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.

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.

Objective: To investigate the effects of scleral crosslinking using genipin on ocular biological parameters and scleral biomechanics of form-deprivation myopia rabbits. Methods: Sixty healthy New Zealand rabbits of 14 days old were collected.The right eyes were selected as experimental eye.The rabbits were randomly divided into three groups: control group with no treatment; myopia model group with eyelid suture procedure performed on the right eye; genipin injection group with eyelid suture procedure performed on the right eye combined with subconjunctival injection of genipin.The suture was removed 60 days after the eyelid suture procedure.The diopter, length of vitreous cavity, and axial length were measured.The sclera at 1: 00 and 7: 00 position of the experimental eye was used to make a scleral strip.The thickness, elastic modulus, creep rate, ultimate stress and ultimate strain of the sclera were measured.This study was approved by the animal experimental Ethics Committee of Bethune International Peace Hospital (2018-ky-09). Results: The diopters of genipin injection group, myopia model group and control group were (2.50±1.38), (0.33±0.52) and (2.08±0.52)D, respectively, the axial lengths of the three groups were (15.33±0.82), (15.83±0.41) and (15.00±0.43)mm, respectively; the changes in vitreous cavity lengths were (1.50±0.79), (2.59±0.83) and (1.48±0.66)mm, respectively; and the ratios of vitreous cavity length to axial length were 0.46±0.02, 0.51±0.02 and 0.47±0.02, respectively.The diopter in myopia model group was significantly lower than those in control group and genipin injection group, the axial length in myopia model group was significantly longer than that in control group, the change in vitreous cavity lengths and ratio of vitreous cavity length to axial length in myopia model group were significantly higher than those in control group and genipin injection group, the axial length in myopia model group was significantly longer than that in control group, the differences were statistically significant (all at P<0.05). The elasticity modulus was (9.10±3.12)MPa and ultimate stress was (1.42±0.57)MPa in genipin injection group, which were significantly higher than (6.98±3.30)MPa and (1.15±0.57)MPa in control group, and (6.25±3.17)MPa and (0.82±0.38)MPa in myopia model group (all at P<0.05). The ultimate strain was (20.99±5.60)% in genipin injection group, which was significantly lower than (25.08±6.35)% in control group and (27.78±8.20)% in myopia model group, with significant differences between them (both at P<0.05). Conclusions Posterior sub-Tenon capsule injection of genipin for collagen crosslinking in the sclera increases the biomechanical strength of sclera and effectively prevents the development of form-deprivation myopia in rabbits, which provides a new idea for the prevention and treatment of myopia in the future.

OBJECTIVE: To determine the clinical significance of the polymerase chain reaction (PCR)-reverse dot blot (RDB) human papillomavirus (HPV) genotyping assay in cervical cancer screening. METHODS: A total of 10,442 women attending the Fujian Provincial Maternity and Children's Health Hospital were evaluated using the liquid-based cytology (thinprep cytologic test [TCT]) and the PCR-RDB HPV test. Women with HPV infection and/or abnormal cytology were referred for colposcopy and biopsy. For HPV DNA sequencing, 120 specimens were randomly selected. Pathological diagnosis was used as the gold standard. RESULTS: Using the PCR-RDB HPV test, overall HPV prevalence was 20.57% (2,148/10,442) and that of high-risk (HR)-HPV infection was 18.68% (1,951/10,442). There was 99.2% concordance between HPV PCR-RDB testing and sequencing. In this studied population, the most common HR-HPV types were HPV-16, -52, -58, -18, -53, -33, and -51, rank from high to low. HPV-16, -18, -58, -59, and -33 were the top 5 prevalent genotypes in cervical cancer but HPV-16, -18, -59, -45, and -33 were the top 5 highest risk factors for cancer (odds ratio [OR]=34.964, 7.278, 6.728, 6.101, and 3.658; all p<0.05, respectively). Among 10,442 cases, 1,278 had abnormal cytology results, of which, the HR-HPV positivity rate was 83.02% (1,061/1,278). To screen for cervical cancer by PCR-RDB HPV testing, when using CIN2+, CIN3+, and cancer as observed endpoints, the sensitivity was 90.43%, 92.61%, and 94.78% and the negative predictive value (NPV) was 99.06%, 99.42%, and 99.78%, respectively. PCR-RDB HPV and TCT co-testing achieved the highest sensitivity and NPV. CONCLUSION: For cervical cancer screening, the PCR-RDB HPV test can provide a reliable and sensitive clinical reference.
Asian Continental Ancestry Group* ; Biopsy ; Child Health ; Colposcopy ; Diagnosis ; Early Detection of Cancer ; Female ; Genotype ; Human papillomavirus 16 ; Humans* ; Mass Screening ; Papillomaviridae ; Polymerase Chain Reaction ; Prevalence ; Risk Factors ; Sequence Analysis, DNA ; Uterine Cervical Neoplasms

OBJECTIVE To evaluate the clinical value of fiberoptic bronchoscopy in the treatment of residual foreign bodies in children after rigid ronchoscopy.METHODS Fiberoptic bronchoscopy was performed in 18 children with residual foreign bodies in the distal bronchus after rigid bronchoscopy between 2012.01 to 2016.12.RESULTS Foreign bodies were found in 17 children,only one case did not found foreign body and was considered to be coughed out.The Foreign bodies were removed in 12 cases under fiberoptic bronchoscopy one time and 5 cases under fiberoptic bronchoscopy more than 2 times.All patients had no laryngeal edema,subcutaneous emphysema,pneumothorax,longitudinal diaphragm emphysema and pneumonia by chest X-ray postoperatively.CONCLUSION Fiberoptic bronchoscopy is a safe and effective method for the diagnosis and treatment of deep residual foreign bodies in children after rigid bronehoscopy.

Through the analysis of current situation of the tension relationship between doctor and patient,this paper expounded that the harmonious management organization theory took the cooperation order as the core of the development of the group organization,and emphasized the running-in process of the internal staffs in the collective group.And it pointed out that the internal cooperation between doctor and patient had the certain cooperation order,and also had obstacles that might cause conflict in cooperation from the perspective of the harmonious management organization theory.This paper analyzed and understood the process of doctor-patient coordination at the group level of harmonious management organization theory,explored and analyzed the obstacles that might cause the conflict during the cooperation process and the reasons in the view of innovation,explored and concluded relevant measures to ease the tension of the doctor-patient relationship,and finally achieved the outcome of maximization of common interests and optimization of treatment effect.