We establish the new capacity-based teaching mode in clinical teaching of nursing obstetrics and gynecology.We have obtained more satisfied teaching quality.

We establish the new student-centered teaching mode and reform the evaluation system in clinical teaching of nursing obstetrics and gynecology. We have got more satisfied teaching quality.

Objective: To investigate the current status and influencing factors of sleep disorders among pregnant women, so as to provide insights into health management during pregnancy. Methods: Pregnant women who underwent prenatal checkups at Hangzhou Obstetrics and Gynecology Hospital from January to October 2023 were selected as subjects, and general data including age, pregnancy period and exercise were collected through questionnaire surveys. Sleep quality, pregnancy stress, anxiety and depression were evaluated using Pittsburgh Sleep Quality Index, Pregnancy Stress Rating Scale, Pregnancy-related Anxiety Scale and Edinburgh Postnatal Depression Scale, respectively. Factors affecting sleep disorders among pregnant women were analyzed using a multivariable logistic regression model. Results: A total of 386 pregnant women was surveyed, with a mean age of (30.28±4.65) years, including 20.47% in the first trimester, 47.93% in the second trimester and 31.61% in the third trimester. Women with anxiety and depression accounted for 14.51% and 21.76%, respectively. Pregnancy stress was mainly moderate, accounting for 51.04%. There were 106 pregnant women with sleep disorders, accounting for 27.46%. Mutivariable logistic regression analysis showed that age (≥35 years, OR=1.656, 95%CI: 1.094-2.503), pregnancy period (third pregnancy, OR=2.097, 95%CI: 1.213-3.621), regular exercise in the past 6 months (OR=0.376, 95%CI: 0.210-0.670), anxiety (OR=2.794, 95%CI: 1.545-5.048), depression (OR=3.501, 95%CI: 1.877-6.529) and pregnancy stress (moderate, OR=1.355, 95%CI: 1.018-1.801; severe, OR=2.538, 95%CI: 1.417-4.540) were the factors affecting sleep disorders among pregnant women. Conclusions Sleep disorders of pregnant women is influenced by age, pregnancy period, pregnancy stress, anxiety, depression and exercise. It is necessary to identify high-risk individuals with sleep disorders early, and to provide psychological intervention and prenatal health guidance.

Objective To explore and analyze the clinical efficacy and effects of the application of dexmedetomidine in the tube drawing period of general anesthesia for the patients receiving laparoscopic surgery. Methods Sixty-eight pa-tients who received laparoscopic surgery in our hospital from December 2012 to December 2013 were selected as the study subjects and randomly divided into the control group and the study group. By the end of surgery, the patients were transferred to the post-anesthesia care unit (PACU) with catheter and different anesthetic drugs were used. The control group received target controlled infusion of propofol and the study group received dexmedetomidine. Results The four groups of patients were different in MAP and BIS at T2, T3, T4 and T5, with statistically significant differ-ences (P<0.05). Regarding to VAS scores and adverse reactions, group A2 and group A3 were different from the control group respectively, with significant differences (P<0.05). Conclusion The application of dexmedetomidine in the tube drawing period of general anesthesia after laparoscopic surgery for the purpose of analgesia and sedation is conducive to maintaining hemodynamic stability, relieving postoperative pain and reducing the incidence of postoperative complica-tions.

Objective To observe and analyze the clinical analgesic anesthesia effect of propofol combined with pare-coxib sodium for the patients receiving bronchofiberscope examination. Methods Eighty-seven patients receiving bron-chofiberscope examination in our hospital from January 2012 to February 2014 were selected as the study subjects and randomly divided into group A, group B and group C. The three groups of patients received parecoxib sodium combined with propofol, propofol combined with fentanyl, and propofol respectively for preoperative anesthesia. The MAP and SPO2 changes, usage amount of anesthetic drugs, and awakening time of the three groups at different time were recorded, and the results were tabulated and analyzed. Results SpO2 of the three groups at different time did not change obvi-ously, with no significant differences (P>0.05). The three groups did not have statistically significant differences in the bronchofiberscope examination time (P>0.05). Group A had the lowest usage amount of anesthetic drugs and the short-est awakening time, which had statistically significant differences to the other two groups (P<0.05). Conclusion In analgesic bronchofiberscope examination, the application of propofol combined with parecoxib sodium for anesthesia and analgesia plays a positive role in increasing the patients' postoperative comfort sensation and postoperative living quality.

Objective:To explore the application value of mindful delivery exercise method in the personalized nursing management program of negative emotions of primipara, so as to improve maternal emotion and ensure the safety of mothers and children.Methods:From January 12, 2018 to January 23, 2019, a total of 120 pregnant women who underwent antenatal examination in Hangzhou Obstetrics and Gynecology Hospital were selected as research objects. According to the random number table method, the patients were divided into the control group and the experimental group. During the study period, 10 cases were dropped, and 110 cases were eventually included in the study. Finally, there were 56 cases in the control group and 54 cases in the experimental group. Pregnant women in the control group received routine prenatal check-ups, and interventions were conducted in the form of courses. The experimental group implemented a mindful delivery exercise method based on the intervention of the control group. The Chinese version of Depression-Anxiety-Stress Scale (DASS-21) was used to evaluate the maternal depression-anxiety-stress status before and after intervention, the pain degree was evaluated by VAS, and the delivery outcomes of two groups were recorded.Results:The scores of stress, anxiety and depression in the DASS-21 of the experimental group one month after intervention were lower than those of the control group, the time of the first stage of labor was shorter than that of the control group, and the spontaneous labor rate was higher than that of the control group. The differences were statistically significant ( P<0.01) . The VAS score of 1 hour after delivery of the experimental group was lower than that of the control group, and the difference was statistically significant ( P<0.01) . Conclusions:The application of mindful delivery exercise in the personalized nursing management of negative emotions of parturient women can help improve maternal mood, relieve pain, shorten the first stage of labor and improve the rate of spontaneous delivery.

Objective To determine the expression of ubiquitin-conjugating enzyme E2S (UBE2S) in malignant melanoma (MM),and to evaluate its effect on the biological behavior of melanoma cells.Methods Immunohistochemical study was performed to determine the UBE2S expression in 128 primary MM tissue chips,64 metastatic MM tissue chips,16 non-tumor tissue chips (8 paralesional normal skin tissues and 8 normal epidermal tissues).Real-time quantitative RCR was conducted to determine the UBE2S mRNA expression in the melanoma cell lines A375,MUM-2B and MUM-2C.The melanoma cell lines A375 and MUM-2B were divided into 2 groups separately:interference group transfected with a lentiviral vector carrying UBE2S RNA interference sequence,and control group transfected with a lentiviral vector carrying control sequence.After 72 hours,real-time quantitative RCR was performed to determine the UBE2S mRNA expression in the melanoma cell lines A375 and MUM-2B.Caspase-3/7 activity in the groups was assessed by using kits,and cell apoptosis and cell cycle distribution were detected by flow cytometry.The effect of UBE2S knockdown on the migratory and invasive abilities of and N-cadherin expression in A375 cells were evaluated by Transwell assay and Western blot analysis respectively.Statistical analysis was carried out with SPSS 22.0 software by using independent sample t-test for the comparison of normally distributed data between two groups,chi-square test for enumeration data,MannWhitney U test for the comparison of non-normally distributed data,and Spearman's coefficient for assessment of the correlation of UBE2S expression with T staging of melanoma.Results UBE2S was highly expressed in 98 (51.0％) MM tissues,but lowly expressed in 16 non-tumor tissues,and the UBE2Sexpression rate significantly differed between the above two kinds of tissues (x2 =11.905,P ＜ 0.01).UBE2S expression was negatively correlated with T staging of melanoma (ρ =-0.210,P =0.043).The relative mRNA expression of UBE2S significantly differed among the A375,MUM-2B,and MUM-2C cells (F =817.228,P ＜ 0.01).After UBE2S knockdown,the caspase-3/7 activity was significantly up-regulated in the A375 interference group (t =17.572,P ＜ 0.01) and MUM-2B interference group (t =24.552,P ＜0.01) compared with the A375 and MUM-2B control groups respectively.Compared with the control group,the A375 interference group showed significantly increased proportion of A375 cells at G1 phase (t =7.365,P ＜ 0.01),decreased proportion at S phase (t =-9.190,P ＜ 0.01),and no change in the proportion of A375 cells at G2/M phase (t =-0.227,P ＞ 0.05).The MUM-2B interference group showed significantly increased proportions of MUM-2B cells at G1 (t =12.676,P ＜ 0.01) and G2/M phases (t =13.045,P ＜0.01),but significantly decreased proportion at S phase (t =-15.718,P ＜ 0.01) compared with the control group.Transwell assay revealed decreased migratory and invasive abilities of A375 cells in the interference group compared with the control group (t =-35.727,-125.000,P ＜ 0.05,＜ 0.01,respectively).Western blot analysis showed down-regulated expression of N-cadherin protein in A375 cells in the interference group compared with the control group.Conclusions UBE2S is over-expressed in melanoma tissues,whose expression is associated with the T staging of melanoma.Knockdown of UBE2S affects the apoptosis,cell cycle,migration and invasion of melanoma cells,and may promote the metastasis of MM cells by regulating N-cadherin expression.

Objective:To discuss the influencing factors of neonatal scalp hematoma, and provide a basis for reducing the occurrence of neonatal scalp hematoma.Methods:Retrospectively analyzed the data of 13 151 parturients and their newborn infants who delivered in the Hangzhou Women′s Hospital from January to December 2020, counted the incidence of neonatal scalp hematoma, and Logistic regression analysis was used to analyze its influencing factors.Results:Among 13 151 newborn baby, 68 cases of neonatal head hematoma occurred, the incidence was 0.52%. Vaginal delivery, forceps, intraspinal analgesia were statistically significant in the occurrence of neonatal scalp hematoma ( χ2=19.26, 19.59, 6.11, all P<0.05). Conclusions:Vaginal delivery, forceps, and intraspinal analgesia are the risk factors for neonatal scalp hematoma. Lateral perineal incision during delivery did not reduce the incidence of neonatal scalp hematoma. In this study, many cases of neonatal scalp hematoma occurred before the crown of the fetal head. Labor management, improve the rate of non-drug analgesia, promote natural delivery, early detection, early prevention, and reduce the incidence of neonatal hematoma.

Objective:The present study used single-cell RNA sequencing(scRNA-seq)to characterize the cellular composition of ovarian carcinosarcoma(OCS)and identify its molecular characteristics.Methods:scRNA-seq was performed in resected primary OCS for an in-depth analysis of tumor cells and the tumor microenvironment.Immunohistochemistry staining was used for validation.The scRNA-seq data of OCS were compared with those of high-grade serous ovarian carcinoma(HGSOC)tumors and other OCS tumors.Results:Both malignant epithelial and malignant mesenchymal cells were observed in the OCS patient of this study.We identified four epithelial cell subclusters with different biological roles.Among them,epithelial subcluster 4 presented high levels of breast cancer type 1 susceptibility protein homolog(BRCA1)and DNA topoisomerase 2-α(TOP2A)expression and was related to drug resistance and cell cycle.We analyzed the interaction between epithelial and mesenchymal cells and found that fibroblast growth factor(FGF)and pleiotrophin(PTN)signalings were the main pathways contributing to communication between these cells.Moreover,we compared the malignant epithelial and mesenchymal cells of this OCS tumor with our previous published HGSOC scRNA-seq data and OCS data.All the epithelial subclusters in the OCS tumor could be found in the HGSOC samples.Notably,the mesenchymal subcluster C14 exhibited specific expression patterns in the OCS tumor,characterized by elevated expression of cytochrome P450 family 24 subfamily A member 1(CYP24A1),collagen type XXIII α1 chain(COL23A1),cholecystokinin(CCK),bone morphogenetic protein 7(BMP7),PTN,Wnt inhibitory factor 1(WIF1),and insulin-like growth factor 2(IGF2).Moreover,this subcluster showed distinct characteristics when compared with both another previously published OCS tumor and normal ovarian tissue.Conclusions:This study provides the single-cell transcriptomics signature of human OCS,which constitutes a new resource for elucidating OCS diversity.

Objective:To summarize the evidence related to the guidance and management of breastfeeding in pregnant women with gestational diabetes mellitus.Methods:UpToDate, BMJ Best Practice, CINAHL, PubMed, Cochrane Library, Embase, Wanfang database, China National Knowledge Infrastructure, and other databases and professional websites were searched by computer for evidence on breastfeeding guidance and management for pregnant women with gestational diabetes mellitus, including clinical decisions, guidelines, evidence summaries, systematic reviews, expert consensus and randomized controlled trials. The search period was from database establishment to April 1, 2023. Two researchers independently conducted literature quality evaluation, evidence extraction, and integration.Results:A total of 23 articles were included, including 4 clinical decision-making articles, 4 guidelines, 4 evidence summaries, 6 systematic reviews, 1 expert consensus and 4 randomized controlled trials. A total of 21 best pieces of evidence were summarized from six aspects of support and education, knowledge and skills, safety issues, feeding issues, dietary care, and blood glucose monitoring.Conclusions:This study summarizes the best evidence on breastfeeding guidance and management for pregnant women with gestational diabetes and suggests that the medical staff should apply the proof according to the clinical situation and the patient's wish.