Objective To develop a Psychological Birth Trauma Assessment Scale and to test its reliability and validity.Methods Through literature review,semi-structured interview,expert conference,Delphi expert enquiry and preliminary investigation,a pre-test scale was formed.From March to May 2023,postpartum women from 38 hospitals of different levels in 15 provinces(Jiangsu,Anhui,Zhejiang,Fujian,Tibet,and Shanghai,etc.)were conveniently selected for investigation.The sample size of the first-round survey was 547,which was used for reliability and validity test.The sample size of the second-round survey was 550,which was used for confirmatory factor analysis.Results The psychological birth trauma assessment scale consisted of 2 parts,with a total of 29 items in 6 dimensions.The intrapartum feeling part included 4 dimensions,with a cumulative variance contribution rate of 63.992％,and the postpartum effect part included 2 dimensions,with a cumulative variance contribution rate of 68.208％.The content validity index of the scale was 0.947,and the content validity index of each item was 0.809～1.000.The total score of the scale and the scores of each dimension were significantly negatively correlated with the total score of the calibration scale(r=-0.784～-0.533,P＜0.001).The total Cronbach's α coefficient was 0.941,and the split-half reliability coefficient was 0.883.Confirmatory factor analysis showed that the main evaluation indicators were all within the acceptable range.Conclusion The Psychological Birth Trauma Assessment Scale has good reliability and validity,and it can be used as an assessment tool for the degree of maternal psychological birth trauma.

Objective To evaluate the effect of an empathy intervention program based on 5-step empathetic model(5-SEM)on stress response,anxiety and depression,and sleep quality among patients with acute cerebral infarction.Methods The 100 participants were admitted to the Second Affiliated Hospital of Wenzhou Medical University from November 2022 to April 2023.According to the admission time,they were divided into two groups,with 50 cases in each group.The patients in the control group received normal care,while those in the observation group underwent an empathy intervention program based on 5-SEM.This program includes the establishment of an empathetic intervention team,comprised of physicians,psychologists,head nurses,and nurses with more than 5 years of work experience and a bachelor's degree or higher.The intervention team,based on searches and collation of relevant literature from databases such as CNKI,Wanfang Data,the National Library of Medicine's PubMed database,and the Dutch medical abstracts EMBase database,is responsible for assessing patient conditions.A final draft of the empathetic intervention plan based on the 5-SEM is then formed by the supervising nurse.nurses in the empathetic intervention team was responsible for implementing the 5-SEM intervention plan.The outcomes were evaluated by Athens insomnia scale(AIS),hospital anxiety and depression scale(HADS),and stress response questionnaire(SRQ).Results After intervention,the scores for sleep quality,anxiety and depression,and stress response in both groups showed a significant decrease compared to pre-intervention[sleep quality scores:control group was 6.74±1.77 vs.12.08±2.94,observation group was 4.84±2.04 vs.11.90±2.80;anxiety scores:control group was 7.14±2.20 vs.8.58±2.38,observation group was 6.06±2.47 vs.8.34±2.03;depression scores:control group was 7.28±2.12 vs.8.72±2.34,observation group was 6.26±2.03 vs.8.82±2.80;physical reaction scores:control group was 17.72±4.29 vs.22.94±3.73,observation group was 16.10±3.19 vs.22.62±3.25;emotional reaction scores:control group was 21.82±2.98 vs.26.80±3.21,observation group was 20.60±2.45 vs.26.32±4.32;behavioral reaction scores:control group was 12.68±1.75 vs.15.46±3.18,observation group was 11.16±1.98 vs.14.90±2.24;stress response scores:control group was 55.40±4.89 vs.69.46±6.28,observation group was 50.98±4.68 vs.68.08±6.18,all P<0.05],post-intervention,the scores in the observation group were significantly lower than those in the control group(all P<0.05).Conclusion The empathy intervention program based on the 5-SEM could alleviate anxiety,depression,and stress responses among patients with acute cerebral infarction,while also improving sleep quality.

Objective : To investigate the influence and molecular mechanism of hypoxia-inducing factor-1 α( HIF- 1 α) gene silencing combined with methyl selenenic acid (MSA) on cervical cancer cell proliferation，apoptosis and cell migration． Methods : HeLa cells were transfected with HIF-1 interference RNA and negative control RNA．Af- ter transfection for 48 h，cells were stimulated with MSA for 24 h，and cell proliferation was determined by CCK-8 assay and colony formation．Apoptosis was determined by flow cytometry combined with Annexin V-FITC / PI．The expression levels of HIF-1α , Bcl-2 ，and E-cadherin were detected by Western blot assay． Cell migration ability was determined by Transwell assay. RNA-seq analysis was used to investigate the differentially expressed genes and differential signaling pathways. Results : Compared with the control group，interfering with HIF-1α combined with MSA significantly inhibited cell proliferation (P ＜0．01) ．Flow cytometry results showed that the combined drug group significantly induced apoptosis．Transwell results showed that interfering with HIF-1α combined with MSA inhibited HeLa cell migration．Compared with the control group，interfering with HIF-1α combined with MSA down- regulated the expression of Bcl-2 and up-regulated the expression of E-cadherin. RNA-sequencing combined with signal pathway enrichment results showed that the expression of apoptotic signal pathway and downstream genes was inhibited． Conclusion HIF-1α gene silencing combined with MSA can synergically inhibit the proliferation and induce apoptosis of cervical cancer cells，and its regulatory mechanism may be related to the expression of Bcl-2 family proteins and the inhibition of p53 signaling pathway.

Objective:To investigate the prognostic value of neuroelectromyography in peripheral facial paralysis and its correlation with House-Brackman classification.Methods:Seventy-eight patients with peripheral facial paralysis who received treatment in Yiwu Central Hospital, China between January 2016 and January 2019 were included in this study. All patients underwent neuroelectromyography. Bilateral nerve conduction velocity, latency, amplitude, and the needle electrode electrogram of orbicularis oris muscles, rbicularis oculi muscles and frontal muscles were analyzed and recorded. After 3 months of treatment, the correlation between prognosis and House-Brackman classification was analyzed.Results:Electromyography examination of 78 patients revealed among 68 patients presenting with prolonged latency, the latency on the affected side was significantly longer than that on the healthy side [(3.78 ± 0.33) ms vs. (2.89 ± 0.35) ms], t = 15.256, P < 0.001]. Among 73 patients presenting with decreased M amplitude, M amplitude on the affected side was significantly lower than that on the healthy side [(0.60 ± 0.27) mV vs. (1.83 ± 0.29) mV, t = 26.522, P < 0.001]. Among 78 patients, normal electromyography findings were observed in 2 patients and abnormal findings in 76 patients, with an abnormal rate of 97.44%. Among 78 patients, 46 patients presented with fibrillation potentials and positive sharp waves in the resting state, 40 patients presented with long duration and multiphase wave percentage of motor unit action potential in mild contraction, and 52 patients presented with abnormal recruitment potential in severe contraction. Three months of follow-up revealed that 23 out of 25 patients with mild peripheral facial paralysis had a complete recovery, with the cure rate of 92.00% (23/25), 28 out of 36 patients with moderate peripheral facial paralysis had a complete recovery, with the cure rate of 77.78% (28/36), 7 out of 10 patients with mild and moderate peripheral facial paralysis had a complete recovery, with the cure rate of 70.00% (7/10), and 3 out of 5 patients with severe peripheral facial paralysis had a complete recovery, with the cure rate of 60.00% (3/5). Conclusion:Neuroelectromyography can improve the accuracy in the identification of injury degree of peripheral facial paralysis and has a strong correlation with House-Brackman classification. Therefore, neuroelectromyography can provide a reference for diagnosis and treatment of peripheral facial paralysis.

Objective:To investigate the effect of metformin on the microRNA (miRNA) expression and screen potential target with network pharmacology analysis in patients with type 2 diabetes.Methods:Fifteen patients with new diagnosed type 2 diabetes admitted to our hospital were selected, who received metformin during hospitalization and after discharge. The expression of serum matrix metalloproteinase (MMP)-9, transforming growth factor (TGF)-β1, and myocardial fibrosis related miRNAs were compared before and 6 month after metformin treatment. In addition, gene ontology (GO) and KEGG pathway enrichment analysis were applied to analyze differential expression miRNAs showing statistical significance. Meanwhile, the network figure was established to reflect the target gene messenger RNA (mRNA) corresponding to differentially expressed miRNA.Results:Compared with pre-medication, the serum level of MMP-9 was significantly decreased after treatment ( P<0.05). Besides, the expression of homo sapiens microRNA (hsa-miR)29a-3p, hsa-miR133a-5p, hsa-miR21-5p, hsa-miR30c-5p, and hsa-miR1-3p in patients with type 2 diabetes were dramatically down-regulated by metformin ( P<0.05 or P<0.01). Results of GO analysis and KEGG pathway enrichment analysis showed that differentially expressed miRNAs were mainly concentrated in endoplasmic reticulum lumen, synapse, basement membrane and other cell components. The molecular functions such as Rho GTPase binding and participation in extracellular matrix structural constituent were exerted through biological processes such as collagen catabolic process, regulation of short-term neuronal synaptic plasticity, and axon extension, which were mainly enriched in advanced glycation end products-receptor for advanced glycation end products (AGE-RAGE) signaling pathway in diabetic complications, tumor necrosis factor (TNF) signaling pathway, and Wnt signaling pathway, etc. The outcome of miRNA-mRNA network analysis demonstrated that there were 230 target genes mRNAs corresponding to differentially expressed miRNA. Conclusion:Metformin could play its role in the treatment of type 2 diabetes by down regulating the expression of miRNA, participating in the transduction of related cellular signaling pathways, regulating chromatin, nucleic acid binding, and enzyme activities.

Objective:To comprehensively evaluate and compare the early warning system's ability to predict the risk of maternal disease in China, such as the British National Intensive Care Audit and Research Center (ICNARC)-Obstetric Early Warning Score (OEWS) system, the National Maternal Safety Early Warning Standard (MEWC) recommended by the National Coalition for Maternal Safety, the Irish Maternity Early Warning System (IMEWS) proposed in the clinical practice guidelines issued by the head of health services at the Royal Medical College of Ireland.Methods:A total of 872 pregnant women who were admitted to the Women′s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital were prospectively observed from January 2019 to December 2019. The data during hospitalization were collected to calculate the scores of the three obstetric early warning scoring systems, to compare and evaluate the prediction and identification ability of three early warning systems for critically ill pregnant women.Results:A total of 872 cases were included in this study, of which 167 were critically ill, accounting for 19.2%, and 705 were non-critically ill, accounting for 80.8%. The three obstetric early warning systems (OEWS,MEWC,IMEWS) in critical group scored 4(2, 6),3(0, 6),5(3, 6), and non-critical group scored 1(0, 1), 0(0, 0), 2(0, 3), respectively. The critical group scored significantly higher than the non-critical group ( P<0.001). The AUC of OEWS was 0.961 (95% CI 0.948-0.975, P<0.001) and that of MEWC was 0.803 (95% CI 0.757 - 0.850, P<0.001). The AUC of IMEWS was 0.853 (95% CI 0.817-0.888, P<0.001). No obstetric critical illness occurred when OEWS was 0. The positive likelihood ratio was 8.208 6 when OEWS≥6. Conclusions:Three kinds of early warning systems have good predictive ability for the occurrence of critical obstetric diseases in China. Among the three warning systems, OEWS has better predictive ability than the other two, and has better hierarchical ability. However, due to the differences in population, environment and conditions in different regions, each obstetric medical unit can improve OEWS according to its own conditions and design an obstetric early warning system that meets its own clinical needs.

OBJECTIVES: To compare the differences in clinical characteristics between Type 1 diabetes mellitus (T1DM) and fulminant Type 1 diabetes mellitus (FT1DM), and to reduce the missed diagnosis, misdiagnosis, and mistreatment of FT1DM by medical staff. METHODS: A total of 101 hospitalized patients with T1DM (including 8 cases of FT1DM) were enrolled in this study from Changsha Central Hospital between June 2012 and December 2018. Clinical characteristics of the 8 FT1DM patients were collected and compared with all T1DM patients. RESULTS: All FT1DM patients were adult with the average age of (30.25±5.28) years old, accompanied by severe diabetic ketoacidosis (DKA) occurred within 1 week after onset. Moreover, pancreatic beta cells in these patients were destroyed and the islet-related antibodies were negative, while the serum pancreatic enzyme levels were increased. Compared with classic T1DM patients, the plasma glucose levels in FT1DM patients were much higher [(41.89±12.54) mmol/L vs (22.57±9.74) mmol/L], but glycosylated hemoglobin (HbA1c) and fasting C peptide levels were significantly lower [(6.08±0.41)% vs (10.87±2.46%)%, CONCLUSIONS The onset time of FT1DM patients is very urgent via driving DKA. These patients have higher blood glucose concentration than classic T1DM patients, accompanied by electrolyte disturbances, impaired renal function, partially impaired liver function, as well as gastrointestinal symptoms and elevated trypsin. Most FTDM patients are adolescents and adults with no gender difference, especially pregnant women who are at high risk. Lifelong insulin dependence in FT1DM patients should be paid more attention in clinical treatment.
Adolescent ; Adult ; Diabetes Mellitus, Type 1/complications* ; Diabetic Ketoacidosis ; Female ; Glycated Hemoglobin A/analysis* ; Humans ; Insulin ; Pregnancy ; Sex Factors ; Young Adult

Objective:To summarize up the care experience about a woman with broad ligament haematoma after cesarean section.Methods:The clinical data of 1 case of broad ligament haematoma of uterus after cesarean section and summarized the main points of clinical nursing was reviewed. The nurse found the signs of intraperitoneal bleeding through closely observation, and it was confirmed to be a hematoma of broad ligament of uterus by B ultrasound. After removal of hematoma, the nurse strengthened the abdominal drainage and circulation monitoring to prevent re-bleeding in the abdominal cavity, nursing the fever in the process of hematoma absorption. At last, it was important to pay attention to psychological nursing, helping the maternal to live through acute period.Results:The woman was discharged on the 8 thpost-operative day. Conclusions:The nurses of obstetric should have the ability of critical thinking in clinical work, carry out postoperative monitoring strictly after cesarean section and timely find signs of internal bleeding. Through multidisciplinary rescue, a serious adverse outcome of broad ligament haematoma can be prevented.

Objective To investigate the effect of baicalin on CT26.WT cells of colon cancer in mice, and to discuss the cell death form. Methods CT26.WT cells were divided into four groups including of control group , routine cultured in fresh medium, the baicalin group, added with concentration of 100 μmol·L-1 baicalin, the z-VAD-fmk group, was added with final concentration of 20 μmol·L-1 z-VAD-fmk, and the combination group, added final concentration of 20 μmol·L-1 z-VADfmk,1 h before adding 100 μmol·L-1 baicalin. Then the inhibitory effect of baicalin on cell proliferation and cell viability were detected by CCK-8 method. The changes of nucleus were detected by DAPI staining, the ultrastructure of cells was observed by TEM, and the effect of baicalin on the expression of RIP3 gene and protein in cells was detected by QPCR method and Western blotting. Results Compared with control group, the differences of baicalin group and combination group had statistically significance (P<0.05) . cell death rate for control group was (10.54±0.19) ％ ,for baicalin group was (34.93±0.16) ％ ,for z- VAD group was (11.23±0.59) ％, and combination group was (23.27±1.20) ％ (P<0.01) . Compared with the normal control group, baicalin group showed nuclear concentration and fragmentation. there was obvious nuclear fragmentation in the combination group against baicalin group. The results of electron microscopy showed that the cells of baicalin were necrotic, cell swelling, mitochondria swelling and contents leaking. Baicalin group significantly up - regulated RIP3 mRNA expression (P < 0. 01) and enhanced RIP3 protein expression (P < 0. 05) . Conclusion Baicalin induces the necrosis of ct26. WT cells, and can significantly increase the gene and protein expression of RIP3.

Objective To investigate the safety and efficacy of endoscopic varices ligation(EVL) plus endoscopic varices sclerotherapy(EVS)for esophageal varices hemorrhage in patients with liver cirrhosis. Methods Fifty?two liver cirrhosis patients with esophageal varices bleeding were randomly divided into EVL group(n=24)and EVLS group(n=28)according to random numbers generated by computer after first EVL. The EVL group continued undergoing EVL, and the EVLS group was treated by EVS. The interval of treatment was 2 weeks till varices disappeared. All patients were followed up for 18 months with endoscopy and endoscopic ultrasonography(EUS). The efficacy,changes of esophageal varices and perforating veins, varices recurrence and rebleeding were observed. Results There was no significant difference of complete cure rate between EVLS group and EVL group[67.9%(19/28)VS 62.5%(15/24),P>0.05]. The mean session of treatment(2.68±1.0 VS 1.83±0.7,P<0.05), and perforating veins obliteration rate after treatment in EVLS group was higher than that in EVL group[70.8%(17/24)VS 23.8%(5/21),P<0.05]. During 18 months of follow?up,there was no significant difference of rebleeding rate between the two groups[3.6%(1/28)VS 12.5%(3/24),P>0.05],and the varices recurrence rate was higher in EVL group than that in EVLS group[77.3%(17/22)VS 44.0%(11/25), P<0.05]. Child?Pugh class B patients in EVL group had a higher varices recurrence rate compared to that in EVLS group[75.0%(9/12)VS 31.5%(5/16), P<0.05]. Endoscopic recurrences occurred in patients with non?occlusive perforating veins. Conclusion EVL plus EVS sequential procedure is safe and effective for treatment of esophageal varices hemorrhage,especially for Child?Pugh class B patients.Perforating veins may play a key role in the development of esophageal varices and recurrence after endoscopic therapy. EUS findings can direct the endoscopic therapy and predict the variceal recurrence.