Objective:To explore the correlation between the total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio during pregnancy and the onset of gestational metabolic syndrome (GMS), as well as its association with pregnancy outcomes.Methods:Clinical data of 153 pregnant women diagnosed with GMS in the third trimester admitted to Women′s Hospital of Nanjing Medical University from January 2020 to December 2022 (observation group) were collected, and data of 153 healthy pregnant women (control group) were randomly selected for a comparative study. Indicators of the two groups were observed and compared. Multiple linear regression and restricted cubic spline analysis were used to analyze the correlation between TC/HDL-C in the first and second trimesters and metabolic indicators in the third trimester and GMS risk, respectively. According to the pregnancy outcomes of GMS pregnant women with different TC/HDL-C ratios, the association between TC/HDL-C ratio and preterm birth subtypes was analyzed.Results:There were statistically significant differences between the two groups in age, gestational week, pre-pregnancy body mass index (BMI), weight gain during pregnancy, abdominal circumference in the third trimester, whether to deliver vaginally, history of preterm birth, history of cesarean section, history of abortion, neonatal birth weight, and neonatal length (all P<0.05). There were statistically significant differences in blood pressure and BMI between the two groups in the second and third trimesters (all P<0.01). In the first trimester (gestational week <14 weeks), there were statistically significant differences in fasting plasma glucose (FPG), HDL-C, and TC/HDL-C ratio between the two groups (all P<0.05). In the second trimester (gestational weeks 14-27) and third trimester (gestational week ≥28 weeks), the levels of FPG, fasting insulin (FINS), triglyceride (TG), TC, low-density lipoprotein cholesterol (LDL-C), and TC/HDL-C ratio in the observation group were higher than those in the control group, while HDL-C was lower (all P<0.05). There were statistically significant differences between the two groups in postpartum abnormal blood pressure, abnormal BMI, abnormal glucose metabolism, and abnormal lipid metabolism (all P<0.05). After adjusting for age, gestational week, and BMI, first-trimester TC/HDL-C ratio was correlated with third-trimester FPG, systolic blood pressure, diastolic blood pressure, TG, TC, and HDL-C (all P<0.05); second-trimester TC/HDL-C ratio was correlated with third-trimester FPG, FINS, systolic blood pressure, diastolic blood pressure, TG, TC, HDL-C, and LDL-C (all P<0.05), and both were linearly related to third-trimester GMS risk ( Pfor trend<0.01). The TC/HDL-C ratio was positively correlated with the preterm birth rate ( RR>1). Conclusions:An increased TC/HDL-C ratio is closely related to the occurrence of GMS, which is prone to cause preterm birth and affect fetal growth and development.

Objective:To explore the correlation between the total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio during pregnancy and the onset of gestational metabolic syndrome (GMS), as well as its association with pregnancy outcomes.Methods:Clinical data of 153 pregnant women diagnosed with GMS in the third trimester admitted to Women′s Hospital of Nanjing Medical University from January 2020 to December 2022 (observation group) were collected, and data of 153 healthy pregnant women (control group) were randomly selected for a comparative study. Indicators of the two groups were observed and compared. Multiple linear regression and restricted cubic spline analysis were used to analyze the correlation between TC/HDL-C in the first and second trimesters and metabolic indicators in the third trimester and GMS risk, respectively. According to the pregnancy outcomes of GMS pregnant women with different TC/HDL-C ratios, the association between TC/HDL-C ratio and preterm birth subtypes was analyzed.Results:There were statistically significant differences between the two groups in age, gestational week, pre-pregnancy body mass index (BMI), weight gain during pregnancy, abdominal circumference in the third trimester, whether to deliver vaginally, history of preterm birth, history of cesarean section, history of abortion, neonatal birth weight, and neonatal length (all P<0.05). There were statistically significant differences in blood pressure and BMI between the two groups in the second and third trimesters (all P<0.01). In the first trimester (gestational week <14 weeks), there were statistically significant differences in fasting plasma glucose (FPG), HDL-C, and TC/HDL-C ratio between the two groups (all P<0.05). In the second trimester (gestational weeks 14-27) and third trimester (gestational week ≥28 weeks), the levels of FPG, fasting insulin (FINS), triglyceride (TG), TC, low-density lipoprotein cholesterol (LDL-C), and TC/HDL-C ratio in the observation group were higher than those in the control group, while HDL-C was lower (all P<0.05). There were statistically significant differences between the two groups in postpartum abnormal blood pressure, abnormal BMI, abnormal glucose metabolism, and abnormal lipid metabolism (all P<0.05). After adjusting for age, gestational week, and BMI, first-trimester TC/HDL-C ratio was correlated with third-trimester FPG, systolic blood pressure, diastolic blood pressure, TG, TC, and HDL-C (all P<0.05); second-trimester TC/HDL-C ratio was correlated with third-trimester FPG, FINS, systolic blood pressure, diastolic blood pressure, TG, TC, HDL-C, and LDL-C (all P<0.05), and both were linearly related to third-trimester GMS risk ( Pfor trend<0.01). The TC/HDL-C ratio was positively correlated with the preterm birth rate ( RR>1). Conclusions:An increased TC/HDL-C ratio is closely related to the occurrence of GMS, which is prone to cause preterm birth and affect fetal growth and development.

Objective To analyze the hotspots and frontiers of researches related to pain in Parkinson's disease. Methods The literatures on pain in Parkinson's disease were retrieved from CNKI,VIP,Wanfang data,CBM and Web of Science Core Collection from inception to November,2023,and were analyzed with CiteSpace 6.1.R6. Results A total of 926 literatures were included with 293 in Chinese and 633 in English,respectively.Chinese high-fre-quency keywords were quality of life,sleep disorders and depression,while English high-frequency keywords were nonmotor symptom,quality of life and levodopa.The latest bursting word in Chinese was pathogenesis,while the latest bursting words in English were exercise and management. Conclusion Number of researches related to pain in Parkinson's disease is gradually rising,and the characteristics,patho-genesis,quality of life,rehabilitation interventions and clinical efficacy have become research hotspots.The mechanism of pain in Parkinson's disease and rehabilitation management program will be the main research top-ics in the future.

Purpose To use two-dimensional speckle tracking imaging(2D-STI)to evaluate left ventricular myocardial strain in term and preterm neonates.Materials and Methods A total of 81 neonates who accepted echocardiography in Soochow University Affiliated Children's Hospital from February to August 2018 were retrospectively enrolled,including 42 term neonates and 39 preterm neonates.Longitudinal and circumferential peak strain of each segment of left ventricle were measured by 2D-STI,and the average global longitudinal peak strain(GLPS-avg)and the average global circumferential peak strain(GCPS-avg)of left ventricular were measured too.Left ventricular ejection fraction(LVEF-M,LVEF-Simpson),short-axis shortening rate(LVFS-M),left ventricular end-diastolic diameter(LVEDD),and tissue Doppler imaging parameters(E',A' and E'/A')of the septal mitral annulus were also measured.The differences in each segment of left ventricle and echocardiography between term neonates and preterm neonate were further compared.Results There were statistically significant differences in GLPS-avg,the global longitudinal peak strain from the apical two-chamber view(GLPS-a2c),GCPS-avg and the global circumferential peak strain in the middle and apical segments(GCPS-M ang GCPS-A)(t=-3.60--2.18,all P<0.05)between term neonates and preterm neonates,while there were no significant differences between the global longitudinal peak strain from the apical four-chamber and three-chamber view(GLPS-a4c and GLPS-a3c),the global circumferential peak strain in the basal segments(GCPS-M)(all P>0.05).There were statistically significant differences in GLPS-a4c,GLPS-a2c,GLPS-a3c in preterm neonates group(F=3.20,P=0.044),and the strain value GLPS-a4c was the highest.There were statistically significant differences in GCPS-B,GCPS-M,GCPS-A in preterm neonates group(F=79.15,P<0.001).There were statistically significant differences in GCPS-B,GCPS-M,GCPS-A in term neonates group(F=97.95,P<0.001),and the strain value increased from the basal segment to the apical segments.There was statistically significant difference in LVEDD between term neonates and preterm neonates(all P<0.05).There were no statistically significant differences in LVEF-M,LVEF-Simpson,LVFS-M,E',A' and E'/A' between term neonates and preterm neonates(all P>0.05).Conclusion 2D-STI may be a useful method of measuring left ventricular myocardial systolic function and can provide early detection of differences in left ventricular myocardial contraction between term and preterm neonates.

Objective:To observe the clinical effect of scraping therapy on lumbar disc herniation (LDH) with different syndromes.Methods:Using the convenient sampling method, a total of 30 non-emergency LDH patients who were admitted to Department of Orthopedics and Traumatology of Yangzhou Hospital of Traditional Chinese Medicine from July 2017 to June 2018 were selected as the research objects. Among them, there were 11 cases of qi stagnation and blood stasis syndrome, 8 cases of damp-heat obstruction syndrome, 7 cases of cold-damp obstruction syndrome and 4 cases of liver and kidney deficiency syndrome. Du meridian, the bladder meridian of Foot Taiyang, as well as Jiaji (EX-B2) in pathological or painful sections, Ashi point, Shenshu (BL 23) , and Weizhong (BL 40) were mainly scraped. The treatment interval is 2~5 days (the marks of scrapping fade) , twice of scrapping as a treatment course and a total of 3 courses involved in the whole treatment. Japanese Orthopaedic Association (JOA) Score, Visual Analogue Scale (VAS) , serum interleukin-1 β (IL-1β) and interleukin-10 (IL-10) were compared before and after scraping.Results:Compared with those before scraping, the JOA score increased, the VAS decreased, the serum IL-1β content decreased and the serum IL-10 content increased after scraping, and the differences were sttaistically significant ( P<0.01) . Among them, the JOA scores of patients with qi stagnation and blood stasis syndrome and cold-damp obstruction syndrome were higher than those of damp-heat obstruction syndrome and liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . The levels of serum IL-10 in patients with qi stagnation and blood stasis syndrome, damp-heat obstruction syndrome and cold-damp obstruction syndrome were higher than those in patients with liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . Conclusions:The curative effect of scraping in the treatment of LDH is definite, and the curative effect is better for excessive syndromes.

The existing researches on scraping mostly focus on the observation of curative effect and preliminary attempts to explore the mechanism of action, but the research on scraping manifestation is slightly insufficient. At present, scraping manifestation studies mainly include skin appearance, skin blood perfusion, and skin temperature. These studies have laid the foundation and provided a reference for the standardization, normalization, and visualization research of scraping technology in the future. However, these studies are still in their infancy and need to be further studied.

Objective To define the traditional Chinese medicine (TCM) nursing core knowledge and practical ability which nurses should be equipped with when carrying out TCM service so as to provide a reference for the training of nursing talents of TCM at home and abroad. MethodsOn the basis of establishing a research group, a questionnaire was formed based on literature research, university research, brain storm and expert interviews. A total of 76 TCM nursing experts from universities and hospitals at home and abroad of TCM were investigated with the questionnaire to form an expert consensus. ResultsA total of 76 questionnaires were issued in this survey, of which 64 were valid.This study formed the core knowledge and practical ability training standard including three course modules of basic courses of TCM, basic courses of TCM nursing and specialized courses of TCM nursing, and 9 courses of basic theory of TCM, diagnosis of TCM, science of Chinese materia medica, pharmacology of TCM, fundamental of TCM nursing, TCM diet therapy, acupuncture and moxibustion and nursing, TCM nursing skill operation, TCM nursing clinical practice. ConclusionsThe standard could provide a basis for the standardized teaching of TCM nursing, establishment of training module, formulation of training plan and evaluation of talent training quality.

The "self and mutual service" is a novel and diverse civil provision model for the aged. As a supplement to social resources for the aged, it is a promising in development. This article reviews the status quo of mutual provision for the aged in China's urban communities, aiming to make feasible proposals for the healthy development of China's mutual provision for the aged.

Objective? To expLore the effects of diaLectic nursing-oriented hybrid teaching modeL in pediatric nursing teaching in traditionaL Chinese medicine (TCM). Methods? TotaLLy 113 nursing students from 2 cLasses (midwifery) admitted in 2015 in the SchooL of Nursing, Nanjing University of Chinese Medicine were seLected by convenient sampLing. ALL the subjects were femaLe. The 2 cLasses were divided into the observation group (n=58) or the controL group (n=55) by coin tossing. Nursing students in the controL group received traditionaL teaching, whiLe nursing students in the observation group were taught with the diaLectic nursing-oriented hybrid teaching modeL. At the end of the course, the objective structured cLinicaL examination (OSCE) was used to evaLuate their diaLectic nursing abiLity; and the SeLf-Rating ScaLe of SeLf-Directed Learning (SRSSDL) was used to evaLuate their seLf-directed Learning abiLity. ResuLts? At the end of the course, the totaL score of diaLectic nursing and scores of various dimensions of the observation group were higher than those of the controL group (P＞ 0.05). The totaL score of seLf-directed Learning abiLity and scores of Learning awareness, Learning behavior, Learning strategy and interpersonaL skiLLs of the observation group were higher than those of the controL group (P＜0.05). ConcLusions? The hybrid teaching modeL in TCM pediatric nursing teaching in universities of Chinese medicine can enhance nursing students' diaLectic nursing abiLity, heLp to cuLtivate their seLf-directed Learning abiLity and achieve the best teaching resuLts.

OBJECTIVETo compare the differences in the therapeutic effects on allergic rhinitis between scraping therapy and cetirizine and observe the differences in the clinical therapeutic effects of scraping therapy on the disease of different differentiated patterns/syndromes.

METHODSThe included participants of allergic rhinitis were randomized into a western medication group and three scraping therapy groups, named a lungdeficiency and cold group, a spleendeficiency group and a kidneydeficiency group, 20 cases in each one. In the western medication group, cetirizine was prescribed for oral administration, 10 mg, once a day, totally for 4 weeks. In the scraping therapy groups, the scraping therapy was applied to the running courses of the large intestine meridian of hand-, the governor vessel and the bladder meridian of foot-, focusing on Yingxiang (LI 20), Yintang (GV29), Hegu (LI 4) and Fengmen (BL 12). In the lungdeficiency and cold group, the scraping focused on the lung meridian of hand-, Feishu (BL 13), Taiyuan (LU 9), Fengchi (GB 20) and Lieque (LU 7). In the spleendeficiency group, the scraping focused on the spleen meridian of foot-, Pishu (BL 20) and Zusanli (ST 36). In the kidneydeficiency, the scraping focused on the kidney meridian of foot-, Mingmen (GV 4) and Shenshu (BL 23). The scraping therapy was given once a week, 4 treatments as one session and 1 session required (4 weeks). Separately before treatment, after treatment and in 3-month follow-up visit, the total score of the main symptoms of allergic rhinitis (sneezing, runny nose, nasal obstruction and nasal itch) was observed and the clinical therapeutic effects were evaluated.

RESULTSThe total symptom scores in the patients of the 4 groups after treatment were all reduced as compared with those before treatment (all<0.05). After treatment and in the follow-up visit, the total symptom scores of the 3 scraping therapy groups were lower than those in the western medication group (all<0.05), and the score in the lungdeficiency and cold group was lower than those in the spleendeficiency group and the kidneydeficiency group (all<0.05). After treatment and in the follow-up visit, the therapeutic effects in the 3 scraping therapy groups were better than those in the western medication group (all P<0.05).

CONCLUSIONThe scraping therapy on the basis of the meridians and acupoints selection achieves the definite therapeutic effects on allergic rhinitis of different differentiated patterns/syndromes, which is better than cetirizine. This therapy achieves the much significant short-term and long-term therapeutic effects on allergic rhinitis differentiated as lung qi deficiency and cold.