Objective:To retrieve, evaluate, and summarize the best evidence for the prevention and management of nipple pain or injury in breastfeeding puerperae, providing evidence-based basis for clinical practice of breastfeeding.Methods:According to the "6S" evidence pyramid model, clinical decisions, guidelines, expert consensus, evidence summaries, and systematic reviews on the prevention and management of nipple pain or injury in breastfeeding puerperae were systematically searched. The search period was from database establishment to March 10, 2023. The research team members independently evaluated the quality of the included article based on the corresponding quality evaluation standards, and combined professional judgment to extract and summarize evidence for the final included article.Results:A total of 15 articles were included, including two clinical decisions, 7 guidelines, and 6 systematic reviews. Finally, 19 best pieces of evidence were summarized, including four themes, namely, assessment of nipple pain or injury, prevention of nipple pain or injury, management of nipple pain or injury, and health education.Conclusions:Obstetrical nurses and midwives should provide standardized nursing for breastfeeding puerperae based on specific clinical scenarios, reduce the incidence of nipple pain or injury in breastfeeding puerperae, and promote puerperae to adhere to breastfeeding.

In this paper, the domestic and international demand and development trend of clinical diagnostic radionuclides are analyzed, and the medium and high-energy cyclotrons, adequate and systematic facilities, and preparation techniques required for the production of medical radionuclides based on solid targets are introduced. This paper focuses on the research and development carried out by some important medical institutions and scientific research institutes in China over the years in the aspects of medium and high-energy cyclotrons, beam transmission lines, high-power irradiation target stations and new medical isotope production processes etc. It also looks forward to some new directions for the development of medical radionuclides in China during the 14th Five-Year Plan period.

Objective:To investigate the effect of white matter hyperintensities (WMHs) location on the clinical outcomes in patients with anterior circulation acute ischemic stroke (AIS) after intravenous thrombolysis.Methods:Patients with anterior circulation AIS treated with alteplase intravenous thrombolysis in Xuzhou Central Hospital from February 2015 to February 2020 were enrolled retrospectively. The severity of periventricular WMHs (PWMHs) and deep WMHs (DWMHs) was assessed by Fazekas scale. According to the score of the modified Rankin Scale at 90 d after onset, the patients were divided into good outcome group (0-2) and poor outcome group (3-6). The demographic and clinical data were compared between the two groups. Multivariate logistic regression analysis was used to investigate the effect of WMHs location on the clinical outcome in AIS patients treated with intravenous thrombolysis. Results:A total of 408 patients with anterior circulation AIS were enrolled in the study, including 272 males (66.7%) and 136 females (33.3%). Their age was 64.1±12.1 years (range, 40-92years). The baseline median National Institutes of Health Stroke Scale (NIHSS) score was 6 (interquartile range, 4-16). Three hundred and fourteen patients (77.0%) were in the good outcome group and 94 (23.0%) were in the poor outcome group. There were significant differences in age, atrial fibrillation, diabetes mellitus, baseline NIHSS score, blood glucose level before thrombolysis, etiological classification of stroke, PWMHs, DWMHs, hemorrhagic transformation, early neurological deterioration and stroke recurrence between the two groups (all P<0.05). Multivariate logistic regression analysis showed that moderate to severe PWMHs were significantly and independently associated with the poor outcomes in patients with anterior circulation AIS treated with intravenous thrombolysis at 90 d after onset (odds ratio 2.357, 95% confidence interval 1.086-5.115; P=0.030). Other independent related factors included age, baseline NIHSS score, etiological classification of stroke (large artery atherosclerosis and cardiogenic embolism), early neurological deterioration, hemorrhagic transformation, and stroke recurrence. Conclusion:Moderate to severe PWMHs is an independent risk factor for poor outcomes at 90 d after onset in patients with anterior circulation AIS treated with intravenous thrombolysis.

Oral and maxillofacial space infections (OMSI) are common diseases of the facial region involving fascial spaces. Recently, OMSI shows trends of multi drug-resistance, severe symptoms, and increased mortality. OMSI treatment principles need to be updated to improve the cure rate. Based on the clinical experiences of Chinese experts and with the incorporation of international counterparts′ expertise, the principles of preoperative checklist, interpretation of examination results, empirical medication principles, surgical treatment principles, postoperative drainage principles, prevention strategies of wisdom teeth pericoronitis-related OMSI, blood glucose management, physiotherapy principles, Ludwig′s angina treatment and perioperative care were systematically summarized and an expert consensus on the diagnosis and treatment of OMSI was reached. The consensus aims to provide criteria for the diagnosis and treatment of OMSI in China so as to improve the level of OMSI treatment.

Objective: To investigate the predictive value of CT-DRAGON score for clinical outcomes after endovascular treatment in patients with acute ischemic stroke. Methods: Patients with acute ischemic stroke underwent endovascular intervention in Xuzhou Central Hospital from May 2015 to June 2019 were enrolled retrospectively. CT-DRAGON score was performed before treatment, and the outcomes of patients were evaluated by the modified Rankin Scale (mRS) at 3 months after treatment, and good outcome was defined as mRS0-2. Multivariate logistic regression analysis was used to determine the independent factors for the outcomes. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of CT-DRAGON score for clinical outcome. Results: A total of 67 patients were enrolled. The age was 68.69±11.63 years. The median CT-DRAGON score was 5 (interquartile interval: 4-7), and the baseline NIHSS score was 17.45±5.19. Thirty-five patients (52.2%) had a good outcome and 32 (47.8%) had a poor outcome, of which 13 (19.4%) died. Multivariate logistic regression analysis showed that higher CT-DRAGON score was an independent predictor for poor outcome (odds ratio 1.997, 95% confidence interval 1.271-3.136; P=0.003). The ROC curve analysis showed that the area under the curve of CT-DRAGON score to clinical outcome was 0.808 (95% confidence interval 0.706-0.911; P<0.001). The optimal cutoff value was 5, the corresponding sensitivity was 65.6%, and the specificity was 80.0%. Conclusions Baseline CT-DRAGON score can effectively predict the clinical outcome of patients with acute ischemic stroke at 3 months after endovascular treatment.

Objective To use Wilks' lambda discriminant analysis for screening of the greatest influence factors in tooth extraction correction and to establish a method for validation.Methods A total of 100 orthodontic patients were selected,aged 14 to 40 years,with average age of 23.6 years,29 males and 76 females.The conventional cephalometry analysis was conducted.Statistical analysis was carried out with using SPSS 18.0 software package.Wilks' lambda statistical method was applied to filter the largest effect on tooth extraction treatment project.Results The UIE-AB and NA/PA calculation results showed statistical differences (P＜0.05),and it set up a tooth extraction rectification regression equation for y =0.125 × NA/PA+0.351 × UIE-AB-3.429;a combination of the initial validation accuracy was 82.6％,and cross validation accuracy was 81.03％.Conclusions Incisor to AB line distance and angle of NA/PA are good tooth extraction judgement indexes.

Objective To investigate the effect of microinvasive thread embedding on vertebral artery blood flow in cervical spondylotic vertebral arteriopathy and further ascerta in that microinvasive thread embedding is a new long-acting acupuncture method for treating cervical spondylotic vertebral arteriopathy.Method Sixty patients meeting the inclusion criteria were randomly allocated to acupuncture and thread embedding groups.The acupuncture group received conventional acupuncture and the thread embedding group, microinvasive thread embedding.The symptoms and function were scored using theEvaluation Scale for Cervical Vertigoand bilateral vertebral artery blood flow was measured using transcranial Doppler after one day and three weeks of treatment.Result The symptoms of vertigo improved somewhatin the thread embedding group at one day after treatment compared with before treatment (P<0.05).At three weeks after treatment,vertigo,neck-shoulder pain, abilities in daily living and working and the total score improved in both groups of patients (P<0.05), and vertigo and abilities in daily living and working improved significantly in the thread embedding group compared with the acupuncture group (P<0.05). Bilateralvertebral artery Vm increased significantly in both groups of patients after treatment(P<0.05) and increased more significantly in the thread embedding group than in the acupuncture group after one day and three weeks of treatment (P<0.05). PIof the rightvertebral arterydecreased somewhat in both groups after three weeks of treatment (P<0.05) but there was no statistically significant difference between the twogroups(P>0.05). The total efficacy rate was 83.3% in the thread embedding group, which was higher than 60.0% in the acupuncture group (P<0.05).Conclusion Microinvasive thread embedding can improve the symptoms, vertebral artery blood flow and the quality of life in patients with cervical spondylotic vertebral arteriopathy.

Objective To evaluate the clinical value of tumor chemosensitivity test in the guidance of the advanced epithelial ovarian carcinoma patients treated with chemotherapy.Methods Women with ovarian cancer were enrolled and fresh tissue samples were collected for chemoresponse testing.Oncologists chose a drug for each patient according to the patient’ s condition by double blind method.Each treatment was classified by the assay as: sensitivity (S); moderate sensitivity (I);resistant (R).Progression-free survival (PFS) and overall survival (OS) were detection.The relationship between treatment response and PFS or OS was analysis.Results 262 patients were enrolled.The PFS and OS were significantly improved in sensitivity patients (S) after chemotherapy,but no significant difference were found in I and R groups.In I+R groups (HR=0.66,P=0.008) , median PFS was 8.9 months, OS was 5.8 months.Chemotherapy response test results was consistent with clinical results cisplatin sensitive and resistant ( HR:0.72 vs.0.66).Multi factor regression analysis showed that tumor chemosensitivity test was independent prognostic factors (HR =0.66, P =0.021).The average OS extended for 14 months (37.6 months for the S group vs.group I +R 23.8 months,HR =0.62, P =0.011).Conclusion Tumor chemosensitivity assay is correlated with the clinical effects and might play an important role in guiding the recurrent epithelial ovarian cancer patients with individualized chemotherapy.

ObjectiveTo evaluate the clinical efficacy of micro-invasive thread-embedding in treating allergic rhinitis.Method Sixty eligible patients were randomized into a control group and a thread-embedding group. Thecontrol group was intervened by Budesonide nasal spray, while the thread-embedding group was by micro-invasive thread-embedding in addition to the nasal spray. The therapeutic efficacy was evaluated after 2-month treatment.ResultThe symptom score and symptom-sign global score were decreased significantly in both groups after intervention (P<0.05), the improvement of stuffy nose and running nose and the global score of the thread-embedding group were significantly superior to that of the control group (P<0.05); the quality of life scores were markedly improved in both groups after intervention (P<0.05), and the improvement of non-nasal/eye symptoms, actual symptoms, and nasal symptoms, as well as the global score in the thread-embedding group were superior to that in the control group (P<0.05); the total effective rate was 96.7% in the thread-embedding group, significantly higher than 66.7% in the control group (P<0.01).ConclusionMicro-invasive thread-embedding can produce a content efficacy in treating allergic rhinitis, and can enhance the quality of life.

OBJECTIVETo explore the relationship between the needling sensation of catgut embedding therapy and the depth of embedded catgut so as to improve the safety of the needle insertion and catgut implantation of the therapy.

METHODSTwenty healthy adults were selected. Under the ultrasound, the structure of the cervical Jiaji (EX-B 2) was observed. In the ultrasound guidance, the catgut was embedded. The two-dimensional imaging method was adopted to observe the anatomic structure and the procedure of needle insertion at the cervical Jiaji (EX-B 2). The high-frequency ultrasound was used to collect the images at Jiaji (EX-B 2) of C5 and determine the depths from the skin surface to the different layers of the point. Additionally, the visual analogue scale (VAS) was adopted to score the needling sensations when the needle inserted at different layers. The persistent sensation duration in the local area was followed continuously.

RESULTSUnder the ultrasound, the anatomic structure and tissue layers of cervical Jiaji (EX-B 2) were displayed clearly. The difference was significant in the average depth from the skin surface to the subcutaneous tissue, trapezius, splenius capitis, semispinalis capitis, semipinalis cervicis, multifidus and vertebral arch between the males and females (all P<0. 01). During the needle insertion, the sensations were apparently different when the implantation went to different layers. The qi arrival presented when the catgut was embedded to the trapezius, splenius capitis, semispinalis capitis, semipinalis cervicis and multifidus. But the distending pain was the most significant when in the myofascial. Commonly, the embedded catgut 2. 5 cm in length may be implanted deeply to the multifidus and the local needling sensation lasted averagely for (72. 0 ± 10. 2) h. Conclusion Under the ultrasound guidance, the depth of embedded catgut is clearly displayed at cervical Jiaji (EX-B 2). The needle insertion and the implanted material are visible, and the relationship between qi arrival and the layer of needle insertion is determined. The accuracy and safety of minimally invasive catgut embedding therapy is improved in the treatment of cervical spondylosis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Catgut ; utilization ; Female ; Humans ; Male ; Middle Aged ; Neck Muscles ; anatomy & histology ; diagnostic imaging ; Qi ; Sensation ; Spondylosis ; diagnostic imaging ; therapy ; Ultrasonography