Intradermal acupuncture in the treatment of rheumatoid arthritis with liver and kidney deficiency syndrome - A sham-controlled, randomized, clinical trial.

BACKGROUND AND PURPOSE: Rheumatoid arthritis (RA) is called "immortal cancer", and it affects the quality of life, disability rate and even the survival of patients. This study aimed to observe the clinical efficacy, and adverse reactions of intradermal acupuncture (IA) in the treatment of RA patients with liver and kidney deficiency syndrome. MATERIALS AND METHODS: 132 RA patients were split into an IA group and a sham IA group at a 1:1 ratio. Both groups were assessed before and after the intervention with the assessments: a traditional Chinese medicine (TCM) syndrome evaluation, the Health Assessment Questionnaire (HAQ), the Disease Activity Score 28 (DAS28) and serum C-reactive protein (CRP). RESULTS: There was a statistically significant difference in TCM syndrome evaluation, HAQ, DAS28, and CRP between both groups before and after treatment (P < 0.01). The improvement of TCM syndrome evaluation (95% CI [1.14(0.38-1.89)]; P = 0.001), HAQ (95% CI [2.00(1.00-3.00)]; P = 0.003), and DAS28 (95% CI [0.11(0.02-0.20)]; P = 0.021) in the IA group was more obvious than that in the sham IA group (P < 0.05), except for CRP (95% CI [0.50(- 2.09 to 7.08)], P = 0.786). The difference in CRP outcome changes between the two groups was not statistically significant (P > 0.05). Both groups had comparable results in the implementation of RA in the upper and lower extremity acupoints and did not differ due to different sites (IA group: P = 0.852; sham IA group: P = 0.861). The comparison of effective rate of the upper limb as well as that of the lower limb was statistically significant (P = 0.001). Besides, patients reported no adverse effects. CONCLUSION: The IA intervention was associated with a promising effect on the decrease in RA disease activity and delayed overall disease progression.

The competitive relationship of scrub plants for water use in the subalpine zone of the Qilian Mountains in China.

Samples of scrub plants and soil were collected from May to October 2019 in the subalpine scrub zone of the Qilian Mountains. Based on measured oxygen isotope values (δ18O) in plant xylem water and soil water, the multivariate linear mixed model (IsoSource) and the proportional similarity index (PS index) were used to analyze the using proportion for each potential water source and the competition relationship for water use of scrub plants in different growing periods and habitats. The results showed that the soil water content gradually decreased with increasing depth of the soil layer, with the maximum value in the soil layer of 0-10 cm. Most of the scrub plants mainly used soil water in the soil layer of 0-30 cm during the different periods of growing season, but Salix sclerophylla Anderss. and Salix oritrepha Schneid. on the semi-sunny slope habitat mainly used soil water in the soil layer of 40-80 cm during the middle period of growing season (July-August), with the proportion of 59.5% and 52.1%, respectively; and Potentilla fruticosa Linn. and Salix cupularis Rehd. on the semi-shady slope habitat mainly used soil water in the soil layer of 30-60 cm during the early period of growing season (May-June), with the proportion of 61.1% and 49.7%, respectively. The competition relationships of scrub plants for water use varied during different periods of growing season (P < 0.05). On the semi-sunny slope habitat, they were fiercest for Salix cupularis Rehd. and Rhododendron thymifolium Maxim., Potentilla fruticosa Linn., and Salix sclerophylla Anderss. during the early period of growing season; Salix cupularis Rehd. and Rhododendron thymifolium Maxim. during the middle period of growing season, and Salix sclerophylla Anderss. and Salix oritrepha Schneid. during the end period of growing season (September-October). On the semi-shady slope habitat, they were fiercest for Salix oritrepha Schneid. and Caragana jubata (Pall.) Poir. during the early period of growing season; Rhododendron przewalskii Maxim. and Rhododendron thymifolium Maxim. during the middle period of growing season; and Salix cupularis Rehd. and Salix oritrepha Schneid. during the end period of growing season. This study reveals the competitive relationship of scrub plants for water use in the subalpine zone and their response to environmental changes, so as to provide theoretical references for the ecological conservation in the ecologically fragile areas of the Qilian Mountains.

Abdominal massage alleviates functional diarrhea in immature rats via modulation of intestinal microbiota and tight junction protein.

Functional diarrhea (FD) is a common type of chronic diarrhea in children. Recurrent diarrhea can negatively impact children's quality of life and raise healthcare costs significantly. However, conventional treatments are ineffective and limited. Moreover, children with chronic conditions have poor medication compliance. Therefore, non-pharmacological and complementary treatments are urgently needed. In China, abdominal massage is widely used to treat diarrhea in children. Numerous clinical studies have verified its usefulness in treating gastrointestinal disorders as well. Nevertheless, its intrinsic mechanisms are still unclear, and the impact of massage direction on treatment effects has received less attention. In our study, we found that FD was not associated with pathogen infection. A dysbiosis of the intestinal microbiota and disruption of the intestinal barrier are most likely to cause FD. Moreover, this study also substantiates that abdominal massage can mitigate functional diarrhea by altering the intestinal microbiota structure and decreasing the number of bacteria that damage intestinal mucosal barriers. The reduction of Ruminococcus_torques_group and Clostridium_innocuum_group at the genus level potentially mediated the beneficial effects of abdominal massage on alleviating diarrhea. Furthermore, massaging from two different directions, clockwise (CW) and counter-clockwise (CCW) massage, would not significantly influence the effect of the massage on intestinal microbiota or tight junction proteins. In summary, abdominal massage is an effective complementary therapy for children suffering from functional diarrhea.

Association between workplace bullying and nurses' professional quality of life: The mediating role of resilience.

AIM: We aim to determine workplace bullying in relation to the professional quality of life of nurses and the mediating role of resilience between workplace bullying and the professional quality of life. BACKGROUND: Workplace bullying is an increasingly serious problem worldwide and deleteriously affects the occupational health and quality of life of nurses. However, it has not attracted adequate managerial attention. METHOD: A cross-sectional study was conducted using a sample of 493 clinical nurses from two tertiary grade A hospitals in Guangzhou, China. Data were collected through an online questionnaire survey in July 2020 and analysed with structural equation modelling. RESULTS: Workplace bullying had negative and direct effects on the professional quality of life of nurses. Resilience mediated the relationship between workplace bullying and the professional quality of life. CONCLUSION: Resilience is a protective factor that helps nurses cope with workplace bullying. Managers can improve the professional quality of life of nurses by reducing workplace bullying and strengthening the resilience of nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Managers must take measures to prevent the workplace bullying of nurses. In addition, nurse supervisors should pay attention to the resilience of nurses and strengthen resilience training to help nurses withstand the pressure of workplace bullying and improve their professional quality of life.

An m-Health Intervention for Rheumatoid Arthritis in China ("Rheumatism Center" app): Study Protocol for a Prospective Randomized Controlled Trial.

AIM: To study the feasibility and effectiveness of a m-Health app in improving the management of rheumatoid arthritis. DESIGN: Randomized controlled trial. METHODS: Sixty rheumatoid arthritis participants will be recruited for a 6-month feasibility study. Patients meeting the inclusion criteria will be randomly allocated to receive standard care or standard care plus the m-Health intervention. The primary outcome is the feasibility of a randomized controlled trial. In addition, we will investigate patient satisfaction in using the "Rheumatism Center" app in the intervention group. The secondary outcomes include the scores for the simplified disease activity index, clinical disease activity index, disease activity score 28, health assessment questionnaire and 6-item self-efficacy scale for chronic diseases. The assessments will be performed at baseline and at 4 weeks, 3 months and 6 months after the study is initiated. At the end of the study, we will also collect user views of the app through qualitative interviews. RESULTS: This study is ongoing. The findings of this study will determine the feasibility and effectiveness of m-Health intervention in the management of rheumatoid arthritis, hoping to enhance the awareness of disease management and quality of life for rheumatoid arthritis patients.

Intradermal acupuncture for rheumatoid arthritis: study protocol for a randomised controlled trial.

BACKGROUND: Rheumatoid arthritis (RA) is a common autoimmune disease that severely impacts quality of life. Currently available medications for the treatment of RA have adverse side effects. Emerging evidence suggests that intradermal acupuncture (IA) is feasible and safe for patients, but its application in RA patients has not been examined. Our study aims to explore the efficacy and safety of IA for the treatment of RA. METHODS: This study is a randomised, sham-controlled, patient-outcome assessor-statistician blind trial that aims to evaluate the effects of IA in patients with RA. We will recruit 132 patients aged ≥ 18 years with a diagnosis of RA. Patients will be randomly allocated with a 1:1 ratio to IA or sham IA groups. Both groups will receive basic treatment and nursing routines for RA. The experimental group will receive actual IA treatment, whereas the control group will receive sham IA treatment. All patients will receive one course of treatment (i.e., four consecutive treatment sessions with an intervening 1-day interval). Primary outcomes will be traditional Chinese medicine (TCM) syndromes before and after a treatment course and Health Assessment Questionnaire (HAQ) scores. Secondary outcomes will be disease activity score 28 (DAS28) and levels of serum C-reactive protein (CRP). Outcome measures will be collected pre- and post-treatment. DISCUSSION: This study aims to provide high-quality evidence for the efficacy and safety of IA for treating RA. In addition, the results will provide references for selection of acupoints for other syndromes in clinical practice. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000038028 . Registered on 8 September 2020.

Study on Pain Catastrophizing From 2010 to 2020: A Bibliometric Analysis via CiteSpace.

Purpose: This study aimed to evaluate the global scientific output of research on pain catastrophizing and explore the hotspots and frontiers from 2010 to 2020 using bibliometric methods. Methods: Publications regarding pain catastrophizing published from 2010 to 2020 were extracted from the Web of Science Core Collection. CiteSpace was used to analyze the number of publications, countries, institutions, journals, authors, cited references, and keywords using standard bibliometric indicators. Results: A total of 1,576 publications on pain catastrophizing were retrieved from 2010 to December 31, 2020. The number and rate of the annual publications gradually increased totally. Pain (130) was the most productive journal. Meanwhile, Pain ranked first in the frequency (1,432) and centrality (0.31) of the cited journals. The most productive country and institution in this frequency field were the United States (642) and the University of Washington (73), respectively. Jensen MP (34) was the most prolific author, and Sullivan MJL (1,196) ranked first among the cited authors. In the ranking of frequency in the cited references, the first article was a critical review about pain catastrophizing published by Quartana (100). The keyword "Low back pain" had the highest frequency (556). "Total hip" was identified as a frontier research item for 2016-2020. Conclusion: The findings of this bibliometric study provide the current status and trends in the clinical research of pain catastrophizing and may help researchers to identify hot topics and explore new research directions in this field.

High Thermoelectric Performance of AgSb1-xPbxSe2 Prepared by Fast Nonequilibrium Synthesis.

AgSbSe2 is a typical member of cubic I-V-VI2 semiconductors, which are known for their extremely low lattice thermal conductivity (κl). However, the low electrical conductivity of AgSbSe2, below ∼10 S cm-1 at room temperature, has hindered its thermoelectric performance. In this work, single-phase AgSbSe2 bulk samples with much higher electrical conductivity were synthesized via self-propagating high-temperature synthesis (SHS) combined with spark plasma sintering (SPS) for the first time. Pb doping through the nonequilibrium process further increases the electrical conductivity to >100 S cm-1. Furthermore, continuously increased effective mass md* can be achieved upon Pb doping because of the multiple degenerate valence bands of AgSbSe2 and the energy-filtering effect induced by in situ-formed nanodots. The simultaneous enhancement of both the electrical conductivity and Seebeck coefficient contributes to an unprecedentedly high average power factor of 6.75 µW cm-1 K-2. Meanwhile, the introduced dense grain boundaries and point defects enhance the phonon scattering and consequently suppress κl, yielding a high ZT value of 1.2 at 723 K in AgSb0.94Pb0.06Se2. This study opens a new avenue for rapid, low-cost, large-scale production of AgSbSe2-based materials and demonstrates that Pb-doped AgSbSe2 prepared via the SHS-SPS method is a promising candidate for thermoelectric applications.

The application of frontal sinus index and frontal sinus area in sex estimation based on lateral cephalograms among Han nationality adults in Xinjiang.

The frontal sinus, due to its unique anatomical features, has become an important element in research for individual identification. Previous studies have demonstrated the use of frontal sinus as an indicator for sex discrimination; however, the sex discrimination rate using frontal sinus was lower compared to that using the traditional morphological methods. In order to improve the sex discrimination percentage, we developed a new method involving the measurement of the frontal sinus index and frontal sinus area from lateral cephalogram radiographs. In this study, 475 digital lateral cephalograms of adult Han citizens from Xinjiang were included. The maximum height, depth, and area of the frontal sinus were calculated using the NemoCeph NX software. The frontal sinus index (ratio of the maximum height to the depth of frontal sinus) was also computed. Statistical analysis results showed significant differences in the frontal sinus index and area between males and females. Discriminant function equation derived from this study differentiated between sexes with 76.6% accuracy. The results demonstrated that the use of frontal sinus index and area for sex discrimination was more accurate than using the frontal sinus index alone.

Analyzing the role of soil and rice cadmium pollution on human renal dysfunction by correlation and path analysis.

The aim of this study was to investigate the role of soil and rice pollution on human renal dysfunction. The participants were 97 inhabitants (46 men and 51 women) who are aged 50 to 60 years old and have been living in Xiaogan (Hubei, China) from birth. We collected samples of soil, rice, and urinary correspondingly. Urinary N-acetyl-ß-D-glucosaminidase (NAG) and ß-2-microglobulin (ß2MG) were used as indicators of renal dysfunction, and urinary cadmium (U-Cd) was used as indicator of total internal cadmium exposure. We made a hypothesis that soil cadmium concentration (S-Cd) and rice cadmium concentration (R-Cd) could be used as indicators of environmental cadmium exposure. Correlation and path analysis were used to estimate the relationships among the levels of rice cadmium (R-Cd), soil cadmium (S-Cd), urinary cadmium (U-Cd), and renal damage indicators (NAG and ß2MG). Our results showed that there was positive significant relationship between S-Cd (R-Cd, U-Cd), and U-NAG (U-ß2MG). The standard multiple regression describing the relationship between S-Cd (R-Cd, U-Cd) and U-NAG was Y1 = 1.26X1-6.53X2 + 9.32, where Y is U-NAG, X1 is U-Cd, X2 is S-Cd. The equation of U-ß2MG was Y = 49.32X1 + 3085.99X2 + 143.42, where Y is U-ß2MG, X1 is U-Cd, X2 is R-Cd. It is obvious that the effect of S-Cd and R-Cd on NAG or U-ß2MG cannot be ignored. Through our study, we can find that the effects of S-Cd on renal health even as significant as R-Cd. To protect people from the damage of cadmium pollution, it is vital to monitor the situation of soil and rice cadmium pollution.

Estimation of the benchmark dose of urinary cadmium as the reference level for renal dysfunction: a large sample study in five cadmium polluted areas in China.

BACKGROUND: Itai-itai disease primarily results from cadmium (Cd) exposure and is known as one of the four major pollution diseases in Japan. Cd pollution is more serious in several areas of China than in Japan. However, there is still a lack of information regarding the threshold level of Cd exposure for the adverse health effects in the general Chinese population. This study aims to evaluate the reference value of urinary Cd (UCd) for renal dysfunction in a Chinese population as the benchmark dose lower confidence limit (BMDL) based on a large sample survey. METHODS: A total of 6103 participants who lived in five Cd polluted areas of China participated in this study. We analyzed UCd levels as a biomarker of exposure and urinary ß2-microglobulin (Uß2-MG) levels as a renal tubular effect biomarker. The BMD studies were performed using BMD software. The benchmark response (BMR) was defined as a 10% additional risk above the background. RESULTS: There was a positive correlation between the UCd levels and the prevalence of Uß2-MG. The BMD of UCd for Uß2-MG was estimated for each province. The findings showed that the BMD levels were related to the participants' geographic region, which may be partially due to the large differences in Cd exposure level, ethnic group, lifestyle and diet of the sample population in these study areas. The reference level of UCd for the renal effects was further evaluated by combining the five sets of data from all 6103 subjects. The overall BMDLs of UCd for Uß2-MG with an excess risk of 10% were 2.00 µg/g creatinine (µg/g cr) in males and 1.69 µg/g cr in females, which were significantly lower than the World Health Organization (WHO) threshold level of 5 µg/g cr for Cd-related renal effects. CONCLUSIONS: The selection of the sample population and geographic region affected the BMDL evaluation. Based on the findings of this survey of a large sample population, the UCd BMDLs for Uß2-MG in males with BMRs at 10% were 2.00 µg/g cr. The BMD was slightly lower in females, which indicated that females may be relatively more sensitive to Cd exposure than males.

Body burden of cadmium and its related factors: a large-scale survey in China.

A survey of more than 6000 participants from four distinct non-polluted and polluted regions in China was conducted to evaluate the body burden of cadmium (Cd) on the Chinese populations using urinary Cd (UCd) as a biomarker. The findings revealed that the UCd level was 1.24 µg/g creatinine (µg/g cr) for the sample population from non-polluted Shanghai, and the UCd levels exceeded 5 µg/g cr, which is the health-based exposure limit set by the World Health Organization (WHO), in 1.1% of people. The mean UCd levels in moderately polluted (Hubei and Liaoning) and highly polluted areas (Guizhou) were 4.69 µg/g cr, 3.62 µg/g cr and 6.08 µg/g cr, respectively, and these levels were 2.9 to 4.9 times the levels observed in Shanghai. Notably, the UCd levels exceeded the recently updated human biomonitoring II values (i.e., intervention or "action level") in 44.8%-87.9% of people from these areas compared to only 5.1%-21.4% of people in Shanghai. The corresponding prevalence of elevated UCd levels (>WHO threshold, 5 µg/g cr) was also significantly higher (30.7% to 63.8% vs. 1.1%), which indicates that elevated Cd-induced health risks to residents in these areas. Age and region were significant determinants for UCd levels in a population, whereas gender did not significantly influence UCd.