Analysis of the current status of community nurses' spiritual care competencies and the factors: A descriptive cross-sectional analysis.

AIM: To examine and analyze the level of spiritual care competency among community nurses. DESIGN: The study employed a cross-sectional design. METHODS: From May to July 2022, 442 nurses from community health clinics were chosen as survey respondents using the convenience sample method. The General Information Questionnaire, the version in Chinese of the Nurses' Spiritual Caregiving Awareness Scale and the Chinese version of the Spiritual Caregiving Competence Scale were used in the survey. There were 442 questionnaires distributed, 422 were collected, and the response rate was 95.4%. RESULTS: The amount of spiritual care competencies of community nurses was positively correlated with the level of spiritual awareness. Simultaneously, their level of education, religious beliefs, marital status and the degree of knowledge of spirituality were all influenced.

Natural phytochemicals prevent side effects in BRCA-mutated ovarian cancer and PARP inhibitor treatment.

Ovarian cancer is among the most common malignant tumors in gynecology and is characterized by insidious onset, poor differentiation, high malignancy, and a high recurrence rate. Numerous studies have shown that poly ADP-ribose polymerase (PARP) inhibitors can improve progression-free survival (PFS) in patients with BRCA-mutated ovarian cancer. With the widespread use of BRCA mutation and PARP inhibitor (PARPi) combination therapy, the side effects associated with BRCA mutation and PARPi have garnered attention worldwide. Mutations in the BRCA gene increase KEAP1-NRF2 ubiquitination and reduce Nrf2 content and cellular antioxidant capacity, which subsequently produces side effects such as cardiovascular endothelial damage and atherosclerosis. PARPi has hematologic toxicity, producing thrombocytopenia, fatigue, nausea, and vomiting. These side effects not only reduce patients' quality of life, but also affect their survival. Studies have shown that natural phytochemicals, a class of compounds with antitumor potential, can effectively prevent and treat the side effects of chemotherapy. Herein, we reviewed the role of natural phytochemicals in disease prevention and treatment in recent years, including sulforaphane, lycopene, catechin, and curcumin, and found that these phytochemicals have significant alleviating effects on atherosclerosis, nausea, and vomiting. Moreover, these mechanisms of action significantly correlated with the side-effect-producing mechanisms of BRCA mutations and PARPi. In conclusion, natural phytochemicals may be effective in alleviating the side effects of BRCA mutant ovarian cancer cells and PARP inhibitors.

Q-Switched Laser Combined with Intense Pulsed Laser in the Treatment of Melasma Based on Reflection Confocal Microscope.

Chloasma is a prevalent clinical hyperpigmentation skin disorder that causes symmetrical brown to tan patches on the cheeks, as well as the neck and forearms on rare occasions. The pathophysiology of this condition is complicated, and there is now no cure. Under the light microscope, the full-thickness melanin of the epidermis in the skin lesions was increased, and the dermal chromophages increased. At present, the treatment of melasma mainly includes topical drugs, chemical peels, systemic drugs, laser therapy, and traditional Chinese medicine. With the development of medical technology, intense pulsed light and Q-switched laser have been widely used in the treatment of melasma, which can emit laser beams to penetrate the dermis uniformly to treat deep pigmented lesions in the dermis. After a stable treatment outcome for melasma is achieved, it is important to minimize side effects such as postinflammatory hyperpigmentation and skin irritation. Therefore, this paper uses a reflection confocal microscope to establish an evaluation index system and then uses a neural network to evaluate the treatment effect. The work of this paper is as follows: (1) this paper introduces various methods of treating melasma at home and abroad and focuses on the application of intense pulsed light therapy and low-energy Q-switched Nd: YAG laser in the treatment of melasma. (2) In this paper, the case data samples are trained with the designed BP network to obtain a reliable evaluation network model. (3) The results and mistakes of the evaluation are produced by training the genetic algorithm optimized backpropagation (GA-BP) network structure model to evaluate the treatment effect of chloasma. Finally, it has been demonstrated that the GA-BP network has great accuracy and stability.

Triage Nurse-Activated Emergency Evaluation Reduced Door-to-Needle Time in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis.

Methods: This was a retrospective analysis in a general hospital emergency department in Beijing, China. 212 adult AIS patients treated with thrombolysis who failed to use EMSs were included. In addition to DNT, door-to-vein open time (DVT), door-to-blood sample deliver time (DBT), and 7-day NIHSS scores were evaluated. Results: 137 (64.6%) patients were in the triage nurse-activated group and 75 (35.4%) patients were in the doctor-activated group. The DNT of the triage nurse-activated group was significantly reduced compared with the doctor-activated group (28 (26, 32.5) min vs. 30 (28, 40) min, p=0.001). DNT less than 45 min was seen in 95.6% of patients in the triage nurse-activated group and 84% of patients in the doctor-activated group (p=0.011, OR 3.972, 95% CI 1.375-11.477). In addition, DVT (7 (4, 10) min vs. 8 (5, 12) min, P=0.025) and DBT (15 (13, 21) min vs. 19 (15, 26) min, p=0.001) of the triage nurse-activated group were also shorter than those of the doctor-activated group (p < 0.05). The 7-day NIHSS scores were not statistically different between the two groups. Conclusions: Triage nurse-activated urgent emergency evaluation could reduce the door-to-needle time, which provides a feasible opportunity to optimize the emergency department service for AIS patients who failed to use emergency medical services.

Systematic Understanding of Mechanism of Danggui Shaoyao San against Ischemic Stroke Using a Network Pharmacology Approach.

PURPOSE: Danggui Shaoyao San (DSS) was developed to treat the ischemic stroke (IS) in patients and animal models. The purpose of this study was to explore its active compounds and demonstrate its mechanism against IS through network pharmacology, molecular docking, and animal experiment. METHODS: All the components of DSS were retrieved from the pharmacology database of TCM system. The genes corresponding to the targets were retrieved using OMIM, CTD database, and TTD database. The herb-compound-target network was constructed by Cytoscape software. The target protein-protein interaction network was built using the STRING database. The core targets of DSS were analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). Then, we achieved molecular docking between the hub proteins and the key active compounds. Finally, animal experiments were performed to verify the core targets. Triphenyltetrazolium chloride (TTC) staining was used to calculate the infarct size in mice. The protein expression was determined using the Western blot. RESULTS: Compound-target network mainly contained 51 compounds and 315 corresponding targets. Key targets contained MAPK1, SRC, PIK3R1, HRAS, AKT1, RHOA, RAC1, HSP90AA1, and RXRA FN1. There were 417 GO items in GO enrichment analysis (p < 0.05) and 119 signaling pathways (p < 0.05) in KEGG, mainly including negative regulation of apoptosis, steroid hormone-mediated signaling pathway, neutrophil activation, cellular response to oxidative stress, and VEGF signaling pathway. MAPK1, SRC, and PIK3R1 docked with small molecule compounds. According to the Western blot, the expression of p-MAPK 1, p-AKT, and p-SRC was regulated by DSS. CONCLUSIONS: This study showed that DSS can treat IS through multiple targets and routes and provided new insights to explore the mechanisms of DSS against IS.

[Effect of grape seed extract on oxidative stress and pathological changes of aorta in rats with chronic periodontitis and arteriosclerosis].

PURPOSE: To investigate the effect of grape seed extract on pathological changes of aorta in rats with chronic periodontitis and arteriosclerosis, and to analyze the possible mechanism. METHODS: Fifteen SPF male rats with chronic periodontitis and arteriosclerosis were randomly divided into three groups, i.e., model group(n=5), low dose of grape seed extract group (n=5), high dose of grape seed extract group (n=5) , and control group (n=10). The rats in the low and high dose groups were treated with 40 mg·kg-1·d-1 and 80 mg·kg-1·d-1 for 4 weeks respectively, while the rats in the normal control group and the model group were treated with the same amount of normal saline at the same time. The maximal intima-media thickness(IMT) of abdominal aorta was measured by H-E staining, the activity of SOD and the content of MDA in serum were measured by colorimetry, the content of GSH-px in serum and serum levels of inflammatory factor (TNF-α) and interleukin-6(IL-6) were detected by ELISA. p38 mitogen-activated protein kinase/nuclear transcription factor Kappa B p65(p38 MAPK/NF-κB p65) pathway was detected by Western blotting. SPSS 20.0 software package was used for statistical analysis. RESULTS: In the model group, the intima of abdominal aorta was irregularly thickened, with a lot of inflammatory cell infiltration, and arterial lesions appeared. In the low-and high-dose groups of grape seed extract, the plaque of abdominal aorta intima decreased and inflammatory cells reduced significantly, arterial vascular disease was improved, and the improvement was more obvious in high dose group than in low dose group. Compared with the control group, the levels of IMT, serum MDA, TNF-α, IL-6, p-p38MAPK/p38MAPK, NF-κB p65 and serum SOD and GSH-px in the model group were increased, while those in the model group were decreased(P＜0.05); the levels of IMT, serum MDA, TNF-α, IL-6, p-p38MAPK/p38MAPK, NF-κB p65 and SOD, GSH-px were decreased in the low and high dose groups(P＜0.05). CONCLUSIONS: Grape seed extract can inhibit the oxidative stress level and inflammatory reaction in serum of chronic periodontitis with arteriosclerosis rats, thus improving the intimal lesion of aorta, possibly by inhibiting the activation of p38MAPK/NF-κB p65 pathway.

A transfer learning framework based on motor imagery rehabilitation for stroke.

Deep learning networks have been successfully applied to transfer functions so that the models can be adapted from the source domain to different target domains. This study uses multiple convolutional neural networks to decode the electroencephalogram (EEG) of stroke patients to design effective motor imagery (MI) brain-computer interface (BCI) system. This study has introduced 'fine-tune' to transfer model parameters and reduced training time. The performance of the proposed framework is evaluated by the abilities of the models for two-class MI recognition. The results show that the best framework is the combination of the EEGNet and 'fine-tune' transferred model. The average classification accuracy of the proposed model for 11 subjects is 66.36%, and the algorithm complexity is much lower than other models.These good performance indicate that the EEGNet model has great potential for MI stroke rehabilitation based on BCI system. It also successfully demonstrated the efficiency of transfer learning for improving the performance of EEG-based stroke rehabilitation for the BCI system.

Factors Influencing Compliance with Auricular Acupressure Therapy in Patients with Cancer-Related Fatigue.

BACKGROUND: Patient compliance can influence the effect of auricular acupressure used to manage cancer-related fatigue (CRF). OBJECTIVE: To explore the barriers and facilitators affecting patients' compliance with treatment. METHODS: The maximum difference sampling method was used to conduct qualitative interviews with 11 CRF patients undergoing auricular acupressure therapy. The interview data were analyzed by Colaizzi's seven-step analysis. RESULTS: Convenience and acceptability of the therapy, preliminary effects of its implementation, fully believing in the benefits of auricular acupressure and being habituated to the therapy, help and reminder from family members are the facilitating factors to improve patient compliance with auricular acupressure therapy, while the hindering factors include having doubts about the effect of acupressure resulting in interruption, having limited access to medical resources, deterioration of the condition resulting in self-abandonment, and weak family support. CONCLUSION: In clinical nursing practice, attention should be paid to the analysis of the facilitating and hindering factors during the implementation of auricular acupressure therapy as well as the development of targeted intervention measures to improve patient compliance so as to enhance the effectiveness of auricular acupressure.

[Effects of honokiol on particulate matter 2.5-induced lung injury in asthmatic mice and its mechanisms].

OBJECTIVE: To explore the therapeutic effect of honokiol on particulate matter 2.5 (PM2.5)-induced lung injury in asthmatic mice and the possible mechanisms.
 Methods: A total of 32 BALB/C mice were randomly divided into four groups: a normal saline group, a model group, a PM2.5 group and a honokiol group (n=8 in each group). The asthma mouse model was established by ovalbumin treatment. The mice were treated with physiological saline, ovalbumin, PM2.5 and honokiol, respectively. Lung tissues and serum were collected. The pathological changes of lung tissues were evaluated. The levels of inflammatory cytokines in bronchoalveolar lavage fluid (BALF) and serum were measured and the expressions of Toll like receptor 4 (TLR4), nuclear factor kappa B (NF-κB), retinoid-related orphan receptor gamma-t (RORγt) and forkhead box protein 3 (Foxp3) in lung tissues were detected.
 Results: 1) The lung tissues of mice in the asthma group showed obvious pathological changes and inflammatory state, suggesting that the asthma model was established successfully. PM2.5 could aggravate the pathological condition of inflammatory injury in lung tissues in asthmatic mice. 2) Compared to the PM2.5 group, the pathological symptoms in the lung tissues were alleviated in the honokiol group and the percentage of inflammatory cells in BALF and the levels of inflammatory cytokines in BALF and serum were significantly reduced (all P<0.05). 3) Compared to the PM2.5 group, the expressions of TLR4, NF-κB (p-p65) and RORγt in lung tissues were significantly decreased, while the expression of Foxp3 was increased; the ratio of RORγt/Foxp3 was also decreased in the honokiol group (all P<0.05).
 Conclusion: Honokiol can resist lung injury induced by PM2.5 in asthmatic mice. These effects are through inhibiting TLR4-NF-κB pathway-mediated inflammatory response or regulating the balance of Th17/Treg cells.

Efficient production of lycopene by engineered E. coli strains harboring different types of plasmids.

The lycopene biosynthetic genes crtE, crtB, and crtI from Deinococcus wulumuqiensis R12 were integrated into three different vector backbones-pET28a, pTrc99A, and pUC18-and the resulting recombinant plasmids pET28a-EBI, pTrc99A-EBI, and pUC18-EBI were introduced into different Escherichia coli hosts. The results showed that lycopene production of strain 28BL was lower than that of 99 series strains without IPTG in LB medium. In addition, lycopene production of 99JM with supplementation of 20% (w/v) glycerol was 1.6-fold higher than with supplementation of 6% (w/v) glucose. After optimization of the host strain and culture medium, the yield of microbial lycopene was increased successfully. When recombinant E. coli 99DH was cultivated under exposure to light in 2YT + Gly medium, the highest lycopene production rate was 26.2 mg/L/h at 30 h, and the maximum specific lycopene content was 67 mg/g dry cell (925 mg/L) at 40 h, which represents a 76% increase over the starting point.

The manganese efflux system MntE contributes to the virulence of Streptococcus suis serotype 2.

Manganese is an essential micronutrient to bacteria and plays an important role in bacterial physiology. However, an excess of manganese is extremely deleterious to the cell. The manganese efflux system is used to control intracellular manganese levels by some bacteria. In this study, we have identified a cation efflux family protein (MntE) that functions as a manganese export system in Streptococcus suis serotype 2. To investigate the role of mntE in S. suis 2, a mntE deletion mutant (ΔmntE) and the corresponding complementation strain (CΔmntE) were constructed. ΔmntE displayed similar growth compared to the wild-type and complementation strains under normal growth conditions, but was defective in medium supplemented with high concentrations of manganese. In addition, the mutant was more sensitive to oxidative stress conferred by diamide. Using a competitive-infection assay in the murine infection model, we demonstrated for the first time that MntE is involved in the virulence of S. suis 2. Collectively, our data indicate that manganese homeostasis controlled by the manganese efflux system MntE is important for the pathogenesis of S. suis 2.

Ultraviolet B Inhibits IL-17A/TNF-α-Stimulated Activation of Human Dermal Fibroblasts by Decreasing the Expression of IL-17RA and IL-17RC on Fibroblasts.

BACKGROUND: Psoriasis is a chronic immune-mediated inflammatory disease, and a mixed Th1/Th17 cytokine environment plays a critical role in the pathogenesis of psoriasis. Dermal fibroblasts secrete certain cytokines such as IL-6, IL-8, and CXCL-1, contributing to the hyperproliferative state of the epidermis in psoriatic skin. Ultraviolet B (UVB) phototherapy is one of the most commonly used treatments in psoriasis but the influence of UVB on human dermal fibroblasts (HDFs) in psoriasis treatment is not completely understood. OBJECTIVES: We conducted this study to mimic a psoriatic microenvironment in order to investigate and illustrate the combined effects of UVB, IL-17A, and TNF-α on HDFs. METHODS: The cultured HDFs were obtained from foreskin samples and divided into four groups, as follows: control; IL-17A/TNF-α; UVB; and IL-17A/TNF-α + UVB. Cultured HDFs were irradiated with 30 mJ/cm2 UVB followed by addition of IL-17A/TNF-α and incubated for 24 h. We used real-time quantitative PCR, Western blot, ELISA analysis, and flow cytometry to examine gene and protein expression of related pro-inflammatory cytokines and chemokines and receptors. RESULTS: HDFs produced significant IL-6, IL-8, and CXCL-1 in response to IL-17A/TNF-α stimulation and UVB irradiation but UVB irradiation inhibited IL-17A/TNF-α-induced IL-6, IL-8, and CXCL-1 expression and downregulated the expression of IL-17RA and IL-17RC at both gene and protein levels. Additionally, UVB irradiation induced significant TGF-ß1 protein secretion and expression of Smad3 mRNA and protein by HDFs. TGF-ß1 significantly induced the expression of Smad3 mRNA and downregulated the IL-17RA and IL-17RC expression on HDFs. CONCLUSION: UVB irradiation inhibits IL-17A/TNF-α-induced IL-6, IL-8, and CXCL-1 production in HDFs by decreasing the expression of IL-17RA and IL-17RC on fibroblasts through TGF-ß1/Smad3 signaling pathway, which reveals a new mechanism of the therapeutic action of UVB on psoriasis.

Systemic abnormalities of psoriatic patients: a retrospective study.

BACKGROUND: Psoriasis is a chronic immune-mediated inflammatory disease related to the metabolic syndrome, cardiovascular disease, and other comorbidities. However, so far there has been no specific research concerning systemic abnormalities in psoriatic patients. OBJECTIVE: A retrospective study was conducted focusing on the detailed systemic abnormalities in psoriatic patients. METHODS: Psoriatic inpatients data was collected from July 2009 to September 2015. The inclusion criteria were first-time hospitalization and without administration of systemic drug therapy or exposure to phototherapy for psoriasis for at least 1 month. Detailed systemic indexes were mainly evaluated. RESULTS: The abnormality rates of blood routine examination, urine examination, blood biochemical examination and chest X-ray of 43 psoriatic patients were significantly higher than those of 44 non-psoriasis controls, and psoriasis patients significantly had higher absolute values of leukocytes and neutrophils, and significantly lower values of lymphocytes. Compared with psoriasis vulgaris, erythrodermic psoriasis had significantly higher abnormality rates of blood biochemical examination and serum electrolyte analysis. Erythrodermic psoriasis had significantly higher absolute values of blood leukocytes, neutrophils, and lower serum calcium compared with those of psoriasis vulgaris. The neutrophil-to-lymphocyte ratio of controls was significantly lower than that of psoriatic patients, and neutrophil-to-lymphocyte ratio of erythrodermic psoriasis was significantly higher in comparison with psoriasis vulgaris. CONCLUSION: This study is the first report in relation to a detailed assessment of systemic abnormalities in psoriatic patients prior to onset of systemic treatment. The systemic condition of psoriatic patients should be observed by clinicians before systemic therapy.

Pustular drug eruption due to Panax notoginseng saponins.

Panax notoginseng saponins (PNS) are a patented product in the People's Republic of China, and have extensive effects on the cardiovascular system. Here we report on four elderly patients (one male and three female) with drug eruption induced by PNS injection. All developed a sudden skin rash with pruritus from head to foot, and subsequently accepted hospitalization. In each case, PNS had been used for less than 1 week before appearance of the rash. No specific short-term medications or changes in diet or exposure to environmental factors immediately prior to appearance of the rash were identified. These four patients had some interesting features in common, ie, pustules, fever, and elevated circulating neutrophil counts, which required high-dose, long-term glucocorticoid therapy. To our knowledge, this is the first report of pustular drug eruption induced by PNS and provides a useful reference and warning for clinicians.

Raddeanin A induces human gastric cancer cells apoptosis and inhibits their invasion in vitro.

Raddeanin A is one of the triterpenoid saponins in herbal medicine Anemone raddeana Regel which was reported to suppress the growth of liver and lung cancer cells. However, little was known about its effect on gastric cancer (GC) cells. This study aimed to investigate its inhibitory effect on three kinds of different differentiation stage GC cells (BGC-823, SGC-7901 and MKN-28) in vitro and the possible mechanisms. Proliferation assay and flow cytometry demonstrated Raddeanin A's dose-dependent inhibitory effect and determined its induction of cells apoptosis, respectively. Transwell assay, wounding heal assay and cell matrix adhesion assay showed that Raddeanin A significantly inhibited the abilities of the invasion, migration and adhesion of the BGC-823 cells. Moreover, quantitative real time PCR and Western blot analysis found that Raddeanin A increased Bax expression while reduced Bcl-2, Bcl-xL and Survivin expressions and significantly activated caspase-3, caspase-8, caspase-9 and poly-ADP ribose polymerase (PARP). Besides, Raddeanin A could also up-regulate the expression of reversion inducing cysteine rich protein with Kazal motifs (RECK), E-cadherin (E-cad) and down-regulate the expression of matrix metalloproteinases-2 (MMP-2), MMP-9, MMP-14 and Rhoc. In conclusion, Raddeanin A inhibits proliferation of human GC cells, induces their apoptosis and inhibits the abilities of invasion, migration and adhesion, exhibiting potential to become antitumor drug.