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Objective: To explore the mechanism of moxibustion for rheumatoid arthritis (RA) by observing the metabolite changes in urine using liquid chromatography-mass spectrometry (LC-MS)-based metabolomic analysis. Methods: Twenty-four rats were randomly divided into a control group, a model group, and a moxibustion group. Rats in the model and moxibustion groups were established as collagen-induced arthritis (CIA) models. The control and model groups did not receive any intervention; rats in the moxibustion group received moxibustion at Shenshu (BL23) and Zusanli (ST36). After three weeks of intervention, ankle joint, serum, and urine samples were collected for pathological examinations and metabolomic tests. Results: After moxibustion treatment, the CIA rats showed increased body mass, reduced swelling of the hind paws and arthritis score, decreased serum cytokine levels, and improved histopathological evaluation of the ankle joint. Twenty-four significantly altered metabolites were found, mainly involved in alanine metabolism, taurine and hypotaurine metabolism, tricarboxylic acid cycle, phenylalanine metabolism, tyrosine metabolism, and primary bile acid biosynthesis. These metabolites may serve as potential biomarkers for RA. Conclusion: Moxibustion can effectively resist inflammation in CIA rats. The potential biomarkers and the abnormal metabolic pathways of RA can be identified by LC-MS-based metabolomics. Metabolomics may be an effective way to explain the mechanism of moxibustion in treating RA.
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Objective:To comprehensively evaluate and compare the early warning system's ability to predict the risk of maternal disease in China, such as the British National Intensive Care Audit and Research Center (ICNARC)-Obstetric Early Warning Score (OEWS) system, the National Maternal Safety Early Warning Standard (MEWC) recommended by the National Coalition for Maternal Safety, the Irish Maternity Early Warning System (IMEWS) proposed in the clinical practice guidelines issued by the head of health services at the Royal Medical College of Ireland.Methods:A total of 872 pregnant women who were admitted to the Women′s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital were prospectively observed from January 2019 to December 2019. The data during hospitalization were collected to calculate the scores of the three obstetric early warning scoring systems, to compare and evaluate the prediction and identification ability of three early warning systems for critically ill pregnant women.Results:A total of 872 cases were included in this study, of which 167 were critically ill, accounting for 19.2%, and 705 were non-critically ill, accounting for 80.8%. The three obstetric early warning systems (OEWS,MEWC,IMEWS) in critical group scored 4(2, 6),3(0, 6),5(3, 6), and non-critical group scored 1(0, 1), 0(0, 0), 2(0, 3), respectively. The critical group scored significantly higher than the non-critical group ( P<0.001). The AUC of OEWS was 0.961 (95% CI 0.948-0.975, P<0.001) and that of MEWC was 0.803 (95% CI 0.757 - 0.850, P<0.001). The AUC of IMEWS was 0.853 (95% CI 0.817-0.888, P<0.001). No obstetric critical illness occurred when OEWS was 0. The positive likelihood ratio was 8.208 6 when OEWS≥6. Conclusions:Three kinds of early warning systems have good predictive ability for the occurrence of critical obstetric diseases in China. Among the three warning systems, OEWS has better predictive ability than the other two, and has better hierarchical ability. However, due to the differences in population, environment and conditions in different regions, each obstetric medical unit can improve OEWS according to its own conditions and design an obstetric early warning system that meets its own clinical needs.
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Objective To understand the health literacy status,influencing factors and demand carrying out the health education based on the mobile terminal among college students to provide a new idea for formulating and implementing the health literacy promotion plan for university students.Methods The multi-stage stratified cluster random sampling method was adopted to extract 1 949 students from partial universities in Nanjing City and conduct the investigation by adopting the Rapid Estimate System of Health Literacy and Health Education Demand Based on the Mobile Terminal Questionnaire of College Students.The influence factors were analyzed by using the univariate analysis and ordinal multi-classification Logistic regression analy sis.Results The university students with high,marginal and low health literacy level accounted for 31.3％,48.9％ and 19.8％ respectively.The proportions of the students with high health literacy in the four dimensions,including health knowledge,health behaviors,health skill and health status,were 57.9％,18.3％,61.0％ and 44.5％ respectively.The ordinal multi-classification Logistic regression analysis showed that the major influence factors affecting the health literacy of university students were gender,education background of mothers,majors,grades,electively taking the health education course.81.2 ％ of university students wanted to or urgently wanted to understand the health literacy knowledge.The main route getting the health literacy knowledge by the university students was network(83.8％).91.8％ of students were willing to learn the health literacy knowledge through mobile terminal.87.1％ of students believed that the WeChat was suitable to learn the health knowledge,81.3％ of students hoped to use the WeChat platform for learning the health knowledge,73.8％ of students hoped the Wechat to push the health knowledge with the modes of words combined with images and video.It was recommended that the health knowledge pushing for 1-3 times per week was suitable.Conclusion The health literacy of university students is at the marginal level.The health behaviors literacy is most lacking and the demand for the health education based on the mobile terminal is stronger.The health literacy intervention of university students should sufficiently apply the new media platform superiority and the emphasis should be placed on the populations of males,low education background mothers,non-medicine major,low grade and without electively taking the health education course.
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<p><b>OBJECTIVE</b>To evaluate the effect of preoperative and postoperative moxibustion at different timings on the recovery of gastrointestinal function in patients undergoing laparoscopic surgery.</p><p><b>METHODS</b>A total of 108 patients were randomly divided into a preoperative moxibustion group (36 cases), a postoperative moxibustion group (36 cases and 1 dropping), and a control group (36 cases and 1 dropping). Routine care after laparoscopic surgery was received in all three groups. In the preoperative moxibustion group, moxibustion was used at bilateral Zusanli (ST 36) one day before surgery, and 6 h after surgery in the postoperative moxibustion group. The treatment was given 20 min per acupoint. Intervention stopped after the patient's first self-exhaust or defecation. The time of first self-exhaust or defecation, the time of solid food tolerated, the postoperative 1-3 days visual analogue scale (VAS) abdominal pain scores, and adverse reactions during the intervention were recorded.</p><p><b>RESULTS</b>Compared with the postoperative moxibustion group and the control group, the time of first self-exhaust or defecation was earlier in the preoperative moxibustion group (both <0.01); the time of solid food tolerated was earlier in the postoperative moxibustion group (both <0.01); postoperative 1-3 d VAS scores were lower (<0.05, <0.01). The VAS scores in the postoperative moxibustion group were lower than those in the control group (all <0.05). No adverse reactions occurred in the three groups.</p><p><b>CONCLUSION</b>Preoperative moxibustion can more effectively promote the recovery of gastrointestinal function after laparoscopic surgery and improve the postoperative quality of life.</p>
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Objective To investigate the effects of different umbilical cord ligation methods on anemia and jaundice in preterm infants with a gestational age less than 32 weeks.Methods A total of 135 preterm infants with a gestational age less than 32 weeks were recruited and randomly divided into the umbilical cord milking group,the delayed cord clamping group and the immediate cord clamping group,with 45 cases in each group.Comparisons among three groups were performed on hemoglobin,hematocrit at 1 h and 1 week after birth,and bilirubin peak,total time of phototherapy,the incidence of anemia,pathologic jaundice as well as polycythemia before discharge.Results Finally 40 cases in the umbilical cord milking group,42 cases in the delayed cord clamping group and 38 cases in the immediate cord clamping group were recruited.Compared with the immediate cord clamping group,Hb(g/L)and hematocrit(％) levels were significantly higher in the umbilical cord milking group and the delayed cord clamping group(P＜0.05),the anemia rate was significantly lower in umbilical cord milking group and the delayed cord clamping group(P＜0.05).However,there were no statistical differences in Hb(g/L) and hematocrit(％) levels as well as ane mia rate between the umbilical cord milking group and the delayed cord clamping group (P＞0.05).There were no significant differences among three groups in bilirubin peak,total time of phototherapy and the incidence of pathologic jaundice as well as polycythemia.Conclusion Umbilical cord milking and delayed cord clamping can both reduce the anemia rate,but not increase the risk of pathological jaundice.Umbilical cord milking can be preferred method for preterm infants with a gestational age less than 32 weeks and asphyxia.
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Objective: To observe the effect of different moxibustion durations on rats with rheumatoid arthritis (RA) and to evaluate the relationship between moxibustion amount and moxibustion efficacy.Methods: Eight rats were randomly selected as a normal group from the 40 male Sprague-Dawley (SD) rats, and the other 32 rats were used to establish typeⅡ collagen-induced RA models. After successful modeling, the 32 rats were randomly divided into a model group, a moxibustion for 20 min group, a moxibustion for 40 min group and a moxibustion for 60 min group, with 8 rats in each group. Rats in the normal group did not receive modeling and moxibustion intervention; rats in the model group did not receive moxibustion after modeling; rats in the moxibustion for 20 min group, the moxibustion for 40 min group and the moxibustion for 60 min group were treated with moxibustion at Shenshu (BL 23) and Zusanli (ST 36) for 20 min, 40 min and 60 min, respectively. Six days were a course of treatment, with a total of 3-course treatments and a 1-day rest between the courses of treatment. After treatment, the serum levels of interleukin (IL)-1β and tumor necrosis factor (TNF)-α, arthritis index (AI) scores, toe volumes and pathological score of synovitis were evaluated in the rats.Results: Compared with the normal group, the serum IL-1β and TNF-α levels, and the toe volumes in the model group were increased, and the differences were statistically significant (P0.05). The synovial histopathological improvement was the most obvious in the moxibustion for 40 min group, when the synovial histopathological changes were compared among the moxibustion for 20 min group, moxibustion for 40 min group and moxibustion for 60 min group.Conclusion: The therapeutic efficacy of moxibustion for 40 min in RA rats was more significant than that of moxibustion for 20 min and moxibustion for 60 min, indicating that the duration of moxibustion is the main factor affecting its therapeutic efficacy.
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BACKGROUND: Moxibustion can improve the symptoms of rheumatoid arthritis and reduce inflammation, but there are no uniform operation standards. The moxibustiondistance becomes one of factor influencing the therapeutic efficacy.OBJECTIVE: To compare the effects of different moxibustion distances on rheumatoid arthritis, and to explore the optimal distance.METHODS: The 8 of 40 male Sprague-Dawley rats were randomlyselected as controls. The other 32 were used to make animal modes of collagen type Ⅱ-induced ankle arthritis, and then given moxibustion at Shenshu (BL23) and Zusanli (ST36) at an interval of 1, 2 and 3 cm, respectively, once daily, 10 minutes at each point, 6 days per course for three courses, with a course interval of 1 day. Model rats with no treatment acted as model group.RESULTS AND CONCLUSION: Compared with the control group, the toe volume, arthritis index and serum levels ofinterleukin-1β and tumor necrosis factor-α except the body mass were significantly increased in the model group (P < 0.01).After moxibustion treatment, these indexes were significantly decreased in the three treatment groups (P < 0.01), especially in the 1 and 2 cm groups (P < 0.01). Narrowed articular cavity, intra-articular inflammation and pannus formation were observed in the model group, while only moderate inflammatorycell infiltration and few pannus formation were found in the 1,2, 3 cm groups. These results indicate that moxibustion improvesjoint functions and regulates immune reaction by downregulating the levels of interleukin-1β and tumor necrosisfactor-α, as well as reducing synovial hyperplasia. In addition,the optimal distance for moxibustion is 1 or 2 cm, which is amomentous proposition to improve therapeutic efficacy.
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In this article we analyzed the current development of moxibustion treating rheumatoid arthritis from the usefulness, advancement, synergistic effect as well as the variance between different kind of moxibustion. We concluded that moxibustion was an effective intervention for treating RA, and the methods used in moxibustion were searched in clinic. But the clinical tralls has a long way to go, we should pay more attention to the critical issues while in the use of moxibustion.
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Objective To investigate the status of research and research utilization in practice among nurses of hospital of Traditional Chinese Medicine.Methods Two hundred and sixty nurses of hospital of Traditional Chinese Medicine were selected to fill out the questionnaire.Results The rates of involvement of research activities and research utilization among nurses of hospital of Traditional Chinese Medicine were low.The score of every factor ranged from the higher to the lower were communication,organization,research and nurse.Conclusions Involvements of research activities and research utilization among nurses of hospital of Traditional Chinese Medicine are insufficient.Most factors associated with nurses' low extent of research utilization are objective factors.It is pivotal for nursing managers to construct supportive professional environment,improve nurses' research and information skills and the capacity of the research utilization.
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Objective To evaluate the effects of high-fidelity simulation training on academic selfefficacy and learning motivation in undergraduate nursing students.Methods 84 undergraduate nursing students were randomized into the control group and the intervention group,nursing students in the control group received traditional health assessment training,while nursing students in the intervention group received health assessment training by high-fidelity simulator.The effects were evaluated by academic self-efficacy,learning motivation and skill performance in undergraduate nursing students.Results There were significant differences on academic self-efficacy,learning motivation and skill performance in undergraduate nursing students between the two groups.Conclusions High-fidelity simulation training can effectively enhance undergraduate nursing students’ academic self-efficacy,learning motivation and skill performance.It is proved to be helpful for competence development in clinical practice.
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Objective To evaluate the effect of physical exercise on health-related quality of life (HRQol),fatigue,depression,anxiety and body-image in breast cancer patients.Methods The Cochrane Library,Pubmed,EMBASE,CINAHL,Psycinfo,SportDiscus,CNKI and CBMdisc were searched to collect randomized controlled trials (RCTs) from 2002 to 2011 which mentioned the physical exercise to breast cancer patients.The quality of the RCTs was appraised and the data were extracted.Results In total,16 RCTs were included.Statistically significant results were found for the effect of physical exercise on HRQol,fatigue,depression,anxiety and body-image.The presence of publication bias was explored and no publication bias was detected.Sensitivity analysis were also performed and there were no significant differences with the former results.Conclusions The results indicated that physical exercise improve HRQol and psychological outcomes in breast cancer patients.Breast cancer patients should be taught to do some moderate exercises as part of their lives to promote rehabilitation.
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<p><b>BACKGROUND</b>To construct the recombinant adenovirus of mutant k-ras by using the method of homogenous recombination in bacteria.</p><p><b>METHODS</b>Mutant k-ras gene was liberated from the vector of pcDNA3-k-ras 12(Val) via KpnI+XhoI digestion, and subcloned into shuttle vector of pAdTrack-CMV, forming transfer vector of pAdTrack CMV/k-ras 12(Val). Then it was linearized with PmeI and cotransformed into BJ5183 cells with adenovirual geonomis plasmid of pAdEasy-1. The DNA of identified recombinant plasmid was digested with PacI and transfected to 293 cells to package adenovirus. The PCR technique was used to detect target gene. The titre and its infection rate of the Ad-k-ras 12(Val) was measured with the aid of GFP expression.</p><p><b>RESULTS</b>There were over 25% positive recombinant bacterial clones after co transformation of BJ5183 bacterial cells with pAdTrack-CMV/k-ras 12 (Val) and pAdEasy-1 by method of CaCl₂. PCR test indicated each the recombinant adenovirus contained the insert of k-ras 12(Val). The titre of purified recombinant adenovirus was 1.2×10¹² pfu/ml.</p><p><b>CONCLUSIONS</b>The method of homologous recombination in bacteria is convenient and efficient, which compared with that of in cell and the pepared Ad-k-ras 12(Val) paves a sound foundation for further study.</p>