For the Good of the People: an interpretive analysis of Chinese volunteerism in the critical matter of care at the start of the pandemic.

PURPOSE: China employed a unique volunteerism system where health care providers outside of Hubei Province, the epicentre, travelled to reverse the devastation wrought by coronavirus disease 2019 (COVID-19) at its global onset. The aim is to study the unique circumstances of Chinese volunteerism in the context of continuing pandemic threats, specifically exploring the experiences of 20 Chinese nurse and physician volunteers fighting COVID-19 during the outbreak. METHODS: Interviews were done through video calling. RESULTS: Using content analysis with a hermeneutic perspective, emerging patterns showed the ways in which China's particular manifestation of volunteerism teaches us how to engage global threats of this nature. The overarching lesson, For the Good of the People, was manifested in several dynamic and overlapping themes: 1) Reaching for Professional Standards Even in Crisis; 2) Constantly Caring Through Failures and Successes; and 3) Holding Fast to the Common Good. The devastation was met by the resilience of volunteers, who overcame profound challenges managing patient care. CONCLUSIONS: Volunteerism required sacrifice and tremendous support in the form of training and administrative direction, family support, and peer collaboration. Volunteers' physical and psychosocial wellbeing was a priority. Recognizing the representative themes can help societies plan for continuing and future events.

[Analysis of regularity of acupoint selection and compatibility of acupuncture in the treatment of postpartum depression].

OBJECTIVE: To analyze the regularity of acupoint selection, and compatibility of acupuncture in the treatment of postpartum depression. METHODS: Articles both in English and Chinese published in databases of CNKI, Wanfang, VIP, Chinese biomedical literature database (SinoMed), PubMed, Embase, Cochrane Library from the inception to February of 2021 were retrieved by using key words "acupuncture" or "moxibustion" or "electroacupuncture" or "acupoint application" or " acupoint burying" or "acupoint injection" or "fire needling" and "postpartum depression" or "puerperal depression". The frequencies of selected acupoints and meridians were counted by using data mining technology, and the points with high frequency were analyzed by cluster analysis. RESULTS: A total of 42 articles were included, containing 65 prescriptions and 80 points. The highest frequency of acupoints were Baihui (GV20), Sanyinjiao (SP6), Taichong (LR3), Neiguan (PC6), Zusanli (ST36) and Shenmen (HT7). The most frequently selected channels were Bladder Meridian, Governor Meridian and Liver Meridian. Among the specific points, intersection points, five-shu points, yuan-source points and back-shu points were widely used. Through cluster analysis, four effective cluster groups ï¼»GV20-SP6, LR3-PC6, Xinshu (BL15)-Ganshu (BL18)-Pishu (BL20)-Guanyuan (CV4), Hegu (LI4)-Qihai(CV6)-Qimen (LR14)ï¼½ were obtained, as well as a group of main points (GV20-SP6-LR3-PC6-ST36-HT7) and two groups of matching points ï¼»LI4-CV6-LR14 and BL15-BL18-BL20-CV4-Sishencong (EX-HN1)ï¼½. CONCLUSION: Through data mining technology, this paper summarized the acupoint selection and compatibility law of acupuncture in the treatment of postpartum depression, focusing on regulating Qi, blood and spirit, so as to provide reference for guiding the clinical acupuncture treatment and scientific research of postpartum depression.

Pheochromocytoma with Takotsubo Syndrome and acute heart failure: a case report.

BACKGROUND: Pheochromocytoma is a neuroendocrine tumor that can overproduce catecholamines. Heart failure and Takotsubo Syndrome (TTS) caused by excessive catecholamines are uncommon pheochromocytoma complications. CASE PRESENTATION: A 27-year-old woman was referred to our center for further preoperative assessment and adrenalectomy. She came to the emergency ward with the typical symptoms of acute coronary syndrome and heart failure, including chest stuffiness, dyspnea, epigastric pain, and diaphoresis. The high level of 24-hour urinary vanillylmandelic acid and abdominal computed tomography findings supported the diagnosis of pheochromocytoma. Transthoracic echocardiography showed diffuse hypokinesis of the left ventricular wall with an ejection fraction of 23%. All symptoms and left ventricular function recovered rapidly after left laparoscopic adrenalectomy. Histopathology findings confirmed the diagnosis of pheochromocytoma. Based on the above findings, we eventually diagnosed her with pheochromocytoma-induced TTS. CONCLUSIONS: This is a rare case of pheochromocytoma without hypertension complicated by TTS and acute heart failure. A diagnosis of pheochromocytoma-induced TTS should be considered for patients presenting with uncommon heart failure, even in patients without hypertension. Standard treatment is the surgical removal of the adrenal mass.

Comparison of cardiac rehabilitation (exercise + education), exercise only, and usual care for patients with coronary artery disease: A non-randomized retrospective analysis.

Cardiac rehabilitation program is well-established but the Rehabilitation After Myocardial Infarction Trial (RAMIT) is reported that it does not affect mortality and morbidity of patients after myocardial infarction during follow-up period. The objectives of the study were to compare functional walking capacity, risk factor control, and morbidities in follow-up for cardiac rehabilitation (exercise + education), exercise only, and usual care among patients with coronary artery disease. A total of 492 male and female patients (age range: 45-73 years) with coronary artery disease after myocardial infarction or underwent percutaneous coronary intervention or coronary artery bypass grafting surgeries referred to cardiac rehabilitation were included in the study. Patients were participating in a cardiac rehabilitation program (exercise + education, CRP cohort, n = 125), exercise only (USC cohort, n = 182), or usual care (NCR cohort, n = 185). Data regarding incremental shuttle walk test, lipid profile, the Patient Health Questionnaire 9, and morbidities in follow-up of patients were retrospectively collected and analyzed. After completion of 1 year, cardiac rehabilitation program (p < 0.0001, q = 20.939) and exercise (p < 0.0001, q = 6.059) were successfully increased incremental shuttle walk test. After completion of 1 year, cardiac rehabilitation program reduced low-density lipoprotein (p = 0.007, q = 3.349) and depressive symptoms (p < 0.0001, q = 5.649). Morbidities were reported fewer in the patients of CRP cohort than those of USC (p = 0.003, q = 3.427) and NCR (p = 0.003, q = 4.822) cohorts after completion of 1 year of program. Cardiac rehabilitation program (exercise +education) improved functional walking capacity, controlled risk factors, and reduced morbidities of patients with coronary artery disease than exercise only and usual care (Level of evidence: III).

Safety analysis regarding acute kidney injuries for chloride-restrictive intravenous fluid administration against that of chloride-liberal for patients admitted in the medical intensive care unit: A non-randomised retrospective (chrachl-mic) study.

BACKGROUND: Acute kidney injuries are common in the medical intensive care unit. Generally, intravenous normal saline is administered in critically ill patients but it is associated with acute kidney injury. Current knowledge of chloride and its effect on the physiological functions of the kidney is limited. The objectives of the study were to compare the safety of chloride-restrictive intravenous fluid administration against that of chloride-liberal regarding acute kidney injuries. METHODS: Data regarding RIFLE (risk, injury, failure, loss, and end-stage renal failure) categories, Kidney Disease: Improved Global Outcomes (KDIGO) stage, Δ creatinine, and requirements of renal replacement therapy of 285 patients admitted to medical intensive care unit for critical illness during 4-months from the hospitalisation were retrospectively collected and analysed. Patients received chloride-liberal intravenous fluid (CL cohort, n = 163) or that of chloride-restrictive (CR cohort, n = 122) during bundle-of-care. RESULTS: Patients with risk (P = .039) and injury (P = .041) categories of RIFLE, high Δ creatinine (0.22 ± 0.02 mg/dL/patient vs 0.18 ± 0.02 mg/dL/patient, P < .0001), and patients with KDIGO stage 1 (P = .023) and stage 2 (P = .048) were reported significantly higher in the CL cohort than the CR cohort. The higher numbers of patients were put on renal replacement therapy in the CL cohort than those of the CR cohort (16 vs 3, P = .014). CONCLUSION: The chloride-restrictive intravenous fluid administration has reduced the chances of acute kidney injuries in the intensive medical care unit.

Influence of transitional nursing on the compliance behavior and disease knowledge of children with purpura nephritis.

BACKGROUND: Purpura nephritis, also called Henoch-Schönlein purpura nephritis, is a systemic disease with small dead vasculitis as the main pathological change. AIM: To observe the influence of transitional nursing activities on the compliance behaviors and disease knowledge of children with purpura nephritis. METHODS: A total of 82 children with purpura nephritis were included and divided into a general nursing group (41 children) and transitional nursing group (41 children) using the envelope method. The general nursing group received routine nursing care, while the transitional nursing group received transitional nursing care. The behaviors, knowledge of the disease, and self-management ability of the two groups were evaluated after nursing care was provided. RESULTS: The scores of four items (self-care ability, self-responsibility, health knowledge level, and self-concept) in the transitional nursing group were significantly higher than those in the general nursing group. CONCLUSION: Transitional nursing can directly improve the disease knowledge level and self-management ability of children with purpura nephritis and effectively reduce complications.

Transcription of seven genes in a model of interferon­Î³-induced persistent Chlamydia psittaci infection.

The obligate intracellular bacterium Chlamydia psittaci is the causative agent of psittacosis in birds and humans. The capability of this zoonotic pathogen to develop a persistent phase may serve a role in the chronicity of infections, in addition to the failure of antibiotic therapy or immunoprophylaxis. In the present study, a C. psittaci strain 6BC persistent infection cell model was induced using interferon (IFN)­Î³, alterations in the infectivity and morphology of the pathogen were analyzed, and the transcript profile of seven selected genes was analyzed. Following treatment with IFN­Î³, the infectivity of C. psittaci 6BC was decreased, the inclusion bodies appeared to be smaller, reticulate bodies were larger and the number of infectious elementary bodies was decreased compared with acute infection. In IFN­Î³­induced persistently infected cells, the relative mRNA expression levels of the genes CPSIT­0208, CPSIT­0310, CPSIT­0846, CPSIT­0844 and CPSIT­0594 were upregulated at 2­48 h post­infection (p.i.). The genes CPSIT­0959 and CPSIT­0057 were downregulated at 2­36 h p.i. The results of the present study advanced the understanding of C. psittaci persistent infection and demonstrated a number of previously unknown alterations in chlamydial gene expression, which may provide novel targets to further analyze this particular host­pathogen interaction.

Prevalence and predictors of posttraumatic stress symptoms in parents of children with ongoing treatment for cancer in South China: a multi-centered cross-sectional study.

PURPOSE: Parents of children with ongoing cancer treatment are exposed to risks of developing posttraumatic stress symptoms (PTSS), but little is known about the prevalence and predictors of PTSS among Chinese parents of children with cancer. This study aimed to examine the predictors of PTSS, and explored the correlation of depression, resilience, and family functions with severe PTSS. METHODS: This cross-sectional survey was conducted from May 2014 to September 2015 among the parents of cancer children treated in four general hospitals in South China. PTSS in the parents were measured using post-traumatic stress checklist-civilian version (PCL-C). Multiple regression analyses were performed to evaluate the predictive values of depression, resilience, family functioning, and the demographic variables for severe PTSS. RESULTS: A total of 279 parents (192 mothers and 87 fathers) participated in the survey. Severe PTSS, as defined by a PCL-C score ≥50, were reported in 32.97% (n = 92) of the total participants, 26.44% (23/87) in the fathers and 35.94% (69/192) in the mothers. The level of PTSS was positively correlated with depression (r = 0.782, P < 0.01) and a poor general family function (r = 0.325, P < 0.01) and negatively correlated with resilience (r = -0.236, P < 0.01). Multivariate analyses indicated that depression, general family function, gender, and education level were significant predictive factors of severe PTSS in the overall parents, accounting for 64.2% of the variance in the prediction of PTSS (R 2 = 0.642, F = 122.602, P = 0.000). For the mothers, depression and family function accounted for 66.5% of the variance in the prediction of PTSS (R 2 = 0.665, F = 187.451, P = 0.000); for the fathers, depression and educational level accounted for 58.8% of the variance in the prediction of PTSS (R 2 = 0.588, F = 59.829, P = 0.000). CONCLUSION: Parents, especially the mothers, of children with ongoing treatment for cancer are at risk of developing PTSS. Supportive psychological interventions to attenuate the negative emotions of the parents and improve their family functions are important means to promote their natural protective mechanisms to cope with the stressful events.

Clinical Analysis of Adverse Drug Reactions between Vincristine and Triazoles in Children with Acute Lymphoblastic Leukemia.

BACKGROUND: Vincristine (VCR) is a major chemotherapy drug for treatment of childhood acute lymphoblastic leukemia (ALL). Triazole antifungal drugs (AFD) are the main agents for the prevention/treatment of invasive fungal infection (IFI), a common complication during the treatment of ALL. This study investigated the adverse drug reactions (ADRs) between VCR and AFD. MATERIAL AND METHODS: A retrospective study was performed on 68 children with ALL (39 boys and 29 girls, median age: 5 years) who were treated with VCR chemotherapy (a total of 136 cases, including both induction and reinduction phases) from January 2012 to December 2013 in our hospital. These cases were divided into 4 groups: the control group without AFD prevention/treatment (n=44), the Itra group receiving itraconazole oral solution (n=44), the Fluc group receiving intravenous fluconazole (n=42), and the Vori group receiving voriconazole oral tablets (n=6). The ADRs in each group was recorded and compared. RESULTS: The incidence of ADRs in the Itra and Vori groups were significantly higher compared with the Fluc and the control group (P<0.05). The incidence of ADRs in the Itra group was significantly higher than that in the Vori group, whereas there was no difference in the incidence between the Fluc and control group. CONCLUSIONS: Given the lower incidence of ADRs between VCR and fluconazole compared with voriconazole or itraconazole, it is relatively safer to use fluconazole in ALL patients receiving VCR chemotherapy. The occurrence of ADRs should be closely monitored when triazoles must be administered concomitantly with VCR.

Transcriptional Analysis of 10 Selected Genes in a Model of Penicillin G Induced Persistence of Chlamydophila psittaci in HeLa Cells.

Chlamydophila psittaci is an important intracellular pathogen. Persistent infection is an important state of the host-parasite interaction in this chlamydial infection, which plays a significant role in spreading the organism within animal populations and in causing chronic chlamydiosis and serious sequelae. In this study, a C. psittaci persistent infection cell model was induced by penicillin G, and real-time quantitative PCR was used to study the transcriptional levels of 10 C. psittaci genes (dnaA, dnaK, ftsW, ftsY, grpE, rpsD, incC, omcB, CPSIT_0846, and CPSIT_0042) in acute and penicillin-G-induced persistent infection cultures. Compared with the acute cultures, the penicillin-G-treated cultures showed a reduced chlamydial inclusion size and a significantly decreased number of elementary body particles. Additionally, some enlarged aberrant reticulate body particles were present in the penicillin- G-treated cultures but not the acute ones. The expression levels of genes encoding products for cell division (FtsW, FtsY) and outer membrane protein E encoding gene (CPSIT_0042) were downregulated (p < 0.05) from 6 h post-infection onward in the persistent infection cultures. Also from 6 h post-infection, the expression levels of DnaA, DnaK, IncC, RpsD, GrpE, and CPSIT_0846 were upregulated (p < 0.05); however, the expression level of OmcB in the persistent infection was almost the same as that in the acute infection (p > 0.05). These results provide new insight regarding molecular activities that accompany persistence of C. psittaci, which may play important roles in the pathogenesis of C. psittaci infection.

The type III secretion system (T3SS) of Chlamydophila psittaci is involved in the host inflammatory response by activating the JNK/ERK signaling pathway.

Chlamydophila psittaci (C. psittaci) is a human zoonotic pathogen, which could result in severe respiratory disease. In the present study, we investigated the role and mechanism of the type III secretion system (T3SS) of C. psittaci in regulating the inflammatory response in host cells. C. psittaci-infected THP-1 cells were incubated with the specific T3SS inhibitor INP0007, inhibitors of ERK, p38, or JNK, and the levels of inflammatory cytokines were analyzed using Q-PCR and ELISA. The levels of ERK, p38, and JNK phosphorylation were analyzed by Western blot. Our results verified that INP0007 inhibited chlamydial growth in vitro, but the coaddition of exogenous iron completely reversed the growth deficit. INP0007 inhibited the growth of C. psittaci and decreased the levels of IL-8, IL-6, TNF-α, and IL-1ß. Exogenous iron restored the chlamydial growth but not the production of inflammatory cytokines. These results demonstrated that the expression of inflammatory cytokines during infection was associated with the T3SS which reduced by incubation with ERK and JNK inhibitors, but not with p38 inhibitor. We concluded that the T3SS elicited inflammatory responses by activating the JNK or ERK signaling pathways in the infection of C. psittaci.

[Effect of the drug-resistant attenuated Bacillus proteus on CD80 and CD86 protein expression in peripheral blood dendritic cells of hepatitis B patients].

OBJECTIVE: To explore the effect of the drug-resistant attenuated Bacillus proteus on the protein expression of CD80 and CD86 in peripheral blood dendritic cells (DCs) of hepatitis B patients. METHOD: Peripheral blood monocytes were isolated from HBV-infected patients and the DCs were separated and induced to differentiate in vitro. The expression of CD80 and CD86 proteins on cultured DCs were examined using flow cytometry. RESULTS: The expression rate of CD80 and CD86 of chronic hepatitis B patients increased significantly (P=0.000), while the positive expression rate of CD80 and CD86 showed no obvious variation in healthy individuals (P=0.185 and P=0.118, respectively). CONCLUSIONS: Bacillus proteus can significantly increase CD80- and CD86-positive cell percentage in peripheral blood DCs of HBV-infected patients, but has no such an effect in healthy individuals.

[An electron microscope observation for the abnormal ultrastructure of the connecting piece in human spermatozoa from infertile painters].

OBJECTIVES: To investigate possible abnormalities of the sperm neck in eight infertile painters observed by transmission electron microscope. METHODS: Spermatozoa from 8 infertile painters (21-32 years old) were observed by transmission electron microscope. RESULTS: The abnormalities of the connecting piece could be divided into 6 types, among which the anomaly of the connecting piece concomitant with a true nuclemalamic condition was the most serious. CONCLUSIONS: The abnormalities may be related to expression obstacles of nuclear genome and mitochondrial genome, and to anomalous cellular signal transduction during spermiogenesis as well.