Objective To review the application scope of risk communication based on eHealth technology in the primary prevention of cardiovascular diseases,so as to provide references for future research and application.Methods A systematic search was conducted in PubMed,Cochrane Library,Embase,Web of Science,CINAHL,PsycINFO,CNKI,Wanfang database,and SinoMed.The search time limit was from the establishment of databases to March 1,2024.The included literature was summarized and analyzed.Results A total of 24 articles were included.The forms of eHealth technology applied in risk communication for primary prevention of cardiovascular include online websites,computerized decision support systems,electronic health records,mobile applications,email,telephone,and text messages.The functions include risk assessment,risk notification,personalized advice,risk tracking and reminders.The outcome indicators include risk perception,physiological indicators,lifestyle and behavior,psychological indicators,feasibility evaluation,decision correlation,doctor-patient communication,intention,risk score,and physician drug prescription.Conclusion The use of eHealth technology in risk communication of cardiovascular diseases has potential value in improving patients'risk perception and promoting healthy behaviors.It is necessary to continuously improve the functions of eHealth technology and enhance its precision and intelligence,so as to better meet the needs of medical staff and patients and promote the efficient implementation of primary prevention of cardiovascular diseases.

Objective To review the application scope of risk communication based on eHealth technology in the primary prevention of cardiovascular diseases,so as to provide references for future research and application.Methods A systematic search was conducted in PubMed,Cochrane Library,Embase,Web of Science,CINAHL,PsycINFO,CNKI,Wanfang database,and SinoMed.The search time limit was from the establishment of databases to March 1,2024.The included literature was summarized and analyzed.Results A total of 24 articles were included.The forms of eHealth technology applied in risk communication for primary prevention of cardiovascular include online websites,computerized decision support systems,electronic health records,mobile applications,email,telephone,and text messages.The functions include risk assessment,risk notification,personalized advice,risk tracking and reminders.The outcome indicators include risk perception,physiological indicators,lifestyle and behavior,psychological indicators,feasibility evaluation,decision correlation,doctor-patient communication,intention,risk score,and physician drug prescription.Conclusion The use of eHealth technology in risk communication of cardiovascular diseases has potential value in improving patients'risk perception and promoting healthy behaviors.It is necessary to continuously improve the functions of eHealth technology and enhance its precision and intelligence,so as to better meet the needs of medical staff and patients and promote the efficient implementation of primary prevention of cardiovascular diseases.

Purpose: To understand the recurrence risk perception of stroke patients and develop a chain mediation model of recurrence risk perception and health behavior. Methods: A cross-sectional study and convenience sampling were used. Stroke survivors were recruited from the neurology departments of three tertiary hospitals. Their recurrence risk perception, behavioral decision-making, social support, self-efficacy, recurrence worry, and health behavior were measured by relevant tools. Data was analyzed through one-way analysis and regression analysis, and the AMOS 21.0 software was used to explore the mediating relationships between variables. Results: Of the 419 participants, 74.7% were aware of stroke recurrence risk. However, only 28.2% could accurately estimate their own recurrence risk. Recurrence risk perception was significantly correlated with behavioral decision-making, social support, self-efficacy, and health behavior (r = .19 ∼ .50, p < .05). Social support and recurrence risk perception could affect health behavior indirectly through self-efficacy, behavioral decision-making, and worry. Behavioral decision-making acted as a main mediator between recurrence risk perception and health behavior, while the path coefficient was .47 and .37, respectively. The chain mediation effect between recurrence risk perception and health behavior was established with a total effect value of .19 (p < .01). Conclusion Most stroke survivors could be aware of recurrence risk but failed to accurately estimate their individual risk. In the mediation model of recurrence risk perception and health behavior, social support seemed to be an important external factor, while self-efficacy, behavioral decision-making, and worry seemed to act as key internal factors.

Objective To explore the value of lipoprotein-associated phospholipase A2(Lp-PLA2)in the diagnostic grading and prog-nostic assessment of pneumonia-associated acute respiratory distress syndrome(p-ARDS).Methods The study was a prospective ob-servational study.Fifty-seven patients with p-ARDS admitted to the ICU ward of Tianjin Hospital from January 2022 to August 2023 were included as the research subjects.Twenty-six pneumonia patients admitted to the general respiratory ward during the same period and 10 healthy individuals undergoing medical examinations were selected as the control group.Their serum samples were collected,and the samples from p-ARDS and pneumonia patients were obtained within 24 hours of admission.The levels of serum Lp-PLA2,in-terleukin 6(IL-6),and IL-8 were detected using the Luminex? multiplex test kit.The baseline data and laboratory test results,inclu-ding routine blood parameters,biochemical markers,C-reactive protein(CRP),procalcitonin(PCT),and D-dimer at admission,were collected from the patients with p-ARDS or pneumonia.The levels of serum Lp-PLA2 were compared by grouping based on clinical diagnosis,severity of ARDS,and clinical outcomes on day 28 after admission.The diagnostic and prognostic value of serum Lp-PLA2 in p-ARDS was evaluated by plotting the receiver operating characteristic(ROC)curve,Spearman correlation analysis,and Logistic regression analysis.Results The levels of serum Lp-PLA2 in the p-ARDS group([233.67±83.49]ng/mL)were significantly higher than that in the pneumonia group([150.86±39.48]ng/mL,P＜0.05),while those in the pneumonia group were significantly higher than that in the healthy control group([150.86±39.48]ng/mL vs[92.07±12.89]ng/mL,P＜0.05).The analysis results of the ROC curve showed that serum Lp-PLA2 had a better ability to distinguish p-ARDS from pneumonia than indicators such as IL-6,IL-8,CRP,and PCT,with an area under the ROC curve(AUCROC)of 0.781(95％CI:0.685-0.878).The diagnostic value of serum Lp-PLA2 combined with D-dimer was higher,with an AUCROC of 0.897(95％CI:0.832-0.963).Subgroup analysis found that as lung inju-ry worsened,the levels of serum Lp-PLA2 increased,and that serum Lp-PLA2 levels were negatively correlated with the PaO2/FiO2 ra-tio in p-ARDS patients(r=-0.549)and positively correlated with the sequential organ failure assessment(SOFA)scores at admission(r=0.412).The levels of serum Lp-PLA2 in the death group of p-ARDS were significantly higher than that in the survival group([314.5±43.1]ng/mL vs[174.9±48.9]ng/mL,P＜0.001).Logistic regression analysis showed that after adjusting for the SOFA score,serum Lp-PLA2 was independently associated with the mortality risk on day 28 after admission(OR=1.099,95％CI:1.026-1.178,P=0.007).Similar results were obtained after adjusting for IL-8 or the PaO2/FiO2 ratio.Conclusion Serum Lp-PLA2 may be used as a biomarker to aid in the diagnostic grading and prognostic assessment of p-ARDS.

Purpose: To understand the recurrence risk perception of stroke patients and develop a chain mediation model of recurrence risk perception and health behavior. Methods: A cross-sectional study and convenience sampling were used. Stroke survivors were recruited from the neurology departments of three tertiary hospitals. Their recurrence risk perception, behavioral decision-making, social support, self-efficacy, recurrence worry, and health behavior were measured by relevant tools. Data was analyzed through one-way analysis and regression analysis, and the AMOS 21.0 software was used to explore the mediating relationships between variables. Results: Of the 419 participants, 74.7% were aware of stroke recurrence risk. However, only 28.2% could accurately estimate their own recurrence risk. Recurrence risk perception was significantly correlated with behavioral decision-making, social support, self-efficacy, and health behavior (r = .19 ∼ .50, p < .05). Social support and recurrence risk perception could affect health behavior indirectly through self-efficacy, behavioral decision-making, and worry. Behavioral decision-making acted as a main mediator between recurrence risk perception and health behavior, while the path coefficient was .47 and .37, respectively. The chain mediation effect between recurrence risk perception and health behavior was established with a total effect value of .19 (p < .01). Conclusion Most stroke survivors could be aware of recurrence risk but failed to accurately estimate their individual risk. In the mediation model of recurrence risk perception and health behavior, social support seemed to be an important external factor, while self-efficacy, behavioral decision-making, and worry seemed to act as key internal factors.

Purpose: To understand the recurrence risk perception of stroke patients and develop a chain mediation model of recurrence risk perception and health behavior. Methods: A cross-sectional study and convenience sampling were used. Stroke survivors were recruited from the neurology departments of three tertiary hospitals. Their recurrence risk perception, behavioral decision-making, social support, self-efficacy, recurrence worry, and health behavior were measured by relevant tools. Data was analyzed through one-way analysis and regression analysis, and the AMOS 21.0 software was used to explore the mediating relationships between variables. Results: Of the 419 participants, 74.7% were aware of stroke recurrence risk. However, only 28.2% could accurately estimate their own recurrence risk. Recurrence risk perception was significantly correlated with behavioral decision-making, social support, self-efficacy, and health behavior (r = .19 ∼ .50, p < .05). Social support and recurrence risk perception could affect health behavior indirectly through self-efficacy, behavioral decision-making, and worry. Behavioral decision-making acted as a main mediator between recurrence risk perception and health behavior, while the path coefficient was .47 and .37, respectively. The chain mediation effect between recurrence risk perception and health behavior was established with a total effect value of .19 (p < .01). Conclusion Most stroke survivors could be aware of recurrence risk but failed to accurately estimate their individual risk. In the mediation model of recurrence risk perception and health behavior, social support seemed to be an important external factor, while self-efficacy, behavioral decision-making, and worry seemed to act as key internal factors.

Objective:To systematically integrate qualitative study on stroke patients' perception of recurrence risk, so as to providing evidence for optimizing stroke risk communication education and secondary prevention strategies.Methods:Qualitative studies related to the perception of recurrence risk in stroke patients were searched through computers on PubMed, Web of Science, Embase, CINAHL, Cochrane Library, Joanna Briggs Institute (JBI) Evidence-Based Health Care Centers Database, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biomedical Medicine Database. The search period was from the establishment of the database to September 2022. The articles quality were evaluated using the quality evaluation criteria for qualitative research of the Australian JBI Evidence-Based Health Care Center (2020) . The results were integrated by Meta-synthesis.Results:A total of 7 articles were included, 37 research results were extracted, 9 new categories were summarized, and 3 integrated results were obtained, which were respectively the perceived characteristics of recurrence risk in stroke patients, the barriers to accurate perception of recurrence risk, and the ways to actively or negatively address recurrence risk.Conclusions:In clinical practice, it is necessary to carry out early dynamic assessment of recurrence risk perception among stroke patients, attach importance to and optimize communication and education on recurrence risk, improve comprehensive support mechanisms, so as to promote stroke patients to participate in and adhere to active risk management.

Objective:To search, evaluate and summarize the best evidence on falls prevention and management in the frail elderly to provide ideas and references for clinical practice.Methods:Evidences related to falls prevention and management in the frail elderly were systematically searched on BMJ Best Practice, UpToDate, Registered Nurses' Association of Ontario, National Guideline Clearinghouse, National Institute for Health and Clinical Excellence, Medlive, Joanna Briggs Institute (JBI) Evidence Based Health Care Center Database in Australia, Scottish Intercollegiate Guideline Network, Cochrane Library, CINAHL, PubMed, Web of Science, Embase, CNKI, Wanfang Database, VIP and China Biology Medicine disc. The search period was from the establishment of the database to March 1, 2023. Three researchers independently evaluated quality of the included literature, and extracted, integrated and graded the evidence.Results:A total of 24 literatures were included, including 13 systematic reviews, 4 expert consensus, 6 guidelines and 1 evidence summary. A total of 30 evidences were summarized from 5 aspects of frailty screening, assessment, disease and medication management, exercise management and nutrition management.Conclusions:This study summarizes the best evidence for fall prevention and management in the frail elderly. It is suggested that practitioners should formulate a management plan in accordance with the actual situation in combination with the application scenario and the situation of the elderly, so as to improve the intervention level and reduce the incidence of falls in the frail elderly.

Objective:To explore the relationship between Th17 immunoregulatory system and depression and reveal the mechanism of depression from the perspective of neuroimmunity, as well to look for biomarkers that can be used to diagnose, evaluate and predict recurrence of depression.Methods:A total of 91 patients with depression including 45 first-episode patients (FED group) and 46 recurrent episodes patients (RMDD group) were collected who were admitted to Psychiatry Department of the First Affiliated Hospital of Zhengzhou University from March 2019 to May 2020. And 40 healthy controls matched with depression patients in age, gender and education level were collected as control group (HC group). The levels of eight inflammatory cytokines in Th17 immunoregulatory system (five pro-inflammatory cytokines: IL-1β, IL-6, IL-17A, IL-21, IL-23; three anti-inflammatory cytokines: TGF-β1, IL-10, and IL-27) were measured by enzyme-linked immunosorbent assay (ELISA). Hamilton depression scale-24 (HAMD-24) was used to evaluate the severity of depressive symptoms. Data analyses were performed with SPSS 23.0.Two independent samples t-test, one-way ANOVA, Mann Whitney U test and Kruskal Wallis H test were used for comparison between groups. Results:(1) Comparison of FED group, RMDD group and HC group showed that the levels of pro-inflammatory cytokines IL-1β (5.321(1.317, 21.287)ng/L, 11.277(4.315, 26.167) ng/L, 8.126(1.179, 9.287) ng/L), IL-6(7.787(2.077, 16.778) ng/L, 5.290(2.364.14.475) ng/L, 4.389(1.453, 4.491) ng/L), IL-21 (6.777(6.293, 9.198) ng/L, 7.261(6.293, 25.058)ng/L, 5.097(3.033, 6.507) ng/L) and anti-inflammatory cytokines TGF-β1 (59.098(13.491, 125.368) ng/L, 46.230(18.852, 122.559) ng/L, 25.292(2.716, 31.874) ng/L), IL-10 (226.930(105.117, 449.444) ng/L, 193.929(109.014, 468.269) ng/L, 131.429(77.587, 157.497) ng/L) and IL-27 (0.968(0.651, 1.879)ng/L, 1.859(0.690, 6.221) ng/L, 0.865(0.679, 1.287)ng/L) in plasma were statistically different( H=7.219, 9.482, 18.989, 16.166, 11.511, 6.262, all P<0.05), while the levels of pro-inflammatory cytokines IL-17A (2.175(1.031, 7.975)ng/L, 3.576(1.896, 11.611)ng/L, 3.807(1.301, 4.710)ng/L)and IL-23 (15.708(2.898, 114.175) ng/L, 26.893(9.282, 58.592) ng/L, 17.041(5.027, 23.613)ng/L) were not statistically significant ( H=2.179, 4.305, both P>0.05). Further pairwise comparisons showed that the levels of pro-inflammatory cytokines IL-6, IL-21 and anti-inflammatory cytokines TGF-β1 and IL-10 in plasma of FED group were higher than those of HC group, and the differences were statistically significant (all P<0.05). The levels of pro-inflammatory cytokines IL-1β, IL-6, IL-21 and anti-inflammatory cytokines TGF-β1, IL-10, IL-27 in RMDD group were higher than those in HC group, and the differences were statistically significant (all P<0.05). There were no significant differences in the eight inflammatory cytokines between FED group and RMDD group (all P>0.05). (2) Spearman correlation analysis showed that IL-1β was positively correlated with total score of HAMD-24 ( r=0.286, P<0.05). IL-6 was positively correlated with total score of HAMD-24 and factor score of anxiety or somatization ( r=0.390, 0.291, both P<0.05). TGF-β1 was negatively correlated with total score of HAMD-24 and factor scores of anxiety or somatization and cognitive impairment ( r=-4.200, -0.321, - 0.361, all P<0.05). IL-21 was positively correlated with factor score of sleep ( r=0.319, P<0.05); IL-10 was negatively correlated with total score of HAMD-24 and factor score of cognitive impairment ( r=-0.306, - 0.270, both P<0.05). There was no significant correlation between other inflammatory cytokines and total score of HAMD-24 and seven factor scores (all P>0.05). Conclusion:There is an imbalance in pro-and anti-inflammatory cytokines of Th17 immunoregulatory system in patients with depression, which is more obvious in recurrent episodes patients.The level of immune activation of Th17 immunoregulatory system may be associated with the severity of clinical symptoms, in which the inflammatory cytokine IL-6 may be a biomarker of major depressive disorder; TGF-β1 and IL-21 may be associated with depressive cognitive impairment and sleep.

Early intervention of alexithymia in patients with Parkinson's disease is of great significance to disease development, quality of life, interpersonal relationship and social support. This article reviews the concept, classification, pathological mechanism, prevalence, influencing factors, adverse effects, evaluation tools and intervention measures of alexithymia in patients with Parkinson's disease, aiming to provide ideas and directions for future research on alexithymia in patients with Parkinson's disease in China.