Objective:To evaluate the stability and bio-safety of warming moxibustion gel-unguentums( WMG) . Methods: With the commercially available package and at 40℃ ± 2℃, RH (75% ± 5%) for six months,the stability of WMG was inspected. Guinea pig skin sensitization test, rabbit skin irritation test and cell toxicity test were used to investigate the safety. Results:Compared to the results of 0 month, there was no difference in the sample character, containing paste percentage, adhesion, shape, weight difference and all theindices in TLC identification. Cell toxicity test showed that WMG had slight cytotoxicity. Guinea pig skin sensitization test and rabbit skin irritation test indicated that the grade of skin reaction was zero and the primary stimulus index of skin tissues was also zero. Conclusion:The quality of WMG is stable and the production preparation technology is feasible. Moreover, it is safe in transder-mal administration.

Background Bipolar disorder is a severe mental disorder characterized by cycling between mania/hypomania and depression,yet its underlying pathophysiological mechanism remains unclear.Several prior studies have suggested a potential role for voltage-gated calcium channel subunit genes in the etiology of bipolar disorder,particularly in their influence on brain structure.Objective To investigate the differences in grey matter volume(GMV)for individuals with bipolar disorder compared to healthy controls,and to explore the potential influence of calcium channel voltage-dependent T-type α1 G subunit(CACNA1G)rs757415 polymorphism on GMV in bipolar disorder and clarify the specific brain regions associated with this genetic variation,thus offering a new opportunity to gain insight into the pathophysiological mechanism of bipolar disorder.Methods A cohort of 289 patients who met the Diagnostic and Statistical Manual of Mental Disorders,fourth edition(DSM-IV)criteria for bipolar disorder were selected for participation.These patients were either admitted to hospital or examined in outpatient clinic for bipolar disorder at the Mental Health Center of West China Hospital,Sichuan University between September 2013 and December 2022.Another 322 healthy individuals were concurrently recruited as a control group from Sichuan University and surrounding communities.All participants underwent brain imaging using a 3.0 T magnetic resonance scanner to acquire data on GMV.Additionally,the presence of the CACNA1G rs757415 polymorphism was validated using the imLDRTM technique.Spearman correlation analysis was utilized to investigate potential relationship between abnormal brain regions identified through GMV data and clinical characteristics of the patients.Then the genotype-by-diagnosis interaction effect for CACNA1G rs757415 on GMV was observed using the full factor method.Results The study successfully enrolled 173 patients with bipolar disorder and 207 healthy controls who completed all the necessary procedures.Analyses revealed decreased GMV for patients with bipolar disorder compared to healthy controls in the left cerebellar declive extending to cerebellar anterior/posterior lobe,fusiform gyrus,parahippocampal gyrus and inferior occipital gyrus(t=5.664,P<0.05);in the right cerebellar anterior/posterior lobe,fusiform gyrus,parahippocampal gyrus extending to lingual gyrus(t=4.583,P<0.05);in the bilateral anterior cingulate/paracingulate gyri,superior frontal gyrus and precuneus(t=7.543,P<0.05);in the left lingual gyrus and superior temporal gyrus(t=6.593,P<0.05);and in the right insula entending to central operculum(t=7.153,P<0.05).Correlation analysis indicated that the duration of bipolar disorder was positively correlated with cerebrospinal fluid volume(r=0.258,P=0.003),whereas negatively correlated with the GMV in the left cerebellar declive extending to cerebellar anterior/posterior lobe,inferior occipital gyrus and parahippocampal gyrus(r=-0.204,P=0.019),in the right cerebellar anterior lobe extending to right cerebellar posterior lobe,fusiform gyrus,parahippocampal gyrus and lingual gyrus(r=-0.238,P=0.006),in the bilateral superior frontal gyrus extending to anterior cingulate/paracingulate gyri and precuneus(r=-0.219,P=0.012),in the left lingual gyrus extending to superior temporal gyrus(r=-0.296,P=0.001),and in the right insula extending to central operculum(r=-0.257,P=0.003).A significant genotype-by-diagnosis interaction effect for CACNA1G rs757415 on GMV was observed in the right parahippocampal gyrus-fusiform gyrus-cerebellum 4-5(F=19.967,P<0.05).In the control group,individuals carrying the non-risk allele showed increased GMV in the right parahippocampal gyrus-fusiform gyrus-cerebellum 4-5 compared to those carrying the risk allele.In contrast,within the patient group,risk allele carriers exhibited increased GMV in the same brain regions when compared to non-risk allele carriers.Moreover,the GMV in the right parahippocampal gyrus-fusiform gyrus-cerebellum 4-5 of patients with bipolar disorder carrying risk alleles was increased compared to healthy controls.Conclusion CACNA1G rs757415 polymorphism may affect the GMV in the right parahippocampal gyrus,fusiform gyrus and cerebellum 4/5 of patients with bipolar disorder.

Objective To systematically retrieve,evaluate and integrate the best evidence on the prevention and management of aspiration in critically ill adult patients and had it summarised to form the best evidence so as to provide an evidence-based reference for prevention and management of aspiration.Methods Following the"6S"pyramid model,literatures on prevention and management of aspiration in critically ill adult patients published from January 2013 to August 2023,were retrieved from databases of BMJ Best Practice,UpToDate,Joanna Briggs Institute Evidence-Based Healthcare Centre in Australia,College of Nurses of Ontario in Canada,International Guideline Network,Guidelines.gov of the United States,National Institute for Health and Care Excellence,Scottish Intercollegiate Guidelines Network,PubMed,Embase,Cochrane Library,CINAHL,Chinese Clinical Practice Guidelines Library,Medlive,Chinese Biomedical Literature Database,CNKI,Wanfang Data and VIP.The retrieved data included clinical decisions,guidelines,evidence summaries,expert consensus/recommendations,systematic reviews/meta-analyses,and randomised controlled trials regarding the prevention and management of aspiration in critically ill adult patients.Two researchers who were trained in evidence-based nursing independently conducted literature selection,quality assessment,evidence extraction and synthesis.Results A total of 33 articles were included,with 4 clinical decisions,4 guidelines,5 evidence summaries,8 expert consensuses,9 systematic reviews/meta analysis and 3 randomised controlled trials.Eventually,36 points of best evidence were summarised from 9 themes,namely aspiration risk assessment,airway management,oral hygiene management,positioning management,enteral nutrition management,drug management and prevention,diagnosis and treatment of aspiration,prevention of post-extubation aspiration,aspiration training,and team management.Conclusions This evidence summary can provide healthcare workers with evidence-based support for prevention and management of aspiration in ICU,which will make ICU nursing more scientific and standard.