Objective:To understand the latent categories of apathy in young and middle-aged patients with hemorrhagic stroke and analyze the relationship between these categories and disability acceptance, providing a theoretical basis for targeted interventions.Methods:A convenience sampling method was used to select young and middle-aged patients with hemorrhagic stroke hospitalized at Huai′an First Hospital Affiliated to Nanjing Medical University between September 2020 and September 2023. A general information questionnaire, the Apathy Evaluation Scale-Clinician Administered, and the Acceptance of Disability Scale Revised were used for a cross-sectional survey. Latent profile analysis was conducted using Mplus 8.7 software to categorize apathy in these patients, and differences in disability acceptance among the categories were compared.Results:A total of 210 questionnaires were distributed and 203 valid questionnaires were collected. Among 203 patients were included, with 112 males and 91 females, aged 30-59 (47.60 ± 8.51) years old. The apathy score was (46.66 ± 8.78) points, and three latent categories were identified: "high active ability-low apathy" (26.1%, 53/203), "high social ability-moderate apathy" (28.6%, 58/203), and "generally high apathy" (45.3%, 92/203). The total disability acceptance scores for the three categories were (78.19 ± 13.30), (69.50 ± 11.01), and (60.86 ± 14.00) points, respectively, with statistically significant differences ( F=30.39, P<0.01). Conclusions:Apathy in young and middle-aged patients with hemorrhagic stroke can be categorized into three latent profiles, with differences in disability acceptance among the categories. Targeted management and interventions should be developed based on these homogeneous groups to improve disability acceptance.

Objective:To understand the latent categories of apathy in young and middle-aged patients with hemorrhagic stroke and analyze the relationship between these categories and disability acceptance, providing a theoretical basis for targeted interventions.Methods:A convenience sampling method was used to select young and middle-aged patients with hemorrhagic stroke hospitalized at Huai′an First Hospital Affiliated to Nanjing Medical University between September 2020 and September 2023. A general information questionnaire, the Apathy Evaluation Scale-Clinician Administered, and the Acceptance of Disability Scale Revised were used for a cross-sectional survey. Latent profile analysis was conducted using Mplus 8.7 software to categorize apathy in these patients, and differences in disability acceptance among the categories were compared.Results:A total of 210 questionnaires were distributed and 203 valid questionnaires were collected. Among 203 patients were included, with 112 males and 91 females, aged 30-59 (47.60 ± 8.51) years old. The apathy score was (46.66 ± 8.78) points, and three latent categories were identified: "high active ability-low apathy" (26.1%, 53/203), "high social ability-moderate apathy" (28.6%, 58/203), and "generally high apathy" (45.3%, 92/203). The total disability acceptance scores for the three categories were (78.19 ± 13.30), (69.50 ± 11.01), and (60.86 ± 14.00) points, respectively, with statistically significant differences ( F=30.39, P<0.01). Conclusions:Apathy in young and middle-aged patients with hemorrhagic stroke can be categorized into three latent profiles, with differences in disability acceptance among the categories. Targeted management and interventions should be developed based on these homogeneous groups to improve disability acceptance.

Objective:To explore latent categories of trajectories in intrinsic capacity in elderly hemodialysis patients and to analyze their influencing factors.Methods:Elderly hemodialysis patients in the Blood Purification Center of Beijing Tongren Hospital affiliated with Capital Medical University from September 2022 to January 2023, were selected for the study using a convenience sampling method. A baseline survey was conducted using the General Information Questionnaire, Hemodialysis Self-Management Instrument, Social Environmental Factor Scale, and Intrinsic Capacity Scale. The Intrinsic Capacity Scale was used to investigate the intrinsic capacity of patients at 6 and 12 months after baseline. The latent class growth model was used to identify latent categories of intrinsic capacity trajectories of elderly hemodialysis patients. Ordered multiclass Logistic regression was used to analyze the influencing factors of latent categories.Results:A total of 317 elderly hemodialysis patients were investigated at baseline, and finally, 309 completed follow-ups. Among the 309 elderly hemodialysis patients, the trajectory of intrinsic capacity was categorized into a low-level slow-decline group (26.2%, 81/309) , a medium-level smooth-decline group (39.8%, 123/309) , and a high-level slow-decline group (34.0%, 105/309) . Ordered multiclass Logistic regression analysis showed that gender, age, mode of residence, per capita monthly income, type of dialyzer, C-reactive protein, score of hemodialysis self-management scale, housing conditions score, transportation condition score, and environmental condition score were the influencing factors of the latent categories of the trajectory in intrinsic capacity of elderly hemodialysis patients, and the difference was statistically significant ( P<0.05) . Conclusions:There is population heterogeneity in the intrinsic capacity trajectory of elderly hemodialysis patients. Healthcare professionals can provide targeted interventions based on the factors influencing the trajectory.

Objective:To investigate the current status and trajectory of intrinsic capacity in community-dwelling older adults and to analyze its influencing factors.Methods:A longitudinal study was conducted from September 2022 to March 2024. A total of 360 older adults were selected by convenience sampling from the Desheng community, Xicheng District of Beijing City and Liucun Community of Xingtai City, Hebei Province. The Intrinsic Capacity Assessment Scale and the Influencing Factors Questionnaire were administered at three-time points: baseline (T1), 6 months (T2), and 12 months (T3). Binary Logistic regression analysis revealed that age, grip strength, the number of geriatric syndromes, and types of social activities were significant influencing factors of intrinsic capacity trajectories in community-dwelling older adults ( P<0.05) . Results:A total of 360 participants were assessed at T1, with 58 and 30 lost to follow-up at T2 and T3, development respectively. Ultimately, 272 older adults completed the follow-up. The growth mixture modeling identified two trajectory types: a high-score stable group (92.3%, 251/272) and a low-score declining group (7.7%, 21/272). Binary Logistic regression analysis showed that age, grip strength, number of geriatric syndromes, and types of social activities were influencing factors of intrinsic capacity trajectories in community-dwelling older adults ( P<0.05) . Conclusions:Intrinsic capacity development trajectories in community-dwelling older adults are heterogeneous. Healthcare professionals should focus on older adults with advanced age, lower grip strength, more geriatric syndromes, and fewer types of social activities to assess and manage their intrinsic capacity and formulate targeted interventions at an early stage.

Objective:To investigate whether there is an association between the total dose of breast cancer radiotherapy, the mean dose of radiation field involving the heart and its substructures, and the long-term incidence of coronary heart disease (CHD) in patients.Methods:A retrospective analysis was conducted on 1125 patients with breast cancer who received radiotherapy with radiation fields involving the hear at Beijing Hospital from January 2009 to June 2022. The heart and its substructures of 54 patients were manually delineated, trained an automatic delineation model, and applied this model to the original radiotherapy planning images to automatically extract dosimetric parameters for the heart and substructures in the original plan. Based on the follow-up results, 1125 breast cancer patients were categorized into the CHD event group ( n=19) and non-event group ( n=1106). Wilcoxon rank-sum test, Chi-square test and adjustment for confounding factors using inverse probability weighting were used to compare the mean radiation dose received by the heart and its substructures, age at presentation, history of smoking, history of alcohol consumption, history of hypertension, and history of diabetes between two groups. The influencing factors of CHD were analyzed by univariate and multivariate logistic regression models. Results:The mean heart dose ( P=0.035), mean dose of right atrium ( P=0.049), right coronary artery ( P=0.013), septum ( P=0.045), and right ventricle ( P=0.039) of the event group were higher than that of the non-event group, and the differences were statistically significant. History of alcohol consumption was an independent risk factor for long-term CHD events in the breast cancer patients ( OR=7.35,95% CI: 1.56-25.58, P=0.004). After adjusting for confounding factors using inverse probability weighting, age at presentation was an independent risk factor for long-term CHD events ( OR=1.03, 95% CI: 1.01-1.05, P=0.004). Conclusions:In the breast cancer population with traditional high-risk factors of CHD receiving radiotherapy, the possibility of CHD probably remains high even if the dose of radiation field involving the heart and its substructures is low. Compared to traditional risk factors of CHD, the mean dose to the heart and its substructures in the radiation field of breast cancer patients exerts less impact on the occurrence of CHD after radiotherapy.

Objective:To explore latent categories of trajectories in intrinsic capacity in elderly hemodialysis patients and to analyze their influencing factors.Methods:Elderly hemodialysis patients in the Blood Purification Center of Beijing Tongren Hospital affiliated with Capital Medical University from September 2022 to January 2023, were selected for the study using a convenience sampling method. A baseline survey was conducted using the General Information Questionnaire, Hemodialysis Self-Management Instrument, Social Environmental Factor Scale, and Intrinsic Capacity Scale. The Intrinsic Capacity Scale was used to investigate the intrinsic capacity of patients at 6 and 12 months after baseline. The latent class growth model was used to identify latent categories of intrinsic capacity trajectories of elderly hemodialysis patients. Ordered multiclass Logistic regression was used to analyze the influencing factors of latent categories.Results:A total of 317 elderly hemodialysis patients were investigated at baseline, and finally, 309 completed follow-ups. Among the 309 elderly hemodialysis patients, the trajectory of intrinsic capacity was categorized into a low-level slow-decline group (26.2%, 81/309) , a medium-level smooth-decline group (39.8%, 123/309) , and a high-level slow-decline group (34.0%, 105/309) . Ordered multiclass Logistic regression analysis showed that gender, age, mode of residence, per capita monthly income, type of dialyzer, C-reactive protein, score of hemodialysis self-management scale, housing conditions score, transportation condition score, and environmental condition score were the influencing factors of the latent categories of the trajectory in intrinsic capacity of elderly hemodialysis patients, and the difference was statistically significant ( P<0.05) . Conclusions:There is population heterogeneity in the intrinsic capacity trajectory of elderly hemodialysis patients. Healthcare professionals can provide targeted interventions based on the factors influencing the trajectory.

Objective:To investigate the current status and trajectory of intrinsic capacity in community-dwelling older adults and to analyze its influencing factors.Methods:A longitudinal study was conducted from September 2022 to March 2024. A total of 360 older adults were selected by convenience sampling from the Desheng community, Xicheng District of Beijing City and Liucun Community of Xingtai City, Hebei Province. The Intrinsic Capacity Assessment Scale and the Influencing Factors Questionnaire were administered at three-time points: baseline (T1), 6 months (T2), and 12 months (T3). Binary Logistic regression analysis revealed that age, grip strength, the number of geriatric syndromes, and types of social activities were significant influencing factors of intrinsic capacity trajectories in community-dwelling older adults ( P<0.05) . Results:A total of 360 participants were assessed at T1, with 58 and 30 lost to follow-up at T2 and T3, development respectively. Ultimately, 272 older adults completed the follow-up. The growth mixture modeling identified two trajectory types: a high-score stable group (92.3%, 251/272) and a low-score declining group (7.7%, 21/272). Binary Logistic regression analysis showed that age, grip strength, number of geriatric syndromes, and types of social activities were influencing factors of intrinsic capacity trajectories in community-dwelling older adults ( P<0.05) . Conclusions:Intrinsic capacity development trajectories in community-dwelling older adults are heterogeneous. Healthcare professionals should focus on older adults with advanced age, lower grip strength, more geriatric syndromes, and fewer types of social activities to assess and manage their intrinsic capacity and formulate targeted interventions at an early stage.

Objective:To investigate whether there is an association between the total dose of breast cancer radiotherapy, the mean dose of radiation field involving the heart and its substructures, and the long-term incidence of coronary heart disease (CHD) in patients.Methods:A retrospective analysis was conducted on 1125 patients with breast cancer who received radiotherapy with radiation fields involving the hear at Beijing Hospital from January 2009 to June 2022. The heart and its substructures of 54 patients were manually delineated, trained an automatic delineation model, and applied this model to the original radiotherapy planning images to automatically extract dosimetric parameters for the heart and substructures in the original plan. Based on the follow-up results, 1125 breast cancer patients were categorized into the CHD event group ( n=19) and non-event group ( n=1106). Wilcoxon rank-sum test, Chi-square test and adjustment for confounding factors using inverse probability weighting were used to compare the mean radiation dose received by the heart and its substructures, age at presentation, history of smoking, history of alcohol consumption, history of hypertension, and history of diabetes between two groups. The influencing factors of CHD were analyzed by univariate and multivariate logistic regression models. Results:The mean heart dose ( P=0.035), mean dose of right atrium ( P=0.049), right coronary artery ( P=0.013), septum ( P=0.045), and right ventricle ( P=0.039) of the event group were higher than that of the non-event group, and the differences were statistically significant. History of alcohol consumption was an independent risk factor for long-term CHD events in the breast cancer patients ( OR=7.35,95% CI: 1.56-25.58, P=0.004). After adjusting for confounding factors using inverse probability weighting, age at presentation was an independent risk factor for long-term CHD events ( OR=1.03, 95% CI: 1.01-1.05, P=0.004). Conclusions:In the breast cancer population with traditional high-risk factors of CHD receiving radiotherapy, the possibility of CHD probably remains high even if the dose of radiation field involving the heart and its substructures is low. Compared to traditional risk factors of CHD, the mean dose to the heart and its substructures in the radiation field of breast cancer patients exerts less impact on the occurrence of CHD after radiotherapy.

Objective To compare the accuracy of bedside lung ultrasound in emergency(BLUE)and combined cardiac-lung and additional ultrasound(CLAUS)for diagnosing the causes of acute dyspnea.Methods Totally 1 016 patients with acute dyspnea were retrospectively enrolled and divided into cardiogenic pulmonary edema group(n=268),pneumonia group(n=574),pneumothorax group(n=33),pulmonary embolism group(n=67)and CAD(chronic obstructive pulmonary disease/asthma/diaphragmatic dysfunction)group(n=74)according to the causes of acute dyspnea.The findings of CLAUS protocol were compared among groups,and the accuracy of BLUE and CLAUS protocol for diagnosing the causes of acute dyspnea were also compared.Results CLAUS showed that B-B and B-C were the most common modes in cardiogenic pulmonary edema group,while A-B/A-C/B-A/B-B/B-C/C-C modes were common in pneumonia group,and A-A mode was the most common in pneumothorax group,pulmonary embolism group and CAD group.Significant differences of the manifestations of pulmonary ultrasound,pleural feature of anterior chest wall,left/right cardiac insufficiency and abnormal inferior vena cava diameter were found among groups(all P＜0.05).The accuracy of BLUE and CLAUS protocol for diagnosing the causes of acute dyspnea was 86.91%(883/1 016)and 94.49%(960/1 016),respectively,the latter was higher than the former(χ2=34.587,P＜0.05).Conclusion CLAUS protocol could be used to effectively diagnose the causes of acute dyspnea,with higher accuracy than BLUE protocol.

Objective: To observe the effects of Danggui Shaoyao powder (DSP) on hepatic lipid metabolism and further explore its mechanism of action by peroxisome proliferator-activated receptor (PPARγ)-liver X receptor (LXRα)-adenosine triphosphate (ATP)-binding cassette transporter A1 (ABCA1) pathway regulation. Methods: Eight C57BL/6J male mice were selected as the control group, and 24 ApoE−/− male mice were randomly divided into the atherosclerosis model (AS) group, atorvastatin calcium (AC) group, and DSP group (n = 8 each group). To establish an AS model, ApoE−/− mice were fed a high-fat diet for 16 weeks. Pathologic changes in the aortic vasculature and liver were identified using Oil Red O staining. Triglyceride (TG), cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) levels were determined in the livers using a single-reagent GPO-PAP method. Fluorescence quantitative polymerase chain reaction and western blot were used to observe and evaluate the mRNA and protein expression of the PPARγ-LXRα-ABCA1 intermediates in the liver. Results: After 16 weeks of a high-fat diet, ApoE−/− mice showed more Oil Red O staining in the aorta and liver compared to the CONT group. Compared to the AS group, the DSP and AC treatment reduced aortic plaque and hepatic lipid deposition to varying degrees. Furthermore, DSP significantly reduced the hepatic lipid area in ApoE−/− mice (P < .001) and decreased the levels of TG, TC, and LDL-C in liver (P < .001, P = .027, P < .001, respectively). DSP also significantly increased the levels of PPARγ, LXRα, ABCA1, and ABCG1 mRNA expression, as well as the PPARγ, LXRα, ABCA1, and ABCG1 protein expression in liver. Conclusion DSP improved hepatic lipid metabolism via PPARγ-LXRα-ABCA1 pathway modulation for AS treatment.