The contents about the central action mechanisms of needling Zusanli (ST 36) were sorted by summarizing the relevant literatures published in the past 10 years, and it was found that: by comparing acupuncture at Zusanli (ST 36), other acupoints or sham points, most studies showed that Zusanli (ST 36) had relatively specific characteristics in the brain function response; studies on the central action mechanisms of Zusanli (ST 36) were mainly focused on sequelae of cerebral apoplexy, pain, gastrointestinal diseases, weight loss and drug addiction withdrawal and so on; acupuncture manipulations, stimulation methods, individual differences, stimulation quantity, and stimulation duration, etc. could also induce different brain function responses; acupuncture at Zusanli (ST 36) had an after-working effect, also called long-term effect, but with poor repeatability. So, it was suggested that the future studies should focus on the factors that affect the clinical efficacies and experimental results, including the compatibility effects of the acupoints, reproducibility of research results, sample size, acupuncture methods, long-term effects and disease entities.

Objective: To observe the influence of Nie-pinching the spine manipulation on the excretory rate of urine D-xylose in the infants with diarrhea due to spleen deficiency, and to assess the clinical effects. Methods:Sixty infants in conformity with the diagnostic criteria of diarrhea due to spleen deficiency were randomly divided into a treatment group and a control group by the random digital table, 30 cases in each group. The infants in the treatment group were treated by Nie-pinching the spine manipulation and traditional infantile tuina, in addition to the routine basic treatment. The infants in the control group were treated by the same traditional infantile tuina in addition to the routine basic treatment. The infants in the two groups were treated once every day, 4 weeks as a course. Totally, the treatment was given for a course. The symptom integrals of spleen deficiency were used to assess the improvement in the symptoms. The colorimetry was used to determine the excretory rate of urine D-xylose. Results:In the comparison of the same group before and after the treatment, the differences in the global score of spleen deficiency symptoms and the excretory rate of urine D-xylose in the two groups were statistically significant (allP<0.01). After the treatment, the differences in the global score of spleen deficiency symptoms and the excretory rate of urine D-xylose between the two groups were all statistically significant (bothP<0.01). Conclusion:Chiropractics can reduce the integrals of spleen deficiency symptoms and elevate the excretory rate of urine D-xylose in the infants with diarrhea due to spleen deficiency, so as to enhance the therapeutic effects by alleviating the symptoms of spleen deficiency and the absorptive function of the small intestine.

Objective:To observe the effect of large pushing Tianheshui manipulation intervention on the body temperature of young rabbits with endotoxin-induced fever and discuss its antipyretic mechanism.Methods:Thirty-two young rabbits meeting the standards were selected from 40 ordinary young male New Zealand rabbits after being adapted for 7 d,and randomly divided into a normal group,a model group,a large pushing Tianheshui group,and an ibuprofen group according to the random number table method,with 8 rabbits in each group.Rabbits in the model group,the large pushing Tianheshui group,and the ibuprofen group were subjected to preparing the endotoxin-induced fever model by intravenous lipopolysaccharide from the marginal ear vein.Rabbits in the large pushing Tianheshui group received Tuina(Chinese therapeutic massage)manipulation intervention 1.5 h and 2.5 h after modeling,respectively.Rabbits in the ibuprofen group were intragastrically given ibuprofen suspension 1.5 h after modeling.The dynamic changes in body temperature were observed for the young rabbits after fever modeling.Enzyme-linked immunosorbent assay was used to determine the content changes in positive mediators of hypothalamic body temperature,including prostaglandin(PG)E2 and cyclic adenosine monophosphate(cAMP),as well as negative mediators of hypothalamic body temperature,including arginine vasopressin(AVP)and α-melanocyte stimulating hormone(α-MSH).Results:The body temperature of the young rabbits in the model group was significantly higher than that in the normal group at 0.5-4.0 h,5.0 h,and 5.5 h after modeling(P＜0.01),showing two obvious fever peaks in the model group at 1.5 h and 3.0 h after modeling,respectively,with the highest peak at 1.5 h.Compared with the model group,body temperatures of the large pushing Tianheshui group and the ibuprofen group decreased significantly after 0.5 h of intervention(P＜0.05).Compared with the normal group,the contents of PGE2 and cAMP were significantly increased(P＜0.05),and the contents of AVP and α-MSH were significantly decreased(P＜0.01)in the hypothalamus of the model group.Compared with the model group,the contents of PGE2 and cAMP were significantly decreased(P＜0.01),and the levels of AVP and α-MSH were significantly increased(P＜0.01)in the hypothalamus in the large pushing Tianheshui group and the ibuprofen group.There were no significant differences in the PGE2,cAMP,AVP,and α-MSH contents in the hypothalamus between the ibuprofen group and the large pushing Tianheshui group(P＞0.05).Conclusion:Large pushing Tianheshui manipulation has a significant antipyretic effect on endotoxin-induced fever in young rabbits.The mechanism may be related to inhibiting the positive regulators(PGE2 and cAMP)and promoting the negative regulators(AVP and α-MSH)of hypothalamic control of body temperature.

Objective:To explore the application effect of clinical nursing pathway based on enhanced recovery after surgery (ERAS) concept in perioperative nursing of gastric cancer in the elderly, so as to provide basis for the selection of clinical nursing plan.Methods:A total of 92 patients with gastric cancer who underwent surgical treatment in Hefei Second People′s Hospital from January 2018 to July 2020 were enrolled. They were divided into the observation group and the control group by random number table method, 46 cases in each group. The control group was given routine nursing intervention, while the observation group was given clinical nursing pathway based on ERAS concept for intervention. The postoperative recovery, improvement of nutritional indexes, postoperative complications were compared between the two groups.Results:The first bowel sound time, first exhaust time, first defecation time, leaving bed time, indwelling time of urinary catheter, and postoperative hospitalization time were (18.43 ± 1.80) h, (43.67 ± 8.79) h, (53.06 ± 5.18) h, (22.65 ± 4.95) h, (29.08 ± 2.69) h, (13.93 ± 2.19) d in the observation group, while (22.96 ± 2.24) h, (47.98 ± 8.46) h, (57.97 ± 5.65) h, (31.30 ± 5.73) h, (35.40 ± 3.66) h, (15.48 ± 2.40) d in the control group, there were significant differences between the two groups ( t values were 2.40-10.69, all P<0.05). There was no significant difference in the nutritional indexes before intervention between the two groups( P>0.05). After intervention, the levels of serum total protein, serum albumin and hemoglobin were (64.43 ± 6.22), (35.43 ± 3.07), (125.88 ± 4.75) g/L in the observation group, while (55.97 ± 5.25), (29.96 ± 2.64), (120.05 ± 5.07) g/L in the control group, there were significant differences between the two groups ( t=7.05, 9.16, 5.69, all P<0.05). The incidence of postoperative complications was 4.35%(2/46) in the observation group, 19.57%(9/46) in the control group, there was significant difference between the two groups ( χ2=5.06, P<0.05). Conclusions:The clinical nursing pathway based on ERAS concept can effectively ensure the nutrition needed by patients with gastric cancer during postoperative rehabilitation, accelerate rehabilitation process, and reduce the incidence of postoperative complications.

Objective:To investigate the effects of preoperative oral high glucose solution on postoperative recovery, homeostasis model assessment-insulinresistance and high sensitivity C-reactive protein level in patients with gastric cancer.Methods:A total of 83 patients with gastric cancer diagnosed and treated in Hefei Hospital of Anhui Medical University from Jan. 2018 to Jun. 2020 were selected and divided into study group (42 cases) and control group (41 cases) according to whether or not they were given oral glucose solution before operation. In the first 4 hours, 500 ml of 10% glucose solution (glucose solution, GS) was taken orally, and the control group did not take it before surgery. The postoperative recovery (time of first exhaust after operation, time of first defecation, length of hospitalization after operation) , postoperative complications, HOMA-IR and serum hsCRP levels between the two groups were observed and compared.Results:The two groups had very small differences in general information such as gender, age, BMI, TNM staging, and surgical methods ( P>0.05) . In comparison of HOMA-IR index, before treatment, the difference of HOMA-IR index between the two groups was small ( P>0.05) ; after treatment, the difference of HOMA-IR index between the two groups increased (1.80±0.45 vs 5.65±1.46 for the study group before and after treatment, 1.92±0.43 vs 11.70±3.05 for the control group before and after treatment) , and the HOMA-IR index of the control group was higher than that of the study group ( P<0.05) . In comparison of hsCRP levels, before treatment, there was little difference in hsCRP levels between the two groups ( P>0.05) ; after treatment, hsCRP levels in the two groups increased (1.23±0.90 vs 40.40±27.05 for the study group before and after treatment, and 1.40±1.15 vs 80.05±38.85 for the control group before and after treatment) , and the hsCRP level of the control group was higher than that of the study group ( P<0.05) . In terms of postoperative recovery, the study group’s first exhaust time, first defecation time, and postoperative hospital stay were significantly shorter than those of the control group [ (3.35±0.50, 4.05±0.50, 14.65±1.90) vs (4.30±0.90, 5.70±1.15, 16.15±2.05) , P<0.05]. In comparison with postoperative complications, the total incidence of postoperative gastric bleeding, anastomotic leakage, intestinal obstruction, and other complications was 11.9% for the study group and the total incidence of complications was 14.63% in the control group ( P>0.05) . Conclusions:After operation, oral GS can reduce insulin resistance and inflammation in patients with gastric cancer. It has positive significance to promote postoperative rehabilitation.

OBJECTIVETo investigate the effect difference between acupuncture and moxibustion for functional dyspepsia (FD).

METHODSSixty patients with FD were randomized into an acupuncture group (29 cases with 1 rejecting) and a moxibustion group (27 cases with 3 dropping). The corresponding manipulations for 4 courses were applied at Zhongwan (CV 12) and Zusanli (ST 36) in the two groups, continuous 5 times as 1 course with 2 days between two courses, once a day and total 20 times. Leed's dyspepsia questionnaire (LDQ) and Nepean dyspepsia index (NDI) were tested before and after treatment, and safety was evaluated.

RESULTSAfter treatment, the total LDQ scores decreased in the two groups (both<0.01), with statistical different value between the two groups (<0.05). Upper abdominal pain, early satiety, epigastric burning in the acupuncture group were improved more obviously compared with those in the moxibustion group (all<0.01). The NDI scores in the two groups increased after treatment (both<0.01), without statistical different value before and after treatment (>0.05).

CONCLUSIONAcupuncture and moxibustion are effective for FD and acupuncture shows superiority.

The "flipped classroom" teaching model practiced in the teaching ofcurriculum was introduced. Firstly, the roles and responsibilities of teachers were clarified, indicating teachers provided examples and lectures, and a comprehensive assessment system was established. Secondly, the "flipped classroom" teaching model was split into online learning, classroom learning and offline learning. Online learning aimed at forming a study report by a wide search of relevant information, which was submitted to teachers for review and assessment. Classroom learning was designed to communicate study ideas among students and teachers. Offline learning was intended to revise and improve the study report and refined learning methods. Lastly, the teaching practice effects of "flip classroom" were evaluated by comprehensive rating and questionnaire assessment, which assessed the overall performance of students and overall levels of paper; the learning ability was enhanced, and the interest and motivation of learning were also improved. Therefore, "flipped classroom" teaching mode was suitable for the curriculum of, and could be recommended into the teaching practice of related curriculum of acupuncture and tuina.