Objective The core competence index system of nurses providing"internet+postpartum maternal and infant home care"service was constructed and preliminarily verified,so as to provide references for objective evaluation of their core competence.Methods Based on literature review and semi-structured interviews,the core competence index system of nurses in"internet+postpartum maternal and infant home care"service was initially constructed with the iceberg model as the theoretical framework.In April to May 2024,the indicators are organized and analyzed using the Delphi method to form a final indicator system.In December 2024,30 nurses providing"internet+postpartum maternal and infant home care"service in a tertiary A obstetrics and gynecology hospital in Hangzhou were selected as the survey subjects,and the index system was preliminarily verified by questionnaires.Results A total of 20 experts completed 2 rounds of correspondence.The authoritative coefficients of the 2 rounds of expert inquiry were 0.88 and 0.90,respectively;the Kendall coordination coefficients were 0.34 and 0.39,respectively(P＜0.001);the variation coefficients were 0～0.17 and 0.05～0.18,respectively.The final index system includes 3 first-class indicators,12 second-class indicators and 68 third-class indicators.The comprehensive,specialized,necessary,applicable,and overall satisfaction scores of the indicator system are(4.27±0.77)points,(4.43±0.56)points,(4.43±0.72)points,(4.47±0.56)points,and(4.46±0.56)points,respectively.Conclusion The core competence index system of nurses in"internet+postpartum maternal and infant home care"service is comprehensive,specialized,scientific and reliable,and can provide references for the training,assessment and evaluation of"internet+postpartum maternal and infant home care"talents.

Objective The core competence index system of nurses providing"internet+postpartum maternal and infant home care"service was constructed and preliminarily verified,so as to provide references for objective evaluation of their core competence.Methods Based on literature review and semi-structured interviews,the core competence index system of nurses in"internet+postpartum maternal and infant home care"service was initially constructed with the iceberg model as the theoretical framework.In April to May 2024,the indicators are organized and analyzed using the Delphi method to form a final indicator system.In December 2024,30 nurses providing"internet+postpartum maternal and infant home care"service in a tertiary A obstetrics and gynecology hospital in Hangzhou were selected as the survey subjects,and the index system was preliminarily verified by questionnaires.Results A total of 20 experts completed 2 rounds of correspondence.The authoritative coefficients of the 2 rounds of expert inquiry were 0.88 and 0.90,respectively;the Kendall coordination coefficients were 0.34 and 0.39,respectively(P＜0.001);the variation coefficients were 0～0.17 and 0.05～0.18,respectively.The final index system includes 3 first-class indicators,12 second-class indicators and 68 third-class indicators.The comprehensive,specialized,necessary,applicable,and overall satisfaction scores of the indicator system are(4.27±0.77)points,(4.43±0.56)points,(4.43±0.72)points,(4.47±0.56)points,and(4.46±0.56)points,respectively.Conclusion The core competence index system of nurses in"internet+postpartum maternal and infant home care"service is comprehensive,specialized,scientific and reliable,and can provide references for the training,assessment and evaluation of"internet+postpartum maternal and infant home care"talents.

Exosomes are spherical microvesicles(30-100 nm)secreted by a variety of cells and contain a variety of proteins, lipids, mRNAs, and microRNAs.These molecules into exosomes can be transferred to adjacent cells and distant tissues or cells by exosomes to develop full effects.Exosomes-released microRNAs are involved in the pathogenesis of Alzheimer's disease(AD)by regulating the abnormal expression of amyloid β-protein(Aβ)and p-Tau protein, initiating the inflammatory response by interacting with toll-like receptors.In addition, exosomal microRNAs can be used as a potential therapeutic target for AD.Exosomes as good carriers have great research values.This review summarized the literatures related to the role of exosomal microRNAs in the development of AD and the potential therapeutic effect on AD.A large amount of evidence indicates that expression disorder of exosomal microRNA plays an important role in the pathogenesis of AD and can be used as a new potential biomarker and therapeutic target for the diagnosis and treatment of AD.

To determine the etiologies and risk factors of intracerebral hemorrhage in young people.
 Methods: A total of 401 young patients with intracerebral hemorrhage were enrolled, and they were assigned into a 20-29 , a 30-39, and a 40-45 age group. The differences of various etiologies and risk factors among the three groups were analyzed.
 Results: There were 273 men and 128 women in the 401 young patients. The etiologies of 294 patients (73.32%) were identified while 107 patients (26.68%) were unknown. Among those with identified etiology, 226 patients (56.36%) suffered from hypertension, 41 patients (10.22%) congenital cerebrovascular malformation (including 25 patients with cerebral arteriovenous malformation, 8 intracranial cavernous hemangioma, and 8 intracranial aneurysm), and 27 other etiologies (including 9 patients with moyamoya disease, 6 cerebral venous sinus thrombosis, 4 drug abuse, 3 hemorrhagic brain tumor, 2 intracranial infection, 1 systemic lupus erythematosus, 1 drug-induced, and 1 eclampsia). Risk factors included hypertension (237 cases, 59.10%), smoking (123 cases, 30.67%), alcohol consumption (74 cases, 18.45%), and others (19 cases, 4.74%; including 8 cases of pregnancy or in the puerperium, 8 family history of intracerebral hemorrhage, and 3 taking anti-platelet aggregation/anticoagulation agents). The rate of hypertension induced hemorrhage significantly increased with age (P<0.01); the rate of vascular malformations in 20-29 age group was obviously higher than other groups (P<0.01); the rate of unknown cause in the 40-45 age group was significantly lower than other groups (P<0.01) and the rate of other etiologies showed no significant difference in the 3 groups. The rate of hypertension was significantly elevated with the age (P<0.01), while smoking, alcohol consumption, and other risk factors showed no significant difference in the 3 groups.
 Conclusion: The rate of intracerebral hemorrhage in young people increases with the increasing of age and hemorrhage affects men more than women; hypertension may be the main cause and congenital cerebrovascular malformation is the second cause, which may be more common in younger patients. Hypertension, smoking, and alcohol consumption may be the major controllable risk factors in intracerebral hemorrhage in young people.
Adult ; Cerebral Hemorrhage ; etiology ; Female ; Humans ; Hypertension ; complications ; Intracranial Aneurysm ; complications ; Intracranial Arteriovenous Malformations ; complications ; Male ; Middle Aged ; Pregnancy ; Risk Factors ; Young Adult

OBJECTIVETo analyze potential mutations of the NOTCH3 gene in two Chinese families featuring cerebral autosomal dominant arteriopathy with subcortical infarct and leucoencephalopathy (CADASIL).

METHODSThe two probands and related family members and 100 healthy controls were recruited. Potential mutations of the NOTCH3 gene were screened by PCR and direct sequencing. PolyPhen-2 and SIFT software were used to predict the protein function.

RESULTSThe conditions of both probands were adult-onset, with main clinical features including recurrent transient ischemic attacks and/or strokes, cognitive impairment. MRI findings suggested multiple cerebral infarcts and severe leukoencephalopathy. A heterozygous mutation c.328C>T (p.Arg110Cys), which was located in exon 3 of the NOTCH3 gene and known as a causative mutation, was identified in proband 1. A novel heterozygous mutation c.1013 G>C (p.Cys338Ser) located in exon 6 of the NOTCH3 gene was identified in the proband 2, which was not reported previously. The same mutations were not detected among the 100 unrelated healthy controls. Function analysis suggested that heterozygous mutation c.1013G>C can severely affect the functions of NOTCH3 protein.

CONCLUSIONTwo heterozygous missense mutations in the NOTCH3 gene have been identified in two families affected with CADASIL. The novel heterozygous Cys338Ser mutation in exon 6 of the NOTCH3 gene probably underlies the CADASIL.

Adult ; Brain ; diagnostic imaging ; CADASIL ; diagnostic imaging ; genetics ; Female ; Heterozygote ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mutation ; Receptor, Notch3 ; genetics