OBJECTIVE: To observe the effect of "Zhibian" (BL54)-toward-"Shuidao" (ST28) needling technique on the relative protein expression of the signaling pathway of nucleotide-binding oligomerization domain-containing protein 1 (NOD1)/ receptor-interacting protein 2 (RIP2)/nuclear factor kappa-B (NF-κB) and the expression of proinflammatory cytokines in the rats with primary dysmenorrhea (PD), so as to explore the underlying mechanism of this acupuncture technique for pain alleviation in PD. METHODS: Thirty female SD rats of SPF grade with normal estrous cycle were randomized into a blank group, a model group and an acupuncture group, 10 rats in each one. Using the intraperitoneal injection with estradiol benzoate combined with oxytocin, PD model was prepared in the model group and the acupuncture group. In the acupuncture group, during model preparation, the intervention with "Zhibian" (BL54)-toward-"Shuidao" (ST28) needling technique was delivered simultaneously, 20 min each time, once daily for consecutive 10 days. On day 11, within 30 min after the intraperitoneal injection with oxytocin, the writhing reaction (latency, frequency and score) was recorded; the morphology of uterine tissue was observed with HE staining, the contents of prostaglandin E₂ (PGE₂), prostaglandin F_2α (PGF_2α), interleukin (IL)-1β, IL-18, cyclooxygenase-2 (COX-2), and tumor necrosis factor-α(TNF-α) in the serum were detected using ELISA method; the relative protein expression of NOD1, RIP2, NF-κB p65, phosphorylation-NF-κB p65 (p-NF-κB p65) was detected in the uterine tissue using Western blot method; and the mRNA expression of NOD1, RIP2 and NF-κB p65 was detected with the quantitative real-time PCR employed. RESULTS: Compared with the blank group, in the model group, the writhing latency was prolonged (P<0.01), the writhing frequency and score increased (P<0.01) in the rats; the endometrial epithelial cells showed massive degeneration and necrosis, with severe endometrial edema and widespread shedding, combined with neutrophil infiltration; the serum PGE₂ content was dropped (P<0.01), while those of PGF_2α, IL-1β, IL-18, COX-2, and TNF-α elevated (P<0.01); the protein expression of NOD1, RIP2, NF-κB p65 and p-NF-κB p65, and the mRNA expression of NOD1, RIP2 and NF-κB p65 in uterine tissue increased (P<0.01). In comparison with the model group, in the acupuncture group, the writhing latency was prolonged (P<0.01), the writhing frequency and score were reduced (P<0.01) in the rats; there was less degeneration and necrosis of endometrial epithelial cells, with mild endometrial edema and very little neutrophil infiltration; the serum PGE₂ content increased (P<0.01), while those of PGF_2α, IL-1β, IL-18, COX-2, and TNF-α decreased (P<0.01); the protein expression of NOD1, RIP2, NF-κB p65 and p-NF-κB p65 and the mRNA expression of NOD1, RIP2 and NF-κB p65 in uterine tissue were dropped (P<0.05, P<0.01). CONCLUSION "Zhibian" (BL54)-toward-"Shuidao" (ST28) needling technique can alleviate the pain symptom of PD rats, and its action mechanism may be related to inhibiting the active expression of NOD1/RIP2/NF-κB signaling pathway in the uterine tissue, thereby reducing the inflammatory response.
Animals ; Female ; Rats, Sprague-Dawley ; Rats ; Signal Transduction ; Dysmenorrhea/metabolism* ; NF-kappa B/metabolism* ; Acupuncture Points ; Humans ; Acupuncture Analgesia ; Nod1 Signaling Adaptor Protein/metabolism* ; Receptor-Interacting Protein Serine-Threonine Kinase 2/metabolism* ; Acupuncture Therapy

OBJECTIVE: To explore the possible mechanism by which the "Zhibian" (BL54) toward "Shuidao" (ST28) acupuncture improves ovarian function in mice with poor ovarian response (POR) by observing its effect on gut microbiota. METHODS: A total of 35 SPF-grade C57BL/6 female mice were screened for normal estrous cycles using vaginal smears, and 30 mice were selected. Ten mice were assigned to the blank group, while the remaining mice were used to establish the POR model by intragastric administration of tripterygium wilfordii suspension. The successfully modeled mice were randomly divided into a model group and an acupuncture group, with 10 mice in each group. After modeling, the acupuncture group received the "Zhibian" (BL54) toward "Shuidao" (ST28) acupuncture method once daily for 20 minutes per session. Ovulation induction began the day after the intervention, and samples were collected after ovulation induction. Vaginal cytology was used to observe estrous cycle changes, and the number of oocytes obtained, ovarian wet weight, and ovarian index were recorded. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and anti-Müllerian hormone (AMH) were detected using ELISA. HE staining was used to observe ovarian histology. Gut microbiota was analyzed using 16S rRNA gene sequencing technology. Western blot was used to detect the relative protein expression levels of Occludin and zonula occludens-1 (ZO-1) in colonic tissue. Correlation analysis was conducted among serum hormone indexes, the number of oocytes obtained, ovarian index and gut microbiota. RESULTS: Compared with the blank group, the model group showed a higher estrous cycle disorder rate (P<0.01), increased serum FSH and LH levels, and a higher LH/FSH ratio (P<0.01), while the number of oocytes obtained, ovarian wet weight, ovarian index, and serum E2 and AMH levels were significantly reduced (P<0.01). Compared with the model group, the acupuncture group showed a lower estrous cycle disorder rate (P<0.01), decreased serum FSH and LH levels, and a lower LH/FSH ratio (P<0.01), along with an increased number of oocytes obtained, higher ovarian wet weight, ovarian index, and elevated serum AMH and E2 levels (P<0.01, P<0.05). The blank group had a large number of well-developed primordial follicles, with abundant and closely arranged follicles at various stages. In the model group, there was a significant increase in the number of atretic follicles, a reduction in the number of follicles at various stages, and loosely arranged ovarian tissue. Compared with the blank group, the model group showed a significant decrease in the number of normal follicles (P<0.01) and an increase in the number of atretic follicles (P<0.01). The acupuncture group showed a reduction in atretic follicles and an increase in the number of follicles at various stages compared with the model group, with a significant increase in normal follicles (P<0.01) and a decrease in atretic follicles (P<0.01). Compared with the blank group, the model group exhibited reduced gut microbiota diversity and richness, with significantly lower Chao1 and Shannon indices (P<0.01), and a greater clustering distance from the blank group. The model group also showed an increase in the relative abundance of Firmicutes_D, Verrucomicrobiota, Paramuribaculum, Dubosiella, and Muribaculum (P<0.01, P<0.05), while the relative abundance of Firmicutes_A and the relative protein expression of Occludin and ZO-1 in colonic tissue were decreased (P<0.01). Compared with the model group, the acupuncture group showed improved gut microbiota diversity and richness, with increased Chao1 and Shannon indices (P<0.05), and a clustering distance closer to the blank group. The acupuncture group exhibited reduced relative abundance of Firmicutes_D, Verrucomicrobiota, and Muribaculum (P<0.05, P<0.01), while the relative abundance of Firmicutes_A and the relative protein expression of Occludin and ZO-1 were significantly increased (P<0.01, P<0.05). Correlation analysis indicated a relationship between gut microbiota and serum hormone indicators, as well as the ovarian index. Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis showed that the metabolic pathways of the intersecting species were related to amino acid biosynthesis and nucleotide metabolism. CONCLUSION The "Zhibian" (BL54) toward "Shuidao" (ST28) acupuncture method improves ovarian function in POR mice, and its mechanism may be related to regulating gut microbiota structure and maintaining intestinal barrier homeostasis.
Animals ; Female ; Gastrointestinal Microbiome ; Mice ; Acupuncture Therapy ; Mice, Inbred C57BL ; Humans ; Ovary/physiopathology* ; Acupuncture Points ; Follicle Stimulating Hormone/metabolism* ; Luteinizing Hormone/metabolism* ; Estrous Cycle ; Anti-Mullerian Hormone/blood*

Artificial intelligence has been a huge success and contributes to the workplace. In the digital era, the amount of data in clinical practice is increasing, which requires healthcare workers to integrate and interpret the various information generated during clinical work. With the help of artificial intelligence techniques, especially machine learning techniques, researchers in cardiovascular medicine have developed a variety of predictive models to improve the efficiency of clinical work and treatment outcomes. The types of machine learning models were introduced, and the current prediction models of cardiovascular diseases using machine learning technology were summarized. The purpose of this paper is to facilitate accurate diagnosis of cardiovascular diseases and to provide a clearer direction for future development of cardiovascular disease prediction models using machine learning techniques.

Objective:To explore the effects of a scenario-based experiential intervention rooted in the transition shock model for the role adaptation of newly employed nurses.Methods:A convenience sampling was used to select newly employed nurses from the First Affiliated Hospital of Xinjiang Medical University between September and November 2020 were designated as the control group ( n=57) , who received standard new nurse training. Those employed between September and November 2021 formed the observation group ( n=62) , who underwent a scenario-based experiential intervention rooted in the transition shock model for three months. The degree of transition shock, psychological resilience, and turnover rates were compared between the two groups. Results:After the intervention, scores on the transition shock scale and its physical, psychological, knowledge and skills, social culture, and development dimensions in the observation group were significantly lower than those in the control group, with statistically significant differences ( P<0.05) . Scores on the Connor Davidson Resilience Scale (CD-RISC) and its tenacity, strength, and optimism dimensions in the observation group were notably higher compared to the control group, which were statistically significant ( P<0.05) . Within one year post-employment, the turnover rates for the observation group and control group were 11.29% (7/62) and 28.07% (16/57) , respectively, with a statistically significant difference ( P<0.05) . Conclusions:The scenario-based experiential intervention founded on the transition shock model can effectively alleviate the transition shocks faced by newly employed nurses. It also enhances their psychological resilience, facilitates their adaptation to new nursing roles, and reduces turnover rates.

Objective:To explore the knowledge, attitude and practice (KAP) status of ICU nurses on enteral nutrition treatment of severe acute pancreatitis and to analyze its influencing factors.Methods:A total of 520 ICU nurses from 7 ClassⅢ Grade A hospitals in Henan Province from February to April 2022 were selected as research objects by the convenient sampling method. General Data Questionnaire and Clinical Nurses' Knowledge, Attitude and Practice Questionnaire on Enteral Nutrition Treatment of Acute Pancreatitis were used to investigate.Results:A total of 520 questionnaires were sent out, and 504 were effectively collected, with an effective recovery rate of 96.92%. The total score of ICU nurses' knowledge, attitude and practice in enteral nutrition for severe acute pancreatitis was (113.68±12.48), including knowledge dimension (10.67±2.58), attitude dimension (61.60±6.38), and practice dimension (41.42±7.44). There were positive correlation among ICU nurses' scores of knowledge, attitude and practice on enteral nutrition in patients with severe acute pancreatitis ( P<0.01). The results of multiple linear regression analysis showed that professional title, length of service in ICU nursing, personnel relations, whether to participate in specialized training, and whether to care for patients with severe acute pancreatitis and enteral nutrition were the influencing factors of knowledge dimension ( P<0.05). Post, whether to participate in specialized training, and whether to care for patients with severe acute pancreatitis undergoing enteral nutrition were influencing factors of attitude dimension ( P<0.05). Gender, professional title, post, whether to participate in specialized training, and whether to care for patients with severe acute pancreatitis undergoing enteral nutrition were the influencing factors of behavioral dimensions ( P<0.05) . Conclusions:ICU nurses have a positive attitude towards enteral nutrition treatment for severe acute pancreatitis, and their knowledge attitude and practice level need to be improved. Nursing managers should establish and improve a training system, strengthen the knowledge and behavior of ICU nurses on enteral nutrition for patients with severe acute pancreatitis and improve their management level of enteral nutrition for patients with severe acute pancreatitis, thereby improving the quality of nursing.

Humans ; Pulmonary Disease, Chronic Obstructive ; Smoke/adverse effects* ; Tobacco ; Tobacco Smoke Pollution

【Objective】 To learn the production efficient of platelet components among prefecture-level blood stations in China, to provide supporting data for those blood stations to optimize the production mode of platelet components and continuously improve production efficiency and supply capacity. 【Methods】 The data from 2017 to 2020 was obtained from 24 prefecture-level blood stations who were the members of the practice comparison network for blood institutes in China. The collection units of apheresis platelets, the number of dual-collections of apheresis platelets and plasma, the average apheresis units of one platelet apheresis procedure, the discarded rate of apheresis platelets, the amount of expired apheresis platelets and the amount of apheresis platelets issued were collected. For concentrated platelets, the prepared amount of platelet concentrates and the amount of expired platelet concentrates were collected; both the quantity of qualified and issued concentrated platelets were submitted for statistical analysis.The total output and efficiency of platelet components were calculated based on the collected data. 【Results】 The average annual growth rate of apheresis platelets collection in 24 prefecture-level blood stations was 12.23%, accounting for 99.80% of the total platelet output; the average collection unit of one platelets apheresis procedure was 1.75; from 2019 to 2020, only 5 blood stations performed dual-collection of platelet and plasma during one apheresis procedure; the discarded rate of apheresis platelets was 0.28%, of which 0.007% was due to expiration. A total of 1 621.2 therapeutic units of concentrated platelets were prepared, and 13.03% of them was discarded due to the expiration. The production efficiency of platelet components was 97.56%, of which the production efficiency of apheresis platelets was 97.61% and the production efficiency of concentrated platelets was 74.43%. 【Conclusion】 There are large regional differences in the supply capacity of platelet components in prefecture-level blood stations. Apheresis platelets are the main resource of platelet components product, and the collection capacity is increasing over the years with the characteristics of high production efficiency and low expiration scrapping rate. However, the preparation of concentrated platelets are still limited with relatively low production and high expiration discarded rate.

Hegu needling is mainly used for the treatment of orthopedic and neurologic diseases, such as cervical spondylosis, third lumbar transverse process syndrome, myofasciitis, periarthritis of shoulder, and stroke sequela, which has a rapid and benefial effect in relieving pain and improving symptoms and signs. It is often combined with other treatment methods, such as point-point needling, electric needling, QI needling, SHU needling, bloodletting, stagnant needling, warm needling, ginger partitioned moxibustion, Qistimulated massage, Tuina, bonesetting and xercise therapy. Filiform needle or round sharp needle are mostly used in Hegu needling. At present, the acupoints of Hegu needling are mostly Ashi points or stimulation points, but the acupoints of the fourteen meridians are rarely selected. Hegu needling is rarely used in the treatment of gynecological and pediatric diseases. Hegu needling has certain effect on dementia, vertigo, panic attack, trigeminal neuralgia, facial paralysis, and cancer pain, but few clinical studies confirmedit.

Objective:To preliminarily understand the living habits, medication taking and treatment status including the therapeutic regimen, compliance and short-term efficacy of patients with chronic atrophic gastritis and erosion in Beijing area.Methods:From April to September in 2019 at Peking Union Medical College Hospital, Peking University Third Hospital and Peking University Shougang Hospital, the outpatients with chronic atrophic gastritis and erosion diagnosed with endoscopy within two weeks before visiting were prospectively included in this non-interventional observation study. Chi square test was used for statistical analysis.Results:A total of 277 patients with chronic atrophic gastritis and erosion had complete follow-up data, of which male patients accounted for 49.8% (138/277). The common initial symptoms of patients with chronic atrophic gastritis and erosion included acid reflux, abdominal distension, epigastric pain and postprandial distension, which accounted for 60.3% (167/277), 59.6% (165/277) , 58.8% (163/277) and 52.3% (145/277), respectively. For treatment, 36.8% (102/277) of the patients only received lifestyle instruction without medication. Among the patients with medication treatment, the short-term efficacy of gastric mucosal protectants+ proton pump inhibitor+ gastro-kinetic agent for abnominal distension, postprandial distention, acid reflux and nausea was highest as compared with other therapeutic regimen, and the differences were statistically significant ( χ2=25.18, 19.49, 13.75, 8.84, all P<0.05). Conclusions:Chronic gastritis with erosion may be caused by a combination of multiple factors, and the symptoms of which lack specific. If necessary, gastroscopy may help the diagnosis. Individualized treatment strategies based on the symptoms of patients is needed for treatment.

Mycobacterium tuberculosis(Mtb)is an intracellular bacteria that lives in the phagocytosis of host macrophages.After it invades the human body, it can cause a series of immune responses.Part of Mtb can be eliminated by the body′s immune function; some of them can survive by the immune escape mechanism and cause latent tuberculosis infection(LTBI)or tuberculosis(TB). Exosomes are extracellular vesicles with a diameter of 30-100 nm that are secreted by living cells.They are rich in proteins, lipids and nucleic acids, and exist in many body fluids of the human body.During Mtb infection, the components of exosomes released by the body can change significantly, and they can play an important role in the body′s infection and immune response, providing new ideas and theoretical basis for the prevention, diagnosis and treatment of tuberculosis infection.This article reviews the role and application value of exosomes in Mtb infection.