OBJECTIVE: To observe the effects of acupoint catgut embedding (ACE) on gut microbiota and fecal short-chain fatty acids (SCFAs) levels in patients with Parkinson's disease (PD) with constipation. METHODS: A total of 80 PD patients with constipation were randomly divided into an observation group and a control group, 40 cases in each group. Additionally, 40 healthy individuals were recruited as a healthy control group. The control group received conventional Western medical treatment for PD combined with polyethylene glycol (PEG), once daily for eight weeks. The observation group received additional ACE treatment at bilateral Tianshu (ST25), Zusanli (ST36), and Shangjuxu (ST37), once every two weeks for eight weeks. The healthy control group received no intervention. The spontaneous bowel movements (SBMs) per week and patient assessment of constipation quality of life (PAC-QOL) scores were assessed at baseline and after treatment in the two groups. Fecal samples were collected at the end of treatment for the observation and the control groups and at baseline for the healthy control group. Gut microbiota composition and diversity were analyzed using 16S rRNA method, and SCFA levels were measured using high-performance liquid chromatography (HPLC). RESULTS: Compared before treatment, the observation group showed a significant increase in SBMs (P<0.01), and PAC-QOL scores including physical discomfort, psychosocial discomfort, worry and concern, and total score were significantly reduced (P<0.01) after treatment; the control group also showed a reduction in PAC-QOL total score after treatment (P<0.01). After treatment, the observation group had significantly more SBMs (P<0.01), and lower PAC-QOL physical discomfort, psychosocial discomfort, worry and concern scores, and total score (P<0.01), and higher PAC-QOL satisfaction score (P<0.01) than the control group. Compared with the healthy control group, the control group showed decreased Chao1 and Ace indices (P<0.01). Compared with the healthy control group, the relative abundance of Prevotella and Roseburia was increased (P<0.05), while that of Enterobacter and Ruminococcus torques (six species in total) was decreased (P<0.05) in the control group. Compared with the control group, the observation group had increased relative abundance of Dialister, Parabacteroides, and Ruminococcus torques (P<0.05), and decreased relative abundance of Prevotella and Eubacterium ruminantium (P<0.05). Compared with the healthy control group, the control group had increased fecal SCFA levels (P<0.05); compared with the control group, the observation group had reduced fecal SCFA levels (P<0.05). Compared with the healthy control group, acetic acid, propionic acid, and butyric acid levels were elevated in the control group (P<0.05); compared with the control group, acetic acid, propionic acid, and butyric acid levels were decreased in the observation group (P<0.05). CONCLUSION ACE could increase spontaneous bowel movements and improve the quality of life in PD patients with constipation, which may be related to the regulation of gut microbiota composition and SCFA levels.
Humans ; Constipation/metabolism* ; Male ; Gastrointestinal Microbiome ; Acupuncture Points ; Female ; Middle Aged ; Parkinson Disease/complications* ; Aged ; Fatty Acids, Volatile/metabolism* ; Catgut ; Feces/microbiology* ; Acupuncture Therapy ; Quality of Life ; Adult

Objective:To gain a deeper understanding of the cognitive differences between lactating women and obstetric nurses regarding their breastfeeding counselling abilities.Methods:This study was a descriptive phenomenology qualitative study. From October 2021 to June 2022, purposive sampling was used to select 11 lactating women who received breastfeeding counselling and 13 obstetric nurses who provided breastfeeding counselling services in Department of Obstetrics at Peking Union Medical College Hospital for semi-structured interviews. Giorgi analysis method was used to extract and analyze data.Results:The cognitive differences between lactating women and obstetric nurses regarding breastfeeding counselling abilities were mainly manifested in four aspects, namely breastfeeding knowledge and skills, counselling practice ability, improving counselling ability, and personality traits.Conclusions:Lactating women and obstetric nurses have cognitive differences in breastfeeding counselling abilities. Obstetric nurses should improve their breastfeeding counselling skills based on the needs of lactating women and provide personalized breastfeeding counselling services.

Irritable bowel syndrome(IBS)is accompanied by impaired intestinal mucosal barrier,and there is currently no ideal drug therapy.Acupuncture has obvious advantages in protecting intestinal mucosal barrier of IBS,but the molecular biological mechanism needs to be further studied.Based on the overall intestinal homeostasis in the"flora-intestinal epithelial dialogue"study to repair damaged intestinal mucosal barrier has become a hot research in this field.Therefore,based on the frontier basis,this paper discusses the feasibility mechanism of acupuncture in repairing IBS intestinal mucosal barrier injury from the perspective of intestinal flora-short-chain fatty acid-intestinal PPAR γ pathway-mediated intestinal epithelial cell metabolic reprogramming,in order to interpret the scientific connotation of acupuncture in repairing intestinal mucosal barrier injury,and provide a scientific basis for acupuncture therapy to play a greater role in public health care and for the modernization of traditional Chinese medicine.

Objective To observe the effect of moxibustion of"Zusanli"and"Ganshu"on the intestinal flora of colorectal cancer cells liver metastasis in nude mice and its possible mechanism was explored.Methods HCT116-GFP colon cancer cells were inoculated by spleen injection,sixty SPF BALB/c male nude mice were divided into model control group,Pre-Mox group,Post-Mox group,Pre-Post-Mox group.Bilateral"Ganshu(BL18)"and"Zusanli(ST36)"acupoints were selected for moxibustion intervention for once a day for 10 minutes each time.the tumor formation rate,liver metastasis rate and the number of tumor of each group were calculated.Furthermore,16S rRNA analysis was used to assess their microbial diversity.Results Moxibustion intervention can significantly reduce the rate of liver metastasis,reduce the number of metastatic foci.Compared with the model control group,Lactobacillus_reuteri and Robinsoniella_peoriensis were significantly lower in Pre-Mox group(P<0.05).Lactobacillus_gasseri decreased significantly,Clostridium_cocleatum and Erysipelatoclostrdum_ramosum multiplex increased significantly in the Post-Mox group(P<0.01).Pre-Post-Mox mice had significantly decreased levels of Lactobacillus_gasseri,and Clostridium_cocleatum,Akkermansia_muciniphila and Clostridium_cocleatum were significantly increased(P<0.05).LEfSe Difference analysis showed that the Pre-Mox group was mainly changed by Coprobacillus;the Post-Mox group was marked by Muribaculaceae and erysipelas;the Pre-Post-Mox group took Verrucomicrobia,Akkermansia_muciniphila and erysipelas as signs.Conclusion Moxibustion could exert an inhibitory effect on CRC liver metastasis,especially the 5-week Pre-PostMox treatment showed the best inhibitory.The potential mechanism might rely on the alteration of microbiota diversity and composition.

Objective To observe the effect of moxibustion of"Zusanli"and"Ganshu"on the intestinal flora of colorectal cancer cells liver metastasis in nude mice and its possible mechanism was explored.Methods HCT116-GFP colon cancer cells were inoculated by spleen injection,sixty SPF BALB/c male nude mice were divided into model control group,Pre-Mox group,Post-Mox group,Pre-Post-Mox group.Bilateral"Ganshu(BL18)"and"Zusanli(ST36)"acupoints were selected for moxibustion intervention for once a day for 10 minutes each time.the tumor formation rate,liver metastasis rate and the number of tumor of each group were calculated.Furthermore,16S rRNA analysis was used to assess their microbial diversity.Results Moxibustion intervention can significantly reduce the rate of liver metastasis,reduce the number of metastatic foci.Compared with the model control group,Lactobacillus_reuteri and Robinsoniella_peoriensis were significantly lower in Pre-Mox group(P<0.05).Lactobacillus_gasseri decreased significantly,Clostridium_cocleatum and Erysipelatoclostrdum_ramosum multiplex increased significantly in the Post-Mox group(P<0.01).Pre-Post-Mox mice had significantly decreased levels of Lactobacillus_gasseri,and Clostridium_cocleatum,Akkermansia_muciniphila and Clostridium_cocleatum were significantly increased(P<0.05).LEfSe Difference analysis showed that the Pre-Mox group was mainly changed by Coprobacillus;the Post-Mox group was marked by Muribaculaceae and erysipelas;the Pre-Post-Mox group took Verrucomicrobia,Akkermansia_muciniphila and erysipelas as signs.Conclusion Moxibustion could exert an inhibitory effect on CRC liver metastasis,especially the 5-week Pre-PostMox treatment showed the best inhibitory.The potential mechanism might rely on the alteration of microbiota diversity and composition.

Irritable bowel syndrome(IBS)is accompanied by impaired intestinal mucosal barrier,and there is currently no ideal drug therapy.Acupuncture has obvious advantages in protecting intestinal mucosal barrier of IBS,but the molecular biological mechanism needs to be further studied.Based on the overall intestinal homeostasis in the"flora-intestinal epithelial dialogue"study to repair damaged intestinal mucosal barrier has become a hot research in this field.Therefore,based on the frontier basis,this paper discusses the feasibility mechanism of acupuncture in repairing IBS intestinal mucosal barrier injury from the perspective of intestinal flora-short-chain fatty acid-intestinal PPAR γ pathway-mediated intestinal epithelial cell metabolic reprogramming,in order to interpret the scientific connotation of acupuncture in repairing intestinal mucosal barrier injury,and provide a scientific basis for acupuncture therapy to play a greater role in public health care and for the modernization of traditional Chinese medicine.

No case of moyamoya syndrome with bilateral posterior cerebral artery (PCA) occlusion has been reported in China so far as this disease is extremely rare. The case shown in this article is a middle-aged women who has a history of atrial fibrillation, hypertension and type 2 diabetes acutely attacked by this syndrome. The main clinical manifestations included binocular blindness, right limb weakness. Imaging findings showed bilateral acute cerebral infarction in the parietal occipital lobe, bilateral anterior cerebral artery and middle cerebral artery smoke angiogenesis, bilateral PCA occlusion with distal smoke angiogenesis. Considering the medical history of the patient, the cause of the disease was diagnosed as embolic stroke of undetermined source. The patient′s consciousness has been recovered and the limb weakness has been improved after active symptomatic treatment. However, the blindness did not see any improvements. This case report aims to improve clinicians′ understanding of bilateral PCA embolization in patients with moyamoya syndrome so the occurrence of cerebral infarction can be effectively prevented.

Objective:To explore the breastfeeding guidance experience of international board certified lactation consultants (IBCLC) in China, so as to provide reference for promoting breastfeeding guidance in China.Methods:This study adopted a descriptive phenomenological approach. From October 2021 to June 2022, purposive sampling was used to select 15 IBCLC from 8 provinces and cities who provided breastfeeding support. The semi-structured in-depth interview was used for data collection, and the Giorgi method was used to analyze the data and extract themes.Results:A total of 4 themes were extracted, namely, a sense of need, a sense of meaning and value, a sense of resistance at work and a sense of expectation for the future.Conclusions:The needs of the public and the improvement of IBCLC guidance capabilities are the foundation for providing breastfeeding guidance. The realization of self-worth and the attention and support of family, society, and hospital managers are conducive to the development of breastfeeding guidance.

Allografts ; COVID-19 ; China/epidemiology* ; Disease Outbreaks ; Humans ; Kidney Transplantation/adverse effects* ; SARS-CoV-2

Objective:To investigate the risk factors for hemorrhagic transformation (HT) in patients with acute posterior circulation ischemic stroke (PCIS) and its impact on outcomes.Methods:From July 2016 to October 2019, patients admitted to the Department of Neurology, the People's Hospital of Zhengzhou and diagnosed as PCIS were enrolled retrospectively. Their demography, clinical data, laboratory and imaging findings were collected. HT was defined as no intracranial hemorrhage detected by the first head CT/MRI after onset, and intracranial hemorrhage was found during head CT/MRI reexamination within 10 d after onset. Symptomatic HT was defined as intracranial hemorrhage indicated by imaging reexamination and the National Institutes of Health Stroke Scale (NIHSS) score was higher than the baseline. The outcome was evaluated by the modified Rankin Scale at 3 months after onset, and >2 were defined as poor outcome. Multivariate logistic regression analysis was used to identify the independent risk factors for HT, symptomatic HT, and poor outcomes. Results:A total of 242 patients with PCIS were enrolled. Their age was 68.02±12.0 years, and 111 were females (45.9%). The baseline median NIHSS score was 5.9 (interquartile range: 3.1-8.8). HT occurred in 19 patients (7.9%), and 14 of them (73.7%) were symptomatic HT. Follow-up at 3 months showed that 74 patients (30.58%) had poor outcomes, of which 12 died. Multivariate logistic regression analysis showed that higher baseline systolic blood pressure (odds ratio [ OR] 1.076, 95% confidence interval [ CI] 1.021-1.135, P=0.006; OR 1.161, 95% CI 1.087-1.240, P<0.001) and larger infarct volume ( OR 31.293, 95% CI 4.542-215.592, P<0.001; OR 2.084, 95% CI 1.414-3.073, P<0.001) were the independent risk factors for HT and symptomatic HT. The higher NIHSS score ( OR 1.511, 95% CI 1.307-1.746; P<0.001), diabetes mellitus ( OR 2.041, 95% CI 1.054-3.952; P=0.034) and symptomatic HT ( OR 4.514, 95% CI 1.458-13.979; P=0.009) were the independent risk factors for poor outcomes. Conclusions:HT is rare in patients with PCIS. Higher baseline systolic blood pressure and larger infarct volume are the independent risk factors for HT in patients with PCIS. Higher baseline NIHSS scores, diabetes mellitus, and symptomatic HT are the independent risk factors for poor outcomes in patients with PCIS.