receiving aripiprazole only for 12 weeks were evaluated by using the Positive and Negative Syndrome Scale (PANSS). Stroop Color-Word Test (SCWT), Continuous Performance Test, Digit-Symbol Coding Test and Trail Making Test-A were used to evaluate the cognitive function both in patients and controls. Serum levels of Nerve Growth Factor (NGF), Brain Derived Neurotrophic Factor (BDNF) and Neurotrophin 3 (NT-3) were measured using enzyme linked immunosorbent assay. Results The clinical scores, cognitive function and levels of neurotrophic factors were different before and after treatment (P<0.01). And those were significantly lower in patients than in control group (P<0.05). Before treatment, BDNF was negatively correlated with PANSS negative symptom score (r=-0.362, P=0.022);NGF was related to the total score of PANSS (r=0.332, P=0.037) and positive symptoms (r=0.401, P=0.010); NT-3 was associated with negative symptom scores (r=-0.376, P=0.017) and SCWT-color words (r=0.332, P=0.037) in patient group. After treatment, the increase in BDNF was correlated with the reduction in PANSS total score (r=0.371, P=0.018), negative symptom score (r=0.345, P=0.029) and general pathology score (r=0.342, P=0.031). There was a correlation of the increase of NGF with the decrease of PANSS total scores (r=0.437, P=0.005) and with positive symptom scores (r=0.357, P=0.024). Conclusion Treatment with Aripiprazole can improve the clinical symptoms and cognitive functiona impairments in patients with schizophrenia, which may be related to the increase in serum levels of BDNF, NGF and NT-3.