Spiritual care perceptions and empathy of Chinese nursing students: The mediating roles of spiritual well-being.

OBJECTIVE: To investigate spiritual care perceptions, spiritual well-being, and empathy, examine the correlations among spiritual care perceptions, spiritual well-being, and empathy, and explore the mediating role of spiritual well-being between other two variables of Chinese nursing students. METHODS: A cross-sectional design was implemented, and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist was used to ensure quality reporting of the study. A cluster sample of 2,718 nursing students was selected from 7 universities and colleges in China. The demographic characteristics questionnaire, the Chinese Version of the Spiritual Care-Giving Scale (C-SCGS), the Spiritual Health Scale Short Form (SHS-SF), and the Jefferson Scale of Physician Empathy-Nursing Student (JSPE-NS) were used. Descriptive statistics, correlation, and process plug-in mediation effect analyses were used to analyze the data. RESULTS: The total score of spiritual care perceptions, spiritual well-being, and empathy were 173.83 ± 25.62, 98.74 ± 12.87, and 105.04 ± 21.34, respectively. Spiritual care perceptions were positively correlated with spiritual well-being (r = 0.617, p < 0.01) and empathy (r = 0.528, p < 0.01). And spiritual well-being played a partial mediating role between the other two variables (accounting for 28.1%). SIGNIFICANCE OF RESULTS: Spiritual care perceptions, spiritual well-being, and empathy were quite moderate, which need in improving. It is suggested that nursing educators pay attention to the spiritual care education of nursing students, perfect the spiritual care education system, and take targeted measures according to nursing students' individual personality traits and differences, improve their spiritual well-being and empathy in multiple ways, so as to improve their spiritual care perceptions and competence.

Holistic analytical characterization and risk assessment of residual host cell protein impurities in an active pharmaceutical ingredient synthesized by biocatalysts.

Host cell proteins (HCPs) are a significant class of process-related impurities commonly associated with the manufacturing of biopharmaceuticals. However, due to the increased use of crude enzymes as biocatalysts for modern organic synthesis, HCPs can also be introduced as a new class of impurities in chemical drugs. In both cases, residual HCPs need to be adequately controlled to ensure product purity, quality, and patient safety. Although a lot of attentions have been focused on defining a universally acceptable limit for such impurities, the risks associated with residual HCPs on product quality, safety, and efficacy often need to be determined on a case-by-case basis taking into consideration the residual HCP profile in the product, the dose, dosage form, administration route, and so forth. Here we describe the unique challenges for residual HCP control presented by the biocatalytic synthesis of an investigational stimulator of interferon genes protein agonist, MK-1454, which is a cyclic dinucleotide synthesized using Escherichia coli cell lysate overexpressing cyclic GMP-AMP synthase as a biocatalyst. In this study, a holistic characterization of residual protein impurities using a variety of analytical tools including nanoscale liquid chromatography coupled to tandem mass spectrometry, together with in silico immunogenicity prediction of identified proteins, facilitated risk assessment and guided process development to achieve adequate removal of residual protein impurities in MK-1454 active pharmaceutical ingredient.

The Addition of ω-3 Fish Oil Fat Emulsion to Parenteral Nutrition Reduces Short-Term Complications after Laparoscopic Surgery for Gastric Cancer.

The incidence of short-term complications after laparoscopic surgery for gastric cancer is higher. Whether ω-3 fish oil fat emulsion can reduce short-term complications of gastric cancer after laparoscopic surgery is controversial. The purpose of this study was to explore the effect of ω-3 fish oil fat emulsion on postoperative recovery of patients with gastric cancer after laparoscopic surgery. A total of 111 patients were included in this study. These patients were given parenteral nutrition for 5 day or more after surgery. We used univariate analysis and multivariate analysis to determine whether ω-3 fish oil fat emulsion could affect the incidence of short-term complications after gastric cancer laparoscopic surgery. The incidence of postoperative short-term complications in patients with parenteral nutrition supplemented with ω-3 fish oil fat emulsion was significantly lower than that in patients without ω-3 fish oil fat emulsion (12/51 VS 26/60, P = 0.027). ω-3 fish oil fat emulsion is an independent risk factor for short-term postoperative complications in patients with gastric cancer (OR = 0.393, CI:0.155-0.996, P = 0.049). In conclusion, the addition of ω-3 fish oil fat emulsion to parenteral nutrition after operation can effectively reduce the incidence of short-term complications in patients with gastric cancer after laparoscopic surgery.

Buyang Huanwu Decoction ameliorates atherosclerosis by regulating TGF-ß/Smad2 pathway to promote the differentiation of regulatory T cells.

ETHNOPHARMACOLOGICAL RELEVANCE: As a classic prescription of Traditional Chinese Medicine in Correction on the Errors of Medical Works, Buyang Huanwu Decoction (BYHWD) has a good curative effect on prevention of atherosclerosis (AS). AIM OF THE STUDY: This study aims to elucidate the anti-atherosclerosis mechanism of BYHWD, which may promote the differentiation of regulatory T cells by regulating the TGF-ß/Smad2 pathway. MATERIALS AND METHODS: ApoE-/- mice were fed a high-fat diet for 12 weeks, then drugs group were given BYHWD with intragastric administration once a day for 4 weeks. The effect of BYHWD on lipid content in peripheral blood and plaque was evaluated by blood lipid test and oil red O staining. The number of Tregs in peripheral blood was tested by flow cytometry, and that in the spleen was evaluated by immunohistochemistry methods. Gene and protein expression relating with Tregs differentiation pathway in mice were checked by RT-PCR and Western blot experiments. CD4+T cells were isolated and interfered by BYHWD drug-loaded serum. The proportion of Tregs was evaluated by flow cytometry. The chemical compositions of BYHWD and rat drug-loaded serum were analyzed by ultra-high performance liquid chromatograph and liquid chromatography-tandem mass spectrometry. RESULTS: BYHWD significantly reduced plaque area and cholesterol accumulation, increased the number of Tregs in spleen and peripheral blood of ApoE-/- AS mice, raised the proportion of Tregs in CD4+T cells, and regulated the levels of inflammatory factors. It also increased the TGF-ß and Smad2 mRNA and protein levels relating with Tregs differentiation pathway in vivo. The mRNA levels of Foxp3/TGF-ß/Smad2 were enhanced via BYHWD in vitro. CONCLUSIONS: BYHWD regulates TGF-ß/Smad2 signaling pathway to promotes the peripheral differentiation of Tregs, increases the number of Tregs, restores the immune balance between CD4+T cells, regulates lipid metabolism, inhibits inflammatory reaction and possesses the potential of enhancing plaque stability.

Efficacy of five-element music interventions in perinatal mental health and labor pain: A meta-analysis.

OBJECTIVE: To systematically review the efficacy of five-element music interventions in perinatal mental health and labor pain. To provide evidence for future research on Chinese Traditional Music Interventions. METHODS: An electronically search was conducted in Web of Science, PubMed, EMbase, The Cochrane Library, CNKI databases, WanFang Data and VIP Database for Chinese Technical Periodicals from inception to January 07, 2020 to collect randomized controlled trials (RCTs) on five-element music interventions for prenatal, perinatal and postpartum women. Literature screening, data extraction, and the risk of bias assessment of all eligible studies were conducted by two reviewers independently. Then, meta-analysis was performed by RevMan 5.3 software. RESULTS: A total of 13 RCTs involving 2387 patients were included. The results of meta-analysis showed that five-element music could significantly improve the depression levels (SMD = -2.03, 95%CI: -2.88 to -1.19, P < 0.00001), anxiety levels (SMD = -3.49, 95%CI: -4.47 to -2.24, P < 0.00001) and severe anxiety rate (OR = 0.42, 95%CI: 0.19 to 0.94, P = 0.04) of perinatal women. Additionally, five-element music produced significant effects on labor pain (MD = -0.67, 95%CI: -0.82 to -0.52, P < 0.00001), labor duration (MD = -0.85, 95%CI: -1.07 to -0.63, P < 0.00001), the hemorrhage 2 h after parturition (MD = -19.55, 95%CI: -35.56 to -3.54, P = 0.02) and the Serum DYN expression level (MD = 1.32, 95%CI: 0.23 to 2.40, P = 0.02). CONCLUSIONS: Five-element music may be efficacious in improving perinatal women' depression, anxiety, labor pain, labor duration, the hemorrhage 2 h after parturition and the Serum DYN expression level. Because of the limitation of quantity and quality of included studies, more high-quality studies were needed to confirm the above conclusion.

Traditional Chinese medicine, Kami-Shoyo-San protects ketamine-induced neurotoxicity in human embryonic stem cell-differentiated neurons through activation of brain-derived neurotrophic factor.

BACKGROUND: Anesthesia-induced neurotoxicity may cause permanent dysfunctions in human brains. In this work, we used a cell-based in-vitro model to demonstrate that traditional Chinese medicine, Kami-Shoyo-San may protect ketamine-induced neuronal apoptosis in human embryonic stem cell-differentiated neurons. METHODS: Human embryonic stem cell-differentiated neurons were cultured in vitro and treated with high-concentration ketamine to induce neuronal apoptosis. Pre-incubation of Kami-Shoyo-San was conducted to evaluate its neuroprotection on ketamine-injured neurons. Quantitative real-time PCR and western blot assays were used to assess brain-derived neurotrophic factor and its receptor, tropomyosin receptor kinase B, in response to Kami-Shoyo-San and ketamine treatment. Brain-derived neurotrophic factor/tropomyosin receptor kinase B signaling pathway was then deactivated, by siRNA application, to further explore its functional role in Kami-Shoyo-San-mediated protection on ketamine-induced apoptosis among human embryonic stem cell-differentiated neurons. RESULTS: High concentration of ketamine-induced significant apoptosis, whereas pre-incubation of Kami-Shoyo-San markedly rescued ketamine-induced apoptosis, in human embryonic stem cell-differentiated neurons. Kami-Shoyo-San activated brain-derived neurotrophic factor/tropomyosin receptor kinase B signaling pathway by upregulating brain-derived neurotrophic factor and inducing tropomyosin receptor kinase B phosphorylation. Conversely, siRNA-mediated brain-derived neurotrophic factor/tropomyosin receptor kinase B signaling pathway deactivation reversed the neuroprotection of Kami-Shoyo-San in ketamine-injured human embryonic stem cell-differentiated neurons. CONCLUSION: Kami-Shoyo-San could protect ketamine-induced neurotoxicity, and the underlying mechanism may involve brain-derived neurotrophic factor/tropomyosin receptor kinase B signaling pathway.

Effects of Short-term High Dose Atorvastatin on Left Ventricular Remodeling in Patients with First Time Attack of Anterior Acute Myocardial Infarction.

Objects The aim of this trial was to evaluate the effect of short-term high-dose atorvastatin therapy on levels of high-sensitivity C-reactive protein (hs-CRP), malonaldehyde (MDA), endothelin-1(ET-1), matrix metalloproteinases (MMPs), and left ventricular (LV) remodeling in patients with first time attack of acute anterior myocardial infarction (AAMI) .Methods A hundred and three patients with first time attack of AAMI who underwent successful primary percutaneous coronary intervention were randomized to receive atorvastatin 40 mg once daily for 1 week followed by 20 mg once daily (intensive treatment group, IT group, n=49), or atorvastatin 20 mg once daily (standard treatment group, ST group, n=54). Plasma levels of hs-CRP, MDA, ET-1, MMP-2 and MMP-9 were measured on admission, at 1 week, 2 weeks and 6 months follow up and compared between the IT group and ST group. Echocardiography was performed on admission, at 2 week, and 1 year follow up. The left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were measured at each echocardiographic examination and compared between the IT group and ST group.Results Plasma levels of hs-CRP (F=7.718, P=0.009), ET-1 (F=7.882, P=0.006), MMP-9 (F=4.834, P=0.028) and pro-BNP (F=4.603, P=0.032) were significantly lower at 1 week after initial onset of AAMI in the IT group compared with the ST group. The changes of LVEDV, LVESV, and LVEF at the 1 year follow-up from the admission did not differ between the IT group and the ST group (t=0.722, P=0.444; t=1.228, P=0.221; t=1.354, P=0.187, repectively).Conclusions Short-term high-dose atorvastatin treatment for AAMI was associated with lower hs-CRP, ET-1 and MMP-9 levels compared to the standard dose treatment. However, this beneficial effect is not likely to related to the left ventricular remodeling.