Objective:To observe the efficacy of gentle moxibustion combined with Western medicine in treating rheumatoid arthritis(RA)due to damp heat affecting bones/joints to further certificate the scientific nature of the theory that"heat pattern can be treated by moxibustion therapy". Methods:A total of 78 patients with RA due to damp heat affecting bones/joints were divided into an observation group and a control group using the random number table method,with 39 cases in each group.The control group was treated with regular Western medicine,on the basic of which the observation group was treated with additional gentle moxibustion.Patients in the observation group received gentle moxibustion therapy once a day for 8 weeks with a one-day rest every 2 weeks.The wrist circumference,wrist pain degree,skin color and temperature of the wrist,and range of dorsiflexion motion of the wrist in the two groups of patients were compared before and after treatment under the condition of safety observed. Results:The total effective rate in the observation group was 94.9%,which was higher than the result of 79.5%in the control group(P<0.05).Among the quantitative indicators of syndrome differentiation,the wrist circumference,pain degree,skin temperature,and range of dorsiflexion motion in both groups were significantly improved(P<0.01),and the improvements were more significant in the observation group than in the control group(P<0.05).The skin color of the wrist joint was improved in both groups after treatment(P<0.05),and there was no statistical significance in comparing the improvement of skin color and the occurrence of adverse reactions between the two groups(P>0.05). Conclusion:Compared with Western medicine treatment alone,the combination of gentle moxibustion and Western medicine treatment has significantly better treatment efficacy and shares high safety,which helps to prove the scientific nature of the theory that"heat pattern can be treated by moxibustion therapy".

Objective To evaluate the feasibility of developing hospital acquired pneumonia (HAP) risk warning model in critically ill patients based on genomic copy number polymorphisms (CNPs) of the genes encoding human neutrophil peptides 1-3 (DEFA1/DEFA3).Methods Seventy-seven HAP patients (group HAP) and 109 non-HAP patients of matched age and sex in intensive care unit (ICU) (group NHAP) were enrolled in the study.The genomic CNPs of DEFA1/DEFA3 was determined by realtime quantitative polymerase chain reaction after extracting DNA from peripheral blood samples.The source of patients,condition of endotracheal intubation within 24 h after admission to ICU,Acute Physiology Score,Acute Physiology and Chronic Health Evaluation Ⅱ score,Sequential Organ Failure Assessment score,mechanical ventilation time,length of hospital and ICU stay and outcomes were obtained.The predictive model was developed using logistic regression through combining DEFA1/DEFA3 copy numbers and clinical characteristics (Acute Physiology Score and source of emergency) within 24 h after admission to ICU.The receiver operating characteristic curve was used to evaluate the predictive efficacy of the model.Results The copy numbers of DEFA1/DEFA3 were significantly lower in HAP group than in NHAP group (P ＜0.05).The area under the receiver operating characteristic curve of the predictive model developed through combining the DEFA1/DEFA3 copy numbers with clinical characteristics was 0.789 (95％ CI 0.724-0.854) when the model was used for predicting HAP.Conclusion CNPs of DEFA1/DEFA3 can be used to develop the HAP risk warning model in critically ill patients.

Objective: To investigate the management knowledge and attitudes of dysphagia in stroke patients in Nanning neurology nurses, and to provide evidence for clinical knowledge training and improvement of clinical nursing quality. Methods: A total of 360 neurology nurses from 7 different levels of hospitals in Nanning were investigated for knowledge and attitudes about stroke dysphagia management. Results: The average score of management knowledge of neurological nurses was 54.52±15.51, and the average score of attitude was 45.12±3.90. There was significant difference in the knowledge score of nurses from different hospital level, ages and titles (t=-1.007, P=0.035; F=3.994, P=0.009; F=0.347, P=0.002). There was significant difference in the attitudes score of nurses from different ages and titles (t=7.435, P=0.007); 61.1% (220/360) of nurses did not learn stroke management guidelines for dysphagia; 60%(216/360) of nurses administered dysphagia were based on their own experience, 73.9%(266/360) of nurses believe that the reason for hindering their own swallowing management is the lack of relevant knowledge and skills. Conclusions Neurology nurses have a positive attitude towards stroke management of dysphagia, but lack of knowledge. Nurses with low age, low professional title and low working years have poor knowledge of management of stroke dysphagia. Nursing managers should carry out targeted training for nurses, provide more education and training opportunities to improve the knowledge and service quality of nurses with dysphagia.