Analytical solutions for the restraint effect of isolation piles against tunneling-induced vertical ground displacements

This paper presents a simplified elastic continuum method for calculating the restraint effect of isolation piles on tunneling-induced vertical ground displacement,which can consider not only the relative sliding of the pile‒soil interface but also the pile rowesoil interaction.The proposed method is verified by comparisons with existing theoretical methods,including the boundary element method and the elastic foundation method.The results reveal the restraining mechanism of the isolation piles on vertical ground displacements due to tunneling,i.e.the positive and negative restraint effects exerted by the isolation piles jointly drive the ground vertical displacement along the depth direction from the original tunneling-induced nonlinear variation situation to a relatively uniform situation.The results also indicate that the stiffness of the pile‒soil interface,including the pile shaft‒surrounding soil interface and pile tip-supporting soil interface,describes the strength of the pile‒soil interaction.The pile rows can confine the vertical ground displacement caused by the tunnel excavation to the inner side of the isolation piles and effectively prevent the vertical ground displacement from expanding further toward the outer side of the isolation piles.

Possible involvement of integrin signaling pathway in the process of recovery from restraint stress in rats

Objective To search novel genes or pathways involved in the recovery process after restraint stress in rats. Methods We compared the hypothalamus transcriptional profiles of two different recovery patterns （fast recovery vs slow recovery） from restraint stress in rats using oligonucleotide microarray, the recovery pattern was determined by the decrement of plasma adrenocorticotropic-hormone （ACTH） and corticosterone levels during one hour recovery period after stress. A real-time quantitative RT-PCR was applied to validate the differential expressed genes. Results Analysis of the microarray data showed that most of genes were not differentially expressed between fast recovery group and slow recovery group. Among the differentially expressed genes we found that talin, together with serine/threonine protein phosphatase PPl-beta catalytic subunit （PP-1B） and integrin α-6 precursor （VLA-6） genes, were at least 1.5 fold upregulated in the fast recovery group, while junctional adhesion molecule 1 （F11r） was 1.5 fold down-regulated in the fast recovery group. Conclusion The results implied that integrin signaling pathway may be involved in the recovery from restraint stress in rats. The present study provided a global overview of hypothalamus transcriptional profiles during the process of recovery from the restraint stress in rats. The integrin signaling pathway seems to be involved in the recovery process, which deserves further study to clarify the integrin-mediated recovery mechanism after restraint stress.

Restraints and Countermeasures for the Sustainable Development of China's Modern Flower Arrangement Art

Factors that influence the development of China's modern flower arrangement art are analyzed in this study,countermeasures and suggestions are proposed for the future development.

Distortional buckling analysis of steel-concrete composite box beams considering effect of stud rotational restraint under hogging moment

Restrained distortional buckling is an important buckling mode of steel-concrete composite box beams(SCCBB)under the hogging moment.Rotational and lateral deformation restraints of the bottom plate by the webs are essential factors affecting SCCBB distortional buckling.Based on the stationary potential energy principle,the analytical expressions for the rotational restraint stiffness(RRS)of the web upper edge as well as the RRS and the lateral restraint stiffness(LRS)of the bottom plate were derived.Also,the SCCBB critical moment formula under the hogging moment was derived.Using twenty specimens,the theoretical calculation method is compared with the finite-element method.Results indicate that the theoretical calculation method can effectively and accurately reflect the restraint effect of the studs,top steel flange,and other factors on the bottom plate.Both the RRS and the LRS have a nonlinear coupling relationship with the external loads and the RRS of the web’s upper edge.Under the hogging moment,the RRS of the web upper edge has a certain influence on the SCCBB distortional buckling critical moment.With increasing RRS of the web upper edge,the SCCBB critical moment increases at first and then tends to be stable.

Determinants of mechanical restraint in an acute psychiatric care unit

BACKGROUND Despite numerous attempts to reduce the use of mechanical restraint(MR),this technique continues to be widely applied in many acute psychiatric care settings.In order to reduce MR,a better understanding of the variables associated with its use and duration in different clinical environments is essential.AIM To determine the proportion of patients subjected to MR and the duration thereof in two acute care psychiatric units;and to identify the variables associated with the use and duration of MR.METHODS Descriptive study of all patients admitted to the acute psychiatric units at the Parc de Salut Mar(Barcelona,Spain)in the year 2018.The number and percentage of patients subjected to MR,as well as the duration of each episode were assessed.The following data were also registered:sociodemographic characteristics,psychiatric diagnosis,and presence of cultural and/or language barriers.Multivariate analyses were performed to assess determinants of MR and its duration.RESULTS Of the 464 patients,119(25.6%)required MR,with a median of 16.4 h per MR.Two factors-a diagnosis of psychotic disorder[Odds ratios(OR)=0.22;95%CI:0.06-0.62;P=0.005]and the presence of a language barrier(OR=2.13;95%CI:1.2-3.7;P=0.007)-were associated with a significantly higher risk of MR.Male sex was associated with a longer duration of MR(B=-19.03;95%CI:-38.06-0.008;P=0.05).CONCLUSION The presence of a language barrier and a psychotic disorder diagnosis are associated with a significantly higher risk of MR.Furthermore,male sex is associated with a longer duration of MR.Individualized restraint protocols that include the required tools are necessary to ultimately limit the use of mechanical restraint.

Design and Optimization for the Occupant Restraint System of Vehicle Based on a Single Freedom Model

Throughout the vehicle crash event, the interactions between vehicle, occupant, restraint system (VOR) are complicated and highly non-linear. CAE and physical tests are the most widely used in vehicle passive safety development, but they can only be done with the detailed 3D model or physical samples. Often some design errors and imperfections are difficult to correct at that time, and a large amount of time will be needed. A restraint system concept design approach which based on single-degree-of-freedom occupant-vehicle model (SDOF) is proposed in this paper. The interactions between the restraint system parameters and the occupant responses in a crash are studied from the view of mechanics and energy. The discrete input and the iterative algorithm method are applied to the SDOF model to get the occupant responses quickly for arbitrary excitations (impact pulse) by MATLAB. By studying the relationships between the ridedown efficiency, the restraint stiffness, and the occupant response, the design principle of the restraint stiffness aiming to reduce occupant injury level during conceptual design is represented. Higher ridedown efficiency means more occupant energy absorbed by the vehicle, but the research result shows that higher ridedown efficiency does not mean lower occupant injury level. A proper restraint system design principle depends on two aspects. On one hand,the restraint system should lead to as high ridedown efficiency as possible, and at the same time, the restraint system should maximize use of the survival space to reduce the occupant deceleration level. As an example, an optimization of a passenger vehicle restraint system is designed by the concept design method above, and the final results are validated by MADYMO, which is the most widely used software in restraint system design, and the sled test. Consequently, a guideline and method for the occupant restraint system concept design is established in this paper.

Physical restraint in mental health nursing: A concept analysis

Objective: Physical restraint is frequently used in medical services,such as in mental health settings,intensive care units and nursing homes,but its nature varies in different institutions.By reviewing related literature,this study aims to clarify the concept of physical restraint in mental health nursing.Method: Three databases (PubMed,PsyclNFO and CINAHL) were retrieved,and Walker and Avant's concept analysis method was used to analyze the concept of physical restraint in mental health nursing.Results: Physical restraint is a coercive approach that enables the administration of necessary treatment by safely reducing the patient's physical movement.It should be the last option used by qualified personnel.Antecedents of physical restraint are improper behavior (violence and disturbance) of patients,medical assessment prior to implementation and legislation governing clinical usage.Consequences of physical restraint are alleviation of conflict,physical injury,mental trauma and invisible impact on the institution.Discussion: This study defined the characteristics of physical restraint in mental health nursing.The proposed concept analysis provided theoretical foundation for future studies.

Vibration Characteristics and Power Transmission of Coupled Rectangular Plates with Elastic Coupling Edge and Boundary Restraints

Coupled-plate structures are widely used in the practical engineering such as aeronautical,civil and naval engineering etc.Limited works can be found on the vibration of the coupled-plate structure due to the increased mathematical complexity compared with the single plate structure.In order to study analytically the vibration characteristics and power transmission of the coupled-plate structure,an analytical model consisting of three coupled plates elastically restrained along boundary edges and elastically coupled with arbitrary angle is considered,in which four groups of springs are distributed consistently along each edge of the model to simulate the transverse shearing forces,bending moments,in-plane longitudinal forces and in-plane shearing forces separately.With elastic coupling condition and general boundary condition of both flexural and in-plane vibrations taken into account by setting the stiffness of corresponding springs,the double Fourier series solution to the dynamic response of the structure was obtained by employing the Rayleigh-Ritz method.In order to validate the model,the natural frequency and velocity response of the model are firstly checked against results published in literatures and the ANSYS data,and good agreement was observed.Then,numerical simulation of the effects of several relevant parameters on the vibration characteristics and power transmission of the coupled structure were performed,including boundary conditions,coupling conditions,coupling angle,and location of the external forces.Vibration and energy transmission behaviors were analyzed numerically.The results show that the power transmission can be significantly influenced by the boundary restraints and the location of excitation.When the excitation is located at the central symmetry point of the model,the energy flow shows a symmetrical distribution.Once the location deviates from the central symmetry point,the power circumfluence occurs and the vortex energy field is formed at high frequency.

Hydrogen sulfide attenuates gastric mucosal injury induced by restraint water-immersion stress via activation of KATPchannel and NF-κB dependent pathway

AIMTo explore the effect of hydrogen sulfide (H2S) on restraint water-immersion stress (RWIS)-induced gastric lesions in rats and the influence of adenosine triphosphate (ATP)-sensitive potassium (KATP) channels and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway on such an effect.METHODSMale Wistar rats were randomly divided into a control group, a physiological saline (PS) group, a sodium hydrosulfide (NaHS) group, a glibenclamide (Gl) group, Gl plus NaHS group, a pyrrolidine dithiocarbamate (PDTC) group, and a PDTC plus NaHS group. Gastric mucosal injury was induced by RWIS for 3 h in rats, and gastric mucosal damage was analyzed after that. The PS, NaHS (100 μmol/kg body weight), Gl (100 μmol/kg body weight), Gl (100 μmol/kg or 150 μmol/kg body weight) plus NaHS (100 μmol/kg body weight), PDTC (100 μmol/kg body weight), and PDTC (100 μmol/kg body weight) plus NaHS (100 μmol/kg body weight) were respectively injected intravenously before RWIS.RESULTSRWIS induced serious gastric lesions in the rats in the PS pretreatment group. The pretreatment of NaHS (a H2S donor) significantly reduced the damage induced by RWIS. The gastric protective effect of the NaHS during RWIS was attenuated by PDTC, an NF-κB inhibitor, and also by glibenclamide, an ATP-sensitive potassium channel blocker, in a dose-dependent manner.CONCLUSIONThese results suggest that exogenous H2S plays a protective role against RWIS injury in rats, possibly through modulation of KATP channel opening and the NF-κB dependent pathway.

Physical restraints:An ethical dilemma in mental health services in China

Given that physical restraints cause adverse effects to patients and nurses,their wide and frequent use has resulted in various clinical and ethical controversies in mental health services.The rate of physical restraints is significantly higher in China than in other countries.Some western and domestic media blamed relevant institutions for compromising the basic rights of psychiatric patients.Therefore,this study aims to collect and synthesize the relevant ethical evidence and to provide corresponding guidance for the nursing practice based on the current situation of the mainland of China.This study synthesized the ethical issue according to the ethical principle of autonomy,justice,beneficence,and nonmaleficence.Given the current situation where the nursing workforce is limited and the mental health service is under-developed in China,applying physical restraints in the psychiatric inpatients to guarantee the safety of patients and nurses is crucial.In regard to respect the basic rights of psychiatric patients,it is recommended to protect the their autonomy,and eliminate the adverse effects of physical restraint.This goal would be achieved by ensuring the informed consent,providing humane care,and regulating the implementation of physical restraints.

Nervous mechanisms of restraint water-immersion stress-induced gastric mucosal lesion

Stress-induced gastric mucosal lesion(SGML)is one of the most common visceral complications after trauma.Exploring the nervous mechanisms of SGML has become a research hotspot.Restraint water-immersion stress(RWIS)can induce GML and has been widely used to elucidate the nervous mechanisms of SGML.It is believed that RWIS-induced GML is mainly caused by the enhanced activity of vagal parasympathetic nerves.Many central nuclei,such as the dorsal motor nucleus of the vagus,nucleus of the solitary tract,supraoptic nucleus and paraventricular nucleus of the hypothalamus,mediodorsal nucleus of the thalamus,central nucleus of the amygdala and medial prefrontal cortex,are involved in the formation of SGML in varying degrees.Neurotransmitters/neuromodulators,such as nitric oxide,hydrogen sulfide,vasoactive intestinal peptide,calcitonin gene-related peptide,substance P,enkephalin,5-hydroxytryptamine,acetylcholine,catecholamine,glutamate,γ-aminobutyric acid,oxytocin and arginine vasopressin,can participate in the regulation of stress.However,inconsistent and even contradictory results have been obtained regarding the actual roles of each nucleus in the nervous mechanism of RWIS-induced GML,such as the involvement of different nuclei with the time of RWIS,the different levels of involvement of the sub-regions of the same nucleus,and the diverse signalling molecules,remain to be further elucidated.

EFFECT OF RESTRAINT STRENGTHENING OF VACUUM-PRESSURED BRAZED JOINT

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Correlation between changes of central neurotransmitter expression and stress response in mice A restraint time-course analysis

BACKGROUND： Changes in central neurotransmitter expression play an important role in stress response and forms the basis for stress-induced psychological and behavior changes. OBJECTIVE： To observe the effects of different restraint stress intervals on brain monoamine neurotransmitter expression, and to investigate the correlation between stress response and neurotransmitter levels. DESIGN： Randomized controlled animal study. SETTING： Chinese Herb and Natural Medicine Institute, Pharmacological College of Jinan University. MATERIALS： Sixty 7-week-old male Kunming mice of clean grade, weighing 18-22 g, were provided by the Guangdong Medical Experimental Animal Center. The experiment was in accordance with animal ethics standards. METHODS： This study was performed at the Chinese Herb and Natural Medicine Institute, Pharmacological College of Jinan University from June 2006 to May 2007. A restraint device for mice was constructed according to published reports. Experimental mice were adaptively fed for 1 week and randomly divided into a control group （n = 10） and an experimental group （n = 50）. The experimental group was sub-divided into five restraint intervals： 4, 8, 12, 18, and 24 hours （n = 10 mice per time point）. Animals in the experimental group were not allowed to eat or drink during the restraint period. Mice in the control group did not undergo restraint, but had identical food and water restrictions. Cerebral cortex and hypothalamus were separated based on observational times and protein was extracted using perchloric acid. Central monoamine neurotransmitter levels were measured using high performance liquid chromatography with electrochemical detection. MAIN OUTCOME MEASURES： Levels of norepinephrine （NE）, dopamine hydrochloride （DA）, 3,4-dihydroxyphen-ylanetic acid （DOPAC）, homovanillic acid （HVA）, 5-hydroxytryptamine （5-HT）, and 5-hydroxyindoleac-etic acid （5-HIAA） in the cerebral cortex and hypothalamus of mice. RESULTS： Sixty mice were included in the final analysis. ① NE levels in the cerebral cortex, hypothalamus, and plasma： four hours after restraint, NE levels in the cerebral cortex and hypothalamus ere significantly lower than control levels （P 〈 0.05）. After 12 hours of restraint, NE levels in the experimental group were significantly higher than in the control group （P 〈 0.05）. At 18 hours of restraint, there was no significant difference in NE levels in the cerebral cortex between the experimental group and the control group （P 〉 0.05）. In addition, NE levels in the plasma gradually increased with longer restraint time, which was significant between experimental groups and the control group （P 〈 0.05-0.01）. ② Levels of DA, DOPAC, and HVA in the cerebral cortex and hypothalamus： there were significant differences in DA levels in the cerebral cortex and hypothalamus after 18 and 24 hours of restraint compared to control animals （P 〈 0.05）. DOPAC and HVA levels in the cerebral cortex were enhanced with longer restraint time, and there was significant difference in all restraint groups compared to control levels （P 〈 0.01）, except for DOPAC levels after 4 hours of restraint. Moreover, DOPAC and HVA levels in the hypothalamus were enhanced with increasing restraint time. Levels of 5-HT and 5-HIAA in the cerebral cortex and hypothalamus： after short restraint periods and in the control group, 5-HT was not detectable. However, it was quantitatively detected at 12 hours after restraint. The 5-HT levels in the cerebral cortex and hypothalamus reached peak levels at 12 and 18 hours of restraint. 5-HIAA levels in the cerebral cortex and hypothalamus showed a similar tendency to increase with restraint time- 5-HIAA levels at 4-8 hours after restraint were significantly higher than control levels （P 〈 0.01）. The 5-HIAA levels decreased at 12 hours after restraint, but remained significantly higher than the control group （P 〈 0.05）. CONCLUSION： Restraint stress affects the hypothalamic-pituitary-adrenal （HPA） axis and causes changes in monoamine neurotransmitters in brain tissues, which suggests stress status could be improved by adjusting HPA axis and neurotransmitter levels in the brain.

Effect of restraint stress on depression-like behaviors in rats after transient focal cerebral ischemic injury

BACKGROUND： Restraint stress is a typical psychophysiological stressor. Simulating the early passion and difficulty in walking of patients after attack of stroke meets onset features.OBJECTIVE： To evaluate the effect of restraint stress on depression-like behaviors in rats after transient focal cerebral ischemic injury, and to investigate the feasibility for its being as modeling method of depression model after stroke.DESIGN： A randomized controlled animal experiment.SETTING： Department of Clinical Medicine, Faculty of Aerospace Medicine of the Fourth Military Medical University of Chinese PLA.MATERIALS： Forty-eight male Sprague-Dawley rats, weighing 240 - 270 g, provided by the Experimental Animal Center of the Fourth Military Medical University of Chinese PLA were used in the current study.METHODS： The experiments were carried out in the Faculty of Aerospace Medicine of the Fourth Military Medical University of Chinese PLA between August 2005 and August 2006. ①Experiment intervention： The rats were randomized into middle cerebral artery occlusion-reperfusion （MCAO） ＋stress group, simple MCAO group, sham-operation ＋ stress group and simple sham-operation group, with 12 rats in each group.Rats in the first two groups were developed into cerebral ischemia/reperfusion models by suture-occluded method. Rats in the MCAO＋stress group were modeled and restraint stress scheme was performed. At week 5 after modeling, the rats were placed in self-made restraining tubes, 2 hours/time, once a day, for 2 successive weeks. The common carotid artery, external and internal carotid arteries of rats in the latter two groups were exposed. The stress way of sham-operation＋ stress group was the same as that of MCAO＋ stress group. ②The neurological status grading and motor performance evaluation （screen test, rota-rod test and balance beam test） were conducted in rats with simple sham-operation group and MCAO group before, 1st and 28^th days after modeling. Depression-like behavior test was performed in the rats of each group by sucrose preference test and open field test at the end of the experiment.MAIN OUTCOME MEASURES： Changes of depression-like behaviors of rats in each group.RESULTS： Forty-eight rats were involved in the experiment. Two rats with meningeal irritation sign were excluded from simple MCAO group, and one rat in the MCAO＋stress group died of some unclear causes during the experiments. The other 45 rats entered the stage of finial analysis. ① Depression-like behavior assessment results： The rats in the MCAO＋ stress group had a significantly decreased preference for sucrose solution, crossing and rearing scores, and increased immobility duration after the 14-day restraint stress,compared with those in other three groups （all P〈0.05）. ②The neurological status grading and motor performance evaluation： There were significant differences in the two indexes of rats in the simple MCAO group before, 1^st and 28^th days after modeling （P〈0.01）, while there was no significant difference before and 28^th days after modeling （P〉0.05）. There were no significant changes in sham-operation group at each time point （P〉0.05）.CONCLUSION： After being exerted restraint stress, the rats with transient focal ischemic injury may show obvious depression-like behaviors. Therefore, restraint stress can be used as a novel animal modeling method for further studying biological mechanism in central nervous system of post-stroke depression animals.

Clinical decision making on the use of physical restraint in intensive care units

Physical restraint is a common nursing intervention in intensive care units and nurses often use it to ensure patients'safety and to prevent unexpected accidents.However,existing literature indicated that the use of physical restraint is a complex one because of inadequate rationales,the negative physical and emotional effects on patients,but the lack of perceived alternatives.This paper is aimed to interpret the clinical decision-making theories related to the use of physical restraint in intensive care units in order to facilitate our understanding on the use of physical restraint and to evaluate the quality of decisions made by nurses.By reviewing the literature,intuition and heuristics are the main decision-making strategies related to the use of physical restraint in intensive care units because the rapid and reflexive nature of intuition and heuristics allow nurses to have a rapid response to urgent and emergent cases.However,it is problematic if nurses simply count their decision-making on experience rather than incorporate research evidence into clinical practice because of inadequate evidence to support the use of physical restraint.Besides that,such a rapid response may lead nurses to make decisions without adequate assessment and thinking and therefore biases and errors may be generated.Therefore,despite the importance of intuition and heuristics in decision-making in acute settings on the use of physical restraint,it is recommended that nurses should incorporate research evidence with their experience to make decisions and adequate assessment before implementing physical restraint is also necessary.

Occupant Restraint System Simulation and Optimization Based on TESW

Integrated into the development process of a chinese independent brand class sedan,optimization about occupant restraint system associated with dummy chest deceleration is studied.Based on this simulated vehicle deceleration and the target vehicle′s chest deceleration,tipped equivalent square wave(TESW)is calculated by combining the average stiffness kof occupant restraint system and the average free flight time t*from the existant CNCAP(China new car assessment program)tested cars.After proposing modeling regulations of occupant restraint system and establishing mathematical dynamic modelling(MADYMO)for occupant restraint system of the target vehicle,four optimization design parameters namely vent area A,load limit L,seat belt extension ratio Band pretension force Fare selected by weighted injury criteria(WIC)rule and the first-order response surface method.The four parameters have been optimized by using orthogonal test design of four factors with five levels and the optimum combination A5L1B1F5 has been chosen by range and variance analyses.The results show that occupant restraint system performance has been optimized and improved,while meeting the chest deceleration calculation peak based on TESW.

Flutter analysis of rotating beams with elastic restraints

The aeroelastic stability of rotating beams with elastic restraints is investigated.The coupled bending-torsional Euler-Bernoulli beam and Timoshenko beam models are adopted for the structural modeling.The Greenberg aerodynamic model is used to describe the unsteady aerodynamic forces.The additional centrifugal stiffness effect and elastic boundary conditions are considered in the form of potential energy.A modified Fourier series method is used to assume the displacement field function and solve the governing equation.The convergence and accuracy of the method are verified by comparison of numerical results.Then,the flutter analysis of the rotating beam structure is carried out,and the critical rotational velocity of the flutter is predicted.The results show that the elastic boundary reduces the critical flutter velocity of the rotating beam,and the elastic range of torsional spring is larger than the elastic range of linear spring.

Low-field NMR inversion based on low-rank and sparsity restraint of relaxation spectra

In this paper,we proposed a novel method for low-field nuclear magnetic resonance(NMR)inversion based on low-rank and sparsity restraint(LRSR)of relaxation spectra,with which high quality construction is made possible for one-and two-dimensional low-field and low signal to noise ratio NMR data.In this method,the low-rank and sparsity restraints are introduced into the objective function instead of the smoothing term.The low-rank features in relaxation spectra are extracted to ensure the local characteristics and morphology of spectra.The sparsity and residual term are contributed to the resolution and precision of spectra,with the elimination of the redundant relaxation components.Optimization process of the objective function is designed with alternating direction method of multiples,in which the objective function is decomposed into three subproblems to be independently solved.The optimum solution can be obtained by alternating iteration and updating process.At first,numerical simulations are conducted on synthetic echo data with different signal-to-noise ratios,to optimize the desirable regularization parameters and verify the feasibility and effectiveness of proposed method.Then,NMR experiments on solutions and artificial sandstone samples are conducted and analyzed,which validates the robustness and reliability of the proposed method.The results from simulations and experiments have demonstrated that the suggested method has unique advantages for improving the resolution of relaxation spectra and enhancing the ability of fluid quantitative identification.

Development of Nursing Protocol for Preventing Discontinuation of Treatments by Methods Other than Physical Restraint during Acute Exacerbation of Chronic Heart Failure in Patients with Impaired Cognitive Function

The purpose of this study is to prepare a nursing protocol for preventing discontinuation of treatments using a method other than physical restraint during acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the study, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 10 nurses in dementia case to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 154 subjects (93.9%) considered effective for patients, in terms of prevention of treatment discontinuation using a method other than physical restraint. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 93.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We also received a comment from the certified nurses that we should include the basic contents for newly graduated nurses. We consider that this nursing protocol will be also useful for newly graduated nurses to acquire knowledge. It helped to standardize nursing care in order to predict potential risks for patients with impaired cognitive function.

Electroacupuncture pretreatment exhibits antidepressive effects by regulating hippocampal proteomics in rats with chronic restraint stress

The clinical effect of electroacupuncture on depression is widely recognized. However, the signal transduction pathways and target proteins involved remain unclear. In the present study, rat models of chronic restraint stress were used to explore the mechanism by which electroacupuncture alleviates depression. Rats were randomly divided into control, model, and electroacupuncture groups. Chronic restraint stress was induced in the model and electroacupuncture groups by restraining rats for 28 days. In the electroacupuncture group, electroacupuncture pretreatment at Baihui（GV20） and Yintang（GV29） acupoints was performed daily（1 m A, 2 Hz, discontinuous wave, 20 minutes） prior to restraint for 28 days. Open field tests and body weight measurements were carried out to evaluate the depressive symptoms at specific time points. On day 28, the crossing number, rearing number, and body weights of the model group were significantly lower than those in the control group. Behavior test results indicated that rat models of depressive-like symptoms were successfully established by chronic restraint stress combined with solitary raising. On day 28, an isobaric tag for a relative and absolute quantitation-based quantitative proteomic approach was performed to identify differentially expressed proteins in hippocampal samples obtained from the model and electroacupuncture groups. The potential function of these differential proteins was predicted through the use of the Cluster of Orthologous Groups of proteins（COG） database. Twenty-seven differential proteins（uncharacteristic proteins expected） were selected from the model and electroacupuncture groups. In addition to unknown protein functions, COG are mainly concentrated in general prediction function, mechanism of signal transduction, amino acid transport and metabolism groups. This suggests that electroacupuncture improved depressive-like symptoms by regulating differential proteins, and most of these related proteins exist in nerve cells.