Objective:To observe the effects of ultrasound guided transversus abdominis plane block (TAPB) on pain, rehabilitation indexes and immune function of postoperative in patients undergoing laparoscopic colorectal cancer surgery.Methods:A total of 100 patients undergoing laparoscopic colorectal cancer surgery admitted to Jiading Branch of Shanghai First People′s Hospital/Jiangqiao Hospital of Jiading District and Shanghai First People′s Hospital from February 2020 to February 2021 were selected as the study subjects, including 43 patients performed epidural block (control group) and 57 patients performed TAPB (observation group). The clinical indicators, vital signs parameters, pain degree, immune function in the two groups were compared.Results:The exhausting time, defecation time, getting out of bed time and hospitalization time in observation group were shorter than those in control group: (2.71 ± 0.54) d vs. (2.99 ± 0.66) d, (3.02 ± 0.49) d vs. (3.49 ± 0.56) d, (3.20 ± 0.89) d vs. (3.85 ± 1.08) d, (6.81 ± 0.98) d vs. (7.71 ± 1.08) d, there were statistical differences ( P<0.05). The diastolic blood pressure, systolic blood pressure and heart rate at pre-anesthesia, immediate incision of the skin, end of the surgery between two groups had no significant differences ( P>0.05). The scores of visual analogue scale at 4, 24, 48 and 72 h after surgery in the observation group were significantly lower than those in the control group ( P<0.05). The levels of CD 3+, CD 4+, CD 4+/CD 8+ and IgM after surgery for 3 d in the observation group were higher than those in the control group: 0.512 ± 0.054 vs. 0.487 ± 0.051, 0.280 ± 0.036 vs. 0.222 ± 0.032, 1.36 ± 0.29 vs. 1.17 ± 0.26, (152.53 ± 34.3) kU/L vs. (138.86 ± 31.18) kU/L, there were statistical differences ( P<0.05). Conclusions:TAPB can effectively reduce the degree of postoperative pain and immunosuppression after laparoscopic colorectal cancer surgery, so as to promote postoperative rehabilitation of patients.

Objective: To investigate the intention of breast reconstruction in breast cancer patients and explore the potentially-related impact factors. Methods: Breast reconstruction related questionnaires were distributed among 525 women breast cancer patients in multiple centers. Proportion constitution, univariate analysis and Logistic regression analysis were applied to the returned data. Results: 84 valid questionnaires were collected. There were 35.1%(170/484) patients who had the intention of breast reconstruction, and the patients with no intention of reconstruction accounted for 40.7%(197/484), while 24.2%(117/484) of the patients showed an unclear attitude to breast reconstruction. The average cognitive and attitude scores of reconstructive patients were significantly higher than those without reconstructive wishes (t=8.194, P<0.05; t=13.795, P<0.05). The higher rate of breast reconstruction willingness in breast cancer patients was associated with a lower age (χ²=13.466, P<0.05) and a better educational background (χ²=14.955, P<0.05). The rate in in-service personnel was higher than that in unemployed personnel (χ²=12.744, P<0.05). The rate of breast reconstruction willingness in the patients with various family income and medical insurance categories was significantly different (χ²=10.551, P<0.05; χ²=4.255, P<0.05). The marital status and the place of residence had no relation to the rate of reconstruction willingness (P>0.05). A further Logistic regression analysis showed that there was a significant correlation between the intention of breast reconstruction and the following factors: the age of patients, family income, medical expense category, the attitude of breast reconstruction (P<0.05). Conclusions Breast cancer patients have severe lack of knowledge of breast reconstruction. However, the young patients, with good economic condition and a positive attitude to reconstruction had a strong desire for breast reconstruction. Therefore, it is necessary to strengthen the communication with breast cancer patients in clinical environment and improve the cognitive level of patients and their families to increase the rate of breast reconstruction.

There are many factors that may affect the microenvironment of acute and chronic wounds.This article reviews the relationship between temperature factor in the external microenvironment of wound surface and wound healing.The temperature changes in different types and stages of wounds are closely related to the wound healing status.Therefore,wound temperature monitoring provides timely,reliable,and non-invasive method in the evaluation of wound status.As low temperature affects the physiological state of wound,relieving the low temperature state and maintaining normal temperature of the microenvironment of wound can promote wound healing.Further research is needed on the wound repair related effector cell proliferation and the mechanism of regulatory function to determine the optimal constant temperature and heat treatment duration needed for wound healing.

Objective To investigate the psychological resilience and perceived stress of nursing students during the initial period of clinical practice and to explore the correlation between them. Methods From July to September 2016, we selected 246 nursing students at two ClassⅢ Grade A hospitals in Harbin City as subjects by convenience sampling. All of the nursing students were investigated with the Connor Davidson Resilience Scale (CD-RISC) and Perceived Stress Scale (PSS) for nursing students during clinical practice. Results A total of 246 questionnaires were sent out and 228 valid questionnaires were collected in this study. The scores of CD-RISC and PSS of nursing students during the initial period of clinical practice were (86.48±14.63) and (59.39±14.64) respectively with a negative correlation between them (r=-0.368, P＜ 0.001). The toughness and competency dimension in the CD-RISC were the influencing factors of perceived stress of nursing students during the initial period of clinical practice (P＜ 0.05). Conclusions Psychological resilience of nursing students during the initial period of clinical practice can influence the perceived stress. Educators should take reasonable intervention to improve psychological resilience of nursing students so as to reduce the perceived stress of nursing students.