Myocardial fibrosis is a serious cause of heart failure and even sudden cardiac death. However, the mechanisms underlying myocardial ischemia-induced cardiac fibrosis remain unclear. Here, we identified that the expression of sterile alpha and TIR motif containing 1 (SARM1), was increased significantly in the ischemic cardiomyopathy patients, dilated cardiomyopathy patients (GSE116250) and fibrotic heart tissues of mice. Additionally, inhibition or knockdown of SARM1 can improve myocardial fibrosis and cardiac function of myocardial infarction (MI) mice. Moreover, SARM1 fibroblasts-specific knock-in mice had increased deposition of extracellular matrix and impaired cardiac function. Mechanically, elevated expression of SARM1 promotes the deposition of extracellular matrix by directly modulating P4HA1. Notably, by using the Click-iT reaction, we identified that the increased expression of ZDHHC17 promotes the palmitoylation levels of SARM1, thereby accelerating the fibrosis process. Based on the fibrosis-promoting effect of SARM1, we screened several drugs with anti-myocardial fibrosis activity. In conclusion, we have unveiled that palmitoylated SARM1 targeting P4HA1 promotes collagen deposition and myocardial fibrosis. Inhibition of SARM1 is a potential strategy for the treatment of myocardial fibrosis. The sites where SARM1 interacts with P4HA1 and the palmitoylation modification sites of SARM1 may be the active targets for anti-fibrosis drugs.

Objective:To explore the current situation and influencing factors of burnout among the primary caregivers of stroke patients, so as provide a basis for clinical intervention measures.Methods:From July 2022 to January 2023, convenience sampling was used to select 506 caregivers of stroke patients who met the inclusion and exclusion criteria from Yinchuan Rehabilitation Hospital and Wuzhong Rehabilitation Hospital as the study subject. The survey was conducted using the General Information Questionnaire, Burnout Scale of Stroke Patients' Caregiver, Multidimensional Scale of Perceived Social Support, Trait Coping Style Questionnaire, and Hospital Anxiety and Depression Scale.Results:The burnout score of caregivers for stroke patients was (72.83±14.32). Multiple linear regression analysis showed that the educational level and self-care ability of patients, social support, coping styles, and depression of primary caregivers were the influencing factors of burnout among primary caregivers in stroke patients ( P<0.05) . Conclusions:Attention should be paid to the burnout of the primary caregivers of stroke patients. Medical and nursing staff should focus on the primary caregivers who care for patients with low educational level and poor self-care ability, and improve their social support, encourage them to actively respond, relieve their depression, to alleviate their burnout.

This paper reviewed the mental health status, influencing factors, and intervention measures of the main caregivers of stroke patients both domestically and internationally, so as to provide reference for clinical work and research.

Objective:To explore the current situation of resourcefulness among the primary caregivers of stroke patients and analyze its influencing factors.Methods:From December 2020 to August 2021, convenience sampling was used to select 311 primary caregivers of stroke patients in the Neurology Department of three ClassⅢ Grade A general hospitals in Yinchuan City as the research subject. A survey was conducted using the General Information Questionnaire, Resourcefulness Scale, Self-Rating Depression Scale, Chinese Perceived Stress Scale, Social Support Revalued Scale, and the Fatigue Scale-14.Results:A total of 311 questionnaires were distributed and 308 valid questionnaires were collected, with a valid response rate of 99.04%. The resourcefulness score of the primary caregivers of 308 stroke patients was (83.98±12.85). The random forest model showed that when the λ-value was 1.667, the error was the smallest, and the corresponding number of influencing factors was 7. The independent variables ranked in the top 7 in importance were included in multiple stepwise regression. Multiple stepwise regression analysis showed that perceived stress, educational level, and fatigue were the main influencing factors on the resourcefulness of the primary caregivers of stroke patients, and the differences were statistically significant ( P<0.05) . Conclusions:The main caregivers of stroke patients have a moderate level of resourcefulness and require certain attention. Nursing staff can collaborate with social workers and other personnel to provide support and assistance to caregivers, alleviate their physical and mental stress, thereby improving their resourcefulness and the quality of care.

Objective:To explore the potential categories of psychological distress in spousal caregivers of stroke patients and differences in quality of life between categories, in order to provide a theoretical basis for early clinical identification and provision of individualized and targeted interventions for psychological distress in spousal caregivers of stroke patients and improvement of their quality of life.Methods:A total of 207 spouse caregivers of stroke patients hospitalized in three class 1-Grade A hospitals in Yinchuan city of Ningxia Hui Autonomous Region, who met the inclusion and exclusion criteria were selected from December 2020 to July 2021 by convenience sampling method as study subjects. The general information questionnaire, Kessler Psychological Distress Scale, and the Mos 36-Item Short from Health Survey were used for a cross-sectional survey.Results:A total of 203 spousal caregivers of stroke patients were finally investigated, 46 males and 157 females with a age of (58.65 ± 9.66) years. Psychological distress among spousal caregivers of stroke patients was categorized into 3 potential categories:no distress group (40%, 81/203), listlessness group (45%, 91/203) and helplessness and restlessness group (15%, 31/203). The psychological distress subgroup was a factor influencing the quality of life of spousal caregivers of stroke patients ( t=-10.03, P<0.05), explaining 33.0% of the variance in quality of life. Conclusions:Psychological distress in spousal caregivers of stroke patients is significantly heterogeneous. Those in the helplessness and restlessness group have the lowest quality of life and should be given focused attention and early intervention.

Objective:To evaluate the epidemiological characteristics and explore the associated factors of breakthrough cases (BC) from Public Health Emergency Events (PHEEs) of varicella in Zhejiang Province from 2019 to 2022.Methods:Data on cases were obtained from the China Information System for Disease Control and Prevention and the PHEEs Reporting Information Database of Varicella in Zhejiang Province. History records were matched through the Zhejiang Provincial Immunization Information System. Descriptive analysis and multiple logistic regression model with a bidirectional stepwise selection method were performed to explore associated factors for BC during 2019-2022.Results:A total of 144 276 varicella cases were reported from 2019 to 2022, with the annual reported incidence of 47.35-82.80 cases per 100 000 population. Among these cases, 109 172 were non-breakthrough cases (NBC, accounting for 75.67%), 34 517 were BC (23.92%), and the rest 587 cases had unclear vaccination history on varicella (0.41%). A total of 214 PHEEs of varicella were reported, of which 99.07% occurred in school settings. The proportion of PHEEs that occurred in high school increased significantly as time went on ( χ2trend=5.742, P=0.017). Multiple logistic regression model which focused on "BC vs. NBC (as the reference)" indicated that the year of onset ( OR=1.585, 95% CI:1.343-1.878), the month of onset (taking January as the reference, OR=2.311-15.652), city (taking Hangzhou as the reference, Jiaxing OR=2.370, Jinhua OR=2.197, Lishui OR=0.134), age ( OR=0.887, 95% CI: 0.826-0.944), PHEEs setting (taking "primary school and below" as the reference, "high school and above" OR=0.516, 95% CI: 0.305-0.897), and the number of rashes ( OR=0.569, 95% CI: 0.458-0.703) were associated factors. Multiple logistic regression model which focused on "two-dose BC vs. one-dose BC (as the reference)" showed that the age of initial vaccination ( OR=0.045, 95% CI: 0.014-0.107), the time interval from onset to the last dose ( OR=0.037, 95% CI: 0.011-0.087) and the age of onset ( OR=20.724, 95% CI: 8.383-72.485) were associated factors. Conclusion:During 2019-2022, the reported high-risk group of varicella in Zhejiang Province has shifted to adolescents and young adults. Although vaccination could not completely prevent the onset of VZV, it could relieve clinical symptoms and delay the age of onset.

Objective:To evaluate the epidemiological characteristics and explore the associated factors of breakthrough cases (BC) from Public Health Emergency Events (PHEEs) of varicella in Zhejiang Province from 2019 to 2022.Methods:Data on cases were obtained from the China Information System for Disease Control and Prevention and the PHEEs Reporting Information Database of Varicella in Zhejiang Province. History records were matched through the Zhejiang Provincial Immunization Information System. Descriptive analysis and multiple logistic regression model with a bidirectional stepwise selection method were performed to explore associated factors for BC during 2019-2022.Results:A total of 144 276 varicella cases were reported from 2019 to 2022, with the annual reported incidence of 47.35-82.80 cases per 100 000 population. Among these cases, 109 172 were non-breakthrough cases (NBC, accounting for 75.67%), 34 517 were BC (23.92%), and the rest 587 cases had unclear vaccination history on varicella (0.41%). A total of 214 PHEEs of varicella were reported, of which 99.07% occurred in school settings. The proportion of PHEEs that occurred in high school increased significantly as time went on ( χ2trend=5.742, P=0.017). Multiple logistic regression model which focused on "BC vs. NBC (as the reference)" indicated that the year of onset ( OR=1.585, 95% CI:1.343-1.878), the month of onset (taking January as the reference, OR=2.311-15.652), city (taking Hangzhou as the reference, Jiaxing OR=2.370, Jinhua OR=2.197, Lishui OR=0.134), age ( OR=0.887, 95% CI: 0.826-0.944), PHEEs setting (taking "primary school and below" as the reference, "high school and above" OR=0.516, 95% CI: 0.305-0.897), and the number of rashes ( OR=0.569, 95% CI: 0.458-0.703) were associated factors. Multiple logistic regression model which focused on "two-dose BC vs. one-dose BC (as the reference)" showed that the age of initial vaccination ( OR=0.045, 95% CI: 0.014-0.107), the time interval from onset to the last dose ( OR=0.037, 95% CI: 0.011-0.087) and the age of onset ( OR=20.724, 95% CI: 8.383-72.485) were associated factors. Conclusion:During 2019-2022, the reported high-risk group of varicella in Zhejiang Province has shifted to adolescents and young adults. Although vaccination could not completely prevent the onset of VZV, it could relieve clinical symptoms and delay the age of onset.

Objective:To explore the potential categories of resourcefulness in primary caregivers of stroke patients and analyze the differences in the characteristics of different types of caregivers, so as to provide basis for clinical construction of effective intervention plans.Methods:The 308 primary caregivers of stroke patients who met the research standards in the Department of Neurology of General Hospital of Ningxia Medical University, People′s Hospital of Ningxia Hui Autonomous Region, the First People′s Hospital of Yinchuan from December 2020 to August 2021 were selected as the research objects by convenient sampling method.The general information questionnaire, Resourcefulness Scale and Social Support Revalued Scale were used for cross-sectional investigation.Results:The resourcefulness of the primary caregivers of stroke patients were divided into 2 potential categories: low resourcefulness group (62.7%, 193/308) and high resourcefulness group (37.3%, 115/308). Uni-variate analysis showed that there were differences between potential categories: age and education level of stroke patients, whether there was long-term medication history, number of other chronic diseases, had there been any complications due to illness, age, education level and occupation of caregivers, average daily care duration, family relations, and social support ( χ2 values were -3.34 - 23.62, all P<0.05). Logistic regression analysis showed that social support and education level of caregivers were the influencing factors of caregiver resourcefulness ( P<0.05). Conclusions:The resourcefulness in the primary caregivers of stroke patients has certain characteristics. Clinically, targeted intervention measures should be formulated according to the different types of caregiver resourcefulness characteristics of caregivers and their influencing factors to improve the caregiver resourcefulness of stroke patients.

Objective:To construct a conceptual framework of burnout among primary caregivers of stroke patients based on grounded theory.Methods:According to the characteristics of age, gender, relationship with patients, length of care and other characteristics of purpose sampling method, from December 2021 to March 2022, 31 primary caregivers of stroke patients were selected for semi-structured interviews in two second-class hospitals, a first-class hospitals and a community health service station in Wuzhong city and Yinchuan city. The data were analyzed in procedural grounded theory method.Results:A total of 29 primary categories and 9 secondary categories were formed. The conceptual framework of burnout among primary caregivers of stroke patients was finally established, which consisted of four main categories (role burnout, physical burnout, psychological burnout and social burnout) and a core category (burnout of primary caregivers of stroke patients).Conclusions:The conceptual framework of burnout among primary caregivers of stroke patients constructed in this study elaborates the connotation of burnout of primary caregivers of stroke patients from four aspects, which can provide a basis for the development of assessment tools and the formulation of intervention measures in the future.

Objective:To explore any effect of the single- and dual-task treadmill training on the functioning of children with bilateral spastic cerebral palsy.Methods:Fifty children with bilateral spastic cerebral palsy were randomly divided into a single-task treadmill training group (the control group, n=25) and a dual-task treadmill training group (the observation group, n=25). All of the children also received routine rehabilitation training, and the control and observation groups also conducted single- and dual-task treadmill training in addition to the routine rehabilitation training, respectively. Before and after 2 months of treatment, each child′s gross motor functioning was quantified using sections D (standing) and E (walking, running and jumping) of the Gross Motor Function Measurement-88 (GMFM-88) instrument. Balance was quantified using the Pediatric Balance Scale (PBS) and walking mobility was quantified using a 1 minute walking test (1MWT). Modified and dual task Timed Up and Go (mTUG) tests and dual-task effects (DTE) tests were also administered. Results:There were no significant differences in average test scores between the two groups before the treatment. After the treatment significant improvement was observed in both groups. There was no significant difference between the two groups in terms of average GMFM-88, PBS and 1MWT scores, but significantly greater improvement was observed in the average dual-task mTUG and DTE results of the observation group.Conclusion:Both single- and dual-task treadmill training are effective supplements to routine rehabilitation training for children with bilateral spastic cerebral palsy. Dual-task treadmill training is more effective than the single-task version.