Objective:To analyze the effect of exercise intervention based on the transtheoretical model on sedentary time and exercise adherence in elderly patients with stroke.Methods:A convenience sample of 60 elderly patients with stroke who visited Fuyang Hospital Affiliated to Anhui Medical University and were registered in community health records between December 2023 and August 2024 was recruited. Participants were randomly assigned to the intervention group ( n=30) and control group ( n=30). The intervention lasted 28 weeks. The control group received standardized home-based exercise program, while the intervention group received exercise intervention based on the transtheoretical model. Sedentary time, exercise adherence, and exercise self-efficacy were assessed before intervention, at week 16, and at week 28. Results:A total of 28 participants in each group completed the study. Sedentary time in the intervention group showed a continuous downward trend over the intervention period and was significantly lower than that in the control group at weeks 16 and 28 ( P<0.05). Exercise adherence in the intervention group was significantly higher at week 28 ( P<0.001). Exercise self-efficacy was significantly higher at week 16 and further improved at week 28 compared with the control group ( P<0.05) . Conclusions:An exercise intervention program designed based on the transtheoretical model can effectively reduce sedentary time, improve exercise adherence, and enhance exercise self-efficacy in elderly patients with stroke.

Background: Maturity-onset diabetes of the young (MODY) due to variants of hepatocyte nuclear factor 1-beta (HNF1β) (MODY5) has not been well studied in the Chinese population. This study aimed to estimate its prevalence and evaluate the application of a clinical screening method (Faguer score) in Chinese early-onset diabetes (EOD) patients. Methods: Among 679 EOD patients clinically diagnosed with type 2 diabetes mellitus (age at diagnosis ≤40 years), the exons of HNF1β were sequenced. Functional impact of rare variants was evaluated using a dual-luciferase reporter system. Faguer scores ≥8 prompted multiplex ligation-dependent probe amplification (MLPA) for large deletions. Pathogenicity of HNF1β variants was assessed following the American College of Medical Genetics and Genomics (ACMG) guidelines. Results: Two rare HNF1β missense mutations (E105K and G454R) were identified by sequencing in five patients, showing functional impact in vitro. Another patient was found to have a whole-gene deletion by MLPA in 22 patients with the Faguer score above 8. Following ACMG guidelines, six patients carrying pathogenic or likely pathogenic variant were diagnosed with MODY5. The estimated prevalence of MODY5 in Chinese EOD patients was approximately 0.9% or higher. Conclusion MODY5 is not uncommon in China. The Faguer score is helpful in deciding whether to perform MLPA analysis on patients with negative sequencing results.

Objective To explore the correlations of serum heat shock protein 70(Hsp70),high-mobility group box 1(HMGB1),glial fibrillary acidic protein(GFAP),and cognitive impair-ment(CI)in patients with cerebral small vessel disease(CSVD).Methods A total of 117 patients with CSVD who were treated at Kailuan General Hospital from July 2023 to July 2024 were selected as study subjects(CSVD group).According to varied scores of the Mini-Mental State Examination(MMSE),they were divided into CI group(54 cases)and non-CI group(63 cases).Additionally,120 healthy individuals who underwent health check-ups during the same period were selected as con-trol group.Clinical data of all subjects were collected.Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression levels of Hsp70,HMGB1,and GFAP in serum.The Spearman method was employed to analyze the correlations of serum Hsp70,HMGB1,and GFAP levels with the occurrence of CI in CSVD patients.Logistic multivariate regression analysis was conducted to screen for influencing factors of CI in CSVD patients.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum Hsp70,HMGB1,and GFAP levels for CI in CSVD patients.Results The serum levels of Hsp70,HMGB1,and GFAP in the CSVD group were higher than those in the control group(P＜0.05).There were no significant differences in gender,age,body mass index,smoking history,drinking history,nature of CSVD,education level,triglyc-erides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),Trail Making Test-A(TMT-A),Trail Making Test-B(TMT-B),and low-density lipoprotein cholesterol(LDL-C)between the CI group and the non-CI group(P＞0.05).The levels of uric acid(UA),serum Hsp70,HMGB1,and GFAP in the CI group were higher than those in the non-CI group,while the Montreal Cognitive Assessment(MOCA)score was lower than that in the non-CI group(P＜0.05).The serum levels of Hsp70,HMGB1,and GFAP in CSVD patients were negatively correla-ted with MMSE scores(r=-0.458,-0.525,-0.431,P＜0.05)and MOCA scores(r=-0.462,-0.583,-0.484,P＜0.05).Logistic regression analysis showed that Hsp70,HMGB1,and GFAP were influencing factors for CI in CSVD patients(P＜0.05).The areas under the curve(AUC)for serum Hsp70,HMGB1,and GFAP levels and their combined prediction of cognitive function in CSVD patients were 0.734,0.769,0.766,and 0.902,respectively.The predictive ef-ficacy of the combined prediction was better than that of individual indicators(P＜0.05).Conclu-sion The serum levels of Hsp70,HMGB1,and GFAP are elevated in CSVD patients,which are closely related to the occurrence of CI.The combined detection of these three proteins has a high predictive value for CI in CSVD patients.

Background: Maturity-onset diabetes of the young (MODY) due to variants of hepatocyte nuclear factor 1-beta (HNF1β) (MODY5) has not been well studied in the Chinese population. This study aimed to estimate its prevalence and evaluate the application of a clinical screening method (Faguer score) in Chinese early-onset diabetes (EOD) patients. Methods: Among 679 EOD patients clinically diagnosed with type 2 diabetes mellitus (age at diagnosis ≤40 years), the exons of HNF1β were sequenced. Functional impact of rare variants was evaluated using a dual-luciferase reporter system. Faguer scores ≥8 prompted multiplex ligation-dependent probe amplification (MLPA) for large deletions. Pathogenicity of HNF1β variants was assessed following the American College of Medical Genetics and Genomics (ACMG) guidelines. Results: Two rare HNF1β missense mutations (E105K and G454R) were identified by sequencing in five patients, showing functional impact in vitro. Another patient was found to have a whole-gene deletion by MLPA in 22 patients with the Faguer score above 8. Following ACMG guidelines, six patients carrying pathogenic or likely pathogenic variant were diagnosed with MODY5. The estimated prevalence of MODY5 in Chinese EOD patients was approximately 0.9% or higher. Conclusion MODY5 is not uncommon in China. The Faguer score is helpful in deciding whether to perform MLPA analysis on patients with negative sequencing results.

Background: Maturity-onset diabetes of the young (MODY) due to variants of hepatocyte nuclear factor 1-beta (HNF1β) (MODY5) has not been well studied in the Chinese population. This study aimed to estimate its prevalence and evaluate the application of a clinical screening method (Faguer score) in Chinese early-onset diabetes (EOD) patients. Methods: Among 679 EOD patients clinically diagnosed with type 2 diabetes mellitus (age at diagnosis ≤40 years), the exons of HNF1β were sequenced. Functional impact of rare variants was evaluated using a dual-luciferase reporter system. Faguer scores ≥8 prompted multiplex ligation-dependent probe amplification (MLPA) for large deletions. Pathogenicity of HNF1β variants was assessed following the American College of Medical Genetics and Genomics (ACMG) guidelines. Results: Two rare HNF1β missense mutations (E105K and G454R) were identified by sequencing in five patients, showing functional impact in vitro. Another patient was found to have a whole-gene deletion by MLPA in 22 patients with the Faguer score above 8. Following ACMG guidelines, six patients carrying pathogenic or likely pathogenic variant were diagnosed with MODY5. The estimated prevalence of MODY5 in Chinese EOD patients was approximately 0.9% or higher. Conclusion MODY5 is not uncommon in China. The Faguer score is helpful in deciding whether to perform MLPA analysis on patients with negative sequencing results.

Background: Maturity-onset diabetes of the young (MODY) due to variants of hepatocyte nuclear factor 1-beta (HNF1β) (MODY5) has not been well studied in the Chinese population. This study aimed to estimate its prevalence and evaluate the application of a clinical screening method (Faguer score) in Chinese early-onset diabetes (EOD) patients. Methods: Among 679 EOD patients clinically diagnosed with type 2 diabetes mellitus (age at diagnosis ≤40 years), the exons of HNF1β were sequenced. Functional impact of rare variants was evaluated using a dual-luciferase reporter system. Faguer scores ≥8 prompted multiplex ligation-dependent probe amplification (MLPA) for large deletions. Pathogenicity of HNF1β variants was assessed following the American College of Medical Genetics and Genomics (ACMG) guidelines. Results: Two rare HNF1β missense mutations (E105K and G454R) were identified by sequencing in five patients, showing functional impact in vitro. Another patient was found to have a whole-gene deletion by MLPA in 22 patients with the Faguer score above 8. Following ACMG guidelines, six patients carrying pathogenic or likely pathogenic variant were diagnosed with MODY5. The estimated prevalence of MODY5 in Chinese EOD patients was approximately 0.9% or higher. Conclusion MODY5 is not uncommon in China. The Faguer score is helpful in deciding whether to perform MLPA analysis on patients with negative sequencing results.

Objective:To explore the effects of proton FLASH irradiation (FLASH-IR) and conventional irradiation (CONV-IR) on the cell cycle, apoptosis, and pyroptosis of renal cancer cells.Methods:Renal cancer cells (769-P) were irradiated with 8 Gy of protons at a dose rate of 40 Gy/s for FLASH-IR and 0.4 Gy/s for CONV-IR, Ctrl group was treated without irradiation. Cells were collected 24 h after irradiation. The changes in the cell cycle were measured using flow cytometry. The expression of genes and proteins related to the cell cycle, apoptosis, and pyroptosis signaling pathways in renal cancer cells was measured using quantitative reverse transcription polymerase chain reaction (RT-qPCR) and Western blot.Results:Proton FLASH-IR increased the proportion of renal cancer cells in the G 0/G 1 phase [FLASH-IR group vs. Ctrl group, (67.01±0.44)% vs. (38.68±0.63)%, t = -63.99, P<0.05], while CONV-IR increased the proportion of renal cancer cells in the G 2/M phase [CONV-IR group vs. Ctrl group, (56.65±1.52)% vs. (23.67±0.51)%, t = -29.17, P<0.05]. Both proton FLASH-IR and CONV-IR caused apoptosis of renal cancer cells ( tFLASH= -16.24 to -5.01, P <0.05; tCONV=-20.08 to 6.11, P < 0.05) and CONV-IR activated the P53/P21 pathway ( t = -16.86 to -9.74, P < 0.05). Both proton FLASH-IR and CONV-IR induced pyroptosis of renal cancer cells ( tFLASH= -23.36 to 20.18, P <0.05; tCONV=-41.62 to 13.95, P <0.05), and the former exhibited a greater effect (FLASH-IR group vs. CONV-IR group, 0.96±0.01 vs. 0.68±0.44, t = -10.46, P <0.05). Conclusions:Both proton FLASH-IR and CONV-IR bring about changes in the cell cycle of renal cancer, promoting apoptosis and pyroptosis. However, there are differences between the two mechanisms that require further exploration. Proton FLASH-IR holds promise for the treatment of renal cancer.

Objective:To explore the effects of proton FLASH irradiation (FLASH-IR) and conventional irradiation (CONV-IR) on the cell cycle, apoptosis, and pyroptosis of renal cancer cells.Methods:Renal cancer cells (769-P) were irradiated with 8 Gy of protons at a dose rate of 40 Gy/s for FLASH-IR and 0.4 Gy/s for CONV-IR, Ctrl group was treated without irradiation. Cells were collected 24 h after irradiation. The changes in the cell cycle were measured using flow cytometry. The expression of genes and proteins related to the cell cycle, apoptosis, and pyroptosis signaling pathways in renal cancer cells was measured using quantitative reverse transcription polymerase chain reaction (RT-qPCR) and Western blot.Results:Proton FLASH-IR increased the proportion of renal cancer cells in the G 0/G 1 phase [FLASH-IR group vs. Ctrl group, (67.01±0.44)% vs. (38.68±0.63)%, t = -63.99, P<0.05], while CONV-IR increased the proportion of renal cancer cells in the G 2/M phase [CONV-IR group vs. Ctrl group, (56.65±1.52)% vs. (23.67±0.51)%, t = -29.17, P<0.05]. Both proton FLASH-IR and CONV-IR caused apoptosis of renal cancer cells ( tFLASH= -16.24 to -5.01, P <0.05; tCONV=-20.08 to 6.11, P < 0.05) and CONV-IR activated the P53/P21 pathway ( t = -16.86 to -9.74, P < 0.05). Both proton FLASH-IR and CONV-IR induced pyroptosis of renal cancer cells ( tFLASH= -23.36 to 20.18, P <0.05; tCONV=-41.62 to 13.95, P <0.05), and the former exhibited a greater effect (FLASH-IR group vs. CONV-IR group, 0.96±0.01 vs. 0.68±0.44, t = -10.46, P <0.05). Conclusions:Both proton FLASH-IR and CONV-IR bring about changes in the cell cycle of renal cancer, promoting apoptosis and pyroptosis. However, there are differences between the two mechanisms that require further exploration. Proton FLASH-IR holds promise for the treatment of renal cancer.

Objective:To explore the barriers encountered by nurses in managing cognitive frailty in elderly patients with chronic heart failure (CHF) .Methods:Using purposive sampling, 15 nurses working in the Cardiovascular and Geriatric Departments of Fuyang Hospital of Anhui Medical University were recruited for semi-structured interviews from January to April 2024. The interview guide was developed based on the Theoretical Domains Framework (TDF), and data were analyzed using thematic analysis.Results:The study identified barriers related to five TDF domains: knowledge/skills, beliefs about consequences, motivation and goals, environmental context and resources, and behavioral regulation. Further refinement revealed specific challenges, including a lack of systematic knowledge and skills in cognitive frailty management for elderly CHF patients, inadequate incentive mechanisms, limited policy support from government and healthcare institutions, and the absence of standardized management protocols for cognitive frailty.Conclusions:Nurses face multiple barriers in managing cognitive frailty in elderly CHF patients. Addressing these challenges requires strengthening training on cognitive frailty knowledge and skills, improving incentive mechanisms, enhancing policy support from governments and healthcare institutions, and establishing standardized quality management systems to enhance nurses' ability to manage cognitive frailty in elderly CHF patients.

Objective:To analyze the effect of exercise intervention based on the transtheoretical model on sedentary time and exercise adherence in elderly patients with stroke.Methods:A convenience sample of 60 elderly patients with stroke who visited Fuyang Hospital Affiliated to Anhui Medical University and were registered in community health records between December 2023 and August 2024 was recruited. Participants were randomly assigned to the intervention group ( n=30) and control group ( n=30). The intervention lasted 28 weeks. The control group received standardized home-based exercise program, while the intervention group received exercise intervention based on the transtheoretical model. Sedentary time, exercise adherence, and exercise self-efficacy were assessed before intervention, at week 16, and at week 28. Results:A total of 28 participants in each group completed the study. Sedentary time in the intervention group showed a continuous downward trend over the intervention period and was significantly lower than that in the control group at weeks 16 and 28 ( P<0.05). Exercise adherence in the intervention group was significantly higher at week 28 ( P<0.001). Exercise self-efficacy was significantly higher at week 16 and further improved at week 28 compared with the control group ( P<0.05) . Conclusions:An exercise intervention program designed based on the transtheoretical model can effectively reduce sedentary time, improve exercise adherence, and enhance exercise self-efficacy in elderly patients with stroke.