Objective:To analyze the correlation between psychological resilience and stigma, self-efficacy and self-esteem in patients with constipation after lower limb fracture surgery, and to determine nursing counter measures.Methods:A total of 102 patients who underwent lower limb fracture surgery in Jingdezhen Hospital of Traditional Chinese Medicine from April 2020 to March 2023 were convenience sampling selected as the study objects by a cross-sectional survey. They were divided into constipation group and normal group according to whether postoperative constipation was complicated. Baseline data, Psychological Resilience Scale (CD-RISC), Social Impact Scale (SIS), General Self-efficacy Scale (GSES), and Pearson ′s method was used to analyze the correlation between CD-RISC score and SIS score, GSES score, and RSES score in patients with constipation. Results:Totally 102 survey subjects aged 18-75 (38.87 ± 6.83), including 57 males and 45 females. Postoperative constipation occurred in 37 patients, accounting for 36.27% (37/102). The average age, constipation secret history rate, postoperative analgesic use rate, CD-RIS, SIS, GSES and RSES scores of the constipation group were (50.74 ± 5.52) years, 72.97% (27/37), 62.16% (23/37), (42.11 ± 5.03) points, (59.78 ± 6.40) points, (22.74 ± 3.57) points, (20.15 ± 2.32) points, respectively. The normal group was (37.81 ± 7.45) years old, 40.00% (26/65), 41.54% (27/65), (78.43 ± 5.95) points, (36.10 ± 4.03) points, (28.26 ± 3.53) points, (27.05 ± 5.29) points, respectively. The difference between the two groups was statistically significant ( t values were 7.52-31.29, χ2 values were 10.27 and 4.01, all P<0.05). In the constipation group, CD-RISC score was negatively correlated with SIS score, and positively correlated with GSES score and RSES score ( r values were -0.869, 0.608, 0.582, all P<0.05). Conclusions:The incidence of constipation after lower limb fracture is high, and its psychological resilience is related to stigma, self-efficacy and self-esteem. Clinical nursing intervention is needed to improve the prognosis of patients.

Objective To screen the main environmental factors affecting the growth of Prunella vulgaris L.based on MaxEnt model and ArcGIS;To predict its potential suitable habitats in China;To provide reference for the artificial cultivation of Prunella vulgaris L.Methods Totally 346 pieces of sample point data of Prunella vulgaris L.were collected.Combined with data of 38 ecological factors,the main environmental factors affecting the distribution of Prunella vulgaris L.were screened using MaxEnt model.ArcGIS software was used to evaluate the habitat suitability of Prunella vulgaris L.and analyze the distribution of suitable areas for Prunella vulgaris L.worldwide and in China.Results The main ecological factors affecting the distribution of Prunella vulgaris L.were upper(0-30 cm)soil gravel volume percentage,soil effective water content,upper(0-30 cm)soil exchangeable sodium salt,specific soil types related to agricultural use in soil units and upper(0-30 cm)soil sand content.The highly suitable areas of Prunella vulgaris L.were mainly in Yunnan,Heilongjiang,eastern Inner Mongolia and central Sichuan.Conclusion The predicted results can provide a reference for the introduction of cultivation and sustainable resource utilization of Prunella vulgaris L.

Anterior cervical discectomy and fusion is one of the classic procedures for the treatment of cervical spondylosis, and dysphagia is a common perioperative complication of this procedure, which affects patients′ recovery to different degrees. This paper summarizes and analyzes the perioperative assessment and interventions in the care of patients with dysphagia after anterior cervical discectomy and fusion, aiming to improve clinical nursing staff′s attention to dysphagia in patients after anterior cervical discectomy and fusion, and provide scientific basis for the prevention and treatment of high-risk groups.

To enhance the learning stickiness, improve low completion rate of online teaching, and promote teaching quality has become the key to solve the contradiction in online teaching. In this paper, taking the teaching of biochemistry as example, based on the trigger mechanism, maintenance mechanism and migration mechanism of sticky learning, guided by the three-dimensional goal of "knowledge and skills, process and method, emotional attitude and values", the BOPPPS (bridge-in, objective, pre-assessment, participatory-learning, post-assessment, summary) teaching model was combined with online teaching. According to the interactive behavior in the course learning space, the Spearman rank correlation analysis was performed by SPSS 18.0 software to comprehensively evaluate the learning stickiness degree. The research has found that, due to its "micro but refined, compact structure and student-centered" characteristics, BOPPPS combining with online teaching can effectively make up for the time and space limitations of offline teaching and the excessively broad online teaching, bring benefits from the perspectives of "inclusion, attraction and production", promote students' active learning, and practically improve learning stickiness. The research provides a new idea for creating online "golden" courses.

Objective:To learn about the epidemic situation and trend of human brucellosis in Menyuan Hui Autonomous County (referred to as Menyuan County) of Qinghai Province, and to provide reference for formulating brucellosis prevention and control measures in Menyuan County.Methods:Data on human brucellosis in Menyuan County reported by the Infectious Disease Reporting Information Management System of China Disease Control and Prevention Information System from 2013 to 2020 were collected and analyzed by descriptive epidemiological analysis (three distribution).Results:A total of 186 cases of brucellosis were confirmed from 2013 to 2020, with an average annual incidence of 14.553/100 000. The annual incidence rate was increasing year by year(χ 2trend = 22.08, P = 0.002). The cases were distributed in 67 villages of 12 towns; cases were more common in the age group of 15-< 65 years old (96.24%, 179/186), and there were more men than women cases (sex ratio was 3.89∶1.00, 148/38). Conclusions:The incidence rate of brucellosis cases in Menyuan County is increasing year by year, and the scope of its impact is constantly expanding. A multi-sectoral joint prevention and control mechanism should be established to strengthen management, increase the prevention and control of brucellosis, and stop the spread of the epidemic to surrounding counties and cities.

Objective:To summarize and analyze the current application status of oral mucosal graft (OMG) technique in the repair of ureteral strictures in China, and clarify the feasibility, safety and effectiveness of this technique.Methods:The 175 patients who underwent repair of ureteral stricture using oral mucosal patches from June 2015 to February 2022 were etrospectively analyzed in 14 medical centers in China, including 49 cases in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 32 cases in Affiliated Seventh Medical Center of PLA General Hospital, 3 cases in The Second Hospital of Anhui Medical University, 6 cases in The First Affiliated Hospital of Zhengzhou University, 56 cases in Peking University First Hospital, 3 cases in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 cases in Shanghai Sixth People' s Hospital, 4 cases in General Hospital of Estern Theater Command, 4 cases in Lanzhou University Second Hospital, 2 cases in Guizhou Province People 's Hospital, 2 cases in Peking University People' s Hospital, 5 cases in Jinzhou First People's Hospital, 5 cases in The First Affiliated Hospital of Wannan Medical College, 1 case in Shandong Provincial Hospital. In this study, 127 patients (72.6%) used lingual mucosal patches, 32(18.3%) labial mucosa, and 16(9.1%) buccal mucosa. The surgical approach for OMG ureteral reconstruction was mainly minimally invasive, with robot-assisted laparoscopy in 84 patients (48.0%), traditional laparoscopic surgery in 87 patients (49.7%), and open surgery in only 4 patients (2.3%). There were 133 males and 42 females with an average age of (35.0±17.2) years. The mean body mass index (BMI) and stenosis length were (23.1±4.1) kg/m 2 and (4.7±1.8) cm, respectively. The stricture was located in the left ureter in 116 patients, right ureter in 58 case and bilateral ureter in 1 case. The most common causes of ureteral stricture were endoscopic surgery in 88(50.3%)patients, congenital stricture in 55(31.4%)patients, failed ureteroplasty in 29(16.6%)patients, history of extracorporeal shock wave lithotripsy in 13(7.4%)patients, radiotherapy history in 3(1.7%)patients and other causes in 6(3.4%)patients. Strictures were mainly located in the upper ureter, accounting for 61.7% (108/175 cases), followed by 36.0% (63/175) at the ureteropelvic junction and 2.3%(4/175)in the middle ureter. According to the surgical methods, the patients were divided into robot-assisted laparoscopic surgery group ( n=84), traditional laparoscopic surgery group ( n=87)and open surgery group ( n=4). Subgroup analysis of patients in robot-assisted laparoscopic and traditional laparoscopic surgery groups was performed. There were no significant difference in preoperative data between the two groups except for age (32.0±18.3) years vs.(37.0±15.9)years, P=0.040], BMI[(22.5±4.3)kg/m 2 vs. (23.7±3.6)kg/m 2, P=0.028], and etiology of stenosis [endoscopic injury, 34(40.5%) vs. 53(60.9%), P=0.012]. Preoperative hydronephrosis and stricture length were assessed by CTU and ureterography. Ureterography 7-9 weeks after surgery showed patency of the reconstructed segment, or no recurrence of hydronephrosis was judged as success. Evaluate the operation method, operation time, success rate, length of OMG in repairing ureteral stricture between laparoscopic and robot-assisted groups. Results:The overall success rate of oral mucosal graft repair surgery reached 97.7%(171/175). The success rate of ureteral reconstruction in the two groups were 96.4%(81/84)and 98.9%(86/87), respectively ( P=0.351), and the difference was not statistically significant. There was no significant difference for operation time, intraoperative blood loss, and mean oral mucosal length between the robotic and laparoscopic groups[(244.7±85.8) min and (222.7±83.5)min ( P=0.116), (58.9±38.6) ml and (68.4±45.5) ml ( P=0.217), (5.0±2.0) cm and (4.6±1.5) cm ( P=0.350)], respectively.Postoperative complications were reported in 23 (13.1%) patients, such as fever, urinary leakage, lymphatic leakage, infection, but only 2 (1.4%) cases patients had complications of Clavien-Dindo score ≥ Ⅲ. The two patients developed urinary stricture after surgery with failed conservative treatment, and no urinary stricture occurred following endoscopic treatment.The short-term (three months after surgery)incidence of complications in the site where the oral mucosa was taken, such as difficulty in opening mouth, pain, and swelling, was 12.0% (21/175), and there was no significant difference for oral complications between patients harvesting different length of mucosal graft. Conclusions:Ureteroplasty with oral mucosal graft is a safe, feasible and reliable technique for ureteral reconstruction. At present, minimally invasive technology is the main surgical approach for ureteroplasty, and there is no significant difference in operation time and success rate between robotic surgery and laparoscopic surgery.

Objective:To explore the effect of grasping force circle training based on knowledge, attitude and practice theory in lung cancer patients with peripherally inserted central catheter.Methods:From March 2020 to December 2021, a total of 90 lung cancer patients with peripherally inserted central catheter in the Second People's Hospital of Datong were selected as the research objects using the convenient sampling method, and were divided into the control group and the observation group by the random number table method, with 45 cases each. The control group adopted routine grasping force circle training, and the observation group conducted grasping force circle training based on knowledge, attitude and practice theory. The scores of knowledge, attitude and practice, self-management ability and the incidence of complications were compared between the two groups.Results:After intervention, the scores of knowledge, attitude and behavior of the two groups were higher than those before intervention, and the scores of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05). After intervention, the scores of compliance of catheter maintenance, abnormal handling, confidence of catheter management, exercise of catheter, daily observation of catheter, information acquisition and daily life of catheter of the two groups were higher than those before intervention, and the scores of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05). After intervention, the incidence of complications of the observation group was lower than that of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Grasping force circle training based on knowledge, attitude and practice theory can improve the knowledge, attitude and practice level of lung cancer patients with peripherally inserted central catheter, improve their self-management ability, and reduce the incidence of complications.

Objective:To explore the clinical application of the posterior tibial artery perforator flap with the great saphenous vein (GSV) in the treatment of severe degloving injury of the forearm.Methods:From June 2015 to October 2020, 5 patinets (4 males and 1 female, aged 20-46 years old, mean age 37 years old) were treated in the Department of Hand Surgery of Yantaishan Hospital in Yantai. Aposterior tibial artery perforator flap with GSV was used to repair the partial wound of the injured forearm, together with the establishment of venous circulation of dorsal hand for all 5 patients. All the patients suffered from severe forearm degloving injury. Of which, 3 accompanied with ulna radius fracture, 2 with ulnar and radial artery injury and 2 with blood supply insufficiency in the injured fingers. The sizes of soft-tissue defect were 26 cm×18 cm-32 cm×25 cm. The sizes of the posterior tibial artery perforator flap with GSV ranged from 12 cm×5 cm to 33 cm×6 cm. The anastomoses were performed on the perforating artery and the radial artery. The GSV was anastomosed with cephalic vein with bridging anastomosis to re-establish the venous circulation of dorsal hand. Combined anterolateral thigh flaps (ALTF) were used to repair the rest wound of injured limbs in 4 patients, and the combined pedicled abdominal flap was used in 1 patient. The donor site of calf flap was sutured directly, and the skin of upper limb was thinned into medium thick to cover the thigh flap donor site, which was packed with pressure dressing. Regular follow-up reviews were carried out by outpatient clinic, telephone, WeChat APP or home-visit after the operation to observe the survival of flaps, the swelling of the distal end of injured limb, functional recovery and healing at the donor site. Functional recovery was evaluated according to the Evaluation Standard of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association.Results:All the grafted flaps in 5 patients survived. Necrosis at epidermal edge occurred in 1 calf flap, and achieved secondary healing after dress changing for 4 weeks. There was neither arterial nor venous crisis in all flaps. The oedema of the hand disappeared within 4-8 weeks, with clear dermatoglyph. There was no obvious enlarged circumference of thumb and fingers. The follow-up was carried out for 8-20 months, with 11 months in average. The flaps were elastic in good colour, and full texture without pigmentation. The donor site of the calf flap showed a linear scar. No swollen was seen in the hands of the injured forearm and the feet of donor lower legs. The range of motion of phalangeal joints was good. Recovery of finger sensation achieved at S 4. The recovery of the sensation of posterior tibial artery perforator flap reached S 3 in 2 patients and S 2 in 3 patients. Assessment of the Upper Limb Function using the Standard Issued by the Hand Surgery Society of Chinese Medical Association rated excellent in 3 patients and good in 2 patients. Conclusion:The posterior tibial artery perforator flap with GSV has a reliable blood supply with a small damage to the donor site. This flap is ideal for repair of severe degloving injury of forearm and meanwhile to achieve the re-establishment of venous circulation in dorsal hand.

Objective:The surgical method and clinical efficacy was studied on the anterior lateral malleolar venous network grafting in repair of the defects of superficial palmar arch.Methods:From February 2015 to July 2021, 8 cases (6 males and 2 females; aged 32-44 years old, mean age at 39 years old) were treated in the Department of Hand Surgery of Yantaishan Hospital. Anterior lateral malleolar venous network was grafted to repair the defects of superficial palmar arch of the patients. The patients had different degrees of tendon damage, and injuries of nerve, deep palmar arch, common palmar digital artery or proper palmar digital artery. The length of the vessel defect was 6.0-10.0 cm. Blood supply insufficiency occurred in 1st-5th digits in 1 case, 2nd-4th fingers in 5 cases, and 2nd-5th fingers in 2 cases. The anterior lateral malleolar venous network was transferred to repair 3 broken ends of vessels in 5 cases, 4 broken ends in 1 case and 5 broken ends in 2 cases. The wound of hand was sutured directly in 2 cases. The emergency surgical repair of the wound of hand by transfer of ALTPF was performed in 2 patients, and elective ALTPF transfer in 3 cases. Forearm dorsi-ulnar flap transfer was performed in 1 case. The follow-up reviews were carried out via the outpatient clinic visit, telephone, WeChat interviews or home visits. The blood supply of the distal digit, skin sensation, TPD, the range of motion of the phalangeal joints were observed.Results:The results showed that all the digits and the grafted flaps survived. The follow-up was carried out for 10-53 months, with an average of 17.9 months. The functions of digit extension and flexion, finger opposition and thumb opposition were restored in 5 cases, and the patients returned back to former jobs. The finger flexion and thumb opposition were limited in 3 cases, and these cases participated in light physical work. The proprioception of the digits were recovered, and the TPD was 5-7 mm. Functional recovery was evaluated according to the Evaluation Standard of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association and rated as excellent in 5 cases and good in 3 cases. The donor sites of the foot showed a linear scar. There was no effect on the function and the shape of the donor site.Conclusion:The anterior lateral malleolar venous network grafting is an ideal method in repair of the defects of superficial palmar arch.

To investigate the incidence and related factors of poststroke depression. Method140 new stroke patients admitted to The Eighth People’s Hospital of Jinan City from April 2019 to October 2019 were selected as the research objects，and the general information was registered. The patients were followed up at 2 weeks（group A ）、3 months（group B）according to Hamilton Depression Scale（HAMD）in order to understand the prevalence，and the related factors were statistically analyzed. ResultThe incidence rate of PSD in group A and group B was 25.7%（36/140）and 40.3%（48/119）respectively，all of them were mainly mild to moderate depression. Female，no stable workers，high education level，left hemisphere lesions，multiple lesions，relapsed patients，diabetes patients and bad habit of smoking and drinking had a high incidence of PSD，but the difference was not statistically significant（P>0.05 ）. Those with a monthly medical expenditure of less than 500 yuan and a lower Barthel score had a higher incidence rate，and the difference was statistically significant（P<0.05）. ConclusionThe incidence rate of post stroke depression is high，the sick crowd and incidence rate are varied with time. Women，unstable workers，high education level，left hemisphere lesions，multifocal disease，relapse，diabetes and patients with bad habit of smoking and drinking have high incidence trend of PSD. Those with monthly disposable medical expenses less than 500 yuan and low activities of daily living were the important risk factors of PSD.