BACKGROUND:Transcranial magneto-acoustic-electrical stimulation is a novel non-invasive neural regulation technique that utilizes the induced electric field generated by the coupling effect of ultrasound and static magnetic field to regulate the discharge activity of the nervous system.However,the mechanism by which it affects synaptic plasticity in the brain is still not enough. OBJECTIVE:To explore the effect of transcranial magneto-acoustic-electrical stimulation intensity on synaptic plasticity of the prefrontal cortex neural network in mice. METHODS:(1)Animal experiment:Twenty-four C57 mice were equally and randomly divided into four groups:the control group receiving pseudo-stimulation,the 6.35 W/cm2 stimulation group receiving coupled stimulation of 0.3 T,6.35 W/cm2,the 17.36 W/cm2 stimulation group receiving coupled stimulation of 0.3 T,17.36 W/cm2,and the 56.25 W/cm2 stimulation group receiving coupled stimulation of 0.3 T,56.25 W/cm2.The local field potential signals and behavioral correctness were recorded during the execution of T-maze in mice.(2)Modeling and simulation experiments:A neural network model of the prefrontal cortex in mice stimulated by transcranial magneto-acoustic-electrical stimulation was constructed to compare the structural connectivity characteristics of the neural network under different stimulation intensities. RESULTS AND CONCLUSION:Transcranial magneto-acoustic-electrical stimulation could effectively shorten the behavior learning time,improve the working memory ability of mice(P＜0.05),and continue to stimulate the frontal lobe of mice after learning behavior.There was no significant difference in the accuracy of the T-maze behavioral experiment among the experimental groups(P＞0.1).Analysis of local field potential signals in the frontal lobe of mice revealed that transcranial magneto-acoustic-electrical stimulation promoted energy enhancement of β and γ rhythms.As the stimulation intensity increased,there was an asynchronous decrease in β and γ rhythms.Through β-γ phase amplitude coupling,it was found that stimuli could enhance the neural network's ability to adapt to new information and task requirements.Modeling and simulation experiments found that stimulation could enhance the discharge level of the neural network,increase the long-term synaptic weight level,and decrease the short-term synaptic weight level only when the stimulation intensity was high.To conclude,there is a complex nonlinear relationship between different stimulus intensities and the functional structure of neural networks.This neural regulation technique may provide new possibilities for the treatment of related neurological diseases such as synaptic dysfunction and neural network abnormalities.

Objective:To analyze the research hotspots of self-management in patients with chronic obstructive pulmonary disease (COPD) at home and abroad.Methods:Related literature on self-management of COPD patients were searched in China National Knowledge Infrastructure and Web of Science databases, and the searched period was from January 1, 2013 to June 30, 2023. CiteSpace 5.8 software was used for keyword cluster analysis.Results:A total of 641 articles in Chinese and 1 192 in English were obtained. Domestic research hotspots about self-management of COPD patients mainly focused on health education, continuing care, rehabilitation care, etc. Foreign research hotspots about self-management of COPD patients mainly focused on mobile health, telemedicine and so on.Conclusions:This paper analyzes the research hotspots of self-management of COPD patients at home and abroad and provides reference for future research on self-management of COPD patients.

Objective:To retrieve, evaluate, and summarize the best domestic and international evidence on non-pharmacological management of sleep disorders in breast cancer patients undergoing chemotherapy, providing evidence-based guidance for healthcare professionals to conduct standardized assessment and management of sleep disorders in these patients.Methods:Clinical questions were translated into evidence-based questions using the PIPOST model. A systematic search of domestic and international databases and professional association websites was conducted for literature related to non-pharmacological management of sleep disorders in breast cancer patients undergoing chemotherapy, including clinical decisions, evidence summaries, guidelines, and systematic reviews. The search covered publications up to December 17, 2022. Two researchers trained in evidence-based nursing independently completed the quality assessment, evidence extraction, and summary of the included literature.Results:A total of 16 publications were included, comprising two clinical decisions, one evidence summary, five guidelines, six systematic reviews, and two randomized controlled studies. The best evidence was summarized from seven aspects: multidisciplinary collaboration, identification of risk factors, assessment and monitoring, referral, psychological behavioral interventions, exercise management, and complementary therapies, resulting in 25 key recommendations.Conclusions:This study summarizes the current best evidence for non-pharmacological management of sleep disorders in breast cancer patients undergoing chemotherapy. Healthcare professionals can follow these best evidence practices to standardize the assessment of patient sleep disorder symptoms and choose appropriate intervention plans based on clinical context and patient preferences, thereby improving patient sleep quality.

Objective:To explore the latent profile types of capability-opportunity-motivation-behavior in stroke patients and analyze the influencing factors of different latent profiles.Methods:From January to October 2023, totally 596 stroke patients from the Neurology Department of five ClassⅢ Grade A hospitals in Henan Province were selected by stratified random sampling. The patients were surveyed using a general information questionnaire, the Stroke Prevention Knowledge Questionnaire (SPKQ), the Social Support Rating Scale (SSRS), the WHO's Quality of Life Questionnaire- Brief Version (WHOQOL-BREF), the Short Form Health Belief Model Scale (SF-HBMS), and the Health Promoting Lifestyle ProfileⅡ (HPLPⅡ). Latent profile analysis was used to classify the capability-opportunity-motivation-behavior characteristics of stroke patients, and multiple logistic regression was conducted to explore the influencing factors of different latent profiles.Results:Three latent profiles of capability-opportunity-motivation-behavior in stroke patients were identified, including low capability-opportunity-motivation-behavior with high health beliefs (32.4%, 193/596), moderate capability-opportunity-motivation-behavior with insufficient health beliefs (47.5%, 283/596), and high capability-opportunity-motivation-behavior with lack of social support (20.1%, 120/596). Multiple logistic regression analysis showed that educational level, smoking history, family history, body mass index, and Charlson Comorbidity Index score were influencing factors of different latent profiles ( P<0.05) . Conclusions:Stroke patients exhibit distinct classifications of capability-opportunity-motivation-behavior. Targeted interventions should be conducted based on the characteristics of each category to improve health behavior management outcomes in patients.

Objective:To explore the mediating effect of rumination between self-perceived burden (SPB) and stigma in stroke patients, so as to provide theoretical basis for the development of targeted nursing interventions in clinical practice.Methods:In September 2022, cluster sampling was used to select 1 126 stroke patients admitted to Department of Neurology of five ClassⅢ Grade A hospitals in Henan Province as subjects. General Information Questionnaire, Self-Perceived Burden Scale (SPBS), Stroke Stigma Scale (SSS), and Chinese Version of Event Related Rumination Inventory (C-ERRI) were used to investigate stroke patients. Pearson correlation analysis was used to explore the correlation between SPB, rumination, and stigma. AMOS 28.0 software was used to establish the structural equation model, and Bootstrap method was used to test the mediating effect.Results:A total of 1 126 questionnaires were distributed, and 1 026 valid questionnaires were collected, with a valid response rate of 91.12% (1 026/1 126). SPBS score of 1 026 stroke patients was (28.68±8.32), the SSS score was (40.53±9.48) and the C-ERRI score was (25.43±12.62). Pearson correlation analysis showed that SPB in stroke patients was positively correlated with stigma and rumination ( P<0.01), and rumination was positively correlated with stigma ( P<0.01). Bootstrap mediating effect test showed that rumination partially mediated the relationship between SPB and stigma in stroke patients, accounting for 55.15% of the total effect. Conclusions:SPB of stroke patients both directly affect stigma and indirectly affect stigma through rumination. Clinical nursing workers should promptly evaluate patients' SPB, pay attention to the mediating role of rumination, develop effective psychological intervention programs, implement personalized and targeted nursing measures, relieve patients' stigma, and improve treatment and rehabilitation compliance.

Objective:To understand the research status and hotspots in the field of stroke health management at home and abroad, and to provide insights for stroke health management research in China.Methods:Relevant literature on stroke health management published between 2013 and 2023 was retrieved from the Web of Science Core Collection and China National Knowledge Infrastructure databases. CiteSpace 6.1.R6 was used for the visual analysis of the number of publications, authors, institutions, countries, and keywords.Results:A total of 382 relevant articles were included, with 169 in English and 213 in Chinese. The number of publications on stroke health management showed a fluctuating upward trend. Research hotspots and frontiers in stroke health management mainly focused on telemedicine, big data and "Internet+", primary and secondary prevention, risk prediction models, quality of life, and swallowing disorders. Future research trends may focus on management models for post-stroke swallowing disorders, risk identification, and the role of caregivers in remote rehabilitation interventions.Conclusions:Researchers can refer to the research hotspots and trends shown by the visual analysis, with particular attention to health management models for patients with post-stroke swallowing disorders and issues related to remote intervention rehabilitation.

Objective To investigate the risk factors of recurrent stroke in IS patients with CHF.Methods A total of 235 elderly IS patients with CHF admitted to Northern Jiangsu People's Hospital from January 2021 to January 2023 were enrolled in this study.According to LVEF clas-sification,they were divided into reduced ejection fraction HF group(HFrEF,LVEF＜40％,80 patients),intermediate ejection fraction HF group(HFmrEF,40％≤LVEF＜50％,57 patients),and preserved ejection fraction HF group(HFpEF,LVEF≥50％,98 patients).After all of them were followed up for 12 months,the patients with recurrent IS were assigned into the recurrent IS group(42 patients)and those without into the non-recurrent IS group(193 patients).Their gener-al data,laboratory results,clinical endpoint events and other indicators were compared in the above groups.Multivariate logistic regression analysis was applied to identify the related risk fac-tors for recurrent stroke in elderly patients with CHF and IS.Results There were significant differences in women ratio,age,history of smoking and drinking,peripheral vascular disease,RBC count,hemoglobin,hematocrit,LDL-C,prothrombin time,international standardized ratio,BNP,LVEF,LVEDD and LVESD among the three groups(P＜0.05,P＜0.01).The recurrent IS group had obviously larger proportion of diabetes mellitus,longer thrombin time,and larger LAD and RAD when compared with the non-recurrent IS group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that diabetes(OR=0.251,95％CI:0.1 96-1.494,P=0.031)and LAD(OR=1.085,95％CI:1.008-1.169,P=0.031)were independent risk factor for recurrent stroke in elderly patients with CHF and IS.There were no significant differences in follow-up period and incidence of clinical endpoints among the three groups(P＞0.05).Conclusion Diabetes and LAD are independent risk factors for recurrent IS in elderly CHF patients with IS.

Objective To investigate the clinical features and related risk factors of chronic heart failure(CHF)patients with ischemic stroke.Methods A total of 153 elderly CHF patients with-out atrial fibrillation(AF)/atrial flutter(AFL)admitted in our hospital from January 2021 to January 2023 were enrolled,and according to diagnosis,they were divided into CHF group(84 cases)and ischemic stroke group(69 cases,CHF+ischemic stroke).General information,medical history and auxiliary examination indicators were collected.All of them were followed up for 6 months.SPSS statistical software was used to analyze the data of the 2 groups of patients,and the risk factors related to ischemic stroke were identified.Results Significant differences were observed in terms of age,hypertension,diabetes,partial thromboplastin time,left atrial diameter,left ventricular ejection fraction,right ventricular diameter,left ventri-cular end-systolic diameter,left ventricular end-diastolic diameter,CHF classification,thrombosis risk(CHA2DS2-VASc)score,HAS-BLED score,and usage of antiplatelet agents between the two groups(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that CHA2DS2-VASc score(OR=2.471,95％CI:1.356-4.502,P=0.003)and HAS-BLED score(OR=6.626,95％CI:2.049-21.432,P=0.002)were independent risk factors for ischemic stroke.ROC curve analysis indicated that the AUC value of CHA2DS2-VASc score and HAS-BLED score in predicting ischemic stroke in elderly CHF patients without AF/AFL was 0.936(95％CI:0.898-0.975,P＜0.01)and 0.922(95％CI:0.880-0.964,P＜0.01),respectively.Conclusion High CHA2DS2-VASc score and high HAS-BLED score are independent risk factors for ischemic stroke in elderly CHF patients with-out AF/AFL.

Purpose/Significance To explore the feasibility of applying blockchain technology to the current healthcare system of hos-pitals,and to achieve the purpose of protecting patients'privacy to the greatest extent possible at a lower cost.Method/Process 505 questionnaires are randomly distributed and collected from people of different age groups in Beijing,Tianjin,Shanghai and Shenzhen who have a certain degree of understanding of blockchain technology,and the results are analyzed.Result/Conclusion Different age groups are highly concerned about personal privacy and privacy protection,and are willing to accept blockchain as an emerging technology.There is a greater demand and acceptance for the application of blockchain technology in the primary health care systems.

We studied the patients diagnosed with X-linked hypophosphatemicrickets(XLH) and treated with burosumab in Peking Union Medical College Hospital from January 2021 to December 2022. In addition, we described the clinical characteristics of the patients, the changes of clinical indexes before and after burosumab treatment, and the adverse drug reactions during treatment. We also evaluated the efficacy and safety of burosumab for XLH. The results showed that three children XLH patients and one adult XLH patients received burosumab treatment. After treatment, the serum phosphorus level of all patients increased; the serum phosphorus of 3 children patients increased above the lower limit of the reference value range; the serum alkaline phosphatase(ALP) of all patients was lower than that of before treatment; the serum ALP of one adult patient was close to the normal range after 2.5 years of treatment. One child patient showed small crystals in kidney through ultrasound 48 weeks after treatment; one child and one adult showed increased serum parathyroid hormone(PTH)level before treatment and serum PTH continued increasing after treatment. Finally, it may be concluded that burosumab increased serum phosphorus levels in XLH patients, kept the level relatively stable, and reduced serum ALP levels. No serious adverse reactions occurred during treatment, in order to provide reference for the use of burosumab in patients with XLH.