Objective To investigate the expression of exosomal α-synuclein(α-syn),serum lipocalcitin-2(LCN-2)levels and the relationship with disease severity in Parkinson's disease(PD)patients.Methods 106 PD patients admitted to Yulin Hospital,the First Affiliated Hospital of Xi'an Jiaotong University,from June 2020 to June 2023 were selected.The PD patients were divided into the early group(n=31),the middle group(n=45)and the late group(n=30)according to their conditions,and 92 healthy volunteers who had outpatient medical checkups during the same period were selected as the control group.The exosome α-syn and serum LCN-2 levels were detected,and the differences in exosome α-syn and serum LCN-2 levels were compared in PD patients with different disease severity levels.Factors affecting the prevalence of PD and the value of exosomal α-syn and serum LCN-2 in diagnosing PD were analyzed.Results The levels of exosomal α-syn(3 086.23±359.46 pg/ml)and serum LCN-2(4.92±1.32ng/ml)in the PD group were higher than those in the control group(1 993.24±244.35 pg/ml,1.96±0.34 ng/ml),and the differences were statistically significant(t=24.636,20.909,all P<0.05).The levels of exosomal α-syn(3 312.72±53.46pg/ml)and serum LCN-2(5.76±0.28ng/ml)in the late-stage group were higher than those in the early-stage(2 843.65±65.29pg/ml,4.02±0.32ng/ml)and the middle-stage group(3 102.35±105.48pg/ml,4.98±0.41ng/ml),and the differences were statistically significant(t=9.092～30.644,all P<0.05).Family history of PD,high level of exosomal α-syn and high level of LCN-2 were the risk factors for the development of PD(Wald χ2=8.121,7.002,4.805,all P<0.05).The AUC(95%CI)of diagnosing PD with serum LCN-2 in combination with exosome α-syn was higher than that of exosome α-syn,while serum LCN-2 alone was used for diagnosis(Z=4.869,5.103,all P<0.05).Conclusion Serum exosomal α-syn and serum LCN-2 levels are significantly higher in PD patients,which can be associated with the exacerbation of PD,and combined exosomal α-syn and serum LCN-2 can assess the risk of developing PD.

Objective:To clarify the complex network structure between self-management levels and supportive care needs of patients undergoing maintenance hemodialysis, utilizing network analysis methods to identify the core and bridging nodes among the variables, thereby defining targets for nursing interventions to implement more precise care strategies.Methods:A cross-sectional survey was conducted from May to November 2023 among 302 outpatient maintenance hemodialysis patients at the hemodialysis centers of two healthcare institutions in Harbin (the Second Affiliated Hospital of Harbin Medical University and Heilongjiang Changjiang Nephrology Specialist Hospital). This involved the use of general information questionnaires, the Hemodialysis Patient Self-Management Scale, and the Supportive Care Needs Scale for Hemodialysis Patients. R language was employed for the network analysis.Results:A total of 300 valid questionnaires were collected, including 186 males and 114 females, with an age range of 23 to 88 years (mean age 55.00 ± 13.78 years). The scores for the dimensions of self-management among dialysis patients were as follows: problem-solving (3.38 ± 0.63), execution of self-care (3.16 ± 0.52), partnership (2.56 ± 0.69), and emotional processing (1.89 ± 0.63). The scores for the dimensions of supportive care needs among dialysis patients were: physiological needs (2.82 ± 1.08), psychological needs (1.51 ± 1.02), social needs (1.97 ± 1.07), emotional needs (1.67 ± 1.12), spiritual needs (2.22 ± 0.77), informational needs (2.83 ± 1.08), and practical needs (2.82 ± 1.03). In network analysis, the strongest intensity was found in the execution of self-care (1.753), and the highest closeness was in psychological needs (0.017). The top three dimensions ranked by bridge strength were social needs (1.463), partnership (1.462), and execution of self-care (1.384). The root mean square error was lowest for psychological needs (0.518) and emotional needs (0.538). The stability and accuracy of the network structure were found to be good.Conclusions:The key intervention targets for nursing care in maintenance hemodialysis patients were identified as executing self-care, psychological needs, emotional needs, and social needs. Among these, executing self-care served as the core intervention focus, while psychological and emotional needs had dominant influences, and social needs exhibited the strongest bridging role. Nursing staff should prioritize these key targets and tailor personalized comprehensive nursing intervention plans to enhance patients′self-management levels and fully meet their care needs.

Objective:To investigate the relationship between adiponectin (ADPN), the ratio of high-sensitivity C-reactive protein (hs-CRP) to albumin (ALB), and the progression of acute cerebral infarction (ACI).Methods:This case-control study involved 147 patients with ACI who were treated at Xingyuan Hospital of Yulin between January 2023 and March 2024. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate disease progression. Based on the progression of the disease, the patients were divided into two groups: the progressive group ( n = 38) and the non-progressive group ( n = 109). ADPN level and the hs-CRP/ALB ratio were compared between the two groups. Additionally, multivariate logistic regression analysis was conducted to identify risk factors for disease progression in ACI patients. The predictive value of ADPN and the hs-CRP/ALB ratio for ACI was assessed using receiver operating characteristic curve analysis. Results:In the progressive group, hs-CRP level and hs-CRP/ALB ratio were (14.38 ± 3.27) mg/L and (0.43 ± 0.13), respectively, both of which were significantly higher than those in the non-progressive group [(8.92 ± 2.73) mg/L, (0.20 ± 0.07), t = 9.22, 10.37, both P < 0.001]. In contrast, the levels of ADPN and albumin in the progressive group were (2.71 ± 0.59) mg/L and (33.54 ± 8.66) g/L, respectively, both of which were significantly lower than those in the non-progressive group [(5.36 ± 1.42) mg/L, (45.05 ± 10.42) g/L, t = -15.99, -6.68, both P < 0.001]. The progressive group had higher admission NIHSS scores, a higher proportion of patients with diabetes, higher white blood cell counts, higher hemoglobin A1c (HbA1c) and fibrinogen levels compared with the non-progressive group ( t = 8.43, 2.88, 5.79, 2.77, χ2 = 4.40, all P < 0.05). Multivariate logistic regression analysis results indicated that higher admission NIHSS scores, HbA1c levels, and hs-CRP/ALB ratios were independent risk factors for disease progression in ACI patients ( OR = 2.438, 1.600, 2.971, all P < 0.05), while higher levels of ADPN were identified as a protective factor against disease progression ( OR = 0.321, P < 0.05). The receiver operating characteristic curve analysis showed that the area under the curve for predicting disease progression after admission for ACI patients using serum ADPN and hs-CRP/ALB ratio alone were 0.730 (95% CI: 0.658-0.800) and 0.758 (95% CI: 0.685-0.826), respectively. The area under the curve for the combined prediction of serum ADPN and the hs-CRP/ALB ratio was 0.895 (95% CI: 0.845-0.940), demonstrating higher predictive efficacy ( Z = 1.80, 2.13, both P < 0.05). Conclusions:ADPN level and hs-CRP/ALB ratio are closely related to the progression of ACI and demonstrate good predictive efficacy for disease progression.

Objective To explore the characteristics of the potential categories of traumatic psychological reactions in ICU patients and analyze the influencing factors of different potential categories,in order to provide ideas for the implementation of scientific and effective personalized intervention in the future.Methods A convenience sample of 300 patients treated in the ICU of a hospital from May 2023 to February 2024 was surveyed.The used instruments included a general information questionnaire,the Social Support Rating Scale,the Brief Resilience Scale,the Acute Stress Disorder Scale,and the Simplified Chinese version of the Post-Traumatic Growth Inventory.Data were analyzed using multivariate Logistic regression.Additionally,a purposive sampling method was used to conduct semi-structured interviews with 12 ICU patients,and the interview data were analyzed by interpretative phenomenological analysis.Results Quantitative research results showed that the traumatic psychological responses of ICU patients were categorized into 4 latent classes,including Trauma-Dependent Type(17.3％),Smooth-Transition Type(36.0％),External-Support Growth Type(25.3％),and Internal-Rooted Growth Type(21.3％).Factors influencing these responses included age,educational level,social support,psychological resilience,household income,and the number of used hormone medications(P＜0.05).Qualitative research results showed that 4 core themes were identified,including immersion in psychological trauma,rational cognition and acceptance of reality,seeking external support for personal growth,and independent exploration of inner self.Influencing factors included age,income level,history of major illness or ICU treatment,level of disease awareness,presence of underage children,and individual capacity for rumination.The quantitative and qualitative results were mutually corroborative and complemented each other.Conclusion The acute stress response of ICU patients is obvious,and there are multiple characteristics in the potential categories of traumatic psychological response,suggesting that medical and nursing staff can identify the characteristics of various types and influencing factors early,formulate personalized intervention programs,and promote their post-traumatic growth.

Objective:To clarify the complex network structure between self-management levels and supportive care needs of patients undergoing maintenance hemodialysis, utilizing network analysis methods to identify the core and bridging nodes among the variables, thereby defining targets for nursing interventions to implement more precise care strategies.Methods:A cross-sectional survey was conducted from May to November 2023 among 302 outpatient maintenance hemodialysis patients at the hemodialysis centers of two healthcare institutions in Harbin (the Second Affiliated Hospital of Harbin Medical University and Heilongjiang Changjiang Nephrology Specialist Hospital). This involved the use of general information questionnaires, the Hemodialysis Patient Self-Management Scale, and the Supportive Care Needs Scale for Hemodialysis Patients. R language was employed for the network analysis.Results:A total of 300 valid questionnaires were collected, including 186 males and 114 females, with an age range of 23 to 88 years (mean age 55.00 ± 13.78 years). The scores for the dimensions of self-management among dialysis patients were as follows: problem-solving (3.38 ± 0.63), execution of self-care (3.16 ± 0.52), partnership (2.56 ± 0.69), and emotional processing (1.89 ± 0.63). The scores for the dimensions of supportive care needs among dialysis patients were: physiological needs (2.82 ± 1.08), psychological needs (1.51 ± 1.02), social needs (1.97 ± 1.07), emotional needs (1.67 ± 1.12), spiritual needs (2.22 ± 0.77), informational needs (2.83 ± 1.08), and practical needs (2.82 ± 1.03). In network analysis, the strongest intensity was found in the execution of self-care (1.753), and the highest closeness was in psychological needs (0.017). The top three dimensions ranked by bridge strength were social needs (1.463), partnership (1.462), and execution of self-care (1.384). The root mean square error was lowest for psychological needs (0.518) and emotional needs (0.538). The stability and accuracy of the network structure were found to be good.Conclusions:The key intervention targets for nursing care in maintenance hemodialysis patients were identified as executing self-care, psychological needs, emotional needs, and social needs. Among these, executing self-care served as the core intervention focus, while psychological and emotional needs had dominant influences, and social needs exhibited the strongest bridging role. Nursing staff should prioritize these key targets and tailor personalized comprehensive nursing intervention plans to enhance patients′self-management levels and fully meet their care needs.

Objective:To investigate the relationship between adiponectin (ADPN), the ratio of high-sensitivity C-reactive protein (hs-CRP) to albumin (ALB), and the progression of acute cerebral infarction (ACI).Methods:This case-control study involved 147 patients with ACI who were treated at Xingyuan Hospital of Yulin between January 2023 and March 2024. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate disease progression. Based on the progression of the disease, the patients were divided into two groups: the progressive group ( n = 38) and the non-progressive group ( n = 109). ADPN level and the hs-CRP/ALB ratio were compared between the two groups. Additionally, multivariate logistic regression analysis was conducted to identify risk factors for disease progression in ACI patients. The predictive value of ADPN and the hs-CRP/ALB ratio for ACI was assessed using receiver operating characteristic curve analysis. Results:In the progressive group, hs-CRP level and hs-CRP/ALB ratio were (14.38 ± 3.27) mg/L and (0.43 ± 0.13), respectively, both of which were significantly higher than those in the non-progressive group [(8.92 ± 2.73) mg/L, (0.20 ± 0.07), t = 9.22, 10.37, both P < 0.001]. In contrast, the levels of ADPN and albumin in the progressive group were (2.71 ± 0.59) mg/L and (33.54 ± 8.66) g/L, respectively, both of which were significantly lower than those in the non-progressive group [(5.36 ± 1.42) mg/L, (45.05 ± 10.42) g/L, t = -15.99, -6.68, both P < 0.001]. The progressive group had higher admission NIHSS scores, a higher proportion of patients with diabetes, higher white blood cell counts, higher hemoglobin A1c (HbA1c) and fibrinogen levels compared with the non-progressive group ( t = 8.43, 2.88, 5.79, 2.77, χ2 = 4.40, all P < 0.05). Multivariate logistic regression analysis results indicated that higher admission NIHSS scores, HbA1c levels, and hs-CRP/ALB ratios were independent risk factors for disease progression in ACI patients ( OR = 2.438, 1.600, 2.971, all P < 0.05), while higher levels of ADPN were identified as a protective factor against disease progression ( OR = 0.321, P < 0.05). The receiver operating characteristic curve analysis showed that the area under the curve for predicting disease progression after admission for ACI patients using serum ADPN and hs-CRP/ALB ratio alone were 0.730 (95% CI: 0.658-0.800) and 0.758 (95% CI: 0.685-0.826), respectively. The area under the curve for the combined prediction of serum ADPN and the hs-CRP/ALB ratio was 0.895 (95% CI: 0.845-0.940), demonstrating higher predictive efficacy ( Z = 1.80, 2.13, both P < 0.05). Conclusions:ADPN level and hs-CRP/ALB ratio are closely related to the progression of ACI and demonstrate good predictive efficacy for disease progression.

Objective This study conducted a dynamic network analysis of the symptoms in patients with hepatocellular carcinoma(HCC)at different postoperative time points,aiming to explore evolving core symptoms and provide a basis for developing precise clinical symptom management programs.Methods A longitudinal study was carried out involving 370 HCC patients who underwent surgical treatment at a hospital in Kunming city between February and December 2024.Questionnaires were administered on postoperative day 2(T1)and day 7(T2),using the Chinese version of the Memory Symptom Assessment Scale.Symptom networks of 18 symptoms were constructed for both time points using R software to explore core symptoms and their interconnections.A network comparison test was also performed to assess differences between the 2 time points.Results All 370 patients completed the questionnaire at T1,and 357 valid responses were collected at T2,yielding a response rate of 96.49％.At T1,"feeling nervous"had the highest centrality(rs=1.29),while at T2,"feeling sad"was most central(rs=1.11).Overall strength of the symptom networks showed that notable changes were observed in the edge weights between symptoms(P=0.01).Conclusion While the overall structure of early postoperative symptoms in HCC patients remained relatively stable over time,the core symptoms shifted."Feeling nervous"emerged as the central symptom at T1,whereas"feeling sad"became predominant.Digestive-related symptoms are progressively more closely linked over time.Healthcare professionals should dynamically assess patients' early postoperative psychological symptoms and digestive system related symptoms,and focus on intervening with symptoms of tension and sadness.

Objective To investigate the expression of exosomal α-synuclein(α-syn),serum lipocalcitin-2(LCN-2)levels and the relationship with disease severity in Parkinson's disease(PD)patients.Methods 106 PD patients admitted to Yulin Hospital,the First Affiliated Hospital of Xi'an Jiaotong University,from June 2020 to June 2023 were selected.The PD patients were divided into the early group(n=31),the middle group(n=45)and the late group(n=30)according to their conditions,and 92 healthy volunteers who had outpatient medical checkups during the same period were selected as the control group.The exosome α-syn and serum LCN-2 levels were detected,and the differences in exosome α-syn and serum LCN-2 levels were compared in PD patients with different disease severity levels.Factors affecting the prevalence of PD and the value of exosomal α-syn and serum LCN-2 in diagnosing PD were analyzed.Results The levels of exosomal α-syn(3 086.23±359.46 pg/ml)and serum LCN-2(4.92±1.32ng/ml)in the PD group were higher than those in the control group(1 993.24±244.35 pg/ml,1.96±0.34 ng/ml),and the differences were statistically significant(t=24.636,20.909,all P<0.05).The levels of exosomal α-syn(3 312.72±53.46pg/ml)and serum LCN-2(5.76±0.28ng/ml)in the late-stage group were higher than those in the early-stage(2 843.65±65.29pg/ml,4.02±0.32ng/ml)and the middle-stage group(3 102.35±105.48pg/ml,4.98±0.41ng/ml),and the differences were statistically significant(t=9.092～30.644,all P<0.05).Family history of PD,high level of exosomal α-syn and high level of LCN-2 were the risk factors for the development of PD(Wald χ2=8.121,7.002,4.805,all P<0.05).The AUC(95%CI)of diagnosing PD with serum LCN-2 in combination with exosome α-syn was higher than that of exosome α-syn,while serum LCN-2 alone was used for diagnosis(Z=4.869,5.103,all P<0.05).Conclusion Serum exosomal α-syn and serum LCN-2 levels are significantly higher in PD patients,which can be associated with the exacerbation of PD,and combined exosomal α-syn and serum LCN-2 can assess the risk of developing PD.

Objective To explore the characteristics of the potential categories of traumatic psychological reactions in ICU patients and analyze the influencing factors of different potential categories,in order to provide ideas for the implementation of scientific and effective personalized intervention in the future.Methods A convenience sample of 300 patients treated in the ICU of a hospital from May 2023 to February 2024 was surveyed.The used instruments included a general information questionnaire,the Social Support Rating Scale,the Brief Resilience Scale,the Acute Stress Disorder Scale,and the Simplified Chinese version of the Post-Traumatic Growth Inventory.Data were analyzed using multivariate Logistic regression.Additionally,a purposive sampling method was used to conduct semi-structured interviews with 12 ICU patients,and the interview data were analyzed by interpretative phenomenological analysis.Results Quantitative research results showed that the traumatic psychological responses of ICU patients were categorized into 4 latent classes,including Trauma-Dependent Type(17.3％),Smooth-Transition Type(36.0％),External-Support Growth Type(25.3％),and Internal-Rooted Growth Type(21.3％).Factors influencing these responses included age,educational level,social support,psychological resilience,household income,and the number of used hormone medications(P＜0.05).Qualitative research results showed that 4 core themes were identified,including immersion in psychological trauma,rational cognition and acceptance of reality,seeking external support for personal growth,and independent exploration of inner self.Influencing factors included age,income level,history of major illness or ICU treatment,level of disease awareness,presence of underage children,and individual capacity for rumination.The quantitative and qualitative results were mutually corroborative and complemented each other.Conclusion The acute stress response of ICU patients is obvious,and there are multiple characteristics in the potential categories of traumatic psychological response,suggesting that medical and nursing staff can identify the characteristics of various types and influencing factors early,formulate personalized intervention programs,and promote their post-traumatic growth.

Objective This study conducted a dynamic network analysis of the symptoms in patients with hepatocellular carcinoma(HCC)at different postoperative time points,aiming to explore evolving core symptoms and provide a basis for developing precise clinical symptom management programs.Methods A longitudinal study was carried out involving 370 HCC patients who underwent surgical treatment at a hospital in Kunming city between February and December 2024.Questionnaires were administered on postoperative day 2(T1)and day 7(T2),using the Chinese version of the Memory Symptom Assessment Scale.Symptom networks of 18 symptoms were constructed for both time points using R software to explore core symptoms and their interconnections.A network comparison test was also performed to assess differences between the 2 time points.Results All 370 patients completed the questionnaire at T1,and 357 valid responses were collected at T2,yielding a response rate of 96.49％.At T1,"feeling nervous"had the highest centrality(rs=1.29),while at T2,"feeling sad"was most central(rs=1.11).Overall strength of the symptom networks showed that notable changes were observed in the edge weights between symptoms(P=0.01).Conclusion While the overall structure of early postoperative symptoms in HCC patients remained relatively stable over time,the core symptoms shifted."Feeling nervous"emerged as the central symptom at T1,whereas"feeling sad"became predominant.Digestive-related symptoms are progressively more closely linked over time.Healthcare professionals should dynamically assess patients' early postoperative psychological symptoms and digestive system related symptoms,and focus on intervening with symptoms of tension and sadness.