Objective:To observe the effects of Yiyuan moxibustion on bladder function and antioxidant level of spinal cord tissues in rats with urinary retention after spinal cord injury (SCI); To explore the mechanism of inhibition of ferroptosis in spinal cord neurons after SCI by Yiyuan moxibustion.Methods:Wistar female rats were divided into sham-operation group, model group, and Yiyuan moxibustion group according to random number table method, with 12 rats in each group. The modified Allen′s vertical percussion method was used to construct the model of urinary retention after SCI in T10 segment. The rats in the Yiyuan moxibustion group were moxibued at the Zhongji acupoint, Guanyuan acupoint, and Shenque acupoint for 20 min per day, and the intervention was continued for 2 weeks. Urodynamic test was used to observe the degree of urinary retention in rats; HE staining was used to observe the morphological changes of the injured spinal cord tissues; transmission electron microscopy was used to observe the mitochondrial ultrastructure of the spinal cord tissues; ferric ion kit was used to detect the ferric ion content of the spinal cord tissues; ELISA was used to detect the GSH and MDA contents of the spinal cord tissues of the rats; Western blot was used to measure the relative expressions of glutathione peroxidase 4 (GPX4) and solute carrier family 7 member 11 (SLC7A11) proteins in rat spinal cord tissue.Results:Compared with the model group, the basal and leakage point pressures of the bladder, and bladder compliance were significantly reduced in the Yiyuan moxibustion group ( P<0.05); the spinal cord tissue structure was restored and mitochondrial morphology improved; the levels of iron ions and MDA in spinal cord tissue decreased ( P<0.05), while the level of GSH increased ( P<0.05), and the relative expressions of GPX4 and SLC7A11 proteins increased ( P<0.05). Conclusion:Yiyuan moxibustion can improve bladder function in rats with urinary retention after SCI, and the mechanism may involve the initiation of antioxidant defense and reduction of lipid peroxidation in spinal cord neuronal cells, thus preventing the occurrence of ferroptosis and achieving the protection of neuronal cells.

Objective To observe the effects of asiaticoside on renal fibrosis in diabetic nephropathy(DN)rats by regulating the Hippo-yes-associated protein(YAP)/transcriptional co-activator with PDZ-binding motif(TAZ)signaling pathway.Methods A DN rat model was established by feeding a high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin(STZ).The successfully modeled rats were randomly divided into model group,low-and high-dose asiaticoside groups,and high-dose asiaticoside+XMU-MP-1(Hippo-YAP/TAZ pathway activator)group,with a normal group set as control.After group intervention,blood urea nitrogen(BUN),serum creatinine(SCr),fasting blood glucose(FBG),and 24-hour urinary protein levels were measured.Hematoxylin-eosin(HE)staining was used to observe renal histopathological changes,Masson staining was used to assess renal fibrosis,and Western Blot was used to detect the protein expressions of YAP and TAZ in renal tissue.Results Compared with the normal group,the model group showed disordered renal tissue structure,enlarged and irregular cystic cavities,enlarged renal tubules with thickened basement membranes,inflammatory cell infiltration,and significant collagen deposition in the glomeruli,renal tubules,and vascular walls.The levels of FBG,BUN,SCr,24-hour urinary protein,and the protein expressions of YAP and TAZ in renal tissue were significantly increased(P＜0.05).Compared with the model group,the low-and high-dose asiaticoside groups showed significant improvement in renal tissue damage and fibrosis,with reduced levels of FBG,BUN,SCr,24-hour urinary protein,and decreased protein expressions of YAP and TAZ in renal tissue(P＜0.05).Compared with the high-dose asiaticoside group,the high-dose asiaticoside+XMU-MP-1 group showed a reversal in all the above indicators.Conclusion Asiaticoside may alleviate renal fibrosis and improve renal injury in DN rats by inhibiting the Hippo-YAP/TAZ pathway.

Objective:To develop the Care Needs Scale for Young and Middle-aged Terminally Ill Patients and test its reliability and validity, so as to provide an effective tool for evaluating the care needs of young and middle-aged terminally ill patients for medical and nursing staff.Methods:This study is a cross-sectional study. Guided by the theory of supportive care needs, an initial scale was formed through literature review, qualitative interviews, Delphi expert consultation, and pre-survey. From July to September 2022, convenience sampling was used to select 570 young and middle-aged terminally ill patients hospitalized in the Oncology Department and Hospice Care Ward of six Class Ⅲ hospitals in Tianjin as the research subject, and a questionnaire survey was conducted on the patients. The items in the scale were selected using item analysis method. The structural validity of the scale was evaluated using exploratory factor analysis and confirmatory factor analysis. The content validity of the scale was evaluated using the scale-level content validity index and the item-level content validity index. The reliability of the scale was evaluated using internal consistency coefficient and half reliability coefficient. A total of 570 questionnaires were distributed, and 565 valid questionnaires were collected, with an effective response rate of 99.12% (565/570) .Results:A total of 18 experts completed two rounds of consultation, with an expert authority coefficient of 0.890, the Kendall's W values of 0.309 and 0.417, respectively ( P<0.05). The Care Needs Scale for Young and Middle-aged Terminally Ill Patients included 6 dimensions and a total of 39 items. Exploratory factor analysis extracted 6 common factors, with a cumulative variance contribution rate of 71.515%. Confirmatory factor analysis showed that the overall model fitted well. The content validity index at the scale level was 0.942, and the content validity index at the item level was 0.833 to 1.000. The total Cronbach's α coefficient of the scale was 0.975, and the half reliability coefficient was 0.911. Conclusions:The reliability and validity of the Care Needs Scale for Young and Middle-aged Terminally Ill Patients are good, and it can be used as an evaluation tool for the care needs of young and middle-aged terminally ill patients.

The potential medicinal value of Ma bamboo (Dendrocalamus latiflorus), one of the most popular and economically important bamboo species in China, has been underestimated. In the present study, we found that D. latiflorus leaf extract (DLE) reduced fasting blood glucose levels, body weight, and low-density lipoprotein cholesterol with low liver toxicity in db/db mice. In addition, gene expression profiling was performed and pathway enrichment analysis showed that DLE affected metabolic pathways. Importantly, DLE activated the AKT signaling pathway and reduced glucose production by downregulating glucose-6-phosphatase (G6PC) and phosphoenolpyruvate carboxykinase 1 (PCK1) expression. Moreover, network pharmacology analysis identified rutin as an active component in DLE through targeting insulin growth factor 1 receptor (IGF1R), an upstream signaling transducer of AKT. Due to its hypoglycemic effects and low toxicity, DLE may be considered an adjuvant treatment option for type 2 diabetes patients.

Objective To explore the effectiveness and feasibility of internet-based structured group cognitive behavior therapy (I-GCBT) in patients with mild depressive disorder.Methods In this randomized controlled trial,based on a random number table which was generated from spss20.0,96 patients with mild depressive disorder were randomized to I-GCBT(n=64) and face-to-face group cognitive behavior therapy(GCBT,n=32).I-GCBT and GCBT patients were assessed by HAMD17,HAMA,Global Assessment of Functioning Scale,GAF and 16 Items Quick Inventory of Depressive Symptomatology-Self Report,QIDS-SR16 at baseline,4th week,8th week and 12th week.The differences between I-GCBT and GCBT were analyzed by repetitive measure analysis of variance and chi-square test.Results (1)There was no significant difference between I-GCBT and GCBT on demographics,duration of past depression history,baseline of HAMD17,GAF and QIDS-SR16,but a significantly higher HAMA seen in GCBT (t=-2.08,P=0.04).(2) The interaction of times and groups was significant in GAF (F=4.09,P＜0.01) but not in HAMD17,HAMA and QIDS-SR16 (F=0.69,P＞0.05;F=0.95,P＞0.05;F=0.64,P＞0.05).In all measurement scales,Time main effects were significant (HAMD17∶ F=32.81,P＜0.01;HAMA∶ F=20.86,P＜0.01;GAF∶ F=105.98,P＜0.01;QIDS-SR16∶ F=25.27,P＜0.01).The symptoms remission rate of the overall patients was 62％ (43/69) after 12 weeks treatment,lower in I-GCBT (57％,25/44) and higher in GCBT (72％,18/25).There was no significant difference between two groups (x2=1.57,P=0.21).(3) The overall dropout rate was 26％ during the 12-weeks treatment specifically 29％(15/51) in I-GCBT and 20％(6/30) in GCBT without significant difference in-between (x2=0.87,P=0.35).97％(58/60) patients rated the treatment as acceptable (I-GCBT∶ 97％(35/36),GCBT∶ 96％ (23/24)),and the difference of acceptability between two groups was not significant (x2=0.09,P=0.78).Conclusion The effectiveness and feasibility of I-GCBT are comparable to GCBT for mild depressive disorder.And the treatment adherence of I-GCBT seems good.

Objective To explore the effectiveness and feasibility of internet-based structured group cognitive behavior therapy (I-GCBT) in patients with mild depressive disorder.Methods In this randomized controlled trial,based on a random number table which was generated from spss20.0,96 patients with mild depressive disorder were randomized to I-GCBT(n=64) and face-to-face group cognitive behavior therapy(GCBT,n=32).I-GCBT and GCBT patients were assessed by HAMD17,HAMA,Global Assessment of Functioning Scale,GAF and 16 Items Quick Inventory of Depressive Symptomatology-Self Report,QIDS-SR16 at baseline,4th week,8th week and 12th week.The differences between I-GCBT and GCBT were analyzed by repetitive measure analysis of variance and chi-square test.Results (1)There was no significant difference between I-GCBT and GCBT on demographics,duration of past depression history,baseline of HAMD17,GAF and QIDS-SR16,but a significantly higher HAMA seen in GCBT (t=-2.08,P=0.04).(2) The interaction of times and groups was significant in GAF (F=4.09,P＜0.01) but not in HAMD17,HAMA and QIDS-SR16 (F=0.69,P＞0.05;F=0.95,P＞0.05;F=0.64,P＞0.05).In all measurement scales,Time main effects were significant (HAMD17∶ F=32.81,P＜0.01;HAMA∶ F=20.86,P＜0.01;GAF∶ F=105.98,P＜0.01;QIDS-SR16∶ F=25.27,P＜0.01).The symptoms remission rate of the overall patients was 62％ (43/69) after 12 weeks treatment,lower in I-GCBT (57％,25/44) and higher in GCBT (72％,18/25).There was no significant difference between two groups (x2=1.57,P=0.21).(3) The overall dropout rate was 26％ during the 12-weeks treatment specifically 29％(15/51) in I-GCBT and 20％(6/30) in GCBT without significant difference in-between (x2=0.87,P=0.35).97％(58/60) patients rated the treatment as acceptable (I-GCBT∶ 97％(35/36),GCBT∶ 96％ (23/24)),and the difference of acceptability between two groups was not significant (x2=0.09,P=0.78).Conclusion The effectiveness and feasibility of I-GCBT are comparable to GCBT for mild depressive disorder.And the treatment adherence of I-GCBT seems good.

Objective To explore the effect of modified meridian breathing training on the lung function of acute stroke patients. Methods Sixty acute stroke patients were randomly divided into an intervention group and a control group, each of 30. In addition to the conventional neurological treatment, the control group received routine breathing training, while the intervention group was given modified meridian breathing training by professional reha-bilitation therapists once a day for 4 weeks. Forced vital capacity ( FVC) and forced expiratory volume in one second ( FEV1) , as well as the rate of pulmonary infection were assessed before and after the treatment. Results After 4 weeks of treatment, a significant increase was observed in the average FEV1 and FVC of both groups, but the im-provement in the intervention group was significantly greater than in the control group. There were 3 lung infections ( 10％) in the intervention group, which was significantly lower than the 7 cases ( 23. 3％) in the control group. Conclusion Modified meridian breathing training can improve the lung function of acute stroke patients and reduce the incidence of lung infection.

Objective·To compare the clinical features between different subtype bipolar patients with first mania episode, and to contribute to early identification of bipolar disorder. Methods·This study was based on the database named as National Bipolar Mania Pathway Survey (BIPAS). From November 2012 to January 2013, bipolar patients from 26 mental health facilities in China were enrolled in current study. The clinical features were compared between mania patients of different subtypes, including hypomania (groupⅠ), mania without psychotic symptoms (groupⅡ), mania with psychotic symptoms (group Ⅲ) and mixed state (group Ⅳ). Results·There was significant difference in the percentage of clinical symptoms between different subtype bipolar patients with first mania episode, especially the mania and anxiety related symptoms. Group Ⅰ, Ⅲ , Ⅳ were further compared with groupⅡ, which was considered as the typical bipolar disorder. The results showed that the mania related symptoms was significantly higher in group Ⅱ, but anxiety related symptoms was significantly higher in group Ⅰ, Ⅲ, Ⅳ. Moreover, Logistic regression analysis revealed that more eloquent or humor and unusually restless could be in favor of the diagnosis of hypomania; younger and mania or hypomania as first episode might be in favor of the diagnosis of mania with psychotic symptoms; older, national minorities and unusually restless could be in favor of the diagnosis of mixed state. Conclusion·The clinical features between different subtype bipolar patients with first mania episode are various, and analysis of the clinical features can contribute to early identification of bipolar disorder.

Anesthesiology rotation is an important part in resident standardization training of surgery. However, there are many problems in the teaching process. For example, the key points of teaching is not clear, the process of teaching is not coherent, and teachers and students lack interaction. The Rotation Record is introduced in order to solve those problems. The Rotation Record effectively reflects the fundamental process and major learning point of anesthesiology department which contains three items: the usage and recording of instrument; the communication and the basic knowledge and operating skills of anesthesia. The Rotation Record can initiate learning activity, emphasize important contents, supervise and urge teaching and improve the learning effect. By introducing Rotation Record, the assessment results in the surgical residency in anesthesiology has greatly improved compared to the previous ones, and has effectively improved the teaching quality of anesthesia.

Objective To observe the effect of acupuncture combined with moxibustion on heart rate variability (HRV) in patients with post-stroke depression. Methods 120 patients were divided into control group (n=60) and treatment group (n=60). Both groups took fluoxetine and accepted acupuncture therapy, and the treatment group accepted moxibustion additionally. Hamilton Depression Rating Scale-17 (HAMD-17) and the change of HRV were compared before and after treatment. Results The score of HAMD was lower, and the reductive ratio was higher in the treatment group than in the control group (P<0.05). The standard deviation of the mean of qualified normal sinus interval (SDNN) and standard deviation of sequential five-minute R-R interval means (SDANN) increased in both groups after treatment (P< 0.05), and were higher in the treatment group than in the control group (P<0.05). The root mean square differences of successive R-R intervals (RMSSD) and percentage of differences between adjacent normal sinus intervals greater than 50 ms (PNN50) decreased in both groups after treatment (P<0.05), and were lower in the treatment group than in the control group (P<0.05). The low frequency (LF), high frequency (HF) and LF/HF were higher in both groups after treatment (P<0.05), and were higher in the treatment group than in the control group (P< 0.05). Conclusion Acupuncture combined with moxibustion therapy can better adjust the function of autonomic nerve and reduce depression in patients with post-stroke depression.