Objective To evaluate application of fist clenching method with shaking hands in venipuncture to elderly angular patients. Methods 360 elderly angular patients were randomly divided into group A and group B with 180 cases in each group. Group A used fist clenching method with shaking hands, group B adopted traditional fist clenching method in venipuncture. Pain degree and one-time success rate of two groups were compared. Results One-time success rate of group A in venipuncture was obviously higher than group B, while pain degree of group A was less than group B. Conclusions Fist clenching method with shaking hands to elderly angular patients can raise success rate in venipuncture, and reduce pain degree of patients.

Objective Analyzing the construction process and application of health appropriate technology database in Zhejiang province and proposing related considerations and recommendations for the database construction.Methods To design and construct the technology database system,and using excel software to calculate statistic data.Results Established a health appropriate technology database,which contains 826 technologies that can be selected and promoted by the demonstration bases in the whole province.Conclusions The establishment of the technology database increased the efficiency of health appropriate technology transformation at the provincial level,and also provided a reference for the national-wide generalizing of health appropriate technology.

Objective To evaluate the positions and forms of temporomandibular joints(TMJ) with different vertical skeletal patterns in Class Ⅱ division 1 patients.Methods Cone-beam CT scans of 117 Class Ⅱ division 1 adolescent patients (including 30 patients with high angle,58 with average angle and 29 with low angle) were selected and reconstructed using Mimics 10.0 software.Fourteen measurements related to the positions and forms of condyle,forms of fossa and joint spaces were performed.Results Compared with high and average angle patients,the condyles in low angle patients located more posteriorly and inferiorly [the vertical distances between condyle and S was (20.67 ± 1.99) mm and the antero-posterior distances between condyle and S was (9.15± 1.61) mm].The joint fossae were deeper[the fosse depths was (7.83 ± 1.06) mm].The angles of posterior joint node bevels were bigger[the inclinations were (28.91 ±3.94)°].The condyles were shorter,thicker,tipped more anteriorly and positioned more posteriorly[the proportions of post-positioned condyles of low angle,average angle and high angle patients were 26％,4％,0％ respectively].Conclusions Class Ⅱ division 1 adolescents with different vertical skeletal patterns had different forms of fossae,and different positions and forms of condyles.

Objective:To investigate the clinical phenotype and gene mutation in a child with developmental disorders caused by CTNNB1 gene mutation. Methods:Clinical data of a child with CTNNB1 gene mutation who was admitted to Xiamen Hospital of Fudan University Affiliated Pediatric Hospital in May 2017 were collected, whole exome sequencing technology was applied to verify the family lineage of the child, and the pathogenicity of mutation site was analyzed. Results:The patient was a 6 years and 1 month old male, with a clinical phenotype including mental retardation, motor developmental disorders, speech disorders, visual disorders (internal strabismus), microcephaly, and behavioral problems (social withdrawal, overdependence, etc.), as well as panic syndrome (i.e., sudden shrieking in response to auditory and visual stimuli, extensional rigidity of the body, etc., followed by short periods of general extensional rigidity). The whole exome sequencing results showed the presence of a de novo mutation c.283(exon4)C>T in the CTNNB1 gene, and the c.283(exon4)C>T mutation was interpreted as pathogenic (PVS1+PS2+PS1+PM2+PM) according to the American College of Medical Genetics and Genomics variant classification criteria and guidelines. No relevant genetic variants were found in the parental family verification. Conclusion:CTNNB1 gene mutation c.283(exon4)C>T can cause neurodevelopmental disorders, including mental retardation, motor developmental disorders, speech disorders, visual disorders, microcephaly and behavioral abnormalities.

Schinzel-Giedion syndrome caused by SETBP1 gene mutation is a rare neurodevelopmental disorder characterized by neurodevelopmental disorders, multi-organ congenital developmental abnormalities (such as skeletal anomalies, urinary and renal malformations, heart defects, etc.), and an increased risk of childhood cancer. The clinical data and diagnosis and treatment process of a patient with Schinzel-Giedion syndrome related neurodevelopmental disorders caused by SETBP1 gene mutation were reported in this article. The clinical characteristics of the disease were analyzed through literature review to improve clinical doctors′ understanding of the disease.

Objective To explore the effect of the physician-nurse-social worker linkage rehabilitation model on the psychological status in patients receiving methadone maintenance treatment(MMT).Methods Ninety-four patients who received MMT were enrolled and randomly divided into experimental group(n = 48)and control group(n = 46).The experimental group received physician-nurse-social worker linkage rehabilitation model intervention,while the control group received conventional methadone treatment service.The anxiety,depression and quality of life of the two groups were evaluated before the intervention,3 months and 6 months after the intervention.Results After 6 months of physician-nurse-social worker linkage rehabilitation mode intervention,the depression status and the anxiety status of the experimental group subjects were significantly improved compared with those before intervention,and both BDI and BAI scores were significantly lower than those of the control group subjects(P＜0.05).Moreover,the proportion of"had depression"and"had anxiety"in the experimental group were significantly lower than those in the control group(P＜0.05).After 6 months of intervention,the QOL-DA score of the experimental group subjects(183.77±8.90)was significantly higher than that of the control group sub-jects(174.76±11.14)(P＜0.01).Conclusion The physician-nurse-social worker linkage rehabilitation model had certain advantages in improving the psychological state of MMT patients,which is worthy of promotion.