Integrative medicine (IM) research in China has largely focused on clinical and experimental research, which is critical to determining the efficacy of treatments and enhancing the standing of IM. Nevertheless, there is also a need to extend research activities to include methods and research perspectives from public health, which will provide a greater understanding of clinical practice and assist government and professional organizations to shape policies and directives in IM. In this article we outline the public health research methods we have used in relation to our program of research on complementary and alternative medicine use and area of residence/geography, to highlight the usefulness of these methods in IM.

The practice of diabetes self-care plays an important role in achieving and maintaining good glycaemic control. However, not all patients with insulin-treated diabetes engage in their self-care activities. There is some evidence that self-care practices in patients with insulin-treated diabetes can be understood and predicted by their health beliefs, although studies are often hampered by methodological weaknesses, and the fact that less is known about adults with insulin-treated diabetes in Malaysia. This study was conducted to examine whether health beliefs (as specified in the Health Belief Model: HBM) can predict self-care practices and glycaemic control in patients with insulin-treated diabetes in Malaysia. Longitudinal design with self-reported questionnaire measures was administered at baseline (Time 1:T1) and six months later (Time 2: T2). Participants were recruited from three endocrinology clinics in Malaysia. The measures included self-care practices (diet, insulin intake, exercise and self-blood glucose monitoring: SMBG), health beliefs and diabetes knowledge. Participants’ glycaemic control was examined based on their glycated hemoglobin (HbA1c) results. Data analysis was performed at different points of the study times; T1, T1-T2 and T2. Diabetes knowledge and demographic data were controlled for in predictive statistical analyses. A total of 159 patients with insulin-treated diabetes (aged 18-40 years) completed the measures at T1. Of these, only 108 (67.9%) completed follow-up measures at T2. However, demographic characteristics were not significantly different between those who completed and dropped out of the study (p>0.05). The HBM was significantly predictive of diet self-care at T2, insulin intake practice at T1 and HbA1c at T1-T2 andT2. Of the HBM constructs, perceived benefits significantly predicted good dietary habits at T1 (OR 1.92) and T2 (OR .23) and adherence to insulin injection at T1 (OR 3.17) and T1-T2 (OR 2.68). With the exception of perceived severity, all other HBM constructs significantly predicted HbA1c [perceived susceptibility (β .169) at T1, perceived barriers (β -.206) and perceived benefits (β -.397) at T2 and cues to action (β -.233) at T1-T2]. Health beliefs predict self-care practices and glycaemic control in young to middle-aged adults with insulin-treated diabetes in Malaysia. Diabetes educators could use this knowledge in their efforts to improve diabetes self-care in this patient groupby modifying those beliefs through their diabetes education.
Insulin-treated diabetes ; health beliefs ; Health Belief Model ; longitudinal design ; self-care ; diet ; exercise ; insulin adherence ; self-monitoring blood glucose ; glycaemic control.

Pain is normally treated with oral nonsteroidal anti-inflammatory agents and opioids. These drugs are dangerous and are responsible for many hospitalizations and deaths. It is much safer to use topical preparations made from plants to treat pain, even severe pain. Topical preparations must contain compounds that penetrate the skin, inhibit pain receptors such as transient receptor potential cation channels and cyclooxygenase-2, to relieve pain. Inhibition of pain in the skin disrupts the pain cycle and avoids exposure of internal organs to large amounts of toxic compounds. Use of topical pain relievers has the potential to save many lives, decrease medical costs and improve therapy.

Sulconazole has been reported to degrade into sulconazole sulfoxide via sulfur oxidation; however, structural characterization data was lacking and the potential formation of an N-oxide or sulfone could not be excluded. To clarify the degradation pathways and incorporate the impurity profile of sulconazole into the United States Pharmacopeia–National Formulary (USP–NF) monographs, a multifaceted approach was utilized to confirm the identity of the degradant. The approach combines stress testing of sulco-nazole nitrate, chemical synthesis of the degradant via a hydrogen peroxide-mediated oxidation reaction, semi-preparative HPLC purification, and structural elucidation by LC―MS/MS and NMR spectroscopy. Structural determination was primarily based on the comparison of spectroscopic data of sulconazole and the oxidative degradant. The mass spectrometric data have revealed a McLafferty-type rearrange-ment as the characteristic fragmentation pathway for alkyl sulfoxides with aβ-hydrogen atom, and was used to distinguish the sulfoxide from N-oxide or sulfone derivatives. Moreover, the generated sulco-nazole sulfoxide was utilized as reference material for compendial procedure development and valida-tion, which provides support for USP monograph modernization.

The present study was conducted to examine the morphology and antigenicity of Photobacterium damselae subsp. piscicida by culturing the bacterium in vivo in the peritoneal cavity of sea bass (Dicentrarchus labrax) within dialysis bags with either a low molecular weight (LMW) cut-off of 25 kDa or a high molecular weight (HMW) cut-off of 300 kDa. Differences were observed in the growth rate between the bacteria cultured in vivo or in vitro. Bacteria cultured in vivo were smaller and produced a capsular layer, which was more prominent in bacteria cultured in the HMW bag. Antigenicity was examined by Western blot analysis using sera from sea bass injected with live Ph. d. subsp. piscicida. The sera recognised bands at 45 and 20 kDa in bacteria cultured in vivo in the LMW bag. Bacteria cultured in vivo in the HMW bag did not express the 45 kDa band when whole cell extracts were examined, although the antigen was present in their extracellular products. In addition, these bacteria had a band at 18 kDa rather than 20 kDa. Differences in glycoprotein were also evident between bacteria cultured in vitro and in vivo. Bacteria cultured in vitro in LMW and HMW bags displayed a single 26 kDa band. Bacteria cultured in the LMW bag in vivo displayed bands at 26 and 27 kDa, while bacteria cultured in vivo in the HMW bag possessed only the 27 kDa band. These bands may represent sialic acid. The significance of the changes observed in the bacterium's structure and antigenicity when cultured in vivo is discussed.
Animals ; Antigenic Variation/*genetics ; Antigens, Bacterial/genetics/*immunology ; Bass/*immunology/microbiology ; Blotting, Western ; Carbohydrates/analysis ; Electrophoresis, Polyacrylamide Gel ; Membranes, Artificial ; Microscopy, Electron, Transmission ; N-Acetylneuraminic Acid/genetics/*immunology ; Photobacterium/genetics/*immunology/ultrastructure

The antigenicity of Photobacterium damselae (Ph. d.)subsp. piscicida, cultured in four different growth media[tryptone soya broth (TSB), glucose-rich medium (GRM),iron-depleted TSB (TSB+IR-), and iron-depleted GRM(GRM+IR-)] was compared by enzyme-linked immuno-sorbent assay (ELISA) and Western blot analysis usingsera obtained from sea bass (Dicentrarchus labrax) raisedagainst live or heat-killed Ph. d. subsp. piscicida. Theantigenic expression of Ph. d. subsp. piscicida was found todiffer depending on the culture medium used. A significantlyhigher antibody response was obtained with iron-depletedbacteria by ELISA compared with non-iron depletedbacteria obtained from the sera of sea bass raised againstlive Ph. d. subsp. piscicida. The sera from sea bass raisedagainst live bacteria showed a band at 22kDa in bacteriacultured in TSB+IR- or GRM+IR- when bacteria thathad been freshly isolated from fish were used for thescreening, while bands at 24 and 47kDa were observedwith bacteria cultured in TSB or GRM. When bacteriawere passaged several times on tryptic soya agar prior toculturing in the four different media, only bands at 24 and47kDa were recognized, regardless of the medium used toculture the bacteria. It would appear that the molecularweight of Ph. d. subsp. piscicida antigens change in thepresence of iron restriction, and sera from sea bassinfected with live bacteria are able to detect epitopes onthe antigens after this shift in molecular weight.
Animals ; Antibodies, Bacterial/blood ; Antigens, Bacterial/immunology/*metabolism ; Bass/blood/*immunology ; Blotting, Western/veterinary ; Cell Count/methods ; Culture Media ; Enzyme-Linked Immunosorbent Assay/veterinary ; Fish Diseases/immunology/*microbiology ; Molecular Weight ; Pasteurella Infections/immunology/microbiology/*veterinary ; Photobacterium/*immunology

OBJECTIVETo evaluate the feature of experimental endplate fracture in lumbar spine and its related factors.

METHODSNineteen cadaveric lumbar motion segments aged 48 - 77 years were compressed by overload to fracture the endplate and dissected into isolated vertebrae to evaluate feature of their endplate failure. Before and after failure of endplate, radiographic tests were taken on every motion segment. The bone mineral density (BMD), bone mineral content (BMC) of the vertebral body and endplate were tested respectively before endplate fracture.

RESULTSAmong 19 motion segments, 16 were fractured and accounted for 84.2% of all and fracture featured as stellate, step, depression and intrusion. Fracture concentrated on the center or anterior of superior endplate of the inferior vertebrae in one motion segment. Failure load of endplate was positively correlated with BMD, BMC of vertebral endplate. Within one vertebral body, the BMD and BMC of its superior endplate was markedly less than that of inferior endplate, on the other hand, the difference of BMD and BMC of endplate around one disc was opposite.

CONCLUSIONSFractures usually concentrate on the center or anterior part of superior endplate of one vertebrae and are hard to be identified by conventional radiographic examination. Failure load of endplate is positively correlated with BMD, BMC of vertebral body and endplate. There might be certain relationship between feature of fracture and severity of disc degeneration.

Aged ; Bone Density ; Cadaver ; Female ; Fractures, Stress ; diagnostic imaging ; pathology ; Humans ; Intervertebral Disc ; diagnostic imaging ; pathology ; Lumbar Vertebrae ; diagnostic imaging ; injuries ; pathology ; Male ; Middle Aged ; Radiography ; Spinal Fractures ; diagnostic imaging ; pathology

Neuropathic pain is a common and very prevalent disorder affecting the citizens of both developed and developing countries. The approved and licensed drugs for neuropathic pain are reported to have associated side effects. Traditional plant treatments have been used throughout the world for the treatment of neuropathic pain. Among the many medications and other alternative medicines, several herbs are known to cure and control neuropathic pain with no side effects. The present paper discusses the plants with neuropathic pain and related beneficial effects originating from different parts of world that are of current interest.
Animals ; Humans ; Neuralgia ; drug therapy ; Phytotherapy ; Plant Extracts ; therapeutic use ; Plants, Medicinal ; chemistry

BACKGROUND: When critically ill patients require specialized treatment that exceeds the capability of the index hospitals, patients are frequently transferred to a tertiary or quaternary hospital for a higher level of care. Therefore, appropriate and efficient care for patients during the process of transport between two hospitals (interfacility transfer) is an essential part of patient care. While medical adverse events may occur during the interfacility transfer process, there have not been evidence-based guidelines regarding the equipment or the practice for patient care during transport. METHODS: We conducted searches from the PubMed, Cumulative Index of Nursing and Allied Health (CINAHL), and Scopus databases up to June 2022. Two reviewers independently screened the titles and abstracts for eligibility. Studies that were not in the English language and did not involve critically ill patients were excluded. RESULTS: The search identified 75 articles, and we included 48 studies for our narrative review. Most studies were observational studies. CONCLUSION: The review provided the current evidence-based management of diverse disease states during the interfacility transfer process, such as proning positioning for respiratory failure, extracorporeal membrane oxygenation (ECMO), obstetric emergencies, and hypertensive emergencies (aortic dissection and spontaneous intracranial hemorrhage).

Chronic Painful Temporomandibular Disorders (TMD) are challenging to diagnose and manage due to their complexity and lack of understanding of brain mechanism. In the past few decades' neural mechanisms of pain regulation and perception have been clarified by neuroimaging research. Advances in the neuroimaging have bridged the gap between brain activity and the subjective experience of pain. Neuroimaging has also made strides toward separating the neural mechanisms underlying the chronic painful TMD. Recently, Artificial Intelligence (AI) is transforming various sectors by automating tasks that previously required humans' intelligence to complete. AI has started to contribute to the recognition, assessment, and understanding of painful TMD. The application of AI and neuroimaging in understanding the pathophysiology and diagnosis of chronic painful TMD are still in its early stages. The objective of the present review is to identify the contemporary neuroimaging approaches such as structural, functional, and molecular techniques that have been used to investigate the brain of chronic painful TMD individuals. Furthermore, this review guides practitioners on relevant aspects of AI and how AI and neuroimaging methods can revolutionize our understanding on the mechanisms of painful TMD and aid in both diagnosis and management to enhance patient outcomes.
Humans ; Facial Pain/diagnostic imaging* ; Artificial Intelligence ; Temporomandibular Joint Disorders/diagnostic imaging* ; Neuroimaging/methods* ; Pain Measurement/methods*