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.

This paper reports the nursing care of 7 patients with liver cirrhosis during pregnancy and childbirth. During the pregnancy period,nursing care focused on integrated management,monitoring of the dynamic changes of liver cirrhosis and individualized care. During delivery and perioperative period,supportive treatment was implemented and complications such as upper gastrointestinal hemorrhage,postpartum hemorrhage and infections were prevented. The 7 patients got through the perinatal period safely.

Objective To explore the establishment of skin photoaging model and the protective effects of nitroxide tempol on skin in guinea pig. Methods The guinea pig skin photoageing model was established by using solar-simulaten radiation (SSR). Dermal structure was observed with hematoxylin-eosin staining. The structure and expression of elastic fiber were analyzed by Weigert's staining. The uhrastructure of dermal fibroblasts and elastic fiber were observed by electron microscopy. Tempol was used before each exposure at the concentration of 5 mg/ml or 0. 5 mg/ml, and the protective effects of tempol on skin were assessed. Results After seventeen weeks' exposure, there was typical "solar elastosis" damage in the upper dermis. Mature elastic fibers were severely degraded and there was large amount of elastotic material accumulated in the upper dermis. Dermal fibroblasts appeared metabolically hyperactive and mitochondria in the cells were damaged. Some cells even broke up. Tempol at the concentration of 5 mg/ml or 0. 5 mg/ml could prevent photodamage of the photoageing model in the dermis, and Tempol at the concentration of 5 mg/ml had stronger protective effects. Conclusions Guinea pig can be applied as an useful animal model of skin photoageing. Antioxidant tempol has photoprotective effects on photodamage of the photoageing model in guinea pig and can be used as an anti-photoageing agent.

Objective To study the status quo of nursing human resource configuration and structure of neonatology department in China's economically developed areas.Methods Using judgment sampling and multi-stage stratified sampling,investigations were conducted by the self-designed questionnaire in letter in 2012.Results In 2012,both the bed nurse ratio(1:0.79) and doctor nurse ratio (1: 1.22) met the Health Ministry's standards (1:0.58-0.61 and 1: 2) respectively.Age distribution of neonatology nursing staff was from 25 to 34 years old (55％).The distribution of wordng experience was average.Nurses with junior college degree as the main body took up 48％,with primary title as the main body 66％,and the appointment system accounted for 42％.The nursing personnel with young ages,senior skilled,higher education degree,and advanced titles were concentrated in Grade Ⅲ-A hospitals and public hospitals of women and children.In terms of distribution equity,two Gini coefficients of geographical and population distribution were both less than 0.35 and near zero,which indicated relatively perfect equity.Conclusions The stock and per capita of neonatology nursing human resources in China's economically developed areas were insufficient in the long run and showed imbalanced allocation among hospitals with different levels.The allocation structure failed to meet the needs of nursing disciplinary development.

Breast milk is the optimal source of nutrition for newborns, and it can bring them important nutritional and neurodevelopmental benefits. Studies have shown bidirectional interactions between the brain and gut flora, which started during the embryonic period. Breastfeeding may play a positive role in neonatal neurodevelopment through gut flora. We outline the effects of breast milk on the neurodevelopment of newborns from the perspective of brain-gut axis to better understanding the benefits of breastfeeding.

Objective To investigate the risk factors related to progressive intracranial hemorrhage (PIH) in patients with acute traumatic brain injury (TBI) and analyze their clinical significance.Methods PIH was validated by comparing the initial and repeated CT scans. Data including gender,age, injury causes, Glasgow Coma Score (GCS) on admission, time interval from injury to the first CT scan, initial CT scan manifestations, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg), thrombin time (TT), platelet (PLT) and D-dimer (D-D) in both groups were compared with Logistic regression analysis to observe the risk factors related to PIH. Results The study involved 498 patients with acute TBI, of which 139 (27.91%) patients suffered from PIH. There were 116 patients (83.45%) with PIH who received the initial CT scan within two hours post injury.There was statistical difference in aspects of age, GCS on admission, time interval from injury to the first CT scan, initial CT scan manifestations ( including fractures, subarachnoid hematoma, contusion and onset hematoma), PT, Fg and D-D values in both groups (P ＜0.01 ). Logistic regression analysis showed that CT scans (subarachnoid hemorrhage, brain contusion and primary hematoma) and plasma D-D values were predictors of PIH ( P ＜ 0.01 ). Conclusions For patients with the initial CT scan manifestations including subarachnoid hemorrhage, brain contusion, primary hematoma together with D-D value increase within two hours post injury, a continuous CT scan should be performed promptly to detect PIH early.

Objectives:To explore the related factors that influence the postpartum loss to follow-up of women with gestational diabetes mellitus and the corresponding countermeasures to improve management of postpartum loss to follow-up in order to improve its rate.Methods:A total of 212 patients were selected from women diagnosed with gestational diabetes before delivery in Women′s Hospital School of Medicine Zhejiang University between December, 2018 and March, 2019. These patients were reminded by hospital education and telephone call-back and followed up by questionnaire at 12 weeks after delivery. The rates of follow up and the rate of postpartum blood glucose screening after delivery were calculated. The demographic and social data, clinical data during pregnancy and delivery, and postpartum blood glucose screening were compared between the follow-up group and the group of loss to follow up. The group of loss to follow up was contacted by telephone to inquiry the reason of loss.Results:Totally 159 out of 212 cases completed postpartum follow-up with the rate of 75.00% (159/212) and the loss rate was 25.00% (53/212). 52 cases underwent postpartum blood glucose screening with the rate of 24.53% (52/212), 22.64% (48/212) in the follow-up group and 1.89% (4/212) in the group of loss to follow up. Permanent residence, occupation, monthly family income, medical payment method, obstetric complications, family history, management doctor's own quality, attendance of pregnancy specialist from outpatient service, acceptance of complication propaganda and education, attitude to postpartum follow-up, etc are the influencing factors, the difference was statistically significant ( χ2 value was 4.392-65.328, P<0.01 or 0.05). Conclusion:Women with gestational diabetes mellitus have a high rate of postpartum loss to follow up. Medical personnel should improve their professional quality and strengthen the multidisciplinary and joint management model, establishing a standardized and targeted postpartum follow-up procedure and strengthening the focus of postpartum follow-up education to improve the quality and efficiency of postpartum follow-up management.

Perineal tear is a common complication of vaginal delivery and will seriously affect the quality of life of these women, if is severe. Given to there was no evidence-based clinical guideline for the prevention and management of perineal tear in China, this evidence-based guideline was developed, based on the methods of WHO handbook for guideline development. Systematic reviews were conducted according to the Cochrane handbook and GRADE was used to assess the quality and certainty of the evidence. Detailed recommendations are provided for 19 clinical questions in the prevention and management of perineal laceration, aiming to guide clinical practice and improve the quality of life of this group of women.