Patients with lacunar infarction (LI) have a higher risk of stroke recurrence compared to other types of stroke, and it is an important pathological basis for vascular dementia. Homocysteine (Hcy) is closely associated with the occurrence and development of LI. The mechanism by which Hcy causes LI involves multiple complex biological processes (including inflammation, oxidative stress, endothelial dysfunction, etc.) and synergistic effects with various risk factors (such as hypertension and hyperglycemia), but the specific mechanism is currently not fully elucidated.

The traditional diagnosis and treatment mode of ischemic stroke faces challenges such as limited diagnostic time window, insufficient drug targeting, and difficulty in penetrating the blood-brain barrier. Nanomaterials, with their unique physicochemical properties and biological effects, provide innovative solutions for precise diagnosis and treatment. In terms of diagnosis, targeted thrombus nanoprobes constructed from nanomaterials, combined with MRI or CT, can achieve high sensitivity and visual detection of thrombi. The development of nano-biosensors has significantly improved the detection efficiency and accuracy of specific biomarkers for ischemic stroke. In terms of treatment, nano-drug carrier systems can efficiently load thrombolytic drugs and promote their penetration of the blood-brain barrier, achieving targeted delivery. Biomimetic nanoparticles effectively promote angiogenesis and neurological function repair in ischemic brain regions by regulating inflammation and oxidative stress. This article systematically reviews the application progress of nanomaterials in the diagnosis and treatment of ischemic stroke, aiming to provide a basis for promoting the translation of nanotechnology from basic research to clinical practice, and to provide new ideas for precise diagnosis and treatment of ischemic stroke.

Objective To explore the effectiveness of the diffusion of innovation theory in com-bination with multidisciplinary nursing collaboration in intervention for patients with severe pneumonia complicated by heart failure.Methods A total of 120 patients with severe pneumonia complicated by heart failure admitted between April 2021 and April 2024 were enrolled and randomly divided into observation group(n=60)and control group(n=60)using a random black-and-white ball method.The control group received conventional nursing intervention,while the observation group received an intervention model combining the diffusion of innovations theory with multidisciplinary collaboration on top of the conventional nursing.Rehabilitation outcomes(time to control of pulmonary inflammation,time to resolution of cough and expectoration,length of hospital stay)and post-intervention cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-systolic volume(LVESV)]were compared between the two groups.The Minnesota Living with Heart Failure Questionnaire(MLHFQ)was used to assess quality of life,and the Self-Care Heart Failure Index(SCHFI)was used to evaluate self-care behaviors.Complications were compared between the two groups,and cost-effectiveness was analyzed(patient medical expenses and re-hospitalization rates).Results The observation group had shorter time to resolution of cough and expectoration,control of pulmonary inflammation,and length of hospital stay compared with the control group,with statistically significant differences(P＜0.05).After intervention,LVEF increased in both groups compared with pre-intervention lev-els,and was higher in the observation group than in the control group,with a statistically significant difference(P＜0.05);ESV decreased in both groups compared with pre-intervention levels,and was lower in the observation group than in the control group,with a statistically significant difference(P＜0.05).After intervention,physiological,emotional,and social functioning scores in the MLHFQ decreased in both groups compared with pre-intervention levels,and were lower in the ob-servation group than in the control group,with statistically significant differences(P＜0.05).After intervention,scores for self-care maintenance,self-care management,and self-care confidence in the SCHFI increased in both groups,and were higher in the observation group than in the control group,with statistically significant differences(P＜0.05).There was no statistically significant difference in the incidence of complications between the two groups(P＞0.05).Conclusion The combination of the diffusion of innovations theory and multidisciplinary collaboration nursing model can accelerate the rehabilitation process in patients with severe pneumonia complicated by heart fail-ure,improve their quality of life,and effectively enhance their self-care abilities.

AIM: To investigate and analyze the current situation and needs of clinical research nurses in China, in order to provide scientific basis for constructing a training system for research nurses, promoting standardized training, and achieving standardized management for them. METHODS:A self-made questionnaire was used to investigate 102 research nurses from nearly 70 well-known clinical trial institutions in China. The contents of the questionnaire mainly included the general information, professional experience and work content of the research nurses, the sense of accomplishment and training needs of clinical trial work. RESULTS: Among the 102 research nurses surveyed, 92.15% have a bachelor's degree or above; 53.92% of those have intermediate or higher professional titles; 74.51% of them are part-time research nurse. Among professional experiences, 19.61% have more than 10 years of clinical trial experience; 47.06%, 40.20%, and 21.17% of surveyed research nurses were authorized to participate in clinical trial drug management, sample management, and quality control; 70.59% of research nurses have a high sense of achievement in their daily work. In terms of education and training needs, clinical trial related laws and regulations, standardized training for clinical trial protocol implementation, and good clinical practice (GCP) are the three most important aspects. CONCLUSION: Clinical research nurses in China have a relatively high level of education and nursing experience, but there is still a large gap in the amount of professional full-time clinical research nurses in China. Due to the rapid development of innovative drugs and devices, as well as the urgent need to improve the clinical research system, it is necessary to establish a training, assessment, and evaluation system for research nurses that is in line with China's national conditions in order to improve the professional level of research nurses, and improve the quantity and quality of clinical trial research on innovative drugs and devices in China.

Post-stroke urinary incontinence (PSUI) is a common complication in patients with stroke, affecting at least one-third of patients with stroke and seriously affecting their quality of life and rehabilitation process. This article reviews the pathogenesis, risk factors, and treatment of PSUI.

Objective To investigate the correlation between serum microRNA(miR)-24-3p,microtubule affinity-regulating kinase 4(MARK4)level expression and cardiac function in serum of patients with coronary atherosclerotic heart disease(CHD).Methods From August 2021 to April 2023,138 CHD patients who visited Sichuan Provincial People's Hospital were collected as the study subjects(CHD group).According to the New York Heart Association(NYHA)grading,patients in the CHD group were separated into grade Ⅱ(n=39),grade Ⅲ(n=68),and grade Ⅳ(n=31).Additionally,123 individuals who underwent physical examinations were selected as the health group during the same period.Real-time fluorescence quantitative PCR(qRT-PCR)method was applied to detect the expression levels of miR-24-3p and MARK4.Cardiac function indicators in the CHD and health groups were detected.Pearson method was applied to analyze the correlation among serum miR-24-3p,MARK4,and cardiac function indicators.Results Compared with the healthy group,the levels of MARK4(1.19±0.21 vs 1.00±0.20),left ventricular end-systolic dimension(LVESd),left ventricular enddiastolic dimension(LVEDd),interventricular septal thickness(IVS),left ventricular end-diastolic volume(LVEDv),left ventricular end-systolic volume(LVESv),and left ventricular mass(LV mass)in the CHD group were increased(t=7.462,18.242,23.888,9.941,2.812,12.520,11.029),while the levels of miR-24-3p(0.62±0.11 vs 1.00±0.18),left ventricular ejection fraction(LVEF),and cardiac output(CO)were reduced(t=20.821,10.212,18.188),and the differences were statistically significant(all P＜0.05).As cardiac function grading increased,MARK4 expression levels(1.09±0.19,1.18±0.17,1.32±0.22),LVESd,LVEDd,IVS,LVEDv,LVESv and LV mass were increased(F=13.025,10.606,11.920,57.956,29.680,21.253,12.954),and miR-24-3p expression levels(0.84±0.15,0.61±0.11,0.37±0.08),LVEF and CO were decreased(F=139.227,9.720,13.411),and the differences were statistically significant(all P＜0.05).Pearson correlation analysis showed a negative correlation between miR-24-3p and MARK4 expression in the serum of patients with CHD(r=-0.540,P＜0.05).The relative expression of miR-24-3p in the serum of patients with CHD was negatively correlated with LVESd,LVEDd,IVS,LVEDv,LVESv and LV mass(r=-0.656,-0.636,-0.617,-0.576,-0.492,-0.687,all P＜0.05),but positively correlated with LVEF and CO(r=0.570,0.683,all P＜0.05).The relative expression level of MARK4 was positively correlated with LVESd,LVEDd,IVS,LVEDv,LVESv,and LV mass(r=0.503,0.542,0.508,0.624,0.516,0.560,all P＜0.05),but negatively correlated with LVEF and CO(r=-0.594,-0.525,all P＜0.05).Conclusion The expression of miR-24-3p in the serum of CHD patients was decreased,while the expression of MARK4 was increased.There was an obvious correlation between the two and cardiac function indicators.

AIM:To investigate and analyze the current situation and needs of clinical research nurses in China,in order to provide scientific basis for constructing a training system for research nurs-es,promoting standardized training,and achieving standardized management for them.METHODS:A self-made questionnaire was used to investigate 102 research nurses from nearly 70 well-known clinical trial institutions in China.The contents of the questionnaire mainly included the general infor-mation,professional experience and work content of the research nurses,the sense of accomplish-ment and training needs of clinical trial work.RE-SULTS:Among the 102 research nurses surveyed,92.15％have a bachelor's degree or above;53.92％of those have intermediate or higher professional titles;74.51％of them are part-time research nurse.Among professional experiences,19.61％have more than 10 years of clinical trial experience;47.06％,40.20％,and 21.17％of surveyed research nurses were authorized to participate in clinical tri-al drug management,sample management,and quality control;70.59％of research nurses have a high sense of achievement in their daily work.In terms of education and training needs,clinical trial related laws and regulations,standardized training for clinical trial protocol implementation,and good clinical practice(GCP)are the three most important aspects.CONCLUSION:Clinical research nurses in China have a relatively high level of education and nursing experience,but there is still a large gap in the amount of professional full-time clinical re-search nurses in China.Due to the rapid develop-ment of innovative drugs and devices,as well as the urgent need to improve the clinical research system,it is necessary to establish a training,as-sessment,and evaluation system for research nurs-es that is in line with China's national conditions in order to improve the professional level of research nurses,and improve the quantity and quality of clinical trial research on innovative drugs and devic-es in China.

In the all-media era,online public opinion events are causing more and more trouble to the healthcare industry,and public hospitals in this situation are facing a severe test in terms of online public opinion management,which is generally problematic.It introduces the hospital network public opinion governance strategies and methods based on hazard vulnerability analysis of Peking University People's Hospital and explores a practical and feasible hos-pital online public opinion management model from the aspects of public opinion risk identification,public opinion management system construction,and improvement of departmental management level,to enhance the level of hospital public opinion governance,with a view to reducing and avoiding negative impacts on the hospital caused by online public opinion events,building a harmonious doctor-patient relationship,and improving the work of medical services.The aim is to reduce and avoid the negative impact of online public opinion events on the hospital,to build a harmonious doctor-patient relationship and improve medical services.

AIM:To investigate and analyze the current situation and needs of clinical research nurses in China,in order to provide scientific basis for constructing a training system for research nurs-es,promoting standardized training,and achieving standardized management for them.METHODS:A self-made questionnaire was used to investigate 102 research nurses from nearly 70 well-known clinical trial institutions in China.The contents of the questionnaire mainly included the general infor-mation,professional experience and work content of the research nurses,the sense of accomplish-ment and training needs of clinical trial work.RE-SULTS:Among the 102 research nurses surveyed,92.15％have a bachelor's degree or above;53.92％of those have intermediate or higher professional titles;74.51％of them are part-time research nurse.Among professional experiences,19.61％have more than 10 years of clinical trial experience;47.06％,40.20％,and 21.17％of surveyed research nurses were authorized to participate in clinical tri-al drug management,sample management,and quality control;70.59％of research nurses have a high sense of achievement in their daily work.In terms of education and training needs,clinical trial related laws and regulations,standardized training for clinical trial protocol implementation,and good clinical practice(GCP)are the three most important aspects.CONCLUSION:Clinical research nurses in China have a relatively high level of education and nursing experience,but there is still a large gap in the amount of professional full-time clinical re-search nurses in China.Due to the rapid develop-ment of innovative drugs and devices,as well as the urgent need to improve the clinical research system,it is necessary to establish a training,as-sessment,and evaluation system for research nurs-es that is in line with China's national conditions in order to improve the professional level of research nurses,and improve the quantity and quality of clinical trial research on innovative drugs and devic-es in China.

OBJECTIVE To establish a comprehensive platform for regional pharmaceutical care among Jiangxi provincial pediatric alliance to realize the management of pediatric hierarchical diagnosis and treatment, and improve the quality of pharmaceutical care. METHODS A unified diagnosis and treatment information standard and a knowledge base of children's rational drug use rules were established among the medical institutions of Jiangxi provincial pediatric alliance. On this basis, the medical records and drug use information of patients in various medical institutions in the region were uploaded to the chain in a structured manner in real time, and a comprehensive platform for regional pharmaceutical care was built. RESULTS The comprehensive platform for regional pharmaceutical care built based on blockchain technology could share medical resources and information among medical institutions, realize rational drug use management, remote prescription review, individualized drug use guidance, popular science education, government supervision, etc., and improve the quality of pharmaceutical care. CONCLUSION The comprehensive platform for regional pharmaceutical care among Jiangxi provincial pediatric alliance can help allocate high-quality medical resources (drug safety knowledge base and pediatric pharmacists) for primary medical institutions. Further more, it lays the foundation for government supervision at the same time ensuring children’s medication safety, which has great practical significance.