Objective To investigate the interaction relationship among symptoms in middle-aged patients during the recovery period of stroke and explore its correlation with rehabilitation confidence,providing a reference for the implementation of precise rehabilitation nursing.Methods A cross-sectional study was conducted,and 365 middle-aged patients in the recovery period of stroke who were hospitalized in 4 tertiary general hospitals in Wuhan from April 20 to August 31,2024 were conveniently selected as the subjects of the investigation.Data were collected using the General Information Questionnaire,Stroke Symptom Experience Scale,and Confidence after Stroke Measure Questionnaire.Symptom network analysis was conducted using R software,and a network structure model of symptoms-rehabilitation confidence was constructed;meanwhile,the stability of the network structure was evaluated.Results Finally,350 middle-aged stroke patients in the recovery period were included.The most common symptom was"limb weakness"(81.1％).Symptom network analysis showed that"limited limb movement"was the core symptom(rs=1.118).The symptoms strongly associated with recovery confidence were"limited physical movement","annoyance at not being able to do what you want to do"and"slow reaction times".Stability tests suggest that the model results are all good.Conclusion Symptoms of middle-aged patients in the recovery period after stroke are interrelated,and the mechanisms by which different symptoms affect rehabilitation confidence are also different.It is recommended that healthcare professionals prioritize interventions based on core symptoms and inter-symptom relationships in order to accurately enhance patient outcomes and improve recovery outcomes.

Objective To explore the temporal characteristics and correlation between active exercise rehabilitation behaviour and related symptoms in middle-aged chronic obstructive pulmonary disease(COPD)patients,and to provide a basis for constructing a full cycle precision rehabilitation management system.Methods The ecological momentary assessment method was used to select 63 middle-aged COPD patients from the respiratory and critical care medicine department of a tertiary comprehensive hospital in Wuhan from October 15 to December 1,2024,using convenience sampling.Their active exercise rehabilitation behaviour(number of exercise projects,duration)and related symptoms(dyspnea,fatigue,anxiety)were continuously monitored for a week by using baseline survey,daily active exercise rehabilitation behavior assessment questionnaire,daily symptom assessment questionnaire.A multi-layer linear model was used to analyze the dynamic correlation between active exercise rehabilitation behaviour and symptoms.Results 58 patients were included.During the 1-week ecological momentary assessment,the system triggered a total of 1,218 momentary assessments and obtained 1,120 valid responses(with the valid response rate of 91.95％),with patients completing an average of(2.76±0.39)assessments per day.Multilevel linear models showed that momentary dyspnoea,fatigue,anxiety symptoms and baseline kinesiophobia all significantly negatively influenced active exercise rehabilitation behaviour(P＜0.05).Conclusion There are dynamic changes in the active exercise rehabilitation behaviour and related symptoms of middle-aged COPD patients.Nursing staff should establish a precise rehabilitation intervention system based on symptom fluctuations,strengthen patient self-management efficiency through dynamic monitoring and hierarchical management,and achieve long-term optimization of lung rehabilitation effects.

Objective To investigate the interaction relationship among symptoms in middle-aged patients during the recovery period of stroke and explore its correlation with rehabilitation confidence,providing a reference for the implementation of precise rehabilitation nursing.Methods A cross-sectional study was conducted,and 365 middle-aged patients in the recovery period of stroke who were hospitalized in 4 tertiary general hospitals in Wuhan from April 20 to August 31,2024 were conveniently selected as the subjects of the investigation.Data were collected using the General Information Questionnaire,Stroke Symptom Experience Scale,and Confidence after Stroke Measure Questionnaire.Symptom network analysis was conducted using R software,and a network structure model of symptoms-rehabilitation confidence was constructed;meanwhile,the stability of the network structure was evaluated.Results Finally,350 middle-aged stroke patients in the recovery period were included.The most common symptom was"limb weakness"(81.1％).Symptom network analysis showed that"limited limb movement"was the core symptom(rs=1.118).The symptoms strongly associated with recovery confidence were"limited physical movement","annoyance at not being able to do what you want to do"and"slow reaction times".Stability tests suggest that the model results are all good.Conclusion Symptoms of middle-aged patients in the recovery period after stroke are interrelated,and the mechanisms by which different symptoms affect rehabilitation confidence are also different.It is recommended that healthcare professionals prioritize interventions based on core symptoms and inter-symptom relationships in order to accurately enhance patient outcomes and improve recovery outcomes.

Objective To explore the temporal characteristics and correlation between active exercise rehabilitation behaviour and related symptoms in middle-aged chronic obstructive pulmonary disease(COPD)patients,and to provide a basis for constructing a full cycle precision rehabilitation management system.Methods The ecological momentary assessment method was used to select 63 middle-aged COPD patients from the respiratory and critical care medicine department of a tertiary comprehensive hospital in Wuhan from October 15 to December 1,2024,using convenience sampling.Their active exercise rehabilitation behaviour(number of exercise projects,duration)and related symptoms(dyspnea,fatigue,anxiety)were continuously monitored for a week by using baseline survey,daily active exercise rehabilitation behavior assessment questionnaire,daily symptom assessment questionnaire.A multi-layer linear model was used to analyze the dynamic correlation between active exercise rehabilitation behaviour and symptoms.Results 58 patients were included.During the 1-week ecological momentary assessment,the system triggered a total of 1,218 momentary assessments and obtained 1,120 valid responses(with the valid response rate of 91.95％),with patients completing an average of(2.76±0.39)assessments per day.Multilevel linear models showed that momentary dyspnoea,fatigue,anxiety symptoms and baseline kinesiophobia all significantly negatively influenced active exercise rehabilitation behaviour(P＜0.05).Conclusion There are dynamic changes in the active exercise rehabilitation behaviour and related symptoms of middle-aged COPD patients.Nursing staff should establish a precise rehabilitation intervention system based on symptom fluctuations,strengthen patient self-management efficiency through dynamic monitoring and hierarchical management,and achieve long-term optimization of lung rehabilitation effects.

Objective Based on the original text of Synopsis of Golden Chamber,we summarized and analyzed the pulse manifestation,characteristics of disease location,nature and syndrome,and main diseases of the stringed pulse in order to provide a systematic reference for its clinical application.Methods The sentences containing"stringed pulse"were sorted out according to the order of chapters in Synopsis of Golden Chamber firstly.Then the characteristics of pulse manifestation and pathogenesis were summarized.Finally,its main diseases and clinical significance were analyzed.Results This study summarized characteristics of the stringed pulse manifestation in Synopsis of Golden Chamber:the pulse flexibility is as tight as a bow string,the pulse shapes are straight up and down.And characteristics of the string pulse pathogenesis:the disease location is mainly interior,located in the chest,abdomen,liver and ribs;the nature of disease mainly tends to cold syndrome and excess syndrome;the main symptom is pain.There are seven main diseases related to string pulse:disease with symptoms such as convulsion,opisthotonos,trismus;malaria;stagnation of qi in chest;cold abdominal colic;Fluid retention disease;gastric disorder causing nausea and spasm.Conclusion The characteristics and main diseases of the string pulse reflected in the Synopsis of the Golden Chamber embody the thinking mode of diagnosis and treatment based on disease,syndrome and pulse,which has had a profound impact on the theory of diagnosis and treatment in later generations.

Objective Based on the original text of Synopsis of Golden Chamber,we summarized and analyzed the pulse manifestation,characteristics of disease location,nature and syndrome,and main diseases of the stringed pulse in order to provide a systematic reference for its clinical application.Methods The sentences containing"stringed pulse"were sorted out according to the order of chapters in Synopsis of Golden Chamber firstly.Then the characteristics of pulse manifestation and pathogenesis were summarized.Finally,its main diseases and clinical significance were analyzed.Results This study summarized characteristics of the stringed pulse manifestation in Synopsis of Golden Chamber:the pulse flexibility is as tight as a bow string,the pulse shapes are straight up and down.And characteristics of the string pulse pathogenesis:the disease location is mainly interior,located in the chest,abdomen,liver and ribs;the nature of disease mainly tends to cold syndrome and excess syndrome;the main symptom is pain.There are seven main diseases related to string pulse:disease with symptoms such as convulsion,opisthotonos,trismus;malaria;stagnation of qi in chest;cold abdominal colic;Fluid retention disease;gastric disorder causing nausea and spasm.Conclusion The characteristics and main diseases of the string pulse reflected in the Synopsis of the Golden Chamber embody the thinking mode of diagnosis and treatment based on disease,syndrome and pulse,which has had a profound impact on the theory of diagnosis and treatment in later generations.

Objective To explore the influencing factors of ecological momentary assessment(EMA)in the implementation of home rehabilitation exercise for middle-aged stroke patients,and to provide a basis for decision-making and practice of precision rehabilitation nursing for stroke.Methods This descriptive qualitative research utilized purposive sampling method to select 8 medical staff,4 information technicians,8 middle-aged stroke patients,and 5 caregivers from a tertiary A general hospital in Wuhan from January 2 to March 10,2024 as the research subjects.Semi-structured interview was conducted based on the framework of diffusion of innovations theory.The data were analyzed using directed content analysis.Results 5 themes and 10 sub-themes were extracted,including relative advantage factors(conducive to precise and dynamic evaluation of patient rehabilitation behavior and symptom trajectory by medical staff;enhancing patient self-management awareness,effectively reducing care burden),compatibility factors(new methods conflict with existing values;new methods are in line with clinical work practice),complexity factors(evaluation frequency affects the accuracy of rehabilitation tracking;limited limb function and social support increase user burden),experimental factors(pilot and real-time feedback improve user experience;experience summary and promotion,the strengthening of practical verification orientation),and observable factors(successful cases of mobile health help popularize new methods;visualization of new methods to enrich mobile health practice).Conclusion There are certain promoting and hindering factors in the implementation of EMA in the field of home rehabilitation exercise for middle-aged stroke patients.In the future,it is necessary to explore the potential of EMA in the field of precision rehabilitation and ensure its compatibility with clinical practice.

Background and objective Both of lung cancer incidence and mortality rank first among all cancers in China.Previous lung cancer screening trials were mostly selective screening for high-risk groups such as smokers.Non-smoking women accounted for a considerable proportion of lung cancer cases in Asia.This study aimed to evaluate the outcome of community-based mass screening in Guangzhou and identify the high-risk factors for lung cancer.Methods Residents aged 40-74 years in Guangzhou were screened with low-dose computed tomography(LDCT)for lung cancer and the pulmonary nodules were classified and managed according to China National Lung Cancer Screening Guideline with Low-dose Computed Tomography(2018 version).The detection rate of positive nodules was calculated.Before the LDCT examination,residents were required to complete a"lung cancer risk factors questionnaire".The risk factors of the questionnaire were analyzed by least absolute shrinkage and selection operator(LASSO)penalized Logistic regression analysis.Results A total of 6256 residents were included in this study.1228 positive nodules(19.63％)and 117 lung cancers were confirmed,including 6 cases of Tis,103 cases of stage Ⅰ(accounting for 88.03％of lung cancer).The results of LASSO penalized Logistic regression analysis indicated that age ≥50 yr(OR=1.07,95％CI:1.06-1.07),history of cancer(OR=3.29,95％CI:3.22-3.37),textile industry(OR=1.10,95％CI:1.08-1.13),use coal for cooking in childhood(OR=1.14,95％CI:1.13-1.16)and food al-lergy(OR=1.10,95％CI:1.07-1.13)were risk factors of lung cancer for female in this district.Conclusion This study highlighted that numerous early stages of lung cancer cases were detected by LDCT,which could be applied to screen-ing of lung cancer in women.Besides,age ≥50 yr,personal history of cancer,textile industry and use coal for cooking in childhood are risk factors for women in this district,which suggested that it's high time to raise the awareness of early lung cancer screening in this group.

Objective We aimed to investigate the mechanism of Tianma(tall gastrodia tuber)-Hongjingtian(rose root)medicinal pair in regulating tumor necrosis factor-α(TNF-α)/nuclear factor-κB(NF-κB)to protect the endothelial cell barrier in mice with hypoperfused-cerebral small vessel disease.Methods Seventy male C57BL/6 mice were assigned to the sham operation group,model group,Tianma-Hongjingtian groupⅠ,Ⅱ,and Ⅲ(the mass ratio of Tianma to Hongjingtian were 1:1,2:1,and 1:2),with 14 mice in each group.A unilateral common carotid artery occlusion mouse model was established.The mice of each group were gavaged once at six hours after the surgery then once every 24 h thereafter.The doses of Tianma-Hongjingtian groupⅠ,Ⅱ,and Ⅲ were 1.30,1.95,and 1.95 g/(kg·d),and the sham operation and model groups were administered with the same volume of saline.Cerebral blood flow detection and behavioral post and sampling were performed on the 3rd day(acute phase)and 7th day(subacute phase)of the experiment.Laser diffuse linear ratio imaging was used to observe changes in cerebral blood flow.A gait analyzer was used to evaluate motor coordination.Hematoxylin-eosin staining combined with light microscopy was used to observe pathological and morphological changes in brain tissue.Western blotting was used to detect the expression level of albumin.Immunofluorescence and Western blotting were used to detect the expression levels of tight junction proteins(Occludin and ZO-1).The expression levels of TNF-α,NF-κB,IL-β,and IL-6 were detected through RT-PCR and Western blotting.Results Compared with the sham operation group,cerebral blood flow was reduced on the 3rd day and 7th day in the model group(P<0.05);gait abnormalities of prolonged swing duration,reduced stride frequency,and reduced gait equilibrium(P<0.05)were observed;severe pathological damage was observed in brain tissues,with increased level of albumin expression,decreased protein expression levels of Occludin and ZO-1(P<0.05);mRNA and protein expression levels of TNF-α,NF-κB,IL-β,and IL-6 increased(P<0.05).Compared with the model group,the cerebral blood flow of mice on the 3rd and 7th day in the three Tianma-Hongjingtian groups was elevated(P<0.05);swinging duration was shortened,step frequency increased,gait equilibrium was elevated(P<0.05);brain histopathological damage was reduced,albumin expression level decreased(P<0.05),and the expression levels of Occludin and ZO-1 proteins were elevated(P<0.05);the mRNA and protein expression levels of TNF-α,NF-κB,IL-β,and IL-6 were decreased(P<0.05).Among them,the combined efficacy was better on the 3rd day of Tianma-Hongjingtian group Ⅱ;the combined efficacy was better on the 7th day of Tianma-Hongjingtian groupⅢ.Conclusion Tianma-Hongjingtian can increase cerebral blood flow,improve gait abnormalities,reduce pathological damage to brain tissue,and protecte the function and structure of the endothelial barrier in mice with hypoperfused cerebral small vessel disease,and the mechanism may be related to decreasing the expression of inflammatory factors.

Objective To investigate the relationship between serum micro RNA(miRNAs)-873 and micro RNA-138-5p expression and tumor immune microenvironment(TIME)and prognosis in patients with non-small cell lung cancer(NSCLC).Methods A total of 108 NSCLC patients(NSCLC group)and 65 healthy volunteers(control group)who were admitted to Ba'nan Hospital Affiliated to Chongqing Medical University from February 2019 to February 2021 were selected.Real-time quantitative fluorescence polymeric chain reaction(qRT-PCR)was used to detect the expression of miR-873 and miR-138-5p in serum,and multiple immunofluorescence staining was used to detect tumor immune microenvironment indicators.Regular follow-up was conducted after discharge.Pearson analyzed the correlation between the expression of miR-873 and miR-138-5p in serum and the TIME index,and Kaplan-Meier and COX proportional risk regression analyzed the relationship between miR-873 and miR-138-5p and the prognosis of NSCLC patients.Results Comparison with control group,the expressions of miR-873(1.02±0.23 vs 3.15±0.82)and miR-138-5p(1.21±0.26 vs 3.54±0.92)in serum of NSCLC group were decreased,and the differences were statistically significant(t=-25.426,-24.769,all P＜0.05).The expressions of serum miR-873 and miR-138-5p of patients with low-to-moderate differentiation in TNM stages Ⅲ to Ⅳ were lower than those with highly differentiated patients in TNM stages Ⅰ to Ⅱ(t=9.615,10.253;6.889,3.361,all P＜0.05).The expressions of miR-873 and miR-138-5p in serum were negatively correlated with the values of PD-1,PD-L1,CD4 and CD8 H(r=-0.418～-0.673,all P＜0.05).The OS survival rate of NSCLC patients with low expression of miR-873 and miR-138-5p was lower than that of those with high expression of miR-873 and miR-138-5p(Log-Rankχ2=4.724,5.607,P＜0.05).TNM stage Ⅲ～Ⅳ was a risk factor for poor prognosis in patients with NSCLC(P＜0.05),and miR-873 and miR-138-5p were protective factors(P＜0.05).Conclusion The expressions of miR-873 and miR-138-5p in serum of NSCLC patients are down-regulated,which is related to TIME and low survival rate.