This article introduces Professor Zhou Peng's clinical experience in treating generalized anxiety disorder(GAD)using spirit-regulating and root-strengthening integrated acupuncture.Based on the pathological characteristics of GAD,Professor Zhou Peng summarizes its pathogenesis as"disharmony of qi,blood,yin,and yang,"pointing out that"deficiency"is the essence of its onset,with spleen and kidney deficiency being the root cause.He advocates treating GAD from the perspective of"deficiency and decline,"focusing on strengthening the spleen and kidneys,consolidating the root,and nourishing the source,while also regulating the mind.The integrated acupuncture therapy includes needling,refined moxibustion,and intradermal needle embedding.Needling is used to harmonize qi and blood,refined moxibustion to regulate and supplement yin and yang to consolidate the root,and intradermal needle embedding to regulate the mind and consolidate the therapeutic effects of acupuncture.Starting from improving patients'compliance with treatment and ensuring sustained therapeutic effects,Professor Zhou emphasizes that acupuncture manipulation should be fast,gentle,and soft,with needle insertion resembling a swift crane touching the waves and needle manipulation like a deer drinking from a clear spring.He places great importance on patients'sensations and aims to holistically regulate the body's qi,blood,yin,and yang,restoring the balance of body and mind,thereby effectively treating generalized anxiety disorder.

Objective:To systematically evaluate the actual experience and needs of family caregivers for cardiac arrest patients.Methods:Qualitative research on the real experience and needs of family caregivers in patients with cardiac arrest was electronically searched in databases such as PubMed, CINAHL, and Embase. Two researchers independently screened the literature, evaluated its quality, and integrated the research results. The search period was from database establishment to May 1, 2023.Results:A total of 15 articles were included, and 51 research results were extracted. The similar results were summarized into nine categories and integrated into three results, including sudden changes in life and substantial impacts; challenges in controlling complex emotions, and multiple psychological experiences; multidimensional needs.Conclusions:Family caregivers' actual experiences and requirements for cardiac arrest patients are diverse. Medical and nursing staff need to pay attention to the emotional experiences of family caregivers and meet their multidimensional needs.

Objective:To observe the effect of ruxolitinib combined with glucocorticoid on cytomegalovirus (CMV) activation in patients with acute graft-versus-host disease (aGVHD) .Methods:The clinical data of 195 patients who underwent allogeneic hematopoietic stem cell transplantation in the Department of Hematology of the First Medical Center of the People’s Liberation Army General Hospital from August 2018 to September 2020 were retrospectively analyzed. According to the severity of aGVHD, the patients were divided into the non-GVHD group, aGVHD grade Ⅰ group, aGVHD grade Ⅱ-Ⅳ group, and aGVHD grade Ⅲ/Ⅳ group. In addition, they were classified into two subgroups according to the first-line treatment regimen for aGVHD: combined regimen group (ruxolitinib combined with glucocorticoid) and classical regimen group (glucocorticoid alone) . The cumulative incidence of CMV activation, the duration of CMV activation, and the duration of CMV negativity in each subgroup at 90 and 180 days after transplantation were analyzed. The overall survival and disease-free survival rates of patients in both regimens were compared.Results:Sixty-four (32.8%) patients in the group did not develop aGVHD. The numbers of patients with grade Ⅰ, Ⅱ-Ⅳ, and Ⅲ/Ⅳ aGVHD were 30 (15.4%) , 101 (51.8%) , and 14 (7.2%) , respectively. Compared with patients in the classical regimen, no significant difference was observed in the cumulative incidence of CMV activation, duration of CMV activation, and duration of CMV negativity in patients with grade Ⅰ-Ⅳ aGVHD in the combined regimen at 90 and 180 days after transplantation ( P>0.05) . Further analysis of patients with grade Ⅱ-Ⅳ and Ⅲ/Ⅳ aGVHD showed that the cumulative incidence of CMV activation, duration of CMV activation, and duration of CMV negativity did not show significant difference between the two treatment regimens ( P>0.05) . In addition, there was no significant difference in the overall survival and disease-free survival rates of patients in both regimens ( P>0.05) . Conclusion:Ruxolitinib combined with glucocorticoid as the first-line therapy for aGVHD did not increase the risk of CMV activation.

Objective:To investigate the implementation status of development supportive care (DSC) for premature infants in hospitals in China and to provide basis for the development of DSC and standard formulation for premature infants in the future.Methods:This study was a cross-sectional study. Using the convenience sampling method, from July to August 2020, 117 hospitals in 22 provinces/ municipalities/ autonomous regions where members of the Pediatric Professional Committee of the Chinese Nursing Association were selected as the survey subjects. The survey was conducted using the "Questionnaire on the Implementation Status of Developmental Support Nursing for Preterm Infants" made by the Pediatric Professional Committee of the Chinese Nursing Association. A total of 117 questionnaires were sent out in this survey, and 106 valid questionnaires were collected, with an effective recovery rate of 90.6%.Results:Among 106 hospitals, 62 (58.5%) carried out DSC for premature infants, 54 (50.9%) regularly carried out DSC training for medical staff, and 40 (37.7%) formulated clinical guidelines or implementation plans for DSC and 99 (93.4%) hospital facilities had no nursing staff certified by DSC. Among the 62 hospitals that had implemented DSC for premature infants, only 6 (9.7%) hospitals carried out corridor visits. There were significant differences in the implementation of DSC for premature infants in different grades and types of hospitals ( P<0.05) . Conclusions:DSC for premature infants has not yet been widely popularized, and the development status is uneven, family-centered nursing mode is limited. It is necessary to strengthen the training of DSC for premature infants professionals, formulate DSC guidelines in line with China and provide talent and institutional guarantees for the development of DSC for premature infants.

Objective:To explore the protective effect of the water-soluble total flavonoids from Isodon lophanthoides var.gerardia-nus (Benth.) H.Hara on LO2 cells damage.Methods:The cytotoxicity was evaluated by MTT cell viability determination to confirm the concentration range .Hepatocyte damage model was established by H 2 O2 treatment.After the oxidative stress hepatocyte was coin-cubated with WSTF at different concentrations for various times , the protective effect of WSTF on H 2 O2-induced hepatocyte damage was evaluated by MTT cell viability determination and the content determination of ALT , AST and MDA in cell supernatant .The inhibition of WSTF against H 2 O2-induced LO2 cells apoptosis was evaluated by the quantitative determination of Rhodamine 123 fluorescence and intracellular ROS.Results:The LO2 cells injured by 0.3 mmol· L-1 H2 O2 treatment for 4 h were used as the hepatocyte damage model.The concentration range of WSTF was 0.0312-0.125 mg· ml-1.WSTF could inhibit H2O2-induced injury in LO2 cells and obviously reduce ALT, AST and MDA.Moreover, WSTF could reverse mitochondrial membrane potential depolarization and decrease the amount of intracellular ROS .Conclusion:WSTF exhibits notable protective and curative effects on hepatocyte damage in vitro.

BACKGROUND AND OBJECTIVES: Previous studies have shown that integrins alpha5beta1 (ITGA5B1) gene-modified rat bone marrow mesenchymal stem cells (rBMSCs) could prevent cell anoikis and increase the nitric oxide (NO) production. Here we examined the capability of rBMSCs/ITGA5B1 on the phenotype modulation of Human Pulmonary Artery Smooth Muscle Cell (HPASMC) in vitro. METHODS AND RESULTS: The synthetic (dedifferentiated) phenotype of HPASMC was induced by monocrotaline (MCT, 1μM) for 24 h and then co-cultured with rBMSCs/ITGA5B1 in a transwell culture system. The activation of NO/cGMP (nitric oxide/Guanosine-3′, 5′-cyclic monophosphate) signaling was investigated in HPASMC. The changes of pro-inflammatory factors, oxidative stress, vasodilator, vasoconstrictor, contractile and synthetic genes, and the morphological changes of HPASMC were investigated. The results of this study showed that the NO/cGMP signal, endothelial nitric oxide synthase (eNOS) expression, the expression of the vasoprotective genes heme oxygenase-1 (HMOX1) and prostaglandin-endoperoxide synthase 2 (PTGS2) were increased, but the expression of transforming growth factor-β1 (TGF-β1), CCAAT/enhancer-binding proteins delta (Cebpd), Krüppel-like factor 4 (KLF4), and activating transcription factor 4 (ATF4) were reduced in MCT treated HPASMC co-cultured with rBMSCs/ITGA5B1. The synthetic smooth muscle cells (SMCs) phenotype markers thrombospondin-1, epiregulin and the vasoconstrictor endothelin (ET)-1, thromboxane A2 receptor (TbxA2R) were down-regulated, whereas the contractile SMCs phenotype marker transgelin expression was up-regulated by rBMSCs/ITGA5B1. Furthermore, rBMSCs/ITGA5B1 promoted the morphological restoration from synthetic (dedifferentiation) to contractile (differentiation) phenotype in MCT treated HPASMC. CONCLUSIONS: rBMSCs/ITGA5B1 could inhibit inflammation and oxidative stress related genes to promote the HPASMC cell differentiation by activation NO/cGMP signal.
Activating Transcription Factor 4 ; Animals ; Anoikis ; Bone Marrow ; Cell Differentiation ; Endothelins ; Epiregulin ; Genes, Synthetic ; Heme Oxygenase-1 ; Humans ; In Vitro Techniques ; Inflammation ; Integrins ; Mesenchymal Stromal Cells ; Monocrotaline ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; Nitric Oxide Synthase Type III ; Nitric Oxide ; Oxidative Stress ; Phenotype ; Prostaglandin-Endoperoxide Synthases ; Pulmonary Artery ; Rats ; Receptors, Thromboxane A2, Prostaglandin H2

Objective To investigate and compare the killing effect of photodynamic therapy (PDT)induced by hematoporphyrin derivative (HpD),hematoporphyrin monomethyl ether (HMME) and photocarcinorin (PsD007) on human leukemia cells K562 in vitro.Methods Human leukemia cells were cultured with serial concentrations of photosensitizers followed by irradiation of different dosage of laser light,then MTT colorimetric assay was applied to measure the relative survival rate of PDT for the cells.Results Significant difference in the inhibitory between the PDT group and control group was observed (P＜0.05).The survival rate of PDT for the cells elevated along with the increase in the concentration of sensitizer and dose of laser light.When the photosensitizer concentration was bigger (25 μg/ml) or the energy density was bigger (7.2 J/cm2),the effect of PsD007 was better than HMME,and they were significantly better than HpD (P＜0.05).Conclusion PDT has significant killing effect on human leukemia cells K562,and its relative inhibitory rate appears to be correlated with the dose of sensitizer and laser light irritation.The effect of PDT is related to the photosensitizers.The effect of HpD-PDT is not as effective as PsD007 and HMME.On the conditions of higher energy density and larger photosensitizer concentration,the effect of PsD007-PDT is better than HMME-PDT.

Objective To investigate the effect of atorvastatin on expression of ABCA1(mRNA,protein) and LXR? mRNA in THP-1 macrophages induced by PMA.Methods Cultured THP-1 cells were induced to differentiate into macrophages by PMA for 48 hours.The macrophages were incubated with atorvastatin in different concentions for 24 or 48 hours.We determined the changes of ABCA1 mRNA,protein and LXR? mRNA by reverse trancriptase polymerase chain reaction(RT-PCR) and immuno-histochemistry.Results The expression level of ABCA1 mRNA(ratio of relative expression 1.21 vs 1.48) and protein as well as LXR? mRNA(0.87 vs1.12) were decreased in THP-1macrophages when cultured with atorvastatin(10 ?mol/L) for 24 h.Conclusion Atorvastatin inhibits the expression of ABCA1 mRNA and protein as well as LXR? mRNA of THP-1macrophages in vitro.

OBJECTIVETo investigate the association between catecholamine-beta-adrenoceptor (beta-AR)-adenosine 3', 5'-monophosphate (cAMP) system and long-term prognosis in patients with chronic heart failure (CHF).

METHODSThe study population comprised 73 patients with CHF (EF: 23% +/- 10%) with a mean follow-up of 3.8 +/- 1.9 years. Plasma levels of norepinephrine (NE) were measured using high performance lipid chromatography, beta-adrenergic receptor density (Bmax) and the content of cAMP in peripheral lymphocytes were calculated using 3H-dihydroalpneolo as ligand and competitive immunoassay, respectively. Deaths due to cardiovascular events within the follow-up period were registered.

RESULTSThe total mortality was 64.7%, 57.4% of which was for cardiogenic (worsening heart failure: 32.4%; sudden death: 25.0%). In the cardiogenic death group, plasma levels of NE and epinephrine (E) (3.74 nmol/L +/- 0.09 nmol/L and 3.17 nmol/L +/- 1.0 nmol/L) and the contents of peripheral lymphocyte cAMP (3.64 pmol/mg protein +/- 1.4 pmol/mg protein) were significantly increased as compared with the survival group (2.68 nmol/L +/- 0.07 nmol/L, 2.41 nmol/L +/- 0.24 nmol/L and 2.73 pmol/mg protein +/- 0.9 pmol/mg protein, respectively, all P < 0.01). In the sudden death group, plasma levels of NE and E (5.01 nmol/L +/- 0.06 nmol/L and 4.13 nmol/L +/- 0.08 nmol/L) were significantly increased as compared with the worsening heart failure group (2.49 nmol/L +/- 0.07 nmol/L and 2.33 nmol/L +/- 0.8 nmol/L, all P < 0.001) and to the survival group (2.68 nmol/L +/- 0.07 nmol/L and 2.41 nmol/L +/- 0.14 nmol/L, all P < 0.01). The incidences of sudden death were 0%, 75%, and 100% (chi(2) = 16.018, P < 0.01) in patients with plasma NE < 2.5 nmol/L, NE 2.5 nmol/L - 4.5 nmol/L, and NE > 4.5 nmol/L, respectively. In the worsening heart failure group, the content of peripheral lymphocyte cAMP (4.46 pmol/mg protein +/- 0.18 pmol/mg protein) was significantly increased compared with the sudden death group (2.39 pmol/mg protein +/- 0.9 pmol/mg protein, P < 0.001) and to the survival group (2.73 pmol/mg protein +/- 1.1 pmol/mg protein, P < 0.001). The worsening heart failure death occurences were 5.0%, 72.2%, and 100% (chi(2) = 14.26, P < 0.01) in patients with a content of peripheral lymphocyte cAMP < 2.5 nmol/L, cAMP 2.5 nmol/L - 4.5 nmol/L, and cAMP > 4.5 nmol/L, respectively. Bmax in peripheral lymphocyte was not significantly different (P > 0.05) among the sudden death, worsening heart failure, and survival groups in CHF patients.

CONCLUSIONSPlasma levels of catecholamine increase significantly, and Bmax and the contents of cAMP in peripheral lymphocytes decrease significantly in patients with CHF. High plasma catecholamine levels may be associated with sudden death, and high intralymphocyte cAMP content may be associated with worsening heart failure in CHF patients.

Adult ; Aged ; Catecholamines ; blood ; Cyclic AMP ; blood ; Death, Sudden, Cardiac ; Female ; Heart Failure ; blood ; mortality ; Humans ; Lymphocytes ; chemistry ; Male ; Middle Aged ; Receptors, Adrenergic, beta ; blood

Methods In the present study, 69 male patients with essential hypertension at different stages were compared with a group of age-matched normotensive controls. β-adrenoreceptor maximum bound volume (Bmax) in pedpheml lymphocytes was measured by 3H-dihydroalprenolol(3 H-DHA) radio ligand binding.β-adrenoreoeptor responsiveness was determined by Salbutamol(injection). Results In patients with essential hypertension at stages Ⅰ and Ⅱ, Bmax was significantly higher (P＜0.01 and P＜0.001, respectively) and the chronotropic doses of Salbutamol reqaired to increase the heart rate by 30 beats/min (CD30) were significantly lower(P＜0.01 and P＜0.001,respectively) than in age-matched normotensive control subjects.In patients with essential hypertension at stage Ⅲ, Bmax was significantly lower and CD30 was significantly higher (both P＜0.01) than those in the age-matched normotensive control subjects.Bmax was significantly higher and CD30 was significantly lower (both P＜0.001) in patients with essential hypertension and with left ventricular hypertrophy (LVH) than that in patients with essential hypertension but without LVH. In patients with essential hypertension and heart failure, Bmax was significantly lower and CD30 was significantly higher (both P＜0.001) than those in patients with essential hypertension without heart failure.Conclusions The changes of β-adrenoreceptor density and function were related to hypertension,hypertension complicated with ventricular hypertrophy,and heart failure. They may be viewed as indexes of the condition in the patients with essential hypertension.