Objective:To explore the developmental trajectory and influencing factors of self-management behavior among stroke patients.Methods:A total of 478 ischemic stroke patients admitted to the department of neurology of a grade-Ⅲ hospital in Henan Province from July 2023 to June 2024 were selected as the investigation objects. Baseline data of patients were collected using the general situation questionnaire, stroke knowledge questionnaire, stroke health belief scale, stroke self-management behavior scale and self-rating depression scale. The self-management behavior level of patients was assessed at discharge, 1 month, 3 months and 6 months after discharge. Mplus 7.0 software was used to conduct trajectory analysis of stroke patients' self-management behaviors, and multiple Logistic regression analysis was used to analyze the influencing factors associated with the development trajectory types of different stroke self-management behaviors.Results:The self-management behavior scores of stroke patients at discharge, 1 month, 3 months and 6 months after discharge were 206.59(167.59, 230.57), 169.59(129.73, 196.73), 149.82(120.89, 171.48), and 147.14(123.02, 181.64), respectively. Four trajectory categories were described. Category 1 was low-level pattern of initial decrease followed by stabilization, accounting for 16.95%(81/478)( P<0.001, intercept=2.701). Category 2 was low-level pattern of initial decrease followed by increase, accounting for 12.97%(62/478)( P<0.001, intercept =2.696). Category 3 was medium-level pattern of initial decrease followed by stabilization, accounting for 57.11%(273/478)( P<0.001, intercept =3.829). Category 4 was high-level pattern of initial decrease followed by increase, accounting for 12.97%(62/478)( P<0.001, intercept=4.366). The self-management behavior of stroke patients with low level of stroke knowledge, low level of health belief, aged 60 to 70 years old, residence in rural areas and middle school and below education level were more likely to belong to the low level group(all P<0.05). Patients with low depression in the low level group were more likely to be classified as low-level pattern of initial decrease followed by increase( P<0.05). Conclusion:The trajectory category of self-management behavior could be predicted by stroke knowledge level, health belief level, age, place of residence, educational background and depression. Their self-management behavior level may be improved through targeted interventions according to the characteristics of different trajectory categories.

Objective:To explore the developmental trajectory and influencing factors of self-management behavior among stroke patients.Methods:A total of 478 ischemic stroke patients admitted to the department of neurology of a grade-Ⅲ hospital in Henan Province from July 2023 to June 2024 were selected as the investigation objects. Baseline data of patients were collected using the general situation questionnaire, stroke knowledge questionnaire, stroke health belief scale, stroke self-management behavior scale and self-rating depression scale. The self-management behavior level of patients was assessed at discharge, 1 month, 3 months and 6 months after discharge. Mplus 7.0 software was used to conduct trajectory analysis of stroke patients' self-management behaviors, and multiple Logistic regression analysis was used to analyze the influencing factors associated with the development trajectory types of different stroke self-management behaviors.Results:The self-management behavior scores of stroke patients at discharge, 1 month, 3 months and 6 months after discharge were 206.59(167.59, 230.57), 169.59(129.73, 196.73), 149.82(120.89, 171.48), and 147.14(123.02, 181.64), respectively. Four trajectory categories were described. Category 1 was low-level pattern of initial decrease followed by stabilization, accounting for 16.95%(81/478)( P<0.001, intercept=2.701). Category 2 was low-level pattern of initial decrease followed by increase, accounting for 12.97%(62/478)( P<0.001, intercept =2.696). Category 3 was medium-level pattern of initial decrease followed by stabilization, accounting for 57.11%(273/478)( P<0.001, intercept =3.829). Category 4 was high-level pattern of initial decrease followed by increase, accounting for 12.97%(62/478)( P<0.001, intercept=4.366). The self-management behavior of stroke patients with low level of stroke knowledge, low level of health belief, aged 60 to 70 years old, residence in rural areas and middle school and below education level were more likely to belong to the low level group(all P<0.05). Patients with low depression in the low level group were more likely to be classified as low-level pattern of initial decrease followed by increase( P<0.05). Conclusion:The trajectory category of self-management behavior could be predicted by stroke knowledge level, health belief level, age, place of residence, educational background and depression. Their self-management behavior level may be improved through targeted interventions according to the characteristics of different trajectory categories.

[Objective]To excavate the medical affairs in the letters of ZHAO Mengfu,an artist in the Song and Yuan Dynasties.[Methods]Based on the method of historical literature research and text analysis,this paper sorts the letters according to the chronological order by referring to the existing documents,summarizes the contents of traditional Chinese medicine and analyzes the corresponding causes,prescriptions and curative effects of ZHAO Mengfu's different diseases,as well as the social medical treatment at that time.Through the interpersonal and personal exchanges between ZHAO Mengfu and his relatives and friends recorded in the letters,this paper explores the literates and rulers'views on medicine in the Song and Yuan dynasties.[Results]ZHAO Mengfu had many illnesses during his life,and he had excellent medical quality.He could not only diagnose and prescribe prescriptions by himself according to the symptoms of the disease,but also give medication suggestions to his relatives and friends.In addition,he exchanged prescriptions with his relatives and friends,and gave each other healthy medicine and food.It proved that the people of Song and Yuan Dynasties would prevent and treat diseases through food therapy,and it showed the social custom of the Confucian scholarian-bureaucrats in practicing medicine and the political attitude of the rulers to pay attention to medicine.[Conclusion]ZHAO Mengfu's letters,as real historical materials,provide new insights into the study of traditional Chinese medicine culture.

【Objective】 To investigate the mechanism of pristane inducing autophagy in macrophages. 【Methods】 Pristane was used to stimulate NR8383， a rat macrophage cell line. The changes in signaling pathways of AMPK， mTOR， and endoplasmic reticulum （ER） stress pathways including eIF2α and IRE1α in the cell model， as well as the expression of transcriptional factor TFEB and its translocation to the nucleus， were detected by using Western blotting. ER stress pathways were intervened by using an inducer DTT or an inhibitor 4-PBA to determin its effect on mTOR expression and autophay. 【Results】 In pristane-stimulated NR8383 cell model， ER stress pathway eIF2α was activated at 0.5 h after stimulation， and then mTOR expression was decreased at 1 and 3 h after stimulation. There was no change for AMPK and IRE1α pathways. With 4-PBA treatment， pristane-reduced mTOR expression and increased LC3-II were reversed， while with DTT treatment， mTOR expression decreased and LC3-II expression increased even more. Pristane induced the expression and activation of TFEB in NR8383 cells. 【Conclusion】 Pristane induces ER stress and leads to autophagy enhancement in rat macrophages.

Objective To investigate the effect of supine regulating on maternal fetal occiput posterior position during the delivery after epidural analgesia. Methods Totally600 cases of parturient with intravaginal posterior occipital position with 3cm voluntary labor analgesia were selected,who were born in Dalian maternity hospital from October 2015 to October 2016.The(Visual Analogue Scale/Score) VAS pain score at 15min after epidural labor analgesia was as effective as less than 3 points.They were randomly divided into the control group and the observation group by random number table method,with 300 cases in each group.The control group monitored parturient respiration, pulse, blood pressure, heart rate and fetal heart rate according to routine treatment.The control group monitored parturient respiration, pulse, blood pressure, heart rate and fetal heart rate according to routine treatment.In the observation group,except for routine treatment according to the labor process,after the opening of 5cm,the pregnant women were instructed to take the lateral prone position,so that the maternal side and the fetal side of the spinal column should be the same side. To observe the difference between the two groups in the rate of spontaneous vaginal delivery, delivery rate, cesarean section rate, fetal cardioversion rate, time of birth process and neonatal Apgar score. Results Totally 283 cases delivery through vagina and 17 cases of cesarean section in observation group,while 257 cases of vaginal delivery and 43 cases of cesarean section in the control group.The successful rate of fetal position transfer in the observation group was 74.6%(211/283) which was significantly higher than 45.9% (118/257) of the control group (Χ2=62.782, P<0.01), natural labor rate was also 87.3% (262/300) which increased significantly according to 64.7% (194/300) (Χ2=42.251, P<0.01),the rate of midwifery (7.0%, 21/300) and cesarean section (5.7%, 17/300) were significantly lower than 21.0% (63/300)and 14.3% (43/300) of the control group (Χ2=24.419, 12.519,P<0.01),the second stage of labor was(1.60±0.56)h which was significantly shortened than(2.19±0.53)h also(t=-12.589,P<0.01).In the observation group, the ratio of the posterior occipital position to the occipital transverse position after the opening of 8-10 cm and the complete dilation of the cervical were 7.4%(21/283)and 13.1%(37/283),which were also significantly increased than 3.4%(9/264),6.8%(18/264) of the control group (Χ2=4.240, 5.911, P<0.05). Conclusions Supine adjustment after the cervix dilatation larger than 5cm is more conducive to fetal rotation and to avoid the adverse complications, reduce the rate of vaginal delivery and cesarean section rate,improve the rate of natural childbirth,shorten delivery time,improve the quality of delivery.

Objective On the basis of theory research, tostrengthen the motivation of benevolence effectively and take the initiative to practice the behavior of benevolence among nursing baccalaureate students, combining with the law of behavior transformation, the author designed and applied "nursing benevolence behavior cultivation program based on field theory". Methods The questionnaire of nursing undergraduates' benevolence behavior based on field theory , interview, observation, interview and reflective journal were designed by our team. Results Of the five dimensionality evaluation indexes, there was no significant difference in the scores between the five dimensions except the field theory (P > 0.05). The"cognitive field theory","belief field theory","self field theory"and"group field theory"were (24.74 ± 2.36), (40.34 ± 4.32), (44.84 ± 4.17), (81.30 ± 8.15) points before cultivation, (25.74 ± 3.37), (42.46 ± 4.19), (46.26 ± 3.97), (82.64 ± 9.60) points during cultivation, (26.65 ± 3.93), (44.47 ± 4.46), (47.78 ± 5.20), (85.78 ± 7.20) points after cultivation, and there were significant differences (F=5.597-16.928, P<0.01). Conclusions The nursing benevolence behavior cultivation scheme based on the field theory is beneficial to the nursing baccalaureate students' benevolence behavior development.

In the context of "big health, big medicine and big medicine", the relationship of medical and humanities have drawn the attention of the medical world again. For the present, how to develop humanistic care and nursing care behavior is the key point of this study. Nursing care behavior acts as an integral part of nursing work, need spiritual implantation, deepen understanding, continuous training and pragmatic practice. Therefore, the designation of "Benevolence and Faith" in the process of nursing should integrate the "Field Theory" of psychology, which focus on the benevolence and faith cultivation during the practice of nursing care behavior. It is necessary to identify the similar cultivation meaning of "benevolence" and "field" behind different manifestations. Consequently, the logical starting point of nursing care behavior could be identified.

Objective To detect the changes of G protein-coupled inwardly rectifying potassium channels (GIRK)expression in allergic asthma model and identify the regulatory factors.Methods The E3 rat asthma models were induced by challenge with ovalbumin 14 days after immunization with ovalbumin and aluminium adjuvant.The asthma models were evaluated based on changes in lung pathomorphology and total IgE levels.The levels of GIRK1-4 mRNA and protein were detected using real time-PCR and Western blot.The anatomic sites where GIRK was expressed dominantly in the lung were identified using immunohistological staining.To identify the effects of IL-4 on the expressions of GIRK channels,GIRK 1 -4 mRNA and protein in IL-4 stimulated bronchial epithelial cell line A549 were detected by RT-PCR and Western blot.Results The levels of GIRK1-4 mRNA and protein decreased significantly in the lung in asthmatic E3 rats.The results of immunohistological staining showed that GIRK channels were dominantly expressed in airway epithelia in the lung.The levels of GIRK 1-4 mRNA and protein were down-regulated in time-and dose-dependent manners in IL-4 treated A549.Conclusion IL-4 down-regulates the expression levels of GIRK subunits in bronchial epithelia during allergic asthma.

[ABSTRACT]AIM:Toexplorethedevelopmentofhepaticsinusoidalcapillarizationintheearlystageofliverfi-brosis induced by carbon tetrachloride (CCl4) in rats.METHODS:Clean SD rats were randomly divided into normal con-trol group (group N, n=6) and liver fibrotic model group (group M, n=32).The rats in group N were intraperitoneal in-jected with saline and the rats in group M were intraperitoneal injected with CCl 4(2 mL/kg, twice a week for 4 weeks).At the end of the 3rd day and the 1st, 2nd and 4th weeks, all rats were killed and then the samples were collected .The patho-logical changes in the livers were observed by HE staining and Masson straining .The development of hepatic sinusoidal capillarization was observed by transmission electron microscopy (TEM) and immunohistochemical staining .The cell sur-face expression of vascular endothelium-associated marker CD31, collagen type Ⅳ(Col IV) and laminin (LN) was deter-mined.RESULTS:HE and Masson staining showed the formation of liver fibrosis after treatment with CCl 4 for 4 weeks. TEM showed that the fenestrate diameter of liver sinusoidal endothelial cells (LSECs) grew down, the fenestrate numbers of LSECs were decreased along with the development of liver fibrosis , and the consecutive basement membrane was formed at the end of the experiment .The expression of CD31 was significantly increased along with the development of defenestration , and the expression of Col IV and LN was significantly increased after the treatment with CCl 4 for 2 weeks and 4 weeks , re-spectively .CONCLUSION:The typical hepatic sinusoidal capillarization was detected in the early stage of liver fibrosis , and the deposition of LN in the liver sinusoidal walls was the mainly factor of formation of the consecutive basement mem -brane .

Objective To observe the effect of proanthocyanidin on the expression of nuclear factor kappa B (NF-кB) and interleukin-6 (IL-6) in rats with spinal cord injury (SCI). Methods 36 healthy adult Sprague-Dawley rats were randomly divided into proanthocyanidin treatment group (group A, n=12), methylprednisolone (MP) treatment group (group B, n=12) and model control group (group C, n=12). Allen's method was used to establish the model of acute spinal cord injury in T9. On the 1st, 3rd and 7th days after operation, 4 rats in each group were assessed with Basso-Beattie-Bresnahan (BBB) scale and Slanting Board Test (SBT), and the expression of NF-кB and IL-6 of the spinal cord were detected with immunohistochemistry. Results The scores of BBB and SBT were better in groups A and B than in the group C 3 and 7 days after SCI (P<0.05). Compared with group C, the expression of NF-кB in group A decreased all the time after SCI (P<0.01), and 3 and 7 days after SCI in group B (P<0.01); while the expression of IL-6 decreased all the time after SCI in groups A and B (P<0.05). Conclusion Proanthocyanidin may inhibit the expression of NF-кB and IL-6 in spinal cord after SCI in order to reduce inflammation and improve the hindlimb motor function in rats after SCI.