Risk factors for central lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study.

Introduction: Thyroid cancer is the most prevalent endocrine malignancy, with its global incidence increasing annually in recent years. Papillary carcinoma is the most common subtype, frequently accompanied by cervical lymph node metastasis early on. Central lymph node metastasis (CLNM) is particularly the common metastasis form in this subtype, and the presence of lymph node metastasis correlates strongly with tumor recurrence. However, effective preoperative assessment methods for CLNM in patients with papillary thyroid carcinoma (PTC) remain lacking. Methods: Data from 400 patients diagnosed with PTC between January 1, 2018, and January 1, 2022, at the Shandong Provincial Hospital were retrospectively analyzed. This data included clinicopathological information of the patients, such as thyroid function, BRAF V600E mutation, whether complicated with Hashimoto's thyroiditis, and the presence of capsular invasion. Univariate and multivariate logistic regression analyses were performed to assess the risk factors associated with cervical CLNM in patients with PTC. Subsequently, a clinical prediction model was constructed, and prognostic risk factors were identified based on univariate and multivariate Cox regression analyses. Results: Univariate and multivariate analyses identified that age >45 years (P=0.014), body mass index ≥25 (P=0.008), tumor size ≥1 cm (P=0.001), capsular invasion (P=0.001), and the presence of BRAF V600E mutation (P<0.001) were significantly associated with an increased risk of CLNM. Integrating these factors into the nomogram revealed an area-under-the-curve of 0.791 (95% confidence interval 0.735-0.846) and 0.765 (95% confidence interval: 0.677-0.852) for the training and validation sets, respectively, indicating strong discriminative abilities. Subgroup analysis further confirmed that patients with papillary thyroid microcarcinoma and BRAF V600E mutations who underwent therapeutic central compartment neck dissection had significantly better 3-year disease-free survival than those who had prophylactic central compartment neck dissection (P<0.001). Conclusion: The study revealed that age >45 years, body mass index ≥25, tumor size ≥1 cm, BRAF V600E mutation, and capsular invasion are the related risk factors for CLNM in patients with PTC. For patients with clinically nodal-negative (cN0) papillary thyroid microcarcinoma, accurately identifying the BRAF V600E mutation is essential for guiding the central lymph node dissection approach and subsequent treatments.

A comprehensive insight on cognitive behavioral therapy for insomnia in pregnant women: A systematic review and meta-analysis.

BACKGROUND: Cognitive behavioral therapy for insomnia (CBT-I) as a first-line treatment may improve insomnia in pregnant women. The efficacy of the components, modalities, doses, and effectiveness of CBT-I in pregnant women at follow-up remains unclear. OBJECTIVES: To assess the effectiveness of CBT-I in pregnant women and identify effective intervention components, modalities, and doses. DESIGN: Systematic review and meta-analysis. METHODS: Six English databases (PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL) and four Chinese databases (CNKI, WanFang Data, SinoMed, and CQVIP) were searched from inception to 10 January 2023. Randomized controlled trials (RCTs) on CBT-I in pregnant women with outcomes of insomnia severity measured by Insomnia Severity Index (ISI) or sleep quality measured by Pittsburgh Sleep Quality Index (PSQI). Two reviewers independently completed records selection, data extraction, and study quality assessment. The fixed-effect or random-effect model was used for pooled analyses. Subgroup analyses were conducted based on different delivery types and intervention duration. The GRADE approach was used to evaluate the certainty of the evidence. Narrative analyses were used when meta-analysis was not appropriate. Mean differences with 95% CIs of insomnia severity and sleep quality scores were the main outcomes (greater scores indicating greater severity). RESULTS: Nine RCTs (N = 978) meeting the inclusion criteria were included. These trials included individual- (n = 6) or group-based (n = 3) interventions, which were conducted via face-to-face (n = 5), digital (n = 3) or telephone and e-mail (n = 1) formats. Six studies stated intervention components specific to pregnant women. CBT-I improved insomnia severity (MD = -2.69, 95% CI: -3.41 to -1.96, P ＜ 0.001, high quality evidence; MD = -3.69, 95% CI: -5.91 to -1.47, P = 0.001, moderate quality evidence) and sleep quality (MD = -2.85, 95% CI: -4.73 to -0.97, P = 0.003, moderate quality evidence; MD = -1.88, 95% CI: -2.89 to -0.88, P ＜ 0.001, moderate quality evidence) immediately after intervention (＜1-month) and at short-term (≥1 month to ＜6 months) follow-up, respectively. Two RCTs reported no effectiveness on insomnia severity at medium-term (≥6 months to＜12 months) follow-up. Only 1 RCT showed reduced insomnia severity at long-term (≥12 months) follow-up. One RCT reported no effectiveness in sleep quality at medium-term follow-up and effectiveness at long-term follow-up was not reported. CONCLUSIONS: Pregnant women may benefit from CBT-I to improve short-term insomnia, but long-term effectiveness is unclear. Rigorous RCTs with long-term follow-ups are warranted.

Attitudes and Barriers to Physical Activity and Exercise Self-Efficacy Among Chinese Pregnant Women: A Cross-Sectional Study.

Background: Most pregnant women do not reach the recommendation for physical activity (PA). As a subcategory of PA, exercise is also essential. Evidence on pregnant women's attitudes and barriers to PA and exercise self-efficacy in China is scarce. Aim: To explore the levels and influencing factors of attitudes and barriers to PA and exercise self-efficacy among pregnant women. Methods: A cross-sectional study of 311 pregnant women was conducted from August to December 2022. Individual characteristics, pregnant women's attitudes toward exercise, barriers to prenatal PA and exercise, and exercise self-efficacy were measured using the self-designed demographic questionnaire, pregnant women's attitudes toward exercise questionnaire, barriers to prenatal PA and exercise questionnaire, and the pregnancy exercise self-efficacy scale, respectively. Results: More than 90% of pregnant women believed exercise benefits themselves and their babies, and 40.8% of pregnant women did not know how to exercise. Women encounter different types of barriers to PA and exercise. Intrapersonal barriers included the proportion of feelings of tiredness (56.6%), low energy (54.7%), lack of interest or motivation (49.2%), feelings of illness and morning sickness (46.6%), and large body weight (43.7%). Interpersonal barriers included pregnant women being advised to avoid PA and exercise (49.2%), lack of clear advice about the intensity and dose of exercise (41.8%), no one to exercise with (38.9%), and lack of advice from healthcare professionals (38.6%). Weather conditions were the most significant environmental barriers (41.2%). The total score of pregnancy exercise self-efficacy was (38.50±7.33). Education level, parity, and attitudes toward exercise independently predict pregnant women's attitudes toward exercise, barriers to prenatal PA and exercise, and exercise self-efficacy, respectively. Conclusion: Pregnant women have a favorable attitude toward exercise and relatively good exercise self-efficacy but lack knowledge of exercise. They face numerous barriers. Medical professionals should encourage pregnant women with lower levels of education to exercise and assist multipara in overcoming obstacles.

Profile analysis of N4-acetylcytidine (ac4C) on mRNA of human lung adenocarcinoma and paired adjacent non-tumor tissues.

BACKGROUND: RNA modification, a major component of post-transcriptional modification, plays an essential role in tumor initiation and progression. N4-acetylcytidine (ac4C) present in different species as a highly conserved RNA modification. ac4C on mRNA increases the stability of mRNA and the efficiency of protein translation. However, the mRNA profiling of ac4C in lung adenocarcinoma (LUAD) is unknown. METHODS: NAT10 expression was tested using immunohistochemistry in tissue microarray (TMA). The ac4C peaks on mRNA were identified through acetylated RNA immunoprecipitation sequencing in both human LUAD tissues and adjacent non-tumor tissues, and differences of acetylation and mRNA between the two groups were analyzed. Furthermore, the function of AC4C-specific acetylated transcripts was analyzed bioinformatically. And a ac-RIP-PCR was used to verify the ac4C acetylation sites of TFAP2A. RESULTS: The expression of acetylated key enzyme NAT10 was obviously increased in LUAD group. Then we found noticeable differences in ac4C mRNA modification between LUAD and adjacent non-tumor tissues. In addition, bioinformatics analysis showed that the distinctive distribution pattern of mRNA ac4C in LUAD affects a variety of cellular functions, such as protein sumoylation and transmembrane transporter activity. Importantly, we verified the ac4C level of TFAP2A was up-regulated in LUAD. CONCLUSIONS: Our study revealed that the degree of ac4C in mRNA in LUAD was significantly higher than in adjacent tissues and was concentrated mainly in the coding sequences with a implications in a wide range of cellular functions. The ac4C may become a new molecular marker and treatment target for lung cancer.

Primary angiosarcoma of breast: A case report and literature review.

INTRODUCTION AND IMPORTANCE: Primary angiosarcoma of breast (PAB)3 is a rare and aggressive malignancy with limited published literature. This article aims to disclose the diagnosis and treatment of this case, review previous case reports, and provide clinical experience to breast surgeons. CASE PRESENTATION: A 36-year-old Asian female presented with a diffuse mass growing rapidly in her left breast. The ultrasonography (USG)4 suspected granulomatous mastitis. The core needle biopsy (CNB)5 confirmed the diagnosis of breast angiosarcoma (AS).6 She underwent mastectomy without axillary lymph node dissection (ALND)7 followed by adjuvant chemotherapy. About 11 months after mastectomy, the patient had bone metastasis. CLINICAL DISCUSSION: PAB is a rare vascular neoplasia, characterized by aggressive patterns, poor prognosis, and high malignant potential. It is difficult to diagnose or differentiate only by clinical or imaging examination. Biopsy and immunohistochemical staining are the most reliable method. Mastectomy is the most common treatment. CONCLUSION: PAB is a rare and malignant cancer. We should pay attention to the diffuse progressive masses in the breast of young female, and perform MRI and biopsy if necessary. Mastectomy is the only treatment known that has proven to benefit these patients. There are no evidence-based guidelines regarding treatment.

Mindfulness-Based Stress Reduction for Quality of Life, Psychological Distress, and Cognitive Emotion Regulation Strategies in Patients With Breast Cancer Under Early Chemotherapy-a Randomized Controlled Trial.

Mindfulness-based interventions (MBIs) have been receiving growing attention in cancer care. This study evaluated the impact of the mindfulness-based stress reduction (MBSR) on quality of life, psychological distress (anxiety and depression), and cognitive emotion regulation strategies in patients with breast cancer under early chemotherapy. A total of 101 patients with breast cancer under early chemotherapy were randomly assigned to either an 8-week MBSR group (n = 50) or a control group (n = 51). The primary outcome was quality of life, measured on Functional Assessment of Cancer Therapy-Breast Cancer. The secondary outcomes were anxiety (Self-rating Anxiety Scale), depression (Self-rating Depression Scale), and cognitive emotion regulation strategies (The Chinese version of Cognitive Emotion Regulation Questionnaire). The participants were assessed at baseline (T0) and week 8 (T1). The data were statistically analyzed by SPSS 21.0. The participants in the MBSR group experienced significantly better outcomes in their quality of life, psychological distress, and cognitive emotion regulation strategies than the control group. The MBSR intervention was demonstrated to improve the positive cognitive emotion regulation strategies and quality of life in patients with breast cancer under early chemotherapy and significantly reduce the patient's anxiety, depression, and negative cognitive emotion regulation strategies, and help the patients to adjust their mental state and promote positive psychology to improve their quality of life.

Effects of Parental Psychological Control on Attitudes Toward Seeking Professional Psychological Help in Senior High School Students: Serial Mediating Effects of Rejection Sensitivity and Social Withdrawal.

The purpose of the current study was to examine the serial mediating effects of rejection sensitivity and social withdrawal on parental psychological control and attitudes toward seeking professional psychological help among senior high school students. In November 2022, 648 students completed a self-report questionnaire. The parental psychological control scale, senior high school students' rejection sensitivity scale, social withdrawal scale, and attitudes toward seeking professional psychological help scale were used for measurement. Correlation analysis showed parental psychological control and rejection sensitivity were positively correlated with social withdrawal (r = 0.387, 0.466, 0.495, all p < 0.001). Parental psychological control and rejection sensitivity were significantly negatively correlated with social withdrawal and attitudes toward seeking professional psychological help (r = -0.325, -0.324, -0.397, all p < 0.001). Mediating effect analysis indicated that parental psychological control had a significant direct effect on attitude toward seeking professional psychological help, and rejection sensitivity and social withdrawal had significant serial mediating effects among parental psychological control and attitudes toward seeking professional psychological help in senior high school students. These aspects warrant attention as they play significant roles in influencing students' willingness to seek psychological assistance. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Relationship between social support and parenting sense of competence in puerperal women: Multiple mediators of resilience and postpartum depression.

Background: Maternal role competence is an important marker of achievement in the role of the mother, but parenting sense of competence (PSOC) among puerperal women is not high. Psychosocial factors, particularly social support, postnatal depression and resilience, have been identified as significant predictors of maternal role competence. However, information is limited regarding the mechanisms through which these psychosocial factors affect maternal role competence. Objective: To evaluate the multiple mediators of resilience and postpartum depression (PPD) in the relationship between social support and PSOC in puerperal women. Methods: A cross-sectional study was performed in a tertiary general hospital in Yangzhou, China. A total of 234 puerperal women at 6-8 weeks after birth completed the socio-demographic questionnaires, Social Support Rating Scale, Connor-Davidson Resilience Scale, Edinburgh Postnatal Depression Scale, and PSOC Scale. Results: Resilience and PPD mediated the relationship between social support and PSOC. The mediation effect of resilience and PPD and the total mediation effect were significant, individually accounting for 22.96, 21.70, and 44.65%, respectively, of the total effect. Moreover, pairwise contrast between the two indirect effects was not significant. The difference between the two pathways suggests that resilience and PPD play different roles in the relationship between social support and PSOC. Conclusions: This study showed that social support may exert its effects on PSOC in puerperal women with multiple mediators of resilience and PPD. This therefore highlights potential intervention targets to improve PSOC.

Effects of Mindfulness-Based Stress Reduction Therapy on Posttraumatic Growth and Quality of Life in Patients With Breast Cancer Under Early Chemotherapy: A Randomized Controlled Trial.

Posttraumatic growth (PTG) in patients with breast cancer has been reported. Mindfulness-based stress reduction (MBSR) has been found to be effective in improving the psychological well-being during cancer care. This study aimed to evaluate the impact of MBSR on the levels of PTG, perceived social support, and quality of life. A sample of 101 participants who experienced early chemotherapy enrolled in an MBSR group (n = 50) and a routine care group (n = 51) for 8 weeks. Their postintervention data were combined with preintervention data through a bundle of questionnaires reporting levels of PTG, perceived social support, and quality of life. MBSR showed the prominent validity in raising the levels of PTG and increasing in perceived social support and quality of life from pre- to posttreatment. MBSR improved the levels of PTG, perceived social support, and quality of life in patients with breast cancer in early chemotherapy. In conclusion, MBSR may help to optimize the positive psychological processes that will be targeted to maximize the efficacy of treatment for future cancer survivors.

Factors associated with benefit finding and mental health of patients with cancer: a systematic review.

PURPOSE: This systematic review was performed to identify the association between benefit finding (BF) and anxiety, depression, and distress, as well as to find factors related to BF in adult cancer patients. METHODS: Five English databases and four Chinese databases were searched to identify eligible articles about BF in adult cancer patients from inception to 4 July 2021. Literature screening, data extraction, and quality assessment were carried out by two reviewers independently according to the inclusion and exclusion criteria. Qualitative synthesis was used to summarize the results. RESULTS: Twenty-one studies involving 9601 cancer patients were included in this study. Qualitative analysis showed that BF was negatively related to anxiety, depression, and distress. Factors associated with BF included sociodemographic factors, disease-related factors, and psychological and environmental factors. CONCLUSIONS: Healthcare providers should pay attention to the summarized factors of BF and construct intervention programs based on the controllable factors to improve BF in adult cancer patients, thus promoting the recovery of patients.

Analysis of the clinicopathological characteristics and prognosis of triple-positive breast cancer and HER2-positive breast cancer-A retrospective study.

Background: Adjuvant chemotherapy and targeted therapy have become standard postoperative therapeutic modalities for human epidermal growth factor receptor 2 (HER2)-positive breast cancer(HER2-positive,HR-negative), including triple-positive breast cancer(HER2-positive,HR-positive). However, these two types of breast cancer differ in terms of pathogenesis. This article analyzes these two types of breast cancer by comparing their prognoses. Methods: The clinicopathological characteristics of 135 patients, including 60 patients with triple-positive breast cancer and 75 patients with HER2-positive breast cancer, were analyzed to compare the disease-free survival (DFS) and overall survival (OS) of the two groups over a 5-year period. A multifactorial Cox risk model was constructed by grouping age, menstrual status, maximum tumor diameter, number of lymph node metastases, pathological staging, and Ki-67 staining results. All statistical data were analyzed in detail using SPSS25.0 statistical software. Results: The 5-year OS rates of patients with breast cancer in the triple-positive and HER2-positive groups were 96.7% and 82.7%, respectively, and the 5-year DFS rates were 90% and 73.3%, respectively. The Cox results revealed that molecular staging was an independent factor affecting recurrent metastasis and survival of breast cancer patients (hazard ratio [HR] =2.199, 95% confidence interval [CI], 1.296-8.266; HR = 9.994, 95% CI, 2.019-49.465). Conclusion: The 5-year DFS and OS rates were significantly better in the triple-positive group than in the HER2-positive group. Subgroups received different prognosis for different chemotherapy regimens. Breast cancer patients should be treated according to the risk of recurrence with symptomatic treatment and precise regulation.

Effects of a Written Expression-Based Positive Psychological Intervention on the Psychological Status of Patients With Inflammatory Bowel Disease: A Randomized Controlled Trial.

This prospective parallel-group controlled trial explored the effects of a written expression-based positive psychological intervention on the psychological status of patients with inflammatory bowel disease. Primary outcomes were anxiety, depression, hope, optimism, and subjective well-being, assessed at 8 weeks. Secondary outcomes were coping mode, quality of life at 8 weeks, and patient feedback. Sixty-eight volunteer patients meeting inclusion criteria were recruited from a hospital in China and randomized into the intervention group (positive psychological intervention+care as usual = 33) and the control group (care as usual = 35). The intervention group showed significantly greater improvements in anxiety, depression, hope, and quality of life (p > .05). The intervention group scored the feasibility, simplicity, and applicability of the positive psychological intervention themes at more than 6.5 for all measures. The study concludes that written expression-based positive psychological interventions alleviate negative emotions in inflammatory bowel disease patients and enhance their positive psychological characteristics. This approach also promotes a positive coping mode in inflammatory bowel disease patients, and the intervention measures devised are convenient, feasible, and well-accepted by patients.

Prolonged endotracheal intubation: a feasible option for tracheomalacia after retrosternal goitre surgery.

BACKGROUND: Tracheomalacia may be caused by long-standing compression of retrosternal goitre because of destruction of support of tracheal cartilages. Life-threatening airway collapses may occur after surgical removal of goitre. However, available literature on management methods of tracheomalacia is sparse. Our study highlights prolonged endotracheal intubation as a feasible treatment method. METHODS: This retrospective study analysed 106 thyroidectomies for retrosternal goitre performed between 1994 and 2019. We recorded each patient's clinical profile. Severe tracheomalacia was confirmed through the following: soft and floppy trachea on intra-operative palpation and the collapse of cross-sectional tracheal area measured in computed tomography (CT) images by >80%. We assessed the extent of airway stenosis of these cases. All severe cases were treated by prolonged endotracheal intubation. RESULTS: Surgical treatment was successfully performed in all 106 retrosternal goitre patients with no mortality. Seventeen severe tracheomalacia cases were confirmed. The extent of airway stenosis was assessed: the minimal tracheal diameter of compressed trachea was 0.2-0.4 [mean 0.31, standard deviation (SD) 0.06] cm, and the narrow tracheal length was 4-6.7 (mean 5.1, SD 0.6) cm. These patients underwent endotracheal intubation for 17-47 h after surgery. All patients were transferred to the general ward after extubation and successfully discharged. There were no cases of tracheal stenosis on follow-up. CONCLUSIONS: Tracheomalacia is a rare but serious complication of retrosternal goitre surgery. Based on our experience, prolonged endotracheal intubation is a feasible treatment for tracheomalacia after retrosternal goitre surgery.

Correlation between computed tomography imaging and pathological stages and subtypes in early lung adenocarcinoma.

BACKGROUND: Detection of early-stage lung cancers has increased due to computed tomography (CT). The pathological stages and subtypes of early lung cancer determine the treatment strategy. We aimed to investigate the correlation between CT characteristics and pathological status in early lung adenocarcinoma (ADC). SUBJECTS AND METHODS: Between June 2018 and December 2019, 415 consecutive patients who underwent surgery for lung ADC with pathological atypical adenomatous hyperplasia (AAH) and ADC in situ (AIS), T1a (mi) N0M0, and T1a-cN0M0 were analyzed. The relationship between CT imaging and pathological status was investigated using Chi-squared or Kruskal-Wallis test and binary logistic regression. RESULTS: When cases of AAH, AIS, and T1a (mi) N0M0 were used as the control group, the lesion size, solid component ratio (SCR), and spiculation were significantly and independently associated with T1a-cN0M0 (P < 0.01). SCR >50% (P < 0.01) and spiculation (P < 0.05) were significantly and independently associated with T1aN0M0. In cases of pathological T1a-cN0M0, SCR >50% was significantly different between adherent wall growth ADC and mucinous ADC (P < 0.01). CONCLUSIONS: Some CT characteristics are related to the pathological stage and subtypes of early lung ADC. Larger diameter, spiculation, and SCR >50% are associated with invasive ADC. SCR >50% is positively correlated with mucinous ADC and negatively with adherent growth ADC.

"I can fight it!": A qualitative study of resilience in people with inflammatory bowel disease.

OBJECTIVES: This study aimed to understand the resilience experiences in patients with inflammatory bowel disease (IBD) and develop the resilience framework for them. METHODS: Semistructured interviews were conducted with 15 patients with IBD who were purposefully recruited from the gastroenterology department of two hospitals in Jiangsu, China to gain diversity in the demographic and clinical characteristics. The data were analyzed using a directed content analysis approach based on the Kumpfer's resilience framework. RESULTS: The resilience framework for patients with IBD was formed from the analysis. This framework was composed of four themes, as follows: (1) complicated factors in the environment, (2) change the environment into a protective one, (3) personality traits, and (4) resilience-related coping. CONCLUSIONS: The resilience framework for patients with IBD can effectively characterize the resilience experience of patients during the disease and assist healthcare professionals to understand how patients recover from the disease. More quantitative studies are needed to further explore the influencing factors of resilience and improve resilience in patient with inflammatory Bowel Disease.

[Research on morphological characteristics change of quercetin and polyphenols of accumulation dynamic of spines of Gleditsia sinensis].

To study morphological characteristics change of the development process and quercetin and polyphenols of accumulation dynamic of the spines of Gleditsia sinensis, measure and compare morphological indexes using Vernier caliper, ruler and balance, calibrate and analysis quercetin and polyphenols content using HPLC and colorimetric method. The spines of G. sinensis development process is divided into formation period (the beginning of August to the beginning of November), dormant period (the beginning of November to the end of March in the following year), germination period (the end of March to the middle of April), fast growth period (the middle of April to the middle of August), browning period (the middle of August to the end of August) and mature period (the beginning of September to the end of December). Formation period the spines primordium divides and forms the scale bubs; dormant period the scale bubs are in a dormant state; germination period the bubs scales fall off, spines primordium began to development; fast growth period rapid growth to maximum; browning period browning from the tip and browns until the whole becomes brown; mature period The early stage of maturity is full of luster, gradually the color deepened and the luster faded. The accumulation of quercetin was gradually decreasing after increasing. The total polyphenol accumulation was significantly decreased and then gradually increased, decreased finally. The content of quercetin was increased from 0.000 4%-0.002 6%, and the polyphenol content decreased from 0.761 9%-0.049 1% and then slowly increased to 0.286 9% in the fast growth period.The quercetin continuous increase to 0.004 3% and total polyphenol increased to 0.421 6% in the browning period. In the mature period, the quercetin content significantly decreased after reaching 0.009 6% in September, and the polyphenols content decreased after reaching 0.723 5% in October. Using principal component analysis results: September first, October 2nd, November 3rd. The morphological characteristics change of the development process and quercetin and polyphenols accumulation were determined. The development process is divided into six periods, the best harvest time is the early stage of mature period. Provide theoretical support for the utilization of the spines of G. sinensis and cultivation techniques of high yield.

[Study on breeding and pollination characteristics of Gleditsia sinensis].

To study the breeding system and pollination characteristics of Gleditsia sinensis, we observed the development of flower development and the processing of pollination, and determined the pollen viability and stigma acceptability by TTC and benzidine-hydrogen peroxide method and detected its breeding system using OCI value, P/O ratio and artificial pollination.The results showed that: ①G. sinensis are racemes, divided into bisexual inflorescences (only a small amount of inactive pollen) and male inflorescences (occasionally a few bisexual flowers), flowers hermaphrodite. ②Male flowers had the strongest pollen activity 4 h after flowering; the stigma receptivity of bisexual was the highest at 1 h after flowering, and pollination was the best in this time. ③The pollen tube had a few elongation when the bisexual flower is half-opened. The number of pollen tube and length significantly increased when blooming. The flower reaches the ovary and even enters the ovule to complete the fertilization. ④When the OCI=4 and P/O=11 684, it means that the breeding system was facultative, outcrossing, and requiring pollinators based on the results of the bagging experiment.There was parthenogenesis. ⑤The characteristics of saponin pollination were wind pollination and insect vector pollination, and pollinators were initially identified as Apis mellifera ligustica. All these results provides a theoretical and technical foundation for the new germplasm of G. sinensis.