This article was to elucidate that the needling depth is closely related to the meridian qi, disease location, disease nature and needled area based on the records of needling depth in Nei Jing (Canon of Internal Medicine). Moreover, different depths will produce different therapeutic efficacies;meanwhile, improper depth may lead to grave consequences.

Objective:To explore the current status and influencing factors of core competence of clinical nurses in national poverty country hospitals in Linfen, Shanxi Province, so as to provide a basis for nursing managers to establish the nurses training program.Methods:From November 1 to November 30, 2018, we selected clinical registered nurses in three national poverty country hospitals (A、B、C) in Linfen, Shanxi Province, as subjects by convenience sampling. The self-designed General Information Questionnaire and Competency Inventory for Registered Nurse Scale (CIRN) were used to investigate the core competence of clinical nurses. Data analysis was carried out with the one-way ANOVA and multiple linear regression. A total of 156 questionnaires were collected and 130 of them were valid with 83.3% for the valid rate.Results:Among 130 clinical nurses in national poverty country hospitals in Linfen, Shanxi Province, the total score of core competence was (131.20±31.61) with a minimum of 33 and a maximum of 212. Univariate analysis showed that in terms of hospital factors, dimension scores of critical thinking and scientific research, clinical nursing, education and consultation and the total score of core competence of B hospital were higher than those of A hospital; dimension scores of critical thinking and scientific research, education and consultation of C hospital were higher than those of A hospital; those differences were statistical differences ( P<0.05) . In the respect of employment mode factors, dimension scores and total score of core competence of temporary workers were lower than those of formal recruitment and contract workers; dimension scores of critical thinking and scientific research, interpersonal relationship, law and ethical practice as well as the total score of core competence of formal recruitment nurses were lower than those of contract nurses with statistical differences ( P<0.05) . In terms of department factors, the score of professional development dimension of Pediatric Ward was lower than those of other wards except for Internal Medical Ward with statistical differences ( P<0.05) . Multivariate regression analysis showed that two influencing factors, the employment mode and department, entered the regression equation of total score of core competence of nurses which could explain 22.5% of the total variation. Conclusions:Clinical nurses of national poverty country hospitals in Linfen in Shanxi Province have the intermediate level of core competence and are competent at nursing work which are affected by the hospital, employment mode and department in varying degrees. Nursing managers should pay more attention to core competence training of nurses, update and perfect training program so as to improve core competence of nurses.

OBJECTIVETo observe the regulatory effects of acupoint electric stimulation on the analgesic substances and the relevant indices of nerve-immunity-endocrine system in the patients undergoing general anesthesia anorectal operation.

METHODSOne hundred and fifty-six patients undergoing hemorrhoids and anal fistula operation were randomized into three groups, 146 cases were included in the analysis. In the No.1 group (48 cases), the conventional intravenous general anesthesia was applied. In the No.2 group (50 cases), besides the conventional intravenous general anesthesia, the acupoint transcutaneous electric stimulation was combined at Neiguan (PC 6), Shenmen (HT 7), Shangliao (BL 31) and Ciliao (BL 32). operation in the No.2 and No.3 groups were lower apparently than that in the No.1 group (<0.05,<0.01).

CONCLUSIONSDuring the general anesthesia anorectal operation, the acupoint transcutaneous electric stimulation achieves analgesic anesthesia through effectively promoting the release of body analgesic substance and reducing the stress level in the operation. With the comprehensive acupoint selection as Neiguan (PC 6) and Shenmen (HT 7) and the local acupoints, the therapeutic effects are better in comparison with the simple selection of local acupoints. In the No.3 group (48 cases), besides the conventional intravenous general anesthesia, the acupoint transcutaneous electric stimulation was combined at Shangliao (BL 31) and Ciliao (BL 32). The electric stimulation was maintained till the end of operation. The patients' saliva was collected 0.5 h before operation and 1 h after operation separately. The indices that reflect the body pain regulation and nerve-immune-endocrine secretion were detected, such as opiophin protein (OPI), secretory immunoglobulin A (SIgA), saliva amylase (sAA), cortisol (Cor) and tumor necrosis factor α (TNF-α). The pain degree was observed 1 h after operation.

RESULTSIn the No.2 group, OPI after operation was higher than that before operation (<0.05). The difference value of OPI in the No.2 group was higher apparently than that in the No.1 group and the No.3 group (both<0.05). SIgA after operation was higher than that before operation in the No.1 group (<0.05). The difference values of SIgA, sAA, Cor in the No.2 group were lower apparently than those in the No.1 group (<0.05,<0.01). TNF-αbefore and after operation and its difference value among the groups were not significant statistically (all>0.05). The pain degrees in 1 h after.

Objective:To investigate college students' acceptance of flipped classroom and its influencing factors, so as to provide basis and suggestions for the promotion of flipped classroom in colleges and universities.Methods:A structured quantitative questionnaire was used to investigate the learning status of 876 students in Chongqing Medical University and their cognition and acceptance of flipped classroom. The influencing factors were analyzed by multiple linear regression.Results:According to the questionnaire, 77.9% of the students did not know about flipped classroom, 32.3% of them had high acceptance to it and 62.0% of them accepted it moderately. The stronger the learning ability and motivation, the higher levels of understanding and acceptance of the flipped classroom.Conclusion:Undergraduates have a certain degree of acceptance to flipped classroom. In daily education, attention should be paid to stimulating students' learning motivation, cultivating their learning ability in various aspects, widely spreading teaching concept of flipped classroom, and actively trying the teaching mode of flipped classroom.

The coronavirus disease 2019 (COVID-19) pandemic has stimulated tremendous efforts to develop therapeutic agents that target severe acute respiratory syndrome coronavirus 2 to control viral infection. So far, a few small-molecule antiviral drugs, including nirmatrelvir-ritonavir (Paxlovid), remdesivir, and molnupiravir have been marketed for the treatment of COVID-19. Nirmatrelvir-ritonavir has been recommended by the World Health Organization as an early treatment for outpatients with mild-to-moderate COVID-19. However, the existing treatment options have limitations, and effective treatment strategies that are cost-effective and convenient for tackling COVID-19 are still needed. To date, four domestically developed oral anti-COVID-19 drugs have been granted conditional market approval in China. These drugs include azvudine, simnotrelvir-ritonavir (Xiannuoxin), leritrelvir, and mindeudesivir (VV116). Preclinical and clinical studies have explored the efficacy and tolerability of mindeudesivir and supported its early use in mild-to-moderate COVID-19 cases at high risk for progression. In this review, we discuss the most recent findings regarding the pharmacological mechanism and therapeutic effects focusing on mindeudesivir and other small-molecule antiviral agents for COVID-19. These findings will expand our understanding and highlight the potential widespread application of China's homegrown anti-COVID-19 drugs.
Humans ; Ritonavir/therapeutic use* ; COVID-19 ; Antiviral Agents/therapeutic use* ; China ; Nitriles ; Lactams ; Proline ; Adenosine/analogs & derivatives* ; Leucine

A new definition of metabolic dysfunction-associated fatty liver disease (MAFLD) has recently been proposed. We aim to examine the associations of MAFLD, particularly its discordance from non-alcoholic fatty liver disease (NAFLD), with the progression of elevated brachial-ankle pulse wave velocity (baPWV) and albuminuria in a community-based study sample in Shanghai, China. After 4.3 years of follow-up, 778 participants developed elevated baPWV and 499 developed albuminuria. In comparison with the non-MAFLD group, the multivariable adjusted odds ratio (OR) of MAFLD group for new-onset elevated baPWV was 1.25 (95% confidence interval (CI) 1.01-1.55) and 1.35 (95% CI 1.07-1.70) for albuminuria. Participants without NAFLD but diagnosed according to MAFLD definition were associated with higher risk of incident albuminuria (OR 1.77; 95% CI 1.07-2.94). Patients with MAFLD with high value of hepamet fibrosis score or poor-controlled diabetes had higher risk of elevated baPWV or albuminuria. In conclusion, MAFLD was associated with new-onset elevated baPWV and albuminuria independently of body mass index, waist circumference, and hip circumference. Individuals without NAFLD but diagnosed as MAFLD had high risk of albuminuria, supporting that MAFLD criteria would be practical for the evaluation of long-term risk of subclinical atherosclerosis among fatty liver patients.
Humans ; Pulse Wave Analysis ; Albuminuria ; Ankle Brachial Index ; Non-alcoholic Fatty Liver Disease/diagnosis* ; Vascular Stiffness ; Prospective Studies ; Risk Factors ; China/epidemiology*