"The sweet and the bitter": mothers' experiences of breastfeeding in the early postpartum period: a qualitative exploratory study in China.

BACKGROUND: In China, the prevalence of exclusive breastfeeding at 6 months was only 20.8%. In promoting breastfeeding for newborns, a number of strategies have been initiated by Chinese government. These actions facilitated a high breastfeeding initiation of 77 to 99.9% in different regions. However, the exclusive breastfeeding rates remained low at 6 months resulting from a high rate of perceived insufficient breast milk and complementary feeding during the early days after childbirth. The aim of this study was to understand the experiences of women in Shenzhen with regard to breastfeeding in the first 6 weeks after giving birth, to identify the facilitators and barriers impacting their breastfeeding decisions and to identify their perceived support needs that might facilitate breastfeeding in the future. METHODS: This was a qualitative exploratory study. Data were collected in November 2018 through semi-structured, face-to-face, in-depth interviews. A purposive sample of early postpartum women was recruited from a postpartum clinic of a tertiary maternal hospital in Shenzhen, China. The dataset was analysed using inductive content analysis. RESULTS: A total of 22women were interviewed within the first 6 weeks after delivery. Three themes related to breastfeeding were identified from the transcribed interviews: "breastfeeding facilitators," "breastfeeding barriers," and "recommendations for breastfeeding promotion." CONCLUSIONS: Women experienced both joy and suffering in their journey of breastfeeding. Insufficient knowledge of breastfeeding, discomfort, intergenerational disagreements regarding nutritional supplements, and a lack of professional support contributed to difficulties and the threat of discontinuation. A supportive environment for breastfeeding is crucial for women's decision on exclusive breastfeeding and the psychological wellbeing of breastfeeding women. Interventions that target to promote exclusive breastfeeding should include both new mothers and significant family members. Future studies could test the effectiveness of breastfeeding training for home visit nurses to promote exclusive breastfeeding in the early postpartum.

Development of a derivatization method for the quantification of hydrogen sulfide and its application in vascular calcification rats.

Hydrogen sulfide (H2S) plays major functional and structural roles in diverse physiological functions and the pathogenesis of a variety of disorders in biological matrices. The significance of H2S has prompted the development of sensitive and selective methods to determine its concentration in biological samples. The fluorescent reagent monobromobimane (MBB) has been widely used to measure various thiol-containing species through alkylation. MBB may prevent the oxidation of sulfide and the reaction of sulfide with several different species (such as superoxide radicals, hydrogen peroxide and peroxynitrite). An isomers of MBB, 3-(bromomethyl)-2, 6, 7-trimethyl-1H, 5H-pyrazolo [1,2-a] pyrazole-1, 5-dione (MMB), is cheaper than MBB and its use in the analysis of H2S has not previously been reported. In the present study, we compared the derivatization reactions of hydrogen sulfide with MMB and MBB and developed a sensitive method to quantify H2S in blood. In our method, H2S was incubated in the dark with excess MMB in 0.1M Tris-HCl buffer (pH 10.1) at 50°C for 120min. 50µL aliquots of the derivatized product were analyzed using HPLC system with gradient elution of 0.1% (v/v) formic acid-acetonitrile. The limit of detection for the derivatized product was 0.03nmol/mL. The derivatization reaction was suitable for detecting low concentrations of H2S. The derivate product is stable over time, permitting batch storage and analysis.

Gastrointestinal bleeding after intracerebral hemorrhage: a retrospective review of 808 cases.

BACKGROUND: This study examined the incidence and risk factors for gastrointestinal (GI) bleeding after spontaneous intracerebral hemorrhage (ICH). METHODS: The available medical records of patients with ICH admitted from June 2008 to December 2009 for any episode of GI bleeding, possible precipitating factors and administration of ulcer prophylaxis were reviewed. RESULTS: The prevalence of GI bleeding was 26.7%, including 3 cases of severe GI bleeding (0.35%). Patients with GI bleeding had significantly longer hospital stay and higher in-hospital mortality compared with patients without GI bleeding. Multivariate logistic regression analyses showed that age, Glasgow Coma Scale scores, sepsis and ICH volume were independent predictors of GI bleeding. About 63.4% of patients with ICH received stress ulcer prophylaxis. CONCLUSIONS: GI bleeding occurred frequently after ICH, but severe events were rare. Age, Glasgow Coma Scale score, sepsis and ICH volume were independent predictors of GI bleeding occurring after ICH.

[Correlation of hemogram changes during pregnancy of healthy women with postpartum blood transfusion].

This study was aimed to explore the correlation of hemogram changes during pregnancy of healthy women with postpartum blood transfusion. The outpatient and inpatient information of expectant lying-in women in our hospitals was collected, the route blood test, lever and kidney function and blood coagulation function tests were performed from the 4th to the 10th month of pregnancy. The pregnant women without underlying diseases and non-elderly pregnant women with single fetus were selected as the subjects of study. They were divided into postpartum blood transfusion group and non-blood transfusion group. The white blood cell (WBC) count, hemoglobin (Hb) level, platelet (Plt) count, plateletocrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW) were compared in 2 groups. The results showed that 68 cases out of 450 expectant lying-in women received blood transfusion, among them 30 cases with complete data of puerperal transfusion were taken as blood transfusion group, the 28 cases of non transfusion puerperal as control group. There was no significant difference of hemogram changes between the two groups. However, there was a slight decline in Plt count and Hb level of late pregnant women. What is more, there was no correlation between Plt count change and the PCT, MPV and PDW. It is concluded that the changes of hemogram during pregnancy has no correlation with postpartum hemorrhage and blood transfusion in healthy pregnant women, the Plt count and Hb level of pregnant women slightly decline. Nevertheless, PCT, MPV and PDW are within the normal range.

Effects of extremely low frequency magnetic field on anxiety level and spatial memory of adult rats.

BACKGROUND: As the widespread use of electric devices in modern life, human are exposed to extremely low frequency magnetic fields (ELF MF) much more frequently than ever. Over the past decades, a substantial number of epidemiological and experimental studies have demonstrated that ELF MF (50 Hz) exposure is associated with increased risk of various health effects. The present study examined the effects of chronic exposure to ELF MF on anxiety level and spatial memory of adult rats. METHODS: The 50-Hz ELF MF was used during the whole experimental procedures and the value of magnetic field (MF) was set to 2 mT. Adult rats were divided randomly to control, MF 1 hour and MF 4 hours group. Anxiety-related behaviors were examined in the open field test and the elevated plus maze; changes in spatial learning and memory were determined in Morris water maze after 4 weeks of daily exposure. RESULTS: Rats in MF 4 hours group had increased anxiety-like behaviors with unaltered locomotor activity. In the Morris water maze test, rats had reduced latency to find the hidden platform and improved long-term memory of former location of platform without changes in short-term memory and locomotor activity. CONCLUSION: Chronic ELF MF exposure has anxiogenic effect on rats, and the promoting effects on spatial learning and long-term retention of spatial memory.

[Changes of nitric oxide and nitric-oxide synthase in the development of cold-induced hypertension].

OBJECTIVE: To study the changes of nitric oxide(NO) and nitric-oxide synthase(NOS) in the development of cold-induced hypertension (CIH). METHODS: Sixty male Sprague-Dawley adult rats were used. Thirty were exposed to cold (4 +/- 1) degrees C as cold-treated group while the other 30 were at (25 +/- 1) degrees C as controls, 4 hours a day for 6 weeks for both groups. Systolic blood pressure (SBP) and heart rate were measured twice every week. Each group was further subdivided into three groups, 10 rats each. A subgroup of the cold-treated and control rats were sacrificed at 2, 4 and 6 week. Plasma was saved to measure superoxide dismutase (SOD) and malondiadehycle (MDA), while heart was homogenated to measure NO, NOS. RESULTS: 1 SBP increased during 6 weeks of exposure to cold. From the second week, SBP of cold-treated group [(94.16 +/- 3.81) mm Hg] was significantly greater than that of control group [(88.77 +/- 4.45 mm Hg), P<0.01]. The highest SBP level was achieved at the sixth week [(116.78 +/- 3.79)mm Hg, P<0.01]. 2 Compared to the control group, SOD in cold-treated group decreased significantly from the second week, and maintained throughout the time of exposure to cold (P<0.05). MDA levels did not differ significantly between cold-treated and control groups though it increased mildly during 6 weeks of cold exposure (P>0.05). Heart NOS in cold-treated group decreased significantly from the fourth week to the sixth week. And a mild decrease was observed in heart NO of cold-treated group during 6 weeks of exposure (P>0.05). CONCLUSION: Cold-induced hypertension is induced in rats after repeated exposure to cold. The levels of NOS, NO decrease accordingly to the rise of blood pressure. This indicates that the dysfunction of NO and NOS is involved in the development of CIH.

[At-home self-care of patients of long-term survival after renal transplantation: a survey of current status].

OBJECTIVE: To understand the current status of at-home self-care implemented by patients with renal transplantation of long-term survival, so as to provide the patients with adequate professional advice and follow-up care after discharge from hospital. METHOD: A survey was conducted in 248 patients who survived for over 3 years with functioning transplanted kidneys by utilizing a self-designed questionnaire. RESULTS: The at-home self-care was generally not well practiced by the patients with apparent lack of self-care awareness and abilities. Though the current status problematic, the survey showed that 96.32% of the patients wished to be informed about self-care knowledge and skills. CONCLUSION: The patients currently lack at-home self-care abilities and the medical staff should carefully design self-care plans tailored to the needs of individual patient to improve the survival of the patients and the transplanted kidneys as well.