Objective:To explore the behavior and influencing factors of mobile health (m-Health) information searching among patients with cancer, aiming to provide evidence for the provision of medical health information.Methods:A cross-sectional survey was conducted.A total of 535 patients with cancer were recruited from a cancer hospital in Zhejiang Province from September to December 2017.Measurement tools included the demographic information questionnaire, mobile health information search behavior questionnaire, mobile health information search environment questionnaire, cancer needs questionnaires-short form and ehealth literacy scale.SPSS 26.0 was used for descriptive statistical analysis, one-way analysis of variance, Pearson correlation analysis and multiple linear regression analysis.Results:The total score of mobile health information search behavior of cancer patients was (60.84±9.60), and 66.5% of participants reported that they "never" or "occasionally" searched health information via mobile.The total score of information needs was (80.99±27.86), electronic health literacy was (26.54±7.85), mobile health information search environment was (8.00±2.86). m-Health information search behavior was positively correlated with information needs ( r=0.251, P<0.01), ehealth literacy ( r=0.538, P<0.01), and m-Health information search environment ( r=0.267, P<0.01). The stepwise regression analysis revealed that the place of residence, working status, income level, ehealth literacy, mobile health information search environment and information needs were statistically significant associated with the m-Health information searching behavior among cancer patients, which accounted for 39.3% of the total variance ( F=12.151, P<0.01). Compared with patients living in the central cities, those living in the small and medium-sized cities( β=0.092, P=0.031) had higher score in m-Health information behavior.Compared with patients working on normal schedule, those took sick days ( β=0.156, P=0.017) and working fewer hours ( β=0.138, P=0.002) had higher score m-Health information behavior.Compared with patients with monthly income of 1 000-3 000 yuan ( β=-0.194, P=0.002), those with monthly income less than 1 000 yuan had higher score in m-Health information behavior.The ehealth literacy ( β=0.425, P=0.000), mobile health information search environment ( β=0.179, P=0.000) and information needs ( β=0.091, P=0.027) were positive influencing factors of m-Health information search behavior. Conclusion:Patients with cancer did not report high m-Health information search behavior.Place of residence, working status, income level, ehealth literacy, m-Health information search environment and information demand were the influencing factors of m-Health information search behavior among patients with cancer.

A growing number of clinical studies have shown that arterial spin labeling (ASL) magnetic resonance imaging has its unique value in the diagnosis and treatment of dementia. This article reviews the application principles and imaging manifestations of ASL in patients with different types of cognitive impairment, such as vascular cognitive impairment and Alzheimer's disease.

A number of studies have shown that the enlarged perivascular spaces (EPVS) are associated with various diseases such as cerebral small vessel disease,Alzheimer's disease,post-stroke depression,and post-stroke cognitive impairment.This article reviews the imaging features,pathophysiological mechanisms and clinical significance of EPVS.

Lacunar stroke is a common ischemic cerebral small vessel disease. It can cause vascular cognitive impairment. Many studies have shown that the number, location, and course of lacunar stroke are closely associated with vascular cognitive impairment. This article reviews the related studies of lacunar stroke and vascular cognitive impairment.

Multiple myeloma(MM)is a highly heterogeneous and refractory plasma cell tumor.It is similar to most solid tumors in the hyp-oxic tumor microenvironment(TME)it is exposed to,promoting hypoxia inducible factor-1(HIF-1)activation and related transcription factors of the corresponding downstream signaling pathways,affecting tumor angiogenesis,myeloma cell dissemination and metastasis,anti-tumor immunity,tumor immune escape promotion as well as altering the cellular energy metabolism and participating in therapeutic resistance in-duction.In this study,based on the above-described mechanisms,we aim at reviewing the current research status of hypoxic microenviron-ment-targeting therapies in MM treatment,focusing on the direct inhibition of HIF factors or signaling pathway targeting;metabolism im-provement and oxygenation increase;effective tumor immunity restoration by targeting immune checkpoints;anti-angiogenesis.Precise hypoxia targeting combined with standardized therapy offers a promising strategy and research hotspot in MM therapy.

Objective:To explore the relationship between total MRI burden and serum homocysteine (Hcy) in patients with cerebral small vessel disease(CSVD), and to provide clues for disease prevention and treatment.Methods:A total of 370 inpatients with CSVD from the neurology department of hospital were consecutively enrolled from September 2016 to December 2018.The clinical data, including serum homocysteine(Hcy) levels were collected.Brain MRI data were collected, including the severity of white matter hyperintensities(WMH), lacune infarcts(LI), cerebral microbleeds(CMBs), and enlarged perivascular spaces(ePVS) to evaluate the total load of CSVD.SPSS21.0 was applied to analyze the association between total CSVD burden and Hcy.Results:(1)Compared with the patients with lower Hcy levels, the higher Hcy group had heavier total burdens of CSVD( P<0.01). (2)According to the total MRI burden scores of CSVD, all patients were further divided into low burden group(106 cases) and moderate-high burden group(264 cases). Multivariate logistic regression analysis showed that Hcy( OR=1.026, 95% CI: 1.003-1.049, P=0.026) was risk factor for increasing CSVD burden and hyperhomocysteinemia was a stronger predictor for total MRI burdens of CSVD( OR=3.202, 95% CI: 1.947-5.268, P<0.001). Conclusion:Serum Hcy can be an independent risk factor for the total MRI burdens of CSVD.This finding provides a promising clue for the prediction and clinical management of CSVD.

Objective:To investigate the relationship between the enlarged of peripheral vascular space and cognitive function in patients with acute ischemic stroke.Methods:Totally 223 patients with first-episode acute cerebral infarction were selected from the department of neurology in Hebei general hospital from September 2016 to December 2018, who completed the test of cognitive function. All patients were divided into cognitive impairment group( n=67)and normal cognitive group( n=156)according to the score of MoCA.The risk factors of cognitive function and the relationship between the enlargement of perivascular space and cognitive function were analyzed by SPSS 21.0. Results:Age, history of coronary heart disease, Hcy, Fib, BG-EPVS and CSO-EPVS were statistically significant different in cognitive impairment group and normal cognitive group(all P<0.05). Age ( B=0.067, OR=1.070, 95% CI=1.035-1.106, P<0.05), Hcy( B=0.032, OR=1.033, 95% CI=1.007-1.060, P=0.013), and BG-EPVS( B=0.720, OR=2.055, 95% CI=1.041-4.055, P=0.038)were independent risk factors for cognitive impairment.The degree of BG-EPVS in the cognitive impairment group was negatively correlated with the total MoCA score( r=-0.332, P<0.05), visual space and execution( r=-0.256, P<0.01), attention( r=-0.256, P<0.01), language( r=-0.182, P<0.05)and orientation( r=-0.370, P<0.05). Conclusion:EPVS, especially BG-EPVS, can be used as an indicator to evaluate the early cognitive function of AIS patients.

Homocysteine participates in the methionine cycle in the body and is excreted by the kidneys. Its abnormal elevation increases the risk of cerebrovascular disease. Studies in recent years have shown that hyperhomocysteinemia is closely related to cerebral small vessel diseases and is an independent risk factor for ischemic stroke and cognitive impairment. Because hyperhomocysteinemia is largely reversible, the significance of drug intervention in the prevention and treatment of cerebrovascular disease has gradually been confirmed. This article reviews the relationship between homocysteine and cerebral small vessel diseases in order to provide a reference for the prevention of stroke and dementia.

The neurovascular unit consists of neurons, glial cells and cerebral blood vessels. Each eomponent synergistically regulates vasomotion and maintains the blood-brain barrier function to maintain the microenvironment homeostasis and ensure normal brain function. Cognitive impairment, especially in the advanced stage of dementia, places heavy economic and mental burdens on society and families. From the perspective of holistic view, this article expounds the role of neurovascular dysfuntion in the two major causes of cognitive impairment, including Alzheimer's disease and vascular cognitive impairment, and aims to provide possible clues for early prevention and treatment of these diseases.