Objective To construct a structural equation model to analyze the effect of various factors on the quality of life in stroke patients.Methods In this cross-sectional study,a total of 657 stroke patients from 2 ter-tiary A hospitals in Shanghai were enrolled as investigation subjects via convenience sampling methodology.General information questionnaire,Sense of Coherence Scale-13,Perceived Social Support Scale,Medical Coping Modes Questionnaire,National Institutes of Health Stroke Scale,Self-Esteem Scale and Stroke-Specific Quality of Life were utilized as the investigating tools;Mplus 7.4 was used to construct a structural equation model.Results The aver age score of quality of life in stroke patients was(178.30±30.30);neurological status,self-esteem were negatively cor-related with quality of life(P＜0.05);sense of coherence,social support,coping style were positively correlated with quality of life(P＜0.05);sense of coherence,taking a confrontational approach for coping,yielding and neurological status had a direct impact on quality of life(path coefficients were 0.471,0.169、0.135,-0.089,P＜0.05);social sup-port,self-esteem,sense of coherence and neurological status had an indirect impact on quality of life(path coefficients were 0.232,0.108,0.058,-0.058,P＜0.001).Conclusion The quality of life in stroke patients is influenced by multi-ple factors interactively,and sense of coherence is an important factor affecting the quality of life;adopting a confron-tational approach as coping styles,good social support and high self-esteem can improve the level of quality of life.

Aim To investigate the relationship between systemic inflammatory immune index(SII)and systemic inflammatory response index(SIRI)and the risk of in-hospital major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI).Methods Retrospective analysis was conducted on AMI patients ad-mitted to the Second Cardiovascular Disease Area of Suining Central Hospital from February 2021 to May 2022.Based on inclusion and exclusion criteria,246 patients were finally enrolled.According to whether MACE occurred during hospital-ization,they were divided into event group and non-event group,and baseline data of the two groups were compared.All variables except SII and SIRI were included in a univariate-multivariate Logistic regression analysis to screen factors af-fecting the risk of MACE,and were used as significant covariates for adjustment to evaluate the relationship between SII and SIRI and the risk of MACE respectively.Results The results of multivariate Logistic regression analysis showed that emergency PCI,left ventricular ejection fraction,albumin level and age were significant factors affecting the risk of in-hos-pital MACE in AMI patients(OR=0.432,95％CI:0.194～0.960,P=0.038;OR=0.930,95％CI:0.890～0.969,P=0.001;OR=0.730,95％CI:0.621～0.845,P＜0.001;OR=1.143,95％CI:1.070～1.228,P＜0.001),and a basic model was established based on this.After adjusting for the significant covariates,SII and SIRI were both independ-ent risk factors for in-hospital MACE(OR=1.004,95％CI:1.001～1.008,P=0.002;OR=4.467,95％CI:2.597～8.142,P＜0.001).The areas under the curves of SII and SIRI were 0.658 and 0.785,respectively,and the optimal cutoff values were 434.83 and 1.03.Restricted cubic spline analysis showed that SII(Nonlinear P=0.639)and SIRI(Nonlinear P=0.683)were linearly related to the risk of MACE after adjusting significant covariates.Threshold effect a-nalysis showed that when SIRI＞0.93,the risk of MACE began to increase.Conclusion Elevated levels of SII and SI-RI are independent risk predictors for the occurrence of in-hospital MACE in AMI patients.