Home-based self-management can effectively improve functional status and slow disease progression in patients with stroke. Modern information technology has brought new opportunities for enhancing stroke self-management at home. This review summarizes the current application of modern information technologies-including artificial intelligence, mobile devices, virtual reality, and the Internet of Things-in home-based self-management for stroke patients. Based on this, the review further discusses the challenges and opportunities associated with applying these technologies, aiming to provide a reference for promoting their broader implementation in stroke patient self-management.

Home-based self-management can effectively improve functional status and slow disease progression in patients with stroke. Modern information technology has brought new opportunities for enhancing stroke self-management at home. This review summarizes the current application of modern information technologies-including artificial intelligence, mobile devices, virtual reality, and the Internet of Things-in home-based self-management for stroke patients. Based on this, the review further discusses the challenges and opportunities associated with applying these technologies, aiming to provide a reference for promoting their broader implementation in stroke patient self-management.

Objective: To explore the status of seroepidemiology on hepatitis A, B and C among students and residents aged equal or greater than 18 years in south Xinjiang, and to provide scientific evidence for prevention and control of viral hepatitis. Methods: Uyghur students in four towns and villages were selected by cluster random sampling from Feb to May, 2015, and Uyghur residents aged 18 to 69 years were selected by stratified cluster sampling from May to September, 2016. 4 507 middle and primary Uygur students and 4 833 Uyghur resides equal or greater than 18 years attended this survey. Self-designed questionnaire was used to collect the demographic information. And Elisa test was adopted to detect HAV-IgG, HBsAg, HBsAb and HCV-IgG. Chi-square test was used to calculate the difference on antibody positive rate of three types of hepatitis among the participants. Results: The overall HAV-IgG positive rate was 99.45% (9 289/9 340). The positive rates were 99.70% (4 006/4 018) in male and 99.27% (5 283/5 322) in female (χ²=7.95, P=0.005). The HAV-IgG positive rate among people aged 10 to 14 years was the highest (99.91%, 2 233/2 235), and the difference between the age specific HAV-IgG positive rates was statistical significant (χ²=38.21, P<0.001). The overall HBsAg positive rate was 4.11% (384 cases), with 4.55% (183 cases) for male and 3.78% (201 cases) for female. The HBsAg positive rate among participants 19 to 24 years old was the highest (9.46%, 21/222) and the differences between the age specific HBsAg was statistically significant (χ²=116.22, P<0.001). The HBsAb positive rate was 35.03% (3 272 cases), with 35.59% (1 430 cases) for male and 34.61% (1 842 cases) for female, and the HBsAb positive rate among participants aged 15 to 18 years was the highest, which was 69.12% (696/1 007). The differences between the age specific HBsAb rates appeared statistically significant (χ²=671.80, P<0.001). The overall HCV-IgG positive rate was 0.65%(61 cases). The HCV-IgG positive rate in female was 0.86% (46 cases) and 0.37% (15 cases) in male (χ²=8.51, P=0.004).The HCV-IgG positive rate among participants aged over 70 years was the highest (3.78%,9/238) , and the difference between the age specific HCV-IgG positive rates had statistic significance (χ²=70.30, P<0.001). The HAV-IgG positive rate in hepatitis A vaccinees (100%, 876/876) was higher than that among the non-vaccinees (99.40%, 8 413/8 464) (χ²=4.26, P=0.039). The HBsAb positive rate in hepatitis B vaccinees was 39.32% (1 816/4 619) which was higher than that among the non-vaccinees (30.84%, 1 456/4 721) (χ²=73.68, P<0.001). Conclusion The positive rate of overall HAV-IgG was high, male and participants aged between 10 to 14 had higher probability to be infected. But the infection rates of hepatitis B and C were low, with the low vaccination rate and the poor protective effectiveness of hepatitis B.

Objective To investigate the epidemiologic characteristics of diabetes mellitus (DM) in Uygur residents in Kashgar of Xinjiang.Methods The survey was conducted among the Uygur residents aged ≥ 18 years selected through stratified cluster sampling in Kashgar by means of questionnaire survey,physical examination and basic laboratory test.The prevalence of different groups were calculated and risk factors of DM was analyzed by logistic vegression model.Results A total of 4 608 adults were surveyed.The prevalence of DM was 11.31％ (standardized prevalence:10.59％) and the prevalence was 13.65％ (standardized prevalence:12.34％) in males and 10.04％ (standardized prevalence:9.83％) in females.The prevalence increased with age.The prevalence of DM was higher than the prevalence of impaired fasting glucose (IFG) in people aged ＞60 years,especially in females.The rates of awareness,treatment and control of DM were 28.02％,21.31％ and 5.57％,respectively.Multivariate logistic regression analysis indicated that people aged 45-55,55-65 and ＞65 years had higher risk of DM and the odds ratio were 2.08 (95％CI:1.24-3.48),2.73 (95％CI:1.63-4.56) and 3.90 (95％ CI:2.24-6.78) for men and 2.63 (95％ CI:1.71-4.02),3.14 (95％ CI:2.00-4.94) and 5.56 (95％CI:3.47-8.92) for woman,respectively.Family history of DM (OR=2.88 for men,95％Cl:1.45-5.72;OR=2.52 for women,95％CI:1.49-4.26) and BMI≥28.0 kg/m2 (OR=1.77 for men,95％CI:1.19-2.64,OR.=1.80 for women,95％CI:1.30-2.50) were also risk factors for DM.Conclusion The prevalence of DM was high in Uygur residents in Kashgar,but the rate of awareness,treatment and control of DM were low.It is necessary to improve the detection rate of DM and conduct targeted prevention and control of DM.

Objective To understand the prevalence of dyslipidemia and normal blood lipids level in Uygur diabetes patients in Kashgar prefecture in southern area of Xinjiang.Methods A total of 5 078 local residents aged ≥ 18 years (42.56％ were men) selected through cluster random sampling in Kashgar were surveyed by means of questionnaire survey,physical examination and laboratory test,and 521 diabetes patients were screened.Results The overall prevalence of dyslipidemia in diabetes patients was 59.50％ (310/521) with adjusted rate as 49.39％.Age ≥65 years,overweight,obesity and abdominal obesity increased the risk for dyslipidemia by 0.771 times (95％ CI:1.015-3.088),1.132 times (95％CI:1.290-3.523),1.688 times (95％CI:1.573-4.592) and 0.801 times (95％CI:1.028-3.155) respectively.Compared with males,female was a protective factor for dyslipidemia (OR=0.507,95％CI:0.334-0.769).The overall normal rate of blood lipids level including total cholesterol (TC),triglycerides (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) for type 2 diabetes patients was 11.13％.Female,higher BMI and abdominal obesity were the factors influencing the overall normal blood lipids level.The normal rate of LDL-C level decreased with increase of age,BMI and waist circumferences (trend test x2=18.049,P＜ 0.001;trend testx2=10.582,P=0.001;x2=19.081,P＜0.001),but increased with educational level (trend testx2=9.764,P=0.002).Conclusion The prevalence of dyslipidemia in Uygur diabetes patients in Kashgar was high,however,the overall normal rate of blood lipid level was relatively low.Obesity was the most important risk factor for dyslipidemia in this area.More attention should be paid to dyslipidemia prevention in women.

Objective To investigate the prevalence of hypertension and risk factors in Uygur adults in Kashgar of Xinjiang.Methods A total of 4 748 Uygur adults aged ≥ 18 years selected through cluster random sampling in Shufu county of Kashgar prefecture were surveyed by means of questionnaire survey,physical examination and laboratory test.The prevalence,awareness,treatment and control rate of hypertension of different groups were calculated and risk factors of hypertension was analyzed by using non-conditional logistic regression model.Results The overall prevalence of hypertension was 15.73％ (age-adjusted prevalence was 13.75％).The prevalence rates of hypertension in men and women were 16.36％ (age-adjusted prevalence was 12.96％),15.39％ (age-adjusted prevalence was 14.34％),respectively.The rates of awareness,treatment and control of hypertension were 59.57％,52.74％,21.29％,respectively.The prevalence of hypertension increased with age.Compared with age group 18-34 years,the age groups 55-64,≥65 years had higher risk of hypertension and the OR values were 10.53,20.96 for men and 16.27,33.20 for women.The overweight (OR=1.47 for men,OR =1.82 for women,P＜0.05) and obesity (OR =1.88 for men,OR=2.66 for women,P＜0.05) also increased the risk of hypertension.The groups with family history of hypertension (OR=3.85 for men,OR=2.34 for women,P＜0.05) also had higher risk of hypertension.Hypertriglyceridemia was positively correlated with the prevalence of hypertension in men (OR=1.62,95％CI:1.09-2.41).Conclusions The prevalence of hypertension in Uygur adults in Kashgar area of Xinjiang was at relatively low level.The related risk factors were age,overweight,obesity,family history and hypertriglyceridemia in men and the risk factors were similar in women except hypertriglyceridemia.

Objective To investigate the knowledge,attitude and practice (KAP) to chronic diseases and associated influencing factors in Uygur adults in Kashgar of southern Xinjiang,and provide basic information for developing ethnic specific prevention and control strategies for chronic diseases.Methods With stratified cluster random sampling,investigations,including questionnaire survey,physical examination and laboratory tests were performed among local residents who were aged ≥ 18 years and selected in Shufu county in southern Xinjiang.KAP scores were calculated and unconditional logistic regression models were used to analyze influencing factors.Results A total of 4 772 Uygur adults were surveyed.The awareness rate of chronic disease related knowledge ranged from 4.32％ to 56.04％,while the awareness rate of preventive measures were from 1.76％ to 85.18％ and the participation rate of prevention program varied from 4.00％ to 97.99％.The average KAP score was 15.90 ± 4.20 and the rate of total KAP was 47.86％.Multi-factor analysis suggested the pass rate of total KAP score increased with educational level.Other factors positively associated with ‘KAP score pass rate’ were commercial insurance investment,hypertension,family history of common chronic diseases,female and abdominal obesity,while overweight was negatively associated with the KAP score pass rate.Conclusions The KAP level on chronic diseases was low in Uygur adults in Kashgar.It is necessary to continuously implement ethnic targeted health education and health promotion campaigns,especially in low education level,low income level,overweight and male groups.

Objective To explore the status of seroepidemiology on hepatitis A,B and C in primary and middle school students in Shufu county,Xinjiang Uygur Autonomous Region of China (Xinjiang) and to evaluate the effect of related immunization.Methods Students in four towns and villages were selected by cluster random sampling method.HAV-IgG,HBsAg,HBsAb and HCV-IgG were detected in Feb to May,2015.Results The overall HAV-IgG positive rate was 99.75％,among 4 830 primary and middle school students.The positive rates were seen 99.92％ in boys and 99.57％ in girls,with difference statistically significant (x2=5.798,P=0.016).The overall HBsAg positive rate appeared as 3.02％,with 3.55％ for boys and 2.47％ for girls,with difference statistically significant (x 2=4.782,P=0.029).The difference between age specific HBsAg positive rates also showed statistically significant (x2=71.990,P=0.000).HBsAg positive rate in the students in rural area (3.28％) was higher than that in the students in urban area (1.61％,x2=6.019,P=0.014).HBsAb positive rate was 38.84％,and the differences between the age specific HBsAb positive rates appeared statistically significant (x2=837.699,P=0.000).HBsAg positive rate in students from the urban area (42.36％) was higher than those from the rural area (38.20％,x2=4.598,P=0.032).2 815 students,accounting for 58.28％ of the total students,showed negative on both HBsAg and HBsAb.The overall HCV-IgG positive rate was 0.19％,and all appeared in students fiom the rural areas,with ethnicity solely as Uygur.Conclusions The effect of hepatitis A vaccine was satisfactory in primary and middle school students in Shufu county but quiet a number of the students missed the vaccination.The infection rate of hepatitis C was low.Publicity and health education on hepatitis immunization and control should be revved up.Programs regarding primary and supplementary immunization on hepatitis,should be carried out timely for children of school age.

OBJECTIVETo investigate the expression of inducible heme oxygenase (HO-1) gene in pulmonary artery smooth muscle cells (PASMCs) exposed to hypoxia, and the influence of carbon monoxide (CO) on the proliferation of PASMCs under hypoxic conditions.

METHODSPrimary culture of rat PASMCs were passed every 3 days, and the 3 - 5 passages were used. After exposure to hypoxic conditions (95% N2, 5% CO(2)) 0, 12, 24 and 48 hours, the level of HO-1 mRNA was examined by reverse transcriptase polymerase chain reaction (RT-PCR). The volume of COHb in the medium was measured spectrophotometrically. The cyclic guanosine mono-phosphate (cGMP) concentration of cell extracts was determined by radioimmunoassay. PASMCs were divided into 5 groups, cultured under normoxia and hypoxia and treated with hemin, hemoglobin (Hb) and exogenous CO respectively. Then 3-(4, 5-cimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT) colorimetric assay and immunocytochemical staining were used to study the energy metabolism and the expression of proliferating cell nuclear antigen (PCNA) in PASMCs. Flow cytometry was used to analyze the cell cycle of PASMCs.

RESULTSAfter exposure to hypoxic conditions for 12, 24, and 48 hours, the HO-1 mRNA increased by 2.7%, 5.7% and 27.1% respectively (P < 0.01). The carboxy-hemoglobin (COHb) in the medium increased by 13.8%, 31.0% and 93.1% (P < 0.01); the cGMP concentrations were 2.7, 4.0 and 6.8-fold compared with the control group (P < 0.01 and P < 0.05). In comparison with the control group, the value of MTT colorimetric assay, the immunocytochemical staining of PCNA and the percentages of PASMCs in S and G2M phases in the hypoxic group were significantly higher (P < 0.01). After treatment with Hemin and CO, the results of the above analysis decreased significantly (P < 0.01 and P < 0.05), but increased significantly after treatment with Hb (P < 0.01 and P < 0.05).

CONCLUSIONSThe expression of HO-1 gene in PASMCs is upregulated by hypoxia and the production of endogenous CO is elevated as well. The endogenous CO suppresses the proliferation of PASMC in an autocrine way. Both the induction of endogenous CO by Hemin and the treatment with exogenous CO can suppress the proliferation of rat PASMCs of under hypoxic conditions.

Carbon Monoxide ; pharmacology ; physiology ; Cell Division ; drug effects ; Cells, Cultured ; Gene Expression ; Heme Oxygenase (Decyclizing) ; genetics ; Hypoxia ; pathology ; Myocytes, Smooth Muscle ; cytology ; drug effects ; pathology ; Pulmonary Artery ; pathology

To investigate the effects of intrinsic nitric oxide (NO) on the expression of interleukin-4 (IL-4) mRNA and interferon-γ (IFN-γ) mRNA in the airway inflammation of asthma,the rat models of asthmatic inflammaiton were established by sensitizing and then challenging the animals with ovalbumin. The 24 animals were randomly divided into control group, sensitized group, sensitized and L-Arg-treated group as well as L-NAME-treated group equally. By using in situ hybridization combined with compute physiological quantitative imaging analysis techniques,the influence of intrinsic NO on the expression of IL-4 mRNA and IFN-γ mRNA in the airway inflammatory cells was observed. In situ hybridization study demonstrated that IL-4 mRNA expression was obviously increased as compared with that in the control group, mainly distributed in the inflammatory cells in the submucous of airways in the sensitized group. The increase of intensity of IL-4 mRNA expression was positively correlated with the numbers of eosinophil (Eos) and lymphocyte (both with P＜0.05) in the sensitized group. There was no statistically difference in IFNγ expression between the control group and the sensitized group. Imaging analysis showed that LNAME could inhibit the expression of IL-4 mRNA (P＜0.05) and increase the expression of IFNγ mRNA (P＜0.05), while L-Arg could increase the expression of IL-4 mRNA in inflammatory cells (P＜0.05). It was indicated that a suitable levels of intrinsic NO can influence the expression of IL-4 mRNA of Th2 lymphocytes and the expression of IFN-γ mRNA of Th1 lymphocytes and in turn, promote the development of asthmatic airway inflammation.