Objective:To explore the application of nursing intervention based on the capability, opportunity, motivation-behavior model (COM-B) in stroke patients during the rehabilitation period.Methods:Using the convenience sampling method, 146 stroke patients admitted to the First Affiliated Hospital of Zhengzhou University from February 2021 to February 2024 were selected as the research objects. According to the admission time sequence, they were divided into the COM-B group and the routine group, with 73 cases in each group. The routine group received routine nursing measures, and the COM-B group was intervened with the COM-B intervention, both for 3 months. The scores of the Health Education Self-Management Scale for Stroke Patients (HES-SP), the Exercise of Self-Care Agency Scale (ESCA), the Fugl-Meyer Assessment (FMA), and the Barthel Index of the two groups before and after the intervention were compared.Results:Finally, 72 patients in the COM-B group and 71 patients in the routine group completed the study. After 3 months of intervention, the scores of ESCA, HES-SP, FMA, and the Barthel Index of the two groups were all higher than those before the intervention, and the scores of COM-B group were all higher than those of the routine group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of the COM-B intervention in stroke patients can improve patients' healthy behaviors and self-care abilities, and enhance their limb motor function and activities of daily living abilities, with a good application effect.

Objective:To explore the application of nursing intervention based on the capability, opportunity, motivation-behavior model (COM-B) in stroke patients during the rehabilitation period.Methods:Using the convenience sampling method, 146 stroke patients admitted to the First Affiliated Hospital of Zhengzhou University from February 2021 to February 2024 were selected as the research objects. According to the admission time sequence, they were divided into the COM-B group and the routine group, with 73 cases in each group. The routine group received routine nursing measures, and the COM-B group was intervened with the COM-B intervention, both for 3 months. The scores of the Health Education Self-Management Scale for Stroke Patients (HES-SP), the Exercise of Self-Care Agency Scale (ESCA), the Fugl-Meyer Assessment (FMA), and the Barthel Index of the two groups before and after the intervention were compared.Results:Finally, 72 patients in the COM-B group and 71 patients in the routine group completed the study. After 3 months of intervention, the scores of ESCA, HES-SP, FMA, and the Barthel Index of the two groups were all higher than those before the intervention, and the scores of COM-B group were all higher than those of the routine group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of the COM-B intervention in stroke patients can improve patients' healthy behaviors and self-care abilities, and enhance their limb motor function and activities of daily living abilities, with a good application effect.

ObjectiveThis study aims to investigate the effect of modified Baitouwengtang （MBTWD） on tumor growth and the number of tumor-associated macrophages （TAMs） in tumor tissue of MC38 cell tumor-bearing mice with colorectal cancer and explores whether MBTWD mediates the remodeling of TAM phenotype to play an immunologically antitumor effect. MethodFirstly， The C57BL/6 mouse tumor model grafted subcutaneously was established， and then model mice were classified into a model group， positive control group（3 mg·kg^-1）， and MBTWD groups with high and low dosages（23.43、46.86 g·kg^-1）， with 10 mice in each group. In addition， 10 healthy mice were set as the blank group， and the changes in body weight， tumor volume， and survival status of mice in each group were observed. Tumor tissue， spleen， and peripheral blood were collected to calculate the tumor volume change， tumor inhibition rate， and spleen mass. Hematoxylin-eosin （HE） staining was used to observe the morphological changes of tumor tissue， and an immunofluorescence assay was used to detect the expression levels of CD4， CD8， and CD206 in tumor tissues of tumor-bearing mice. The secretion levels of transforming growth factor （TGF）-β， interleukin （IL）-6， and chemokine （C-C Motif） ligand 2 （CCL2） in peripheral serum were measured by using enzyme-linked immunosorbent assay （ELISA）. Secondly， a co-culture model induced by IL-4 in vitro of MC38 cells and murine monocytic macrophage RAW264.7 cells was established. Cell proliferation and activity assay （CCK-8） was used to detect the inhibitory effect of MBTWD containing serum on cell proliferation. A transwell experiment was used to detect the effect of IL-4-induced M2 macrophages on the invasion of MC38 cells. Flow cytometry was used to detect the expression of CD86 on the membrane of M2 macrophages induced by IL-4 with MBTWD containing serum. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the effect of MBTWD containing serum on the mRNA expression levels of M1 macrophage-related polarization factors CD86， nitric oxide synthase （iNOS）， and IL-12， as well as M2 macrophage-related polarization factors CD206， CD163， and IL-10 after co-cultivation. Finally， the protein expression levels of colony-stimulating factor 1 receptor （CSF1R）， stimulator of interferon genes （STING）， and TANK binding kinase 1 （TBK1） in tumor tissues of tumor-bearing mice were detected by Western blot. ResultIn vivo experimental results show that compared with the model group， the MBTWD can significantly inhibit the tumor growth of tumor-bearing mice. Immunofluorescence experiments show that the MBTWD can increase the number of CD8⁺ T cell infiltration in tumor tissue of tumor-bearing mice， reduce the number of CD206⁺ TAMs infiltration， and down-regulate the secretion levels of cytokines IL-6， TGF-β， and CCL2 in peripheral blood of tumor-bearing mice. The results of in vitro experiments show that the MBTWD containing serum has no obvious inhibitory effect on cell proliferation， but the cell supernatant after co-cultivation with RAW264.7 cells can inhibit the proliferation activity of MC38 cells， and the invasion ability of MC38 cells is enhanced by IL-4-induced M2 macrophages. However， this effect can be inhibited in a concentration-dependent manner by the MBTWD containing serum. At the same time， the results of Real-time PCR show that the MBTWD containing serum can up-regulate the mRNA expression levels of M1 macrophage-related polarization factors CD86， iNOS， and IL-12 and down-regulate those of M2 macrophage-related polarization factors CD206， CD163， and IL-10. Flow cytometry results also confirm that the MBTWD containing serum can increase the number of repolarized CD86⁺ M1 macrophages， indicating that MBTWD can induce M2 macrophages to repolarized M1 macrophages to play an anti-tumor growth role. Finally， Western blot results show that MBTWD can down-regulate the expression of CSF1R protein and up-regulate that of STING and TBK1 proteins in tumor tissue of tumor-bearing mice. ConclusionMBTWD can down-regulate the infiltration number of CD206⁺ TAMs and increase the infiltration of CD8⁺ T cells， thereby playing an immunologically antitumor effect on the growth inhibition of colorectal cancer， which may be related to regulating CSF1R signaling and then activating STING/TBK1 signaling pathway to induce phenotypic remodeling of TAMs.

Objective To investigate the clinical features,treatment and the causes of death in severe infectious disease complicated with capillary leak syndrome(CLS)in neonates.Methods The clinical data,laboratory finding,treatmand clinical outcome of 11 neonates who had severe infectious disease complicated with CLS in our NICU from Jan 2009 to Jul 2010 were collected and analysed retrospectively.Results Among the 11neonates,five had pneumonia and the other six had sepsis.All the 11 cases appeared progressive edema on skin and mucosa,dyspnoea,infective shock,oliguria and hypoalbuminemia(10～20 g/L).We treated the 11cases with hydroxyethyl starch(10～15 ml/kg,every 8 to 12 h)at early stage on the basis of infection control,anti-shock treatment,mechanical ventilation,symptomatic treatment and a stable internal environment.At last,6 cases were rescued,in whom 4 cases were well-developed,had normal intelligence and athletic ability,the other two cases had hydrocephalus or muscle tone high of both lower extremities.Five cases died.Conelusion CLS is a severe complication of neonatal severe infection,and had high mortality.Treating with hydroxvethvl starch at an early stage can increase the survival rate.