Humans ; Glycated Hemoglobin ; Diabetes Mellitus, Type 1 ; Blood Glucose ; Diabetes Mellitus, Type 2

Objective To investigate the mechanism of inducing macrophage polarization induced by acupoint effect of electroacupuncture to promote the repair of acute skeletal muscle injury.Methods 45 SD rats were randomly divided into blank group,model group,electroacupuncture group(EA group),sodium chrominate group (DSCG group) and electroacupuncture+sodium chrominate group (hereinafter referred to as EA+DSCG group),with 9 rats in each group. The rats in the EA group and the EA+DSCG group were subjected to EA intervention at the right "Chengshan" (BL57) and "Yanglingquan"(GB34),with a frequency of 2 Hz/100 Hz. The gait changes of rats were recorded by animal gait analyzer. The morphological changes of the right gastrocnemius were observed by HE staining. The changes of mast cell aggregation and degranulation in local skin muscles of "chengshan" point were observed by toluidine blue staining. The expressions of Pax7,MyoD and skin mast cells and 5-HT in the right gastrocnemius were detected by immunofluorescence method. The positive expressions of CD68 and CD206 in right gastrocnemius macrophage was observed by immunohistochemical staining.Results Compared with blank group,the wiggle time of the right hind leg in model group and DSCG group increased,stride length decreased,HE staining showed inflammatory cell infiltration,myocyte enlargement,degeneration and necrosis. The degranulation rate of local skin mast cells in "Chengshan" (BL57) area increased,and the expressions of mast cell tryptase,5-HT,Pax7,MyoD,CD68 and CD206 increased (P<0.05). Compared with model group,the wiggle time of the right hind leg in EA group and EA+DSCG group decreased,stride length increased,HE staining showed that inflammatory cell infiltration was reduced,muscle cells were uniform in size and arranged neatly. Mast cell degranulation rate increased significantly in EA group,and the expressions of mast cell tryptase,5-HT,Pax7,MyoD and CD206 increased (P<0.05),while CD68 expression decreased (P<0.05). Compared with EA+DSCG group,the degranulation rate of mast cells and the expressions of mast cell tryptase,5-HT,Pax7,MyoD and CD206 increased (P<0.05),while CD68 expression decreased in EA group (P<0.05). Conclusion EA "Chengshan" (BL57) and "Yanglingquan" (GB34) can stimulate acupuncture points to locally induce mast cell degranulation,promote the polarization of macrophages,and then activate muscle satellite cells to play the regulatory process of repairing skeletal muscle injury.

Objective To analyze the incidence of and risk factors for white matter hyperintensity(WMH)in pilots.Methods A retrospective case-control study was performed.The subjects were 1,415 pilots ages 19 to 58 who had undergone cranial MRI examination in a hospital between September 2020 and August 2023.They were divided into two groups:the WMH group and the control group(without WMH).Univariate and multivariate logistic regression analysis were used to identify the risk factors for WMH.Results There were 219 cases in the WMH group and 1,196 cases in the control group.The total incidence of WMH was approximately 15.48％,with mild,moderate and severe cases of WMH accounting for 70.78％,24.20％,and 0.47％,respectively.Regression analysis results showed that age(OR=1.625,95％CI:1.099-2.404)and flight time(OR=1.282,95％CI:1.033-1.592)were risk factors for WMH in pilots.Conclusion The incidence of WMH in pilots was approximately 15.48％.Most of WMH were mild according to Fazekas grading.Age increase and long flight time are risk factors for WMH in pilots.

The stimulator of interferon genes(STING),an integral adaptor protein in the DNA-sensing pathway,plays a pivotal role in the innate immune response against infections.Additionally,it presents a valuable therapeutic target for infectious diseases and cancer.We observed that fangchinoline(Fan),a bis-benzylisoquinoline alkaloid(BBA),effectively impedes the replication of vesicular stomatitis virus(VSV),encephalomyocarditis virus(EMCV),influenza A virus(H1 N1),and herpes simplex virus-1(HSV-1)in vitro.Fan treatment significantly reduced the viral load,attenuated tissue inflammation,and improved survival in a viral sepsis mouse model.Mechanistically,Fan activates the antiviral response in a STING-dependent manner,leading to increased expression of interferon(1FN)and interferon-stimulated genes(ISGs)for potent antiviral effects in vivo and in vitro.Notably,Fan interacts with STING,preventing its degradation and thereby extending the activation of IFN-based antiviral responses.Collectively,our findings highlight the potential of Fan,which elicits antiviral immunity by suppressing STING degra-dation,as a promising candidate for antiviral therapy.

Objective:To explore the effect of early intermittent enteral nutrition (EN) in critically ill patients after cardiac surgery.Methods:We developed an early EN feeding regimen for critically ill patients after cardiac surgery. A prospective analysis was conducted on 178 critically ill patients admitted to the Cardiothoracic Surgery Intensive Care Unit of a tertiary hospital in Shanghai from May 2022 to May 2023. They were divided into the control group ( n=88) and the observation group ( n=90) using a random number table method. The control group received routine EN feeding, while the observation group received early intermittent EN feeding. Comparison between groups was performed in terms of the tolerability and interruption of EN administration, nutrition related outcome indicators, and prognosis indicators. Results:The observation group had significantly lower rates of abdominal distension, diarrhea, nausea and vomiting (or reflux), and EN interruption, as well as shorter duration of EN interruption, compared to the control group ( P<0.05). After 7 days of early EN, 87.8% of patients in the observation group met the calorie goal, which was significantly higher than that of 22.5% in the observation group ( P<0.05). The nutritional related indicators (serum prealbumin, hemoglobin, actual intake of nutritional fluids) were also better in the observation group patients compared to the control group ( P<0.05). The duration of mechanical ventilation and length of ICU stay in the observation group were significantly shorter than those in the control group, with statistical significance ( P<0.05). There was no significant difference in the length of hospital stay between the two groups. Conclusion:Early EN program can improve the symptoms of feeding intolerance in patients, reduce the occurrence and duration of feeding interruption, increase the rate of calorie goal fulfillment, improve nutritional status,and promote patient recovery and outcome in critically ill patients after cardiac surgery.

Objective:To investigate the relationship between basic psychological needs satisfaction, family resilience and psychological resilience with self-neglect in older adults on maintenance hemodialysis, and to analyze the mediating effect of family resilience and psychological resilience between basic psychological needs satisfaction and self-neglect.Methods:The social demographic questionnaire, basic psychological needs satisfaction scale, the Connor-Davidson resilience scale 10-item, family resilience questionnaire and scale of the elderly self-neglect were applied to 623 older adults on maintenance hemodialysis randomized sampled from 50 hemodialysis centers in Hunan Province from July to December 2021. The data were statistically described and mediated pathway analysis was performed using SPSS 28.0 and AMOS 24.0.Results:The scores of basic psychological needs satisfaction, psychological resilience, family resilience and elderly self-neglect in older adults on maintenance hemodialysis were (4.95±1.01), (23.24±8.19), (78.60±12.49) and (7.99±5.60), respectively.Correlation analysis showed that self-neglect was statistically negatively correlated with basic psychological needs satisfaction, psychological resilience and family resilience ( r=-0.398, -0.419, -0.451, all P<0.001), basic psychological needs satisfaction was positively correlated with resilience and family resilience ( r=0.594, 0.534, both P<0.001), and psychological resilience was positively correlated with family resilience ( r=0.477, P<0.001).Analysis psychological of mediation effects showed that basic psychological needs satisfaction had a total effect of -0.462 on self-neglect. The direct effect was -0.113, accounting for 25% of the total effect. The mediating effects of family resilience and psychological resilience were -0.189 and -0.122 respectively, accounted for 41% and 26% of the total effect. The chain mediating effect was -0.038, with an effect size of 8%. Conclusion:Basic psychological needs satisfaction for older adults on maintenance hemodialysis can affect self-neglect either directly or indirectly through family resilience and psychological resilience, and self-neglect can be reduced in the future by increasing family resilience and psychological resilience through meeting the basic psychological needs of older adults on maintenance hemodialysis.

Objective To explore the influencing factors of ecological momentary assessment(EMA)in the implementation of home rehabilitation exercise for middle-aged stroke patients,and to provide a basis for decision-making and practice of precision rehabilitation nursing for stroke.Methods This descriptive qualitative research utilized purposive sampling method to select 8 medical staff,4 information technicians,8 middle-aged stroke patients,and 5 caregivers from a tertiary A general hospital in Wuhan from January 2 to March 10,2024 as the research subjects.Semi-structured interview was conducted based on the framework of diffusion of innovations theory.The data were analyzed using directed content analysis.Results 5 themes and 10 sub-themes were extracted,including relative advantage factors(conducive to precise and dynamic evaluation of patient rehabilitation behavior and symptom trajectory by medical staff;enhancing patient self-management awareness,effectively reducing care burden),compatibility factors(new methods conflict with existing values;new methods are in line with clinical work practice),complexity factors(evaluation frequency affects the accuracy of rehabilitation tracking;limited limb function and social support increase user burden),experimental factors(pilot and real-time feedback improve user experience;experience summary and promotion,the strengthening of practical verification orientation),and observable factors(successful cases of mobile health help popularize new methods;visualization of new methods to enrich mobile health practice).Conclusion There are certain promoting and hindering factors in the implementation of EMA in the field of home rehabilitation exercise for middle-aged stroke patients.In the future,it is necessary to explore the potential of EMA in the field of precision rehabilitation and ensure its compatibility with clinical practice.

Narrative medicine, an interdisciplinary subject merging medicine and the humanities, serves as a vital instrument in capturing, comprehending, and integrating the diverse perspectives of all stakeholders involved in the realm of illness. In the context of pediatric palliative care, the implementation of narrative medicine fosters effective doctor-patient communication and enhances the doctor-patient relationship. This article delves into the importance and practicality of narrative medicine in pediatric palliative care, shedding light on the hurdles faced during its implementation. The study highlights the pressing need for further extensive and in-depth research of narrative medicine in pediatric palliative care, aiming to provide evidence-based insights that can inform clinical interventions and decision-making processes.

ObjectiveTo explore the possible peripheral analgesic mechanism of electroacupuncture （EA） at promimal and distal acupoints in treatment of myofascial pain syndrome （MPS）. MethodsTwenty-four SD rats were randomly divided into blank group， model group， proximal group， and distal group， with six rats in each group. MPS model was prepared by “strike combined with centrifugal exercise” in all groups except for the blank group. After modeling， the rats in the proximal group received EA at the local myofascial trigger points （MTrPs）， namely the Ashi points， with dilatational waves of frequency of 2/100 HZ and voltage of 2-4 V， current intensity depending on a slight trembling of the left lower limbs， once a day， 15min each time，for 14 days. The rats in the distal group received EA at “Yanglingquan” （GB 34） and “Yinlingquan” （SP 9）， with the same operations as the proximal group. The rats in the blank group and the model group were only grasped and hedged， without other interventions. After intervention， the paw withdrawl mechanical threshold （PWMT） was measured， and variability between the left and right hind paws was calculated. Musculoskeletal ultrasound imaging and electromyography monitoring were performed on the left lower extremity vastus medialis. The morphological changes of vastus medialis muscle of the left lower extremity were observed by HE staining. The positive expression of substance P （SP）， calcitonin gene-related peptide （CGRP）， CD68 and CD206 in muscle tissue was detected by immunohistochemistry. Abdominal aortic serum interleukin-1β （IL-1β）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， interleukin-10 （IL-10）， and interleukin-8 （interleukin-8） were detected by ELISA. ResultsCompared to those in the blank group， the fibers of the vastus medial muscle of the rats in the model group were broken and distorted with thickness in variation， and the myofascia was broken， with fibrillation potential， enlarged muscle cells， inward moved nucleus， and widened muscle space； the variability of PWMT between the left and right hind paws significantly increased， as well as the levels of SP， CGRP， CD68， and CD206 in the vastus medialis muscle （P＜0.01）， and the serum IL-8 and TNF-αlevels were significantly elevated （P＜0.05 or P＜0.01）. Compared to those in the model group， the muscle fibers in the proximal and distal group were complete in shape and arranged in an orderly manner， with continued non-broken myofascia， regular shape of muscle cells， and significantly reduced level of IL-8 （P＜0.01）； the amplitude and frequency of spontaneous discharge in the proximal group significantly decreased， as well as the variability of PWMT between the left and right hind paws， and the levels of SP， CGRP， and CD68 in the vastus medialis muscle， while the CD206 level increased significantly （P＜0.05 or P＜0.01 ）； there was complex discharges in the distal group， with significantly decreased level of CD68 in the vastus medialis muscle and increased level of CD206 （P＜0.01）. Compared to the proximal group， the level of IL-8 in the distal group was significantly higher （P＜0.05）. ConclusionsEA at proximal acupoints can significantly improve the pain threshold and local muscle tissue morpho-logy in rats， and its mechanism may be related to reducing the levels of pain-causing substances and related inflammatory factors and promoting the polarization of macrophages. The analgesic effect of EA at distal acupoints is not obvious， and the mechanism is still unclear.

Objective:To understand the current research status and hotspots in this field based on the literature on early oral nutrition for postoperative patients with esophageal cancer in Web of Science.Methods:The literature on early oral nutrition for postoperative patients with esophageal cancer was searched on Web of Science from September 2012 to September 2022, and the annual number of articles, distribution of authors and countries, citation analysis, keyword co-occurrence, keyword clustering and keyword emergence were analysed using CiteSpace.Results:From 2012 to 2022, a total of 113 articles related to early oral nutrition after esophageal cancer surgery were published, with an overall upward trend in the number of publications, and the top five countries with the largest number of publications were Japan, China, the United States, New Zealand and the United Kingdom. The co-occurrence analysis of keywords and cluster analysis revealed three research hotspots: the safety research of early oral nutrition, the curative effect research of early oral nutrition, and the application research of early oral nutrition in accelerated recovery. Keyword emergence reveals that nutritional management was a future research trend.Conclusions:Early oral nutrition research in postoperative patients with esophageal cancer is currently in the stage of practical exploration and continues to receive attention. In the future, cooperation between regions and authors needs to be strengthened. Promoting the development of standardized and normalized early oral nutrition management strategies and exploring the role of early oral nutrition strategies in nutrition management can become a research trend in the future.