Fragile X syndrome (FXS) is the most common monogenic disease that causes intellectual disability and autism spectrum disorder (ASD),causing moderate to severe mental retardation with unusual facial features and connective tissue abnormalities.Fragile X syndrome is caused by the mutation of FMR1 gene,resulting in the reduction or loss of its product,fragile X mental retardation protein (FMRP).The diagnosis is mainly based on the detection of FMR1 gene,and there is no effective treatment for fragile X syndrome.Therefore,it is very important to strengthen genetic counseling and prenatal diagnosis,and effectively reduce the incidence of fragile X syndrome.

Objective To explore the operation of grasping forceps and nursing staff made telescopic injection device were used for the clinical effect of Hemostasises thoracoscopic lobectomy. Methods 60 cases of thoracoscopic lobectomy for patients according to the date of surgery were divided into operation group and telescopic grasping forceps injection device group 30 patients were given hemostasia operation grasping forceps extraction hemostatic powder and hemostatic powder into the injection device for telescopic wound hemostasis treatment and preventive treatment, were compared between the two groups in the instrument body, completely hemostatic powder cover the wound time, evacuation time of endoscopic instruments, single hemostatic powder wound coverage, wound bleeding rate, the incidence of bleeding again installed. Results The telescopic injection device group and operation time grasping forceps group into cavity instruments, endoscopic evacuation equipment time showed no significant difference (P>0.05). Hemostatic powder completely cover the wounds of time (24.90 ± 5.90) s and (55.60 ± 25.60) s, there was significant difference between two groups (t=6.401, P<0.01). The single ended wound coverage of blood meal was 86.67%(26/30) and 76.67%(23/30), there was significant difference between two groups (χ2=2.016, P<0.05). Wound bleeding rate was 10.00%(3/30) and 33.33%(10/30), there was statistically significant difference between the two groups (χ2=4.812, P<0.05). The incidence of bleeding again to install powder was 10.0%(3/30) and 93.3%(28/30), there was significant difference between two groups (χ2=41.713, P <0.01). Conclusions The nursing staff made telescopic injection device assisted surgery were thoracoscopic lobectomy of the wound to stop bleeding and prevent rebleeding, wound coverage than grasping forceps, completely cover the wound operation less time than grasper, re install a low incidence of hemostatic powder, the whole process to shorten the operation time.

Objective To explore the effects of steering group model on knowledge of pelvic floor muscle exercise and postoperative discomfort and complications after cesarean section, so as to improve the effect of pelvic floor muscle exercise. Methods A total of 108 patients who underwent cesarean section from August 2015 to August 2016 were randomly divided into experimental group and control group by the random number table method, with 54 cases in each group. The puerperae in the control group were treated with conventional pelvic floor muscle exercise. In the experimental group, the nursing staff and the patients' one-on-one steering group was set up and the individualized pelvic floor muscle exercise was carried out during the hospitalization. The puerperae of the two groups were compared in stress urinary incontinence, pelvic organ prolapse, defecating unfinished feeling, pelvic bulge, lower genital tract discomfort, the level of cognition and behavior of pelvic floor muscle exercise and the puerpera satisfaction in the reexamination after 6 weeks of discharge. Results The number of puerperae with stress urinary incontinence and pelvic organ prolapse in the experimental group was less than that in the control group, and the difference was statistically significant (P< 0.05). The number of puerperae with defecating unfinished feeling, pelvic bulge and lower genital tract discomfort in the experimental group was significantly less than that in the control group (P< 0.05). The score of knowledge level of the pelvic floor muscle in the experimental group was (4.60±1.38), and the exercise behavior score was (4.36±1.17). The score of knowledge level of the pelvic floor muscle in the control group was (2.26±1.27), and the exercise behavior score was (2.57±1.24). The differences were statistically significant (P<0.05). The satisfaction rate was 81.48% in the experimental group and 42.59% in the control group (χ2=5.793,P<0.05). Conclusions The establishment of the steering group for maternal recovery exercise guidance can improve the maternal knowledge of exercise, so as to reduce all kinds of discomfort and complications, improve pelvic floor muscle exercise effect and improve maternal satisfaction.

Objective:To construct an outpatient counseling record sheet of breastfeeding based on Delphi method, so as to standardize the consultation process of breastfeeding clinics.Methods:Through literature analysis and discussion of the research group, the expert letter questionnaire was designed by themselves. From September to October 2020, two rounds of Delphi letter inquiries were conducted with 16 experts in Hangzhou to determine the outpatient counseling record sheet of breastfeeding.Results:The positive coefficients of two rounds of expert letter inquiries were 100%, the expert authority coefficients were respectively 0.93 and 0.95, and the Kendall's coefficient of concordance were 0.135-0.204 and 0.234-0.563 ( P< 0.05) . The final counseling record sheet constructed included 8 first-level items, 99 second-level items and 94 third-level items. Conclusions:Letter consulting experts have high enthusiasm, high degree of authority and good coordination. The breastfeeding clinic consultation record based on the Delphi method is highly scientific and practical, which can be applied to breastfeeding clinics in various maternal and infant medical institutions.