Caregivers for chronic disease patients of caregiver activation emphasizes the subjective initiative and preparedness of caregivers in managing patients' health conditions and medical needs.Caregivers with high activation levels can participate more effectively in disease management,significantly improve the quality of care,and have a positive impact on their own mental health and quality of life.This article reviews the concept,assessment tools,current situation,influencing factors,and intervention strategies of caregiver activation,and proposes future research directions,aiming to provide references for conducting research and practical exploration related to caregiver activation.

Objective To investigate the nutritional quality characteristics of vitamin D3-fortified yogurt and explore its improving effect on vitamin D metabolism in the body under simulated weightlessness,thereby providing a theoretical basis for the development of functional foods.Methods Using reconstituted milk as the matrix and Vitamin D3(VD3)microcapsule powder as the fortifier,VD3-fortified yogurt was prepared.A systematic study was conducted to investigate the effects of different gradients(1.25 μg/100 mL,2.50 μg/100 mL,3.75 μg/100 mL,5.00 μg/100 mL,6.25 μg/100 mL)of VD3 microcapsule addition on its quality characteristics(titratable acidity,solid content,water-holding capacity,syneresis).In vivo assessments were conducted using a Sprague-Dawley(SD)rat tail-suspension model to simulate weightlessness.Levels in serum 25(OH)D3,1,25-(OH)2D3,calcium(Ca),and phosphorus(P)were detected using the enzyme-linked immunosorbent assay(ELISA)to evaluate its metabolic capacity.Results During fermentation(3 h),titratable acidity of VD?-fortified yogurt initially increased,then decreased,and eventually stabilized with rising microcapsule dosage,while total solid content remained consistent.WHC exhibited an initial increase followed by a decline,whereas syneresis showed an inverse trend.At an optimal dosage of 3.75 μg/100 mL,the yogurt displayed a dense and uniform network structure,characterized by non-Newtonian fluid behavior with shear-thinning properties.This formulation demonstrated robust structural stability under high-frequency mechanical stress,alongside desirable textural,flavor,and sensory attributes.Animal experiments revealed that the serum concentrations of 25(OH)D3,1,25-(OH)2D3,calcium,and phosphorus in the vitamin D?-fortified yogurt intervention group were significantly higher than those in the tail-suspended control group(P<0.05).Conclusion VD? microencapsulation technology effectively preserves and enhances the nutritional quality characteristics of yogurt and mitigates vitamin D metabolic dysregulation under simulated weightlessness.

Objective:To document any effect of combining transcranial magnetic stimulation (rTMS) with peripheral magnetic stimulation (rPMS) to relieve shoulder pain in hemiplegic stroke survivors.Methods:Sixty hemiplegic stroke survivors with shoulder pain were randomly divided into a Central Group ( n=20), a Peripheral Group ( n=20), and a Combined Group ( n=20). In addition to routine pharmacological intervention and rehabilitation training, the Central Group received 10Hz rTMS over the M1 area of the affected hemisphere, the Peripheral Group received 20Hz rPMS at Erb′s point of the affected limb, while the Combined Group received rTMS followed by rPMS. Before as well as after 2 and 4 weeks of treatment, all were assessed using a numerical pain intensity rating scale (NRS), for passive range of motion (PROM) of the shoulder joint, and using the Fugl-Meyer upper extremity assessment (FMA). Results:Before the treatment there were no significant differences among the 3 groups. After 2 weeks there was significant improvement in the average shoulder PROM and FMA scores, and a significant decrease in the average NRS ratings. After 4 weeks there was continued significant improvement. After 2 and 4 weeks, the Combined Group gave significantly lower NRS ratings than the others and had greater average shoulder PROM improvement. The average FMA score of the Combined Group (36.10±13.32) after two weeks was significantly better than those of the Central and Peripheral groups. However, no significant differences were found between the Central and Peripheral Groups in the other measurements.Conclusions:Both rTMS and rPMS can relieve shoulder pain and promote the recovery of motor function, with superior synergistic effects observed in their combined application.

Caregivers for chronic disease patients of caregiver activation emphasizes the subjective initiative and preparedness of caregivers in managing patients' health conditions and medical needs.Caregivers with high activation levels can participate more effectively in disease management,significantly improve the quality of care,and have a positive impact on their own mental health and quality of life.This article reviews the concept,assessment tools,current situation,influencing factors,and intervention strategies of caregiver activation,and proposes future research directions,aiming to provide references for conducting research and practical exploration related to caregiver activation.

Objective:To document any effect of combining transcranial magnetic stimulation (rTMS) with peripheral magnetic stimulation (rPMS) to relieve shoulder pain in hemiplegic stroke survivors.Methods:Sixty hemiplegic stroke survivors with shoulder pain were randomly divided into a Central Group ( n=20), a Peripheral Group ( n=20), and a Combined Group ( n=20). In addition to routine pharmacological intervention and rehabilitation training, the Central Group received 10Hz rTMS over the M1 area of the affected hemisphere, the Peripheral Group received 20Hz rPMS at Erb′s point of the affected limb, while the Combined Group received rTMS followed by rPMS. Before as well as after 2 and 4 weeks of treatment, all were assessed using a numerical pain intensity rating scale (NRS), for passive range of motion (PROM) of the shoulder joint, and using the Fugl-Meyer upper extremity assessment (FMA). Results:Before the treatment there were no significant differences among the 3 groups. After 2 weeks there was significant improvement in the average shoulder PROM and FMA scores, and a significant decrease in the average NRS ratings. After 4 weeks there was continued significant improvement. After 2 and 4 weeks, the Combined Group gave significantly lower NRS ratings than the others and had greater average shoulder PROM improvement. The average FMA score of the Combined Group (36.10±13.32) after two weeks was significantly better than those of the Central and Peripheral groups. However, no significant differences were found between the Central and Peripheral Groups in the other measurements.Conclusions:Both rTMS and rPMS can relieve shoulder pain and promote the recovery of motor function, with superior synergistic effects observed in their combined application.

Objective:To explore the significance of CAS-R-2 frameless brain stereotactic apparatus assisted trepanation and drainage in the treatment of hypertensive basal ganglia cerebral hemorrhage.Methods:The clinical data of 60 patients with hypertensive basal ganglia cerebral hemorrhage, who underwent CAS-R-2 frameless brain stereotactic apparatus assisted trepanation and drainage in Beijing Luhe Hospital, Capital Medical University from January 2018 to December 2022, were retrospectively analyzed. The surgical related indexes and adverse reactions were recorded. The patients were followed up for 6 months, and the prognosis was evaluated using the Glasgow outcome score (GOS).Results:A total of 60 cases of CAS-R-2 frameless brain stereotactic apparatus assisted trepanation and drainage were all successfully performed, and the operation time was (53 ± 18) min. There were 2 cases (3.3%) of postoperative puncture path hematoma, which were completely resolved with conservative treatment. The expansion of postoperative intracerebral hematoma was not observed. The drainage tube retention after operation ≤2 d was in 44 cases (73.3%), and the drainage tube retained for 3 to 4 d was in 16 cases (26.7%), all of them had no intracranial infection after operation. Fifteen cases (25.0%) were complicated with severe pneumonia after operation, and 2 cases (3.3%) died due to severe pneumonia combined with multiple organ failure. Follow up at 6 months after operation, 17 cases (28.3%) were good, 19 cases (31.7%) had mild disability, 16 cases (26.7%) had severe disability, 6 cases (10.0%) had vegetative survival status, and 2 cases (3.3%) died.Conclusions:The CAS-R-2 frameless brain stereotactic instrument assisted trepanation and drainage for the treatment of hypertensive basal ganglia cerebral hemorrhage has the characteristics of simple operation, accurate positioning, minimal trauma, and fewer complications. It is a safe and effective method for treating hypertensive basal ganglia cerebral hemorrhage.

This study aimed to explore the roles of microRNAs (miRNAs) in the post-transcriptional regulation of cocaine- and amphetamine-regulated transcript (CART) peptide in the bovine hypothalamus and to screen key regulatory miRNAs. Targetscan was used to predict the potential miRNAs binding to CART 3' untranslated regions (3'UTR). Bioinformatics analysis predicted 7 miRNA binding sites in the bovine CART 3'UTR, which were bta-miR-377, bta-miR-331-3p, bta-miR-491, bta-miR-493, bta-miR-758, bta-miR-877, and bta-miR-381, respectively. Reverse transcription-PCR (RT-PCR) was carried out to determine the endogenous expression of CART and target miRNAs in the bovine hypothalamus. All the 7 target miRNAs and CART were endogenously expressed in the bovine hypothalamus. The dual-luciferase reporter gene assay was employed to detect the targeted binding relationship between CART 3'UTR and target miRNAs obtained from bioinformatics analysis. The dual-luciferase reporter gene assay confirmed that the 3'UTR of CART had a targeted binding relationship with the 7 target miRNAs. Cell experiments were conducted to examine the effects of target miRNAs on the messenger RNA (mRNA) and protein levels of exogenous CART and screen for key regulatory miRNAs. The results of cell experiments showed that the 7 miRNAs downregulated the mRNA level of CART, with bta-miR-491 demonstrating the strongest downregulating effect. Bta-miR-377, bta-miR-331-3p, bta-miR-491, bta-miR-493, and bta-miR-381 downregulated the protein level of CART, with bta-miR-381 exerting the strongest downregulating effect. Animal experiments were conducted to explore the effects of key regulatory miRNAs on the mRNA and protein levels of CART in the hypothalamus and the CART concentration in the serum. The results from animal experiments showed that miR-491 and miR-381 regulated the endogenous expression of CART in the hypothalamus and the concentration in the serum by binding to the CART 3'UTR. These results suggest that miR-491 and miR-381 are the main miRNAs regulating CART expression in the bovine hypothalamus, which can affect serum CART concentration by modulating endogenous CART expression.
Animals ; MicroRNAs/metabolism* ; Cattle ; Hypothalamus/metabolism* ; 3' Untranslated Regions/genetics* ; Nerve Tissue Proteins/metabolism* ; Gene Expression Regulation ; Binding Sites ; Base Sequence ; Computational Biology/methods* ; Cocaine- and Amphetamine-Regulated Transcript Protein

Objective This study was to evaluate the relative applicability of serum cystatin C(Cys C)-based formulas and serum creatinine-based formulas for renal glomerular filtration rate(GFR) of Chinese children with chronic kidney disease(CKD).Methods Six hundred and nine Chinese CKD patients of less than 18 years old were enrolled from January 2011 to October 2016 in Shengjing Hospital of China Medical University.The value for estimated GFR (eGFR) was derived from using the 11 formulas,and 99mTc-DTPA renal dynamic imaging was the golden standard of standard GFR(sGFR).SPSS 22.0 statistical software was used to compare the accuracy of each assessment formula and the correlation between GFR markers(Cys C, β2-MG) and sGFR.Results A total of 609 children were enrolled,including 332 patients in CKD stage 1 (211 males and 121 females),165 patients in CKD stage 2(99 males and 66 females),70 patients in CKD stage 3(43 males and 27 females),22 patients in CKD stage 4(13 males and 9 females),and 20 patients in CKD stage 5(16 males and 4 females).All of the formulas either overestimate or underestimate GFR in chil-dren with CKD. In contrast with other formulas,CKD-EPI formula and Filler formula performed better regardless of gender and age difference.Serum β2-MG and serum Cys C all showed a negative relationship with sGFR(respectively r= -0.478 and r= -0.585,P<0.01).Conclusion CKD-EPI formula and Filler formula provide the better approximation to sGFR than other formulas in Chinese children with CKD.Howev-er,we need to try our best to enroll more patients to develop a more accurate GFR estimation formula in Chinese children.

OBJECTIVETo investigate the outcomes after combined organ radical resection for the recurrent gastric cancer.

METHODSComplete clinicopathological data of 48 recurrent gastric cancer patients who received radical resection before and underwent reoperation again in the Sun Yat-sen Memorial Hospital and The Second Affiliated Hospital of Xinjiang Medical University from January 2008 to December 2013 were analyzed retrospectively. Of 48 patients, 32 received combined organ radical resection(radical group) and 16 received combined organ palliative gastric stump resection (palliative group).

RESULTSIn the radical group, one case(3.1%,1/32) died 5 days after operation due to hepatorenal syndrome and 9 had postoperative complications (28.1%,9/32), including external intestinal fistula, pancreatic fistula, biliary fistula and anastomotic bleeding. In the palliative group, only one patient(6.2%, 1/16) had postoperative pneumonia and partial intestinal obstruction, with lower complication morbidity as compared to the radical group(P<0.05). The median survival time was significantly longer in the radical group(36.0 vs. 11.5 months, P<0.01). The 1- and 3-year survival rates were 93.1%, 72.4% in the radical group, and 31.3%, 18.8% in palliative group, whose differences were statistically significant. Multivariate Cox regression analysis showed that clinical stage (HR:3.106, 95% CI:1.357-6.321, P=0.008), peritoneal metastasis (HR:10.167, 95% CI:3.230-35.234, P=0.000) and radical cure situation(HR:3.256, 95% CI:1.267-9.389, P=0.009) were independent prognostic factors.

CONCLUSIONThe combined organ radical resection can provide better survival for recurrent gastric cancer patients, while the indications should be controlled strictly with preoperative multidisciplinary assessment and precise surgical judgment in order to decrease the complication.

Gastrectomy ; Gastric Stump ; surgery ; Humans ; Neoplasm Recurrence, Local ; surgery ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Stomach Neoplasms ; surgery ; Survival Rate