Efficacy of acupuncture as an adjunctive treatment to patients with stable COPD: a multicenter, randomized, sham-controlled trial protocol.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common respiratory disease and the third leading cause of death worldwide. Previous evidence has shown that acupuncture may be an effective complementary alternative therapy for stable COPD. However, large-sample, rigorously designed long-term follow-up studies still need to be completed. Notably, the relationship between the frequency of acupuncture and clinical efficacy in studies on acupuncture for stable COPD still needs further validation. This study aims to evaluate the efficacy and safety of acupuncture for stable COPD and further investigate the dose-effect relationship of acupuncture. METHODS/DESIGN: This is a multicenter, randomized, controlled trial that uses central randomization to randomly allocate 550 participants in a 1:1:1:1:1 ratio to once a week acupuncture group, twice a week acupuncture group, three times a week acupuncture group, sham acupuncture group and waiting-list control group. The sham acupuncture group will receive placebo acupuncture treatments three times per week, and the waiting-list control group will not receive any form of acupuncture intervention. The study consists of a 2-week baseline, 12-week of treatment, and 52-week of follow-up. Patients with COPD between 40 to 80 years old who have received stable Western medication within the previous 3 months and have had at least 1 moderate or severe acute exacerbation within the past 1 year will be included in the study. Basic treatment will remain the same for all participants. The primary outcome is the proportion of responders at week 12. Secondary outcomes include the proportion of responders at week 64, change in the St. George's Respiratory Questionnaire (SGRQ) Scale, change in the Modified-Medical Research Council (mMRC) Scale, change in the COPD Assessment Test (CAT) Scale, change in the Lung Function Screening Indicators (LFSI), change in the 6-min walk distance (6-MWD), change in Short-Form 36 Health Survey (SF-36) Scale, the number of moderate and severe acute exacerbations and adverse event rate during the follow-up period. DISCUSSION: This study will provide robust evidence on whether acupuncture is safe and effective for treating stable COPD. Meanwhile, comparing the differences in efficacy between different acupuncture frequencies will further promote the optimization of acupuncture for stable COPD. TRIAL REGISTRATION: This study was registered in the Chinese Clinical Trial Registry (ChiCTR2200058757), on April 16, 2022.

Factors influencing the mental health status of support nurses and their workload during the COVID-19 epidemic.

OBJECTIVES: The authors used the National Aeronautics and Space Administration Task Load Index (NASA-TLX) and general health questionnaire to analyze the factors influencing the mental health status and the workload of support nurses during the COVID-19 epidemic. MATERIAL AND METHODS: The authors conducted a cross-sectional survey of 349 support nurses in April-October 2022. Using QuestionStar, a powerful online survey tool, the authors administered surveys to the participants, collected data on the mental health status and workload of support nurses, and analyzed the influencing factors based on the collected data. RESULTS: A total of 316 questionnaires were successfully collected, with an effective rate of 98.75%. The proportion of support nurses with mental health problems was 25% and the value of the NASA-TLX questionnaire was: M±SD 68.91±7.28 pts. Multi-factor analysis revealed that the number of children, family support, and nursing support location were the influencing factors of mental health status, while the multivariate analysis revealed that the presence of symptoms, nursing support location, support work type, and total 12-item General Health Questionnaire (GHQ-12) score were the influencing factors of the workload of support nurses. CONCLUSIONS: Compared to their counterparts in the plains, nurses working in isolated plateau regions who were caring for children and lacked family support, were more likely to have mental health issues. There was a positive correlation between the changes in GHQ-12 and NASA-TLX scores of the study participants. Compared to their counterparts in the plains and the tropical regions, nurses working in plateau regions had a heavier workload. As part of the follow-up measures to prevent and treat patients impacted by the COVID-19 epidemic, it is important to improve the mental health evaluation, consultation, and treatment of the support nurses to guarantee the high quality of the first-line support work. Int J Occup Med Environ Health. 2023;36(6)761-72.

The Relationship Between Mindfulness, Fatigue, and Perceived Symptoms Among Frontline Nurses Who Performed Nucleic Acid Sample Collection During the COVID-19 in China: A Cross-Sectional Study.

Objective: Given the immense stress faced by medical staff during the COVID-19 pandemic, this study aimed to evaluate the relationship between mindful attention awareness, fatigue, and perceived symptoms among frontline nurses who performed nucleic acid sample collection during the COVID-19 pandemic, to reduce their fatigue and help them cope with perceived uncomfortable symptoms. Methods: A convenience sampling method was used to survey nurses who travelled to Hainan for nucleic acid sampling in August 2022 using an online (WeChat) questionnaire. A total of 514 frontline nurses who performed nucleic acid tests completed the questionnaire. The questionnaire covered basic demographic information, Mindful Attention Awareness Scale (MAAS) ratings, and Fatigue Severity Scale (FSS) ratings. Spearman correlation analysis was used to separate the relationship between MASS and FSS, and univariate and multivariate factor analyses were used to explore the relevant influences contributing to the occurrence of fatigue. Results: A total of 514 individuals completed the survey,93.97% (n=483) were female, mean age was 31.15 ± 5.7, MASS score was 69.01 ± 13.53, and 296 (57.59%) nurses experienced symptoms of fatigue during the auxiliary period. Spearman correlation analysis showed that FSS was associated with MASS. Multifactorial analysis showed that sex, age, marital status, fertility status, years of work, adaptation to dietary habits, hidrorrhea, and MAAS scores affected the presence of fatigue symptoms among the medical staff in Hainan (P<0.05). Conclusion: The psychological status of frontline nurses undergoing nucleic acid testing during the pandemic was poor, and the appearance of fatigue symptoms could be effectively reduced by increasing levels of positive thinking among medical staff to help them cope with public health emergencies.

Relationship between valvular structure and biochemical indices of non-valvular atrial fibrillation and senile degenerative valvular heart disease.

Background: Valvular heart disease (VHD) is a common clinical condition in geriatric-related cardiovascular diseases that is connected to heart dysfunction. Atrial fibrillation (AF) is the most frequent arrhythmia. Considering these two common clinical conditions, so far no sufficient data on the relationship between degenerative VHD and non-valvular atrial fibrillation (NVAF). We aimed to explore the relationship between valvular structure and biochemistry of nonvalvular AF and degenerative valvular heart disease in the elderly. Methods: In our study, 234 VHD patients who were diagnosis evaluated by transthoracic echocardiography were enrolled in this retrospective study from January 2015 and December 2018. Significant valvular diseases were defined according to ACC/AHA Classification as any moderate or severe mitral regurgitation (MR), aortic regurgitation (AR), tricuspid stenosis, regurgitation, or aortic stenosis (AS). Data on relevant laboratory indicators were also collected. Results: A total of 234 patients with degenerative VHD were enrolled, of whom 81 had NVAF and 153 had sinus rhythm. Gender, smoking history, and some comorbidities, such as coronary artery disease, diabetes, and renal dysfunction, did not differ significantly between the two groups, but there were significant differences in age and hypertension {79 [74-83] vs. 70 [65-79] years} After propensity-score matching (PSM), we identified 68 VHD patients with NVAF and 68 VHD patients without NVAF. The NVAF + VHD had higher low-density lipoprotein (LDL) cholesterol (2.94±0.84 vs. 2.26±1.33 mmol/L, P=0.001), lower high-density lipoprotein (HDL) cholesterol [1.03 (0.89-1.34) vs. 1.56 (0.99-2.71) mmol/L, P<0.001], and higher uric acid (UA) (438.18±145.83 vs. 376.67±148.03 µmol/L, P=0.02) than the VHD group. The ejection fraction (EF) of the NVAF + VHD group was lower than that of the VHD group {63 [51-68] vs. 66 [62-69], P=0.013}. In addition, the left atrial size, MR, and calcification of the NVAF + VHD group were higher than those of the VHD group. Conclusions: Pronounced MR, valve calcification and hyperlipidemia were more likely in VHD patients with NVAF. These structures and biomarkers changes maybe important clinical parameters for disease prevention and management, which indicate early drug intervention to AF and hyperlipidemia is necessary.

A target-oriented algorithm for maintaining serum calcium stability automatically in regional citrate anticoagulation.

BACKGROUND: Regional citrate anticoagulation (RCA) for renal replacement therapy is widely practiced in critically ill patients. However, concern exists regarding its labor-intensiveness for monitoring and the associated hypocalcemia. In this study, we provided an algorithm for prescribing RCA and evaluated its safety in patients. METHODS: During 18 hemofiltration treatments with calcium-free replacement solution, participants were randomized to receive algorithm-based or trial-and-error RCA protocol. The effluent volume, post-filter and in vivo ionized calcium (iCa), and calcium in the sera and effluents were periodically measured at an interval of 1 to 2 h. RESULTS: For patients received algorithm-based RCA protocol, no one had a serum iCa less than 0.9 mmol/L, and none needed calcium supplement adjustment to maintain serum calcium stability. For patients accepted trial-and-error protocol, all patients had a serum iCa below 0.9 mmol/L, their serum iCa and calcium levels fluctuated dramatically, and all patients need additional calcium supplement adjustment during RCA. None of the participants showed a post-filter iCa > 0.4 mmol/L. CONCLUSION: We provided a safe algorithm for calculating calcium supplementation doses that could maintain serum calcium stability without additional adjustment during RCA.

[Construction of Graphitic Carbon Nitride-Bismuth Oxyiodide Layered Heterostructures and Their Photocatalytic Antibacterial Performance].

The thin layered graphitic carbon nitride (g-C3N4) was prepared by the thermal polymerization process with urea as the precursor. The layered heterostructure of graphitic carbon nitride-bismuth oxyiodide (g-C3N4/BiOI) was constructed by the in-situ synthetization of bismuth oxyiodide (BiOI) on the surface of the thin layered g-C3N4. The morphology, specific surface area, crystal structure, molecular structure, light absorption properties, and surface properties were characterized by TEM, BET, XRD, FT-IR, UV-Vis DRS, and XPS, respectively. The disinfection performance of the synthesized catalysts under visible light irradiation was investigated. The antibacterial mechanism of g-C3N4/BiOI in the photocatalytic process was further revealed by the capture of sacrificial agents. The results indicate that the prepared sample has a layered heterojunction structure with a specific surface area of 63 m2·g-1 and its light absorption side can obtain 600 nm. The results of the photocatalytic activity test indicate that g-C3N4/BiOI can kill bacteria within 4 h, which is significantly higher than that of g-C3N4 and BiOI. The main active species of g-C3N4/BiOI in the photocatalytic process can be attributed to the photogenerated holes.

[Community characteristics of crustacean zooplankton and its relationship with environmental factors in Suzhou Industrial Park, Jiangsu Province, China].

The monthly sampling data from June 2012 to May 2013 were used to study the composition and structure of the crustacean zooplankton community in the lakes and rivers of Suzhou Industrial Park. The variations in density and biomass of the crustacean zooplankton and their relationship with the environment factors were investigated. The results showed that a total of 42 species of crustacean zooplankton were found, including 24 species of cladocerans which belonged to 6 families and 12 genera, and 18 copepods which belonged to 7 families and 13 genera. The dominant species were Diaphanosoma brachyurum, Bosmina longirostris, Sinocalanus dorrii and Cyclops vicinus in all seasons of the year both in the rivers and the lakes. The density and biomass of the crustacean zooplankton in summer and autumn were higher than that in winter and spring, and there were two peaks in summer and autumn respectively both in the lakes and the rivers. The average density and biomass of cladocerans in the rivers were significantly higher than that in the lakes. There was no significant difference in the average density of Copepods between the rivers and the lakes, but the biomass in the rivers was higher than that in the lakes significantly. There were significant differences in dissolved oxygen, pH, Secchi depth, total dissolved solids, salinity, total phosphorus, total nitrogen and ammonium nitrogen between the lakes and the rivers. Redundancy analysis showed that the distribution of most of crustacean zooplankton was positively correlated with water temperature, the salinity, COD(Mn) and total phosphorus concentrations and only the distribution of the species belonging to genus Daphnia and Scapholeberis was positively correlated with O2 concentration, pH, and Secchi depth in both the rivers and the lakes in Suzhou Industrial Park.

[Effects of exogenous NO on ascorbate-glutathione cycle in loquat leaves under low temperature stress].

Three-year-old 'Zaozhong No. 6' loquat (Eriobotrya japonica Lindl.) seedlings were foliar-sprayed with 0.2, 0.5, 1.0 and 1.5 mmol x L(-1) of sodium nitroprusside (SNP), subjected to low temperature (-3 degrees) stress for 6 hours, and then cultured at 25 degrees C for four days. The antioxidant metabolites and enzymes in the seedling leaves were determined 0, 1, and 4 days after recovery. Comparing with the control (water spraying), all SNP treatments had a decreased H2O2 content but an increased content of glutathione (GSH) and ascorbic acid (AsA) and increased activity of ascorbate peroxidase (APX), glutathione reductase (GR), dehydroascorbate reductase (DHAR) and monodehydroascorbate reductase (MDAR) in the seedling leaves. Four days after recovery, the H2O2 content in the seedling leaves treated with 0.5 mmol x L(-1) of SNP decreased by 75.53%, while the GSH and AsA contents and the APX, GR, DHAR and MDAR activities were increased by 29.12%, 23.40%, 50.0%, 44.4%, 49.53%, and 62.68%, respectively. All of these suggested that appropriate dosage of exogenous NO could enhance the activity of antioxidant system in loquat leaves and alleviated the cell injury of loquat leaves under low temperature stress. In this study, the appropriate dosage of NO was 0.5 mmol x L(-1) of SNP.