Purpose: The aim of this paper is to develop a scale for measuring the perinatal bereavement care competence of midwives and assess its psychometric properties. Methods: The Perinatal Bereavement Care Competence Scale was developed in four phases. (1) Item generation: 75 items were formulated based on a literature review and interviews with midwives. (2) Delphi expert consultation: 15 experts evaluated whether the items were clear/appropriate/relevant to the questionnaire dimensions, and the items were optimized. (3) Pilot test: The comprehensibility, acceptability, and time required to complete the questionnaire by midwives were assessed. (4) Evaluation of reliability and validity: The scale was validated by initial item analysis, exploratory and confirmatory factor analyses, and internal consistency reliability and testeretest reliability. Results: The final scale consisted of six dimensions and 25 items: maintaining belief (three items), knowing (four items), being with (six items), preserving dignity (four items), enabling (five items), and self-adjustment (three items). Exploratory factor analysis yielded a six-factor structure that was consistent with the theoretical framework and explained 70.8% of the total variance. Confirmatory factor analysis indicated a good fit for the six-factor model. Cronbach's a for the scale was 0.931, and the test eretest reliability coefficient was 0.968. Conclusion The Perinatal Bereavement Care Competence Scale is a valid and reliable instrument for measuring the competence of midwives in caring for bereaved parents who have experienced perinatal loss.

Objective:To investigate the value of peripheral blood eosinophils (EOS) in predicting the therapeutic effect of sublingual specific immunotherapy (SLIT) in patients with allergic rhinitis (AR).Methods:From January 2018 to June 2020, 200 patients with AR who received SLIT in Dongguan Kanghua Hospital were evaluated for their symptoms before treatment and 6 months after treatment. The curative effect was evaluated according to the improvement of the total symptom score. The number of eosinophils, percentage of eosinophils in peripheral blood were measured before treatment. The correlation between curative effect and EOS count and EOS percentage was analyzed and the value of these two indicators in predicting the efficacy of SLIT was evaluated.Results:Of the 200 AR patients, 178 patients were confirmed to have completed the treatment course of 6months. 126 effective and 52 ineffective, the effective rates were 70.8%. There was a weak correlation between the number of EOS in peripheral blood and the percentage of EOS in peripheral blood before treatment and the efficacy of SLIT ( r=0.168, P=0.048; r=0.250, P=0.001). The area under the curve of peripheral blood EOS count was 0.380, and the percentage of peripheral blood EOS was 0.355, which were all less than 0.5. Conclusions:There was no significant correlation between the number of peripheral blood EOS count and peripheral blood EOS percentage and the efficacy of SLIT , therefore, both of blood EOS count and blood EOS percentage have no value in predicting the efficacy of SLIT.

Ziziphi Spinosae Semen (ZSS), a traditional Chinese medicine, is used in clinics for the treatment ofinsomnia in China and other Asian countries. Herein, we described for the first time a comparative pharmacokinetics study of the six major compounds of ZSS in normal control (NC) and para-chlor-ophenylalanine (PCPA)-induced insomnia model (IM) rats that were orally administered the aqueous extract of ZSS. An ultra-high-performance liquid chromatography coupled with quadrupole orbitrap mass (UHPLC-Q-Orbitrap-MS) method was developed and validated for the simultaneous determination of coclaurine, magnoflorine, spinosin, 6'''-feruloylspinosin, jujuboside A (JuA), and jujuboside B (JuB) in ZSS in rat plasma. The established approach was successfully applied to a comparative pharmacokinetic study. The systemic exposures of spinosin and 6'''-feruloylspinosin were decreased in the IM group compared to the NC group, while plasma clearance (CL) was significantly increased. The Tmax values of JuA and JuB in IM rats were significantly lower than those in NC rats. The T1/2 of JuA in the IM group was significantly accelerated. The pharmacokinetic parameters of coclaurine and magnoflorine were not evidently affected between the two groups. These results indicate that the pathological state of insomnia altered the plasma pharmacokinetics of spinosin, 6'''-feruloylspinosin, JuA, and JuB in the ZSS aqueous extract, providing an experimental basis for the role of ZSS in insomnia treatment. The comparative pharmacokinetics-based UHPLC-Q-Orbitrap-MS using full-scan mode can therefore provide a reliable and suitable means for the screening of potentially effective substances applied as quality markers of ZSS.

Extramedullary plasmacytoma is a localized plasmacytoma originating from tissues other than bone marrow, and epididymal affecting is rare. This paper summarizes a case of this tumor admitted to our hospital in recent years, with the purpose of improving the further understanding and treatment of this tumor and avoiding misdiagnosis.

Objective To study the correlation between laryngopharyngeal reflux (LPR) and secretory otitis media (SOM).Methods A total of 294 adult patients with reflux-related symptoms were recruited in this study.The patients were evaluated with reflux symptom index (RSI) and reflux finding score (RFS).Tympanometry was conducted to all the patients.The 54 patients with the otitis media effusion with type B tympanograms were tested by auripuncture.Results Among the 294 patients,168 cases showed RSI＜13,in which 128 cases,31 cases and 9 cases had type A,type C,and type B tympanograms,respectively.The other 126 patients showed RSI＞13 in which 52 cases,29 cases and 45 cases had type A,type C,and type B tympanograms,respectively.Among the 294 patiems,172 patients showed RFS＜7,in which 131,32 and 9 cases had type A,type C,and type B tympanograms,respectively.The left 122 patients showed RFS＞7,in which 49,28 and 45 cases had type A,type C,and type B tympanograms,respectively.The ratio of type B tympanograms in the patients with RSI＞13 and RFS＞7 were both significantly higher than those in the patients with RSI＜13 and RFS＜7 (P＜0.05).The RSI scores of patients with type A,C,and B tympanogram were 8.6± 3.8,15.9±7.5,and 23.9±8.6,respectively,and the RFS score were 5.6±2.6,9.6±4.7,and 15.3±6.6,respectively.Compared with type A and C,the patients with type B tympanogram had significantly higher RSI and RFS score (P＜ 0.05).Among the 54 patients of type B tympanograms,those with RSI＜13 were found to have serous fluid,grume fluid,glue fluid as in 6 cases,2 cases,and 1 case,while the patient of the RSI＞ 13 had serous fluid,grume fluid,glue fluid in 13 cases,23 cases,and 9 cases,respectively.The otitis media effusion of the patients with the RSI＜13 were mainly serous,while those with the RSI＞13 were mainly sticky.Conclusion The correlation between LPR and SOM was significant.LPRmay accelerate the progress of SOM.

BACKGROUND: Endothelin and nitrogen monoxide (NO) which are regarded as a pair of factors to maintain equilibrium between vascular stress and hemodynamics have different responses during various diseases. It is the key point for the treatment of atherosclerosis to find out the effect and pathophysiological mechanism of hyperlipemia on endothelial cells, and seek the methods and drugs for protecting vascular endothelin.OBJECTIVE: To observe the effect of herbal cake-separated moxibustion on contents of plasma endothelin and NO and analyze its regulative mechanism.DESIGN: Randomized controlled animal study.SETTING: College of Acupuncture and Moxibustion, Hunan University of Traditional Chinese Medicine.MATERIALS: A total of 60 healthy New Zealand white rabbits weighing 1.5-2.5 kg of both genders were selected in this study. Herbal cake was made of danshen, shanzha, yujin, dahuang and zexie, which were crushed into powder according to a certain ratio. Then, vinegar was added to make paste which was 5-8 mm in diameter and 2-3 mm in depth. Moxa cone:(Shenjiu 300) was provided by Suzhou Dongfang Airong Factory (type:Dongfang I; batch number: 20021212).METHODS: The experiment was carried out in the Experimental Animal Center of Hunan University of Traditional Chinese Medicine between November 2003 and October 2004. All rabbits were randomly divided into 4 groups: blank control group, hyperlipemia model group, direct moxibustion group and herbal cake-separated moxibustion group with 15 in each group. Except blank control group, rabbits in other three groups were fed with high fat forage to establish hyperlipemia models. Two groups of acupoints were acupunctured alternatively: Group Ⅰ: Juque (CV14), Tianshu (ST25) at bilateral sides, and Fenglong (ST 40) at bilateral sides; Group Ⅱ:Xinshu(BL15),Ganshu(BL18) and Pishu(BL20), at bilateral sides respectively.On the first day, moxa cone was directly adherent to acupoints of rabbits in direct moxibustion group and lighten for acupuncture, but in herbal cakeseparated moxibustion group, moxa cone which was gotten rid of the carriage was adherent to herbal cake which was put on acupoints and lighted for acupuncture. Each acupoint was acupunctured for 4 successive dosages for once a day. On the next day, the other group of acupoints was acupunctured.The course was 40 days. Rabbits in other two groups were not treated with any ways. On the 41st day, contents of plasma endothelin and NO were measured in each group with radio-immunity method and nitrate-reductase reduction method, respectively.MAIN OUTCOME MEASURES: Contents of plasma endothelin and NO of rabbits after 40-day treatment.RESULTS: Five rabbits died because of diarrhoea or other reasons, including 2 in blank control group, 1 in model group, 1 in direct moxibustion group and 1 in herbal cake-separated moxibustion group. Therefore, 55 rabbits were involved in the final analysis. ① Content of plasma endothelin was lower in herbal cake-separated moxibustion group than that in model group [(431.57±63.68), (500.14±75.41) ng/L, P ＜ 0.05], but there was no significant difference between herbal cake-separated moxibustion group and direct moxibustion group [(431.57±63.68), (429.08±77.07) ng/L, P ＞ 0.05]. ② On NO content, there was an increasing tendency of model group ＜ blank group ＜ herbal cake-separated moxibustion group ＜ direct moxibustion, but there was no significant difference between any two groups [(27.17±16.55),(29.39±13.24), (30.24±20.25), (30.47±19.62) μmol/L, P ＞ 0.05].CONCLUSION: Effects of both two methods of moxibustion in the rabbits with hyperlipemia on content of endothelin are significant and similar, but there are no significant effects on NO content.

Action Potentials ; Animals ; Ear, Inner ; blood supply ; Facial Nerve ; physiopathology ; Hearing Loss, Sensorineural ; etiology ; Rabbits