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Objective@#To explore the facilitators and barriers of the implementation of evidence based mental health practice, in order to provide practical experience for promoting the development of evidence based mental health services in primary schools in China.@*Methods@#Semi structured interviews were conducted with 4 education bureau managers, 8 school administrators, 7 classroom teachers, and 7 treatment providers after providing evidence based practice in 10 primary schools in Henan Province, China. Data was analyzed using thematic analysis.@*Results@#Evidence based practice in primary schools faced multiple factors at the macro level, school level, and individual level. A total of 8 facilitators and 9 barriers were extracted. Among these factors, some factors were particularly striking. These included the "exclusion" of teacher title evaluation system, time conflict between practice and school schedule, stigmatization of mental health and mismatch between perceived effectiveness of services and expectations.@*Conclusion@#Evidence based mental health practice is feasible in Chinese schools. The implementation process needs to take full account of macro, school and individual multi level factors to move evidence based mental health services from theory and data to practice in China.
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Objective:To investigate the effects of a eukaryotic expression plasmid for IL-6 and B-cell activating factor (BAFF) fusion protein on the histopathological changes in salivary and lacrimal glands of non-obese diabetic (NOD) mice with Sj?gren′s syndrome and to elucidate the possible therapeutic mechanism of IL-6/BAFF fusion protein eukaryotic expression plasmid in NOD mice.Methods:The eukaryotic expression plasmid for IL-6/BAFF fusion protein was constructed. After transfecting CHO cells with the plasmid, the expression of IL-6/BAFF fusion protein was detected by Western blot. BALB/c mice were injected with the plasmid every two weeks for three times and the titers of anti-IL-6 and anti-BAFF antibodies were measured by ELISA. Twenty-one NOD mice were randomly divided into three groups (control group, empty vector group and therapy group) by numerical table method. The mice in the therapy group were injected with the IL-6/BAFF fusion protein eukaryotic expression plasmid once a week for six times and the mice in the empty vector group were injected with empty plasmid. The levels of anti-IL-6 and anti-BAFF antibodies as well as cytokines (IL-6, BAFF, INF-γ, IL-10 and IL-17A) in mouse serum samples were detected by ELISA. The proportions of Th17, Treg, Th1 and Th2 cells in mouse splenocytes were measured by flow cytometry. Focal lymphocyte infiltration and pathological changes in the lacrimal and salivary glands of mice were observed under light microscopy after HE staining.Results:The eukaryotic expression plasmid for IL-6/BAFF fusion protein increased the levels of anti-IL-6 and anti-BAFF antibodies in the serum of BALB/c mice ( P<0.05). The levels of anti-IL-6 and anti-BAFF antibodies in the serum of NOD mice in the therapy group increased ( P<0.01), while the expression of IL-6, BAFF, INF-γ, IL-10 and IL-17A in NOD mice in the therapy group was lower than that in the control group and the empty vector group ( P<0.05). The percentages of Treg and Th2 cells in the splenocytes of NOD mice increased after treatment ( P<0.05). Moreover, the eukaryotic expression plasmid for IL-6/BAFF fusion protein significantly improved the irregular size and morphology of glandular vesicles in the lacrimal and salivary glands, reduced the ductal dilatation and decreased the focal lymphocyte infiltration in NOD mice. Conclusions:The eukaryotic expression plasmid for IL-6/BAFF fusion protein induced the production of anti-IL-6 and anti-BAFF antibodies, decreased the expression of inflammatory cytokines, regulated the balance of Th17/Treg and Th1/Th2 cells, improved the irregular alveolar structure and ductal dilation in the lacrimal and salivary glands and reduced the focal lymphocyte infiltration in NOD mice. This study showed that eukaryotic expression plasmid for IL-6/BAFF fusion protein might serve as a potential target for therapeutic targeting of T and B cells.
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Objective:To systematically review parents ′ experience of caring for children with chronic kidney disease (CKD) to fully understand care needs and improve the psychological state and caregiving quality of parents. Methods:The qualitative studies on parents ′ experience of caring for children with CKD were retrieved from following databases, including PubMed, Web of Science, CNKI, VIP, CBM, and WanFang Data from inception to March 2020. The quality of included researches was evaluated according to the JBI Critical Appraisal Tool for qualitative studies in Australia. The results were integrated by pooled integration methods. Results:A total of 14 studies were included. 69 results were summarized and integrated to form 10 categories. These categories extracted 4 integrated results: parents' physical and mental condition are affected, relationship between parents and their support system has changed, reconstruction of parents ′ life, unmet care needs and problems. Conclusions:Parents are crucial to the disease management of children with CKD, so clinical medical staff should not only provide medical services for children, but also pay more attention to the psychological status and needs of parents, so as to provide guidance and support to promote parents to better implement care and disease management for children.
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Objective To study the effect of dexmedetomidine in the functional endoscopic sinus surgery (FESS) on the recovery period of general anesthesia. Methods Fifteen min before the end of surgery, 40 FESS patients were treated with intravenous infusion of dexmedetomidine at 0.6μg/kg. The occurrence of cough response, degree of pain and agitation in patients were observed. Result The response score of choking cough of the patients with intravenous infusion of dexmedetomiindine was (1.2 ± 0.5), the score of VSA was (1.9 ± 0.5), and the degree of agitation was (1.2 ± 0.4). Conclusion For those undergoing FESS, postoperative use of dexmedetomidine 15 min before the end of surgery, can not only have an effective effect for reducing the incidence of choking cough and agitation and but also decrease the pain degree so that the patients can live through the general anesthesia recovery period.
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Objective To provide solid data for TCM treatment and research of triple negative breast cancer (TNBC) by investigating its syndromes distribution.Methods 180 patients diagnosed of TNBC in Department of Oncology,Guang'anmen Hospital from Janurary 2007 to November 2012 participated in this clinical trial.Eight principals syndrome differentiation,and Qi,Blood and viscal syndrome differentiation were used.According to the syndromes diagnosis standard,the differentiation of one single syndrome firstly and then multi-syndrome were conducted and related variables were analyzed finally Results 404 symptoms presented in all 180 patients.Qi deficiency syndrome (35.89％) and blood stasis syndrome (32.18％) showed statistical difference when compared with blood deficiency syndrome (3.22％),yin deficiency syndrome (4.95％),yang deficiency syndrome (3.96％),spleen-dampness syndrome (3.47％),qi stagnation syndrome (7.43％),toxic heat syndrome (4.95％) and dampness-heat syndrome (1.49％) (P＜0.01,x2=124.709,116.007,127.813,126.913,105.411,116.007,140.015; 118.273,105.447,117.630,120.445,97.411,105.447,110.273respectively).92.22％ syndroms were multi-syndrome including 23.89％ bi-syndrome,32.22％ tri-syndrome and 25.56％ qua-syndrome.Conclusion The syndromes of TNBC were complicated but with predominant Qi dificency and Blood stasis; single syndrome identification should be put in the first place and then combining them together may be practical approaches; Replenishing Qi and activating blood circulation might be breaking through in TNBC treatment.
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Objective Observing the effect of Shuganyishen formula on hormone-dependant metastatic breast cancer and the mechanisms of anti-resistance and endocrine therapy. Methods 226 ITT cases were divided into two cohorts by treatment. 126 cases were treated with the combination of Shuganyishen formula and standard western medicine including endocrine therapy, and 100 cases were treated with western medicine alone. The end points were time to progress (TTP) and overall survival and quality of life (QOF). The effect of Shuganyishen formula on growth of TAM-resistance cell line in vitro was observed. Results There were statistical significances of median TTP between combination and western medicine in Luminal A (ER+ /PR+, HER2-) as well as Luminal B (ER+/PR+, HER2+), but no significances of OS; The extent and incidence of hot flush, sweat and syndromes related to bone were decreased significantly in combination treated group. Shuganyishen formula could reverse resistance to TAM. Conclusion Patients with LuminalA and LuminalB metastatic breast cancer benefit from Shuganyishen formula, which maybe related with its reverse resistance to endocrine therapy.