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 systematically review current status and trends of alexithymia research and identify key research hotspots and frontiers in China through a visualised analysis,thereby to provide a reference for future studies.Methods The literature related to alexithymia in China from the establishment of CNKI and Web of Science core collection databases to July 7,2024 was searched,and the visual analysis was carried out through CiteSpace.Results The number of papers published in alexithymia in China showed a steady upward trend,and the publishing institutions were relatively concentrated,the cooperation between various institutions was less,and the research was relatively scattered.The research hotspots mainly focused on exploring the correlation and influencing factors between neurosis,mood disorders,mental health,personality characteristics,depression and alexithymia,etc.,and the current situation of elderly care and its correlation with alexithymia have become the current research hotspots.The key populations were mainly students,the elderly and teenagers.Conclusion The number and depth of papers published on alexithymia is on the rise of researchers.In the future,we should encourage and strengthen the cooperation and exchange of scholars and research institutions,and formulate evaluation plans and interventions based on the cultural characteristics of China,so as to form an accurate and standardized research system.

Objective To systematically review current status and trends of alexithymia research and identify key research hotspots and frontiers in China through a visualised analysis,thereby to provide a reference for future studies.Methods The literature related to alexithymia in China from the establishment of CNKI and Web of Science core collection databases to July 7,2024 was searched,and the visual analysis was carried out through CiteSpace.Results The number of papers published in alexithymia in China showed a steady upward trend,and the publishing institutions were relatively concentrated,the cooperation between various institutions was less,and the research was relatively scattered.The research hotspots mainly focused on exploring the correlation and influencing factors between neurosis,mood disorders,mental health,personality characteristics,depression and alexithymia,etc.,and the current situation of elderly care and its correlation with alexithymia have become the current research hotspots.The key populations were mainly students,the elderly and teenagers.Conclusion The number and depth of papers published on alexithymia is on the rise of researchers.In the future,we should encourage and strengthen the cooperation and exchange of scholars and research institutions,and formulate evaluation plans and interventions based on the cultural characteristics of China,so as to form an accurate and standardized research system.

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 influencing factors of clinical pregnancy outcomes in patients with hydrosalpinx undergoing in vitro fertilization-embryo transfer(IVF-ET) after interventional embolization and whether residual hydrops has an adverse impact on pregnancy outcomes.Methods:Clinical data from 65 patients who underwent interventional embolization and IVF-ET for hydrosalpinx at the Third Affiliated Hospital of Zhengzhou University from March 2021 to October 2022 were collected retrospectively. The hydrops index was quantified by the ratio of the widest diameter to the pelvic transverse diameter of the intraoperative hydrops, and the patient′s age, body mass index(BMI), follicle-stimulating hormone(FSH), lutenizing hormine(LH), estradiol(E2), automated matetials hangling(AMH), endometrial thickness at the time of transplantation, the number of transplanted embryos, embryo type, and location of the hydrosalpinx were recorded. In addition, the clinical pregnancy outcomes of the first transplantation after embolization were followed. Two independent samples t-test, rank sum test and chi-square test were used to analyze the difference of the above indexes among different clinical pregnancy outcomes by SPSS 25.0. The receiver operating characteristic (ROC) curves and Youden index were used to calculate the cut-off value of the water accumulation index. Results:Among 65 patients, the clinical pregnancy rate was 63.1%(41/65), among the 45 patients who underwent embryo transfer before embolization without success, the clinical pregnancy rate after embolization was 62.2%(28/45). Based on data analysis, it showed that IVF-ET clinical pregnancy outcomes were not associated with age, BMI, FSH, LH, E2, AMH, endometrial thickness at the time of transplantation, the number of transplanted embryos, embryo type, as well as location of hydrosalpinx( P>0.05), but associated with hydrosalpinx index( P<0.001). ROC curve analysis showed that the hydrops index could be used as a predictor of pregnancy outcome, and the area under the curve was 0.825, and the optimal cut-off value of the hydrops index was 12.925% based on the Youden index analysis result. Conclusions:Interventional embolization of hydrosalpinx may improve clinical pregnancy rates. When the hydrosalpinx is large enough, it could adversely affected IVF-ET clinical pregnancy, and further aspiration of hydrosalpinx should be performed prior to transplantation.

Objective:To explore the surgical technique and therapeutic effect of flap wrapping repair of soft tissue defect after digit degloving injury with free arm medial perforator flap.Methods:From October 2009 to December 2020, 15 patients with soft tissue defect after digit degloving injury were repaired with free arm medial perforator flaps. The patients were 9 males and 6 females aged 22 to 50 years old, with an average of 32 years old. Injury mechanism: 13 cases of machine strangulation and 2 cases of machine crushing. Plane of sleeve avulsion injury: at the distal metacarpophalangeal joint of thumb in 2 cases, at the middle and distal segment of single finger of 2nd to 5th fingers in 4 cases, and at distal metacarpophalangeal joint of 2nd to 5th fingers in 9 cases. Seven cases were in left hand and 8 in right hand. Emergency surgery was performed in 2 cases and scheduled surgery in 13 cases. The flap was designed in a shape of a long strip, and the size of the flap was 5.0 cm×2.5 cm-14.0 cm×3.5 cm. During the operation, the artery of the flap pedicle was anastomosed with the palmar digital proper artery or common digital artery of the recipient digit, the subcutaneous vein or the companion vein of the artery was anastomosed with the dorsal or palmar digital subcutaneous vein, and the medial brachial cutaneous nerve carried in the flap was anastomosed with the stump of palmar digital proper nerve. All the donor sites were directly sutured. After the surgery, follow-up visits were conducted regularly at outpatient clinic, or via telephone and WeChat review or by home visit. The flap appearance, sensation and function recovery of digital joints were observed together with the patient satisfaction. Results:All flaps survived successfully after surgery. Six patients with degloving defect of the whole digit had encountered poor wound healing caused by distal phalangeal necrosis. The second stage stump trimming was performed to keep the digit to the distal end of the middle segment. Two cases of thumb and 2 cases of middle finger suffered further burning and worn tears at 7-9 months after surgery and self-healed. The follow-up period was 6-28 (average 16) months. The flap was soft without bloating. The sensation recovered to S 2-S 3. The shape of fingers was good, and no secondary flap surgery was necessary. The overall movement of interphalangeal joints was poor. According to the evaluation standard of Michigan hand function questionnaire, 15 patients achieved very satisfactory with the overall appearance and function of hands. The linear scars at donor site were hidden without complications such as tenderness and contraction. Conclusion:The free medial perforator flap of the arm is easy to design and thin, hence does not affect the shape of a digit. So, it is ideal for the repair of soft tissue defect after digit degloving injury.

Objective:To evaluate the efficacy of esketamine for patient-controlled intravenous analgesia (PCIA) in elderly patients undergoing modified radical mastectomy for breast cancer.Methods:Ninety elderly female patients, aged 65-78 yr, weighing 46-75 kg, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, undergoing elective modified radical surgery for breast cancer under general anesthesia, were divided into 2 groups ( n=45 each) using a random number table method: esketamine PCIA group (group E) and sufentanil PCIA group (group S). Anesthesia was induced with target-controlled infusion of propofol, intravenous atracurium besylate and sufentanil and maintained with target-controlled infusion of propofol and remifentanil and intermittent intravenous boluses of cis-benzenesulfonic acid atracurium.The patients were connected to an analgesic pump for PCIA at 10 min before completion of operation.The PCIA solution in group E contained esketamine 2 mg/kg, ketorolac tromethamine 90 mg and tropisetron 5 mg in 100 ml of normal saline.The PCIA solution in group S contained sufentanil 1 μg/kg, ketorolac tromethamine 90 mg and tropisetron 5 mg in 100 ml of normal saline.The PCA pump was set up with a 1.5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 1.5 ml/h, and the analgesia was performed until 48 h after operation.When numeric rating scale score ≥ 4 points and the efficacy of patient-controlled analgesia was not good, tramadol 100 mg was intravenously injected for rescue analgesia.Steward recovery scores were recorded at 4, 8, 24 and 48 h after operation.The requirement for rescue analgesia, effective pressing times of analgesic pump and time to first flatus were recorded within 48 h after operation.The nausea and vomiting, respiratory depression, dizziness and pruritus within 48 h after operation and delirium within 7 days after operation were recorded.The 40-item Quality of-Recovery scale was used to evaluate the early postoperative recovery of patients at 24 and 48 h after operation. Results:Compared with group S, the 40-item Quality of Recovery scale score was significantly increased at each time point, postoperative time to first flatus was shortened, the incidence of postoperative nausea and vomiting and pruritus was decreased ( P<0.05), and no significant change was found in the Steward recovery score at each time point after operation, effective pressing times of PCA and requirement for rescue analgesia in group E ( P>0.05). Conclusions:Esketamine provides better efficacy than sufentanil when used for PCIA in elderly patients undergoing modified radical mastectomy for breast cancer.

Objective:To explore the of short-term psychodynamic psychotherapy on anxiety and depression of gout patients and its influence on well-being index, family function and compliance.Methods:60 gout patients were selected from June 2018 to December 2019 in the outpatient department of rheumatism and immunity department of Dongguan Kanghua Hospital by prospective case-control study. They were randomly divided into control group and treatment group, 30 cases respectively. Both groups were given gout related clinical treatment and routine nursing, and the treatment group was given short-term dynamic orientation psychotherapy. The treatment compliance, the psychological status, well-being index and blood uric acid (UA) level of the two groups were compared before intervention, immediately after intervention and 3 months after intervention.Results:The scores of Patient Health Questionnaire-9 (PHQ-9) and the generalized anxiety disorder 7-item scale (GAD-7) in the two groups were gradually decreased immediately and 3 months after intervention ( P<0.05), and the scores of well-being index were gradually increased ( P<0.05); Compared with the control group, the scores of PHQ-9 and GAD-7 in the treatment group decreased more significantly ( P<0.05), and the score of well-being index increased more significantly ( P<0.05); The scores of communication, behavior control and total function of family function in the treatment group decreased gradually immediately after intervention and 3 months after intervention ( P<0.05), and were significantly lower than those in the control group ( P<0.05); The level of serum UA in the two groups decreased gradually immediately after intervention and 3 months after intervention ( P<0.05), but there was no significant difference in UA level at each time point between the two groups. The treatment compliance of the treatment group was significantly better than that of the control group ( P<0.05). Conclusions:The short-term dynamic orientation psychotherapy for gout patients has obvious effect in improving the state of anxiety and depression, improving the index of well-being, family function and treatment compliance.

Objective:To understand the status of maternal testing, detection and trends of HIV infection among pregnant women in Liangshan Yi Autonomous Prefecture (Liangshan) of Sichuan province during 2008-2016.Methods:Data were collected from the monthly work report on maternal HIV testings and the case-reporting records of HIV-positive pregnant women, from the National Management Information System of China’s Prevention of Mother-to-child transmission of HIV, syphilis, and HBV Program. Descriptive method was applied to show both the maternal HIV and predelivery HIV testing rates and maternal HIV positive rates as well as the distribution in different counties, between 2008 and 2016.Results:During 2008-2016, both maternal HIV test rates and predelivery maternal HIV testing increased from 40.7 % (8 191/20 125) and 8.0 % (1 607/20 125) to 95.7 % (88 000/91 946) and 70.1 % (64 421/91 946), respectively (trend χ2=94 497.28, P<0.001; trend χ2=90 655.03, P<0.001). A total of 3 271 HIV-positives were detected from 436 519 pregnant women, with the HIV positive rate as 0.75 % (95 %CI: 0.72 %-0.77 %). Among 3 271 HIV-positive pregnant women, 1 527 (46.7 %) of them were tested at labor. The maternal HIV-positive rates at labor increased yearly (trend χ2=9.21, P=0.002). In 2016, the maternal HIV-positive rate at labor was 1.32 % (95 %CI: 1.18 %-1.47 %), which was higher than that (0.67 %, 95 %CI: 0.61 %-0.73 %) in the pregnant women who received HIV test predelivery ( χ2=88.23, P<0.001). The maternal HIV- positive rates in Butuo, Zhaojue, Jinyang, Meigu, and Yuexi counties all appeared ≥1 %, in 2016,respectively. Conclusions:The maternal HIV test rates increased in Liangshan during 2008-2016, but the maternal HIV test rates at labor were relatively high. The HIV prevalence among pregnant women in Liangshan was severe and late for pregnant women to receive testing.

Objective:To investigate the damage and mechanism of artemisia annua pollen on tight junction of human nasal mucosa epithelial cells (HNEpC).Methods:HNEpC were cultured in vitro. Different concentrations of artemisia annua pollen (0, 20, 40, 80, 100, 160, 200 μg/ml) were used to intervene the cells for 24 h, and the cell proliferation activity was detected by the CCK-8 method. The expression and phosphorylation of p38MAPK signaling pathway were detected by Western Blot before and after the intervention of SB203580, a p38MAPK inhibitor in HNEpC. Immunofluorescence chemical staining, Western Blot and quantitative real-time PCR (qPCR) were used to observe the expression and distribution of tight junctions Occludin and Claudin-1. SPSS 21.1 software was used for statistical analysis.Results:CCK-8 results showed that, compared with the control group, the proliferation activity of HNEpC increased after 6 h intervention with different concentrations of artemisia annua pollen (all P<0.05). After 12 h of intervention, the proliferation activity of HNEpC in the 20, 40, 80, 100 and 160 μg/ml groups was not significantly changed (all P>0.05), while that in the 200 μg/ml group was decreased ( P<0.05). After the intervention for 24 h, the proliferation activity of cells in the 20 and 40 μg/ml groups was not significantly changed (all P>0.05), while that in the 80, 100, 160 and 200 μg/ml groups was decreased (all P<0.05). Immunofluorescence staining showed that the Occludin and Claudin-1 proteins in the normal control group were localized on the cell membrane and expressed more and formed a ring structure around the cell membrane. However, under the intervention of high concentration artemisia annua pollen, its expression level decreased, appeared broken, fuzzy, and nonuniform distribution. Western Blot and qPCR results showed that after 24 h of intervention, the expression levels of HNEpC Claudin-1 protein and its mRNA in the pollen groups (40, 80, 100, 160, 200 μg/ml) of artemisia annua decreased compared with those of those of the control group (mRNA expression levels were 0.567±0.214, 0.443±0.109, 0.462±0.160, 0.497±0.134, 0.388±0.076 compared with 1.001±0.067, respectively, all P<0.05). However, the mRNA of Occludin protein and its mRNA only decreased in the 200 μg/ml treatment group (mRNA expression level was 0.631±0.109 compared with 1.016±0.026, P<0.05), while all the other treatment groups increased (mRNA expression levels were 1.258±0.134, 1.827±0.103, 2.429±0.077, 1.707±0.085, 1.477±0.066 compared with 1.016±0.026, respectively, all P<0.05). Western Blot showed that p-p38MAPK expression increased after intervention with 100, 160, 200 μg/ml artemisia annua pollen for 24 h. SB203580 could inhibit the decreasing expression of Occludin caused by artemisinin pollen (mRNA expression was 1.255±0.179 compared with 0.631±0.109, P<0.05), but had no effect on Claudin-1 protein expression. Conclusion:Pollen from artemisia annua may activate p38MAPK signaling pathway and destroy the close connection of HNEpC.