n-3 polyunsaturated fatty acids alleviate the progression of obesity-related osteoarthritis and protect cartilage through inhibiting the HMGB1-RAGE/TLR4 signaling pathway.

Osteoarthritis (OA) is a common joint degenerative disease. There is currently no cure for OA. Dietary fatty acids have potential value in the prevention and treatment of OA. n-3 polyunsaturated fatty acids (PUFAs) have anti-inflammatory effects, but their anti-OA mechanism remains unclear. High-mobility group box 1 (HMGB1) promotes inflammation and participates the pathogenesis of OA. The purpose of this study was to investigate the protective effect of n-3 PUFAs on cartilage and whether n-3 PUFAs could exert an anti-OA effect through inhibiting HMGB1-RAGE/TLR4 signaling pathway. We established an obesity-related post-traumatic OA mice model and an in vitro study was conducted to explore the regulatory mechanism of n-3 PUFAs on HMGB1 and its signal pathway against OA. We found that diet rich in n-3 PUFAs alleviated OA-like lesions of articular cartilage with the decrease of HMGB1-RAGE/TLR4 signaling protein in mice. In SW1353 cells, DHA significantly reduced the expression of HMGB1-RAGE/TLR4 signaling protein which was up-regulated by IL-1ß stimulation. HMGB1 overexpression reversed the inhibitory effect of DHA on HMGB1-RAGE/TLR4 signaling pathway. The activation of SIRT1 may participate the inhibitory effect of DHA on HMGB1-RAGE/TLR4 signaling pathway. In conclusion, n-3 PUFAs could attenuate the progression of obesity-related OA and exert protective effect on cartilage by inhibiting HMGB1-RAGE/TLR4 signaling pathway, which may be associated with the activation of SIRT1. Dietary n-3 PUFAs supplements can be considered as a potential therapeutic substance for OA.

Analysis of the Current Situation and Factors Influencing the Clinical Thinking Ability of Nursing Undergraduates.

Context: Clinical thinking encompasses the critical analysis, judgment, and decision-making pertaining to the existing or potential nursing problems of patients. It plays a pivotal role in effectively executing clinical nursing work in alignment with the prescribed nursing procedures. Proficient clinical thinking empowers nurses with the capability to identify, analyze, and resolve problems. Objective: The study intended to investigate the current situation of clinical thinking ability of nursing students and its influencing factors, so as to improve their clinical thinking ability. Methods: This was a cross-sectional study and the research took place at Taizhou University in Taizhou, Zhejiang province, China in the Faculty of Nursing. 143 full-time undergraduate nursing students at the University were selected for the cross-sectional survey, including a general questionnaire and a clinical thinking ability questionnaire for undergraduate nursing students. The respondents included nursing students in their sophomore, junior and senior years. Results: The survey results obtained between the first and the third year of study were included. Age of the participants ranged from 18 to 24 years, with an average age of 21.58 ± 2.45 years. The professional knowledge score of undergraduate nursing students in this survey was found to be 52.59 ± 13.93; ​the score of professional emotion was 14.21 ± 2.40; ​the score of professional will was 19.51 ± 2.15; ​the score of professional values was 14.40 ± 2.31; ​the professional skill score was 18.52 ± 2.06; the professional expectation was found to be 12.73 ± 1.30; and ​the total score was (99.26 ± 7.96). All dimensions and total scores of clinical ability of thinking among undergraduate nursing students in this survey were found to be average. Conclusions: Clinical thinking of undergraduate nursing students is found to be of a medium level, and the main influencing factors are grade and the satisfaction of teachers. Nursing colleges and practice hospitals should unite to adopt various ways to help nursing undergraduates cultivate and improve their clinical thinking ability.

Current Situation and Factors Influencing the Disaster Response Capability of Undergraduate Nursing Students.

Context: China is a country in which frequent natural disasters occur, but there is a lack of disaster education in Chinese institutions of higher education. Nursing students should receive disaster and emergency training in addition to their professional medical training. Objective: Our study aimed to investigate the current situation and disaster knowledge and training needs of nursing students and to increase the disaster first aid knowledge of college nursing students. Design: This was a cross-sectional study. Setting: The study took place at Taizhou University in Taizhou, Zhejiang, China. Participants: Participants were 443 full-time undergraduate nursing students at Taizhou University in China. Outcome Measures: This cross-sectional survey included a general questionnaire and an undergraduate nursing student disaster nursing ability questionnaire. Results: The survey results were from the first to the third year of study. Students were age 20 to 23 years, with an average age of 20.57±1.85 years. The largest group (35.44%) was made up of juniors. The scores of 3 dimensions of this survey were: dimension of physical and mental quality dimension (3.76 ± 0.71), theoretical system dimension (3.00 ± 0.57) and practical competencies dimension (2.89 ± 0.68). The ability to adapt to rescue needs at the disaster site and whether or not the student had heard of the term "disaster nursing" is the dominant factor affecting the disaster nursing skills of undergraduate nursing students. Conclusions: The disaster relief of male undergraduate nursing student seniors is more positive and their physical and mental quality is better than female nursing students, but knowledge of disaster prevention and practical capability in disaster relief remain weak and there is a lack of a corresponding theoretical system and competence in practical knowledge and skills. It is recommended that systematic disaster nursing education at universities be improved. Knowledge of disaster rescue should be taught systematically to improve awareness of disaster procedures and response and improve the level of practical skills in disaster rescue. We should learn from the educational approach and models of disaster nursing training in developed countries in order to establish a disaster nursing education model in China.

Oxygen Therapy Confers Little Benefit in Patients with Acute ST-Segment Elevation Myocardial Infarction: A Systematic Review and Meta-Analysis.

Objective: We aimed to investigate the clinical benefit of oxygen therapy in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: We searched PubMed, Embase and the Cochrane Library from database inception to June 2020 to identify randomized controlled trials (RCTs) on oxygen therapy in acute STEMI. Literature screening, data extraction and study quality assessment were independently carried out by the 2 investigators according to the predefined eligibility criteria, and RevMan 5.3 analysis software was utilized for all analyses. Results: Finally, 5 RCTs with a total of 4824 patients with STEMI were eligible for further meta-analysis. The RCT results demonstrated that oxygen therapy exerted non-significant effects in reducing the risks for short-term all-cause mortality (risk ratio [RR] = 1.21; 95% CI, 0.80-1.53; P = .53), cardiac arrest (RR = 1.20; 95% CI, 0.94-1.54; P = .79), recurrent myocardial infarction (MI) (RR = 0.68; 95% CI, 0.43-1.08; P = .10) and cardiogenic shock (RR = 0.81; 95% CI, 0.58-1.15; P = .24) and the incidence of other outcome indicators of acute STEMI. Conclusions: Oxygen therapy does not provide more benefits than adverse effects in patients with acute STEMI. Personalized oxygen treatment based on dynamic oxygen saturation is recommended in patients with hypoxia. Supplemental oxygen in patients with acute STEMI has no effect on reducing infarct size, and has no benefit in all-cause mortality, cardiogenic shock, etc.

Electroacupuncture Ameliorates Propofol-Induced Cognitive Impairment via an Opioid Receptor-Independent Mechanism.

While general anesthesia is known to induce cognitive deficits in elderly and pediatric patients, its influence on adults is less well-characterized. The present study was designed to evaluate the influence of propofol on the learning and memory of young adult rats, as well as the potential neuroprotective role of electroacupuncture (EA) in propofol-induced cognitive impairment. Intravenous anesthesia with propofol was administered to young adult male Sprague-Dawley (SD) rats for 6 h, and EA was administered three times before and after anesthesia. The Morris Water Maze (MWM) test was conducted to determine the rat's cognitive performance following the anesthesia treatment. Our results showed that propofol induced obvious cognitive impairment in young adult rats, which could be ameliorated by multiple EA treatments. Moreover, the decreased level of phosphorylated glycogen synthase kinase 3 ß (pGSK-3ß) in the CA1 region of the hippocampus accompanying the cognitive impairment was also reversed by EA treatment. Further experiments demonstrated that neither 2 nor 10 mg/kg (I.P.) naloxone blocked the effect of EA, indicating that the neuroprotective effect of EA on propofol-induced cognitive impairment was not mediated via the opioid receptors. The present study suggests that EA could ameliorate the cognitive impairment induced by prolonged anesthesia with propofol in young adult rats, which is likely associated with pGSK-3ß levels in the CA1 independently of opioid receptors. These findings imply that EA may be used as a potential neuroprotective therapy for post-operative cognitive dysfunction (POCD).

[Controlling methods of clinical research on acu-moxibustion commonly used of abroad].

With the application of scientific studying methods, the level of clinical study has been improved greatly, and people has been paid more attention to scientific evaluation of the clinical effect of Chinese medicine and acu-moxibustion. Formerly, because of lack in acceptance and application of modern scientific studying methods in Chinese clinical acu-moxibustion researchers, their achievements weren't approved by the international academy for the faulty model of study. Randomized Control Trial (RCT) is the golden standard method widely accepted at present, so it is of great importance for clinical acu-moxibustion researchers to exert control methods correctly and effectively. The commonly used controlling methods of overseas clinical acu-moxibustion studies were discussed in this article in order to give some suggestion and benifits to the internal acu-moxibustion clinical researchers.

A novel sham moxibustion device: a randomized, placebo-controlled trial.

OBJECTIVES: (1) Develop a sham moxibustion device; (2) determine whether volunteer participants and practitioners can distinguish the sham procedure from real moxibustion during treatment for prevention of the common cold; and (3) assess the feasibility of conducting a larger clinical trial of the device. DESIGN: Double-blinded, randomized, placebo-controlled clinical trial. SETTING: A community outpatient health station in Chaoyang district, Beijing, China, from early November through late December 2003. METHODS: Sham and real moxibustion pillars were made by affixing moxa cones onto special collar bases. These pillars resemble each other in appearance, burning procedure and residue, but the base of the sham pillar isolates the moxa-produced heat and smoke and prevents them from radiating to the skin. These devices were tested in a pilot clinical trial in which patients received moxibustion at Zusanli (ST 36) for prevention of the common cold. Volunteers (n = 71) aged 55-75 years were given pre-treatment questionnaires to assess their knowledge of moxibustion and their expectations and motives for participating in the trial, randomized into treatment (n = 36) and placebo-controlled (n = 35) groups, and treated once every 2 days for 1 month. Questionnaires assessing the effectiveness of the blinding were given to the volunteers at the end of the trial and to practitioners after each treatment session. RESULT: There were no significant differences between the two groups of patients in past moxibustion experience, knowledge of moxibustion, expectations and motivation. The number of volunteers in the treatment group and the placebo group who believed they received: (1) real moxibustion; (2) sham moxibustion; and (3) were uncertain as to which they received is 30, 0, 5; 29, 0, 4, respectively. The results show no significant statistical differences (P = 1.000). The number of volunteers in the treatment group and the placebo group who were believed, by the two practitioners who provided the treatments, to have received: (1) real moxibustion; (2) sham moxibustion; and (3) and an undisclosed treatment were 10, 6, 19; 9, 4, 20 and 11, 7, 17; 12, 5, 16, respectively. There were no statistically significant differences between the practitioners (P = 0.811 and 0.840). CONCLUSION: The sham moxibustion device was successfully validated in the present study. The results demonstrate that these specially designed real and sham moxibustion pillars can be used together to provide an effective placebo-control in moxibustion research and can successfully fulfill the double blinding protocol in moxibustion clinical trials.