Objective To explore the effect of team resource management mode in reducing the door-to-needle time (DNT) of acute ischemic stroke. Methods A total of 272 acute ischemic stroke patients admitted to our hospital from January to December 2014 were set as the observation group. The observation group adopted the team resource management mode which was composed of emergency triage nurses, thrombolysis group nurses, emergency CT nurses, emergency intensive care nurses, interventional radiology nurses, cerebrovascular medicine nurses and rehabilitation medicine nurses. Another 264 acute ischemic stroke patients admitted to our hospital from January to December 2013 were named as the control group who was given traditional emergency treatment mode. The DNT, the activities of daily living and the nursing service satisfaction of patients were compared between the observation group and the control group. Results The DNT, Barthel index and the nursing service satisfaction of patients in the observation group were (44.93 ±11.47) min, 65.26 ±21.36, 93.39% (240/257), which were better than those of the control group, (111.99±11.10) min, 39.53±20.56, 80.41%(197/245), the differences were significant (t=115.516, 14.559, χ2=18.740, P < 0.01). Conclusions The team resource management mode is an effective tool to shorten the DNT, promote the recovery of patients and improve the quality of patients′life.

This study was conducted to elucidate the effects of different fluid shear stress on the expression of IL-8 receptors CXCR1 in endothelial cells. The HUVEC cell lines, EA. Hy926 cells, were cultured in vitro, exposed to 5.56, 10.02, and 15.27 dyn/cm2 laminar shear stress, respectively, and then the shear stress grous were each investigated at the time-points of 0h, 1h, 2h, 4h and 8h. Western blotting was used for detecting the expression of IL-8 receptor CXCR1 at the time-points. The results showed that, under 5.56 dyn/cm2 shear stress, the expression of CXCR1 increased with time significantly (P < 0.01). The maximum expression of CXCR1 appeared at 4 h and was 2.2 times that of the control. When exposed to 10.02 dyn/cm2, the expression of CXCR1 increased gradually with time and finally remained at a constant higher level. When exposed to 15.27 dyn/cm2, CXCR1 expression decreased significantly with time (P < 0.01). The minimum CXCR1 expression appeared at 8 h and was 62. 59 percent of that of the control. These results indicate that the expression of CXCR1 in endothelial cell is regulated by laminar shear stress.
Cell Line ; Endothelial Cells ; cytology ; metabolism ; Humans ; RNA, Messenger ; biosynthesis ; genetics ; Receptors, Interleukin-8A ; genetics ; metabolism ; Shear Strength ; Stress, Mechanical ; Umbilical Veins ; cytology

[Abstract]? Objective? To construct a theoretical knowledge system for stroke emergency nurses and to provide reference for the establishment of the theoretical knowledge training course for stroke emergency nurses. Methods? Through literature review and referring to relevant guidelines, the preliminary items of theoretical knowledge of stroke emergency nurses were formed. Through Delphi method, 20 experts were inquired for two rounds, and the main points of theoretical knowledge were established. Results? The positive coefficients of the two rounds of expert inquiries were 100%, and the positive coefficients of experts were high. The judgment basis, familiarity and authority coefficients of expert consultation were 0.925, 0.844 and 0.885, respectively, all＞ 0.700, and the reliability of consultation results was high. The Kendall Harmony Coefficient of the secondary indicators was 0.462 and 0.293 respectively (P＜0.01). The theoretical knowledge system of stroke emergency nurses included 8 primary indicators, 24 secondary indicators and 45 key points of knowledge. Conclusions? The consultation experts' opinions are concentrated and the results are credible. The establishment of the theoretical knowledge system of the stroke emergency nurses can provide a reference for setting up the theoretical training courses for stroke emergency nurses.

[Abstract]? Objective? To explore the position and responsibilities of stroke emergency specialist nurses. Methods? The interviewing method in qualitative studies was adopted and in-depth semi-structured interviews were conducted on four doctors, four nurses, two technicians and six managers. Claizzi's seven-step phenomenological data analysis method was used to encode, assemble, categorize, analyze and refine the content theme. Results? The position of stroke emergency specialist nurses is compound specialist and team coordinator. Its duties include accurate identification of stroke patients, early warning for CT room and rapid preparation before thrombolysis, assisting family members in clinical decision-making, ensuring seamless connection of all steps, handing over with rescue room and digital subtraction angiography (DSA) room and ward, ensuring adequate material supply, establishing and maintaining database and continuing patient return visit. Conclusions? The post setting of stroke emergency specialist nurses laid a foundation for the rapid treatment of stroke patients. Their role was positioned as senior practical nurses, and their post setting faced a series of challenges. Promoting the mature experience of post setting of stroke emergency specialist nursess can train a group of stroke emergency specialist nursess and lead the development of specialized stroke nursing.

Objective:To explore the status quo and influencing factors of self-management behavior in high-risk stroke patients, so as to provide a basis for improving their self-management behavior.Methods:From March to June 2023, convenience sampling was used to select 395 high-risk stroke patients admitted to the First Affiliated Hospital of Naval Medical University as the study subject. A survey was conducted on patients using the General Information Questionnaire, Self-management Behavior Scale for High-risk Stroke Patients, and Cerebral Apoplexy Knowledge Questionnaire. Pearson correlation was used to analyze the correlation between self-management behavior and stroke knowledge. A total of 395 questionnaires were distributed, and unqualified questionnaires (such as regular or repetitive responses, conflicting options before and after) were excluded. Finally, 387 valid questionnaires were collected, with an effective response rate of 97.97%.Results:The score of the Self-management Behavior Scale for High-risk Stroke Patients for 387 high-risk stroke patients was (137.60±25.47), with a score indicator of 62.53%, which was at a moderate level. The score of the Cerebral Apoplexy Knowledge Questionnaire was (19.26±10.19), which was at a low level. The random forest algorithm showed that the importance order of influencing factors was stroke knowledge, number of ways to obtain health information, educational level, number of risk factors, frequency of physical examinations, medical insurance, age, work situation, and gender. The Lasso regression indicated that there were four influencing factors corresponding to the minimum error. The top four factors in importance were included in multiple linear regression, and the results showed that educational level, number of risk factors, number of ways to obtain health information, and stroke knowledge were the influencing factors of self-management behavior in high-risk stroke patients ( P<0.05) . Conclusions:The self-management behavior of high-risk stroke patients was at a moderate level. Medical and nursing staff should strengthen stroke knowledge education, provide personalized education for different risk factors, and improve the self-management of the target population to reduce the incidence of stroke.

Objective:To explore the mediating effect of coping style on disease perception and pre-hospital delayed behavioral intention in patients with acute ischemic stroke.Methods:This study was a cross-sectional study. From February to July 2023, convenience sampling was used to select 205 patients with acute ischemic stroke admitted to the First Affiliated Hospital of Naval Medical University as the study subject. The survey was conducted using the General Information Questionnaire, Stroke Pre-Hospital Delay Behavior Intention, Brief Illness Perception Questionnaire, and Simplified Coping Style Questionnaire.Results:205 questionnaires were filled out, 195 valid questionnaires, and the validity rate of the questionnaire was 95.1%. The Stroke Pre-Hospital Delay Behavior Intention score of patients with acute ischemic stroke was (63.61±16.12). Pre-hospital delayed behavioral intention in patients with acute ischemic stroke was positively correlated with disease perception and negative coping ( r=0.360, 0.266; P<0.01), and negatively correlated with positive coping ( r=-0.279, P<0.01). The mediating effects of positive and negative coping on disease perception and pre-hospital delayed behavioral intention in ischemic stroke patients were 0.111 and 0.097, respectively, accounting for 26.89% and 23.49% of the total effect. Conclusions:There is a partial mediating effect of coping strategies between disease perception and pre-hospital delayed behavioral intention in ischemic stroke patients. In the process of stroke management, medical and nursing staff can reduce pre-hospital delayed behavioral intentions by improving disease cognition and coping style.

Objective:To describe the current status of the resilience of the primary caregivers ′ families of patients with first-ever stroke and to explore the factors that influence it, in order to assist medical professionals in timely identification of related factors, formulate targeted nursing rehabilitation programs, and provide better support and care to patients and their families. Methods:Using convenience sampling, the primary caregivers ′ families of patients with first-ever stroke admitted to The First Affiliated Hospital of Naval Medical University of the People ′s Liberation Army of China and Shanghai Tenth People ′s Hospital from May 2021 to January 2022 were selected as subjects for a cross-sectional survey of family resilience. The Family Resilience Assessment Scale was used to evaluate the primary caregivers of first-ever stroke patients, and multiple linear regression was employed to clarify the influencing factors of the family resilience of primary caregivers. Results:A total of 307 questionnaires were distributed, and 288 valid questionnaires were collected. There were 84 males and 204 females, aged ≤30 years old with 23 cases, aged 31-40 years old with 63 cases, aged 41-50 years old with 63 cases, aged 51-60 years old with 32 cases, aged ≥ 61 years old with 107 cases. The total score of family resilience of the primary caregivers was (210.80±17.32) points. Univariate analysis showed that there were statistical differences in the caregiver ′s occupational status, relationship with the patient, age, family residence, marital status, type of family, daily caregiving time, and the patient ′s gender and age with the caregiver ′s family resilience score ( t=2.06, -3.38, F values were 4.96-21.32, all P<0.05). The level of family resilience of primary caregivers was positively correlated with social support, positive coping methods, and family support ( r=0.375, 0.627, 0.642, all P<0.05), and negatively correlated with caregiving burden and negative coping methods ( r=-0.444, -0.563, both P<0.05). The multiple linear regression equation showed that social support, family support, positive coping, and negative coping were the main influencing factors of the family resilience of primary caregivers of patients with first-ever stroke ( t values were -6.68-6.27, all P<0.05), explaining 57.5% of the variance in family resilience. Conclusions:The family resilience of primary caregivers of patients with first-ever stroke is at a high level. Primary caregivers who receive more family support and social support, and who adopt positive coping methods and reduce negative coping methods, have higher levels of family resilience.