The relationship between education attainment and gout, and the mediating role of modifiable risk factors: a Mendelian randomization study.

Objective: To investigate the causal relationship between educational attainment (EA) and gout, as well as the potential mediating effects of individual physical status (IPS) such as body mass index (BMI) and systolic blood pressure (SBP) and lifestyle habits (LH) including alcohol intake frequency (drinking), current tobacco smoking (smoking), and time spent watching television (TV). Methods: Utilizing two-sample Mendelian randomization (MR), we analyzed the causal effects of EA on gout risk, and of IPS (BMI and SBP) and LH (smoking, drinking, and TV time) on gout risk. Multivariable MR (MVMR) was employed to explore and quantify the mediating effects of IPS and LH on the causal relationship between EA and gout risk. Results: An elevation of educational attainment by one standard deviation (4.2 years) exhibited a protective effect against gout (odds ratio 0.724, 95% confidence interval 0.552-0.950; p = 0.020). We did not observe a causal relationship between smoking and gout, but BMI, SBP, drinking, and TV time were found to be causal risk factors for gout. Moreover, BMI, SBP, drinking, and TV time acted as mediating factors in the causal relationship between EA and gout risk, explaining 27.17, 14.83, 51.33, and 1.10% of the causal effects, respectively. Conclusion: Our study indicates that having a genetically predicted higher level of EA may provide protection against gout. We found that this relationship is influenced by IPS factors such as BMI and SBP, as well as LH including drinking and TV time.

Mindfulness-based stress reduction with acupressure for sleep quality in breast cancer patients with insomnia undergoing chemotherapy: A randomized controlled trial.

PURPOSE: The objective of this randomized controlled trial was to evaluate and compare the effectiveness of mindfulness-based stress reduction (MBSR), acupressure, and MBSR combined with acupressure in improving sleep quality in breast cancer patients with sleep disorders, as well as the potential effects of these interventions on relieving fatigue, anxiety, and depression. METHODS: A four-arm parallel-group randomized controlled trial was conducted in a tertiary hospital in Fujian between July 2019 and January 2021. A total of 147 breast cancer patients were randomly assigned to a usual care group (n = 34), a MBSR group (n = 38), an acupressure group (n = 36), or a combined group (n = 39). We assessed patients' sleep quality (Pittsburgh Sleep Quality Index-PSQI and 6 actigraphy indices), fatigue, anxiety, and depression at baseline and at the mid-intervention (fourth week) and the end of intervention (eighth week). RESULTS: The ANOVA showed a significant difference (p < 0.05) in PSQI, and all sleep parameters measured by wrist actigraphy, and anxiety between groups. The three active treatments led to better PSQI outcomes (p < 0.001), reduced fatigue (p < 0.001), decreased anxiety (p < 0.05), and improved sleep measured by all actigraphy indices with two exceptions (MBSR did not differ from control on Sleep Latency (p = 0.235) and mean waking by time (MWBT) (p = 0.058)). Both acupressure and the combined intervention outperformed MBSR on four actigraphy indices: Sleep Efficiency (SE), Sleep Latency (SL), Totatl Sleep Time (TST), and Wake after sleep onset (WASO) (p < 0.05), and the combined intervention further outperformed MBSR on PSQI (p = 0.03) and Number of awakings (NOA) (p = 0.003). Moreover, there was no significant difference across all outcomes between acupressure and combined intervention (p ≥ 0.05). CONCLUSIONS: MBSR, acupressure, and combined therapy all show a remarkable advantages in allemiating sleep quality, fatigue, and anxiety. Acupressure and combined therapy outperformed MBSR in improving sleep quality.

Effect of the Novel Coronavirus Pneumonia Pandemic on Medical Students' Psychological Stress and Its Influencing Factors.

In December 2019, an outbreak of the novel coronavirus pneumonia infection occurred in Wuhan City, Hubei Province, China, and it has received substantial attention globally. Few studies have investigated the psychological stress of students in Health University during the COVID-19 outbreak, and almost no work has attended to the influencing factors that may cause their psychological stress risk. This cross-sectional, survey-based, region-stratified study collected demographic data and mental measurement from 2,498 medical students and 1,177 non-medical students in 31 provinces from March 5, 2020, to March 10, 2020, in China. The psychological stress was measured using the Chinese Perceived Stress Scales (CPSS) under a self-design questionnaire. Sociodemographic, major characteristics, and knowledge of the novel coronavirus pneumonia were also identified as potential influencing factors of stress. The study revealed that medical students are suffering from more stress than non-medical students almost in all provinces of China. Four influencing factors including level of familiarity with the novel coronavirus, family income, major of students, and status of the intern student can be significantly related to students' stress in the medical group by using the univariate and multivariate analysis. Further analysis showed that students with low stress had a greater number of positive psychological emotions and a lower number of negative psychological emotions than with medical students with high stress. In addition, high stress caused low enthusiasm for learning in these medical students and lead to little/no willingness to do professional medical work in the future. In conclusion, we need to increase the level of our knowledge related to the novel coronavirus pneumonia to reduce stress and strongly focus on the special populations in medical students with certain features, such as intern students, clinical nursing students, and low-income families, to improve their learning attitudes and establish positive professional mental outlooks.

[Effect of acupuncture and moxibustion on post-stroke constipation: a network Meta-analysis].

OBJECTIVE: To systematically review the therapeutic effect of acupuncture-moxibustion therapies on post-stroke constipation based on the network Meta-analysis. METHODS: The randomized controlled trials of acupuncture and moxibustion for post-stroke constipation were retrieved from the databases, starting from the time of establishment through to June, 2019, i.e. the PubMed, EMbase, Cochrane Library, Web of Science, SinoMed, CNKI, Wanfang and VIP. The literature was selected according to inclusion and exclusion criteria, the quality of literature was evaluated by bias risk assessment tool of Cochrane Review Manual 5.3 and the data was statistically analyzed by softwares of Stata 13.1 and R Language. RESULTS: A total of 28 trails were included, involving 9 intervention methods. The therapeutic effect was arranged from high to the low according to the surface under cumulative ranking area (SUCRA), i.e. acupuncture combined with medication (0.86), warm needling (0.83), electroacupuncture combined with medication (0.68), electroacupuncture (0.68), moxibustion (0.50), auricular point sticking (0.44), acupuncture (0.31), Chinese herbal medicine (0.12) and western medication (0.04). CONCLUSION: Acupuncture- moxibustion therapies have superiority on treating post-stroke constipation, acupuncture combined with medication has the most optimum therapeutic effect and the therapeutic effect of acupuncture-moxibustion combined with medication is superior to the single treatment of medication.

Effectiveness of Perioperative Auricular Therapy on Postoperative Pain after Total Hip Arthroplasty: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

Auricular therapy (AT) is a conventional therapy in traditional Chinese medicine. However, the effectiveness of perioperative AT in pain treatment after total hip arthroplasty (THA) is still controversial. Nine randomised controlled trials (RCTs) involving 605 patients who have undergone THA with or without AT from inception to March 2018 were collected and included in this study by searching more than 12 databases (e.g., PubMed, Excerpta Medica Database, and Cochrane Library). A random-effects model that pooled seven articles showed that the visual analogue scale (VAS) in the AT group was lower than that of the control group at each postoperative time point in patients after THA, except at the time points of 6 and 36 h. The intraoperative body mass-adjusted fentanyl amount in the AT group was also lower than that of the control group in two trials. The other outcomes (time to first analgesic request and incidence of postoperative nausea and vomiting, perioperative bradycardia, and transitory hypotension) showed insignificant difference. Then, subgroup analysis showed similar results to those of the total articles with the term "VAS". Regression analysis found that the prolonged time after the operation decreased the difference in VAS between the two groups. Although all the outcomes were assessed as very low to low in the GRADE system, evidence on the effectiveness of perioperative AT in pain treatment after total hip replacement was positive.