Objective:To deeply explore the experience of lactation mastitis women, so as to provide a basis for formulating reasonable support measures.Methods:This study was a qualitative study. From November to December 2022, purposive sampling was used to select 13 patients with lactation mastitis who visited the Breast Specialist Nursing Clinic of Dongfang Hospital, Beijing University of Chinese Medicine as the research subject. This study used semi-structured interviews to collect data, and applied the Colaizzi 7-step analysis method to analyze, summarize, and extract themes.Results:The experience of lactation mastitis patients were mainly summarized as self-emotional experience and interpersonal relationship experience. Self-emotional experiences included feelings of anxiety, stress, helplessness, and self-blame. Interpersonal relationship experiences consisted of feelings of helplessness, useless, decision-making difficulties, desire for help and understanding.Conclusions:Lactation mastitis patients face various negative psychological experiences and burdens. Medical and nursing staff, family caregivers, and society should jointly pay attention to the patients' feelings and provide targeted support measures.

We applied literature review and the Delphi method to develop technical operation of manual lactation technique. The databases and websites were systematically searched, such as UpToDate, the Cochrane Library, CNKI, VIP, Wanfang, and SinoMed. The evidence related to the technique was evaluated by Appraisal of Guidelines for Research and Evaluation (AGREE Ⅱ), and A Measure Tool to Assess Systematic Reviews 2 (AMSTAR 2). the included evidence was classified and summarized to form the preliminary draft of the technical operation specification. A total of 26 experts were selected to evaluate the draft, and some recommendations were deleted and modified according to the screening criteria and expert opinions, resulting in the final technical specifications for manual lactation technique applicable to health care professionals. The study included 4 guidelines, 5 expert consensus articles, 2 clinical decisions, and 3 systematic reviews, and the overall quality of the evidence was fair. A total of 26 questionnaires were collected in each of 2 rounds of expert consultation, with a 100% return rate and an overall authority coefficient of 0.91. The technical practice specification was formed in 11 aspects, including assessment content, indications, contraindications, operation methods, adverse events, and treatment methods, with a total of 50 recommendations. The technical operation specification is comprehensive, and the recommendations are clearly expressed, which is in line with the real clinical situation and can provide effective reference for the clinical practice of this technique.

Objective:To investigate the diagnosis and management of partial or complete hydatidiform mole with coexistent intrauterine pregnancy.Methods:Clinical data of 10 cases of hydatidiform mole with coexistent intrauterine pregnancy admitted to the Third Affiliated Hospital of Guangzhou Medical University, from September 2009 to May 2019 were retrospectively described.Results:(1) During the same period, 65 960 women were delivered at our hospital, and hydatidiform mole with coexistent intrauterine pregnancy was accounted for 1/6 596, among which complete hydatidiform mole and coexisting fetus (CHMCF) and partial hydatidiform mole and coexistent fetus (PHMCF) were found in four and six cases, respectively. The mean age of the ten patients were (30.9±4.1) years old, ranging from 26 to 35 years old, with 2.5 (1-4) times of pregnancies. Nine cases were identified at 22 +3 (12 +3-32 +3) gestational weeks and one at 9 + weeks. (2) Recurrent vaginal bleeding during pregnancy occurred in six cases, nausea and vomiting in three cases, and hyperthyroidism in mid- and late pregnancy in two cases. One patient developed preeclampsia and one case of severe mitral regurgitation with mild pulmonary hypertension. (3) In the 10 patients, the summit serum β -hCG level was 139 935 (16 990-546 033) U/L, and CHMCF and PHMCF patients were 212 500 (200 000-546 033) U/L and 60 768 (16 990-225 000) U/L, respectively. (4) The ultrasound results revealed a dark honeycomb area of the placenta in five cases, placental thickening in two cases, and vesicular placenta in one case. One case was found with bilateral giant luteinized ovarian cyst by ultrasound, multiple metastases in the left lower lobe of the lung by chest CT, multiple nodules in the pleural wall of the left lung by lung MRI, and CHMCF by pelvic MRI. In one case, ultrasound at 14 weeks of gestation showed interrupted fetal abdominal wall, visible mass, gastric bubble, liver, part of the intestinal echoes, and omphalocele. One case was found with embryo arrest. (5) The karyotype analysis of one case through amniocentesis was 46,XX with no anomalies, and chromosome microarray analysis was arr[hg19](1-22)×2. Prenatal diagnosis was refused in the remaining cases. (6) Among the ten patients, three were terminated by rivanol intra-amniotic injection, two received drug abortion, and uterine evacuation, and two with spontaneous abortion followed by curettage with a visible fetus and hydatidiform tissue. Total hysterectomy was performed in one patient due to partial invasion of the uterus by hydatidiform mole. One patient underwent a cesarean section on account of the left lower lung metastasis. One case developed preeclampsia at 33 +4 weeks of gestation and delivered two premature infants by cesarean section. Pathology examination found a complete and partial vesicular fetal mass in four and six cases, with P57 (－) and P57 (+), respectively. (7) During the follow-up, two women developed the persistent trophoblastic disease and received chemotherapy, while the remaining eight cases did not. Conclusions:When hydatidiform mole with coexistent intrauterine pregnancy is found, a timely differential diagnosis between CHMCF and PHMCF is needed. CHMCF is at a higher risk of abortion, intrauterine death, premature delivery, preeclampsia, and other maternal complications. Therefore, termination of CHMCF should be individualized. Most PHMCF patients have fetal malformation or fetal loss; thereby, timely termination is recommended.

Objective:To investigate the appropriate method of labor induction in the second trimester for complete placenta previa patients.Methods:The labor induction outcomes of 85 cases with complete placenta previa in the second trimester were retrospectively analyzed. Twenty patients in group A were treated with cesarean section, 30 patients in group B were treated with ethacridine and mifepristone combined with uterine artery embolization (UAE), and 35 patients in group C were induced by using ethacridine and mifepristone. The clinical features and induction outcomes of three groups were compared.Results:The total duration of labor in group B [(28.7±30.1) hours] was significantly longer than that of group C [(24.3±21.9) hours; P<0.05]. The total amount of blood loss during induction and labor in group B [(302±271) ml] was significantly lower than those of group C [(393±523) ml] and group A [(626±487) ml; P<0.05]. The incidence of fever in group B (13%, 4/30) was significantly higher than those of group C (11%, 4/35) and group A (10%, 2/20; P<0.05). In group C, 13 patients (37%, 13/35) underwent emergency UAE, and 2 patients (6%, 2/35) underwent emergency cesarean section. As to average hemoglobin level and blood transfusion rate, there were no difference among the three groups (all P>0.05). Conclusion:Prophylactic UAE combined with drug induction in patients with complete placenta previa in the second trimester could significantly reduce the amount of bleeding during induction and reduce the risk of emergency procedures.

Objective:To explore the effect of medical care, elderly care and nursing management mode on self-care ability and blood pressure management in elderly patients with hypertension.Methods:From July 2018 to June 2019, 164 elderly patients with hypertension admitted into the outpatient department of the ZhejiangHospital were selected as the study objects by convenience sampling method, and randomly divided into the control group and the experimental group, 82 cases in each group. Routine hypertension management mode was given in the control group and medical care, elderly care and nursing management mode was given in the experimental group for 6 months. The Exercise of Self-Care Agency Scale (ESCA) scores and blood pressure control of the two groups were compared before and after intervention.Results:The ESCA total score and self-concept, self-care responsibility, self-care skills, and health knowledge scores of the experimental group were higher than those before intervention [(123.3±17.2) vs. (88.3±10.4) points, (26.8±3.7) vs. (20.6±3.0) points, (22.3±4.2) vs. (16.6±2.1) points, (29.3±4.1) vs. (17.6±2.4) points, (44.9±5.4) vs. (33.5±4.5) points], and higher than those of the control group [(90.0±10.2) points, (21.2±3.2) points, (16.1±2.1) points, (18.2±2.5) points, (34.5±4.2) points] (all P<0.05). The systolic blood pressure and diastolic blood pressure of the two groups after the intervention were lower than those before the intervention [control group: (142.5±7.8) vs. (161.6±8.5) mmHg (1 mmHg=0.133 kPa), (91.3±6.2) vs. (98.6±10.2) mmHg, experimental group: (132.2±8.5) vs. (160.6±8.1) mmHg, (84.2±7.4) vs. (98.1±10.3) mmHg], and the experimental group was lower than the control group (all P<0.05). The blood pressure control rate of patients in the experimental group was 88.8%, which was higher than the control group of 48.6% ( P<0.05). The satisfaction rate of quality of life in the experimental group was higher than that in the control group (28.8% vs. 18.1%), and the dissatisfaction rate was lower than in the control group (18.8% vs. 34.7%) ( P<0.05). Conclusion:The medical care, elderly care and nursing management mode can effectively improve the self-care ability and blood pressure management ability of elderly patients with hypertension.

Objective The aim of this study is to explore the hypoglycemic effect of active components of Anoectochilus roxburghii on zebrafish models. Methods Anoectochilus roxburghii components were extracted and separated into three groups: the alcohol extraction group, macromolecular polysaccharide group (≥ 5 ×103) and small molecular polysaccharide group (＜5×103). Zebrafish embryos were exposed to 2% glucose solution (2% Glu) at 24 h to imitate acute hyperglycemia phenotype, and then treated with the three Anoectochilus roxburghii components. Based on this high-glucose model, the zebrafish embryos at 72 h were collected to detect the whole tissue glucose value. Furthermore, semi-quantitative PCR and whole mount in situ hybridization were performed to detect the expression of mRNA levels of glycometabolism-related genes. Results An acute diabetic zebrafish model was induced by high glucose stress. In this model, some key factors during glycometabolism such as insulin, pck-1 and pdx-1 were significantly affected, while the alcohol extracts of Anoectochilus roxburghii obviously reversed these abnormalities induced by high glucose stress, even to normal levels. Conclusions The alcohol extracts of Anoectochilus roxburghii has obvious hypoglycemic effect on diabetic zebrafish model. Our result suggest that Anoectochilus roxburghii has a potential application in the hypoglycemic drug screening.

Objective To summarise the clinical characteristics and surgical treatment experience of primary cardiac tumours treated by tumorectomy under extracorporeal circulation .Methods The clinical data of 352 patients with primary cardiac tumors in our hospital from January 1980 to December 2015,who received surgical treatment of tumorectomy under extracorporeal circulation were retrospectively ana -lyzed.Results Among the 352 cases in all, there were 338 cases (96%) of benign tumor, including 309 cases (87.8%) of myxoma and 14 cases (4.0%) of malignant tumor.There were 4 cases of perioperative death, and all the 4 cases were malignant tumor.Conclusion Myxoma is the most common primary cardiac tumor ,and the best solution for the cardiac benign tumor is surgery .However , the effect of sur-gical operation on malignant cardiac tumors was poor .

Objective The aim of this study was to explore the inhibitory effect of alcohol extracts of Narcissus bulb on melanogenesis in zebrafish embryos.Methods Zebrafish embryos were exposed to different concentrations of alcohol extracts of Narcissus (0, 50, 100, 200, and 500 μg/mL), and then the formation of melanin was observed.Furthermore, we measured the enzyme activity of tyrosinase (TYR), which plays a pivotal role in melanogenesis.Meanwhile, the spatial and temporal pattern of melanin-specific marker genes were detected.Arbutin (Ar) was used as a positive control in all these experiments.Results The treatment of alcohol extracts of Narcissus bulb inhibited melanogenesis in the zebrafish embryos in a dose-dependent manner.Furthermore, the mRNA expression levels of melanin-related genes such as tyrosinase (TYR), silver (SILV) and Mitfa were significantly reduced after treatment with different concentrations of Narcissus extracts by in-situ and semi-quantitative PCR.Finally, the enzyme activity of tyrosinase was also gradually decreased with increasing concentrations of the alcohol extracts.Conclusions Narcissus alcohol extracts can effectively inhibit the production of melanin in zebrafish embryos.This study provides potential evidence and approaches for the screening of natural whitening compounds using zebrafish models.

Objective: To evaluate the efifcacy of modiifed extended Morrow procedure on hypertrophic obstructive cardiomyopathy (HOCM) in adolescent patients. Methods: We retrospectively studied 29 consecutive HOCM patients at the age≤21 years who received modiifed extended Morrow procedure in our hospital from 2011 to 2015 for their clinical conditions to assess surgical efifcacy. Echocardiography was performed to compare left atrial size, left ventricular end diastolic diameter, left ventricular ejection fraction, left ventricular outlfow tract peak pressure, ventricular septal thickness, mitral systolic anterior motion and mitral regurgitation grade before and after operation. Moreover, pre-operative and post-operative plasma NT-proBNP levels were determined. Cardiac function was evaluated by New York Heart Association functional class. Results: There were 17 (58.6%) patients received isolated modiifed extended Morrow procedure and 12 patients had concomitant operation including 8 (27.6%) with coronary artery bypass grafting. Compared with pre-operation, the post-operative thickness of ventricular septum decreased from (24.6 ± 6.8) mm to (16.9 ± 7.1) mm, left ventricular outlfow tract gradient decreased from (68.8 ± 15.7) mmHg to (10.7 ± 4.2) mmHg, bothP<0.001; mitral regurgitation degree reduced from (1.7 ± 1.3) to (0.2 ± 0.4),P<0.01; NYHA classification improved from (3.4 ± 0.8) to (1.4 ± 0.5),P<0.01; plasma level of NT-proBNP reduced from (1957.6 ± 392.5) ng/ml to (458.7 ± 161.0) ng/ml,P<0.01. There was no peri-operative death, the survival rates at 12, 24 and 36 months post-operation were 100%, 86.7% and 86.7% respectively. Conclusion: Modiifed extended Morrow procedure has been a safe and effective method for treating adolescent HOCM patients, adequate exposure is the key point to assure surgical efifcacy.

Objective To study the feasibility and safety of trial of labor after cesarean section (TOLAC). Methods Retrospective analysis of five medical center of Guangdong province from January 2011 to December 2015 hospitalized delivery information, compare the same scar TOLAC (research group) with the scar pregnancy (control group) pregnancy outcomes, to study the feasibility and safety of TOLAC. Results (1)During 2011-2015, total delivery 95 600 cases in five medical center, 13 824 cases of thme with uterine scar pregnancy, including 12 027 cases elective repeat cesarean section and 1 797 cases (13.00%, 1 797/13 824) with scar uterus vaginal trial of labor. Among 1 308 cases of vaginal delivery,the success for trial of labor rate was 72.79% (1 308/1 797). From 2011 to 2015, there were increased rate of pregnancy after cesarean section, which were respectively 10.71%, 13.28%, 14.45%, 15.54%and 16.98%. The will of vaginal birth were rising and the rate were respectively 11.85%, 12.25%, 13.49%, 13.82%and 12.93%. (2) There were 489(27.21%,489/1 797) cases of scar uterus maternal emergency cesarean section in the trial of labor, reason for“social factors”require for cesarean delivery have 68 cases, the percentage was 13.91% (68/489), compared with control group (7.18%, 206/2 869), the difference was statistically significant difference (χ2=27.356,P=0.000). Doctors diagnosed as“aura uterine rupture”in the labor was 11.86% (58/489), compared with that in control group (1.43%, 41/2 869), the differences were statistically significant difference (χ2=1 578.223,P=0.000). (3) The incidence of uterine rupture of the research group(0.74%,9/1 211)was significantly higher than that of control group (0.01%,2/31 200;χ2>2 000,P=0.000). The incidence of postpartum hemorrhage in research group was 6.94% (84/1 211), compared with that in the control group (3.05%, 951/31 200), there was statistically significant difference (χ2=16.328,P=0.000). While, there were no statistical significancefor the labor time limit,birth rate of severe asphyxia and neonatal birth weight average differences between two groups (P>0.05). Conclusions The rate of pregnancy after cesarean section is increasing year by year, and the will of vaginal birth is increasing, while it still are generally low. TOLAC is safe and feasible, but also significantly higher risk, strictly labor monitoring and can proceed fast cesarean delivery in delivery room is an important guarantee of safe delivery.