Objective:To explore the benefit finding and influencing factors of primary caregivers of children with cerebral palsy.Methods:This study adopted the method of random sampling, 158 primary caregivers of children with cerebral palsy in the outpatient and inpatient wards of the Children′s Rehabilitation Department of the Second Affiliated Hospital of Wenzhou Medical University from November 2020 to January 2021 were selected as the research objects. The basic data questionnaire, Chinese version of benefit finding scale, simple coping style questionnaire and perceived social support scale were used to do investigation. The influencing factors of benefit finding of main caregivers of children with cerebral palsy were investigated by single factor analysis, Pearson correlation analysis and multiple linear regression analysis.Results:The score of benefit finding of the main caregivers of children with cerebral palsy was (62.4±7.0),which was above the middle level. The years of diagnosis, the payment method of medical expenses, the place of residence and the length of caring for children had a significant impact on the benefit finding of the main caregivers of children with cerebral palsy ( F=3.45, 3.75, 3.97, 6.60, all P<0.05). The main caregivers′ sense of benefit finding was positively correlated with positive coping style, family support, friend support, others′ support and perceived social support ( r=0.43, 0.20, 0.32, 0.24, 0.30, all P<0.05), and negatively correlated with negative coping style ( r=-0.36, P<0.01).The importance of those factors influencing the benefit finding of the main caregivers of children with cerebral palsy was as follows: positive coping style, place of residence and length of caring for children (standardized regression coefficients were 0.33, 0.22, -0.32, all P<0.05). Conclusions:The main caregivers of children with cerebral palsy have a good sense of benefit finding. The main factors affecting the benefit finding of the main caregivers are the children′s residence, the length of care and coping style.

Objective:To investigate the clinical effect of "mutual support" framework in costal cartilage rhinoplasty.Methods:From June 2020 to December 2021, the patients were enrolled and undergone rhinoplasty with bilateral lower lateral cartilage margin incision combined with nasal columnar incision in the Department of Plastic & Reconstructive Surgery of Zhejiang Provincial People’s Hospital. During the operation, the sixth costal cartilage was made into the nasal columella support graft(strut) and the nasal tip graft integrated scaffold, and the septal extension grafts (SEG). The strut and SEG were sutured in the same plane to construct the framework to correct the aesthetic defects of the nose. Abode Photoshop CS 6.0 was used to measure a series of aesthetics index before and 6 months after surgery, including nasofrontal angle, nasorostral angle, nasolabial angle, columella lobular angle, ratio of tip projection to the length of the nose and ratio of the length of the infratip lobule to the length of the nasal columella to evaluate the surgical effect. Visual analogue scale (VAS) and rhinoplasty outcome evaluation (ROE) were used to investigate the patients’ satisfaction. Paired t-test was used for data analysis and P<0.05 was considered statistically significant. Results:A total of 53 patients were enrolled, including 4 males and 49 females, aged from 18 to 45 years (average age: 25.6 years). Forty-nine cases were primary rhinoplasty and 4 cases were secondary rhinoplasty. No short-term complications including hemorrhage and infection occurred in 53 patients. All patients were followed up for 6-12 months. There were statistically significant differences in nasofrontal angle, nasorostral angle, nasolabial angle, columella lobular angle, ratio of tip projection to the length of the nose and ratio of the length of the infratip lobule to the length of the nasal columella( P<0.01), which sugguested that aesthetic defects of the nose were corrected and no obvious deflection and rotation of nasal tip occured. VAS score and ROE score postoperatively were 7.6±0.4 and 21.3±2.1, respectively, which were significantly higher than preoperatively( 6.1±0.5, 10.5±1.6)( P< 0.01). Postoperative satisfaction survey showed that swelling disappeared within 4-6 weeks after surgery, and no obvious ventilatory disorder, paresthesia and hyposmia symptoms occurred. Most patients were satisfied with the aesthetic and functional results. Conclusions:The "mutual support" framework in costal cartilage rhinoplasty can reduce the risk of framework deflection and nasal tip rotation and obtain satisfactory nasal columella shape.

Objective:To investigate the clinical effect of "mutual support" framework in costal cartilage rhinoplasty.Methods:From June 2020 to December 2021, the patients were enrolled and undergone rhinoplasty with bilateral lower lateral cartilage margin incision combined with nasal columnar incision in the Department of Plastic & Reconstructive Surgery of Zhejiang Provincial People’s Hospital. During the operation, the sixth costal cartilage was made into the nasal columella support graft(strut) and the nasal tip graft integrated scaffold, and the septal extension grafts (SEG). The strut and SEG were sutured in the same plane to construct the framework to correct the aesthetic defects of the nose. Abode Photoshop CS 6.0 was used to measure a series of aesthetics index before and 6 months after surgery, including nasofrontal angle, nasorostral angle, nasolabial angle, columella lobular angle, ratio of tip projection to the length of the nose and ratio of the length of the infratip lobule to the length of the nasal columella to evaluate the surgical effect. Visual analogue scale (VAS) and rhinoplasty outcome evaluation (ROE) were used to investigate the patients’ satisfaction. Paired t-test was used for data analysis and P<0.05 was considered statistically significant. Results:A total of 53 patients were enrolled, including 4 males and 49 females, aged from 18 to 45 years (average age: 25.6 years). Forty-nine cases were primary rhinoplasty and 4 cases were secondary rhinoplasty. No short-term complications including hemorrhage and infection occurred in 53 patients. All patients were followed up for 6-12 months. There were statistically significant differences in nasofrontal angle, nasorostral angle, nasolabial angle, columella lobular angle, ratio of tip projection to the length of the nose and ratio of the length of the infratip lobule to the length of the nasal columella( P<0.01), which sugguested that aesthetic defects of the nose were corrected and no obvious deflection and rotation of nasal tip occured. VAS score and ROE score postoperatively were 7.6±0.4 and 21.3±2.1, respectively, which were significantly higher than preoperatively( 6.1±0.5, 10.5±1.6)( P< 0.01). Postoperative satisfaction survey showed that swelling disappeared within 4-6 weeks after surgery, and no obvious ventilatory disorder, paresthesia and hyposmia symptoms occurred. Most patients were satisfied with the aesthetic and functional results. Conclusions:The "mutual support" framework in costal cartilage rhinoplasty can reduce the risk of framework deflection and nasal tip rotation and obtain satisfactory nasal columella shape.

Objective:To figure out the structure and relevant data measurements of zygomatic ligament by cadaver anatomy and review of previous studies.Methods:From July 2018 to January 2020, the zygomatic areas of 20 Chinese frozen fresh cadaver hemifaces were dissected in the Department of Anatomy, Health Science Center of Hangzhou Normal University. Then the structures of zygomatic ligaments were shown. The characters of the ligament and the relationship with adjacent tissue were described and measured. And 16 previous studies were reviewed to get a comprehensive description about the characters of zygomatic ligaments.Results:Zygomatic ligaments were even and dense fibrous tissue structures distributed vertically between the skin and the subcutaneous tissue. Under the SMAS plane, the ligaments divided into two bundles. The origin of major bundle located beyond the origin of the zygomatic major muscle on the periosteum, and the origin of minor bundle located between the origin of the zygomatic minor and major muscle.Conclusions:The anatomy of the zygomatic ligament has a regular pattern, and its anatomical data has certain directive significance for clinical application.

Objective:Facial artery is the main blood supply source of facial soft tissue, which has an important influence on facial plastic surgery and injection procedures. There are many types of facial arteries. They have wide coverage, and travel several layers. In this study, the detailed characteristics of the facial arteries were revealed by cadaver dissection.Methods:In 19 donated fresh cranial (28 sides) specimens, the facial arteries were dissected. And then the type, layer, relationship with nasolabial groove, length, diameter, distance from the oral commissure, branches and submental artery were observed and measured.Results:Facial arteries were found in all cadavers, starting from the external carotid arteries, branching submental arteries below the mandibular margins, ascending to the anterior edge of the masseter muscles, crossing the mandibles and entering the faces. After entering into the faces, the facial arteries branched the submental arteries(100%, 28/28), lower labial arteries (100%, 28/28), upper labial arteries (100%, 28/28), lateral nasal arteries (92.9%, 26/28) and the angular arteries (57.2%, 16/28) throughout the courses. According to the vascular route, the facial artery was classified into four types. In TypesⅠ(8 sides), all branches were included and the angular arteries arose directly from the lower segment of the facial arteries (28.6%). In TypesⅡ(8 sides), all branches were included and the angular arteries were the terminal branches (28.6%). In TypesⅢ(10 sides), angular arteries were absent (35.7%). In Type Ⅳ (2 sides), angular arteries and lateral nasal arteries were absent (7.1%). The lower segment of facial artery coursed under the facial expression muscles, and continued to the middle segment at the point which was (26.0±5.0) mm away from the oral commissure on the lateral side. The layer that the facial artery coursed was varied. It passed through the superficial layer of the facial expression muscles. After passing the horizontal line parallel to the lower margin of nasal sill, the upper segment continued to on the superficial layer of the facial expression muscles. The facial arteries were mostly located medial to the nasolabial fold(24 sides, 85.7%) and occasionally across the nasolabial fold(4 sides, 14.3%). The lengths of the upper, middle and lower segments of facial artery were (26.4±10.9) mm, (29.7±8.4) mm, and(33.5±6.9) mm, respectively. The diameters in starting point of upper, middle and lower sections were(2.45±0.48) mm, (1.85±0.12) mm, and (1.09±0.21) mm, respectively. The facial artery passed lateral to the oral commissure and the distance from the intersection of the horizontal line to the oral commissure was (26.0±5.0) mm. The starting point of the superior labial artery locacted below the horizontal line was (8.0±1.4)mm away from the horizontal line of the oral commissure and(55.0±5.2) mm from the mandibular angle. The starting point of the inferior labial artery located below the horizontal line was (17.1±11.1) mm from the horizontal line of the oral commissure, and the distance from the mandibular angle was (44.2±5.2) mm. The diameter of the submental artery in its starting point was (1.4±0.1) mm. The distance from the starting point of the submental artery to the horizontal line of the oral commissure was (34.9±2.6) mm, and the distance from the mandibular angle was (29.4±5.8) mm. The starting point of the submental artery was (6.4±0.8) mm from the lower margin of the mandible. In the midline of the mandible, the distance between the submental artery and the lower margin of the mandible was (9.0±1.0) mm. In the midsagittal plane, the starting point of the submental artery was(8.4±1.0) mm from the lower margin of the mandible.Conclusions:There were several types of facial arteries and the courses were various, but the way they branched and the layers they coursed had certain rules. Understanding the anatomy of facial arteries is helpful to keep the treatment safe.

Objective:Facial artery is the main blood supply source of facial soft tissue, which has an important influence on facial plastic surgery and injection procedures. There are many types of facial arteries. They have wide coverage, and travel several layers. In this study, the detailed characteristics of the facial arteries were revealed by cadaver dissection.Methods:In 19 donated fresh cranial (28 sides) specimens, the facial arteries were dissected. And then the type, layer, relationship with nasolabial groove, length, diameter, distance from the oral commissure, branches and submental artery were observed and measured.Results:Facial arteries were found in all cadavers, starting from the external carotid arteries, branching submental arteries below the mandibular margins, ascending to the anterior edge of the masseter muscles, crossing the mandibles and entering the faces. After entering into the faces, the facial arteries branched the submental arteries(100%, 28/28), lower labial arteries (100%, 28/28), upper labial arteries (100%, 28/28), lateral nasal arteries (92.9%, 26/28) and the angular arteries (57.2%, 16/28) throughout the courses. According to the vascular route, the facial artery was classified into four types. In TypesⅠ(8 sides), all branches were included and the angular arteries arose directly from the lower segment of the facial arteries (28.6%). In TypesⅡ(8 sides), all branches were included and the angular arteries were the terminal branches (28.6%). In TypesⅢ(10 sides), angular arteries were absent (35.7%). In Type Ⅳ (2 sides), angular arteries and lateral nasal arteries were absent (7.1%). The lower segment of facial artery coursed under the facial expression muscles, and continued to the middle segment at the point which was (26.0±5.0) mm away from the oral commissure on the lateral side. The layer that the facial artery coursed was varied. It passed through the superficial layer of the facial expression muscles. After passing the horizontal line parallel to the lower margin of nasal sill, the upper segment continued to on the superficial layer of the facial expression muscles. The facial arteries were mostly located medial to the nasolabial fold(24 sides, 85.7%) and occasionally across the nasolabial fold(4 sides, 14.3%). The lengths of the upper, middle and lower segments of facial artery were (26.4±10.9) mm, (29.7±8.4) mm, and(33.5±6.9) mm, respectively. The diameters in starting point of upper, middle and lower sections were(2.45±0.48) mm, (1.85±0.12) mm, and (1.09±0.21) mm, respectively. The facial artery passed lateral to the oral commissure and the distance from the intersection of the horizontal line to the oral commissure was (26.0±5.0) mm. The starting point of the superior labial artery locacted below the horizontal line was (8.0±1.4)mm away from the horizontal line of the oral commissure and(55.0±5.2) mm from the mandibular angle. The starting point of the inferior labial artery located below the horizontal line was (17.1±11.1) mm from the horizontal line of the oral commissure, and the distance from the mandibular angle was (44.2±5.2) mm. The diameter of the submental artery in its starting point was (1.4±0.1) mm. The distance from the starting point of the submental artery to the horizontal line of the oral commissure was (34.9±2.6) mm, and the distance from the mandibular angle was (29.4±5.8) mm. The starting point of the submental artery was (6.4±0.8) mm from the lower margin of the mandible. In the midline of the mandible, the distance between the submental artery and the lower margin of the mandible was (9.0±1.0) mm. In the midsagittal plane, the starting point of the submental artery was(8.4±1.0) mm from the lower margin of the mandible.Conclusions:There were several types of facial arteries and the courses were various, but the way they branched and the layers they coursed had certain rules. Understanding the anatomy of facial arteries is helpful to keep the treatment safe.

Objective:To understand the current status of family function and empathy ability among clinical nurses in some ClassⅢ Grade A hospitals of Zhejiang Province, and to explore the correlation between them.Methods:From January to May 2019, we selected 1 050 clinical nurses from five ClassⅢ Grade A hospitals in Zhejiang Province by convenience sampling to carry out a questionnaire survey. Questionnaires included the General Information Scale, Family APGAR Index as well as the Jefferson Scale of Empathy-Health Professionals (JSE-HP) . In this study, a total of 1050 questionnaires were distributed and 1 032 were collected with 98.3% for the questionnaire recovery rate.Results:Among 1 032 clinical nurses, the total scores of Family APGAR Index and JSE-HP were (6.04±2.90) and (87.33±21.02) respectively. Correlation analysis results showed that dimensions scores of Family APGAR Index had positive correlations with dimensions of JSE-HP with a statistical difference ( r=0.128-0.490, P<0.05) . Multiple linear regression analysis indicated that family function had a positive predictive effect on the empathy ability of clinical nurses with a statistical difference ( P<0.05) . Conclusions:Among clinical nurses in ClassⅢ Grade A hospitals, marital status and family function are important factors that affects the level of empathy. Nursing managers should actively pay attention to the empathy of nurses, and provide corresponding help by using relevant organizational support and social support so as to reduce the occurrence of empathy fatigue.

Objective: To study the characteristics of sentinel vein (SV) and middle temporal vein (MTV) and influence in surgery of periorbital and temporal areas. Methods: From January 2018 to August 2019, 20 donated fresh/frozen head specimens (12 males and 8 females) were collected in various regions of China, with an average age of 47.2 (21 to 88) years. Temporal region of 29 hemi-facial area was dissected in layers, and the occurrence rate, route, geometric parameters, branchesand correlation of SV and MTV were observed and measured. Results: Occurrence rate of SV was 96.6% (28/29), the subcutaneous subordinate branches of SV were 2.5±1.0 in average, with both joining together in 6 kinds of mode. The horizontal section length was (5.8±3.8) mm, and outside diameter was (1.0±0.1) mm. The vertical section length was (8.2±4.3) mm, and outside diameter was (1.2±0.4) mm, steering vertically to the deep through the superficial temporal fascia, middle temporal fascia (MTF) and superficial layer of deep temporal fascia (SDTF), continuing to the MTV. The minimal average distance between the SV and TFN was (6.0±2.7) mm. Occurrence rate of MTV was 96.6% (28/29). The first half of MTV was parallel to the zygomatic arch and ran across the superficial temporal fat pad, then turned down near the upper pole of the external ear wheel, and run vertically in front of the ear, and 5.9±2.7 peripheral branches were collected along the way. The length of temporal middle vein was (82.3±8.6) mm, and outer diameter of the thickest point was (3.6±0.7) mm. Conclusions Sentinel vein is the main branch of middle temporal vein. It passes through several layers of soft tissue vertically and directly into the MTV. Position of sentinel vein is relatively constant, which is an important localization marker in the operation of the temporal region. The middle temporal vein has large diameter, fixing in the superficial temporal fat pad, collecting the venous reflux of the temporal area at both superficial and deep, which may be the main cause of pulmonary infarction produced by the temporal fat transplantation, and injury should be avoided.

Objective Lab color mode can be used to digitize the color.This study explores the possibility of using Lab model to measure facial pigmentations.Methods Lab color model was used to measure the normal skin and three common clinical pigmentations (Ota nevus,freckles and melasma).We also analyzed the characteristics and assessed the data changes after the treatment.Results Average L,a and b values were 54.4,13.8 and 19.0 in normal skin,34.6,5.17 and 6.9 in Ota nevus,43.25,16.15 and 23.05 in freckles and 40.5,16.8 and 23.35 in melasma,respectively.The Lab values of freckles and melasma were close.The order of L value was:normal skin ＞ freckle ＞ melasma ＞Ota nevus;the order of value of a and b was:melasma ＞ freckle ＞ normal skin ＞ Ota nevus.After treatment,the Lab values gradually tended to be the values of normal skin.Conclusions The Lab color mode can be used as a digital description method for skin color and facial pigmentation,which provides an objective measure for clinical research.

OBJECTIVE: To explore the effects of Bushen Jianpi Huoxue Recipe, a compound traditional Chinese herbal medicine for tonifying the kidney, invigorating the spleen and promoting blood circulation, on tibial stress injuries in rabbits. METHODS: Thirty-five mature male rabbits were used in the experiment, and randomly divided into 7 groups: sedentary control (SC) group, 1-week exercise (E-1W) group, 2-week exercise (E-2W) group, 3-week exercise (E-3W) group, 4-week exercise (E-4W) group, 3-week exercise and 1-week Chinese herbal medicine treatment (EMT-1W) group, and 4-week exercise and 2-week Chinese herbal medicine treatment (EMT-2W) group. There were 5 rabbits in each group. A rabbit model of tibial stress injuries was established by stimulating the rabbits to jump and run within a high-voltage and low-current electronic cage. Radiologic features, bone scintigraphy, histology and electron microscopy of rabbit tibia were observed, and the content of blood parathyroid hormone (PTH), bone gla protein (BGP) and testosterone was detected by using radioimmunoassay method. RESULTS: After 2-week exercise, changes in histology and osteocytes had a tendency towards stress injuries. Serum PTH and BGP levels were remarkably increased, while serum testosterone level was lower than that in the SC group. Three- and four-week continuous exercise resulted in tibial stress injuries, and the positive changes were observed in X-ray features and radionuclide images. Compared with E-3W group, the levels of serum BGP and testosterone were decreased remarkably. A series of positive results such as prevailing negativeness of X-ray features and radionuclide images, increasing process of osteogenesis, typical osteogenic phase of osteocytes and favorable transformation of biochemical markers was shown in EMT-1W and EMT-2W groups. It also showed remarkable rising levels of serum BGP and testosterone and remarkable reducing level of serum PTH in EMT-1W and EMT-2W groups as compared with E-1W and E-2W groups. CONCLUSION: Bushen Jianpi Huoxue Recipe can prevent and treat exercise-induced tibial stress injuries by stimulating new bone formation and increasing serum testosterone level.