Objective To translate the Context Assessment for Community Health(COACH)scale into Chinese,thereby providing a standardized measurement tool for context assessment in clinical evidence-based practice.Methods The scale was translated following the Brislin translation model,ultimately forming the Chinese version of the COACH scale.Using convenience sampling,584 healthcare professionals were recruited from 3 tertiary hospitals in Jiangxi,Henan,and Liaoning provinces and 2 community hospitals in Liaoning province from May to September 2024 to evaluate the reliability and validity of the scale.In October 2024,the Chinese version of COACH was applied to 44 healthcare professionals in a hypertension specialist ward of a provincial tertiary hospital.Results Of the 584 distributed questionnaires,519 valid questionnaires were collected(the effective response rate of 88.87％).The Chinese version consists of 7 dimensions with 42 items.The overall Cronbach's α coefficient was 0.975;the McDonald's omega coefficient was 0.979;split-half reliability was 0.808,and the test-retest reliability was 0.917.The scale-content validity index/average was 0.950,and the scale-content validity index/universal agreement was 0.980,with item-content validity index ranging from 0.775 to 1.000.Exploratory factor analysis extracted 7 factors,accounting for 79.260％of the cumulative variance,with factor loadings ranging from 0.569 to 0.954.Confirmatory factor analysis showed good model fit.The preliminary application results showed that the total score of the scale was 185.18±17.82.The correlation coefficients between dimensions and total score ranged from 0.116 to 0.905.Conclusion The Chinese version of the COACH scale demonstrates good reliability and validity,making it suitable as a context measurement tool for implementation research at different stages in clinical and public health settings.

Objective To analyze the effects of intravenous tirofiban following endovascular treatment on the prognosis of patients with acute anterior circulation large vessel occlusion stroke who did not achieve successful recanalization.Methods This retrospective study included consecutive patients with acute anterior circulation ischemic stroke who underwent endovascular treatment but did not achieve successful recanalization.These patients were retrospectively enrolled from the Department of Neurology at Nanjing Jinling Hospital,Affiliated Hospital of Medical School,Nanjing University,the Second Affiliated Hospital of Soochow University,Wuhan No.1 Hospital,and Yijishan Hospital of Wannan Medical College(the First Affiliated Hospital of Wannan Medical College)between January 2015 and April 2023.Baseline and clinical data were collected including age,sex,medical history(hypertension,diabetes,atrial fibrillation,hyperlipidemia),personal history(smoking and drinking),National Institutes of Health stroke scale(NIHSS)score at admission,trial of Org 10172 in acute stroke treatment(TOAST)classification(large artery atherosclerosis,cardioembolism,or other types),Alberta stroke program early CT score(ASPECTS)on admission,intravenous thrombolysis,onset-to-puncture time(OTP),collateral circulation status(poor collaterals:American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology[ASTIN/SIR]score 0-2;good collateral:ASTIN/SIR score 3-4),procedure duration(from femoral or radial artery puncture to device removal),occlusion site,number of passes for thrombus retrieval,and post-procedural modified thrombolysis in cerebral infarction(mTICI)grade.Patients were divided into a tirofiban group and a non-tirofiban group based on whether they received post-procedural intravenous tirofiban.The primary outcome is a favorable functional outcome at 90-day since onset(modified Rankin scale[mRS]score ≤ 3).Safety outcomes included mortality at 90-day since onset(mRS score 6),any intracranial hemorrhage within 24 h post-procedure,and symptomatic intracranial hemorrhage within 24 h post-procedure.1∶1 propensity score matchings using the nearest neighbor method was performed based on variables with P＜0.05 in the comparison between the tirofiban and non-tirofiban groups.Differences in primary and safety outcomes between the matched groups were compared.Univariate and multivariate Logistic regression analyses were conducted with favorable outcomes at 90 days as the dependent variable to evaluate the effect of intravenous tirofiban administration after endovascular therapy on 90-day prognosis in patients without successful recanalization.Results A total of 356 patients without successful recanalization after endovascular treatment were included,comprising 195 males and 161 females,with a median age of 70(61,78)years(32-92 years).Among them,76 and 280patients were assigned to the tirofiban and non-tirofiban groups,respectively.At 90 days,114 patients had favorable outcomes,while 242 had unfavorable outcomes.(1)Before the 1∶1 propensity score matching,significant differences were observed between the tirofiban and non-tirofiban groups in terms of admission NIHSS score,ASPECTS,good collateral circulation,intravenous thrombolysis,and mTICI grade(all P＜0.05).After 1∶1 propensity score matching,66 matched pairs(132 patients)were obtained.No significant differences in the baseline and clinical characteristics were found between the two groups after matching(all P＞0.05).(2)After 1∶1 matching,a significant difference was observed in the rate of favorable outcomes at 90 days between the two groups(48.5％[32/66]vs.30.3％[20/66],P=0.033)after propensity score matching,while no significant differences were found in 90-day mortality,intracranial hemorrhage within 24h,or symptomatic intracranial hemorrhage within 24h(all P＞0.05).(3)Univariate analysis after 1∶1 matching indicated that age,atrial fibrillation,smoking history,admission NIHSS score,M2 segment middle cerebral artery occlusion,good collateral circulation,number of passes for thrombus retrieval,and tirofiban treatment were factors influencing favorable outcomes at 90 days.Multivariate Logistic regression analysis showed that younger age(aOR,0.942,95％CI 0.906-0.978,P=0.002),lower admission NIHSS score(aOR,0.855,95％CI 0.777-0.941,P=0.001),good collateral circulation(aOR,5.534,95％CI 2.141-14.301,P＜0.01),tirofiban treatment(aOR,2.774,95％CI 1.092-7.046,P=0.032),and M2 segment MCA occlusion(reference:internal carotid artery occlusion;aOR,4.874,95％CI 1.428-16.632,P=0.011)were independent predictors of favorable outcomes at 90 days.Conclusions Intravenous tirofiban administration after endovascular therapy may improve 90-day neurological outcomes in patients with acute anterior circulation large vessel occlusion stroke who did not achieve successful recanalization without increasing the risk of hemorrhage.Further large-scale randomized controlled trials are warranted to validate these findings.

Objective:To carry out a scoping review on eHealth literacy in patients with cardiovascular disease to sort out eHealth literacy from four aspects of concepts, assessment tools, influencing factors and interventions, with a view to informing future research and practice.Methods:Based on Arksey and O'Malley's framework for reporting scoping reviews, the literature on eHealth literacy in patients with cardiovascular disease was systematically searched in PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, VIP, Wanfang Data, and China Biomedical Database. The search period was from database establishment to May 3, 2024. Literature was screened, summarized and analyzed.Results:A total of 23 papers were included. The concepts and theoretical frameworks on eHealth literacy had their own focus, but no consensus was reached. The most commonly used tool to assess eHealth literacy in patients with cardiovascular disease was the eHealth Literacy Scale. The influencing factors included four aspects of demographic sociological and disease-related factors, psycho-cognitive factors, eHealth literacy knowledge and skills, and other factors. Interventions to improve eHealth literacy among patients with cardiovascular disease primarily included eHealth literacy training and use of portal-related digital toolkit.Conclusions:Currently there is no specific assessment tool for eHealth literacy for cardiovascular disease patients. In the future, eHealth literacy assessment tools need to be revised and improved according to the population characteristics and cultural background of cardiovascular disease patients. E-health literacy among patients with cardiovascular disease is at a moderately low level and is influenced by multiple factors. The influencing factors can be analyzed in depth through large-sample cross-sectional studies or longitudinal studies, and then a variety of intervention programs can be constructed at home or in the community with the help of multimedia and apps, with a view to improving the e-health literacy of patients with cardiovascular diseases.

Objective To analyze the effects of intravenous tirofiban following endovascular treatment on the prognosis of patients with acute anterior circulation large vessel occlusion stroke who did not achieve successful recanalization.Methods This retrospective study included consecutive patients with acute anterior circulation ischemic stroke who underwent endovascular treatment but did not achieve successful recanalization.These patients were retrospectively enrolled from the Department of Neurology at Nanjing Jinling Hospital,Affiliated Hospital of Medical School,Nanjing University,the Second Affiliated Hospital of Soochow University,Wuhan No.1 Hospital,and Yijishan Hospital of Wannan Medical College(the First Affiliated Hospital of Wannan Medical College)between January 2015 and April 2023.Baseline and clinical data were collected including age,sex,medical history(hypertension,diabetes,atrial fibrillation,hyperlipidemia),personal history(smoking and drinking),National Institutes of Health stroke scale(NIHSS)score at admission,trial of Org 10172 in acute stroke treatment(TOAST)classification(large artery atherosclerosis,cardioembolism,or other types),Alberta stroke program early CT score(ASPECTS)on admission,intravenous thrombolysis,onset-to-puncture time(OTP),collateral circulation status(poor collaterals:American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology[ASTIN/SIR]score 0-2;good collateral:ASTIN/SIR score 3-4),procedure duration(from femoral or radial artery puncture to device removal),occlusion site,number of passes for thrombus retrieval,and post-procedural modified thrombolysis in cerebral infarction(mTICI)grade.Patients were divided into a tirofiban group and a non-tirofiban group based on whether they received post-procedural intravenous tirofiban.The primary outcome is a favorable functional outcome at 90-day since onset(modified Rankin scale[mRS]score ≤ 3).Safety outcomes included mortality at 90-day since onset(mRS score 6),any intracranial hemorrhage within 24 h post-procedure,and symptomatic intracranial hemorrhage within 24 h post-procedure.1∶1 propensity score matchings using the nearest neighbor method was performed based on variables with P＜0.05 in the comparison between the tirofiban and non-tirofiban groups.Differences in primary and safety outcomes between the matched groups were compared.Univariate and multivariate Logistic regression analyses were conducted with favorable outcomes at 90 days as the dependent variable to evaluate the effect of intravenous tirofiban administration after endovascular therapy on 90-day prognosis in patients without successful recanalization.Results A total of 356 patients without successful recanalization after endovascular treatment were included,comprising 195 males and 161 females,with a median age of 70(61,78)years(32-92 years).Among them,76 and 280patients were assigned to the tirofiban and non-tirofiban groups,respectively.At 90 days,114 patients had favorable outcomes,while 242 had unfavorable outcomes.(1)Before the 1∶1 propensity score matching,significant differences were observed between the tirofiban and non-tirofiban groups in terms of admission NIHSS score,ASPECTS,good collateral circulation,intravenous thrombolysis,and mTICI grade(all P＜0.05).After 1∶1 propensity score matching,66 matched pairs(132 patients)were obtained.No significant differences in the baseline and clinical characteristics were found between the two groups after matching(all P＞0.05).(2)After 1∶1 matching,a significant difference was observed in the rate of favorable outcomes at 90 days between the two groups(48.5％[32/66]vs.30.3％[20/66],P=0.033)after propensity score matching,while no significant differences were found in 90-day mortality,intracranial hemorrhage within 24h,or symptomatic intracranial hemorrhage within 24h(all P＞0.05).(3)Univariate analysis after 1∶1 matching indicated that age,atrial fibrillation,smoking history,admission NIHSS score,M2 segment middle cerebral artery occlusion,good collateral circulation,number of passes for thrombus retrieval,and tirofiban treatment were factors influencing favorable outcomes at 90 days.Multivariate Logistic regression analysis showed that younger age(aOR,0.942,95％CI 0.906-0.978,P=0.002),lower admission NIHSS score(aOR,0.855,95％CI 0.777-0.941,P=0.001),good collateral circulation(aOR,5.534,95％CI 2.141-14.301,P＜0.01),tirofiban treatment(aOR,2.774,95％CI 1.092-7.046,P=0.032),and M2 segment MCA occlusion(reference:internal carotid artery occlusion;aOR,4.874,95％CI 1.428-16.632,P=0.011)were independent predictors of favorable outcomes at 90 days.Conclusions Intravenous tirofiban administration after endovascular therapy may improve 90-day neurological outcomes in patients with acute anterior circulation large vessel occlusion stroke who did not achieve successful recanalization without increasing the risk of hemorrhage.Further large-scale randomized controlled trials are warranted to validate these findings.

Objective To translate the Context Assessment for Community Health(COACH)scale into Chinese,thereby providing a standardized measurement tool for context assessment in clinical evidence-based practice.Methods The scale was translated following the Brislin translation model,ultimately forming the Chinese version of the COACH scale.Using convenience sampling,584 healthcare professionals were recruited from 3 tertiary hospitals in Jiangxi,Henan,and Liaoning provinces and 2 community hospitals in Liaoning province from May to September 2024 to evaluate the reliability and validity of the scale.In October 2024,the Chinese version of COACH was applied to 44 healthcare professionals in a hypertension specialist ward of a provincial tertiary hospital.Results Of the 584 distributed questionnaires,519 valid questionnaires were collected(the effective response rate of 88.87％).The Chinese version consists of 7 dimensions with 42 items.The overall Cronbach's α coefficient was 0.975;the McDonald's omega coefficient was 0.979;split-half reliability was 0.808,and the test-retest reliability was 0.917.The scale-content validity index/average was 0.950,and the scale-content validity index/universal agreement was 0.980,with item-content validity index ranging from 0.775 to 1.000.Exploratory factor analysis extracted 7 factors,accounting for 79.260％of the cumulative variance,with factor loadings ranging from 0.569 to 0.954.Confirmatory factor analysis showed good model fit.The preliminary application results showed that the total score of the scale was 185.18±17.82.The correlation coefficients between dimensions and total score ranged from 0.116 to 0.905.Conclusion The Chinese version of the COACH scale demonstrates good reliability and validity,making it suitable as a context measurement tool for implementation research at different stages in clinical and public health settings.

Objective:To carry out a scoping review on eHealth literacy in patients with cardiovascular disease to sort out eHealth literacy from four aspects of concepts, assessment tools, influencing factors and interventions, with a view to informing future research and practice.Methods:Based on Arksey and O'Malley's framework for reporting scoping reviews, the literature on eHealth literacy in patients with cardiovascular disease was systematically searched in PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, VIP, Wanfang Data, and China Biomedical Database. The search period was from database establishment to May 3, 2024. Literature was screened, summarized and analyzed.Results:A total of 23 papers were included. The concepts and theoretical frameworks on eHealth literacy had their own focus, but no consensus was reached. The most commonly used tool to assess eHealth literacy in patients with cardiovascular disease was the eHealth Literacy Scale. The influencing factors included four aspects of demographic sociological and disease-related factors, psycho-cognitive factors, eHealth literacy knowledge and skills, and other factors. Interventions to improve eHealth literacy among patients with cardiovascular disease primarily included eHealth literacy training and use of portal-related digital toolkit.Conclusions:Currently there is no specific assessment tool for eHealth literacy for cardiovascular disease patients. In the future, eHealth literacy assessment tools need to be revised and improved according to the population characteristics and cultural background of cardiovascular disease patients. E-health literacy among patients with cardiovascular disease is at a moderately low level and is influenced by multiple factors. The influencing factors can be analyzed in depth through large-sample cross-sectional studies or longitudinal studies, and then a variety of intervention programs can be constructed at home or in the community with the help of multimedia and apps, with a view to improving the e-health literacy of patients with cardiovascular diseases.

Background:Bioinformatics is an effective technology for microarray data mining and gene function prediction. Aims:To analyze the gene CRELD2 that associated with pathogenesis,disease activity and efficacy of biological agents in ulcerative colitis( UC)by bioinformatics to provide a theoretical basis for subsequent studies on its biological function and molecular mechanism in the development and progress of UC. Methods:The microarray data associated with pathogenesis, disease activity and efficacy of biological agents in UC were downloaded from the Gene Expression Omnibus( GEO database);the data mining and analyses were conducted by using bioinformatics tools such as BRB-ArrayTools, ProtParam,ELM,SignalP 4. 1,PBIL-IBCP Lyon Gerland,GO and STRING. Results:Cross-over analyses revealed that expressions of four genes(CDC25B,CRELD2,IL1RN,PITPNC1)were up-regulated in the order from colonic mucosa of healthy subjects,un-inflamed mucosa of active UC patients to inflamed mucosa of active UC patients,meanwhile these four genes were significantly down-regulated in infliximab responders after treatment when compared with that before treatment and infliximab non-responders. The function of CRELD2 gene was unknown. Bioinformatics analyses showed that CRELD2 gene was located on the long arm of chromosome 22(22q13. 33),and encoded a secreted protein composed of 402 amino acids. This protein contained several epidermal growth factor( EGF)-like domains,mainly distributed in Golgi apparatus, endoplasmic reticulum and extracellular site and had calcium- and protein-binding effect. Interactions existed between CRELD2 and CHRNA4,CHRNB2 and RHBDD3 proteins. Conclusions:Gene CRELD2 may have EGF-like biological function and via participating directly or indirectly the regulation of immunocytes to affect the pathogenesis and disease activity of UC. It might be used as a biomarker for diagnosis and assessment of disease activity and therapeutic efficacy of UC. Furthermore,it might be a potential target for treatment of UC.

Objective To investigate genes and involved biological processes closely associated with stem cell markers of colorectal cancer-epithelial cell adhesion molecule (EpCAM) + and CD44+.Methods By the bioinformatics method,with microarray data of colorectal cancer from gene expression omnibus (GEO) database and R2 platform,the genes significantly related with CD44 and EpCAM expression were screened out.The differences in expression of related genes were analyzed on the basis of gender,family history of cancer,alcohol and Dukes stage.The expression of related genes in colorectal cancer was compared with that of other tumors and healthy subjects.At same time,the pathways of the genes and Kyoto encyclopedia of genes and genomes (KEGG) of CD44 and EpCAM significantly related genes were analyzed with gene ontology (GO) and KEGG method.Single factor analysis of variance and Chi-square test of four-fold table with correction for continuity were used for statistical analysis by R2 platform embedded statistical tools.Results The expressions of CD44 and EpCAM were detected in all 315 colorectal cancer samples.A total of 888 and 6 316 genes were screened out which were significantly associated with CD44 and EpCAM expression.CD44 was positively correlated with EpCAM.There was no obvious correlation between the expression of five genes which expressed in all 315 tissues and gender family history of cancer,alcohol and Dukes stage (all P＞0.05).By further compared with the expression in other tumors and tissues,the expressions of two genes solute carrier family 12,member 2 (SLC12A2) and proteome of centriole 1 centriolar protein B (POC1B) in colorectal tumor were significantly higher than that in other tumors (F=289.422、128.456,all P＜0.01),and its expression in colorectal cancer was obviously higher than that in tissues of health subjects (F=349.519、128.456,all P＜0.01).GO analysis indicated there were 15 GO semantics related with both CD44 and EpCAM.The genes related with CD44 and EpCAM were analyzed by KEGG access pathway method,while seven and 10 pathways were found to be statistically significant (all P＜0.01).Conclusions CD44 and FpCAM commonly expressed in colorectal cancer.The genes related with CD44 and EpCAM expression are involved in multiple tumor biological processes.