Self-Medication with Antibiotics Among Children in China: A Cross-Sectional Study of Parents' Knowledge, Attitudes, and Practices.

Background: Self-medication with antibiotics (SMA) among children is a common practice in low-income and middle-income countries, which has accelerated antibacterial abuse. Objective: This study aimed to estimate the prevalence and associated factors of SMA among children in China, including parents' knowledge, attitudes, and practices towards antibiotic use. Methods: A cross-sectional study based on a structured questionnaire survey of parents was conducted in Nantong between July and September 2020. A total of 1699 respondents participated. Information on participants' demographic and family characteristics, knowledge, attitudes, and practices towards antibiotics use was collected. Hierarchical binary logistic regression was used to examine the predictors of SMA among children. Results: Among 1699 participants, 23.31% practiced SMA to their children in the past year. Cough (59.6%) was the most common symptom leading to self-medication and penicillins (85.4%) were the most commonly used drugs. Hierarchical regression indicated that parents with higher level of antibiotic knowledge scores (OR=1.163, 95% CI: 1.067-1.268) and buying antibiotics without a prescription from pharmacy (OR=1.475, 95% CI: 1.097-1.983) were more likely to practice SMA to their children both in urban and in rural areas. Storing antibiotics at home resulted in an increased likelihood of self-medication in urban areas but not in rural areas. In addition, there was also a higher probability of non-prescribed antibiotics in children without chronic diseases (OR=1.959, 95% CI:1.072-3.578). Conclusion: The prevalence of SMA in children is high in China. Higher knowledge scores and practices of buying and storing non-prescribed antibiotics behaviors increased parents' antibiotic self-medication in their children. Practical and effective education intervention for children's rational use of antibiotics is urgently strengthened.

[Professor ZHANG Jian-bin's clinical experience in "moving cupping therapy on the back"].

This paper summarizes Professor ZHANG Jian-bin's experience in "moving cupping therapy on the back" in clinical practice. Professor ZHANG Jian-bin is good at applying the theory of governor vessel to the clinical diagnosis and treatment. He believes that the moving cupping therapy is the supplementation of "spinal therapy" in clinical diagnosis and treatment. He emphasizes that during the moving cupping therapy exerted, the physicians should observe carefully to in-time obtain the perceived feedback of treatment in patients. Afterward, the cupping marks left should be inspected to discover the location of disorder in the body, thus, a targeted treatment can be provided. Besides, the prognosis of the disease can be judged by the feedback after many treatments with the moving cupping therapy. The moving cupping therapy displays its important value in the diagnosis and treatment of disease, as well as the evaluation of the prognosis.

[Effect of electroacupuncture at "Tianshu" (ST25) on the regulation of nitrergic neurons in different intestinal segments in streptozotocin induced type 2 diabetic rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) at "Tianshu" (ST25) on nitrergic neurons in jejunum and distal colon in type 2 diabetic rats, so as to explore its mechanism of regulating different intestinal segments. METHODS: Twenty-four SD rats were randomly divided into control, model and EA groups (n=8 in each group). The diabetes model was established by intraperitoneal injection of streptozotocin (35 mg/kg) and high-sugar and high-fat diet for 2 weeks. EA (2 Hz/15 Hz, 2 mA) was applied to bilateral ST25 for 20 min, once a day, 6 days a week for 4 weeks. The intestinal motility was evaluated by observing the first red stool excretion time and the distal colon bead excretion time. HE staining was used to observe the histological changes of jejunum and distal colon. The positive expression and protein expression of intestinal total neuronal marker protein gene product 9.5（PGP9.5） and neuronal nitric oxide synthase (nNOS) in jejunum and distal colon were detected by immunofluorescence staining and Western blot, respectively. RESULTS: After modeling, the blood glucose was significantly increased (P<0.01), the first red stool excretion time and the distal colon bead excretion time were shortened (P<0.01), the expression levels of PGP9.5 and nNOS in jejunum and distal colon were decreased (P<0.01) in the model group relevant to the control group. After treatment, compared with the model group, the blood glucose was decreased (P<0.01), the first red stool excretion time and the distal colon bead excretion time were prolonged (P<0.01, P<0.05), and the expression levels of PGP9.5 and nNOS in jejunum and distal colon were increased (P<0.05, P<0.01) in the EA group. HE staining showed disordered structure in intestinal mucosa of the jejunum and distal colon, and reduction of the number of goblet cells in the model group, which was relatively milder in the EA group. CONCLUSION: EA can effectively improve the intestinal mucosal damage and restore intestinal motor function in type 2 diabetic rats, which may be related to its function in regulating the number of nitrergic neurons in the intestinal nervous system.

[Progress of researches on involvement of corticospinal tract in the effect of acupuncture on improvement of post-stroke motor dysfunction].

The corticospinal tract (CST), descending from the frontoparietal cortex and traveling down to terminate at the anterior horn of the spinal cord to mediate voluntary movements, is frequently injured from the infarcted or hemorrhagic cerebrovascular insults due to stroke. Under the circumstances, motor dysfunction seriously affects the patient's quality of life. Acupuncture therapy has a sequelae, especially in improving motor deficits. In the present paper, we reviewed the current development of researches on acupuncture treatment of poststroke motor dysfunction and its biological mechanisms from 1) delaying patients' development of neuronal degeneration and white matter fibrosis (Wallerian degeneration), 2) improving patients' upper limb motor function and daily life ability by promoting the repair of white matter tracts and CST on the affected side, 3) promoting the compensation of CST on the healthy side, 4) reconstructing the motor conduction pathway to strengthen the bilateral brain connection in ex-perimental animals, and 5) strengthening the sprouting of the contralateral CST to dominate the affected side again across the midline. In addition, acupuncture stimulation induced improvement of axonal rewiring for corticospinal innervation is also possibly related to its functions in accelerating the synthesis and release of neurotrophic factors, down-regulating Nogo-A/RhoA signaling and activating vascular epithelial growth factor/Dll4/Notch signaling pathways.

[LU Shan-zhong's academic contribution to the recent and modern acupuncture and moxibustion].

By arranging Mr. LU Shan-zhong's papers and works, his academic contributions to acupuncture and moxibustion were summarized. It mainly includes standardizing the clinical diagnosis and treatment of acupuncture and moxibustion, and finding the fusion point of the western and traditional medicine; building the acupuncture and moxibustion education system, innovating acupuncture and moxibustion talent training programs; exploring the academic connotation of acupuncture and moxibustion, and promoting acupuncture and moxibustion therapy.

[Exploration of practice of acupuncture-moxibustion scientization by HUANG Xue-long, the successor of Chengjiang school].

HUANG Xue-long is a direct disciple of CHENG Dan-an. He is the second-generation representative heir of Chengjiang school. Through research on his practice and achievements of acupuncture and moxibustion scientization, we found that his main contributions were as follows. He has carried out beneficial explorations along with the scientific thinking of Chengjiang school, elucidated the theory of acupoints, clarified acupuncture and moxibustion manipulations, and explained the mechanism of acupuncture and moxibustion. His explorations promote the scientific process of acupuncture and moxibustion and enrich the academic system of acupuncture and moxibustion.

[Origin and development of HUA Tuo's acupuncturing sensation technique].

Based on HUA Tuo's personal experience, teaching experience, works as well as ancient books of similar times, this paper discusses the origin and development of HUA Tuo's acupuncturing sensation technique, and analyzes the reasons why this technology has been lost. The formation of this technique is influenced by the descriptions of "regulating qi " "arrival of qi " and "reaching qi" in Neijing (Internal Canon of Medicine) and Nanjing, and combines with the clinical summary of conduction direction and specific position of acupuncturing sensation. Due to HUA Tuo's personal experience, the inheritance characteristics of acupuncture technology and the background of his times, this technology may have been lost, but it still affects the acupuncture concept and practice of "qi reaching affected area" in later generations.

Producing and storing self-sustaining drinking water from rainwater for emergency response on isolated island.

Drinking water on isolated islands includes treated rainwater, water shipped from the mainland, and desalinated seawater. However, marine transportation and desalination plants are vulnerable to emergencies, such as extreme weather, making self-sustaining stand-by water for emergency response essential. Rainwater is ideal for producing the stand-by water, and rainwater harvesting is sustainable and clean, and prolonged biostability can be ensured by managing biological and chemical parameters. The present study applied a stand-by drinking water purification system (primarily including nanofiltration and low-dose chlorination) to explore the feasibility of producing and storing cleaner drinking water from rainwater and the following conclusions were drawn. First, treatment of rainwaters ensures biosafety for seven days, which is longer than that for untreated rainwater; the proportion of opportunistic pathogens decreased from 23.40-7.77% after nanofiltration, and it was proposed that the microbial community converges after advanced water treatment. Second, chemical qualities were improved. Local resource coral sand prevents pH in rainwater from decreasing below 6.5, and treated rainwater had lower disinfection by-product potential and higher disinfection efficiency, allowing periodical rainwater recycling. Third, harvesting rainwater was extremely cost-effective, with an operation cost of 1.5-2.5 RMB/m3. From biosafety, chemical safety, and economic cost perspectives, self-sustaining water from rainwater can contributes to the development of sustainable and cost-effective water supply systems on isolated islands. Mixing treated rainwater and desalinated seawater reasonably guarantees sufficiency and safety.

[Discussion on the needling technique with filiform needle in acupuncture-moxibustion teaching materials in the Republic of China].

Through collecting the literature data of the needling technique with filiform needle in 20 acupuncture-moxibustion teaching materials in the Republic of China， the manipulation techniques with filiform needle were analyzed, such as the technique of needle insertion, the technique of reinforcing and reducing, and the management of acupuncture abnormal conditions, as well as manual techniques and analgesics methods. It is found that the era of the Republic of China was the transition period of traditional acupuncture techniques to the modern ones in acupuncture-moxibustion teaching materials, in which, the twirling technique was predominated in the technique of needle insertion. In that period, the insertion technique of tube needle had been introduced and simplified, the theory and method of the new-style technique of reinforcing and reducing were emerged and the types of acupuncture abnormal conditions recorded in the teaching materials were different from those at present. Additionally, the applicable manipulation had not been specified nationally. There were the highly influential teaching materials, i.e. Advanced Acupuncture and Moxibustion Teaching Materials: Science of Acupuncture and Science of Moxibustion, Chinese Acupuncture and Moxibustion Teaching Materials and New Acupuncture and Moxibustion. The acupuncture-moxibustion teaching materials in the Republic of China has been influenced by the transition of acupuncture-moxibustion education modes, the introduction of Chinese-translation version of Japanese acupuncture-moxibustion books, the academic thoughts of acupuncture masters and the manufacturing process of needle devices.

[Definition of lost acupuncture technique: based on Dictionary of Chinese Acupuncture- Moxibustion].

OBJECTIVE: By defining the inclusion criteria of the lost acupuncture technique and sorting out the content of lost acupuncture technique (possibly lost acupuncture technique), this article aimed to provide ideas and methods of the inheritance of acupuncture technique. METHODS: The whole entries of Dictionary of Chinese Acupuncture-Moxibustion were searched. The items of acupuncture technique were screened and used as the key terms to retrieve the literature from the database of CNKI, Wanfang, VIP and SinoMed. After that, the lost acupuncture technique and the possibly lost technique were selected from included items, and the terminologies of acupuncture technique were standardized. RESULTS: A total of 364 items of acupuncture technique were retrieved, including 17 items of lost acupuncture technique and 12 items of possibly lost acupuncture technique. CONCLUSION: The lost acupuncture technique is defined as the acupuncture technique recorded in ancient classics but can not be retrieved in modern literature of clinical application or expert's experience. The change of government or alternation of dynasty, the evolution of acupuncture-moxibustion theories and education are the related causes of lost acupuncture technique.

Preparation and Thermal Performance Enhancement of Low Temperature Eutectic Composite Phase Change Materials Based on Na2SO4·10H2O.

In this paper, a series of Na2SO4·10H2O⁻KCl eutectic mixtures were prepared by adding different mass fractions of KCl (1 wt.%, 3 wt.%, 5 wt.%, or 7 wt.%) to Na2SO4·10H2O. Polyacrylamide (PAM) was proposed as the thickener, sodium tetraborate decahydrate (STD) was proposed as the nucleating agent, and expanded graphite (EG) was proposed as the high thermal conductivity medium for Na2SO4·10H2O⁻5 wt.% KCl eutectics. The results showed that in Na2SO4·10H2O⁻5 wt.% KCl eutectics with 5 wt.% PAM and 5 wt.% STD, almost no phase separation occurred, and the degree of supercooling was reduced to 0.4 °C. The thermal performance of Na2SO4·10H2O⁻5 wt.% KCl composite phase change materials (CPCMs) with varying contents of EG was explored. The results showed that EG could improve the thermal conductivity effectively and that the mass fraction of EG should be no more than 3%, otherwise the crystallization value and supercooling would deteriorate. The thermal reliability of the Na2SO4·10H2O⁻5 wt.% KCl eutectic CPCMs containing 5 wt.% PAM, 5 wt.% STD, and 3 wt.% EG was investigated, mainly through the ambient temperature, thermal cycling test, and TGA analysis. The results demonstrated that these CPCMs showed perfect thermal reliability.

[Evolvement of Acupuncture Needle Manipulation Techniques Described in Textbooks of Acupuncture and Moxibustion of Successive Editions].

This paper summarizes the evolvement of the needle manipulation techniques described in the textbooks of Acupuncture and Moxibustion of the past successive 10 editions in Chinese, analyzes the reasons for the evolvement and its impact on clinical treatment, and proposes future developing trends. After analyzing characteristics of needle-manipulation techniques of the well-known Chinese acupuncture specialists, and those described in multi-editions of the textbooks, we found that the currently evoluted contents primarily contain the definition and types of manipulating techniques. However, the reasons for the evolvement and connotation of needle manipulating are probably due to a) undefined descriptions in the history; b) changes in the academic studies and clinical application of acupuncture and moxibustion during the textbook compilation; c) the well-known specialists' and the participated editors' academic thoughts; d) the textbook content setting needs, etc. The evolvement reflects the changed preoccupations of factors affecting clinical efficacy of acupuncture manipulations, and facilitates the implementation of standardized clinical operative procedures. The development of current acupuncture needle manipulation techniques emphasizes the quantification of manual manipulations, fits clinical needs, and pays more attention to the pressing hand during needle insertion.

[Evolution of filiform needle insertion methods in multi-edition of Acupuncture and Moxibustion].

This paper reviewed the filiform needle insertionmethods in multi-edition of Acupuncture and Moxibustion, explored its evolution and reasons, and analyzed its development trend. By referring multi-edition of Acupuncture and Moxibustion and related literature regarding acupuncture manipulation published after 1940s, combined with acupuncture manipulation characteristics of modern and contemporary acupuncture masters, it was found that the definition of needle insertion methods needed to be improved after several changes. The classification of needle insertion methods was stable over development. The thrusting method of needle insertion was previously included, and then disappeared. The description of needle insertion methods was improving. These evolutions were mainly influenced by the academic and clinical background, the academic thought of writers and acupuncture masters, the internationalization and standardization of acupuncture and so on. The twist-inserting method and some other needle-inserting instrument meet the safe, sterile, painless and convenient development trend, which might be included in Acupuncture and Moxibustion in the future.