Background and aims As a ferroptosis inducer, sorafenib, a first-line treatment for hepatocellular carcinoma (HCC), has a significant antitumor effect. Nonetheless, HCC patients frequently develop sorafenib resistance. Here, we investigated the impacts of progestagen-associated endometrial protein (PAEP), which controls sorafenib resistance and tumorigenesis in HCC. Furthermore, we investigated the function of PAEP and the underlying molecular mechanisms that cause HCC ferroptosis when sorafenib is applied. Methods Western blot analysis, cell proliferation, colony formation and animal experiments were performed to investigate the function of PAEP in sorafenib resistance and tumorigenesis in HCC. We detected the levels of reactive oxygen species, iron, and malondialdehyde and preformed transmission electron microscopy to investigate the relationship between PAEP and ferroptosis. Co-immunoprecipitation (co-IP) assay was performed to investigate the underlying molecular mechanisms of PAEP that cause HCC ferroptosis. Results PAEP was significantly overexpressed in HCC tissues, and this was associated with a poor clinical prognosis. PAEP silencing dramatically reduced HCC cells’ malignant phenotype. We found that sorafenib-induced ferroptosis was more sensitive to HCC cells with PAEP knockdown. Furthermore, the orthotopic cell line-derived xenograft mouse model results showed that sorafenib sensitivity can be effectively increased in vivo by PAEP knockdown. We determined that transferrin (TF) was a PAEP target using the String database, and we further supported this finding with Co-IP analysis. Additionally, on sorafenib-induced ferroptosis in HCC cells, TF partially reversed the effects of PAEP knockdown. Conclusions Our research indicates that PAEP may be a potential biomarker for predicting sorafenib resistance in HCC and disruption of PAEP expression may be a potential cancer-directed therapeutic option for HCC.

Objective:To understand the real experience of previous breastfeeding difficulties experienced by multiparous women in late pregnancy based on the theory of pressure interaction, and to explore the previous experience of breastfeeding difficulties and its impact on the next breastfeeding.Methods:This study was a qualitative study. Purposive sampling was used to select nine cases of late-pregnancy multiparous women in Guangzhou Women and Children's Medical Center of Guangzhou Medical University from July to September 2023 as the study subjects. Multiparous women aged 28 to 42 years with gestational weeks of 30 +2 to 38 +6 weeks. Semi-structured interviews were conducted using the phenomenological research method, and the data were analyzed using the Colaizzi 7-step analysis. Results:The results of the interviews were collated to distill three themes, including previous breastfeeding difficulties were hurtful, threatening, and challenging to late-pregnant multiparous women; multiparous women mainly sought help from non-professional when experiencing breastfeeding difficulties; and late-pregnant multiparous women who experienced breastfeeding difficulties had coexisting psychological states of craving, fear, and craving and fearing of breastfeeding again.Conclusions:Healthcare professionals need to identify people with breastfeeding difficulties at an early stage and provide personalized interventions in a timely manner. At the same time, they need to actively guide pregnant women and their family members to seek professional help through formal channels when they encounter breastfeeding difficulties. Healthcare professionals need to pay close attention to changes in psychological status caused by difficult breastfeeding experiences. Pregnant women with breastfeeding trauma can develop a fear of future breastfeeding. Trauma-informed care combined with psychosocial support interventions and guided feedback can be used to reduce the impact of breastfeeding trauma on the next breastfeeding.

Objective:To adapt the Mindful Breastfeeding Scale (MINDF-BFS) into Chinese and assess its reliability and validity among breastfeeding mothers in China.Methods:Following the Beaton cross-cultural adaptation guideline, the original scale was translated, back-translated, discussed by experts, pre-tested, culturally adapted, and revised to develop the Chinese version of the MINDF-BFS. A convenience sampling method was used to select 305 postpartum women from Guangzhou Women and Children's Medical Center, Guangzhou Medical University, who visited between March and June 2024, as the study participants. The reliability and validity of the Chinese version of MINDF-BFS were evaluated.Results:The Chinese version of MINDF-BFS consisted of nine items, with the item-level content validity index ranged from 0.900 to 1.000, and the average scale-level content validity index was 0.990. Exploratory factor analysis extracted one common factor, with a variance contribution of 73.290%. Confirmatory factor analysis showed a good model fit. The Cronbach's α coefficient for the scale was 0.923, the split-half reliability coefficient was 0.915, and the test-retest reliability coefficient was 0.926.Conclusions:The Chinese version of MINDF-BFS has good psychometric properties and is suitable for assessing the mindful breastfeeding levels of Chinese postpartum women.

Objective:To understand the real experience of previous breastfeeding difficulties experienced by multiparous women in late pregnancy based on the theory of pressure interaction, and to explore the previous experience of breastfeeding difficulties and its impact on the next breastfeeding.Methods:This study was a qualitative study. Purposive sampling was used to select nine cases of late-pregnancy multiparous women in Guangzhou Women and Children's Medical Center of Guangzhou Medical University from July to September 2023 as the study subjects. Multiparous women aged 28 to 42 years with gestational weeks of 30 +2 to 38 +6 weeks. Semi-structured interviews were conducted using the phenomenological research method, and the data were analyzed using the Colaizzi 7-step analysis. Results:The results of the interviews were collated to distill three themes, including previous breastfeeding difficulties were hurtful, threatening, and challenging to late-pregnant multiparous women; multiparous women mainly sought help from non-professional when experiencing breastfeeding difficulties; and late-pregnant multiparous women who experienced breastfeeding difficulties had coexisting psychological states of craving, fear, and craving and fearing of breastfeeding again.Conclusions:Healthcare professionals need to identify people with breastfeeding difficulties at an early stage and provide personalized interventions in a timely manner. At the same time, they need to actively guide pregnant women and their family members to seek professional help through formal channels when they encounter breastfeeding difficulties. Healthcare professionals need to pay close attention to changes in psychological status caused by difficult breastfeeding experiences. Pregnant women with breastfeeding trauma can develop a fear of future breastfeeding. Trauma-informed care combined with psychosocial support interventions and guided feedback can be used to reduce the impact of breastfeeding trauma on the next breastfeeding.

Objective:To adapt the Mindful Breastfeeding Scale (MINDF-BFS) into Chinese and assess its reliability and validity among breastfeeding mothers in China.Methods:Following the Beaton cross-cultural adaptation guideline, the original scale was translated, back-translated, discussed by experts, pre-tested, culturally adapted, and revised to develop the Chinese version of the MINDF-BFS. A convenience sampling method was used to select 305 postpartum women from Guangzhou Women and Children's Medical Center, Guangzhou Medical University, who visited between March and June 2024, as the study participants. The reliability and validity of the Chinese version of MINDF-BFS were evaluated.Results:The Chinese version of MINDF-BFS consisted of nine items, with the item-level content validity index ranged from 0.900 to 1.000, and the average scale-level content validity index was 0.990. Exploratory factor analysis extracted one common factor, with a variance contribution of 73.290%. Confirmatory factor analysis showed a good model fit. The Cronbach's α coefficient for the scale was 0.923, the split-half reliability coefficient was 0.915, and the test-retest reliability coefficient was 0.926.Conclusions:The Chinese version of MINDF-BFS has good psychometric properties and is suitable for assessing the mindful breastfeeding levels of Chinese postpartum women.

Objective:To explore the effects of problem-solving therapy on breastfeeding self-efficacy and psychological status among primiparas, to provide basis for improving the breastfeeding of primipara.Methods:A total of 102 primiparas were divided into experimental group and control group by random number table method, each group contained 51 cases. Finally, 47 cases in the experimental group and 49 cases in the control group completed the study. The control group received routine nursing, while primiparas in the experimental group carried out problem-solving therapy. Before and after 6-week intervention, the effects was assessed by Breastfeeding Self-Efficacy Scale (BSES), Edinburgh Postnatal Depression Scale (EPDS) and General Well-being Schedule (GWB), respectively.Results:After intervention, the scores of primapara feedig cognition, feeding feeling, feeding skills and BSES total scores were (21.13±2.97) points, (65.47±6.63) points, (31.94±2.59) points, (118.53±8.47) points in the experimental group, significantly higher than (19.43±3.28) points, (61.76±5.20) points, (30.53±2.01) points, (111.71±6.11) points in the control group ( t values were 2.658-4.507, P<0.01); the scores of EPDS were (6.04±1.49) points in the experimental group, significantly lower than (6.92±2.08) points in the control group; the scores of life satisfaction and interest, depression and pleasure, energy, relaxation and tension in General Well-Being (GWB) and total scores were (7.51±1.71) points, (20.19±2.47) points, (21.68±2.32) points, (17.06±2.74) points, (90.45±4.96) points in the experimental group, significanlty higher than (6.41±1.82) points, (18.71±2.98) points, (20.57±1.87) points, (15.78±1.79) points, (84.61±5.26) points in the control group, the difference was statistically significant ( t values were 2.380-5.587, P<0.05 or 0.01). Conclusion:Problem-solving therapy can improve breastfeeding self-efficacy and alleviate postnatal depression as well as enhance subjective well-being of primipara women.

Objective:To understand the attitudes of obstetricians and midwives towards the development of nurse practitioner in China.Methods:The phenomenological method in qualitative research was used to conduct semi-structured interviews with 24 medical staff in the third-A general hospitals and women and children's hospitals in Guangzhou and Dongguan City. The interview data were analyzed by Colaizzi's 7-step analysis method.Results:Four themes were extracted, namely, unanimous approval attitude, imperfect midwifery discipline and management system, insufficient independent practice capacity, low support and recognition in midwifery area.Conclusions:Obstetricians and midwives hold a positive attitude towards the development of midwifery nurse practitioner. At the same time,its development is restricted in many aspects. They can gradually develop midwife′s legislation, improve the management system, try some prescription rights, and increase the education and talents of midwifery subjects. Cultivation and promotion of social recognition will help gradually train midwifery nurse practitioner in China.

Objective: This study was summarized and analyzed the reporting data of pressure ulcer events in children for nearly 4 years. We expected this study can provide a recommendation for design of the subsequent reporting system, especially the pressure ulcer. Methods: A total of 207 children with pressure ulcers from January 2015 to September 2018 were exported from the adverse event reporting system that made a retrospective analysis based on structured method. Results: Among the 207 pressure ulcer cases, 173 (83.57%) cases were hospital acquired, 65 (31.40%) were female, 104 (50.24%) were male, and 38 (18.36%) were missing data. The factors that are prone to pressure ulcers in children are in CICU(74/173), the occipital (83/207), and with stage I(112/207). 111(64.16%)cases were delayed reporting, and the median delayed reporting time was 38(143) days. There are many missing records in the description of the event, the medical treatment, the analysis of the possible causes and other items. In univariate analysis, the setting was associated with missing records in system; the occipital and stage I pressure ulcers were associated with a delayed reporting of hospital acquired pressure ulcers. Conclusions For the prevention of pressure ulcers in children, different high-risk populations should have corresponding strategies. The adverse event of pressure ulcers were reported to be missed and delayed that was attributed to the cumbersome process. The reporting process and system should be standardized.