Objective: To analyze the mediating effect of activities of daily living (ADL) among patients with chronic obstructive pulmonary disease (COPD) on caregiver ability and caregiver burden, so as to provide a basis for improving the quality of care. Methods: From February 2024 to March 2025, COPD patients and their caregivers from the Department of Pulmonary and Critical Care Medicine of a tertiary hospital in Haikou were selected using convenience sampling method. Data on the basic characteristics of both caregivers and patients were collected through questionnaire surveys. The Chinese version of the Family Caregiver Capacity Scale, the Chinese version of the Caregiver Burden Inventory, and the Barthel Index were used to assess caregiver ability, caregiver burden, and patients' ADL, respectively. The mediating effect of ADL among COPD patients on caregiver ability and caregiver burden was analyzed using the Process macro 4.0, with the significance tested via the Bootstrap method. Results: A total of 348 caregivers were surveyed, among whom 274 (78.74%) were females and 74 (21.26%) were males. The majority of caregivers were aged 40 years and above, with 291 individuals (83.62%). The relationship between caregivers and patients was primarily that of being their children, with 185 individuals (53.16%). Correspondingly, 348 COPD patients were surveyed, and the predominant type of medical insurance was the New Rural Cooperative Medical Scheme, with 172 cases (49.43%). The median scores of caregiver ability, caregiver burden, and patients' ADL were 19.00 (interquartile range, 5.00), 47.00 (interquartile range, 8.00) and 45.00 (interquartile range, 15.00) points, respectively. Mediating analysis showed that caregiver ability directly affected caregiver burden, with an effect value of 0.693 (95%CI: 0.553-0.832). It also indirectly affected caregiver burden through the patients' ADL, with an effect value of 0.104 (95%CI: 0.029-0.179). This mediating effect accounted for 13.05% of the total effect. Conclusion The ADL of COPD patients played a mediating role between caregiver ability and caregiver burden, with caregiver ability exerting a significant positive indirect effect on caregiver burden through patients' ADL.

AIM:This study aims to investigate the effect of Agaricus blazei extract FA-2-b-β on ferroptosis of Burkitt lymphoma cells and its mechanism.METHODS:Burkitt lymphoma cell lines Raji and CA46 were treated with FA-2-b-β alone and in combination with ferrostatin-1,a ferroptosis inhibitor,or Stattic,a signal transducer and activator of transcription 3(STAT3)inhibitor.Cell viability was assessed using the CCK-8 method,and the half-maximal inhibitory concentration(IC50)of FA-2-b-β was calculated.Flow cytometry was used to detect apoptosis,cell cycle,mitochondrial membrane potential,and reactive oxygen species(ROS).Additionally,malondialdehyde(MDA)and glutathione(GSH)levels were measured using kits.The mRNA and protein expression levels of ferroptosis-related molecules were determined by RT-qPCR and Western blot.RESULTS:The extract FA-2-b-β at different concentrations significantly inhibited the proliferation of Raji and CA46 cells(P＜0.05),promoted their death,regulated cell arrest in G0/G1 phase,and decreased the mitochondrial membrane potential.(2)ROS and MDA levels were significantly increased with different concentrations of the extract FA-2-b-β(P＜0.05),while the GSH content was significantly decreased(P＜0.05).(3)The protein and mRNA levels of signal transducer and activator of transcription 3(STAT3),p-STAT3,and glutathione peroxidase 4(GPX4)were down-regulated at different concentrations of the extract FA-2-b-β.In addition,prostaglandin-endoperoxide synthase 2(PTSG2)and transferrin receptor protein 1(TfR1)protein and mRNA were up-regulated(P＜0.05),while the protein and mRNA levels of solute carrier family 7 member 11(SLC7A11)were not significantly changed.CONCLU-SION:The extract FA-2-b-β can induce ferroptosis in burkitt lymphoma,and the mechanism may be related to the inhibi-tion of STAT3/GPX4 signaling pathway.

Objective To investigate the prevalence of substantia nigra(SN)hyperechogenicity in patients with Parkinson's disease(PD)using transcranial ultrasound(TCS),identify the associated influencing factors,and construct a predictive model.Methods A retrospective analysis was conducted on 101 PD patients admitted to Chengde City Central Hospital between August 2022 and July 2024.All patients underwent TCS examination to detect SN hyperechogenicity.Based on TCS findings,patients were categorized into case group(SN hyperechogenicity,stagesⅢ-V)and control group(normal SN echogenicity,stagesⅠ-Ⅱ).The prevalence of TCS-detected SN hyperechogenicity in PD patients was evaluated,and the clinical and laboratory data between two groups were compared.The risk factors for SN hyperechogenicity in PD patients were identified using multivariate Logistic regression,and a regression equation model of Logit(P)was established based on the results of multivariate analysis.The established model was validated by the Hosmer-Lemeshow goodness-of-fit test and the likelihood ratioχ2 test.Receiver operating characteristic(ROC)curve was constructed to evaluate the predictive accuracy of the model for SN hyperechogenicity in PD patients,and the area under the curve(AUC)was calculated.Results Among 101 PD patients,34(33.66%)exhibited SN hyperechogenicity.Compared with control group,case group had higher percentages of olfactory dysfunction,sleep disorders and H-Y stage≥Ⅲ(P<0.05),and lower levels of serum copper and ceruloplasmin(P<0.05).Multivariate Logistic regression analysis identified olfactory dysfunction,sleep disorders,H-Y stage≥Ⅲ,decreased serum copper and reduced ceruloplasmin as independent risk factors for SN hyperechoicity in PD patients(OR=2.168,2.008,2.063,2.300,1.921,respectively;P<0.05).The predictive model was formalized as Logit(P)=-9.233+olfactory dysfunction×0.774+sleep disorders×0.697+H-Y stage≥Ⅲ×0.724+decreased serum copper×0.833+reduced ceruloplasmin×0.653.ROC analysis showed that when Logit(P)>13.00,the AUC value was 0.876(95%CI:0.795-0.933),with a sensitivity of 73.53%and a specificity of 82.09%.Conclusion The phenomenon of TCS-detected SN hyperechogenicity is severe in PD patients,and its occurrence was associated with olfactory dysfunction,sleep disorders,H-Y stage≥Ⅲ,decreased serum copper and reduced ceruloplasmin,and the predictive model incorporating these factors demonstrated excellent predictive value.

Breast cancer is the number one killer threatening women's health, and the side effects caused by its treatment seriously affect patients' quality of life. Research has confirmed that good patient activation can effectively improve the quality of life of breast cancer patients, and it is of great significance to improve the quality of care and the recovery process of breast cancer patients.The purpose of this study is to review the current situation, assessment tools, influencing factors, and interventions of breast cancer patients' activation, in order to provide reference for researchers to conduct patient activation-related studies in the future.

AIM:This study aims to investigate the effect of Agaricus blazei extract FA-2-b-β on ferroptosis of Burkitt lymphoma cells and its mechanism.METHODS:Burkitt lymphoma cell lines Raji and CA46 were treated with FA-2-b-β alone and in combination with ferrostatin-1,a ferroptosis inhibitor,or Stattic,a signal transducer and activator of transcription 3(STAT3)inhibitor.Cell viability was assessed using the CCK-8 method,and the half-maximal inhibitory concentration(IC50)of FA-2-b-β was calculated.Flow cytometry was used to detect apoptosis,cell cycle,mitochondrial membrane potential,and reactive oxygen species(ROS).Additionally,malondialdehyde(MDA)and glutathione(GSH)levels were measured using kits.The mRNA and protein expression levels of ferroptosis-related molecules were determined by RT-qPCR and Western blot.RESULTS:The extract FA-2-b-β at different concentrations significantly inhibited the proliferation of Raji and CA46 cells(P＜0.05),promoted their death,regulated cell arrest in G0/G1 phase,and decreased the mitochondrial membrane potential.(2)ROS and MDA levels were significantly increased with different concentrations of the extract FA-2-b-β(P＜0.05),while the GSH content was significantly decreased(P＜0.05).(3)The protein and mRNA levels of signal transducer and activator of transcription 3(STAT3),p-STAT3,and glutathione peroxidase 4(GPX4)were down-regulated at different concentrations of the extract FA-2-b-β.In addition,prostaglandin-endoperoxide synthase 2(PTSG2)and transferrin receptor protein 1(TfR1)protein and mRNA were up-regulated(P＜0.05),while the protein and mRNA levels of solute carrier family 7 member 11(SLC7A11)were not significantly changed.CONCLU-SION:The extract FA-2-b-β can induce ferroptosis in burkitt lymphoma,and the mechanism may be related to the inhibi-tion of STAT3/GPX4 signaling pathway.

Objective To investigate the prevalence of substantia nigra(SN)hyperechogenicity in patients with Parkinson's disease(PD)using transcranial ultrasound(TCS),identify the associated influencing factors,and construct a predictive model.Methods A retrospective analysis was conducted on 101 PD patients admitted to Chengde City Central Hospital between August 2022 and July 2024.All patients underwent TCS examination to detect SN hyperechogenicity.Based on TCS findings,patients were categorized into case group(SN hyperechogenicity,stagesⅢ-V)and control group(normal SN echogenicity,stagesⅠ-Ⅱ).The prevalence of TCS-detected SN hyperechogenicity in PD patients was evaluated,and the clinical and laboratory data between two groups were compared.The risk factors for SN hyperechogenicity in PD patients were identified using multivariate Logistic regression,and a regression equation model of Logit(P)was established based on the results of multivariate analysis.The established model was validated by the Hosmer-Lemeshow goodness-of-fit test and the likelihood ratioχ2 test.Receiver operating characteristic(ROC)curve was constructed to evaluate the predictive accuracy of the model for SN hyperechogenicity in PD patients,and the area under the curve(AUC)was calculated.Results Among 101 PD patients,34(33.66%)exhibited SN hyperechogenicity.Compared with control group,case group had higher percentages of olfactory dysfunction,sleep disorders and H-Y stage≥Ⅲ(P<0.05),and lower levels of serum copper and ceruloplasmin(P<0.05).Multivariate Logistic regression analysis identified olfactory dysfunction,sleep disorders,H-Y stage≥Ⅲ,decreased serum copper and reduced ceruloplasmin as independent risk factors for SN hyperechoicity in PD patients(OR=2.168,2.008,2.063,2.300,1.921,respectively;P<0.05).The predictive model was formalized as Logit(P)=-9.233+olfactory dysfunction×0.774+sleep disorders×0.697+H-Y stage≥Ⅲ×0.724+decreased serum copper×0.833+reduced ceruloplasmin×0.653.ROC analysis showed that when Logit(P)>13.00,the AUC value was 0.876(95%CI:0.795-0.933),with a sensitivity of 73.53%and a specificity of 82.09%.Conclusion The phenomenon of TCS-detected SN hyperechogenicity is severe in PD patients,and its occurrence was associated with olfactory dysfunction,sleep disorders,H-Y stage≥Ⅲ,decreased serum copper and reduced ceruloplasmin,and the predictive model incorporating these factors demonstrated excellent predictive value.

Breast cancer is the number one killer threatening women's health, and the side effects caused by its treatment seriously affect patients' quality of life. Research has confirmed that good patient activation can effectively improve the quality of life of breast cancer patients, and it is of great significance to improve the quality of care and the recovery process of breast cancer patients.The purpose of this study is to review the current situation, assessment tools, influencing factors, and interventions of breast cancer patients' activation, in order to provide reference for researchers to conduct patient activation-related studies in the future.

Pressure injury (PI) not only reduces the quality of life of patients but also is expensive to manage, placing a heavy financial burden on patients and their families, and society. Despite the increasing diversity of methods used to identify early PI, there are still few methods that can truly and accurately predict early PI. The sub-epidermal moisture scanner is the first U.S. Food and Drug Administration-authorized PI management device that can predict the occurrence and development of PI by measuring the level of local tissue bio-capacitance and monitoring the tissue viability. As an emerging diagnostic instrument, the sub-epidermal moisture scanner has already shown great advantages in clinical practice, which can promote the informatization, digitization, and intelligent prevention and management of PI. This paper introduces the pathophysiological mechanism of PI, elucidates the working principle and parameter settings of the sub-epidermal moisture scanner, its clinical application in monitoring tissue viability in early PI, and its limitation, and looks forward to its future development.

Cardiovascular dysfunction and reduced exercise capacity are common adverse effects of anti-cancer treatments, severely impacting the prognosis and quality of life of cancer patients. This review summarizes the intervention protocols and application effects of resistance training on cardiovascular function and/or exercise capacity in cancer patients. The aim is to provide a reference for the practice of exercise interventions targeting cardiovascular function and exercise capacity among cancer patients in China.

Objective To summarize the relevant evidence of skin management around venous leg ulcers,and to provide a reference for medical staff and patients to manage the skin.Methods According to the 6S model,we searched UpToDate,BMJ Best Practice,Guidelines International Network,Medlive,Joanna Briggs Institute,Cochrane Library,PubMed,CNKI,Wanfang data,Health Service Executive,Wound,Ostomy,and Continence Nurses Society,European Society for Vascular Surgery,Association for the Advancement of Wound Care,Wound Healing Society,New Zealand Wound Care Society for all the articles related to skin management around venous leg ulcers.The retrieved literature included clinical decision-making,guidelines,best practices,expert consensuses,evidence summaries,systematic reviews,and randomized controlled trials.The retrieval period was from the inception of databases to October 11,2023.There were 2 nursing postgraduate who evaluated the quality of the included literature,and the evidence was extracted and summarized combined with the opinions of evidence-based nursing experts and wound care specialists.Results A total of 13 articles were included,including 1 clinical decision,1 evidence summary,6 guidelines,1 best practice,1 systematic review,and 3 RCTs.Finally,5 evidence themes and 24 pieces of best evidence were formed including skin therapy,skin cleaning,skin moisturizing,exudation management,and pressure therapy.Conclusion This study summarized the best evidence for the treatment,nursing,exudation management,and pressure therapy of the skin around the ulcer in patients with venous leg ulcers,to provide resource preparation for clinical transformation and guidance for clinical medical care and patient management of the skin around the ulcer.