Search

Background: Cervical spondylosis (CS) is a prevalent disorder that can have a major negative impact on quality of life. Traditional conservative treatment has limited efficacy, and electroacupuncture (EA) is a novel treatment option. We investigated the application and molecular mechanism of EA treatment in a rat model of cervical intervertebral disk degeneration (CIDD). Methods: The CIDD rat model was established, following which rats in the electroacupuncture (EA) group received EA. For overexpression of IL-22 or inhibition of JAK2-STAT3 signaling, the rats were injected intraperitoneally with recombinant IL-22 protein (p-IL-22) or the JAK2-STAT3 (Janus kinase 2—signal transducer and activator of transcription protein 3) inhibitor AG490 after model establishment. Rat nucleus pulposus (NP) cells were isolated and cultured. Cell counting kit-8 and flow cytometry were used to analyze the viability and apoptosis of the NP cells. Expression of IL-22, JAK2 and STAT3 was determined using RT-qPCR. Expression of IL-22/JAK2-STAT3 pathway and apoptosis related proteins was detected by Western blotting (WB). Results: EA protected the NP tissues of CIDD rats by regulating the IL-22/JAK2-STAT3 pathway. Overexpression of IL-22 significantly promoted the expression of tumor necrosis factor (TNF)-α, IL-6, IL-1β, matrix metalloproteinase (MMP)3 and MMP13 compared with the EA group. WB demonstrated that the expression of IL-22, p-JAK2, p-STAT3, caspase-3 and Bax in NP cells of the EA group was significantly reduced and Bcl-2 elevated compared with the model group. EA regulated cytokines and MMP through activation of IL-22/JAK2-STAT3 signaling in CIDD rat NP cells. Conclusion: We demonstrated that EA affected apoptosis by regulating the IL-22/JAK2-STAT3 pathway in NP cells and reducing inflammatory factors in the CIDD rat model. The results extend our knowledge of the mechanisms of action underlying the effects of EA as a potential treatment approach for CS in clinical practice. [ABSTRACT FROM AUTHOR]

Newly registered nurses' emergency response capability falls short of their employers' expectations. Therefore, they need to develop this ability to cope with various changes in the clinic. Unfortunately, traditional learning has not been good enough in cultivating nursing skills and fostering self-directed learning which plays a key role in the learning process. Therefore, we attempted to integrate virtual simulation into the flipped learning format to optimize the training of newly registered nurses, and investigate its effectiveness. This study employs a pre- and post-test quasi-experimental design. The control and experimental groups each consisted of 43 newly registered nurses recruited in 2019 and 2020, respectively. The control group was trained using the traditional learning while the experimental group used the flipped learning format combined with virtual simulation for a 4–week emergency response training course. The data were collected through The Assessment Questionnaire of Clinical First-aid Capability of Nurses in the Non-Emergency Department and the Rating Scale of Self-directed Learning Competence for Nurses. Multivariate analysis of covariance was used for statistical analysis and the results show that the flipped learning combined with virtual simulation is more suitable and effective in improving nurses' emergency response abilities and self-directed learning compared to traditional learning. [ABSTRACT FROM AUTHOR]

Aim: Nurses play roles in hospitals, families, society and other aspects and often face stress sources, such as heavy workload, doctor–patient conflict and medical accidents. Resilience can help the nurses to avoid or reduce various adverse consequences caused by stress sources; however, this phenomenon remains ill‐defined and under‐researched. The aim of this review was to summarize the experiences of development of nurses' resilience and explore the reasons for the formation of resilience by examining the findings of the existing qualitative studies. Design: The review is a systematic review and meta‐synthesis of qualitative studies. Data Sources: PubMed, Cochrane Library, CINAHL, Web of Science, Embase, and Ovid and Chinese databases include the following: Chinese National Knowledge Infrastructure (CNKI), Wanfang Database (CECDB), VIP Database and China Biomedical Database (CBM). Review Methods: Relevant publications were identified by systematic searches across 11 databases in June 2021. All qualitative and mixed‐method studies in English and Chinese that explored the experiences of development of nurses' resilience were included. The qualitative meta‐synthesis followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) recommendations. Two independent reviewers selected the studies and assessed the quality of each study. Meta‐synthesis was performed to integrate the results. Results: A total of nine studies revealed 10 sub‐themes and three descriptive themes: being psychologically strong, physical positive coping and adoption of external support. Conclusion: Several factors contributed to the development of nurses' resilience, and various supporting strategies in the nursing management and education are helpful to their adaption ability. However, it is necessary to focus on the cultivation of nurses' resilience to improve the quality of clinical nursing. Leaders or organizations are required to establish and sustain multifaceted strategies to improve nurse' resilience through scientific resilience training programmes and improved organizational support. [ABSTRACT FROM AUTHOR]

Background: Obstetric critical illness is an important factor that leads to an increase in maternal mortality. Early warning assessment can effectively reduce maternal and neonatal mortality and morbidity. However, there are multiple early warning systems, and the effect and applicability of each system in China still need to be explored. Objectives: To elaborate on the application, effectiveness and challenges of the existing early warning systems for high‐risk obstetric women in China and to provide a reference for clinical practice. Design: A scoping review guided by the Arksey and O'Malley framework and reported using the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis for scoping review (PRISMA‐ScR) guidelines. Eligibility criteria: We included original studies related to early warning and excluded those that were guidelines, consensus and reviews. The included studies were published in Chinese or English by Chinese scholars as of June 2021. Data sources: CNKI, Wanfang, VIP, Cochrane, CINAHL, Embase, PubMed and Web of Science databases were searched systematically, and the reference sections of the included papers were snowballed. Results: In total, 598 articles were identified. These articles were further refined using keyword searches and exclusion criteria, and 17 articles met the inclusion criteria. We extracted data related to each study's population, methods and results. Early warning tools, outcome indices, effects and challenges are discussed. Conclusions: Although all studies have shown that early warning systems have good application effects, the use of early warning systems in China is still limited, with poor regional management and poor sensitivity for specific obstetric women. Future research needs to develop more targeted early warning tools for high‐risk obstetric women and address the current challenges in clinical applications. [ABSTRACT FROM AUTHOR]

Coal fires are widespread in the coal–major producing countries, which causes serious environmental issues due to the high temperature and hazardous gases during coal combustion. Under oxygen–depleted atmospheres, the thermal behaviors and kinetic characteristics during coal combustion at high temperatures were paid more attention by the method of TG–DSC synchronous thermal analysis. The results indicate that the focused weightlessness and heat release processes became scattered under oxygen–depleted atmospheres, and the influence of oxygen concentration obviously increased when it was below 13 vol.%. The mass presented a linear correlation to the quantity of heat release, and the relationship between the mass and quantity of heat release showed stage characteristics with oxygen concentration. Moreover, the kinetic modes transformed from random nucleation and subsequent growth to contractive sphere, and the critical oxygen concentrations are consistent to these of thermal behaviors. These findings are significant for better understanding the characteristics of coal spontaneous combustion at high-temperature and under low-oxygen concentrations. [ABSTRACT FROM AUTHOR]