Objective Based on the intervention map to develop a comprehensive nutrition education program for pancreaticoduodenectomy patients and to explore the effect of its clinical application,aiming at providing references for clinical nursing practice.Methods A convenience sampling method was used to select 76 patients who were to undergo pancreaticoduodenectomy in the department of hepatobiliary and pancreatic surgery of a tertiary hospital in Anhui Province as the study subjects.The 38 patients admitted from October 2021 to September 2022 were in a control group,and the 38 patients admitted from October 2022 to July 2023 were in an experimental group.The experimental group received the comprehensive nutritional education programme constructed in this study,and the control group used conventional nutrition health education measures,and the length of intervention for both groups was from pre-hospitalization to discharge for 6 months.Nutrition-related indicators,postoperative complications,hospitalisation time,hospitalisation costs and satisfaction were compared between the 2 groups.Results A total of 64 patients completed this study,with 33 in the experimental group and 31 in the control group.Repeated measurement analysis of variance showed that the interaction effects of BMI,total serum protein and serum preprotein were statistically significant(P＜0.05).The incidence of complications,hospitalization days and hospitalization costs of the experimental group were lower than those of the control group(P＜0.05).The scores of nutrition education-related satisfaction in the experimental group were higher than those in the control group(P＜0.001).Conclusion A comprehensive nutritional education program based on intervention map can improve the nutritional status of pancreaticoduodenectomy patients to a certain extent,reduce the occurrence of complications,and promote patients'recovery.

Objective To report two cases of type A insulin resistance syndrome with new insulin receptor gene mu-tations.Methods Clinical data,laboratory examination,imaging examination and mutation scanning of insulin re-ceptor gene were collected,and type A insulin resistance syndrome reported by domestic and foreign scholars were analyzed retrospectively.Results One case had dry mouth,polydipsia and hyperandrogenemia,and another case had primary amenorrhea,both of them had insulin resistance.Two cases had heterozygous missense mutation in in-sulin receptor gene C.3449T＞c(p.L1150P).The mothers of the two probands all carried this mutation,while the fathers did not.This mutation has not been reported previously.Literature review shows that the onset age of this disease is young,and it is more common in women.BMI 20.37±5.47 kg/m2,fasting blood-glucose 4.50 mmol/L(4.10,13.00),the proportion of insulin resistance is 100％,92.0％has acanthoid nigricans,and the proportion of Testosterone above normal is 81.3％,diabetes complications appear earlier.Conclusions Genetic analysis is helpfulfor the etiological diagnosis in children with severe insulin resistance.

OBJECTIVE: To observe the effects of the "Zhibian" (BL54)-toward-"Shuidao" (ST28) acupuncture on key regulatory factors during mitochondrial apoptosis of testicular tissue in asthenozoospermia mice, and explore the potential mechanism of the protective effect of acupuncture on reproductive function. METHODS: Thirty C57BL/6 male mice were randomly divided into a blank group, a model group and an acupuncture group, 10 mice in each group. In the model and the acupuncture groups, the intraperitoneal injection of cyclophosphamide (30 mg•kg^-1•d^-1) was delivered for 7 days to prepare the asthenozoospermia model. After the success of modeling, the modeled mice in the acupuncture group were intervened with "Zhibian" (BL54)-toward-"Shuidao" (ST28) acupuncture, once daily and the needles were retained for 20 min. The duration of the intervention was 2 weeks. The general condition of each mouse was observed, and the body mass was recorded before modeling, after modeling and after intervention completion. After intervention, the testicular mass was recorded and the weight coefficient was calculated, and the mouse sperm quality was examined; the serum contents of testosterone (T), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were detected using ELISA, the morphology of testicular tissue was observed using HE, the mitochondrial ultra-microstructure of testicular tissue was observed under transmission electrone microscopy, the mitochondrial membrane potential level of testicular tissue was detected using JC-1 staining, the positive rate of apoptosis cell of testicular tissue was observed using TUNEL; and the mRNA and protein expression of b-cell lymphocytoma-2 (Bcl-2), Bcl-2 associated X protein (Bax), cytochrome c (Cyt C), apoptotic protease-activating factor1 (Apaf-1), Caspase-9 and Caspase-3 of testicular tissue was detected using real-time quantitative fluorescence PCR and Western blot methods separately; and the positive expression of Cleaved Caspase-3 of the testicular tissue was detected using immunohistochemistry. RESULTS: Compared with the blank group, the mice were in listless spirits, had shaggy hairs, the reduced appetite and movement, and weight loss in the model group (P<0.01); the testicular mass and the weight coefficient decreased (P<0.01); the total number of sperms, sperm motility, and sperm viability were declined (P<0.01); while the levels of serum T, FSH, and LH were dropped (P<0.01). The morphology of seminiferous tubules in testicular tissue was abnormal, the number of spermatogenic cells and the number of mitochondria decreased, the inner mitochondrial crest was fractured and lost, and vacuoles appeared. The level of mitochondrial membrane potential was reduced (P<0.01); and the positive rate of apoptosis cell in testicular tissue increased (P<0.01). The mRNA and protein expression of Bax, Cyt C, Apaf-1, Caspase-9 and Caspase-3 was elevated (P<0.01, P<0.05), the mRNA and protein expression of Bcl-2 was dropped (P<0.01), and the average absorbance value of Cleaved Caspase-3 increased (P<0.01). When compared with the model group, in the acupuncture group, the general condition of mice was improved, the testicular mass and the weight coefficient elevated (P<0.01); the total number of sperms, sperm motility, and sperm viability increased (P<0.01); while the levels of serum T, FSH, and LH rose (P<0.01). The pathological morphology of testicular tissue and the inner mitochondrial ultra-microstructure were ameliorated, the level of mitochondrial membrane potential was elevated (P<0.01); the positive rate of apoptosis cell was reduced (P<0.01). The mRNA and protein expression of Bax, Cyt C, Apaf-1, Caspase-9 and Caspase-3 was dropped (P<0.01, P<0.05), the mRNA and protein expression of Bcl-2 elevated (P<0.05), and the average absorbance value of Cleaved Caspase-3 declined (P<0.01). CONCLUSION "Zhibian" (BL54)-toward- "Shuidao" (ST28) acupuncture may ameliorate mouse reproductive function by inhibiting mitochondrial apoptosis pathway, alleviating testicular tissue damage in the asthenospermia mice induced by cyclophosphamide.
Animals ; Male ; Mice ; Apoptosis ; Acupuncture Therapy ; Mitochondria/metabolism* ; Asthenozoospermia/genetics* ; Humans ; Testis/metabolism* ; Mice, Inbred C57BL ; Spermatozoa/metabolism* ; Acupuncture Points ; Sperm Motility ; Testosterone/blood* ; Proto-Oncogene Proteins c-bcl-2/genetics* ; Caspase 3/genetics* ; Follicle Stimulating Hormone/blood* ; Reproduction ; Cytochromes c/genetics* ; bcl-2-Associated X Protein/genetics* ; Apoptotic Protease-Activating Factor 1/genetics*

OBJECTIVE: To observe the effect of "Zhibian" (BL54)-toward-"Shuidao" (ST28) needling technique on the relative protein expression of the signaling pathway of nucleotide-binding oligomerization domain-containing protein 1 (NOD1)/ receptor-interacting protein 2 (RIP2)/nuclear factor kappa-B (NF-κB) and the expression of proinflammatory cytokines in the rats with primary dysmenorrhea (PD), so as to explore the underlying mechanism of this acupuncture technique for pain alleviation in PD. METHODS: Thirty female SD rats of SPF grade with normal estrous cycle were randomized into a blank group, a model group and an acupuncture group, 10 rats in each one. Using the intraperitoneal injection with estradiol benzoate combined with oxytocin, PD model was prepared in the model group and the acupuncture group. In the acupuncture group, during model preparation, the intervention with "Zhibian" (BL54)-toward-"Shuidao" (ST28) needling technique was delivered simultaneously, 20 min each time, once daily for consecutive 10 days. On day 11, within 30 min after the intraperitoneal injection with oxytocin, the writhing reaction (latency, frequency and score) was recorded; the morphology of uterine tissue was observed with HE staining, the contents of prostaglandin E₂ (PGE₂), prostaglandin F_2α (PGF_2α), interleukin (IL)-1β, IL-18, cyclooxygenase-2 (COX-2), and tumor necrosis factor-α(TNF-α) in the serum were detected using ELISA method; the relative protein expression of NOD1, RIP2, NF-κB p65, phosphorylation-NF-κB p65 (p-NF-κB p65) was detected in the uterine tissue using Western blot method; and the mRNA expression of NOD1, RIP2 and NF-κB p65 was detected with the quantitative real-time PCR employed. RESULTS: Compared with the blank group, in the model group, the writhing latency was prolonged (P<0.01), the writhing frequency and score increased (P<0.01) in the rats; the endometrial epithelial cells showed massive degeneration and necrosis, with severe endometrial edema and widespread shedding, combined with neutrophil infiltration; the serum PGE₂ content was dropped (P<0.01), while those of PGF_2α, IL-1β, IL-18, COX-2, and TNF-α elevated (P<0.01); the protein expression of NOD1, RIP2, NF-κB p65 and p-NF-κB p65, and the mRNA expression of NOD1, RIP2 and NF-κB p65 in uterine tissue increased (P<0.01). In comparison with the model group, in the acupuncture group, the writhing latency was prolonged (P<0.01), the writhing frequency and score were reduced (P<0.01) in the rats; there was less degeneration and necrosis of endometrial epithelial cells, with mild endometrial edema and very little neutrophil infiltration; the serum PGE₂ content increased (P<0.01), while those of PGF_2α, IL-1β, IL-18, COX-2, and TNF-α decreased (P<0.01); the protein expression of NOD1, RIP2, NF-κB p65 and p-NF-κB p65 and the mRNA expression of NOD1, RIP2 and NF-κB p65 in uterine tissue were dropped (P<0.05, P<0.01). CONCLUSION "Zhibian" (BL54)-toward-"Shuidao" (ST28) needling technique can alleviate the pain symptom of PD rats, and its action mechanism may be related to inhibiting the active expression of NOD1/RIP2/NF-κB signaling pathway in the uterine tissue, thereby reducing the inflammatory response.
Animals ; Female ; Rats, Sprague-Dawley ; Rats ; Signal Transduction ; Dysmenorrhea/metabolism* ; NF-kappa B/metabolism* ; Acupuncture Points ; Humans ; Acupuncture Analgesia ; Nod1 Signaling Adaptor Protein/metabolism* ; Receptor-Interacting Protein Serine-Threonine Kinase 2/metabolism* ; Acupuncture Therapy

Inflammatory bowel disease(IBD)is a chronic inflammatory bowel disease with a complex etiology,mainly including two types:ulcerative colitis(UC)and Crohn's disease(CD),whose risk factors for its development are still incompletely understood.In recent years,Mendelian randomization(MR)has gained increasing attention in IBD research.MR mainly uses genetic variation as an instrumental variable to infer causality between exposure and outcome,effectively avoiding confounding and reverse causality in observational studies and randomised controlled trials.This review summarises currently published MR studies related to IBD,focusing on causal relationships between different risk factors and IBD development.Current findings support a causal relation-ship between IBD and selected oral diseases,skin diseases,psychiatric disorders,autoimmune diseases,bone diseases,gut diseases,gut microbiota,cytokines and nutrients,but not between IBD and lifestyle,cardiovascular diseases and neurodegenerative diseases.Despite its limitations,MR studies are of great significance in improving understanding of etiology of IBD and in identifying potential therapeutic interventions.

Inflammatory bowel disease(IBD)is a chronic inflammatory bowel disease with a complex etiology,mainly including two types:ulcerative colitis(UC)and Crohn's disease(CD),whose risk factors for its development are still incompletely understood.In recent years,Mendelian randomization(MR)has gained increasing attention in IBD research.MR mainly uses genetic variation as an instrumental variable to infer causality between exposure and outcome,effectively avoiding confounding and reverse causality in observational studies and randomised controlled trials.This review summarises currently published MR studies related to IBD,focusing on causal relationships between different risk factors and IBD development.Current findings support a causal relation-ship between IBD and selected oral diseases,skin diseases,psychiatric disorders,autoimmune diseases,bone diseases,gut diseases,gut microbiota,cytokines and nutrients,but not between IBD and lifestyle,cardiovascular diseases and neurodegenerative diseases.Despite its limitations,MR studies are of great significance in improving understanding of etiology of IBD and in identifying potential therapeutic interventions.

Objective Based on the intervention map to develop a comprehensive nutrition education program for pancreaticoduodenectomy patients and to explore the effect of its clinical application,aiming at providing references for clinical nursing practice.Methods A convenience sampling method was used to select 76 patients who were to undergo pancreaticoduodenectomy in the department of hepatobiliary and pancreatic surgery of a tertiary hospital in Anhui Province as the study subjects.The 38 patients admitted from October 2021 to September 2022 were in a control group,and the 38 patients admitted from October 2022 to July 2023 were in an experimental group.The experimental group received the comprehensive nutritional education programme constructed in this study,and the control group used conventional nutrition health education measures,and the length of intervention for both groups was from pre-hospitalization to discharge for 6 months.Nutrition-related indicators,postoperative complications,hospitalisation time,hospitalisation costs and satisfaction were compared between the 2 groups.Results A total of 64 patients completed this study,with 33 in the experimental group and 31 in the control group.Repeated measurement analysis of variance showed that the interaction effects of BMI,total serum protein and serum preprotein were statistically significant(P＜0.05).The incidence of complications,hospitalization days and hospitalization costs of the experimental group were lower than those of the control group(P＜0.05).The scores of nutrition education-related satisfaction in the experimental group were higher than those in the control group(P＜0.001).Conclusion A comprehensive nutritional education program based on intervention map can improve the nutritional status of pancreaticoduodenectomy patients to a certain extent,reduce the occurrence of complications,and promote patients'recovery.

Objective We aimed to investigate the relationship between microscopic pattern of blood stasis and renal pathological grade and related physical and chemical indexes in children with Henoch-Sch?nlein purpura nephritis(HSPN).Methods We conducted a retrospective analysis of 800 HSPN children from the medical records of the First Affiliated Hospital of Henan University of Chinese Medicine.Laboratory indicators(blood routine test,urine routine test,coagulation test,liver function)and renal pathological indicators of them were collected.According to the severity of renal pathological microscopic lesions,the microscopic pattern of blood stasis was divided into three types,including choroidal discord,dead blood coagulation and intracarenal disease accumulation.The classification of renal microscopic pattern of blood stasis and the correlation between laboratory indexes and renal pathological index were analyzed by Spearman grade correlation and binary Logistic regression analysis.Results(ⅰ)There was no statistical difference of the distribution of the renal microscopic pattern of blood stasis in the different traditional Chinese medicine patterns.(ⅱ)There were significant differences in the contents or the grade of albumin and fibrinogen in the HSPN children with different microscopic pattern of blood stasis(all P＜0.05).(ⅲ)The maximum area under the receiver operating characteristic(ROC)curve between fibrinogen and intracarenal disease accumulation was 0.594(95％CI from 0.540 to 0.633,P＜0.001);sensitivity was 0.447,specificity was 0.725;the best threshold on the ROC curve of 0.172 was 3.755 g/L.(ⅳ)There were positive correlations between the content of fibrinogen,ISKDC grade and Bohle A grade respectively with the scores of intracarenal disease accumulation type(r=0.176,r=0.315,r=0.656;all P＜0.001).(ⅴ)There were positive correlations between the content of fibrinogen,ISKDC grade and Bohle A grade respectively with the renal microscopic pattern of blood stasis(r=0.157,r=0.377,r=0.429;all P＜0.001).Conclusion The microscopic renal pattern of blood stasis can not only reflect the severity of renal blood stasis,but also reflect the severity and long-term prognosis of renal diseases.Albumin and urinary protein grade can reflect the early stage of the microscopic renal pattern of the blood stasis(choroidal discord).The content of fibrinogen increases with the aggravation of renal microscopic pattern of blood stasis,reflecting the end-stage of HSPN,which has the correlation with the formation and severity of related indexes.Fibrinogen can be used as a laboratory indicator to assist in the diagnosis of irreversible lesionsin the renal pathology of HSPN children.

OBJECTIVE: We aimed to understand the willingness and barriers to the acceptance of tuberculosis (TB) preventive treatment (TPT) among people with latent TB infection (LTBI) in China. METHODS: A multicenter cross-sectional study was conducted from May 18, 2023 to December 31, 2023 across 10 counties in China. According to a national technical guide, we included healthcare workers, students, teachers, and others occupations aged 15-65 years as our research participants. RESULTS: Overall, 17.0% (183/1,077) of participants accepted TPT. There were statistically significant differences in the acceptance rate of TPT among different sexes, ages, educational levels, and occupations ( P < 0.05). The main barriers to TPT acceptance were misconceptions that it had uncertain effects on prevention (57.8%, 517/894), and concerns about side effects (32.7%, 292/894). CONCLUSION An enhanced and comprehensive understanding of LTBI and TPT among people with LTBI is vital to further expand TPT in China. Moreover, targeted policies need to be developed to address barriers faced by different groups of people.
Humans ; China/epidemiology* ; Adult ; Male ; Female ; Cross-Sectional Studies ; Middle Aged ; Young Adult ; Adolescent ; Aged ; Latent Tuberculosis/prevention & control* ; Patient Acceptance of Health Care ; Tuberculosis/prevention & control* ; Antitubercular Agents/therapeutic use* ; Health Knowledge, Attitudes, Practice