Abstract To improve adolescent health behavior, the study summarizes and analyzes the performance, pathways of transmission, and influencing factors of the intergenerational transmission of adolescent health behaviors from the perspective of intergenerational transmission. The study emphasizes the need to deepen research on the intergenerational transmission of adolescent health behaviors, promote multidisciplinary and cross team collaboration, and shift adolescent health care from individual focused care to a holistic approach that prioritizes family and community culture. Simultaneously, an action framework should be established to block the intergenerational transmission of health risk behaviors, with a focus on childhood and adolescence. Additionally, parent-child participatory health education and health promotion activities should be carried out under a tripartite coordinated intervention model involving the community, school, and family, collectively fostering the development of healthy behaviors among adolescents.

Objective To investigate the immediate effect of transcranial direct current stimulation(tDCS)combined with seated Tai-jiquan Yunshou training under different sequences on cerebral cortical activation in stroke patients with hemiple-gia.Methods From September to December,2024,14 stroke inpatients with hemiplegia were enrolled from the Fifth Hospi-tal of Xiamen.Based on the routine medication and rehabilitation,the patients were randomly assigned to a spe-cific intervention sequence,receiving three interventions in a fixed order:tDCS followed by Yunshou(S-Y group),Yunshou followed by tDCS(Y-S group),and simultaneous tDCS and Yunshou(Sim group).Functional near-infrared spectroscopy was used to detect oxyhemoglobin(HbO?)concentration in bilateral sensorimotor cor-tex,premotor and supplementary motor cortex,and prefrontal cortex before and after each intervention.Results Three patients dropped out.In all the regions of interest,inter-group effects were significant in HbO? concentra-tions(F>3.697,P<0.05),and interaction effects were significant in some brain regions(F>3.276,P<0.05).Post-hoc test showed a general trend of Sim Group≥S-Y Group>Y-S Group(P<0.05),although some varia-tions existed across different brain regions.Conclusion Both simultaneous intervention(tDCS and Yunshou)and tDCS followed by Yunshou are more effective on immediate activation of key motor-related cortices in stroke patients with hemiplegia than Yunshou followed by tDCS intervention.

Objective To investigate the immediate effect of transcranial direct current stimulation(tDCS)combined with seated Tai-jiquan Yunshou training under different sequences on cerebral cortical activation in stroke patients with hemiple-gia.Methods From September to December,2024,14 stroke inpatients with hemiplegia were enrolled from the Fifth Hospi-tal of Xiamen.Based on the routine medication and rehabilitation,the patients were randomly assigned to a spe-cific intervention sequence,receiving three interventions in a fixed order:tDCS followed by Yunshou(S-Y group),Yunshou followed by tDCS(Y-S group),and simultaneous tDCS and Yunshou(Sim group).Functional near-infrared spectroscopy was used to detect oxyhemoglobin(HbO?)concentration in bilateral sensorimotor cor-tex,premotor and supplementary motor cortex,and prefrontal cortex before and after each intervention.Results Three patients dropped out.In all the regions of interest,inter-group effects were significant in HbO? concentra-tions(F>3.697,P<0.05),and interaction effects were significant in some brain regions(F>3.276,P<0.05).Post-hoc test showed a general trend of Sim Group≥S-Y Group>Y-S Group(P<0.05),although some varia-tions existed across different brain regions.Conclusion Both simultaneous intervention(tDCS and Yunshou)and tDCS followed by Yunshou are more effective on immediate activation of key motor-related cortices in stroke patients with hemiplegia than Yunshou followed by tDCS intervention.

OBJECTIVE To optimize the stir-frying process of Platycodon grandiflorum,compare the protective effect of P.grandiflorum on lung injury in mice before and after stir-frying,and preliminarily explore the characteristics of"enhanced efficacy through processing"of stir-frying P.grandiflorum.METHODS On the basis of single-factor experiment,the stir-frying time,temperature and frequency were taken as factors,and the comprehensive scores of appearance traits,platycodin D content and alcohol extract content were taken as indexes.Box-Behnken response surface experiment was designed to optimize the stir-frying process of P.grandiflorum and verify it.The mice were divided into blank control group,model group,dexamethasone group(positive control drug,5 mg/kg),P.grandiflorum low-dose and high-dose groups(0.6,1.2 g/kg),fried P.grandiflorum low and high dose groups(0.6,1.2 g/kg),with 8 mice in each group.The treatment was given once a day for 10 consecutive days.After the last administration,acute lung injury model was established by intratracheal instillation of lipopolysaccharide.The levels of interleukin-6(IL-6),IL-1β,tumor necrosis factor-α(TNF-α)in serum and superoxide dismutase(SOD),myeloperoxidase(MPO)and malondialdehyde(MDA)in lung tissue were detected,lung wet/dry weight ratio and thymus index were calculated,and the pathological changes of lung tissue were observed.RESULTS The optimum processing conditions were as follows:stir-frying temperature of 120℃,stir-frying time of 12 min,stir-frying frequency of 19 r/min;the comprehensive scores of the three batches of process verification were all greater than 97 points,RSD＜3%(n=3).The results of pharmacodynamic experiments showed that compared with blank control group,the lung dry-wet weight ratio as well as the levels of IL-6,IL-1β,TNF-α,MPO and MDA in the model group were significantly increased(P＜0.01),the thymus index and SOD level were significantly decreased(P＜0.01),and the lung tissue was significantly damaged.Compared with model group,above indexes of the mice in each administration group were significantly improved(P＜0.01),and the lung tissue injury was significantly reduced.At the same dose,except for the lung dry-wet weight ratio,the above indexes of the mice in the stir-fried P.grandiflorum groups were significantly improved compared with P.grandiflorum groups(P＜0.05),and the lung tissue damage was further reduced.CONCLUSIONS The optimized stir-frying process is stable and feasible.The protective effect of stir-fried P.grandiflorum on acute lung injury in mice is better than that of raw products at the same dosage.

Objective:To compare the antiplatelet effects of vicagrel and clopidogrel in patients with different cytochrome P450 (CYP) 2C19 genotypes.Methods:This is a post-hoc analysis of a phase Ⅱ clinical trial of vicagrel, which included patients with coronary heart disease who underwent percutaneous coronary intervention from August 2018 to June 2019 in 18 centers. Patients were categorized based on the presence of CYP 2C19 *2 or *3 loss-of-function (LOF) alleles into LOF carrier group ( n=111) and non-LOF carrier group ( n=90). Each group included patients received vicagrel 5 mg, 6 mg, 7.5 mg, or clopidogrel 75 mg for 28 days per study protocol. P2Y 12 reaction units (PRU) were measured using VerifyNow at baseline, 6 to 8 hours after loading dose, 7 to 10 days after randomization, and 28 days after randomization and the percentage inhibition of platelet aggregation (%IPA) was calculated. The primary endpoint was %IPA on day 28. Within the patients from the General Hospital of Northern Theater Command, 8 to 12 patients in each study arms were enrolled in a prespecified pharmacokinetic sub-study, measuring the time to reach maximum plasma concentration (T max), peak plasma concentration (C max), and area under the plasma concentration-time curve (AUC). Results:Among 201 patients, the age was (58.8±8.5) years, and 139 (69.2%) were male. In non-LOF carriers, there was no significant differences in PRU values and %IPA between the vicagrel 5 mg, 6 mg, 7 mg, and clopidogrel groups at all time points (all P>0.05). In LOF carriers, %IPA was significantly higher in the vicagrel-treated groups than in the clopidogrel group at 6-8 hours after loading dose (22.9 (14.2, 31.5)% vs. 19.8 (11.0, 28.6)% vs. 29.5 (20.9, 38.0)% vs. 12.9 (3.9, 21.9)%, P=0.038) and 7-10 days after randomization (22.4 (14.2, 30.5)% vs. 34.4 (26.1, 42.6)% vs. 39.8 (31.8, 47.9)% vs. 24.7 (16.3, 33.2)%, P=0.001), with a trend towards higher %IPA in the vicagrel-treated groups at day 28 (30.4 (21.3, 39.6)% vs. 36.5 (27.2, 45.7)% vs. 40.8 (31.8, 49.8)% vs. 30.7(21.2, 40.2)%, P=0.056). Pharmacokinetic results of 35 patients showed that the C max and AUC of the active metabolite M15-2 of vicagrel was similar to that of clopidogrel in non-LOF carriers, but AUC between vicagrel 5 mg, 6 mg, 7 mg and clopidogrel were significantly different in LOF carriers ((5.6±0.6) h·μg -1·L -1 vs. (6.8±2.7) h·μg -1·L -1 vs. (9.2±3.3) h·μg -1·L -1 vs. (4.2±1.9) h·μg -1·ml -1, P=0.020). Conclusion:Vicagrel and clopidogrel have similar antiplatelet effects in non-LOF carriers, but vicagrel exhibits superior antiplatelet effects in LOF carriers.

Despite quitting smoking, patients with acute coronary syndrome (ACS) still have an increased risk of cardiovascular events. Clonal hematopoiesis of indeterminate potential (CHIP), which may be induced by smoking, has been identified to be associated with the development of coronary artery disease. However, it is unclear whether CHIP has a detrimental effect on the poor prognosis of ACS patients even after smoking cessation. This single-center, prospective cohort study will recruit 1,029 ACS patients undergoing complete percutaneous coronary intervention. The enrolled patients will be categorized into 3 groups based on their smoking status at admission: current smoker, non-smoker, and previous smoker. Previous smokers are defined as patients who have quit smoking for at least 1 year before experiencing the index ACS event. Whole-exome sequencing will be performed to identify the occurrence of CHIP in each patient. The primary endpoint is major adverse cardiovascular and cerebrovascular events, defined as a composite of cardiac death, non-fatal myocardial infarction, ischemia-driven revascularization, hospitalization for heart failure, and ischemic stroke. The association between CHIP and the primary endpoint will be determined by using Cox proportional hazard regression. This study aims to investigate the association among smoking cessation, CHIP, and the prognosis of ACS patients to provide new insights into the impact of CHIP on ACS patients, particularly among those who have quit smoking. The results will be published following the STROBE in a peer-reviewed scientific journal (Trial registration number: NCT04987268).

Objective To develop an evidence-based practice program for ICU eye care and evaluate its application effect using Stetler model of research utilization.Methods The systematic search was carried out in domestic and foreign guid elines,systematic reviews,evidence summaries,expert consensuses on eye care for ICU patients.The quality of the included literature was evaluated and the evidence was summarized.The evidence based on expert advice,clinical context and stakeholder opinions was screened.According to Stetler model of research utilization,the evidence translation/application was formulated from 3 aspects,including method,level and type of evidence application,and the evidence translation was implemented using a stepwise trial design.Five ICUs in a tertiary hospital in Zhejiang Province were selected,and the order of enrollment of each ICU was determined by computer-generated random numbers from April to september,2022.In the first month,all ICUs were in pre-evidence-based practice period,and in the second month,an ICU was trained and entered the evidence-based practice period.Until the 6th month,all ICUs entered the evidence-based practice period.Then the rate of ocular symptoms and implementation rate of eye care measures were compared before and after EBP.Results A total of 1 540 patients were included.With regard to the implementation rate of eye care measures,the rate of lubricant use and suspected ocular infection management in patients at high risk for ocular complications in evidence-based practice period was significantly higher compared with pre-evidence-based practice period(P＜0.001),and no statistically significant difference was found in the rate of eyelid closure.The incidence of conjunctival exposure,subconjunctival hemorrhage,conjunctival congestion,and ocular discharge in non-neurology critical care patients decreased compared with pre-evidence-based practice period(P＜0.05),and the incidence of conjunctival edema and conjunctival congestion in NICU patients decreased compared with pre-evidence-based practice period as the intervention continued(P＜0.001).Conclusion Evidence-based practice in eye care for ICU patients using Stetler model of research utilization can standardize the practice of eye care for ICU patients and improve the quality of care.

Despite quitting smoking, patients with acute coronary syndrome (ACS) still have an increased risk of cardiovascular events. Clonal hematopoiesis of indeterminate potential (CHIP), which may be induced by smoking, has been identified to be associated with the development of coronary artery disease. However, it is unclear whether CHIP has a detrimental effect on the poor prognosis of ACS patients even after smoking cessation. This single-center, prospective cohort study will recruit 1,029 ACS patients undergoing complete percutaneous coronary intervention. The enrolled patients will be categorized into 3 groups based on their smoking status at admission: current smoker, non-smoker, and previous smoker. Previous smokers are defined as patients who have quit smoking for at least 1 year before experiencing the index ACS event. Whole-exome sequencing will be performed to identify the occurrence of CHIP in each patient. The primary endpoint is major adverse cardiovascular and cerebrovascular events, defined as a composite of cardiac death, non-fatal myocardial infarction, ischemia-driven revascularization, hospitalization for heart failure, and ischemic stroke. The association between CHIP and the primary endpoint will be determined by using Cox proportional hazard regression. This study aims to investigate the association among smoking cessation, CHIP, and the prognosis of ACS patients to provide new insights into the impact of CHIP on ACS patients, particularly among those who have quit smoking. The results will be published following the STROBE in a peer-reviewed scientific journal (Trial registration number: NCT04987268).

Objective:To assess the effect of flash glucose monitoring (FGM) compared with self-monitoring of blood glucose (SMBG) on glycemic control, residual islet function, and patient-reported outcomes in children and adolescents with newly diagnosed type 1 diabetes within 1 year.Methods:133 children and adolescents with newly diagnosed T1DM in the T1D clinic of the Second Xiangya Hospital of Central South University from January 2016 to January 2020 were divided into two groups: FGM group ( n=82) and SMBG group ( n=51). The observation indexes included hemoglobin A1c (HbA 1c), fasting and postprandial blood glucose (FBG and 2 h BG), C-peptide (FCP and 2 h CP) during the one-year follow-up, Δ CP (2 h CP-FCP), patient-reported hypoglycemia and questionnaires regarding self-management of diabetes and quality of life. Results:At 6 months, HbA 1c in 2 groups was significantly decreased (all P<0.05); at 6 to 12 months, HbA 1c in FGM group tended to be stable ( P>0.05); at 12 months, HbA 1c in SMBG group was significantly increased compared with 6 months ( P=0.001). At 12 months, HbA 1c in SMBG group was higher than that in FGM group ( P=0.001). At 12 months, FBG in FGM group was equivalent to the baseline level ( P>0.05), while FBG in SMBG group was significantly higher than the baseline level ( P=0.006). 2 h BG only decreased at the 6th and 12th month in FGM group (all P<0.05). The FCP of SMBG group was significantly decreased at 12 months ( P<0.05), and the 2 h CP, Δ CP in the two groups decreased gradually (all P<0.05). FGM group had more hypoglycemic events at 6 and 12 months (all P<0.05). At 6 months, the score of Self-Management of T1D for Adolescents (SMOD-A) in FGM group was significantly improved ( P=0.001). During the follow-up period, the quality of life score of FGM group was stable ( P>0.05), while the quality of life score of SMBG group had a downward trend ( P=0.052). Conclusions:In newly diagnosed children and adolescents with T1DM, early application of FGM for blood glucose management will help to improve HbA 1c and reduce postprandial blood glucose. In addition, the self-management ability of children with FGM was improved after 6 months.

Objective:To investigate the value of ultrasound and Ki-67 for early predicting pathological complete response (pCR) of triple negative breast cancer(TNBC) after neoadjuvant chemotherapy (NAC).Methods:Retrospective analysis was performed in 190 patients with TNBC who underwent surgery after NAC treatment at the Cancer Hospital of Fudan University from January 2019 to December 2022. All patients underwent ultrasound examination before and after 2 and 4 cycles of NAC treatment. According to the operation pathological results after NAC, the patients were divided into pCR group and non-pCR group. The differences in ultrasound and Ki-67 parameters were compared between the pCR and non-pCR groups, and binary Logistic regression analysis was performed to determine the independent predictors for pCR. The ROC curve was plotted to evaluate the diagnostic efficacy.Results:Tumor maximum diameter, relative change rates of tumor maximum diameter after 2-cycle and 4-cycle NAC (ΔD2, ΔD4), relative change rate of lymph node short diameter after 2-cycle NAC (ΔS2), T-stage, N-stage and Ki-67 showed statistically significant differences between the pCR group and the non-pCR group (all P<0.05). Logistic regression analysis showed that ΔD4, T-stage, N-stage and Ki-67 were independent predictors for pCR ( OR=1.029, P=0.011; OR=0.300, P=0.009; OR=0.653, P=0.048; OR=1.028, P=0.001). The area under the curve (AUC) of pCR was 0.804 (95% CI=0.742-0.866), the sensitivity and specificity were 67.5% and 83.2% respectively. Conclusions:The combination parameters of ΔD4, T-stage, N-stage and Ki-67 have certain clinical value for predicting pCR of TNBC.