Objective To develop the Perceived Spouse Support Scale for pregnant women in the second and third trimester of pregnancy and test its reliability and validity,so as to provide an effective tool for assessing the perceived spouse support level of pregnant women.Methods With social support theory as the theoretical framework,the questionnaire item pool was initially constructed through literature review and semi-structured interview,and the initial questionnaire was formed through expert correspondence and cognitive interview.From April to November 2023,570 pregnant women in the second and third trimester of pregnancy were selected by random sampling method for investigation,item analysis and reliability and validity test of the scale.Results Eventually 558 pregnant women completed the suivey.The Perceived Spouse Support Scale for pregnant women in the second and third trimesters contained 22 items,including instrumental support,informational support and emotional support.The Cronbach's α coefficient of the scale was 0.867;the split-half reliability was 0.793;the retest reliability was 0.965;the content validity index was 0.980.The cumulative variance contribution rate of the 3 common factors was 54.138％.Confirmatory factor analysis suggested that the model fit well.Conclusion The Perceived Spouse Support Scale has good reliability and validity,and it can be used as an evaluation tool for spouse support level of pregnant women.

Aim To investigate the predictive value of lipoprotein(a)[Lp(a)]combined with systemic inflam-matory response index(SIRI)on in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with coronary heart disease.Methods The clinical data of 770 patients with coronary heart disease who underwent PCI in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Xinjiang Medical University from May 2012 to December 2024 and underwent coronary angiography six months after surgery were collected.According to the imaging re-sults,the patients were divided into ISR group(n=194)and non-ISR group(n=576).Multivariate Logistic regression and random forest model were used to analyze the independent risk factors of ISR.Risk factors included in the analysis were glycated hemoglobin,SIRI,Lp(a),lymphocyte count,apolipoprotein A1(ApoA1)and residual cholesterol.Results The levels of Lp(a)and SIRI in the ISR group were significantly higher than those in the non-ISR group(P＜0.05).ROC curve analysis showed that the area under the curve of the combined indicator of Lp(a)and SIRI was 0.789,which was higher than the 0.652 of the single indicator Lp(a)and 0.778 of SIRI.Conclusion Lp(a)and SIRI are independent risk factors for the occurrence of ISR after PCI,and the combination of Lp(a)and SIRI can better predict the occurrence of ISR.

Aim To investigate the predictive value of lipoprotein(a)[Lp(a)]combined with systemic inflam-matory response index(SIRI)on in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with coronary heart disease.Methods The clinical data of 770 patients with coronary heart disease who underwent PCI in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Xinjiang Medical University from May 2012 to December 2024 and underwent coronary angiography six months after surgery were collected.According to the imaging re-sults,the patients were divided into ISR group(n=194)and non-ISR group(n=576).Multivariate Logistic regression and random forest model were used to analyze the independent risk factors of ISR.Risk factors included in the analysis were glycated hemoglobin,SIRI,Lp(a),lymphocyte count,apolipoprotein A1(ApoA1)and residual cholesterol.Results The levels of Lp(a)and SIRI in the ISR group were significantly higher than those in the non-ISR group(P＜0.05).ROC curve analysis showed that the area under the curve of the combined indicator of Lp(a)and SIRI was 0.789,which was higher than the 0.652 of the single indicator Lp(a)and 0.778 of SIRI.Conclusion Lp(a)and SIRI are independent risk factors for the occurrence of ISR after PCI,and the combination of Lp(a)and SIRI can better predict the occurrence of ISR.

Objective To develop the Perceived Spouse Support Scale for pregnant women in the second and third trimester of pregnancy and test its reliability and validity,so as to provide an effective tool for assessing the perceived spouse support level of pregnant women.Methods With social support theory as the theoretical framework,the questionnaire item pool was initially constructed through literature review and semi-structured interview,and the initial questionnaire was formed through expert correspondence and cognitive interview.From April to November 2023,570 pregnant women in the second and third trimester of pregnancy were selected by random sampling method for investigation,item analysis and reliability and validity test of the scale.Results Eventually 558 pregnant women completed the suivey.The Perceived Spouse Support Scale for pregnant women in the second and third trimesters contained 22 items,including instrumental support,informational support and emotional support.The Cronbach's α coefficient of the scale was 0.867;the split-half reliability was 0.793;the retest reliability was 0.965;the content validity index was 0.980.The cumulative variance contribution rate of the 3 common factors was 54.138％.Confirmatory factor analysis suggested that the model fit well.Conclusion The Perceived Spouse Support Scale has good reliability and validity,and it can be used as an evaluation tool for spouse support level of pregnant women.

Objective:To evaluate the clinical efficacy of allogeneic hematopoietic stem cell transplantation（allo-HSCT）in children with severe aplastic anemia（SAA）.Methods:Twenty-seven cases with SAA who had been treated with allo-HSCT from January 2020 to December 2022 were retrospectively analyzed and reviewed.Results:（1）A total of 27 SAA patients were enrolled，including 18 males and 9 females，with a median age of 8 (2-15) years.There were 20 cases of SAA-Ⅰ type,7 cases of SAA-Ⅱ type.Based upon donor sources，three cases of matched sibling donors hematopoietic stem cell transplantation,and 24 cases of haploidentical hematopoietic stem cell transplantation were adopted.（2）Hematopoietic reconstruction was achieved in all 27 cases.The median implantation time of neutrophils and platelets was 10（9-20）days and 12（7-26）days respectively.The cumulative incidence of acute graft-versus-host disease（GVHD）was 66.67%（18/27）.The incidence of grade Ⅰ-Ⅱ was 55.56%（15/27）and that of grade Ⅲ-Ⅳ was 11.11%（3/27）.The incidence of chronic GVHD was 7.41%（2/27）.Transplant-associated thrombotic microangiopathy (TA-TMA) occurred in 7.41%（2/27）patients,cytomegalovirus viremia in 62.96%（17/27）patients,epstein-barr virus infection in 33.33%（9/27）patients,and 14.81%（4/27）patients progressed to post-transplant lymphoproliferative disorder (PTLD).（3）The median follow-up time was 12 (2-28) months.The overall survival rate was 96.29%.Twenty-six patients survived,and one patient died due to multiple complications of severe acute GVHD,TA-TMA,cytomegalovirus infection,PTLD and secondary epilepsy.Conclusion:Allo-HSCT is an effective therapy for SAA in children.The effective rate of this research is 96.29%.Acute GVHD is still the key to therapy.The incidence rate of acute GVHD is 66.67% in this study.The blood incompatibility of donor and recipient may affect the incidence of GVHD.The intensity of GVHD prevention should be reduced after HLA-matched sibling donor-hematopoietic stem cell transplantation so as to avoid the complications of virus recurrence and PTLD.

Objective To investigate the value of non-contrast CT(NCCT)-based radiomics for identifying acute unilateral middle cerebral artery occlusion(MCAO)with negative hyperdense artery sign(HAS).Methods All 80 patients with acute unilateral MCAO confirmed by angiography(MR angiography[MRA]or CT angiography[CTA]or DSA)and presenting with negative NCCT presentation for HAS were enrolled from January 2015 to June 2023 in the Emergency Department of Stroke Center of Affiliated Hospital of Yangzhou university.On the NCCT images,the occluded segment of the middle cerebral artery on the affected side of each case and the corresponding segment of the vessel on the normal side were used as the regions of interest,and a total of 108 radiomic features were extracted.The least absolute shrinkage and selection operator(LASSO)was used to screen the key features,construct and calculate the radiomics score,and four imaging histology models,support vector machine(SVM),light gradient boosting machine(LightGBM),GradientBoosting and adaptive boosting(AdaBoost),were built respectively to predict MCAO.Predictive performance was evaluated by the area under the receiver operating characteristic curves,and comparisons between the modeled receiver operating characteristic curves were made using the Delong test.Finally,the value of the application of radiological modeling was assessed by clinical decision curve analysis(DCA).Results The NCCT images based on 160 vessels were finally screened for 6 key features,including skewness,energy,gray level size zone matrix(GLSZM)-gray uneven,GLSZM-low gray area emphasis,GLSZM-size area non-uniform standardization,GLSZM-area entropy.The area under the curve(AUC)of the SVM-test was 0.688(95％CI 0.497-0.878)with an accuracy of 0.688;the AUC of the LightGBM-test was 0.787(95％CI 0.620-0.955)with an accuracy of 0.781;the AUC of the GradientBoosting-test was 0.654(95％CI 0.457-0.852)with an accuracy of 0.688;the AUC of the AdaBoost-test was 0.707(95％CI 0.515-0.899)with an accuracy of 0.750.The Delong test showed a statistically significant difference between LightGBM-test and GradientBoosting-test(P=0.040),and no statistically significant difference in performance between the remaining models(all P＞0.05).DCA showed that the LightGBM-test performed better.Conclusion NCCT-based radiomics has good diagnostic efficacy for identifying acute unilateral MCAO with negative HAS,and this conclusion needs to be further verified by multi-center and large sample studies.

OBJECTIVE: To observe the clinical efficacy of moxibustion and acupuncture at acupoints of the governor vessel combined with repeated transcranial magnetic stimulation (rTMS) in the treatment of post-stroke fatigue (PSF). METHODS: A total of 78 patients with PSF were randomized into an observation group (39 cases, 1 case dropped out) and a control group (39 cases, 1 case dropped out). The patients in both groups received conventional medical basic treatment. In the control group, rTMS was adopted, 20 min each time. On the basis of the treatment in the control group, therapy of moxibustion and acupuncture at acupoints of the governor vessel was delivered in the observation group, Baihui (GV 20), Dazhui (GV 14), Shenting (GV 24), Fengfu (GV 16), Zhiyang (GV 9), Mingmen (GV 4) and Yaoyangguan (GV 3) were selected, Baihui (GV 20) was treated with moxibustion, Dazhui (GV 14) was treated with collateral-pricking, other acupoints were treated with conventional acupuncture, moxibustion and acupuncture were sustained for 30 min. The treatment in both groups was given once a day for continuous two weeks. Before and after treatment, the scores of fatigue severity scale (FSS), Pittsburgh sleep quality index (PSQI) and Fugl-Meyer motor function assessment (FMA) were observed, and the serum levels of C-reactive protein (CRP), interleukin (IL)-1β and IL-6 were detected in both groups. RESULTS: After treatment, in the two groups, the FSS and PSQI scores, as well as the serum levels of CRP, IL-1βand IL-6 were decreased compared with those before treatment (P<0.05), while FMA scores were increased compared with those before treatment (P<0.05). After treatment, in the observation group, FSS and PSQI scores, as well as the serum levels of CRP, IL-1β and IL-6 were lower than those in the control group (P<0.05), while FMA score was higher than that in the control group (P<0.05). The serum levels of CRP, IL-1β and IL-6 were positively correlated with FSS score in the observation group (P<0.01). CONCLUSION Moxibustion and acupuncture at acupoints of the governor vessel combined with rTMS can effectively alleviate the fatigue, improve the sleep quality and limb function in PSF patients, its mechanism on alleviating fatigue may be related to the down-regulation of serum inflammatory factors.
Humans ; Acupuncture Points ; Male ; Moxibustion ; Female ; Middle Aged ; Aged ; Fatigue/physiopathology* ; Stroke/complications* ; Transcranial Magnetic Stimulation ; Acupuncture Therapy ; Treatment Outcome ; Combined Modality Therapy ; Adult ; Interleukin-6/blood* ; C-Reactive Protein/metabolism*

Objective:To systematically analyze and integrate the psychological experience of heart failure patients using mobile medical applications (App) for self-management.Methods:Qualitative research on the self-management experience of heart failure patients using mobile medical App was retrieved through computer on PubMed, Web of Science, Embase, Cochrane Library, CINAHL, PsycINFO, Australian Joanna Briggs Evidence-Based Health Care Center Database, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biomedical Literature Database. The search period was from the establishment of the database to December 30, 2022. The quality of literature was evaluated in accordance with the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center (2016) . The results were integrated using the aggregative integration method.Results:A total of 14 articles were included, 32 research results were extracted, and 7 new categories were summarized. Finally, three integrated results were obtained (positive experience of heart failure patients using mobile medical App, risks and challenges of heart failure patients using mobile medical App, and preferences and expectations of heart failure patients towards mobile medical App) .Conclusions:The mobile medical App provides new ideas for self-management of heart failure patients, and its effectiveness is recognized by most heart failure patients, who perceive significant benefits. Future research should enrich the functionality and participation forms of the App based on the personalized needs of patients and their families, explore remote health management intervention models at home, and promote the promotion and application of mobile medical App.

BACKGROUND: The literature recommends that reduced dosage of CPT-11 should be applied in patients with UGT1A1 homozygous mutations, but the impact of UGT1A1 heterozygous mutations on the adverse reactions of CPT-11 is still not fully clear. METHODS: A total of 107 patients with UGT1A1 heterozygous mutation or wild-type, who were treated with CPT-11 from January 2018 to September 2021 in Peking University Third Hospital, were retrospectively enrolled. The adverse reaction spectra of patients with UGT1A1*6 and UGT1A1*28 mutations were analyzed. Adverse reactions were evaluated according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) 5.0. The efficacy was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. The genotypes of UGT1A1*6 and UGT1A1*28 were detected by digital fluorescence molecular hybridization. RESULTS: There were 43 patients with UGT1A1*6 heterozygous mutation, 26 patients with UGT1A1*28 heterozygous mutation, 8 patients with UGT1A1*6 and UGT1A1*28 double heterozygous mutations, 61 patients with heterozygous mutation at any gene locus of UGT1A1*6 and UGT1A1*28. Logistic regression analysis showed that the presence or absence of vomiting (P=0.013) and mucositis (P=0.005) was significantly correlated with heterozygous mutation of UGT1A1*28, and the severity of vomiting (P<0.001) and neutropenia (P=0.021) were significantly correlated with heterozygous mutation of UGT1A1*6. In colorectal cancer, UGT1A1*6 was significantly correlated to diarrhea (P=0.005), and the other adverse reactions spectrum was similar to that of the whole patient cohort, and efficacy and prognosis were similar between patients with different genotypes and patients treated with reduced CPT-11 dosage or not. CONCLUSIONS In clinical use, heterozygous mutations of UGT1A1*6 and UGT1A1*28 are related to the risk and severity of vomiting, diarrhea, neutropenia and mucositis in patients with Pan-tumor and colorectal cancer post CPT-11 therpy. In colorectal cancer, UGT1A1*6 is significantly related to diarrhea post CPT-11 use, efficacy and prognosis is not affected by various genotypes or CPT-11 dosage reduction.
Camptothecin/therapeutic use* ; Glucuronosyltransferase/genetics* ; Humans ; Lung Neoplasms/drug therapy* ; Mutation ; Polymorphism, Genetic ; Retrospective Studies

Objective:To evaluate the value of vasoactive-inotropic Score (VIS) at different time points in predicting the 28-day mortality of patients with septic shock, so as to reduce the risk of death and improve the prognosis of patients.Methods:This experiment was a single-center retrospective cohort study. The clinical data of 275 adult patients with septic shock who were treated with vasoactive drugs in the intensive care unit of the Affiliated Hospital of Xuzhou Medical University from February 2016 to February 2020 were collected. According to the 28-day survival condition, all recruited patients were divided into the death group and the survival group, and the maximum vasoactive-inotropic score of all patients at the first 24 h and the second 24 h were calculated, which were expressed as VIS max24 and VIS max48. Multivariate logistic regression analysis was used to find the independent risk factors that influencing the prognosis. The receiver operating characteristic curve was used to analyze the predictive value of VIS. Results:There was no significant difference between the death group and the survival group in the characteristics including age, sex, weight, infection sites, blood culture results, cardiac arrest, hormone use, and 24 h rehydration volume ( P>0.05). APACHE II score, basic lactic acid, and lactic acid after 24 h of treatment were increased significantly in the death group ( P<0.05). VIS max24 could accurately predict the 28-day mortality (AUC=0.953, 95% CI: 0.924-0.982), which were more efficent compared to VIS max48 (AUC=0.919, 95% CI: 0.881-0.957), basic lactic acid (AUC=0.937, 95% CI: 0.900-0.966) and APACHEⅡ score (AUC=0.865, 95% CI: 0.818-0.913). Conclusion:VIS max24 can more accurate predict the 28-day mortality in patients with septic shock.