Objective:Based on data mining, the basic acupoint selection rules of allergic rhinitis were discussed, which provided a reference for the clinical treatment of allergic rhinitis.Methods:Computer search for literature on auriculo-sensitive rhinitis in VIP, China National Knowledge Infrastructure, Wanfang, China Biomedical Database, PubMed, Embase, Web of Science, the search period was from establishment of the database until August 29, 2023. The frequency, symptom type and distribution of ear point prescriptions were counted, and the association rules and cluster analysis of ear point prescriptions were carried out.Results:A total of 109 studies were included, and 127 prescriptions for ear points were extracted, involving 33 ear points. The association rules showed that the lungs, inner nose, adrenal glands and wind creek were the core ear points, and the cluster analysis formed six types of combinations: "spleen, kidney, lung, wind creek""subcortical, trachea, liver, throat, shenmen" "large intestine" "internal nose, adrenal gland" "endocrine" "sympathetic, external nose".Conclusions:Auricle therapy for allergic rhinitis mainly involves lungs, inner nose, adrenal glands and wind creeks, and dialectical acupoints are selected according to internal organs and symptoms, providing reference and reference for clinicians.

ObjectiveTo explore the effect of Dingkundan on Qi stagnation and blood stasis syndrome in patients with chronic obstructive pulmonary disease （COPD） at a stable phase. MethodA randomized controlled clinical design method was adopted， and 60 patients who were diagnosed with Qi stagnation and blood stasis syndrome in COPD at a stable phase in the outpatient and inpatient departments of the respiratory department of Guang' anmen Hospital of China Academy of Chinese Medical Sciences from June 2019 to December 2019 were divided into observation group and control group according to 1∶1. During the study period， there was no dropout， loss of follow-up， or exclusion between the two groups. On the basis of both groups receiving traditional Chinese medicine （TCM） lung rehabilitation training， the observation group took Dingkundan 7 g/time orally， twice a day. The control group received oral administration of the same specification of Dingkundan starch simulator of 7 g/time， twice a day. Both groups have a treatment period of 12 weeks. The COPD Assessment Test （CAT）， modified Medical Research Council （mMRC）， fatigue scale-14 （FS-14）， self-rating anxiety scale （SAS）， self-rating depression scale （SDS）， 6-minute walk distance （6MWD）， and pulmonary function before and after treatment were evaluated. ResultAfter treatment， both groups showed improvements in CAT， mMRC， FS-14， SAS scores， and 6MWD （P<0.05）. The observation group also showed improvements in SDS scores and lung function indicators （P<0.05）. Compared with the control group after treatment， the observation group showed more significant improvement in CAT， FS-14， SAS， SDS scores， and 6MWD （P<0.05）. ConclusionDingkundan has a clear therapeutic effect on Qi stagnation and blood stasis syndrome in patients with COPD at a stable phase. It can reduce symptom burden， enhance exercise capacity， and improve psychological status and has the potential to improve lung function.

Objective:To investigate the real experience of patients returning to work after total hip and knee arthroplasty, in order to provide a reference for patients to return to work successfully.Methods:We searched for qualitative studies on the real experience of patients after total hip and knee arthroplasty in the returning to work process at home and abroad in the databases such as Cochrane Library, PubMed and Embase, etc, and the search period was from the establishment of the library to May 29, 2023, and the results were integrated by Meta-integration.Results:A total of 6 studies were included, 46 results were extracted, and 9 categories were formed and integrated into 4 themes, patients had different motivations for returning to work, there were many factors influencing patients′ return to work, and patients were eager to be helped in the process of returning to work, and learned from experience to improve their confidence in successfully returning to work.Conclusions:Patients with joint replacement have many obstacles and psychological burden in the process of regression, and hope to receive support from many aspects. Healthcare workers should pay attention to the needs of these populations, provide improved medical support, and actively promote the return of patients to work.

Objective:To explore whether there is a mediating role of emotional intelligence between perceived stress and burnout in ICU nurses. Praide a basis for ICU nurses managers to develop corresponding intervention plans.Methods:Using a convenience sampling method, 683 nurses in 15 class A tertiary hospitals were conducted a cross-sectional surrey from January to April 2023 using general information, the Chinese version of the Perceived Stress Scale, the Emotional Intelligence Scale, and the Burnout Scale.Results:Chinese version of the Perceptual Stress Scale Score (45.59 ± 6.70), Emotional Intelligence Scale score (57.06 ± 9.22), Burnout Scale score (54.50 ± 11.63); pearson correlation analysis showed a positive correlation between perceptual stress and burnout ( r = 0.543, P<0.01); emotional intelligence was a negative correlation ( r = -0.465, P<0.01). A negative correlation was found between perceived stress and emotional intelligence ( r = -0.585, P<0.01); emotional intelligence mediated the effect between perceived stress and burnout, accounting for 24.2% of the total effect. Conclusions:Emotional intelligence is a mediating variable between perceived stress and burnout among nurses in ICU. Nursing managers should pay attention to their perceived stress and emotional intelligence levels, regularly assess them, and target take timely interventions to improve emotional management ability and develop resilience to cope with stress, so as to reduce the burnout level of nurses in ICU.

BACKGROUND: Massive bleeding is the main concern for the management of placenta percreta (PP). Intra-abdominal aortic balloon occlusion (IABO) is one method for pelvic devascularization, but the efficacy of IABO is uncertain. This study aims to investigate the outcomes of IABO in PP patients. METHODS: We retrospectively reviewed the clinical data of PP cases from six tertiary centers in China between January 2011 and December 2015. PP cases with/without the use of IABO were analyzed. Propensity score matching analysis was performed to reduce the effect of selection bias. Postpartum hemorrhage (PPH) and the rate of hysterectomy, as well as neonatal outcomes, were analyzed. RESULTS: One hundred and thirty-two matched pairs of patients were included in the final analysis. Compared with the control group, maternal outcomes, including PPH (68.9% vs. 87.9%, χ2 = 13.984, P < 0.001), hysterectomy (8.3% vs. 65.2%, χ2 = 91.672, P < 0.001), and repeated surgery (1.5% vs. 12.1%, χ2 = 11.686, P = 0.001) were significantly reduced in the IABO group. For neonatal outcomes, Apgar scores at 1 minute (8.67 ± 1.79 vs. 8.53 ± 1.68, t = -0.638, P = 0.947) and 5 minutes (9.43 ± 1.55 vs. 9.53 ± 1.26, t = 0.566, P = 0.293) were not significantly different between the two groups. CONCLUSIONS IABO can significantly reduce blood loss, hysterectomies, and repeated surgeries. This procedure has not shown harmful effects on neonatal outcomes.
Aorta ; Balloon Occlusion/methods* ; Blood Loss, Surgical ; Female ; Humans ; Hysterectomy ; Infant, Newborn ; Placenta Accreta/surgery* ; Placenta Previa/surgery* ; Postpartum Hemorrhage ; Pregnancy ; Retrospective Studies

Objective:To explore the clinical significance of recurrent laryngeal nerve inlet zone(RLNIZ) lymph node metastasis in papillary thyroid cancer(PTC).Methods:The clinical data of the clinicopathologic characteristics of 738 cases with papillary thyroid cancer at our centers from Jul 2017 to Jun 2018 was retrospectively reviewed. 108 cases with RLNIZ lymph node dissection for pathological examination were included. The relationship between metastasis of RLNIZ lymph node and clinicopathologic characteristics was analyzed.Results:RLNIZ lymph node was detected in 12.3%(91/738)cases, the mean lymph node number in RLNIZ was 1.5±0.7, and 30.8%(28/91) cases suffered RLNIZ lymph node metastasis. RLNIZ lymph node metastasis(LNM) is associated with tumor size( P=0.028), capsular invasion( P=0.019), No. of central compartment LNM( P<0.001) and lateral neck LNM( P<0.001). No. of central compartment LNM was found to be the independent risk factor of RLNIZ lymph node metastasis. The incidence of dysphagia and inferior parathyroid damage was 0.9%(1/108)respectively. Conclusions:RLNIZ lymph node metastasis is common among PTC patients , therefore, RLNIZ lymph node should be routinely removed especially in patients with tumor size over 1cm、suspected capsular invasion and lateral neck lymph node metastasis confirmed by preoperative imaging examination.

Objective To investigate the situation and the causes of neonatal death in Henan Province.Methods This study retrospectively analyzed the clinical data of 277 neonates who died at 18 hospitals in Henan Province in 2017.Distribution and causes of neonatal deaths,differences between perinatal conditions of premature and term/post-term infants,causes of early (＜ 7 d) and late (7-28 d) neonatal deaths and the differences in neonatal death cases between Maternal and Child Health Care Hospitals and General/Children's Hospitals were analyzed.We used t,rank-sum and Chi-square test (or corrected Chi-square test,or Fisher's exact test) for statistical analysis.Results (1) A total of 50 993 newboms were admitted to the 18 hospitals in 2017,297 of which died with a mortality of 5.82‰.After excluding 20 cases with uncertain birth or maternal pregnancy history or clinical data,277 cases with complete data were analyzed.Among them,168 (60.6％) were preterm neonates and 109 (39.4％) were term/post-term ones.Early and late neonatal deaths accounted for 74.0％ (205 cases) and 26.0％ (72 cases),respectively.(2) The top five causes of neonatal deaths were infection (78 cases,28.2％),asphyxia (54 cases,19.5％),neonatal respiratory distress syndrome (NRDS,33 cases,11.9％),severe congenital malformations (26 cases,9.4％) including cyanotic congenital heart diseases,digestive malformations,airway malformations and neural tube defects and pulmonary hemorrhage (23 cases,8.3％).Among them,the top three causes of early neonatal deaths were asphyxia (48 cases,23.4％),infection (43 cases,21.0％) and NRDS (33 cases,16.1％),while the main causes of late neonatal deaths were infection (35 cases,48.6％),major congenital malformations (9 cases,12.5％) and chromosome abnormities/inherited metabolic diseases (7 cases,9.7％).(3) Maternal complications during pregnancy accounted for 79.1％ (219 cases) and the predominant types were pregnancy-induced hypertension (43 cases,19.6％),followed by infection (36 cases,16.4％),placental-related conditions (32 cases,14.6％),gestational diabetes mellitus (23 cases,10.5％),hypothyroidism (20 cases,9.1％),fetal distress (18,8.2％),twin-twin transfusion syndrome (10 cases,4.6％) and cholestasis syndrome (9 cases,4.1％).(4) Compared with the term/post-term cases,the preterm cases had higher proportions of multiple births [27.4％ (46/168) vs 6.4％ (9/109),x2=14.016,P ＜ 0.05],assisted reproduction [7.1％ (12/168) vs 0.9％ (1/109),x2=4.421,P ＜ 0.05] and maternal hypertensive disorders of pregnancy [21.4％ (36/1 68) vs 6.4％ (7/109),x2=11.353,P ＜ 0.05],infection [16.7％ (28/168) vs 7.3％ (8/109),x2=4.295,P ＜ 0.05] and twin-to-twin transfusion syndrome [6.0％ (10/168) vs 0.0％ (0/109),x2=6.707,P ＜ 0.05].(5) Among all the early neonatal deaths,preterm cases had a higher incidence of NRDS than term/post-term neonates [20.3％ (27/133) vs 8.3％ (6/72),x2=1 1.937,P ＜ 0.05],but lower incidence of meconium aspiration syndrome (MAS),severe congenital malformations and chromosome abnormalities/inherited metabolic diseases [0.8％ (1/133) vs 5.6％ (4/72),x2=4.508;3.8％ (5/133) vs 16.7％ (12/72),x2=10.233;1.5％ (2/133) vs 6.9％ (5/72),~=4.172;all P ＜ 0.05].Among the late neonatal deaths,the incidence of severe intracranial hemorrhage in preterm infants was higher than that in term/post-term neonates [7.1％ (3/42) vs 0.0％ (0/30),x2=2.205,P ＜ 0.05].(6) Compared with the cases in General/Children's Hospitals,those in Maternal and Child Health Care Hospitals showed a higher proportion of preterm neonatal deaths [67.3％ (105/156) vs 52.1％ (63/121),x2=6.010,P ＜ 0.05],younger gestational age [(32.8±5.3) weeks vs (34.6±4.9) weeks,t=3.072,P ＜ 0.05],lower birth weight [(2 132.6± 1 014.5) g vs (2 409.4±987.3) g,t=-2.513,P ＜ 0.05],and higher average age of death [M(P25-P75),3 (1-8) d vs 2 (1-4) d,Z=3.710,P ＜ 0.05].Conclusions Neonatal death occurs mainly within one week after birth in those with maternal complications.Late preterm deaths and term/post-term cases account for nearly half of total neonatal deaths.The causes of death for preterm and term/post-term newborns vary with postnatal age.Infection,asphyxia and severe congenital malformations are important causes of neonatal deaths.

Objective To survey the survival status, functional status, marital status and the present situation of the survival patients with spinal cord injury 40 years after Tangshan earthquake. Methods From February to May, 2016, a total of 216 patients with spinal cord injury were surveyed with questionnaire, in which 139 cases lived centralized and 77 cases lived scattered. The questionnaire was self-designed and included eleven items and 51 questions, which related to ability of daily life, marital status, employment status and socioeconomic status and so on. Results A total of 960 (25.15%) patients with spinal cord injury survived 40 years after Tangshan earthquake. In 216 surveyed pa-tients, the employment rate was 9.3%, the married rate was 53.2%, and 44.9%earned less than 500 yuan every month. The incidence was 25.9%for pressure score, 50.50%for neuralgia (severe pain accounted for 23.51%), and 19.40%for urinary tract stones. 56%of patients could take their own basic self-care. Conclusion There were many problems such as high complication rate, low employment rate and poor economic condition in the spinal cord injury group 40 years after Tangshan earthquake.

Objective To explore the correlation between TCM constitution and sleep status in escort troops. Methods Standardized TCM Constitution Questionnaire and Pittsburgh Sleep Quality Index (PSQI) were used to investigate escort troops. Factors of PSQI and constitution types were analyzed. Results The results of PSQI showed the number of escort troops who had bad sleeping (PSQI>7) was 64, which accounted for 46%of the escort troops, among which, 45 people (70.3%) were justified as biased constitution, while 19 were normal constitution (29.7%). The top three biased constitution in bad sleeping were:qi deficiency, phlegm-dampness and dampness-heat. PSQI factors such as sleep disorder, daytime dysfunction and total score had positive correlation with qi deficiency, yang deficiency, yin deficiency, dampness-heat and blood stasis, and negative correlation with normal constitution. Conclusion Sleep condition of escort troops has correlation with TCM constitution, which indicates that sleep status could be improved by regulating TCM constitution.

Objective To discuss the cause of death in patients with spinal cord injury from Tangshan earthquake 37 years latter, and compare them with the survey before. Methods The causes of death of the spinal cord injury patients lived in 1 sanatorium and 1 rehabilitation village in Tangshan city, and 6 sanatoriums in villages from 2003 were surveyed. The questionnaire included their general condition, the main cause of death, time of death, age at death, etc., and the findings in 1988 and 2003 were compared. Results Uremia and pressure sore infection were the most major causes of death, in which pressure sore infection was the first cause in the village, and uremia was the first both in the village and city, and the epidemiology of them decreased than before. Cardiovascular disease and cerebrovascular disease were the second and third causes of death respectively. The epidemiology of malignancies increased in this survey, and the longest life time of patients with cervical spinal cord injury was 36 years. Conclusion The top causes of death in spinal cord injury patients from Tangshan earthquakeare uremia, pressure sore infection, cardiovascular disease and cerebrovascular disease. 37 years after Tangshan earthquake, the cause of death and the life expectancy of patients with spinal cord injury have been close to general levels.