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.

Purpose: This study aimed to investigate reproductive concerns among breast cancer patients of reproductive age, analyze the influencing factors, explore the relationship between coping styles, fear of progression (FOP), and reproductive concerns, and identify the multiple effects of coping styles on the relationship between FOP and reproductive concerns among Chinese breast cancer patients. Methods: A cross-sectional, descriptive study was conducted among breast cancer patients in four tertiary grade A hospitals in Fujian, China, from January 2022 to September 2022. A total of 210 patients were recruited to complete paper-based questionnaires, which included the general data questionnaires, the Reproductive Concerns After Cancer Scale (RCACS), the Fear of Progression Questionnaire-Short Form (FOP-Q-SF), and the Medical Coping Modes Questionnaire (MCMQ). Structural equation models were utilized to evaluate the multiple effects of coping styles on FOP and reproductive concerns. Results: Reproductive concerns in breast cancer patients had a mean score of 53.02 (SD, 10.69), out of a total score of 90, and coping styles for cancer (confrontation, avoidance) were closely associated with FOP and reproductive concerns. FOP showed a significant positive correlation with reproductive concerns (r = .52, p < .01). At the same time, confrontation was significantly negatively correlated with both FOP (r = −.28, p < .01) and reproductive concerns (r = −.39, p < .01). Avoidance was positively correlated to both FOP (r = .25, p < .01) and reproductive concerns (r = .34, p < .01). The impact of FOP on reproductive concerns is partially mediated by confrontation and avoidance, with effect sizes of .07 and .04, respectively. These mediating factors account for 22.0% of the total effect. Conclusions The FOP directly impacted reproductive concerns, while coping styles could partially mediate the association between FOP and reproductive concerns. This study illustrates the role of confrontation and avoidance in alleviating reproductive concerns, suggesting that it is necessary to focus on the changes in reproductive concerns among reproductive-age breast cancer patients. Healthcare professionals can improve disease awareness and reduce patients' FOP, thereby promoting positive psychological and coping behaviors and ultimately alleviating reproductive concerns.

Objective:The epidemiological and clinical characteristics of 18 cases of Japanese spotted fever (JSF) in Zigui County were analyzed in order to improve the prevention and treatment of JSF.Methods:This is a case series analysis. The epidemiological and clinical data, laboratory tests and imaging characteristics of 18 JSF cases with median age of 60 years (54, 68) identified by The People′s Hospital of Zigui from April 2021 to August 2022 were collected and analyzed retrospectively.Results:Most (17/18) of the patients were farmers and all had a field exposure history. The patient′s onset was from April to October. Spring and autumn were the seasons with the highest incidence of JSF. The first symptoms of patients were high fever, headache, and fatigue. Of the 18 cases, 15 had a rash and 12 presented an eschar and 3 had neither rash nor eschar. In addition, 10 of 18 cases experienced edema of both lower extremities, and 3 got disturbance of consciousness. Laboratory tests found that 15 patients had abnormal white blood cells and 11 patients had decreased platelets. C-reactive protein, procalcitonin, D-dimer, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase were elevated in all patients; 13 patients with elevated alanine aminotransferase, 14 patients with elevated aspartate transamination. Kidney damage caused by Rickettsia japonica infection showed by abnormal proteinuria in 11 of the patients. Conclusions:The most common clinical manifestations of JSF are non-specific indications such as high fever, chills, fatigue, headache. The eschar and rash, which are the main features of Rickettsia infection, are not present in all patients, resulting delay of diagnosis or misdiagnosis. Medical workers should be more alert to rickettsial infections in patients with fever of unknown origin, especially in seasons of high incidence of spotted fever. Early diagnosis and correct antibiotic treatment shall be given according to the patient′s clinical manifestations, laboratory results and imaging test to control disease progression.

Objective:To analyze the effectiveness and safety of assisted reproductive technology in the fertility needs of female patients with malignant tumors.Methods:A total of 37 female malignant tumor patients (case group) who underwent adjuvant reproductive therapy in Fujian Provincial Maternity and Children's Hospital from 2013 to 2018 were enrolled. Totally 74 non-tumor patients were matched as control group according to age and egg retrieval time using a 1：2 matching method. By analyzing the demographic data and the first pregnancy data, the clinical pregnancy rate and the implantation rate of the first transplant cycle were calculated, and the pregnancy outcomes of case group and control group were evaluated.Results:There was no significant difference in the demographic data between the two groups. There was no significant difference in the basic follicle-stimulating hormone (FSH) level, basic luteinizing hormone (LH) level, estradiol and progesterone levels on human chorionic gonadotropin (hCG) injection day during the first treatment period ( P>0.05). The differences of total amount of gonadotropin (Gn) used [(1 984.93±756.79) IU vs. (2 610.59±988.52) IU, P=0.001], duration of Gn used [(9.68±2.57) d vs. (11.64±2.47) d, P<0.001], high-quality embryo rate (49.56% vs. 58.94%, P=0.016) and the number of embryos transferred (1.4±0.5 vs. 1.8±0.4， P=0.001) between case group and control group were statistically significant. There was no significant difference in the clinical pregnancy rate and the implantation rate between the two groups ( P>0.05). Cumulative pregnancy rate, cumulative live birth rate, the number of egg retrieval cycles per live birth, the number of transplant cycles, the number of embryos, and the number of high-quality embryos were not statistically significant ( P>0.05). Tumor patients receiving assisted reproductive assistance have not been found so far recurrence or new tumor. Conclusion:Compared with control group, the pregnancy outcomes after assisted reproductive technology in female malignant tumor patients were not significantly different. Assisted reproductive technology can fulfill the fertility needs of female malignant tumors after surgery and is safety.

Objective:To analyze the effectiveness and safety of assisted reproductive technology in the fertility needs of female patients with malignant tumors.Methods:A total of 37 female malignant tumor patients (case group) who underwent adjuvant reproductive therapy in Fujian Provincial Maternity and Children's Hospital from 2013 to 2018 were enrolled. Totally 74 non-tumor patients were matched as control group according to age and egg retrieval time using a 1：2 matching method. By analyzing the demographic data and the first pregnancy data, the clinical pregnancy rate and the implantation rate of the first transplant cycle were calculated, and the pregnancy outcomes of case group and control group were evaluated.Results:There was no significant difference in the demographic data between the two groups. There was no significant difference in the basic follicle-stimulating hormone (FSH) level, basic luteinizing hormone (LH) level, estradiol and progesterone levels on human chorionic gonadotropin (hCG) injection day during the first treatment period ( P>0.05). The differences of total amount of gonadotropin (Gn) used [(1 984.93±756.79) IU vs. (2 610.59±988.52) IU, P=0.001], duration of Gn used [(9.68±2.57) d vs. (11.64±2.47) d, P<0.001], high-quality embryo rate (49.56% vs. 58.94%, P=0.016) and the number of embryos transferred (1.4±0.5 vs. 1.8±0.4， P=0.001) between case group and control group were statistically significant. There was no significant difference in the clinical pregnancy rate and the implantation rate between the two groups ( P>0.05). Cumulative pregnancy rate, cumulative live birth rate, the number of egg retrieval cycles per live birth, the number of transplant cycles, the number of embryos, and the number of high-quality embryos were not statistically significant ( P>0.05). Tumor patients receiving assisted reproductive assistance have not been found so far recurrence or new tumor. Conclusion:Compared with control group, the pregnancy outcomes after assisted reproductive technology in female malignant tumor patients were not significantly different. Assisted reproductive technology can fulfill the fertility needs of female malignant tumors after surgery and is safety.

Objective To investigate the safety and effectiveness of endoscopic resection of tumors originated from gastric fundus muscularis propria.Methods Data of 53 patients with tumors originated from gastric fundus muscularis propria detected by endoscopic ultrasonograpy,treated by endoscopic resection and followed up at our hospital between January 2012 and June 2014 were reviewed.The postoperative pathology and complications were retrospectively analyzed to evaluate the therapeutic effect and safety.Results The procedure was successfully performed on all patients and all lesions were removed in one procedure.The lesion size ranged from 0.5 to 4.5 cm and the operation time was 25-155 min[mean(46.7 ±18.2)min].Mild bleeding (5 ~150 ml)occurred in all cases,which was successfully managed by argon plasma coagulation,hot biopsy probe or endoclip.Perforation occurred in 8 patients(8 /53),seven of whom were closed with titanium clips and titanium clips combined with nylon cord.Laparoscopic intervention was applied to 1 case because of severe perforation.Gastrointestinal decompression,acid suppression with proton pump inhibitors and antibiotics were performed on all cases.No severe hemorrhage occurred.The average length of hospitalization was (5.3 ± 1.4)days(3-14 d).Pathology confirmed 46 cases of gastrointestinal stromal tumors and 7 cases of leiomyoma. The patients were followed up for 3 to 27 months,and no tumor residue or recurrence was observed. Conclusion Endoscopic resection is a method not only to get the accurate pathologic diagnosis but also to meet principle of the local resection for stomach.It is safe,effective and worthy of recommendation.

AIM: To establish a cell line of stable silencing of P2X7 receptor (P2X7R) expression through short hairpin RNA ( shRNA)-mediated interference in murine RAW264.7 macrophages, and to investigate the proliferation and apoptosis in the cell line.METHODS:Stable silencing of P2X7 R gene in the RAW264.7 cells was achieved by re-combinant shRNA plasmid targeting murine P2X7 R gene via liposome mediated transfection, followed by G418 selection. The efficacy of plasmid transfection and P2X7 R silencing in G418 resistant cells was verified by immunofluorescent micros-copy and real-time PCR, respectively.The proliferative activity was analyzed by CCK-8 assay and EdU cell proliferation as-say.The cell cycle distribution and apoptosis were evaluated by flow cytometry.RESULTS:The expression of P2X7 R at mRNA and protein levels was down-regulated by 80% in shP2X7 R group compared with negative control ( NC) plasmid transfection.In addition, P2X7 R-silencing cells exhibited higher proliferative activity compared with NC and wild-type RAW264.7 cells (P<0.05).Compared with NC cells, P2X7R silencing resulted in an increase in the phagocytosis of the cells ( P<0.05) .CONCLUSION:A cell line RAW264.7 of stable silencing of P2X7 R expression was successfully es-tablished.P2X7 R gene silencing stimulates the proliferation, and changes phagocytic function in murine RAW264.7 macro-phages.

OBJECTIVEThis study aimed to investigate the effects of different tooth preparations on the fracture strength and pattern of failure of teeth with severe wedge-shaped defect restored with post and core crowns.

METHODSAccording to whether the teeth above the wedge-shaped defect was removed (represented by B) or not (represented by A), the ferrule next to the wedge-shaped defect was prepared (represented by D) or not (represented by C), the cast post-and-core was chosen (represented by E) or glass-fiber post and resin core was chosen (represented by F). A total of 64 human mandibular premolar teeth were randomly divided into 8 groups: A1-1 (A + C + E), A1-2 (A + C + F), A2-1 (A + D + E), A2-2 (A + D + F), B1-1 (B + C + E), B1-2 (B + C + F), B2-1 (B + D + E), B2-2 (B + D + F), each group 8 teeth. All the teeth were prepared and restored accordingly and then mounted on an electronic pressure universal testing machine. The maximum fracture strength and the patterns of failure were recorded.

RESULTS1) The fracture strength of Group A1-1 > that of Group B1-1, Group A1-2 > Group B1-2, Group B2-1 > Group B1-1, and Group B2-1 > Group B2-2 with significant differences (P < 0.05). 2) The patterns of repairable fracture in Group A1-2 and B1-2 were both 37.5%, and that of the other groups were 0. Furthermore, the difference was significant, and Group A1-2 and B1-2 were higher than other groups.

CONCLUSIONThe maintenance of the overhang above the severe wedge-shaped defect aid in the improvement of the fracture strength of the tooth restored with post and core crown. The ferrule of the wedge-shaped defect is not recommended to be prepared. Furthermore, the glass-fiber post and resin core is favorable for the re-repair of the teeth than the cast post and core.

Objective To investigate the expression of the Toll-like receptor-4 (TLR-4) in temporomandibular joint synovitis in rats,and to discuss the correlation between the expression of TLR-4 and the synovitis.Methods Sixty male wistar rats were randomly divided into five groups,12 each.Group A was the control group in which the rats were given normal diet.In Group B,the rats' bilateral masseter muscles were cut off (masseter resection group).In Group C,An cast metal crown were bonded on the mandibular right first molar of each rat (occlusal interference group).In Group D,occlusal pad were bonded on maxillary molars of each rat (occlusal dimension increase group).In Group E,rats' bilateral masseter muscles were resected and occlusal pads were bonded on their maxillary molars (masseter resection and occlusal dimension increase group).Pathological changes of synovium were observed using hematoxylin and eosin (HE) stains and pathology scores were evaluated.The expression of TLR-4 were determined by immunohistochemical stains,and the expression of TLR-4 mRNA were determined by real-time PCR.The correlation between the expression of TLR-4,TLR-4 mRNA and the pathological score were analyzed using Spearman analysis.Results The pathological scores of Group A-E were 0.5±0.5,2.5±1.0,2.7±1.0,3.0±0.9,5.3±1.2 respectively.The expression of TLR-4 were (3.2±1.5) ％,(16.0±2.6) ％,(15.8±2.1) ％,(17.5±2.4) ％,(38.2±4.4) ％.The expression of TLR-4 mRNA were 1.07±0.09,2.12±0.33,2.07±0.29,2.17±0.34,4.53±0.46.Compared with group A,groups B-E showed significant higher pathology score (P＜0.05) and increased expression of both TLR-4 (P＜0.05) and TLR-4 mRNA (P＜0.05).An significant positive correlation was found between the expression of TLR-4 and the pathology score (r=0.785,P＜0.05),and between the expression of TLR-4 mRNA and the pathology score (r=0.720,P＜0.05).Conclusions TLR-4 may be closely associated with the development of the synovitis of TMJ of rats.

Objective This study aimed to investigate the effects of different tooth preparations on the fracture strength and pattern of failure of teeth with severe wedge-shaped defect restored with post and core crowns. Methods According to whether the teeth above the wedge-shaped defect was removed (represented by B) or not (represented by A), the ferrule next to the wedge-shaped defect was prepared (represented by D) or not (represented by C), the cast post-and-core was chosen (represented by E) or glass-fiber post and resin core was chosen (represented by F). A total of 64 human mandibular premolar teeth were randomly divided into 8 groups: A1-1 (A+C+E), A1-2 (A+C+F), A2-1 (A+D+E), A2-2 (A+D+F), B1-1 (B+C+E), B1-2 (B+C+F), B2-1 (B+D+E), B2-2 (B+D+F), each group 8 teeth. All the teeth were prepared and restored accordingly and then mounted on an electronic pressure universal testing machine. The maximum fracture strength and the patterns of failure were recorded. Results 1) The fracture strength of GroupA1-1>that of Group B1-1, Group A1-2>Group B1-2, Group B2-1>Group B1-1, and Group B2-1>Group B2-2 with significant differences (P<0.05). 2) The patterns of repairable fracture in Group A1-2 and B1-2 were both 37.5%, and that of the other groups were 0. Furthermore, the difference was significant, and Group A1-2 and B1-2 were higher than other groups. Conclusion The maintenance of the overhang above the severe wedge-shaped defect aid in the improvement of the fracture strength of the tooth restored with post and core crown. The ferrule of the wedge-shaped defect is not recommended to be prepared. Furthermore, the glass-fiber post and resin core is favorable for the re-repair of the teeth than the cast post and core.