Objective To investigate the predictive value of B-type natriuretic peptide(BNP)for acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated by right heart failure(RHF).Methods This study selected AECOPD patients admitted to Jiangyin Hospital Affiliated to Nantong University and Nanjing Chest Hospital from January 2022 to January 2024 as ob-jects.According to the inclusion and exclusion criteria,122 patients were ultimately enrolled.The patients were divided into observation group(AECOPD with RHF,n=72)and control group(AECOPD without RHF,n=50)based on whether they had RHF.Differences in various indicators between the two groups were compared,and the predictive value of BNP for AECOPD patients with RHF was assessed through Logistic regression analysis and receiver operating characteristic(ROC)curves.The cut-off value of BNP was determined using the ROC curve.Results Statistically signifi-cant differences were observed between the two groups in terms of gender,body temperature,albumin,blood glucose,chloride ions,pulmonary artery pressure(PAP),and BNP levels(P＜0.05).Logistic regression analysis showed that BNP was an independent predictor for AECOPD patients with RHF(OR=1.03;95％CI,1.01 to 1.04;P＜0.05).The ROC curve results indicated that when the BNP cut-off value was 83.5 pg/mL,the sensitivity was 0.820,the specificity was 0.972,and the Youden index was 0.792.The area under the curve for BNP was 0.875(95％CI,0.800 to 0.949,P＜0.001).When the BNP level in AECOPD patients exceeded 83.5 pg/mL,the incidence of RHF significantly increased.Conclusion Patients with AECOPD complicated by RHF have higher plasma BNP levels than those without RHF,and BNP has significant predictive value for determining whether AECOPD patients have RHF.

Objective·To investigate the association of serum osteoglycin(OGN)levels with renal function and blood pressure in non-diabetic patients with hypertension.Methods·Hypertensive patients without a diagnosis of diabetes mellitus were recruited from the Hypertension Department of Ruijin Hospital,Shanghai Jiaotong University School of Medicine.A total of 36 renal dysfunction patients(renal dysfunction group)and 38 normal renal function patients(normal renal function group),matched for age,gender and clinic blood pressure,were included in this study.Serum OGN concentrations were measured by the enzyme-linked immunosorbent assay(ELISA).Estimated glomerular filtration rate(eGFR)was calculated from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI)equation.The serum OGN levels were compared between the renal dysfunction group and the normal renal function group.The correlations of serum OGN level with eGFR and blood pressure were analyzed.Results·There was no significant statistical difference in serum OGN levels between the renal dysfunction group and the normal renal function group(P=0.708).Serum OGN levels were not significantly associated with eGFR(P=0.952).In the renal dysfunction group,mean arterial pressure,age and current smoking status were relevant factors of serum OGN levels(P<0.05).After adjustment for confounders,serum OGN levels were independently associated with clinic systolic and diastolic blood pressure,24-hour ambulatory mean systolic and diastolic blood pressure in the renal dysfunction group(P<0.05),but not in the normal renal function group(P?0.05).Conclusion·In non-diabetic patients with hypertension,serum OGN levels are not significantly associated with eGFR.In patients with renal dysfunction,higher serum OGN levels are independently associated with higher clinic systolic blood pressure,clinic diastolic blood pressure,24-hour ambulatory mean systolic and diastolic blood pressure.

Objective To analyze the mediation effect of self-efficacy and mental toughness between self-management behavior and postoperative rehabilitation in patients with cervical spondylotic radiculopathy.Methods A total of 180 patients with cervical spondylotic radiculopathy diagnosed and treated in the First Hospital ofNanchang from April 2022 to April 2024 were selected by convenience sampling method.The patients were investigated by general data questionnaire,Connor-Davidson resilience scale(CD-RISC),chronic disease self-efficacy scale(CDES),rehabilitation evaluation scale for cervical spondylotic radiculopathy(RES-CSR)and chronic disease self-management scale(CDSMS).Results The scores of CD-RISC,RES-CSR,CDES and CDSMS were(64.41±10.12)points,(78.84±12.07)points,(41.26±3.18)points and(53.14±6.38)points respectively.The results of correlation analysis showed that postoperative rehabilitation was significantly positively correlated with mental toughness,self-efficacy and self-management,self-management was significantly positively correlated with mental toughness and self-efficacy,mental toughness was significantly positively correlated with self-efficacy(P＜0.05).Mental toughness and self-efficacy played a mediating role in the relationship between self-management and postoperative rehabilitation of patients with cervical spondylotic radiculopathy,and the mediating effect value was 0.270 and 0.136.The two continuous paths had a chain mediating effect,and the mediating effect value was 0.150,accounting for 18.70％,9.42％and 10.39％of the total effect value,respectively.Conclusion The self-management behavior of patients with cervical spondylotic radiculopathy has an important impact on their postoperative rehabilitation,in which mental toughness and self-efficacy play a chain intermediary role.Nursing intervention can enhance the self-management behavior and mental toughness of patients with cervical spondylotic radiculopathy and improve their self-efficacy,so as to improve their postoperative rehabilitation level.

Objective To analyze the mediation effect of self-efficacy and mental toughness between self-management behavior and postoperative rehabilitation in patients with cervical spondylotic radiculopathy.Methods A total of 180 patients with cervical spondylotic radiculopathy diagnosed and treated in the First Hospital ofNanchang from April 2022 to April 2024 were selected by convenience sampling method.The patients were investigated by general data questionnaire,Connor-Davidson resilience scale(CD-RISC),chronic disease self-efficacy scale(CDES),rehabilitation evaluation scale for cervical spondylotic radiculopathy(RES-CSR)and chronic disease self-management scale(CDSMS).Results The scores of CD-RISC,RES-CSR,CDES and CDSMS were(64.41±10.12)points,(78.84±12.07)points,(41.26±3.18)points and(53.14±6.38)points respectively.The results of correlation analysis showed that postoperative rehabilitation was significantly positively correlated with mental toughness,self-efficacy and self-management,self-management was significantly positively correlated with mental toughness and self-efficacy,mental toughness was significantly positively correlated with self-efficacy(P＜0.05).Mental toughness and self-efficacy played a mediating role in the relationship between self-management and postoperative rehabilitation of patients with cervical spondylotic radiculopathy,and the mediating effect value was 0.270 and 0.136.The two continuous paths had a chain mediating effect,and the mediating effect value was 0.150,accounting for 18.70％,9.42％and 10.39％of the total effect value,respectively.Conclusion The self-management behavior of patients with cervical spondylotic radiculopathy has an important impact on their postoperative rehabilitation,in which mental toughness and self-efficacy play a chain intermediary role.Nursing intervention can enhance the self-management behavior and mental toughness of patients with cervical spondylotic radiculopathy and improve their self-efficacy,so as to improve their postoperative rehabilitation level.

Objective·To investigate the association of serum osteoglycin(OGN)levels with renal function and blood pressure in non-diabetic patients with hypertension.Methods·Hypertensive patients without a diagnosis of diabetes mellitus were recruited from the Hypertension Department of Ruijin Hospital,Shanghai Jiaotong University School of Medicine.A total of 36 renal dysfunction patients(renal dysfunction group)and 38 normal renal function patients(normal renal function group),matched for age,gender and clinic blood pressure,were included in this study.Serum OGN concentrations were measured by the enzyme-linked immunosorbent assay(ELISA).Estimated glomerular filtration rate(eGFR)was calculated from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI)equation.The serum OGN levels were compared between the renal dysfunction group and the normal renal function group.The correlations of serum OGN level with eGFR and blood pressure were analyzed.Results·There was no significant statistical difference in serum OGN levels between the renal dysfunction group and the normal renal function group(P=0.708).Serum OGN levels were not significantly associated with eGFR(P=0.952).In the renal dysfunction group,mean arterial pressure,age and current smoking status were relevant factors of serum OGN levels(P<0.05).After adjustment for confounders,serum OGN levels were independently associated with clinic systolic and diastolic blood pressure,24-hour ambulatory mean systolic and diastolic blood pressure in the renal dysfunction group(P<0.05),but not in the normal renal function group(P?0.05).Conclusion·In non-diabetic patients with hypertension,serum OGN levels are not significantly associated with eGFR.In patients with renal dysfunction,higher serum OGN levels are independently associated with higher clinic systolic blood pressure,clinic diastolic blood pressure,24-hour ambulatory mean systolic and diastolic blood pressure.

Scientific and rigorous selection of theories,models or frameworks is the premise of high-quality nursing research.This work introduces the development process,basic information,application in nursing of T-CaST(Theory Comparison and Selection Tool,T-CaST),and shows the specific application process of this tool through examples,to provide evaluation methods for nursing scholars to choose appropriate guiding theories in the research process,and has guiding significance for developing high-quality nursing research under the guidance of theories,models or frameworks.

Objective: This study uses structural magnetic resonance imaging to explore changes in the cerebellar lobules in patients with autism spectrum disorder (ASD) and further analyze the correlation between cerebellar structural changes and clinical symptoms of ASD. Methods: A total of 75 patients with ASD and 97 typically developing (TD) subjects from Autism Brain Imaging Data Exchange dataset were recruited. We adopted an advanced automatic cerebellar lobule segmentation technique called CEREbellum Segmentation to segment each cerebellar hemisphere into 12 lobules. Normalized cortical thickness of each lobule was recorded, and group differences in the cortical measures were evaluated. Correlation analysis was also performed between the normalized cortical thickness and the score of Autism Diagnostic Interview-Revised. Results: Results from analysis of variance showed that the normalized cortical thickness of the ASD group differed significantly from that of the TD group; specifically, the ASD group had lower normalized cortical thickness than the TD group. Post-hoc analysis revealed that the differences were more predominant in the left lobule VI, left lobule Crus I and left lobule X, and in the right lobule VI and right lobule Crus I. Lowered normalized cortical thickness in the left lobule Crus I in the ASD patients correlated positively with the abnormality of development evident at or before 36 months subscore. Conclusion These results suggest abnormal development of cerebellar lobule structures in ASD patients, and such abnormality might significantly influence the pathogenesis of ASD. These findings provide new insights into the neural mechanisms of ASD, which may be clinically relevant to ASD diagnosis.

Hypertension significantly increases the risk of embolic stroke and systemic embolism in patients with atrial fibrillation, while statin therapy can improve long-term outcomes in hypertensive patients at high risk. However, it is still unclear whether patients with both hypertension and atrial fibrillation can benefit from intensive management of blood pressure and cholesterol. IMPRESSION is a 3-year prospective, randomized, open-label, blinded-endpoint investigation. A total of 1200 hypertensive patients with atrial fibrillation from about 40 clinical centers nationwide will be included upon confirming the presence of both hypertension and atrial fibrillation and will be randomly assigned to groups for intensive or standard management of blood pressure and cholesterol. Patients in all groups will have office and home blood pressure measured by the end of the first month and every 3 months thereafter. The effects of blood pressure and cholesterol management strategies in patients with hypertension and atrial fibrillation on fatal and non-fatal stroke, acute myocardial infarction, and cardiovascular death at 3 years will be assessed. The IMPRESSION study protocol has received approval from the Ethics Committee of Ruijin Hospital, Shanghai Jiaotong University School of Medicine. The procedures set out in this protocol are in accordance with the principles of the Declaration of Helsinki and Good Clinical Practice guidelines. The results will be published following the CONSORT statement in a peer-reviewed scientific journal (Trial registration number: NCT04111419).

Hypertension significantly increases the risk of embolic stroke and systemic embolism in patients with atrial fibrillation, while statin therapy can improve long-term outcomes in hypertensive patients at high risk. However, it is still unclear whether patients with both hypertension and atrial fibrillation can benefit from intensive management of blood pressure and cholesterol. IMPRESSION is a 3-year prospective, randomized, open-label, blinded-endpoint investigation. A total of 1200 hypertensive patients with atrial fibrillation from about 40 clinical centers nationwide will be included upon confirming the presence of both hypertension and atrial fibrillation and will be randomly assigned to groups for intensive or standard management of blood pressure and cholesterol. Patients in all groups will have office and home blood pressure measured by the end of the first month and every 3 months thereafter. The effects of blood pressure and cholesterol management strategies in patients with hypertension and atrial fibrillation on fatal and non-fatal stroke, acute myocardial infarction, and cardiovascular death at 3 years will be assessed. The IMPRESSION study protocol has received approval from the Ethics Committee of Ruijin Hospital, Shanghai Jiaotong University School of Medicine. The procedures set out in this protocol are in accordance with the principles of the Declaration of Helsinki and Good Clinical Practice guidelines. The results will be published following the CONSORT statement in a peer-reviewed scientific journal (Trial registration number: NCT04111419).

To explore the immunomodulatory effects of interleukin-17 (IL-17) on acute lung injury (ALI) induced by lipopolysaccharide (LPS). Methods Thirty-six SPF-class C57BL/6 mice were divided into normal saline control group (NS group) and LPS-induced ALI model group (LPS group, LPS 5 mg/kg intratracheal drip) according to random number table method, with 18 mice in each group. Six mice were sacrificed at 2, 6 and 24 hours after model reproduction, and peripheral blood, lung and spleen tissues were harvested. After staining with hematoxylin-eosin (HE), the pathological changes of lung tissue were observed under microscope and the infiltration level of lymphocytes, neutrophils and macrophages in the alveolar wall and tracheal wall were detected. Immunohistochemistry was used to detect the protein expression of IL-17 in alveolar wall and tracheal wall, and the correlation between IL-17 expression and lymphocytes, neutrophils and macrophages infiltration in alveolar wall and tracheal wall were analyzed. The level of IL-17 in lung tissue homogenate was determined by enzyme linked immunosorbent assay (ELISA). Flow cytometry was used to detect the proportion of CD4+IL-17+ helper T cells (Th17 cells) in CD4+ T cells in peripheral blood, lung tissue and spleen tissue. Results ① Microscopy showed that the lung tissue structure of NS group was basically normal at each time after model reproduction, and there was no obvious inflammatory cell infiltration, while the lung tissue edema and inflammatory reaction were gradually aggravated in the LPS group, and the lung injury score was significantly higher than that in NS group at each time (2 hours: 4.47±1.42 vs. 1.10±0.55, 6 hours: 7.93±2.14 vs. 1.23±0.50, 24 hours:12.67±2.67 vs. 1.20±0.61, all P < 0.01). ② Immunohistochemistry showed that the protein expression of IL-17 in alveolar wall and tracheal wall of LPS group increased gradually with time, while that in NS group was negative or weak positive. Quantitative analysis showed that the immunohistochemical staining score of IL-17 protein in alveolar wall and tracheal wall of LPS group were higher than those of NS group (alveolar wall: 2.70±1.40 vs. 0.90±0.37 at 2 hours, 5.10±1.76 vs. 1.17±0.59 at 6 hours, 9.67±1.32 vs. 1.10±0.45 at 24 hours; tracheal wall: 2.87±0.89 vs. 0.90±0.39 at 2 hours, 4.97±1.48 vs. 1.10±0.41 at 6 hours, 8.67±1.54 vs. 1.03±0.29 at 24 hours; all P < 0.05). ③ Correlation analysis showed that the protein expression of IL-17 in alveolar wall and tracheal wall were positively correlated with the degree of lymphocyte, neutrophil and macrophage infiltration (alveolar wall: r value was 0.632, 0.550, 0.466; tracheal wall: r value was 0.695, 0.662, 0.575, respectively; all P < 0.01). ④ IL-17 content (μg/L) in lung tissue homogenate was significantly higher than that in NS group at each time after model reproduction (2 hours: 1.37±0.14 vs. 1.01±0.18, 6 hours: 1.65±0.19 vs. 1.11±0.18, 24 hours: 1.92±0.36 vs. 1.17±0.24, all P < 0.01). ⑤ The proportion of Th17 cells in the peripheral blood, lung tissue and spleen tissue of the LPS group were higher than those of the NS group at each time after model reproduction [peripheral blood: (2.62±0.62)% vs. (1.42±0.40)% at 2 hours, (3.74±0.43)% vs. (1.27±0.32)% at 6 hours, (4.44±0.65)% vs. (1.59±0.45)% at 24 hours; lung tissue: (2.32±0.44)% vs. (1.50±0.25)% at 2 hours, (3.66±0.36)% vs. (1.33±0.24)% at 6 hours, (4.60±0.54)% vs. (1.60±0.27)% at 24 hours; spleen tissue: (1.49±0.36)% vs. (0.69±0.21)% at 2 hours, (2.58±0.55)% vs. (0.59±0.18)% at 6 hours, (3.76±0.57)% vs. (0.65±0.26)% at 24 hours; all P < 0.01]. Conclusion IL-17 is involved in the inflammatory immune regulation of ALI mice.