?? [Abstract]? Objective? To understand the knowledge level of part-time nurses on dynamic posts of obstetric nursing and their needs for dynamic post training of obstetric nursing,so as to provide basis for the formulation of staff management training programs for dynamic posts of obstetric nursing. Methods? By purposive sampling, 47 part-time nurses hired by the Department of Nursing in China-Japan Friendship Hospital from November to December of 2018 were selected for the study. Self-designed Obstetric Nursing Dynamic Post Perception and Training Implementation Questionnaire was used to investigate the participants' perception and training needs towards the dynamic posts of obstetric nursing. In the study, totally 47 questionnaires were distributed and 47 valid ones were collected, yielding an effective recovery rate of 100%. Results? In the 47 part-time nurses, 68.09%(32/47) of them understood the dynamic post of obstetric nursing, 87.23%(41/47) of them held the opinion that admission criteria was needed for the dynamic post, 100% of them expressed the needs for pre-service training. The contents of the top three training needs were: "emergency management of sudden changes of obstetric patients" "effects of commonly used drugs in Obstetric Department" "theoretical knowledge of Obstetrics specialty", and different training time was set according to the difficulty of posts. Conclusions? Part-time nurses have insufficient knowledge of dynamic posts in obstetric nursing, and need to acquire obstetric specialty knowledge urgently. At the same time, training programs and assessment criteria for dynamic posts of obstetric nursing should be formulated to ensure the safe and effective operation of nursing work.

Objective:To explore the status quo of postpartum hemorrhage assessment in obstetric doctors and nurses and provide a reference for developing a scientific, effective and practical early warning assessment tool for postpartum hemorrhage.Methods:The obstetric doctors and nurses were selected from 92 hospitals across China by convenient sampling from April 6th to 13th, 2019. The self-designed questionnaire was used to investigate their demographic information and status of postpartum hemorrhage assessment. Totally 4 490 questionnaires were distributed. The questionnaires were reviewed to ensure the integrity of information after collected. Totally 4 490 valid questionnaires were collected, with a recovery rate of 100%.Results:The hospitals where 4 406 out of the 4 490 obstetric doctors and nurses worked assessed high risk factors for postpartum hemorrhage, accounting for 98.1%. There was statistically significant difference in assessing high risk factors for postpartum hemorrhage or not between hospitals of different kinds ( P<0.05) . Among the hospitals which assessed high risk factors for postpartum hemorrhage, high risk factors for postpartum hemorrhage were assessed jointly by doctors and nurses or midwives in the hospitals where 77.6% of the obstetric doctors and nurses worked, and the postpartum hemorrhage high risk factor scale was used for postpartum hemorrhage assessment in hospitals where 62.1% of the obstetric doctors and nurses worked. The top 2 time of assessing high risk factors for postpartum hemorrhage was postpartum assessment and intrapartum assessment. The most frequently used method to measure amount of bleeding was weighing. According to the obstetric doctors and nurses, the biggest challenge when assessing high risk factors for postpartum hemorrhage was "no appropriate tool for assessing high risk factors for postpartum hemorrhage". Conclusions:Obstetric doctors and nurses pay attention to the assessment of high risk factors for postpartum hemorrhage, but there is no continuous and dynamic assessment for these high risk factors yet, and the measurement of amount of bleeding needs to be consistent. Hospital managers and obstetric doctors and nurses are in badly need of a postpartum hemorrhage assessment tool which is suitable for clinical use.

Objective To investigate the effect and mechanism of mitomycin C in reducing hypertrophic scar in rat traumatic osteomyelitis model.Methods A total of 120 Wistar rats were divided into control group (Group A,n =40),traumatic osteomyelitis group (Group B,n =40),traumatic osteomyelitis treated with Mitomycin C group (Group C,n =40),according to the random number table.The model of traumatic osteomyelitis was produced by Staphylococcus aureus.Muscle tissues around the focus were harvested at 15 d and 30 d postinjury.HE staining was used to observe the changes of muscle tissue structure.Immunohistochemistry was used to detect expression of transforming growth factor (TGF)-β1.Masson staining was used for collagen deposition evaluation.Western blot was used for detection of levels of TGF-β1 and collagen Ⅰ.Results HE staining revealed consistent alignment of fibers within the muscle in Group A.Fibrosis with the muscle was observed in both Group B and C,but the degree of muscle fiber disorder was decreased in Group C compared to Group B.Either 15 d or β0 d after injury,expressions intensity of TGF-β1,collagen fraction volume,and activation levels of TGF-β1 as well as collagen Ⅰ were higher in Group B and C than Group A,and all parameters were decreased in Group C compared to Group B (all P ＜ 0.05).Conclusion Mitomycin C can reduce hypertrophic scar formation in traumatic osteomyelitis model,and the potential mechanism relates to downregulated TGF-β1 and collagen Ⅰ.

Objective:To explore the trend of postpartum hemorrhage after two-child policy and to analyze the high-risk risks of postpartum hemorrhage so as to put forward intervention measures to reduce the postpartum hemorrhage.Methods:We retrospectively selected 8 784 delivery women with routine production inspection and hospitalized at a ClassⅢ Grade A hospital from 2014 to 2018. We collected the general information, record of production inspection, delivery record and analyzed the trend of postpartum hemorrhage rate, blood loss and related high-risk factors.Results:From 2014 to 2018, there were statistical differences in the postpartum hemorrhage rate, serious postpartum hemorrhage rate and blood loss ( P<0.05) . The trend showed an increasing trend. In 2017, the postpartum hemorrhage rate, serious postpartum hemorrhage rate and blood loss were 16.9%, 6.1% and (540.1±758.2) ml respectively highest in those years. From 2014 to 2018, the percentage of delivery women with advanced ages, multiple pregnancy, pregnancy times≥2, history of cesarean section≥2 were increasing; delivery women with the prenatal hemoglobin≤110 g/L and percentage of natural labor were decreasing with a statistical difference ( P<0.05) ; the percentage of emergency cesarean section was on the rise; the percentage of placental expulsion time from 15 to 30 minutes declined with statistical differences ( P<0.05) ; the percentage of placental expulsion time≥30 minutes and above was no significant trend. Conclusions:From 2014 to 2018, the postpartum hemorrhage rate, serious postpartum hemorrhage rate and blood loss did not show an increasing trend. However, the percentage of high-risk pregnant and delivery women increased gradually. Therefore, we should carry out the pregnancy risk assessment rating for pregnant and delivery women and formulate a suitable high-risk assessment tool for postpartum hemorrhage so as to reduce the incidence of postpartum hemorrhage.

Objective:To explore the methods of confirming and grading the core competence possessed by clinical nurse midwives.Methods:By the objective sampling method, semi-structured interviews were conducted with 14 midwifery medical experts, managers, teachers and nurse midwives in Beijing from February 2018 to June 2018. The phenomenological research method in the qualitative research method was used to analyze the data.Results:Three themes were extracted, namely: the need to implement the nurse midwife core competency classification, classification method and characteristics at all levels of nurse midwife core competency and the positive effect of nurse midwife core competency classification on future work.Conclusions:Managers should assess the core competence of nurse midwives in various aspects and grade them according to their core competence, so as to improve the allocation of human resources for nurse midwives, improve their core competence and promote the safety and health of pregnant women and newborns.

Objective:To explore the influencing factors of the failure of labor induction by oxytocin and delivery outcome, and provide a basis for standardizing pregnancy management and process management of labor induction by oxytocin.Methods:Using a self-designed data collection form, the data of 1 705 pregnant women who underwent labor induction by oxytocin in the Department of Obstetrics of China-Japan Friendship Hospital from 2014 to 2018 were retrospectively collected, and the influencing factors of the failure of labor induction by oxytocin and the outcome of delivery were analyzed.Results:A total of 1 705 primary mothers were included in the study. Multiple factor analysis show that, amniotic fluid pollution, macrosomia, and the duration of labor induction by oxytocin were independent influencing factors for the failure of labor induction by oxytocin. The duration of labor induction by oxytocin was related to the method of delivery, weight of the newborn, and amount of postpartum hemorrhage, and the difference was statistically significant ( P<0.01) . The outcome of delivery labor induction by oxytocin was the cause of cesarean delivery, and "intrauterine fetal distress" and "cephalopelvic disproportion" accounted for the highest proportion. Conclusions:The main influencing factors for the failure of labor induction by oxytocin are amniotic fluid pollution, macrosomia, etc., and the influencing factors will gradually increase with the process of labor induction, thereby reducing the natural delivery rate. Therefore, it is necessary to strengthen pregnancy management, control pregnancy weight and fetal weight, and reduce pregnancy complications. It is also necessary to strengthen clinical management of labor induction by oxytocin, provide sound education and guidance for labor induction by oxytocin, and increase the vaginal delivery rate after labor induction by oxytocin.