Extensive burns can cause nonnegligible acute and chronic damage to central nervous system of patients. The damage of central nervous system may have a profound impact on patients, including neurobehavioral changes such as post-traumatic stress disorder, depression, anxiety, and sleep disorder. These changes may persist after injury, greatly affecting patients' integration into society and return to work. This paper systematically reviewed the clinical manifestations, pathogenesis, and current intervention methods of mental disorders in patients with extensive burns, aiming to provide a basis for further understanding, prevention, and treatment of patients with mental disorders after burns.

Objective:To compare the pros and cons of harvesting ear cartilage through anterior and posterior auricular approaches during rhinoplasty.Methods:From January 2017 to December 2018, 63 patients with otochondral rhinoplasty in our hospital were enrolled in this study, 60 were female and 3 were male; the average age was 31.6 years (range, 18 to 43) . They were randomly divided into anterior auricular approach group with 32 cases (64 sides) and posterior auricular approach group with 31 cases (62 sides). Surgical duration, complications and postoperative scar of the two methods were analyzed.Results:The average time for harvesting the ear cartilage through posterior auricular approach and anterior auricular approach was (20.8±1.7) min and (12.6±1.1) min, respectively ( P<0.01). The overall complication rate was 15.6% for posterior auricular approach group and 4.8% for anterior auricular approach group. The wound healed well in both groups, and there was no significant difference in postoperative scar between the two groups during an average 13 months follow-up period. Conclusions:While both the anterior and the posterior auricular approaches present with similar inconspicuous scarring, the use of anterior auricular approach alone to harvest ear cartilage during rhinoplasty provides both the surgeons and the patients with easier access, shorter surgical duration, and fewer complications. Hence, we believe that the anterior auricular approach possesses greater advantages than the posterior auricular approach.

Objective:To investigate the clinical effect of facial depression correction by using free anterolateral thigh adipofascial flap and human acellular dermal matrix.Methods:Nineteen facial depression patients (3 males and 16 females), age ranges from 16 to 56 years (average age: 29.1±10.37 years), caused by different reasons were selected in this research from Jan. 2008 to Dec. 2020. In the stage I operation, anterolateral thigh adipofascial flap was designed according to facial depression area and harvested to fill in the depression with vascular anastomosis; In the stage II operation, the human acellular dermal matrix was used to fill in the remained depression edge according to facial subunit.Results:All free anterolateral thigh adipofascial flap survived well. All patients revealed fascial subunit tissue atrophy of different degree in infraorbital, nasolabial sulcus and temporal areas which were repaired by using cellular dermal matrix and obtained satisfying effect during 1 to 8 years of follow-up with no obvious rejection. 18 of 19 patients showed flap hypertrophy and corrected by liposuction. All patients recovered well after 1 to 8 years of follow-up.Conclusions:Humana cellular dermal matrix could make up the limitations of treating fascial depression deformity when using anterolateral thigh adipofascial flap. The combination method of above approaches could obtain satisfying clinical effect, which is worthy of clinical promotion.

Background/Aims: Older adults are vulnerable to central obesity, while the association of changes in central fatness with risk of diabetes and metabolic control has not been investigated among this particular population. This study was aimed to address these issues. Methods: A total of 1,815 adults aged ≥ 60 years without diabetes at baseline were followed for 4 years. Incident diabetes was ascertained based on plasma glucose, hemoglobin A1c, medical history, and/or the use of anti-diabetic drugs. Central fatness was assessed by waist circumference (WC), waist-height ratio (WHtR), and body roundness index (BRI). Logistic regression analyses were used to assess the association of changes in central fatness with risk of diabetes, along with dose-response and mediation analyses. Results: During the 4-year follow-up, 177 participants developed diabetes. The risk of diabetes was increased by 42%, 41%, and 40% per 1 standard deviation increases in WC, WHtR, and BRI, respectively, in multivariable-adjusted models (all p < 0.01). Moreover, these relationships were all linearly-shaped (all pnonlinearity ≥ 0.11). Increases in WC, WHtR, and BRI correlated with increases in hemoglobin A1c, triglycerides-and-glucose index, triglycerides, white blood cell, and C-reactive protein (all p ≤ 0.04). Yet only changes in hemoglobin A1c and triglycerides-and-glucose index were identified as the possible mediators for risk of diabetes, with their mediating effect being about 35% and 21%, respectively. Conclusions Increases in central fatness were related to elevated risk of diabetes, and this association might be partly explained by the worsening of glycemic control and insulin resistance in older adults.

Objective:To evaluate the clinical effect of autologous nanofat combined with pearl fat transplantation in comprehensive improvement of lacrimal groove depression.Methods:Seventy-eight patients (age ranges from 28 to 56 years, with average 38 years) who desired for lacrimal groove improvement were involved in this study from Jan. 2019 to Jun. 2020 in the Department of Plastic Surgery in Peking Union Medical College Hospital. Primary fat tissue was obtained and purified by liposuction. Nanofat and pearl fat were prepared and injected into lacrimal groove area in different layers and multiple points evenly to ameliorate depression. Visual analogue scoring (VAS) was used for evaluating injection pain. Dark eye circles, faint lines on lower eyelid, color spots and lacrimal groove depression between pre-operation pictures and post-operation pictures of 1 year follow-up were evaluated by patients＇ satisfaction scores.Results:All 78 patients revealed mild swelling and disappeared in 3 to 4 days. Injection areas were stable in 3 months. All patients appeared no complications such as infection, hematoma, fat liquefaction, local induration and so on. Among 78 patients, 2 patients showed ecchymosis after surgery which disappeared in 10 days, and 1 patient showed uneven appearance which disappeared after timely treatment. After 1 year of follow-up, the average satisfaction score of improvement was 8.9±0.5, which showed satisfied post-operative effect.Conclusions:Autologous nanofat combined with pearl fat transplantation has high feasibility, short operation time, which could achieve good effect of facial rejuvenation with high patients＇ satisfaction. In this case, this technique is worthy of clinical promotion.

Breast cancer-related lymphedema is incurable once it occurs. The management of lymphedema is a long-term and continuous process, in which self-management plays an important role. This article reviews the research on self-management of lymphedema from three aspects: prevention, subclinical stage and maintenance stage. It aims to provide reference for effective self-management of breast cancer-related lymphedema in clinic.

Objective To explore the application effect of self-made micro-video in practical teaching of mental and psychological nursing.Methods Two classes in major Nursing enrolled in 2013 were selected randomly. A total of 51 students from Class 12 were designated as the experimental group, and were taught assisted by self-made micro-videos, while another 53 students from Class 11 belonged to the control group, and were taught assisted by traditional instructional video. The students were surveyed by questionnaire on knowledge awareness rate on mental disease prevention, regulated in mental health work index investigation and evaluation scheme, formulated by General Office of National Health and Family Planning Commission of the People's Republic of China, basing on which, teaching effect was compared.Results After practical teaching, total accuracy rate of case examination by students in the experimental group was 94.12% (compared with 39.22% before the practice), and in control group, 81.13% (compared with 33.96% before the practice). Scores of attitude towards mental disease in the experimental group were (54.39±4.68), and in the control group (35.15±7.69) (t=15.49, P<0.01).Conclusions Applying self-made micro-video in practical teaching of mental and psychological nursing can effectively improve accuracy rate of mental disease recognition of the students, correct their attitude towards patients with mental disorders, with satisfying effect in practice.

Objective To investigate the physical activity status in patients with acute myocardial infarction during recovery period and its influencing factors. Methods Patients at 3 to 6 months after acute myocardial infarction were enrolled in our study by convenience sampling method. They accepted questionnaire survey with international physical activity questionnaire (IPAQ), patient health questionnaire (PHQ-9) and a self-developed questionnaire about sexual life. Results Forms of patients′physical activities mainly presented as walking and moderate intensity activities whose medians of total metabolic equivalent ( MET) of physical activity for 1 week were 1 386. 00 and 410. 40. A few of patients attended intensity activities whose median total MET of physical activity for 1 week was 0. 00. Patients took part in physical activities mainly focusing on leisure time, transportation activities and housework. Patients lacked physical activity above moderate intensity. There was no significant relationship between physical activity level and BMI, heart function at discharge (Killip classification), ejection fraction (EF) (P >0. 05). There were significant differences in patients′ total energy consumption of walking, physical activity for 1 week, moderate intensity activities and housework according to cardiac functional grading at present (P<0. 05). However, there were still some patients who exercised little with good cardiac functions and normal EF values. Physical activities in patients with depression were less than that in patients with non depression (P<0. 05). Lastly, sexual life of most patients had not restored. Conclusions There were not enough physical activities in patients with acute myocardial infarction during recovery period. Lack of knowledge, low self confidence and excessive caution may be the main influencing factors. Individualized health-education and nursing intervention are needed to promote the healthy behaviors.

Objective To investigate the effects of problem-based learning (PBL) applied in the chapter of " Chronic diseases nursing in community" in course of Community Nursing in traditional Chiuese medicine colleges.Methods A total of 50 undergraduate students of 201 1 in the nursing specialty in some traditional Chinese medicine colleges were chosen with the convenience sampling method.They were randomly divided into control group and observation group,with 25 students in each group.PBL was applied in the observation group,choosing 2 teaching blocks from the course of Community Nursing.The same blocks were chosen for the method of teaching and learning,which was applied in the control group.The score of California Critical Thinking Disposition Inventory (CCTDI) of students and the teaching effects in two groups were evaluated one week before and after PBL implemented.Results The total score of CCTD1 in the observation group was(275.36 ± 16.41) after intervention,while the score in the control group was(266.28 ± 18.67) (P ＞0.05).The mean increase scores in the observation group were higher than that in the control group,but the difference was not statistically significant (P ＞ 0.05).The mean scores of PBL teaching evaluation were closed to the median in basic knowledge reserve,study attitude,ability improvement,cooperation,professional quality in the observation group.Conclusions The application of PBL teaching method in the teaching of Community Nursing does not have strongly impact on the ability of students' critical thinking.

[Abstract ] Objective Liver cirrhosis modeling with carbon tetrachloride (CCL4) may be influenced by many factors, such as drug concentration and dosing methods.In this article, we explored the influences of different concentrations and different dosing methods and time of CCL4 on the induction of liver cirrhosis in rats. Methods We constructed rat models of liver cirrhosis with different con-centrations of CCL4(30%and 50%), using different dosing methods (subcutaneous injection, intraperitoneal injection, and intragastric administration) , and for different lengths of dosing time (8 wk, 10 wk, and 12 wk) .We collected blood and liver tissues from the rats at different time points for HE and MTC staining, biochemical and histomorphological scores based on the Scoring Model for Liver Cirrho-sis Disease (SLCD, expressed by R) and the Laennec Fibrosis Scoring System (LFSS, expressed by L), and analysis of the results by 3 ×2 ×3 factorial experiment design. Results The R value was lower in the intraperitoneal injection than in the subcutaneous injection and intragastric administration groups, and so was it in the 50% than in the 30%CCL4 group, decreasing with the extending of dosing time, with statistically significant differences in the main effects ( P<0.05) as well as a remarkable correlation among drug concentrations, dosing methods, and dosing time (P<0.05).The L value was higher in the intraperitoneal injection than in the subcutaneous injection and intra-gastric administration groups, and so was it in the 50% than in the 30% CCL4 group and in the 12 wk than in the 10 wk and 8 wk groups, with statistically significant differences in the main effects ( P<0.05) but no remarkable correlation among drug concentrations, dosing methods, and dosing time ( P>0.05) .The death rate showed an increasing trend in the intraperitoneal injection, subcutaneous injection and intragastric administration of 30% CCL4 (25.33%, 37.78%, and 38.37%) and 50% CCL4 (42.97%, 47.85%, and 51.88%), higher in the 50%than in the 30%CCL4 .However, no significant differences were found in the survival curves among differ-ent dosing methods or between different drug concentrations (P>0.05). Conclusion Intraperitoneal injection was better than subcu-taneous injection and intragastric administration of CCL4 in inducing liver cirrhosis, and the three dosing methods all showed progressively improved efficiency of modeling with the increase of drug concentration and dosing time.