Value of HFMEA-based Predictive Care Combined With Multimodal Analgesia in Improving Rehabilitation After Orthopedic Internal Fixation Implantation.

Context: Orthopedic internal fixation implantation (OIFI) is a frequently adopted surgery for fractures, but it can trigger various adverse reactions and increase patients' risks of postoperative complications. Reducing those risks is paramount for obtaining better therapeutic effects for OIFI. Objective: The study intended to analyze the value of predictive nursing, based on healthcare failure modes and effects analysis (HFMEA), and combined with multimodal analgesia for improving postoperative rehabilitation after orthopedic internal fixation (OIFI), with the aim of offering reliable, accurate, and novel ideas and directions for future clinical OIFI and prognosis improvement for patients. Design: The research team designed a retrospective analysis. Setting: The study took place in the Department of the Operating Room at Hefei First People's Hospital in Hefei, Anhui, China. Participants: Participants were150 patients who needed OIFI at the hospital between January and December 2020. Intervention: Participants were assigned to one of two groups, 87 to the intervention group, who received treatment with HFMEA-based predictive care combined with multimodal analgesia after OIFI, and 63 to a control group who received routine nursing combined with multimodal analgesia after OIFI. Outcome Measures: Postintervention, the study measured the effective treatment rate, risk priority number (RPN)-the severity, possibility, and detectable degree of the risk, analgesic effects, self-controlled delivery times, tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) levels, and incidence of adverse symptoms. Also postintervention, the participants completed a visual analogue scale (VAS) to indicate their satisfaction with the nursing as well as the Exercise of Self-care Agency (ESCA) scale and the Spielberger State-trait Anxiety Inventory (STAI). Results: The study found significant differences between the groups. The intervention group showed significantly lower RPN values, VAS scores for analgesia, TNF-α and IL-6 levels, and incidence of adverse symptoms and also indicated greater satisfaction with the nursing, a significantly higher ESCA score, and a significantly better psychological state. Conclusions: HFMEA-based predictive care combined with multimodal analgesia can substantially lower the risk and pain levels of patients undergoing OIFI and can improve their nursing experience and self-care ability, so it's worthy of clinical application, having great significance for patients' rehabilitation.

Fire-needle acupuncture for upper limb spastic paralysis after stroke: Study protocol for a randomized controlled trial.

BACKGROUND: Fire-needle acupuncture, an important kind of acupuncture therapy, has been clinically used to treat upper limb spastic paralysis (ULSP) after stroke. Clinical experience has indicated that fire-needle acupuncture treatment takes less time, requires fewer visits, and has more rapid results and fewer side effects compared to chemical medicine alternatives. This study will evaluate the effects of fire-needle acupuncture for ULSP in the context of standardized clinical research and provide high-quality data to inform clinical procedures and future study design. METHODS/DESIGN: A randomized controlled trial will be carried out to evaluate the effects of fire-needle acupuncture therapy in patients with ULSP from stroke. ULSP patients (n = 120) will be recruited at Changhai Hospital in Shanghai, China. Patients will be randomly divided into three groups, including fire-needle acupuncture group (FAG), filiform-needle acupuncture group (FFAG) and rehabilitation treatment group (RTG). During the 3-week treatment, the FAG will be treated every two days, while FFAG and RTG will be treated 5 d in a row and then rest for 2 d. The Simplified Fugl-Meyer Motor Function Scale and Modified Ashworth Scale will be used as the primary outcome measures. Statistical analysis will be conducted by an independent statistician. DISCUSSION: Through this study, the utility of fire-needle acupuncture in treating ULSP after stroke will be tested, and some specific claims of fire-needle acupuncture therapy will be evaluated, such as relieving spasm and muscular tension, improving activities of daily living, rapidity of response and less frequency of treatment compared with other treatments. TRIAL REGISTRATION: Chinese Clinical Trial Registry (identifier: ChiCTR-IOR-17013875; registration date: 28 December 2016).

Methotrexate ameliorates pristane-induced arthritis by decreasing IFN-γ and IL-17A expressions.

OBJECTIVE: This study was carried out to test the effects of methotrexate (MTX) and black seed oil (BSO) on pristane-induced arthritis (PIA) in rats. METHODS: Inbred dark agouti (DA) rats were induced by a single subcutaneous injection of pristane, and then treated with MTX or BSO. Arthritis severity was evaluated macroscopically and microscopically. Plasma nitric oxide (NO) concentration was determined by the Griess method and cytokine mRNA expression in the spleen was detected by the real-time reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: The clinical arthritis severity was decreased after MTX treatment, while the BSO groups did not show significant changes compared with the disease group. The plasma NO level of the MTX group was significantly decreased compared with the disease group, but the BSO groups showed no difference from the disease group in plasma NO levels. The interferon-γ (IFN-γ) and interleukin-17A (IL-17A) mRNA expressions in the spleens were significantly decreased in the MTX group, but only showed a declining trend in the BSO groups compared with the disease group. Neither MTX nor BSO had an effect on the mRNA expressions of IL-4, transforming growth factor ß (TGF-ß), and tumor necrosis factor-α (TNF-α) in the spleen. CONCLUSIONS: MTX, but not BSO, can reduce the arthritis severity and decrease the mRNA expressions of IFN-γ and IL-17A in pristane-induced arthritis of rats.

[Professor He Pu-ren: the founder of Santong method of acupuncture and moxibustion].

Professor He Pu-ren, the founder of Santong method of acupuncture and moxibustion, is a well known acupuncturist at home and abroad. His main contributions include combined martial arts and Chinese medicine, showing obvious therapeutic effect; taking part in establishment of The Department of Acupuncture, Beijing Chinese Medicine Hospital; creating Santong method of acupuncture and moxibustion; advocating fire needle therapy; writing medical books and teaching students; advocating the culture of acupuncture; making the metal model of acupuncture and moxibustion, and others. His achievements have become an important part of acupuncture and moxibustion science.

Crystal structure of an avian influenza polymerase PA(N) reveals an endonuclease active site.

The heterotrimeric influenza virus polymerase, containing the PA, PB1 and PB2 proteins, catalyses viral RNA replication and transcription in the nucleus of infected cells. PB1 holds the polymerase active site and reportedly harbours endonuclease activity, whereas PB2 is responsible for cap binding. The PA amino terminus is understood to be the major functional part of the PA protein and has been implicated in several roles, including endonuclease and protease activities as well as viral RNA/complementary RNA promoter binding. Here we report the 2.2 ångström (A) crystal structure of the N-terminal 197 residues of PA, termed PA(N), from an avian influenza H5N1 virus. The PA(N) structure has an alpha/beta architecture and reveals a bound magnesium ion coordinated by a motif similar to the (P)DX(N)(D/E)XK motif characteristic of many endonucleases. Structural comparisons and mutagenesis analysis of the motif identified in PA(N) provide further evidence that PA(N) holds an endonuclease active site. Furthermore, functional analysis with in vivo ribonucleoprotein reconstitution and direct in vitro endonuclease assays strongly suggest that PA(N) holds the endonuclease active site and has critical roles in endonuclease activity of the influenza virus polymerase, rather than PB1. The high conservation of this endonuclease active site among influenza strains indicates that PA(N) is an important target for the design of new anti-influenza therapeutics.