OBJECTIVE: To explore the mechanism of acupuncture on improving ovarian hypofunction in aged rats from two perspectives: the overall regulation of the hypothalamic-pituitary-ovarian (HPO) axis and the local ovarian follicle stimulating hormone (FSH)/cyclic adenosine monophosphate (cAMP) signaling pathway. METHODS: Six 3-month-old female SPF-grade Sprague-Dawley (SD) rats were selected as the blank group. Another twelve 9-month-old female SD rats were randomly divided into a model group and an acupuncture group, with six rats in each. The acupuncture group received acupuncture at "Baihui" (GV20), "Guanyuan" (CV4), and bilateral "Ciliao" (BL32) for 20 min per session, once every other day, for a total of 10 sessions. Vaginal smear tests were performed daily to observe the estrous cycle of the rats. Ovarian morphology was observed using HE staining, and follicles at various stages were counted. ELISA was used to detect levels of serum FSH, luteinizing hormone (LH), estradiol (E₂), anti-müllerian hormone (AMH), hypothalamic gonadotropin-releasing hormone (GnRH), pituitary FSH and LH, and ovarian cAMP. Immunohistochemistry and Western blot were used to detect the protein expression of ovarian cAMP protein kinase catalytic subunit, FSH receptor (FSHR), and P450. Real-time quantitative PCR was used to measure mRNA expression levels of FSHR and P450 in ovarian tissue. RESULTS: Compared with the blank group, the model group showed an increased rate of estrous cycle disorder (P<0.01), reduced granulosa cell layers with blurred boundaries and disordered arrangement, decreased numbers of developing follicles at all stages, and increased numbers of atretic follicles (P<0.01); the serum levels of FSH and LH were increased (P<0.01), while E₂ and AMH levels were decreased (P<0.01); the hypothalamic GnRH and pituitary FSH and LH levels were elevated (P<0.01), and ovarian cAMP level was decreased (P<0.01); the positive expression and protein expression of ovarian P450, cAMP protein kinase catalytic subunit, and FSHR were reduced (P<0.01), and ovarian FSHR and P450 mRNA expression was decreased (P<0.01). Compared with the model group, the acupuncture group showed a reduced rate of estrous cycle disorder (P<0.01), clear granulosa cell margins, increased numbers of primordial and secondary follicles, and decreased numbers of atretic follicles (P<0.01); the serum FSH and LH levels were decreased (P<0.01, P<0.05), while E₂ and AMH levels were increased (P<0.05, P<0.01); the hypothalamic GnRH and pituitary FSH and LH levels were decreased (P<0.01, P<0.05), and ovarian cAMP level was increased (P<0.01); the positive expression and protein expression of ovarian P450, cAMP protein kinase catalytic subunit, and FSHR were elevated (P<0.01), and ovarian FSHR and P450 mRNA expression was increased (P<0.01). CONCLUSION Acupuncture could delay ovarian hypofunction in aged rats, possibly through regulating the HPO axis and the FSH/cAMP signaling pathway.
Animals ; Female ; Rats ; Rats, Sprague-Dawley ; Follicle Stimulating Hormone/genetics* ; Acupuncture Therapy ; Ovary/metabolism* ; Signal Transduction ; Humans ; Cyclic AMP/metabolism* ; Hypothalamo-Hypophyseal System/metabolism* ; Aging/metabolism* ; Hypothalamus/metabolism* ; Pituitary Gland/metabolism* ; Gonadotropin-Releasing Hormone/metabolism*

Objective To examine the mediating role of empathy and emotional competence in the association between family functioning and internalizing and externalizing problem behaviors among adolescents in China.Methods In this study,we used the data from the June-July 2022 survey of Chengdu Positive Child Development(CPCD)cohort.All respondents were 5th-9th graders from six primary or secondary schools in Chengdu.The Achenbach Child Behavior Checklist(CBCL),the Chinese Family Assessment Instrument(C-FAI),the empathy subscale of the Chinese version of the Interpersonal Reactivity Index(C-IRI),and the emotional competence(EC)subscale of the Chinese Positive Youth Development Scale(CPYD)were used to evaluate the respondents'internalizing and externalizing problem behaviors,family functioning,empathy,and emotional competence,respectively.The average score derived from the total score of a scale divided by the number of entries in each dimension was used as the final score of the scale.Independent samples t-tests or one-way analysis of variance(ANOVA)were performed to examine the differences in family functioning,empathy,emotional competence,and internalizing and externalizing problem behaviors across student groups with different demographic characteristics(sex,grade,and region).Pearson correlation analysis was conducted to examine the relationship between family functioning,empathy,emotional competence,and internalizing and externalizing problem behaviors.AMOS 24.0 was used to validate the hypothesized model and structural equation modeling was used to analyze the mediating effects of empathy and emotional competence between family functioning and internalizing and externalizing problem behaviors among adolescents.Results A total of 3026 eligible participants were included,including 1548(51.16%)male students and 1478(48.84%)female students.Among the respondents,798(26.37%)were 5th graders,738(24.39%)were 6th graders,567(18.74%)were 7th graders,614(20.29%)were 8th graders,and 309(10.21%)were 9th graders.In addition,2064(68.21%)of all respondents were from urban areas and 962(31.79%)were from rural areas.The results of the difference analysis showed that the differences in adolescents'internalizing and externalizing problem behaviors were statistically significant between students of different grades(P=0.004),and that the differences in family functioning and empathy scores were also statistically significant between students of different grades(all P<0.001),whereas the differences in adolescents'internalizing and externalizing problem behaviors were not statistically significant between sexes and regions(P=0.919,0.959).The results of correlation analysis showed that family functioning scores(the higher the score,the worse the family functioning)were significantly negatively correlated with empathy and emotional competence(r=-0.482,-0.432,P<0.01),and significantly positively correlated with internalizing and externalizing problem behaviors(r=0.220,P<0.01).Empathy was significantly positively correlated with emotional competence(r=0.402,P<0.01).Empathy and emotional competence were significantly negatively correlated with all the dimensions of internalizing and externalizing problem behaviors(r=-0.115,-0.305,P<0.01).Emotional competence partially mediated the relationship between family functioning and adolescents'internalizing and externalizing problem behaviors,with a mediation effect value being 0.042(95%[confidence interval]CI:0.031-0.057).Empathy and emotional competence had chain mediation effect between family functioning and adolescents'internalizing and externalizing problem behaviors,with the value of the mediation effect being 0.010(95%CI:0.007-0.014).Conclusion Family functioning influences adolescents'internalizing and externalizing problem behaviors in a direct way and through the chain-mediating roles of empathy and emotional competence.

Objective To investigate the effect of empathy on depressive symptoms in adolescents and to explore the potential mediating role of family functioning in the effect of empathy on depressive symptoms.Methods The 2022 cross-sectional data from the Chengdu Positive Child Development(CPCD)cohort were analyzed in the study.A survey was conducted in Chengdu in June 2022,involving 3 020 students in grades 5-8 from three randomly selected stratified schools.The Interpersonal Reactivity Index(IRI-C),the Chinese Family Assessment Instrument(C-FAI),and the Center for Epidemiologic Studies Depression Scale for Children(CES-DC)were used in the survey.Chi-square test or one-way analysis of variance was performed to examine the differences in various demographic characteristics(sex,grade,region,and total monthly household income)between groups of respondents,as well as the differences in family functioning,empathy,and depression.Pearson correlation coefficient was used to examine the correlation between family functioning,empathy,and depressive symptoms.Structural equation modeling and SPSS PROCESS component Model 4 were used to analyze whether family functioning played a mediating role in the effect of empathy on depressive symptoms in adolescents.Results The detection rate of depressive symptoms among survey respondents was 25.40%.The results of the difference analysis revealed significant differences in the detection rates of depressive symptoms among respondents of different grades,regions,and monthly household incomes(P<0.05).There was no significant difference in the detection rates of depressive symptoms between male and female students.There was a significant difference in the detection rate of depressive symptoms between respondents with different scores for family dysfunction and empathy ability(P<0.001).Correlation analysis results showed that empathy scores were negatively correlated with depression(r=-0.11,P<0.001),that family dysfunction was positively correlated with depression(r=0.29,P<0.001),and that empathy scores were negatively correlated with family functioning(r=-0.37,P<0.001).The mediating role of family dysfunction in the relationship between empathy and depressive symptoms was established,with the direct effect being 0.039(95% confidence interval[CI]:0.010-0.069,P<0.001)and the indirect effect value being-0.096(95% CI:-0.115--0.079,P<0.001).The direct effect value accounted for 28.89% of the total effect value,while the mediation effect value accounted for 71.11% of the total effect value.Conclusion The empathy ability of adolescents is correlated to depressive symptoms,and family functioning plays a mediating role between empathy and depressive symptoms in adolescents.It is suggested that adolescents'empathy ability and family functioning should be enhanced through multiple channels to reduce the occurrence of depressive symptoms.

Objective:To explore the effect of continuous nursing model based on family unit in long-term warfarin anticoagulation in elderly patients with mechanical heart valve replacement (MHVR) .Methods:From July 2018 to March 2021, 87 elderly patients who underwent MHVR in Wuxi Second People's Hospital and received long-term warfarin anticoagulation after surgery were selected by convenience sampling as the research subject. The patients were divided into the observation group ( n=46) and the control group ( n=41) by random number table method. The control group adopted the routine nursing model, and the observation group adopted the family unit-based continuous nursing model on this basis. The two groups of patients were compared in terms of 3 indicators, namely treatment compliance, treatment effectiveness, and treatment safety. Results:In terms of treatment compliance, the compliance rates of smoking and drinking cessation, diet control, compliance with medicines and regular review of patients in the observation group were better than those in the control group, and the differences were statistically significant ( P<0.05) . In terms of treatment effectiveness, the international normalized ratio (INR) compliance rate and the quality of life score of the observation group were higher than that of the control group with statistical differences ( P<0.05) . In terms of treatment safety, there was no significant difference in the incidence of bleeding events and thrombosis events between the two groups ( P>0.05) . Conclusions:The continuous nursing model based on family unit is effective and safe, and can improve the compliance of elderly patients with MHVR taking warfarin after surgery, and improve the INR compliance rate and quality of life of elderly patients.

OBJECTIVE：To inv estigate the effects of 4-hydroxy-2（3H）-benzoxazolone on inflammatory and apoptosis signaling pathways in non-alcoholic fatty liver disease （NAFLD）model rats. METHODS ：SD rats were divided into normal control group（10 rats）and modeling group （50 rats）. Normal control group was given basic diet ，and modeling group were given high-fat diet to induce NAFLD model. After modeling ，the rats were divided into normal control group ，model group ，silibinin group （26.25 mg/kg），and 4-hydroxy-2（3H）-benzoxazolone high-dose ，medium-dose and low-dose groups （100，50，25 mg/kg），with 8 rats in each group. Normal control group and modeling group were given 0.6％ CMC-Na intragastrically ，and other groups were given relevant medicine 10 mL/kg intragastrically ，once a day ，for consecutive 4 weeks. After last medication ，the serum levels of albumin（ALB），total protein （TP），globulin（GLB），ALB/GLB and free fatty acid （FFA）were detected ；TUNEL staining was used to observe the apoptosis of rat hepatocytes. Western blot assay was used to detect the protein expression and phosphorylation level of inflammatory signaling pathway related proteins [Toll-like receptor 4（TLR4），myeloid differentiation factor 88（MyD88）， nuclear factor-κB p65（NF-κB p65），NF-κB inhibitor protein（IκBα）] in liver tissue as well as the expression of apoptosis signaling pathway related proteins [B cell lymphoma 2（Bcl-2），Bax，caspase-3]. RESULTS ：Compared with model group ，serum levels of TP （except for low-dose group ），GLB and FFA ，the protein expression of TLR 4（except for low-dose group ），MyD88 （except for medium-dose group ）and caspase- 3，the phosphorylation levels of NF-κB p65 and IκBα protein were decreased significantly（P＜0.05 or P＜0.01）. The ratio of A LB/GLB in serum and the ratio of Bcl- 2/Bax in liver tissue were significantly increased（P＜0.05 or P＜0.01），and the phenomenon of hepatocyte apoptosis was improved. CONCLUSIONS ：4-hydroxy-2 （3H）-benzoxazolone can ameliorate NAFLD in rats ，and the mechanism may be associated with inhibiting the expression TLR 4/ MyD88/NF-κB signaling pathway-related proteins and apoptosis-related proteins in liver tissues.

OBJECTIVE：To s tudy improvement effect and mech anism of ilicifoliosids alkaloid A （HBOA）on non-alcoholic fatty liver disease in rats. METHODS ：SD rats were randomly divided into blank control group ，model group ，Silybin capsule group（positive control ，26.25 mg/kg），HBOA high-dose ，medium-dose and low-dose groups （100，50，25 mg/kg），with 10 rats in each group. Except that blank control group fed normal feed ，the other groups were continuously fed with high-fat diet for 8 weeks to induce non-alcoholic fatty liver disease model. Form the 9th week ，blank control group and model group were given constant volume of 0.6％ CMC-Na solution ，and administration groups were given corresponding drugs by intragastric admini- stration，once a day ，for consecutive 4 weeks. The general information of rats were observed and the body weight increase ，organ （liver，kidney and spleen ）indexes were calculated ；the contents of AST ，ALT，TC，TG and NEFA in liver tissue were detected ， and SOD，GSH-Px activities and MDA content in the serum were also determined. The protein expression of PPARα in liver tissue was detected by immunohistochemistry. RESULTS ：Compared with blank control group ，the body mass increase and liver index of rats in model group were increased significantly （P＜0.01）；fat deposition could be observed in the liver ；the activities of SOD and GSH-Px in serum were reduced significantly ，and the contents of MDA ，the contents of AST ，ALT，TC，TG and NEFA in liver tissue were significantly increased ，and the protein expression of PPARα was decreased significantly（P＜0.01）. Compared with model group ，the body mass increase and liver index of the rats were decreased significantly in administration groups （P＜0.05 or P＜0.01），liver fat deposition was improved ，the activity of SOD and GSH-Px in serum （except for HBOA low-dose group ）were increased significantly while MDA content ，the contents of AST ，ALT，TC（except for HBOA low-dose group ），TG（except for HBOA low-dose group ） and NEFA in liver tissue were decreased significantl y，while protein expression of PPAR α 15177460685@163.com was increased significantly （P＜0.05 or P＜0.01）. Some of the above indexes of HBOA high-dose group were 电话：0771-5302433。E-mail：junlin898@126.com significantly better than HBOA medium- and low-dose group（P＜0.05）. CONCLUSIONS ：HBOA has a certain improvement effect on non-alcoholic fatty liver disease in rats caused by high-fat diet ，and its mechanism may be related to improving lipid metabolism disorders ，anti-oxidative stress and up-regulating the expression of PPARα.

Objective? To investigate the effect of the cardiac rehabilitation program based Omaha system on patients after percutaneous coronary intervention (PCI). Methods? A convenient sampling method was used to select 127 patients from the Department of Cardiology of Wuxi Second People's Hospital from October 2017 to April 2018. According to the patient's hospitalization number, they were randomly divided into two groups, including 64 in the experimental group and 63 in the control group. During the intervention, 2 patients were lost in the experimental group and 1 patient was lost in the control group. There were 62 patients in each group to complete the study. Patients in the control group received routine care, while patients in the experimental group received cardiac rehabilitation based on the Omaha system. The effect of the intervention was measured by 6 min exercise test, secondary prevention knowledge and behavior questionnaire for post-PCI patients. Results? After the intervention, The 6-minute exercise distance was (439.28±67.94) m in the experimental group, and it was (315.62±45.18) m in the control group. The exercise endurance of the experimental group was higher than that of the control group, and the difference was statistically significant (t=11.934, P＜ 0.01). The secondary prevention knowledge and behavior scores of the experimental group were (87.21±12.46) and (84.27±14.58), which were higher than those of the control group (71.30±8.12) and (65.94±8.97). The differences were statistically significant (t=8.423, 8.431; P ＜0.01). Conclusions? Cardiac rehabilitation programs based Omaha system can improve exercise endurance and secondary prevention behaviors of patients after PCI and its application should be promoted.

OBJECTIVETo investigate the effect and safety of acupuncture with regulating menstruation to promote pregnancy for diminished ovarian reverse (DOR).

METHODSAccording to prospective case series, 46 patients were observed and finally 40 cases were included. The acupoints were ① Baihui (GV 20), Shenting (GV 24), Guanyuan (CV 4) and bilateral Benshen (GB 13), Huangshu (KI 16), Dahe (KI 12), Luanchao (Extra), Zusanli (ST 36), Sanyinjiao (SP 6), Taixi (KI 3), Taichong (LR 3) and ② bilateral Shenshu (BL 23) and Ciliao (BL 32). The points in the two groups were used alternately. Acupuncture was given for 3 courses, 12 times as a course and 3 times a week. Before and after treatment, and 3 months after treatment, follicle-stimulating hormone (FSH), follicle-stimulating hormone/luteinizing hormone (FSH/LH), estradiol (E), antral follicle count (AFC) and TCM symptom score were observed. The safety was evaluated.

RESULTSCompared with before treatment, the levels of FSH, FSH/LH decreased, and the levels of Eand AFC increased after treatment and at follow-up (all<0.05). And the TCM symptom scores were significantly lower than those before treatment (both<0.05). The rate of pregnancy after treatment was 15% (6/40). There was no infection and organ injury.

CONCLUSIONAcupuncture with regulating menstruation to promote pregnancy can safely improve the ovarian reserve of patients with DOR.

Objective To understand the situation of psychological distress, self-disclosure and intimate relationship in spouses of patients with breast cancer and analysis their interrelationship. Methods Totally 240 spouses of breast cancer patients from 3 class Ⅲ grade A hospitals in Jiangsu Province were investigated with distress thermometer (DT), distress disclosure index(DDI), short marital adjustment and prediction test as well as general information questionnaire from July 2015 to July 2016. Single factor analysis was performed using rank test, and correlations analysis was performed by Spearman analysis. Results The average score of psychological distress was(5.2±4.7) points, self-disclosure (36.5±32.7) points, intimate relationship (118.2±36.5) points and marital disorder detection rate was 25.9%. The prevalence of psychological distress was 67.4% and there was a significant difference in DT score among the spouses of patients with different education level (Z= 7.519,P<0.05). Spouse psychological distress was negatively correlated with self-disclosure degree and the degree of intimacy(r=-0.673,-0.721;P<0.01). Intimate relationship took a partial effects as mediator between the psychological distress and the degree of self-disclosure. Conclusions The incidence of psychological distress is high in spouses of patients with breast cancer, and the severity is influenced by self-disclosure and intimate relationship. Intimacy takes a partial effects as mediator between the psychological distress and the degree of self-disclosure.

Objective To explore the application effect of concept map teaching of group-discussing mode in standardized nursing training. Methods A total of 80 standardized training nurses in Wuxi No.2 People's Hospital from January 2016 to December 2016 were selected by purposive sampling and randomly divided into the intervention group and the control group, with 40 students in each. The control group was taught according to the conventional teaching method, and the intervention group was taught with the concept map teaching of group-discussing mode. The scores of the independent learning ability assessment scale and the scores of theoretical examination were compared before and after the intervention. The scores of the feedback evaluation scale of concept map teaching of group-discussing mode in the intervention group were observed. Results The score of each dimension and the total score of the independent learning ability assessment scale of the intervention group after intervention were higher than those in the control group, and the difference was statistically significant (P<0.05). The score of theoretical examination in the intervention group was higher than that in the control group with statistical difference (P<0.001). The nurses in the intervention group had a better feedback on the concept map teaching of group-discussing mode. Conclusions The concept map teaching of group-discussing mode obtains good application results in clinical nursing teaching and training, and it can improve the nurses' independent learning ability.