Objective:To evaluate the clinical efficacy of Huolong moxibustion combined with Shaofu Zhuyu ointment acupoint application in the treatment of sequelae of pelvic inflammatory disease with cold coagulation and stasis syndrome.Methods:Randomized controlled trial study was performed. 102 patients with pelvic inflammatory disease in our hospital from June 2021 to June 2023 were selected as the observation subjects. They were divided into two groups according to random number table method, with 51 cases in each group. The control group was treated with conventional Western medicine therapy, with 10 days as one course of treatment, for a total of 3 courses of treatment. The observation group was treated with Huolong Moxibustion combined with Shaofu Zhuyu Ointment acupoint application, once every 3 days, with 5 sessions as a course of treatment, for a total of 3 menstrual cycles. TCM syndrome scores were performed before and after treatment; doppler ultrasound diagnostic instrument was used to detect the maximum systolic blood flow velocity (PSV), end diastolic blood flow velocity (EDV), pulsatile index (PI), and resistance index (RI) of the uterine artery; ELISA was used to detect levels of β - endorphin (β - EP), prostaglandin F2α(PGF2α), and serum substance P (SP). Adverse reactions during treatment were recorded, and clinical efficacy was evaluated.Results:The total effective rate of the observation group was 92.16% (47/51), while that of the control group was 76.47% (39/51),the difference between the two groups was statistically significant ( χ2=4.74, P=0.029).After treatment, the observation group had lower abdominal pain refusal to press (1.76 ± 0.45 vs. 2.12 ± 0.54, t=3.66),limb coldness and chills (1.85 ± 0.47 vs. 2.21 ± 0.60, t=3.37), menstrual disorders (1.93 ± 0.56 vs. 2.31 ± 0.58, t=3.37), tongue purple coating white score (2.04 ± 0.55 vs. 2.52 ± 0.50, t=4.25) and total score (7.58 ± 1.56 vs. 9.16 ± 1.92, t=4.56) than the control group ( P<0.01); the EDV [(18.86 ± 3.65) cm/s vs. (14.45 ± 3.51) cm/s, t=6.23] and PSV [(37.94 ± 5.19) cm/s vs. (32.21 ± 4.97) cm/s, t=5.70] of the uterine artery were higher than those in the control group ( P<0.01); the RI [(72.62 ± 7.56)% vs. (78.31 ± 6.58)%, t=4.05], PI [(41.94 ± 5.90)% vs. (47.52 ± 5.59)%, t=4.90] were lower than those in the control group ( P<0.01);the levels of β-EP [(49.86 ± 5.87) μg/L vs. (55.41 ± 5.91) μg/L, t=4.76], PGF2α [(71.94 ± 8.13) μg/L vs. (78.21 ± 8.97) μg/L, t=3.70], and SP [(19.12 ± 3.98) μg/L vs. (22.34 ± 3.81) μg/L, t=4.17] were lower than those in the control group ( P<0.05).The incidence of adverse reactions during treatment was 11.76% (6/51) in the observation group and 3.9% (2/51) in the control group, with no statistically significant difference between the two groups ( χ2=0.44, P=0.505). Conclusion:The combination of Huolong Moxibustion and Shaofu Zhuyu Ointment acupoint application can effectively improve the microcirculation status of the uterine artery in patients with pelvic inflammatory disease sequelae of cold coagulation and blood stasis syndrome, reduce the level of pain factors, alleviate the main symptoms of patients, improve clinical efficacy, and have good safety.

Objective To investigate the effect of dexmedetomidine on renal function in patients with septic-associated acute kidney injury(SAKI).Methods A prospective cohort study was conducted in 180 patients with sepsis admitted to ICU in the Second Affiliated Hospital of Guangdong Medical University from October 2021 to April 2023.According to the principle of randomized controlled trials,60 non-acute kidney injury(AKI)patients were divided into S-D group(n = 30,dexmedetomidine + conventional treatment)and S group(n = 30,conventional treatment),and the occurrence and disease score of AKI after treatment were compared between the two groups.A total of 120 AKI patients were divided into SA-D-RT group(n = 30,dexmedetomidine + blood purification + conven-tional treatment),SA-D group(n = 30,dexmedetomidine + conventional treatment),SA-RT group(n = 30,blood purification + conventional treatment)and SA group(n = 30,conventional treatment).Renal function,inflammatory factor level and disease change of the four groups were compared after treatment.Results After treatment,the inci-dence of AKI in S-D group was lower than that in S group,and the APACHEII score and SOFA score in S-D group were lower than those in S group on the 7th day after treatment(P<0.05).After 7 days of treatment,the level of Scr,BUN and CysC in the 4 groups was significantly lower than that on the 1st and 3rd day,and those in the SA-D-RT group were lower than those in the SA-D group,SA-RT group and SA group(P<0.05).After 7 days of treatment,the level of CRP,PCT,TNF-α,IL-6 and IL-1β in four groups was significantly decreased compared with on the 1st and 3rd day,and the level of CRP,PCT,TNF-α,IL-6 and IL-1β in SA-D-RT group was lower than that in SA-D group,SA-RT group and SA group(P<0.05).After 7 days of treatment,the APACHEII score and SOFA score of the four groups were significantly lower than on the 1st and 3rd day,and the scores of the SA-D group were lower than those of the SA-D group,the SA-RT group and the SA group(P<0.05).Conclusion Dexmedetomidine can effectively reduce the incidence of AKI,affect the expression level of renal function markers and inflammatory factors in serum of SAKI patients,and improve the condition of patients.

Objective:To explore the effect of Zhisanzhen acupuncture on cognition ability and apoptosis in the hippocampus using a murine model of cerebral ischemia.Methods:Thirty-two male C57 mice were randomly divided into a control group, a model group, a sham acupuncture group and a Zhisanzhen group, each of 8. All except the control group received middle cerebral artery occlusion and reperfusion (MCAO/R) surgery. Successful modeling was confirmed using Bederson scoring and 2, 3, 5-triphenyltetrazolium chloride staining. Beginning 24 hours after successful modeling, the Zhisanzhen group was given 30 minutes of acupuncture at the Shenting and bilateral Benshen points with the injection 3mm deep daily for five days The sham acupuncture group was given acupuncture at 5 mm next to the Shenting and bilateral Benshen points 3mm deep. Twenty-four hours after the last session of acupuncture, the rats′ cognition was tested using a water maze. After the experiment the hippocampus was sampled on the affected side and any apoptosis of hippocampal neurons was detected using the terminal deoxynucleotidyl transferase nick-end labeling (TUNEL) assays. Changes in caspase-3, cleaved caspase-3 protein and p38 mitogen-activated protein kinase (MAPK) protein in the hippocampal tissue were evaluated using western blotting. The total serine phosphorylation level of caspase-3 protein was detected using immunoprecipitation.Results:Compared to the model and the sham groups, the average escape latency in the Zhisanzhen group was significantly shorter and the times crossing the platform was significantly greater. There were significantly fewer TUNEL-positive cells in the Zhisanzhen group on average, and less caspase-3 and cleaved caspase-3, but significantly more p38-MAPK and greater serine phosphorylation of its substrate caspase-3.Conclusion:Zhisanzhen acupuncture can ameliorate recognition difficulties after cerebral ischemia. It promotes phosphorylation of caspase-3, limiting its cleavage and activation, and decreasing neuron apoptosis in the hippocampus.

Objective:To investigate the epidemiological characteristics, diagnosis, treat-ment and prognosis of gallbladder cancer in China from 2010 to 2017.Methods:The single disease retrospective registration cohort study was conducted. Based on the concept of the real world study, the clinicopathological data, from multicenter retrospective clinical data database of gallbladder cancer of Chinese Research Group of Gallbladder Cancer (CRGGC), of 6 159 patients with gallbladder cancer who were admitted to 42 hospitals from January 2010 to December 2017 were collected. Observation indicators: (1) case resources; (2) age and sex distribution; (3) diagnosis; (4) surgical treatment and prognosis; (5) multimodality therapy and prognosis. The follow-up data of the 42 hospitals were collected and analyzed by the CRGGC. The main outcome indicator was the overall survival time from date of operation for surgical patients or date of diagnosis for non-surgical patients to the end of outcome event or the last follow-up. Measurement data with normal distribu-tion were represented as Mean±SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range), and com-parison between groups was conducted using the U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis was performed using the Logistic forced regression model, and variables with P<0.1 in the univariate analysis were included for multivariate analysis. Multivariate analysis was performed using the Logistic stepwise regression model. The life table method was used to calculate survival rates and the Kaplan-Meier method was used to draw survival curves. Log-rank test was used for survival analysis. Results:(1) Case resources: of the 42 hospitals, there were 35 class A of tertiary hospitals and 7 class B of tertiary hospitals, 16 hospitals with high admission of gallbladder cancer and 26 hospitals with low admission of gallbladder cancer, respectively. Geographical distribution of the 42 hospitals: there were 9 hospitals in central China, 5 hospitals in northeast China, 22 hospitals in eastern China and 6 hospitals in western China. Geographical distribution of the 6 159 patients: there were 2 154 cases(34.973%) from central China, 705 cases(11.447%) from northeast China, 1 969 cases(31.969%) from eastern China and 1 331 cases(21.611%) from western China. The total average number of cases undergoing diagnosis and treatment in hospitals of the 6 159 patients was 18.3±4.5 per year, in which the average number of cases undergoing diagnosis and treatment in hospitals of 4 974 patients(80.760%) from hospitals with high admission of gallbladder cancer was 38.8±8.9 per year and the average number of cases undergoing diagnosis and treatment in hospitals of 1 185 patients(19.240%) from hospitals with low admission of gallbladder cancer was 5.7±1.9 per year. (2) Age and sex distribution: the age of 6 159 patients diagnosed as gallbladder cancer was 64(56,71) years, in which the age of 2 247 male patients(36.483%) diagnosed as gallbladder cancer was 64(58,71)years and the age of 3 912 female patients(63.517%) diagnosed as gallbladder cancer was 63(55,71)years. The sex ratio of female to male was 1.74:1. Of 6 159 patients, 3 886 cases(63.095%) were diagnosed as gallbladder cancer at 56 to 75 years old. There was a significant difference on age at diagnosis between male and female patients ( Z=-3.99, P<0.001). (3) Diagnosis: of 6 159 patients, 2 503 cases(40.640%) were initially diagnosed as gallbladder cancer and 3 656 cases(59.360%) were initially diagnosed as non-gallbladder cancer. There were 2 110 patients(34.259%) not undergoing surgical treatment, of which 200 cases(9.479%) were initially diagnosed as gallbladder cancer and 1 910 cases(90.521%) were initially diagnosed as non-gallbladder cancer. There were 4 049 patients(65.741%) undergoing surgical treatment, of which 2 303 cases(56.878%) were initially diagnosed as gallbladder cancer and 1 746 cases(43.122%) were initial diagnosed as non-gallbladder cancer. Of the 1 746 patients who were initially diagnosed as non-gallbladder cancer, there were 774 cases(19.116%) diagnosed as gallbladder cancer during operation and 972 cases(24.006%) diagnosed as gallbladder cancer after operation. Of 6 159 patients, there were 2 521 cases(40.932%), 2 335 cases(37.912%) and 1 114 cases(18.087%) undergoing ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) examination before initial diagnosis, respec-tively, and there were 3 259 cases(52.914%), 3 172 cases(51.502%) and 4 016 cases(65.205%) undergoing serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis, respectively. One patient may underwent multiple examinations. Results of univariate analysis showed that geographical distribution of hospitals (eastern China or western China), age ≥72 years, gallbladder cancer annual admission of hospitals, whether undergoing ultrasound, CT, MRI, serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis were related factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.45, 1.98, 0.69, 0.68, 2.43, 0.41, 1.63, 0.41, 0.39, 0.42, 95% confidence interval as 1.21-1.74, 1.64-2.40, 0.59-0.80, 0.60-0.78, 2.19-2.70, 0.37-0.45, 1.43-1.86, 0.37-0.45, 0.35-0.43, 0.38-0.47, P<0.05). Results of multivariate analysis showed that geographical distribution of hospitals (eastern China or western China), sex, age ≥72 years, gallbladder cancer annual admission of hospitals and cases undergoing ultrasound, CT, serum CA19-9 examination before initially diagnosis were indepen-dent influencing factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.36, 1.42, 0.89, 0.67, 1.85, 1.56, 1.57, 0.39, 95% confidence interval as 1.13-1.64, 1.16-1.73, 0.79-0.99, 0.57-0.78, 1.60-2.14, 1.38-1.77, 1.38-1.79, 0.35-0.43, P<0.05). (4) Surgical treatment and prognosis. Of the 4 049 patients undergoing surgical treatment, there were 2 447 cases(60.435%) with complete pathological staging data and follow-up data. Cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb were 85(3.474%), 201(8.214%), 71(2.902%), 890(36.371%), 382(15.611%), 33(1.348%) and 785(32.080%), respectively. The median follow-up time and median postoperative overall survival time of the 2 447 cases were 55.75 months (95% confidence interval as 52.78-58.35) and 23.46 months (95% confidence interval as 21.23-25.71), respectively. There was a significant difference in the overall survival between cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb ( χ2=512.47, P<0.001). Of the 4 049 patients undergoing surgical treatment, there were 2 988 cases(73.796%) with resectable tumor, 177 cases(4.371%) with unresectable tumor and 884 cases(21.833%) with tumor unassessable for resectabi-lity. Of the 2 988 cases with resectable tumor, there were 2 036 cases(68.139%) undergoing radical resection, 504 cases(16.867%) undergoing non-radical resection and 448 cases(14.994%) with operation unassessable for curative effect. Of the 2 447 cases with complete pathological staging data and follow-up data who underwent surgical treatment, there were 53 cases(2.166%) with unresectable tumor, 300 cases(12.260%) with resectable tumor and receiving non-radical resection, 1 441 cases(58.888%) with resectable tumor and receiving radical resection, 653 cases(26.686%) with resectable tumor and receiving operation unassessable for curative effect. There were 733 cases not undergoing surgical treatment with complete pathological staging data and follow-up data. There was a significant difference in the overall survival between cases not undergoing surgical treatment, cases undergoing surgical treatment for unresectable tumor, cases undergoing non-radical resection for resectable tumor and cases undergoing radical resection for resectable tumor ( χ2=121.04, P<0.001). (5) Multimodality therapy and prognosis: of 6 159 patients, there were 541 cases(8.784%) under-going postoperative adjuvant chemotherapy and advanced chemotherapy, 76 cases(1.234%) under-going radiotherapy. There were 1 170 advanced gallbladder cancer (pathological staging ≥stage Ⅲa) patients undergoing radical resection, including 126 cases(10.769%) with post-operative adjuvant chemotherapy and 1 044 cases(89.231%) without postoperative adjuvant chemo-therapy. There was no significant difference in the overall survival between cases with post-operative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.23, P=0.629). There were 658 patients with pathological staging as stage Ⅲa who underwent radical resection, including 66 cases(10.030%) with postoperative adjuvant chemotherapy and 592 cases(89.970%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.05, P=0.817). There were 512 patients with pathological staging ≥stage Ⅲb who underwent radical resection, including 60 cases(11.719%) with postoperative adjuvant chemotherapy and 452 cases(88.281%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemo-therapy and cases without post-operative adjuvant chemo-therapy ( χ2=1.50, P=0.220). Conclusions:There are more women than men with gallbladder cancer in China and more than half of patients are diagnosed at the age of 56 to 75 years. Cases undergoing ultrasound, CT, serum CA19-9 examination before initial diagnosis are independent influencing factors influencing initial diagnosis of gallbladder cancer patients. Preoperative resectability evaluation can improve the therapy strategy and patient prognosis. Adjuvant chemotherapy for gallbladder cancer is not standardized and in low proportion in China.

Objective:To describe the current status quo of humanistic care quality of psychiatric nurses in China, analyze its influence factors, and explore the relationship between humanistic care quality, professional values and sense of organizational support of psychiatric nurses.Methods:Using multi-stage stratified cluster sampling method selected, totally 5 003 nurses from 43 the psychiatric hospitals or psychiatric department in general hispitals were investigated with general information questionnaire, Nursing Caring Characters Assessment Tool, Perceived Organizational Support Scale (POS) and Nurses Professional Values Scale-Revised (NPVS-R) from May to August, 2018.Results:In 5 003 psychiatric nurses, the total score of Nursing Caring Characters Assessment Tool was 4.21 ± 0.63. The humanistic care knowledge dimension and humanistic care ability dimension were better (4.27±0.65, 4.21 ± 0.63), while the humanistic care concept dimension and humanistic care perception dimension were weaker(4.16±0.66, 4.17±0.66). The results of structural equation model showed that personal background, care environment, sense of organizational support and professional values had influence on the humanistic care quality of psychiatric nurses, and the standardized total effect values were 0.047, 0.106, 0.508 and 0.512 respectively.Conclusions:The overall level of humanistic care quality of psychiatric nurses is good, but there is still room for further improvement, especially the concept and perception of humanistic care. in order to meet the growing needs of the public for nursing services and the needs of nursing professional development and discipline development, caring for the environment, personal background, sence of organizational support and professional values are important factors affecting the quality of humanistic care of psychiatric nurses.

Objective:To investigate the value of 3D printing combined with intraoperative electrophysiological monitoring in excision of cerebellopontine angle (CPA) tumor.Methods:The clinical data of 43 patients with CPA tumor, admitted to our hospital from October 2016 to October 2019, were collected and analyzed. These patients were voluntarily divided into ordinary group ( n=27) and optimized group ( n=16). Patients in the ordinary group were operated microscopically, and those in the optimized group were operated microscopically with 3D printing combined with intraoperative electrophysiological monitoring. The degrees of tumor resection and neurological functions (facial and auditory nerve function, swallowing function, limb activity) improvements were compared between the two groups. Results:The degrees of tumor resection of the optimized group were significantly higher than those of the ordinary group ( P<0.05), and the improvement of facial and auditory nerve function in the optimized group was significantly better than that in the ordinary group ( P<0.05). There was no significant difference in improvements of swallowing function and limb activity between the two groups ( P>0.05). Conclusion:The 3D printing combined with intraoperative electrophysiological monitoring can improve the resection rate of CPA tumor, protect the facial auditory nerve, and improve the quality of life of patients after surgery.

Objective:To understand the understanding and attitudes of psychiatric nurses, patients and caregivers to humanistic care quality of psychiatric nurses, so as to provide references for the intervention countermeasures and nursing management to improve the humanistic care quality of psychiatric nurses.Methods:In August 2018, 16 psychiatric nurses, 11 patients and 11 caregivers in Beijing Huilongguan Hospital were selected to conduct semi-structured interviews using the purposive sampling method to understand the views of nurses, patients and caregivers on the humanistic care quality of nurses.Results:Through repeated reading of interview materials, "cognition of psychiatric nurses on humanistic care quality" and "cognition of psychiatric patients and caregivers on humanistic care of nurses" were extracted as the themes of qualitative research.Conclusions:Psychiatric nurses promote the establishment of caring relationships by communicating more with caregivers and family members and provide more targeted humanistic care during special periods such as when patients are admitted to hospital, when side effects of drugs occur and after discharge.

Objective? To understand the status quo of humanistic care quality of psychiatric nurses in Beijing and its influencing factors. Methods? From May to August 2018, This study selected all the psychiatric hospitals in Beijing and stratified by the tertiary, secondary and first-level psychiatric hospitals. Through random number sampling, 2 to 3 hospitals were selected from each group to conduct cluster surveys. To analyze the humanistic care quality of psychiatric nurses and its influencing factors, 890 psychiatric nurses were surveyed using general information questionnaire, Nursing Caring Characters Assessment Tool (NCCAT), Perceived Organizational Support Scale (POS) and Nurses Professional Values Scale-Revised (NPVS-R). 861 valid surveys were returned with the response rate of 96.74%. SPSS 18.0 was used for data input and statistical analysis. Results? In 861 psychiatric nurses, NCCAT score was 86.36% (125.22±19.79); POS total score was 72.16% (45.46±10.87); NPVS-R score was 81.73% (106.25±21.31). Univariate analysis showed that there were statistically significant differences in the scores of nurses of different levels of hospitals, education backgrounds, professional titles, job satisfaction, parental support, voluntariness, family support, and humanistic training (P＜0.05). Pearson correlation analysis showed that the dimensions of humanistic care of psychiatric nurses were positively correlated with organizational support (r=0.593,P＜0.01), and professional values (r=0.712,P＜0.01). Multiple linear regression analysis showed that hospital level, education, voluntariness, humanistic training, organizational support and professional values were the influencing factors of psychiatric nurses' humanistic care quality (P＜ 0.01). Conclusions? The quality of humanistic care of psychiatric nurses in Beijing is at a high level. Through humanistic training, strengthening on-the-job education, increasing organizational support, and improving professional values can improve the quality of psychiatric nurses' humanistic care.

Objective To evaluate the efficacy and safety of DA-EPOCH-R protocol for patients with B-cell non-hodgkin lymphoma (NHL). Methods 43 patients with B-cell NHL received DA-EPOCH-R protocol, and their efficacy and adverse reactions were analyzed. Results 43 patients received a total of 203 cycles of chemotherapy and the median chemotherapy cycle was 6 (2ˉ8 cycles). 32 patients (74.4%) achieved complete remission (CR) after 2ˉ4 cycles of chemotherapy. A further analysis found that age ≤60 years and>60 years, stageⅠ/Ⅱand stageⅢ/Ⅳ, germinal center B-cell (GCB), non-GCB, double expression lymphoma (DEL) and non-DEL patients had no significant differences (P> 0.05). With a median follow-up of 40 months (9ˉ62 mouths), the overall survival (OS) rate of 1-year and 3-year was 97.6 % and 92.8 % respectively. The major toxicity of DA-EPOCH-R protocol was hematologic toxicity. Other toxicities were mild, and no treatment-related deaths occurred. At the end of follow-up, no secondary tumors were found. Conclusions DA-EPOCH-R protocol is an effective and safe protocol for patients with NHL. The result shows that the curative effect of patients in stageⅢandⅣis similar to the patients in stageⅠandⅡ.

Objective: To optimize the extraction technology of Panax notoginseng and Scrophulariae radix from Rupixiao granule.Methods: With the dry extract rate and transfer rates of ginsenoside Rg1, ginsenoside Rb1 and harpagoside as the comprehensive index, the orthogonal design was adopted to investigate the effects of the amount and concentration of ethanol, extracting duration and times on the extraction technology.The contents of ginsenoside Rg1, ginsenoside Rb1 and harpagoside were determined by HPLC.Results: The optimal extraction technology was extracted twice with 8-fold amount of 60% ethanol with 2 h per time.The transfer rate of ginsenoside Rg1, ginsenoside Rb1 and harpagoside was (79.4%±1.56%), (42.62%±0.68%) and (44.89%±0.58%)(n=3), respectively.The dry extract rate was (20.99%±0.411%).Conclusion: The optimized extraction technology is stable and feasible, which can be used for extracting Panax notoginseng and Scrophulariae radix from Rupixiao granule.