BACKGROUND:Chronic visceral pain is one of major complaints of irritable bowel syndrome which seriously affects patient’s quality of life. Recent researches have shown that moxibustion therapy has positive effects on aleviating chronic visceral pain in irritable bowel syndrome patients.
OBJECTIVE: To study the clinical utility of moxibustion in coping with chronic visceral pain of irritable bowel syndrome patients, and shed light on the theoretical basis of moxibustion analgesia, thereby to give insights into the further research and application on moxibustion.
METHODS: With the key words of “moxibustion, irritable bowel syndrome, visceral pain, abdominal pain” in Chinese and in English, respectively, a computer-based search was performed in CNKI, VIP, Wanfang and PubMed databases for articles published from January 1990 to October 2014. After the initial screening, the remained articles went through further selection and categorization.
RESULTS AND CONCLUSION:The result shows promising results of moxibustion on relieving chronic visceral pain for both two subtypes of irritable bowel syndrome patients, diarrhea type and constipation type. Moxibustion may exert an analgesic effect on chronic visceral pain in irritable bowel syndrome patients through regulation of visceral hypersensitivity, gastrointestinal motility disorders, brain-gut axis and neuroendocrine system disorders, immune dysfunction and low-grade inflammation in the gut, psychological abnormalities, and alteration of intestinal flora. However, to fuly understand the analgesia effect of moxibustion and elucidate its mechanism, more standardized randomized controled trials employing advanced scientific techniques and equipments wil stil be needed in the future.

Objective:To analyze the incidence and risk factors of non-acute symptomatic portal vein thrombosis (PVT) after endoscopic gastric variceal injection (GVI) in the treatment of liver cirrhosis with gastric variceal bleeding (GVB).Methods:66 patients with GVB who were treated with GVI for the first time from July 2017 to October 2019 in Minhang Hospital Affiliated to Fudan University were retrospectively analyzed. The data of gender, age, preoperative Child-Pugh grade, preoperative platelet count, preoperative plasma D-dimer concentration, preoperative splenic length, preoperative portal vein velocity, preoperative splenic vein velocity, preoperative portal vein diameter, preoperative splenic vein diameter, treatment times, total number of injection points, total dose of sclerosing agent and tissue adhesive agent were collected. The patients were divided into PVT group and non-PVT group according to the occurrence of non-acute symptomatic PVT within one year after GVI. Univariate analysis was performed first, and then the factors with P<0.2 were included in the binary logistic regression model to screen the risk factors of PVT after GVI. Results:There were 25 cases (37.88%) in PVT group and 41 cases (62.12%) in non-PVT group. There were significant differences in D-dimer concentration, spleen length, Child-Pugh grade and total dose of sclerosing agent between the two groups ( P<0.05). The D-dimer concentration ( OR=2.319, 95% CI:1.359-3.956), spleen length ( OR=1.044, 95% CI:1.007-1.081) and total dose of sclerosing agent ( OR=1.075, 95% CI:1.004-1.152) were independent risk factors for PVT ( P<0.05). Conclusions:Preoperative D-dimer concentration, spleen length and total dose of sclerosing agent can predict the risk of PVT after GVI. In order to reduce the risk of PVT after GVI, the dose of sclerosing agent should be reduced as much as possible.

Quantum dots are an emerging semiconductor nanocrystalline material with optical and electronic properties. Quantum dots in the environment are transmitted into human body mainly via digestive system. Quantum dots in the workplace are transmitted into human body via various pathways such as the respiratory tract and mucocutaneous surface. They cross the blood brain barrier to affect the nervous system, eventually leading to irreversible damage. Quantum dots have more complex biological toxicity than ordinary nanomaterials and metal ions, due to their core-shell structure and surface modifiers. The physicochemical properties of quantum dots, such as particle size, surface modification, and charge, greatly influence their neurotoxic effects. Quantum dots can induce oxidative stress and inflammatory responses, causing neuronal damage and functional impairment, thereby affecting learning, memory, and synaptic plasticity. Its mechanisms may be the modulation of signaling pathways such as the mitogen-activated protein kinase/extracellular signal regulated kinase pathway. In the future, the neurotoxicity of different types of quantum dots should be systematically analyzed, and multi-omics methods should be used to elucidate the mechanism of quantum dots on neuronal damage to improve the safety of workers exposed to quantum dots.

Objective To explore the effects of virtual reality (VR) on skill retention and retraining time of cardiopulmonary resuscitation (CPR) among medical students.Methods From May to November 2018, we selected students majored in clinical medicine of two classes in a medical university of Guangdong Province by convenience sampling. All of them were randomly divided into two groups taking class as the unit, 30 cases in each group with CPR training by VR and scenario simulation respectively. Examination scores of CPR skills were carried out at the end of training, one and six months after training to compare achievements between two groups. Results At the end of training and one month after training, the examination scores of CPR skills of students in the VR group were (95.426±4.296) and (92.326±7.753) respectively higher than those in the scenario simulation group (t=8.204, 4.797;P<0.05). Six months after training, there was no statistical difference in the examination score between the VR group (87.054±10.323) and the scenario simulation group (81.550±9.241), (t=2.176,P>0.05).Conclusions VR training is propitious to maintain students' CPR skills and to extend the retraining time of skills which provides a new method for medical education.

Objective To investigate the knowledge,attitude and practice of nurses from hospitals in Tibet Autonomous Region on the use of peripheral venous needle and analyze the influencing factors.Methods Utilizing a convenience sampling approach,we conducted a survey from November to December 2023 involving 1 319 nurses from 62 hospitals across 7 cities(regions)of Tibet Autonomous Region.Custom-made electronic questionnaires were utilized.Results A total of 1 320 questionnaires were collected,of which 1 319 were valid,with an effective response rate of 99.92％.The scores of nurses'knowledge,attitude and practice were 46.24±13.68,79.75±10.30,and 60.38±14.15,respectively.808(61.26％)nurses had received relevant training experience.The results of multiple linear regression analysis showed that the influencing factors of nurses'knowledge of peripheral venous indwelling needle included whether they had received training experience,ethnicity,education background,professional title,department and hospital region(P＜0.05).Training experience,ethnicity,educational background,profession title and hospital region were the influence factors of nurses'attitude of venous indwelling needle(P＜0.05).Whether they had received training,ethnicity,education background,department and hospital region were the influencing factors of nurses'practice of peripheral venous indwelling needle(P＜0.05).Conclusion Nurses from hospitals in Tibet Autonomous Region have a good attitude towards using venous indwelling needle.However,the knowledge level is not ideal and the practice is still needed to be improved.Nursing managers should implement targeted training and enrich the training form and content,so as to meet the needs of nurses and to improve the quality of intravenous therapy in the Tibet Autonomous Region.

In the practice of building its humanistic environment of a research hospital,Nanjing Drum Tower hospital adheres to such humanistic characteristics of the hospital as humanistic concept,planning, environment,management,service,and quality.Furthermore,the hospital upholds such keys as learning, innovation, cooperation, undertaking, competition and development. High focus, high starting point planning,persistence,and down-to-earth efforts,effectively promoting hospital development.

Neonatal lymphatic dysplasia is a congenital maldevelopment,causing effusion of chyle or lymph into the limbs or into the pleural,pericardial or peritoneal cavities,forming chylothorax ascites or edema,resulting in immunodeficiency and malnutrition.Neonatal lymphatic dysplasia is rare in neonate,but associated with significant mortality.So far,the etiology and pathological mechanism are still unclear.Lymphoscintigraphy is a diagnostic tool in newborns to obtain early diagnosis.Octreotide has been proposed for treatment of lymphatic dysplasia recently,however,the effiency and safety remain controversial.This article is to review the update in diagnosis and treatment of neonatal lymphatic disorders.

Objective:To investigate the status and the relationship of social support, depression, personality and sleep quality in patients with malignant bone tumors and their relationship, and provide scientific basis for postoperative rehabilitation and nursing.Methods:186 patients with malignant bone tumors undergoing chemotherapy in orthopedics department of the Second Xiangya Hospital of Central South University from January 2017 to December 2019 were selected to complete the Center for Epidemiological Studies Depression Scale (CES-D), the Perceived Social Support Scale (PSSS), the Optimism-Pessimism Scale (OPS), and the Pittsburgh Sleep Quality Index (PSQI). The demographic differences of various variables were compared and the correlation among social support, personality, sleep quality and depression in patients with malignant bone tumors were tested. Then, by structural equation model, the mediating role of personality and sleep quality between social support and depression was analyzed.Results:The incidence of depression in patients with malignant bone tumors was 57.6%(107/186), and the incidence of severe depression was 14.7%(27/186). Depression in patients with malignant bone tumors was negatively correlated with scores of social support and pessimism (all P<0.01), and positively correlated with scores of optimism and sleep quality (all P<0.05); Family support, pessimism, sleep quality and daytime dysfunction can effectively predict depression in patients with malignant bone tumors (all P≤0.05); Structural equation model analysis showed that personality and sleep quality play a chain mediating role between social support and depression. Conclusions:The incidence of depression is higher in patients with malignant bone tumors. Family support, pessimism, sleep quality and daytime dysfunction are predictors of depression in patients with malignant bone tumors. Personality and sleep quality play a chain mediating role in the influence of social support on depression.

Objective:To investigate the clinical features and outcome of congenital chylothorax and chyloperitoneum ascites in infants.Methods:The clinical data of infants admitted to the Neonatal Department of Shengjing Hospital of China Medical University and diagnosed with congenital chylothorax and chyloperitoneum from January 2011 to December 2018 were analyzed retrospectively.According to outcome, the infants were assigned into survival group and death group.The clinical characteristics between the two groups were compared.Results:The total cases were 25(the ratio of male to female is 3.2). The gestational age ranged from 30 to 39 weeks, and the birth weight was 1 620 to 4 770 g. There were twenty infants were diagnosed before delivery accounted for 80%.Five infants(20%)presented with fetal edema.There were twenty-one infants were diagnosed with congenital chylothorax(84.0%, 5 with chyloperitoneum). Fourteen cases of congenital chylothorax were bilateral(66.7%), seven infants were unilateral, six infants(85.7%)were right-sided chylothorax.There four infants(16.0%)were diagnosed with chyloperitoneum.There were fifteen cases in the survival group, including eleven cases of chylothorax(73.3%), three cases of chyloperitoneum(20.0%), and one case of chylothorax combined with chyloperitoneum(6.7%). There were ten cases in the death group, all of which were premature infants, including nine cases of chylothorax and seven cases of bilateral chylothorax(70.0%). The median gestational age(33w)and birth weight(2 486 g)of the death group was significantly lower than the survival group(38w and 3 342 g), and the median gestational age when prenatal diagnosis[(30±1)weeks]was significantly lower than the survival group[(34±1)weeks]. The difference between the two groups was statistically significant( P<0.05). The proportion of mechanical ventilation in the death group was significantly higher than the survival group( P<0.05). Conclusion:The gestational age, birth weight, and the time of intrauterine diagnosis affect the outcome of congenital chylothorax and chyloperitoneum.The mortality rate is higher in premature, lower gestational age at the time of intrauterine diagnosis and bilateral chylothorax.

Objective To explore the application of quantitative EEG(QEEG)trends in the assessment of the state of brain function in patients with severe stenosis of the internal carotid artery and its predictive value for the risk of acute occlusion in the short term.Methods The clinical and imaging data of a case of severe left internal carotid stenosis were retrospectively analyzed,and QEEG trends were used for evaluating the state of brain function.Results It showed that rhythmicity spectrogram,amplitude-integrated EEG,fast Fourier transformation spectrogram and fast Fourier transform power spectrum in QEEG trends could quickly and visually display theta activity and amplitude at the side of severe internal carotid artery stenosis continued to increase compared with the healthy side hemisphere.Acute occlusion of the left internal carotid artery and large artery atherosclerotic cerebral infarction occurred in the patient after 3 days.Conclusion As a supplement to neuroimaging examination,QEEG trends may be helpful for rapidly diagnosing brain function damage in the early stage of patients with severe internal carotid artery stenosis who are under the ischemic attack state,and even have potential predictive values for patients with acute occlusion in the short term.