Objective To investigate the current status of breastfeeding motivation in early post-partum women and analyze the influencing factors of breastfeeding motivation.Methods A conven-ience sampling method was used to select 205 hospitalized women within 48 to 72 hours postpartum as the study subjects.The women were surveyed using a general information questionnaire,a breastfeed-ing motivation scale,a breastfeeding knowledge questionnaire,and a short-form scale for breastfeed-ing self-efficacy.Multiple linear regression analysis was conducted to explore the influencing factors of breastfeeding motivation among the women.Results The average score for autonomous motivation to-wards breastfeeding among 205 women was(49.94±7.62),and the average score for controlled mo-tivation was(23.76±3.59).The results of multiple linear regression analysis showed that age,par-ticipation in breastfeeding-related courses during pregnancy,planned duration of breastfeeding,skill dimension score of the short-form scale for breastfeeding self-efficacy,and total score on the breast-feeding knowledge questionnaire were influencing factors for the autonomous motivation score towards breastfeeding(P＜0.05);participation in breastfeeding-related courses during pregnancy,skill di-mension score on the short-form breastfeeding self-efficacy,and total score on the breastfeeding knowledge questionnaire were influencing factors for the controlled motivation score towards breast-feeding(P＜0.05).Conclusion The level of breastfeeding motivation in early postpartum women needs to be improved.Healthcare providers should focus on maternal age and planned duration of breastfeeding,strengthen breastfeeding knowledge education,and enhance maternal breastfeeding self-efficacy to improve maternal breastfeeding motivation and breastfeeding rates.

Objective To investigate the effect of smoking on the semen quality in infertile men.Methods A total of 360 male infertility patients were enrolled and divided into the smoking group(n=190)and non-smoking group(n=170)based on whether they smoked or not.Furthermore,the smoking group was subdivided into group A(≤10 sticks/d,n=63),group B(11～20 sticks/d,n=80),and group C(>20 sticks/d group,n=47)according to the amount of smoking.Semen volume,liquefaction time,sperm concentration,motility,DNA fragmentation rate and normal morphological rate were observed and compared between and within the groups.Results There were significant differences in semen volume,liquefaction time,sperm motility,normal morphological rate and DNA fragmentation rate between the smoking group and the non-smoking group(P<0.05).The semen volume,sperm motility and normal morphological rate of the smoking group were lower than those in the non-smoking group,and the DNA fragmentation rate and semen liquefaction time were higher than those in the non-smoking group.And with the increase of smoking volume,sperm motility and normal morphological rate decreased,semen liquefaction time and DNA fragmentation rate increased,and there was no significant difference in the sperm concentration between the smoking group and non-smoking group(P>0.05).There was no significant difference in the semen volume between the three groups with different smoking amounts(P>0.05).Conclusion Smoking has a negative impact on the sperm quality parameters such as semen volume,sperm motility,normal morphological rate,sperm motility,liquefaction time and DNA fragmentation,and the effect of heavy smoking is particularly obvious.We should strengthen the comprehensive health education,promote the healthy lifestyles and reduce smoking.

Objective:To explore the mediating effects of parental psychological control and psychological resilience in adolescents between parental marital conflict and early adolescent depression, loneliness.Methods:From October to December 2022, a total of 805 adolescents from three middle schools in Luzhou City, Sichuan Province and Chongqing City were surveyed with children's perception of interparental conflict scale, the parental psychological control scale, Connor-Davidson resilience scale, the center for epidemiological studies depression scale, UCLA loneliness scale.SPSS 26.0 software was used for descriptive analysis, correlation analysis.Mplus 7.0 software was used for chain mediating model construction, the mediating effects were tested by Bootstrap method.Results:(1)Parental marital conflict (2.05±0.51), parental psychological control (2.53±0.88), early adolescent depression (0.84±0.62) and loneliness (2.02±0.59) were significantly and positively correlated with each other ( r=0.47-0.78, all P<0.01), while psychological resilience in adolescents(2.42±0.66) was significantly and negatively correlated with marital conflict, parental psychological control, early adolescent depression and loneliness ( r=-0.60--0.36, all P<0.01). (2)The direct effects of parental marital conflict on early adolescent depression and loneliness were 0.183, 0.170, accounting for 34.08%, 32.82% of the total effects.There were three paths of the indirect effects between parental marital conflict and early adolescent depression, loneliness.The specific indirect effects of parental psychological control were 0.148, 0.127, accounting for 27.56%, 24.52% of the total effects.The specific indirect effects of psychological resilience were 0.186, 0.199, accounting for 34.64%, 38.41% of the total effects.The chain mediating effects of parental psychological control and psychological resilience were 0.020, 0.022, accounting for 3.72%, 4.25% of the total effects. Conclusion:Parental marital conflict can directly affect early adolescent depression, loneliness, and can indirectly affect early adolescent depression, loneliness through parental psychological control and psychological resilience in adolescents.

Heterotrophic nitrification-aerobic denitrification (HN-AD) bacteria are aerobic microorganisms that can remove nitrogen under high-salt conditions, but their performance in practical applications are not satisfactory. As a compatible solute, trehalose helps microorganisms to cope with high salt stress by participating in the regulation of cellular osmotic pressure, and plays an important role in promoting the nitrogen removal efficiency of microbial populations in the high-salt environment. We investigated the mechanism of exogenous-trehalose-enhanced metabolism of HN-AD community under high-salt stress by starting up a membrane aerobic biofilm reactor (MABR) to enrich HN-AD bacteria, and designed a C₁₅₀ experimental group with 150 μmol/L trehalose addition and a C₀ control group without trehalose. The reactor performance and the community structure showed that NH₄⁺-N, total nitrogen (TN) and chemical oxygen demand (COD) removal efficiency were increased by 29.7%, 28.0% and 29.1%, respectively. The total relative abundance of salt-tolerant HN-AD bacteria (with Acinetobacter and Pseudofulvimonas as the dominant genus) in the C₁₅₀ group reached 66.8%, an 18.2% increase compared with that of the C₀ group. This demonstrated that trehalose addition promoted the enrichment of salt-tolerant HN-AD bacteria in the high-salt environment to enhance the nitrogen removal performance of the system. In-depth metabolomics analysis showed that the exogenous trehalose was utilized by microorganisms to improve proline synthesis to increase resistance to high-salt stress. By regulating the activity of cell proliferation signaling pathways (cGMP-PKG, PI3K-Akt), phospholipid metabolism pathway and aminoacyl-tRNA synthesis pathway, the abundances of phosphoethanolamine, which was one of the glycerophospholipid metabolites, and purine and pyrimidine were up-regulated to stimulate bacterial aggregation and cell proliferation to promote the growth of HN-AD bacteria in the high-salt environment. Meanwhile, the addition of trehalose accelerated the tricarboxylic acid (TCA) cycle, which might provide more electron donors and energy to the carbon and nitrogen metabolisms of HN-AD bacteria and promote the nitrogen removal performance of the system. These results may facilitate using HN-AD bacteria in the treatment of high-salt and high-nitrogen wastewater.
Nitrification ; Denitrification ; Trehalose ; Phosphatidylinositol 3-Kinases/metabolism* ; Heterotrophic Processes ; Salt Stress ; Nitrogen/metabolism* ; Aerobiosis ; Bioreactors/microbiology*

Objective:To explore the clinical value of the geriatric potentially inappropriate medication(PIM)evaluation system in elderly inpatients.Methods:As a prospective cohort study, 203 elderly inpatients with polypharmacy were randomly divided into the control group and experimental group.Geriatric PIM evaluation system(based on the criteria for judging potential inappropriate drug use in Chinese elderly 2017 edition)on wechat platform was applied to patients of experimental group.During the 6 months, the number of elderly syndromes, types of drugs, the days in hospitalization, readmission rates and all-cause mortality were compared between two groups.Results:The age of 203 elderly inpatients ranged from 60 to 94(77.30±10.34)years, including 121 males and 82 females.The morbidity proportion of top five diseases were 69.95%(142/203)in cerebral infarction(non-acute phase), 62.07%(126/203)in hypertension, 24.14%(49/203)in coronary heart disease, 9.85%(20/203)in atrial fibrillation, and 6.40%(13/203)in cardiac insufficiency.The 97.53%(198/203)of elderly hospitalized patients had at least one senile syndrome, the average was 4.3±2.0.Insomnia, fall and frailty accounted for 32.87%(15/198), 28.45%(56/198)and 13.66%(27/198)respectively.Compared with the control group, the average length of stay in hospital in the experimental group significantly decreased[(16.38±4.29) vs.(21.32±6.10)d, t=2.438、 P=0.025], the number of senile syndrome, the score of fall, weakness and the re-admission rate were also decreased significantly(3.11±2.14 vs.4.32±1.50, t=0.854、 P=0.032; 6.19±1.35 vs.8.61±3.22, t=4.078、 P=0.044; 3.94±1.92 vs.5.65±1.34, t=2.843、 P=0.038; 9.81%(10/102) vs.1.98%(2/101), χ2=4.772、 P=0.029), and the frequency of PIM was significantly different between two groups(417.36±49.21 vs.210.25±38.23, t=2.136、 P=0.034). Conclusions:After making the drug adjustment on the elderly inpatients with multiple drugs, PIM evaluation system for the elderly are able to reduce the incidence of geriatric syndrome, shorten the length of stay in hospital, improve the rational use of drugs, and enhance the quality of life of the elderly patients.

Objective To observe the effects of dual-task motor training on motor and balance function for stroke patients. Methods From January, 2016 to June, 2017, 30 patients with stroke were assigned randomly into control group (n = 15) and treatment group (n = 15). Both groups accepted routine physical therapy, the control group accepted anti-gravity treadmill training, while the treatment group accepted dual-task training with anti-gravity treadmill, for four weeks. They were measured with balance training and evaluation system, and assessed with Fugl-Meyer Assessment-lower extremity (FMA-L), Berg Balance Scale (BBS) and modified Barthel Index (MBI), before and after treatment. Results The range of swaying on X axial (Rx) and Y axial (Ry), as well as rectangle area (RecArea) decreased after treatment in the treatment group (t > 4.719, P < 0.001), while RecArea decreased in the control group (t = 5.069, P < 0.001). Ry and RecArea were less in the treatment group than in the control group (t > 2.288, P < 0.05). The scores of FMA-L, BBS and MBI improved after treatment in both groups (t > 7.316, P < 0.001), and improved more in the treatment group than in the control group (t > 2.322, P < 0.05). Conclusion The dual-task training via anti-gravity treadmill may improve motor and balance function in stroke patients, and promote the activities of daily living.

Objective To investigate the effects of different control methods in cuff pressure (Pcuf) on the incidence of ventilator associated pneumonia (VAP) for the patient receiving mechanical ventilation with implication of artificial airway by oral endotracheal intubation.Methods A total of 80 patients receiving mechanical ventilation with oral endotracheal were numbered according to the order of using mechanical ventilation. Patients with odd numbers were recruited into intervention group (40 cases), while patients with even numbers were included in control group (40 cases). Patients in intervention group used Arto continuous air pressure control device to continuously control the cuff pressure, while the control group used German VBM airbags pressure gauge to measure and regulate cuff pressure three times a day. Sputum specimens of patients were taken and pepsin levels were tested at tracheal intubation, 48 h and 96 h post mechanical ventilation. Pcuf, pepsin levels in sputum specimens and the incidence of VAP were compared between two groups.ResultsAt 96 h post mechanical ventilation, Pcuf of patients in intervention group were in the ideal range (20~30cmH2O) for 479 times, and in control group the number were 389 times. The difference was statistically significant (χ2=124.830,P<0.01). The pepsin levels of sputum specimens in intervention group were (617.32±67.13) and (653.13±71.32) ng/ml at 48 h and 96 h post mechanical ventilation, both of which were significantly lower than those in control group (t=-11.217,-14.500;P<0.01). The incidences of VAP were 25.0% and 47.5% in intervention and control group respectively, with statistically significant difference between two groups (χ2=4.381,P<0.05).Conclusions The continuous air pressure control device can better keep the air pressure in the ideal range and reduce gastric contents aspiration of the patients with mechanical ventilation so as to reduce the incidence of VAP.

ObjiectiveTo investigate the clinical efficacy of Chinese medicineShuxin-Huoxue decoction on coronary heart disease and angina pectoris.MethodsThis study was a randomized controlled trial. 86 patients with coronary heart disease and angina pectoris and conformed to the indusive criteria were randomly divided into a control group and a treatment group, with 43 cases in each group. The control group was treated with conventional western medicine, the treatment group was treated with traditional Chinese medicineShuxin-Huoxue decoction. Serum homocysteine (Hcy) was measured by enzymatic cycling assay, high sensitive C reactive protein (hs-CRP) was measured by immunotubidimetric assay and left ventricular ejection fraction (LVEF), stroke volume (SV), cardiac output (CO), cardiac index (CI) were measured by color doppler echocardiography before and after treatment. The clinical effect of the two groups was evaluated.ResultsThe total effective rate of the treatment group and the control group was 90.7% (39/43) and 74.4% (32/43) respectively,there was significant difference (χ2=3.957,P=0.047). Followed up for 4 weeks, LVEF(65.7% ± 8.7% vs. 61.5% ± 8.4%,t=2.277), SV(86.9 ± 16.8 ml vs.79.2 ± 16.5 ml,t=2.144), CO(49.3 ± 9.1 ml/m2 vs. 44.7 ± 8.8 ml/m2,t=2.383), CI (3.7 ± 0.9 L/min?m2 vs. 3.3 ± 0.7 L/min?m2,t=2.301) of the treatment group were significantly improved after treatment than those of the control group (P<0.05), and the decrease of serum Hcy  (8.7± 3.7mmol/L vs. 11.4± 3.5mmol/L,t=3.476), hs-CRP (2.7± 1.1 mg/L vs. 3.5± 1.3 mg/L,t=3.081) level of the treatment group were better than those of the control group(P<0.01).ConclusionTraditional Chinese medicineShuxin-Huoxue decoction has good therapeutic effect on coronary heart disease and angina pectoris.

Objective To explore the application of intensive nursing in improving preg-nancy outcomes of preeclampsia.Methods 48 patients with preeclampsia were randomly divided into conventional group and intensive nursing group.Conventional group was received conventional education,nursing assessment,executive orders of doctors and blood pressure monitoring while the intensive nursing group was conducted a series of nursing operations to ensure the most effective, satisfactory diagnosis,treatment and nursing for patients and to avoid serious complications.Post-partum hemorrhage,fetal deaths of twins,eclampsia,numbers of caesarean birth,preterm birth and disease from mild to severity were compared.Results The occurrence of postpartum haemor-rhage,twins fetal death,eclampsia,cesarean section,premature delivery and disease from mild to severity in the intensive nursing group were all lower than that in the conventional group (P <0.05).Conclusion Intensive nursing could improve pregnancy outcomes and avoid serious com-plications,so it is significant in reality.

Objective To explore the application of intensive nursing in improving preg-nancy outcomes of preeclampsia.Methods 48 patients with preeclampsia were randomly divided into conventional group and intensive nursing group.Conventional group was received conventional education,nursing assessment,executive orders of doctors and blood pressure monitoring while the intensive nursing group was conducted a series of nursing operations to ensure the most effective, satisfactory diagnosis,treatment and nursing for patients and to avoid serious complications.Post-partum hemorrhage,fetal deaths of twins,eclampsia,numbers of caesarean birth,preterm birth and disease from mild to severity were compared.Results The occurrence of postpartum haemor-rhage,twins fetal death,eclampsia,cesarean section,premature delivery and disease from mild to severity in the intensive nursing group were all lower than that in the conventional group (P <0.05).Conclusion Intensive nursing could improve pregnancy outcomes and avoid serious com-plications,so it is significant in reality.