OBJECTIVE: The present study evaluated the effects of deep acupuncture at Weizhong acupoint (BL40) on bladder function and brain activity in a rat model of overactive bladder (OAB), and investigated the possible mechanisms around the acupuncture area that initiate the effects of acupuncture. METHODS: Adult female Sprague-Dawley rats were randomly divided into six groups, comprising a control group, model group, group treated with deep acupuncture at BL40, group treated with shallow acupuncture at BL40, group treated with acupuncture at non-acupoint next to BL40, and group treated with acupuncture at Xuanzhong (GB39). Urodynamic evaluation was used to observe the urination, and functional magnetic resonance imaging was used to observe the brain activation. The mechanism of acupuncture at BL40 in regulating bladder function was explored by toluidine blue staining and enzyme-linked immunosorbent assay, and the mechanism was verified by stabilizing mast cells (MCs) or blocking tibial nerve. RESULTS: Deep acupuncture at BL40 significantly increased the intercontraction interval in OAB rats and enhanced the mean amplitude of low frequency fluctuation of primary motor cortex (M1), periaquaductal gray matter (PAG), and pontine micturition center (PMC). It also increased the zero-lag functional connectivity between M1 and PAG and between PAG and PMC. Shallow acupuncture at BL40 and acupuncture at non-acupoint or GB39 had no effect on these indexes. Further studies suggested that deep acupuncture at BL40 increased the number and degranulation rate of MCs as well as the contents of 5-hydroxytryptamine, substance P, and histamine in the tissues around BL40. Blocking the tibial nerve by lidocaine injection or inhibiting MC degranulation by sodium cromoglycate injection obstructed the effects of acupuncture on restoring urinary function and modulating brain activation in OAB rats. CONCLUSION Deep acupuncture at BL40 may be more effective for inhibiting OAB by promoting degranulation of MCs around the acupoint and stimulating tibial nerve, thereby regulating the activation of the brain area that controls the lower urinary tract. Please cite this article as: Liu X, Zhang CY, Du XY, Li SS, Wang YQ, Zheng Y, Deng HZ, Fang XQ, Li JY, Wang ZQ, Xu SF, Mi YQ. Acupuncture at Weizhong (BL40) attenuates acetic acid-induced overactive bladder in rats by regulating brain neural activity through the modulation of mast cells and tibial nerves. J Integr Med. 2025; 23(1): 46-55.
Animals ; Urinary Bladder, Overactive/physiopathology* ; Mast Cells/physiology* ; Rats, Sprague-Dawley ; Female ; Acupuncture Therapy ; Acupuncture Points ; Rats ; Brain/physiopathology* ; Tibial Nerve/physiopathology* ; Acetic Acid ; Urinary Bladder/physiopathology*

Objective:To examine the manifestations and causes of administrative burden among primary healthcare professionals,and to explore its impact on job burnout through the mediating role of role conflict,providing theoretical and empirical support for governance-level burden-reduction strategies.Methods:An exploratory sequential mixed-methods design was employed,focusing on primary healthcare professionals in Shandong Province.In the first phase,in-depth interviews were conducted with 175 participants;in the second phase,a questionnaire survey of 1,096 participants and follow-up interviews with 107 participants were carried out.Results:The proportions of respondents who reported"heavy"or"very heavy"burdens were 62.7%for inspection,54.8%for documentation,51.8%for reporting,and 24.4%for meetings.Structural equation modeling showed that administrative burden had a direct effect on job burnout(0.150)and an indirect effect through role conflict(0.093).Qualitative findings further indicated that administrative burden largely stemmed from public health traceability requirements and medical insurance policies,and operated through both resource-based and value-based conflicts.Conclusions:Primary healthcare professionals face considerable administrative burdens,which may heighten job burnout through role conflict.Governance reforms should optimize inspection and assessment,streamline data reporting,refine record-keeping,and promote collaborative governance to break the chain of institutional pressure leading to burnout.

Objective To investigate the effect of LINC00839 on the malignant biological behavior of endometrial cancer cells by regulating the miR-625-5p/cytoplasmic polyadenylation element binding protein 4 (CPEB4) axis. Methods The cancer tissues and adjacent tissues of 46 patients with endometrial cancer were obtained,endometrial cancer cells of HEC-1B,Ishikawa and RL95-2 and human endometrial epithelial cells (HEEC) were cultured in vitro,and the expression levels of LINC00839,miR-625-5p and CPEB4 in tissues and cells were detected. HEC-1B cells were divided into the HEC-1B group (conventional culture),sh-Ctrl group (transfected with sh-Ctrl),sh-LINC00839 group (transfected with shRNA-LINC00839),anti-miR-625-5p group (transfected with shRNA-LINC00839 and miR-625-5p inhibitor),and anti-NC group (transfected with shRNA-LINC00839 and inhibitor-NC). The proliferation,apoptosis,migration and invasion abilities of HEC-1B cells in each group were compared,and the expressions of CPEB4 and epithelial-mesenchymal transition (EMT) related proteins were determined. The targeting relationships between LINC00839 and miR-625-5p,and miR-625-5p and CPEB4 were analyzed. Results The mRNA expression of LINC00839 and CPEB4,as well as the positive expression rate of CPEB4 protein in endometrial cancer tissues were higher than those in adjacent tissues,and the expression of miR-625-5p was lower than that in adjacent tissues (P<0.05). Compared with HEEC cells,the expression of LINC00839 and the mRNA and protein expression of CPEB4 in Ishikawa,RL95-2 and HEC-1B cells increased (P<0.05),and the expression of miR-625-5p decreased (P<0.05). Compared with the sh-LINC00839 group and anti-NC group,the protein expression of N-cadherin,Vimentin,and CPEB4,24-hour absorbance,and migration and invasion cell numbers of HEC-1B cells in the HEC-1B group,sh-Ctrl group and anti-miR-625-5p group increased (P<0.05),while the expression of E-cadherin protein and cell apoptosis rate decreased (P<0.05). There were binding sites between LINC00839 and miR-625-5p,miR-625-5p and CPEB4,with targeting regulatory relationships. Conclusion LINC00839 is related to the malignant biological behavior of endometrial cancer cells,interference with LINC00839 expression can inhibit the proliferation,invasion and migration,and promote apoptosis of HEC-1B cells,and its mechanism may be achieved by regulating the miR-625-5p/CPEB4 axis.

Objective:To examine the manifestations and causes of administrative burden among primary healthcare professionals,and to explore its impact on job burnout through the mediating role of role conflict,providing theoretical and empirical support for governance-level burden-reduction strategies.Methods:An exploratory sequential mixed-methods design was employed,focusing on primary healthcare professionals in Shandong Province.In the first phase,in-depth interviews were conducted with 175 participants;in the second phase,a questionnaire survey of 1,096 participants and follow-up interviews with 107 participants were carried out.Results:The proportions of respondents who reported"heavy"or"very heavy"burdens were 62.7%for inspection,54.8%for documentation,51.8%for reporting,and 24.4%for meetings.Structural equation modeling showed that administrative burden had a direct effect on job burnout(0.150)and an indirect effect through role conflict(0.093).Qualitative findings further indicated that administrative burden largely stemmed from public health traceability requirements and medical insurance policies,and operated through both resource-based and value-based conflicts.Conclusions:Primary healthcare professionals face considerable administrative burdens,which may heighten job burnout through role conflict.Governance reforms should optimize inspection and assessment,streamline data reporting,refine record-keeping,and promote collaborative governance to break the chain of institutional pressure leading to burnout.

Objective To investigate the effect of LINC00839 on the malignant biological behavior of endometrial cancer cells by regulating the miR-625-5p/cytoplasmic polyadenylation element binding protein 4 (CPEB4) axis. Methods The cancer tissues and adjacent tissues of 46 patients with endometrial cancer were obtained,endometrial cancer cells of HEC-1B,Ishikawa and RL95-2 and human endometrial epithelial cells (HEEC) were cultured in vitro,and the expression levels of LINC00839,miR-625-5p and CPEB4 in tissues and cells were detected. HEC-1B cells were divided into the HEC-1B group (conventional culture),sh-Ctrl group (transfected with sh-Ctrl),sh-LINC00839 group (transfected with shRNA-LINC00839),anti-miR-625-5p group (transfected with shRNA-LINC00839 and miR-625-5p inhibitor),and anti-NC group (transfected with shRNA-LINC00839 and inhibitor-NC). The proliferation,apoptosis,migration and invasion abilities of HEC-1B cells in each group were compared,and the expressions of CPEB4 and epithelial-mesenchymal transition (EMT) related proteins were determined. The targeting relationships between LINC00839 and miR-625-5p,and miR-625-5p and CPEB4 were analyzed. Results The mRNA expression of LINC00839 and CPEB4,as well as the positive expression rate of CPEB4 protein in endometrial cancer tissues were higher than those in adjacent tissues,and the expression of miR-625-5p was lower than that in adjacent tissues (P<0.05). Compared with HEEC cells,the expression of LINC00839 and the mRNA and protein expression of CPEB4 in Ishikawa,RL95-2 and HEC-1B cells increased (P<0.05),and the expression of miR-625-5p decreased (P<0.05). Compared with the sh-LINC00839 group and anti-NC group,the protein expression of N-cadherin,Vimentin,and CPEB4,24-hour absorbance,and migration and invasion cell numbers of HEC-1B cells in the HEC-1B group,sh-Ctrl group and anti-miR-625-5p group increased (P<0.05),while the expression of E-cadherin protein and cell apoptosis rate decreased (P<0.05). There were binding sites between LINC00839 and miR-625-5p,miR-625-5p and CPEB4,with targeting regulatory relationships. Conclusion LINC00839 is related to the malignant biological behavior of endometrial cancer cells,interference with LINC00839 expression can inhibit the proliferation,invasion and migration,and promote apoptosis of HEC-1B cells,and its mechanism may be achieved by regulating the miR-625-5p/CPEB4 axis.

Objective:To identify risk factors for infections by multidrug-resistant organisms(MDRO)in elderly patients admitted to the intensive care unit(ICU)based on an retrospective analysis of data from the Medical Information Mart for Intensive Care-Ⅳ v2.0(MIMIC-Ⅳ v2.0).Methods:Structured query language was used to extract basic information, disease severity scores, laboratory test results, medications, medical procedures, and outcome events of elderly patients from MIMIC-Ⅳ v2.0.Patients were divided into a non-MDRO group and an MDRO group based on whether they had MDRO infections.Univariate analysis was performed according to the type of variables.For significant variables identified from univariate analysis, logistic regression was used to calculate the odds ratio and the 95% confidence interval for MDRO infections.The Kaplan-Meier method was used to draw survival curves.The log-rank test was used to analyze the 28-day survival rate.Results:A total of 31 237 cases were enrolled, including 26 032 with non-MDRO infections and 5 205 with MDRO infections.The MDRO infection rate was 16.7%.MDRO were most frequently found in urine cultures, and the most common bacteria belonged to the genus Enterobacter.Multivariate logistic regression analysis showed that age( P=0.006), being male( P<0.001), coronary artery disease( P<0.001), brain disease( P=0.042), hemoglobin( P<0.001), albumin( P<0.001), and mechanical ventilation( P<0.001)were protective factors against MDRO infections.Diabetes( P<0.001), COPD( P<0.001), chronic kidney disease( P<0.001), white blood cell( P=0.001), SAPS Ⅱ( P<0.001), previous use of antibiotics( P<0.001), use of proton pump inhibitors( P<0.001), glucocorticoids( P<0.001), immunosuppressants( P<0.001)and sedatives( P<0.001), and continuous renal replacement therapy(CRRT)( P=0.015)were risk factors for MDRO infections.The 28-day mortality rates of the non-MDRO and MDRO groups were 16.3% and 19.1%, respectively.The log-rank test showed that the difference between two groups was statistically significant( P<0.001). Conclusions:The mortality rate among patients with MDRO infections is higher than among those with non-MDRO infections.Previous use of antibiotics, use of proton pump inhibitors, glucocorticoids, immunosuppressants and sedatives, mechanical ventilation, and CRRT are risk factors for MDRO infections.

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) infection posed a huge threat and burden to public healthcare in late 2022. Non-drug measures of traditional Chinese medicine (TCM), such as acupuncture, cupping and moxibustion, are commonly used as adjuncts in China to help in severe cases, but their effects remain unclear. OBJECTIVES: To observe the clinical effect of TCM non-drug measures in improving respiratory function and symptoms among patients with severe COVID-19. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This study was designed as a multicenter, assessor-blind, randomized controlled trial. Hospitalized patients with COVID-19 were randomly assigned to the treatment or control group. The treatment group received individualized TCM non-drug measures in combination with prone position ventilation, while the control group received prone position ventilation only for 5 consecutive days. MAIN OUTCOME MEASURES: The primary outcome measures were the percentage of patients with improved oxygen saturation (SpO₂) at the end of the 5-day intervention, as well as changes of patients' respiratory rates. The secondary outcome measures included changes in SpO₂ and total score on the self-made respiratory symptom scale. The improvement rate, defined as a 3-day consecutive increase in SpO₂, the duration of prone positioning, and adverse events were recorded as well. RESULTS: Among the 198 patients included in the intention-to-treat analysis, 159 (80.3%) completed all assessments on day 5, and 39 (19.7%) patients withdrew from the study. At the end of the intervention, 71 (91%) patients in the treatment group had SpO₂ above 93%, while 61 (75.3%) in the control group reached this level. The proportion of participant with improved SpO₂ was significantly greater in the intervention group (mean difference [MD] = 15.7; 95% confidence interval [CI]: 4.4, 27.1; P = 0.008). Compared to the baseline, with daily treatment there were significant daily decreases in respiratory rates in both groups, but no statistical differences between groups were found (all P ≥ 0.05). Compared to the control group, the respiratory-related symptoms score was lower among patients in the treatment group (MD = -1.7; 95% CI: -2.8, -0.5; P = 0.008) after day 3 of treatment. A gradual decrease in the total scores of both groups was also observed. Thirty-one adverse events occurred during the intervention, and 2 patients were transferred to the intensive care unit due to deterioration of their illness. CONCLUSION: TCM non-drug measures combined with prone positioning can effectively treat patients with severe COVID-19. The combined therapy significantly increased SpO₂ and improved symptom scores compared to prone positioning alone, thus improving the patients' respiratory function to help them recover. However, the improvement rate did not differ between the two groups. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR2300068319). Please cite this article as: Yin X, Jin Z, Li F, Huang L, Hu YM, Zhu BC, Wang ZQ, Li XY, Li JP, Lao LX, Mi YQ, Xu SF. Effectiveness and safety of adjunctive non-drug measures in improving respiratory symptoms among patients with severe COVID-19: A multicenter randomized controlled trial. J Integr Med. 2024; 22(6): 637-644.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Acupuncture Therapy/methods* ; China ; COVID-19/complications* ; Medicine, Chinese Traditional/methods* ; Moxibustion/methods* ; Oxygen Saturation ; Prone Position ; Respiration, Artificial ; Treatment Outcome

Objective To evaluate the bioequivalence and safety of ibuprofen arginine granules test and reference formulations in Chinese healthy volunteers under fasting and postprandial conditions,and to provide evidence for consistency evaluation and clinical application of the drugs.Methods A single-center,single-dose,randomized,open-label,fasting and postprandial,two-period,two-crossover trial design was used.Twenty-four healthy Chinese volunteers were enrolled in the fasting and postprandial trial,respectively.The test preparation and reference preparation of ibuprofen arginine granules 0.4 g were taken orally in a randomized crossover single dose.Data analysis was performed using Phoenix WinNonlin 8.3.Results In the fasting group,the main pharmacokinetic parameters of ibuprofen in plasma after administration of the test and reference formulations of ibuprofen arginine granules were as follows:Cmax were(51.07±7.43)and(50.10±7.64)μg·mL-1;AUC0-,were(122.78±20.62)and(119.94±21.03)μg·h·mL-1;AUC0_∞ were(125.84±21.31)and(122.64±21.87)μg·h·mL-1,respectively.In the postprandial group,the main pharmacokinetic parameters of ibuprofen in plasma after administration of the test and reference formulations of ibuprofen arginine granules were as follows:Cmax were(17.47±3.56)and(17.89±4.47)μg·mL-1;AUC0-twere(114.33±17.12)and(122.13±29.46)μg·h·mL-1;AUC0_∞ were(134.04±36.72)and(133.96±30.35)μg·h·mL-1,respectively.The 90％confidence intervals of the geometric mean ratio of the two preparations were as follows:Cmax 97.96％-106.02％,AUC0_t 98.77％-105.14％,AUC0-∞ 99.34％-105.19％in fasting group;in postprandial group,Cmax was 92.37％-103.05％,AUC0-t was 93.31％-99.56％,AUC0-∞ was 93.89％-102.91％.Conclusion The test preparation and reference preparation of ibuprofen arginine granules in this study are bioequivalent in healthy adult Chinese volunteers.

Objective:The purpose of this study was to analyze the clinical characteristics of auditory neuropathy (AN) patients with normal hearing or mild hearing loss.Methods:Data from Multicenter Study on Clinical Diagnosis and Intervention of Acoustic Neuropathy (registration number: ChiCTR2100050125). According to the Chinese clinical practice guideline of auditory neuropathy (version 2022), these patients divided into two groups: the normal hearing group (PTA Normal, PTA N group, the average hearing threshold<20 dB HL) and the mild hearing loss group (PTA Mild hearing loss, PTA M group, the average hearing threshold between 20-35 dBHL). The audiology characteristics, clinical features, and follow-up were analyzed. Data analysis was conducted using GraphPad Prism 8 and SPSS 20.0 software. Results:A total of 75 AN with normal hearing or mild hearing loss were included in this study. The PTA N group consisted of 19 patients (38 ears), including 12 males and 7 females. The average onset age was (16.9±4.5) years old, while the test age was (22.1±5.8) years old for PTA N group. The PTA M group consisted of 56 patients (112 ears), including 29 males and 27 females. The average onset age was (16.2±7.9) years old, while the test age was (23.9±9.0) yeas old for PTA M group. The average hearing threshold of low frequency (0.125-0.5 kHz) was significantly decreased. ABR disappeared in 86.00% (126/150) of the patients. The speech recognition rate was 71.80±22.44% in the PTA N group and 58.08±29.28% in the PTA M group.-SP/AP was 0.98±0.47 in the PTA N and 1.07±0.63 in PTA M group; 40 (53.33%) patients had tinnitus. 29 patients (58 ears) were followed up, including 10 patients (20 ears) in the PTA N group and 19 patients (38 ears) in the PTA M group. There was no significant change in hearing threshold in short-term follow-up (<3 years). With the extension of the disease duration (>3 years), the PTA N group tended to decrease at low frequency, and the PTA M group decreased at high frequency first. The hearing threshold at 0.25 kHz in the PTA N group and 4 kHz in the PTA M group decreased significantly. Conclusions:AN patients with normal hearing or mild hearing loss exhibit abnormal results in audiological examination results, including ABR, electrocochleography and speech discrimination score. A combination of audiological tests should be used to make the diagnosis of AN. With the progression of the disease, AN with normal hearing or mild hearing loss tends to decrease.

Objective:To investigate the application effect of comprehensive intervention combined with cognitive psychological care based on the quality chain in patients with BPH.Methods:We prospectively selected 110 cases of BPH treated in our hospital from January 2022 to March 2023 and equally randomized them into groups A and B,the former given routine intervention,while the latter comprehensive intervention combined with cognitive psychological care based on the quality chain in addition.We analyzed the results of intervention,the patients'scores on Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS),improvement of clinical indicators,self-efficacy,disease awareness and treatment compliance,and compared the data obtained between the two groups of patients.Results:The effectiveness of intervention was significantly better in group B than in A(96.36%vs 65.45%,χ2=17.009,P<0.05).Compared with the baseline,the SAS and SDS scores were remarkably improved in the two groups after inter-vention(P<0.05),even more significantly in group B than in A(P<0.05).Group B also showed a markedly shorter duration of bladder spasm,lower frequency of bladder spasm per day,shorter urethral catheterization time and postoperative hospital stay,better e-motion control and health management,more regular schedule,higher disease knowledge awareness,and better treatment compliance than group A(all P<0.05).Conclusion:Comprehensive intervention combined with cognitive psychological care based on the quality chain is significantly effective in improving BPH patients'clinical indicators,disease awareness and treatment compliance,re-ducing their depression and anxiety,and enhancing their self-efficacy management.