Objective To investigate the clinical efficacy of Shangke Huangshui medicated gauze in the treatment of small-area deep second-degree burn wounds with fire-heat injuring fluid type.Methods Sixty patients who were diagnosed as small-area deep second-degree burn wounds of fire-heat injuring fluid type in Foshan Hospital of Traditional Chinese Medicine from January 2024 to July 2024,were selected as the research objects.The patients were randomly divided into trial group and control group by random number table method,with 30 cases in each group.The trial group was treated with external application of Shangke Huangshui medicated gauze,and the control group was treated with external application of Silver Sulfadiazine Cream.The treatment lasted for 21 days,and then the patients were followed up for 7 days.The changes of Visual Analogue Scale(VAS)score of wound pain,and serum levels of C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the two groups were observed before and after treatment.The wound healing rate,wound healing time,bacterial infection of the wound,and adverse reactions were compared between the two groups.Results(1)During the treatment,there was no fell-off case in the trial group while there was one patient falling off from the control group.Eventually,a total of 59 patients were included in the statistical analysis,including 30 in the trial group and 29 in the control group.(2)On day 14 and 21 of treatment,the wound healing rates of the two groups were significantly higher than those on day 7 of treatment(P＜0.05),and wound healing rates in the trial group on the day 14 and 21 of treatment were significantly superior to those of the control group(P＜0.05).(3)The time for the complete healing of wound in the trial group was(22.07±2.30)days,which was significantly shorter than that of the control group[(27.07±4.10)days],and the difference was statistically significant(P＜0.05).(4)After 7,14 and 21 days of treatment,the VAS scores of wound pain in the two groups were lowered compared with those before treatment(P＜0.05),and the VAS scores in the trial group were significantly lower than those in the control group(P＜0.05).(5)On day 7 of treatment,the levels of serum CRP,IL-6 and TNF-α in the two groups were lowered compared with those before treatment(P＜0.05),and the levels in the trial group were significantly lower than those in the control group(P＜0.05).(6)On day 7 of treatment,the positive rate of bacterial culture for wound discharge in the trial group was 6.67%(2/30),which was significantly lower than 27.59%(8/29)in the control group,and the difference was statistically significant(P＜0.05).(7)There were no serious adverse events or adverse reactions occurring in the two groups during the trial.Conclusion Shangke Huangshui medicated gauze can accelerate the healing of burn wounds,shorten the wound healing time,reduce the wound infection rate and the level of serum inflammatory factors,and has fewer adverse reactions with high safety.

Objective:To construct an outpatient counseling record sheet of breastfeeding based on Delphi method, so as to standardize the consultation process of breastfeeding clinics.Methods:Through literature analysis and discussion of the research group, the expert letter questionnaire was designed by themselves. From September to October 2020, two rounds of Delphi letter inquiries were conducted with 16 experts in Hangzhou to determine the outpatient counseling record sheet of breastfeeding.Results:The positive coefficients of two rounds of expert letter inquiries were 100%, the expert authority coefficients were respectively 0.93 and 0.95, and the Kendall's coefficient of concordance were 0.135-0.204 and 0.234-0.563 ( P< 0.05) . The final counseling record sheet constructed included 8 first-level items, 99 second-level items and 94 third-level items. Conclusions:Letter consulting experts have high enthusiasm, high degree of authority and good coordination. The breastfeeding clinic consultation record based on the Delphi method is highly scientific and practical, which can be applied to breastfeeding clinics in various maternal and infant medical institutions.

Based on the inheritance, the research group summarized the transmissive pathogenesis of depression in three typical stages, formulating the stepward treatment units which included Chinese medicine, acupuncture and TCM characterized psychotherapy, and formed a sequential treatment plan that balanced the principle of strengthening healthy Qi to eliminate pathogens, active and passive treatment, physical therapy and psychotherapy. Based on the retrospective analyses, ten typical clinical syndromes have been formed, constituting the pattern differentiation of "Three Phases, Five internal organs and Ten syndromes" for depression, which sysmatically showed the TCM syndrome differentiation. This work promoted the experiences and methods of treating depression by Chinese medicine.

Objective To explore the effect of focus solution mode on the health education for women with non-drug delivery analgesia.Methods A total of 196 cases of natural childbirth women were randomly divided into observation group and control group from March 2013 to February 2016,each with 98 cases. The delivery women in the observation group were given health education with the focus solution mode for non-drug delivery analgesia, and the delivery women in the control group received routine health education for non-drug delivery analgesia. The scores of anxiety and depression, self-care ability and analgesic effect of the two groups were compared before and after interventions.Results At the time of admission, the depression and anxiety scores of the two groups had no statistically significant difference (P>0.05); after interventions, the scores of depression and anxiety for delivery women in the observation group were significantly lower than that of the control group, and the differences were statistically significant (t=3.331, 3.458;P<0.01). After intervention, the maternal self-concept, health knowledge, nursing skills, self responsibility and total score in the observation group were higher than those in the control group, and the differences were statistically significant (t=6.389, 4.254, 3.365, 2.421, 3.541;P<0.05). The number of delivery women with the pain of grade I and below was 102 in the observation group, and the effective analgesia rate was 91.07%; in the control group was 37, and the effective rate of analgesia was 34.69%, so the effective rate of analgesia in the observation group was significantly higher than that of the control group(χ2=70.789,P<0.01).Conclusions Focus solution mode for health education can alleviate the degree of depression and anxiety, improve the self-management ability of delivery women, and improve the effective rate of analgesia.

Objective To discuss the application effects of health education accompanied by the spouse on non-drug delivery analgesia.Methods A total of 224 cases of natural childbirth in Zhejiang Xiaoshan Hospital from June 2013 to May 2016 were randomly divided into the observation group and the control group, 112 cases respectively. There were three cases lost in the control group so that 109 cases were included. During the non-drug delivery analgesia, patients in the observation group received health education accompanied by the spouse, while patients in the control group received routine health education. The maternal labor time, postpartum hemorrhage amount for 24 h, labor analgesia score, analgesic effect and nursing satisfaction were compared between the two groups.Results The maternal labor time, postpartum hemorrhage amount for 24 h and pain scores in the observation group were lower than those in the control group. The differences between the two groups were statistically significant (P<0.01). There were 102 cases of maternal with grade I and below in the pain degree in the observation group, and the effective analgesia rate was 91.07％. In the control group, 37 cases of maternal with grade I and below in the pain degree were observed, and the effective rate of analgesia was 33.94％. The effective rate of analgesia in the observation group was significantly higher than that in the control group (Z=114.110,P<0.001). The satisfaction with health education, service attitude, ward management, care and communication ability of patients in the observation group were higher than those in the control group, and the differences were statistically significant (χ2=8.010, 6.884, 13.622, 8.039, 11.334;P<0.01).Conclusions The health education accompanied by the spouse can increase the effective analgesia rate, shorten the delivery time, reduce the amount of postpartum hemorrhage, and improve the satisfaction rate of nursing.