Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Lower Extremity ; physiopathology ; Male ; Middle Aged ; Muscle Spasticity ; etiology ; therapy ; Paralysis ; etiology ; therapy ; Stroke ; complications

Sepsis is a frequent condition with high mortality,and its early diagnosis in the pediatrics department is one of the keys to improve survival. C-reactive protein and procalcitonin have been used as bio-markers in the diagnosis of sepsis,but they have limited susceptibility and specificity,and can be elevated in non inflammatory condition. Presepsin is the free fragment of a glycoprotein expressed on monocytes/macro-phages. Preliminiary reports suggest that levels of presepsin are significantly higher in septic patients com-pared to healthy individuals, and presepsin is useful for evaluating the severity of sepsis.

Objective To identify hot research areas of nursing human caring in PubMed from 2012 to 2016, and to explore the present research status and development directions. Methods PubMed was searched using key words human caring. BICOMB 2.0 and SPSS 11.5 software were used to analyze high-frequency keywords and conduct co-word clustering analysis. Results We searched for 3088 related articles and extracted 42 high-frequency keywords (30.97%). Seven hot research areas were identified,including:human caring in nursing practice;nursing models,nursing theories;nursing education of human caring;hospice care;relationship between human caring and nurse-patient relation;human caring of cancer patients;family system,social support and human caring. Conclusion Analysis of research areas of nursing human caring in past 5 years is beneficial to understanding the present research status and development directions,and providing references for practice,research and education of human caring.

This study was aimed to investigate the effect of visceral pain and water metabolism on irritable bowel syndrome with diarrhea (IBS-D) model rats by moxibustion and its products. A total of 40 SD rats were randomly di-vided into the normal group, model group, moxibustion group, non-smoke moxibustion group, and moxa smoke group. IBS-D model was induced by colorectal distension with an inflatable balloon. The general condition of rats was ob-served. Visceral pain was assessed by abdominal withdrawal reflex (AWR) scores. The immunohistochemical method was used in the detection of claudin-1, AQP3, AQP8 and Na+/K+-ATPase protein expression. The results showed that compared with the normal group, the AWR scores, claudin-1, AQP3, AQP8 and Na+/K+-ATPase protein expres-sion in the colon were decreased in the model group (P < 0.01). The stool was loose, which was on hair around the anus. After moxibustion, non-smoke moxibustion and moxa smoke stimulation, the stool conditions of IBS-D model rats were improved. The AWR scores were decreased in different degrees (P < 0.05 or P < 0.01). Except Na+/K+-ATPase, expressions of claudin-1, AQP3 and AQP8 in colon were increased in different degrees (P < 0.05 or P <0.01). The comprehensive therapeutic effect showed that moxibustion was better than non-smoke moxibustion; and non-smoke moxibustion was better than moxa smoke stimulation. It was concluded that the combination of warm stimulation, optical radiation and moxa smoke induced best effect in improving visceral pain and water metabolism on IBS-D model rats. Among them, warm stimulation and optical radiation may play the main role.

Objective: To observe the efficacy of electroacupuncture (EA) in treating dry eye syndromes (DES) and its regulatory effects on patient's quality of life (QOL), anxiety, and depression.Methods: By following a randomized controlled study design, eligible DES patients were allocated to an EA group (EAG) or an acupuncture group (AG). Patients in the AG were intervened by acupuncture alone, while in the EAG, electrical stimulation was applied to Cuanzhu (BL2) and Taiyang (EX-HN5) in addition to the same treatment in the AG. Changes in clinical manifestations, ocular surface disease index (OSDI), Schirmer tear test-1 (STT-1), tear-film break-up time (TF-BUT), cornea fluorescein staining (CFS), and corneal sensitivity (CS) were observed, as well as changes in the short-form 36-item health survey (SF-36) and hospital anxiety and depression scale (HADS) scores. Results: The scores of clinical symptoms, OSDI, and CFS decreased significantly in both EAG and AG when compared with the baseline values (P<0.05), respectively, while the TF-BUT and CS increased significantly (P<0.05), and the tear secretion of patients in the EAG increased (P<0.05). Compared with those before treatment, the scores of physical role functioning, general health perception, emotional role functioning, and mental health of patients in both EAG and AG showed significant increases after treatment (P<0.05), together with a marked decrease in the score of anxiety (P<0.05). Compared with the AG, the EAG obtained a more significant increase in STT-1 (P<0.05).Conclusion: DES patients respond well to both EA and acupuncture treatments, manifested by prolonged TF-BUT and improvement of CS. Meanwhile, the two approaches can improve QOL and reduce anxiety. Furthermore, EA appears more effective in increasing tear secretion than acupuncture alone.

Sepsis-associated encephalopathy (SAE) is the most common neurological complication of sepsis, with an incidence of up to 70% in sepsis, and contributes to the increased mortality and disability in sepsis. To date, the exact pathogenesis of SAE is not clear. Most of current researches indicated that blood-brain barrier (BBB) dysfunction, active neuroinflammation, glial cell over activation as well as cerebral microcirculation dysfunction contributed to the pathophysiology of SAE. BBB, as a complex cellular structure between the central nervous system and the peripheral system, strictly controls the entrance and discharge of substances and plays an important role in maintaining the balance between biochemical system and immune system of central system. During the progress of sepsis, inflammatory cytokines and reactive oxygen species resulting from peripheral system directly or indirectly resulted in the damage to the integrity and structure of BBB, which helped above species easily enter into the central system. Above these damages caused glial cell activation (microglia and astrocyte), the imbalance of neurotransmitters, mitochondrial dysfunction and neural apoptosis, which also reversely contributed to the damage to the integrity and permeability of BBB via decreasing the expression of tight junctional protein between cells. Therefore, this review focuses on the structural and functional changes of BBB in SAE, and how these changes lead to the development of SAE, in order to seek a BBB-targeted therapy for SAE.

Objective To evaluate the efficacy and safety of nemonoxacin as a combination drug in the treatment of patients with adult community acquired pneumonia (CAP) in the Department of Respiratory. Methods The data of patients with CAP treated with nemonoxacin as an agent in a combined therapy and admitted to Department of Respiratory of Shengjing Hospital of China Medical University from July to October 2018 were retrospectively analyzed. The patients' symptoms, curative effects and adverse reactions were recorded. Results Totally 48 patients with CAP were treated with combined nemonoxacin, including 6 patients with severe pneumonia. All the patients were treated with intravenous drip of β-lactams combined with oral nemonoxacin 500 mg, once a day. After 3 days of treatment, the improvement rate of symptoms was 47.92% (23/48), and 89.58% (43/48) of the patients were cured or improved after (9.83±3.49) days of treatment, no adverse reactions occurred during the period of oral administration;91.67% (44/48) of the patients were satisfied with the effect of medication. Compared with 178 CAP patients who were hospitalized in Department of Respiratory in the same period in 2017, the patients' length of stay in hospital in the present study was shorter (days: 12.52±4.45 vs. 14.53±6.73, P < 0.05). Conclusion As a combination drug, nemonoxacin is a safe and effective treatment for CAP patients admitted to Department of Respiratory, it can better control symptoms, shorten hospitalization time, induce less adverse reactions and its patients' tolerance is good.

Objective To explore the curative effect of the microsurgical excision and spinous process and vertebral plate complex orthotopic replantation to spinal canal plasty for the treatment of spinal canal schwannoma.Methods The clinical data of 18 patients with spinal schwannomas,admitted to our hospital from September 2011 to June 2014,were analyzed retrospectively.All these 18 patients were treated by microsurgical excision and spinous process and vertebral plate complex orthotopic replantation to spinal canal plasty,and were followed up for 3-18 months (mean:10 months).After the surgery,vertebral canal MRI was adopted to evaluate the tumor,and CT three-dimensional reconstruction or X-ray of the spine was used for assessing the vertebral canal formation,and Frankel grading standard was employed to evaluate the recovery of spinal cord function.Results All tumors in 18 patients were excised with the help of a microscope,and no endorachis and nerve roots were damaged during the surgery.After the surgery,the patients showed significantly improved symptoms and signs without the leakage of cerebrospinal fluid,infection of incisional wound,tumor recurrence,spinal stenosis and spinal instability.At 3 months after the surgery,Frankel grading standard was adopted to assess the recovery of the spinal cord function,and the results showed grade D in 4 patients and grade E in 14 patients.Conclusion Microsurgical excision and spinous process and vertebral plate complex orthotopic replantation to spinal canal plasty is an effective way in treating spinal canal schwannoma as it can completely expose the tumor,maximize the excision extension and decrease the spinal cord injury;meanwhile,the spinal canal is formed well and the spine is stable after the surgery.

Objective:To compare the clinical and imaging characteristics of patients with stage I coal worker's pneumoconiosis (CWP) .Methods:All 347 cases of coal workers' pneumoconiosis diagnosed in the Third Hospital of Peking University from January 2014 to December 2018 were included in the study. According to different working posts, the subjects were divided into three categories: mining, tunneling and mixing workers. Dust exposure duration, initial dust exposure age, diagnosis age, latency, small shadow shape and lung regions distribution in X-ray chest film of different categories of CWP patients were analyzed.Results:Among the 347 patients, 216 were mining workers (62.2%) , 77 were tunneling workers (22.2%) and 54 were mixing workers (15.6%) . The dust exposure duration of mining, tunneling and mixing workers were (14.5±7.0) , (16.3±8.2) and (19.0±8.8) years, respectively. There are statistically significant differences in dust exposure duration between different categories of workers ( P<0.05) . There were no significant difference in the age of diagnosis, initial dust exposure age and the latency between different categories of workers ( P>0.05) . The X-ray films of mining, tunneling and mixing workers showed small round shadow, accounting for 50.9% (110/216) , 96.1% (74/77) and 96.3% (52/54) respectively. 48.1% (104/216) of the mining workers and 38.9% (21/54) of mixing workers, the distribution of small shadow in chest X-ray films reached middle and lower lung regions, while in the 48.1% (37/77) of the tunneling workers, the distribution of small shadow in chest X-ray films reached lower lung regions. There were differences in above indicators among workers with different categories ( P<0.05) . Conclusion:The dust exposure duration, the shape and the distribution of lung area on chest X-ray films are different in stage I CWP patients of different occupational categories.

Objective:To compare the clinical and imaging characteristics of patients with stage I coal worker's pneumoconiosis (CWP) .Methods:All 347 cases of coal workers' pneumoconiosis diagnosed in the Third Hospital of Peking University from January 2014 to December 2018 were included in the study. According to different working posts, the subjects were divided into three categories: mining, tunneling and mixing workers. Dust exposure duration, initial dust exposure age, diagnosis age, latency, small shadow shape and lung regions distribution in X-ray chest film of different categories of CWP patients were analyzed.Results:Among the 347 patients, 216 were mining workers (62.2%) , 77 were tunneling workers (22.2%) and 54 were mixing workers (15.6%) . The dust exposure duration of mining, tunneling and mixing workers were (14.5±7.0) , (16.3±8.2) and (19.0±8.8) years, respectively. There are statistically significant differences in dust exposure duration between different categories of workers ( P<0.05) . There were no significant difference in the age of diagnosis, initial dust exposure age and the latency between different categories of workers ( P>0.05) . The X-ray films of mining, tunneling and mixing workers showed small round shadow, accounting for 50.9% (110/216) , 96.1% (74/77) and 96.3% (52/54) respectively. 48.1% (104/216) of the mining workers and 38.9% (21/54) of mixing workers, the distribution of small shadow in chest X-ray films reached middle and lower lung regions, while in the 48.1% (37/77) of the tunneling workers, the distribution of small shadow in chest X-ray films reached lower lung regions. There were differences in above indicators among workers with different categories ( P<0.05) . Conclusion:The dust exposure duration, the shape and the distribution of lung area on chest X-ray films are different in stage I CWP patients of different occupational categories.