A theoretical framework for interaction of nursing discipline with genetics and genomics

Background:Since the completion of the Human Genome Project,health science has been strongly influenced by the advances in genetics and genomics.However,the progress of embracing genetics and genomics into nursing discipline is limited.One of the main barriers is lack of understanding on the relevancy of genetics and genomics to nursing discipline.Objectives:This paper aims to synthesize and develop a theoretical framework for the interaction of nursing discipline with genetics and genomics.Methods:Through content analysis and constant comparative method,a theoretical framework was developed from synthesis of the studies regarding nursing and genetics/genomics indexed in multiple English and Chinese databases.Results:Four main theoretical statements were constructed in the framework:1)There are three ways to show how genetics and genomics can influence nursing discipline:a new specialty,new technologies and a new lens;2)The significant contribution of nursing discipline to genetics and genomics lies in how nurses could focus on the association between human responses and genes and how nurses could advocate for their clients in the genetic and genomic era;3)A paradigm shift occurs after a constant interaction of nursing discipline with genetics and genomics;4)Implementation strategies could be used to facilitate the integration of genetics and genomics to nursing discipline and advance the paradigm shift.Conclusions:The framework will help to understand the relationship between nursing discipline and genetics and genomics and implicate the future studies integrating genetics and genomic science into nursing discipline.

Intrauterine high androgen promotes obesity of the offspring of rats with polycystic ovarian syndrome via activating macrophage-angiogenesis-related androgen signaling

The development of polycystic ovary syndrome(PCOS)is closely related to the chronic inflammatory and obese.Recent studies have found macrophages regulate the chronic inflammation and adipose tissue remodelling,but the underlying mechanisms have not been clarified.In this study,we established a model of PCOS in the offspring rats by high androgen exposure during late pregnancy in parental and established a female rat macrophage eliminating model by rejection of clodronate liposome.Then,the offspring rat macrophage phenotype in offspring female rat adipose tissue,and levels of testosterone,angiogenic factors(PDGF and VEGF)and inflammatory factors(TNF-αand MCP-1)were investigated.By coculture of RAW264.7 macrophage with adipocytes or C166 endothelial cells(ECs),the mobility of adipocytes,and the ECs function with associated signalling pathway were detected by using of androgen inhibitor Apalutamide,NF-κB inhibitor JSH-23 and ERK1/2 inhibitor LY3214996.It was found that high androgen exposure during late pregnancy led to increased testosterone levels and overweight and obesity,increased size and reduced number of subcutaneous and intra-abdominal adipocytes,and increased secretion of TNF-αand MCP-1 in female rats in the offspring.Eliminating macrophages significantly increased adipocytes and angiogenesis in offspring of rats with intrauterine high androgen,and reduced TNF-αand MCP-1.Macrophages promoted mobility of adipocytes,and inhibited proliferation,migration,tube formation of ECs under hyperandrogenic condition,which were significantly inhibited by Apalutamide,JSH-23 and LY3214996.Thus,intrauterine high androgen promotes obesity of the offspring of rats with polycystic ovarian syndrome through increasing M1 differentiation of pro-inflammatory macrophages and activating VEGF-related angiogenesis via androgen/NF-κB/ERK1/2 signalling pathway.

Efficacy and safety of Yiqi Peiyuan granules for improving the short-term prognosis of patients with acute kidney injury:A multicenter,double-blind,placebo-controlled,randomized trial

Background:Yiqi Peiyuan(YQPY)prescription,a composite prescription of traditional Chinese medicine,has been used to prevent or delay the continued deterioration of renal function after acute kidney injury(AKI)in some institutions and has shown considerable efficacy.Objective:This is the first randomized controlled trial to assess efficacy and safety of YQPY for improving short-term prognosis in adult patients with AKI.Design,setting,participants and interventions:This is a prospective,double-blind,multicenter,randomized,and placebo-controlled clinical trial.A total of 144 enrolled participants were randomly allocated to two groups according to a randomization schedule.Participants,caregivers and investigators assessing the outcomes were blinded to group assignment.Patients in the YQPY group received 36 g YQPY granules twice a day for 28 days.Patients in the placebo group received a placebo in the same dose as the YQPY granules.Main outcome measures:The primary outcome was the change in the estimated glomerular filtration rate(eGFR)between baseline and after 4 and 24 weeks of treatment.The secondary outcomes were the change of serum creatinine(Scr)level between baseline and after treatment,and the incidence of endpoint events,defined as eGFR increasing by more than 25%above baseline,eGFR>75 mL/min per1.73 m2or the composite endpoint,which was defined as the sum of patients meeting either of the above criteria.Results:Data from a total of 114 patients(59 in the YQPY group and 55 in the control group)were analyzed.The mean changes in eGFR and Scr in weeks 4 and 24 had no difference between the two groups.In further subgroup analysis(22 in the YQPY group and 31 in the control group),the mean change in eGFR after treatment for 4 weeks was 27.39 mL/min per 1.73 m2in the YQPY group and 5.78 mL/min per1.73 m2in the placebo group,and the mean difference between groups was 21.61 mL/min per 1.73 m2(P<0.001).Thirteen(59.1%)patients in the YQPY group and 5(16.1%)in the placebo group reached the composite endpoints(P=0.002).During the intervention,2 and 4 severe adverse events were reported in the YQPY and placebo groups,respectively.Conclusion:The YQPY granules can effectively improve the renal function of patients 4 weeks after the onset of AKI,indicating that it has good efficacy for improving short-term renal outcomes in patients with AKI.The YQPY granules may be a promising therapy for adults with AKI.

CO2 Laser Moxibustion for Knee Osteoarthritis: Study Protocol for A Multicenter, Double-Blind, Randomized Controlled Trial

Background:Knee osteoarthritis(OA)is a major cause of disability among the older adults.Few treatments are safe and effective.Moxibustion is commonly used in treating knee OA in Chinese medicine(CM).CO2 Laser moxibustion device is a substitute for traditional moxibustion,which mimics the effects of traditional moxibustion.More data are needed to support its application in knee OA.Objective:The trial aims to assess the effect and safety of CO2 laser moxibustion in patients with knee osteoarthritis compared with a sham control.Methods:This is a protocol for a multicenter,randomized,double-blind,placebo-controlled trial.A total of 392 participants were recruited and assigned to the CO2 laser moxibustion group and sham laser moxibustion group with a 1:1 ratio at 6 outpatient clinics in Shanghai,China.Participants in both groups received treatment at the affected knee(s)at the acupuncture point Dubi(ST 35)and an Ashi point.There were 3 sessions per week for 4 weeks,and an additional 20-week follow-up.Primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)pain scores at week 4.Secondary outcomes were WOMAC function score,stiffness score and overall score,VAS pain,Short-Form heath survey(SF-36),and patients’global assessment.The serum levels of cytokines involved in progress of knee OA were explored.Safety was assessed during the whole trial.Masking effectiveness was assessed by both participants and treatment providers.Discussion:CO2 laser moxibustion device,designed as a substitute for CM moxibustion,is easy to use and control with no choking smoke and smell,and is a plausible method for double-blind research.This study would provide rigorous evidence for the effect and safety of CO2 laser moxibustion in treating knee OA.

Clinical observation on electroacupuncture plus Yi Jin Jing(Sinew-transforming Qigong Exercises)for knee osteoarthritis

Objective:To observe the efficacy of electroacupuncture(EA)plus Yi Jin Jing(Sinew-transforming Qigong Exercises)for knee osteoarthritis(KOA).Methods:A total of 60 patients with KOA were divided into an observation group and a control group according to the random number table method,with 30 cases in each group.Patients in the observation group received the treatment of EA plus Yi Jin Jing(Sinew-transforming Qigong Exercises),while patients in the control group only received EA treatment.Both groups were treated for 5 weeks.The changes of Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)and visual analog scale(VAS)scores in the two groups were observed after treatment.Results:After treatment,the total effective rate in the observation group(92.3%)was significantly higher than that in the control group(70.0%),(P<0.05);the WOMAC and VAS scores in both groups were significantly lower than those before treatment,showing statistical significance(all P<0.01);there were significant differences in the post-treatment changes in the WOMAC and VAS scores between the two groups(P<0.05,P<0.01).Conclusion:EA plus Yi Jin Jing(Sinew-transforming Qigong Exercises)is clinically effective for KOA.This combined treatment can alleviate clinical symptoms.