1.Impacts of sports games on prosocial behavior of children with intellectual and developmental disabilities attending regular classes
DUAN Guanting, SHANG Xiaoxia, HOU Huisheng, ZHENG Shicheng, SHI Wenxia
Chinese Journal of School Health 2025;46(2):177-180
Objective:
To explore impacts of sports games designed based on the information-motivation-behavioral skills model (IMB) on prosocial behavior in children with intellectual and developmental disabilities (IDD) attending regular classes, so as to provide a theoretical basis for promoting the development of prosocial behavior in school age IDD children.
Methods:
From February to March 2023, 40 children with intellectual disabilities aged 8-9 who were enrolled in ordinary schools in Beijing were recruited by using WeChat parents to send messages. They were randomly divided into an experimental group (19 before intervention, 17 after intervention) and a control group (19 before intervention, 19 after intervention) by lottery method. During the study period, children in both groups received the same frequency and quality of regular physical activities. The experimental group, in addition, underwent a 13 week sports game intervention based on the IMB model, 4 times a week, each session lasting 50 minutes. The sports game intervention scheme based on IMB model was divided into two modules,including basic training and development training:low difficulty sports game intervention based on emotion recognition, and medium low difficulty and medium difficulty sports game intervention based on social training such as "prosocial". The Griffith Empathy Measure (GEM) and the Prosocial Behavior Scale for Adolescents (PBSA) were used to assess empathy ability and prosocial behavior levels of children in both groups before and after the intervention.
Results:
After intervention, the cognitive empathy dimension, emotional empathy dimension and total score of GEM in the experimental group (39.15±2.85, 38.54±1.94, 77.69±3.95) were higher than control group (32.18±4.18, 32.28± 4.28, 64.56±6.48) and before intervention (33.92±4.94, 31.30±4.61, 65.23±8.47), and the differences were statistically significant ( F =12.06, 6.99, 14.90; 8.95, 7.36, 13.22, P <0.05). After intervention, compliance with public welfare factors, trait factors and total score (31.33±1.97, 16.67±1.03, 71.83±2.93) were higher than control group (22.65±1.58, 12.59±0.71, 59.47± 2.18 ) and before intervention (22.00±1.27, 12.17±0.75, 58.00±1.67), and the differences were statistically significant ( F = 17.00 , 36.54, 12.71; 29.87, 13.09, 13.12, P <0.05).
Conclusion
Sports game intervention based on IMB model can effectively promote the development of prosocial behavior of children with IDD attending regular classes.
2.Effect of Compatibility of Effective Monomer Components of Fujin Shengjisan on Angiogenesis of HUVEC Based on Uniform Design
Xianying LU ; Jing GAO ; Dingxi BAI ; Chaoming HOU ; Wenting JI ; Huan CHEN ; Chenxi WU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(8):9-20
ObjectiveTo determine the optimal combination of the effective monomer components "quercetin-kaempferol-abietic acid-boswellic acid" in Fujin Shengjisan for promoting diabetic ulcer (DU) wound healing through uniform design, thereby achieving the modern application of the ancient formula. MethodsFollowing the principle of "uniform design-pharmacodynamic experiment-mathematical modeling and model verification", the U14(145) uniform design table was adopted.The four monomer components of Chinese medicine were considered as the independent variables, and the proliferation rate of human umbilical vein endothelial cells (HUVECs) induced by glucose was used as the pharmacodynamic indicator. A mathematical model was constructed using DPS software to correlate the effective monomer components with the pharmacodynamic indicator. The results of uniform design were verified through CCK-8 assay, cell scratch healing, tube formation, Western blot, and Real-time PCR. ResultsAmong the 14 compatibility groups, compared with the high-glucose model group, compound compatibility group 6 showed the strongest proliferation effect and statistical significance (P<0.05). Four quadratic polynomial regression equations (Y1-Y4) were obtained through DPS modeling. Considering the model's fit, stability, and practical application, equations Y1-Y3 were selected for the follow-up verification. To ensure experiment reproducibility, group 6 was used for validation. Group 6 and equations Y1-Y3 were renamed as compound prescription ① to compound prescription④, respectively, to represent the modern application of the ancient FJSJ Powder through compatibility of monomer components. Verification experiments showed that in the CCK-8, scratch healing, and tube formation assays, the cell viability, wound healing rate, and tube formation number of HUVECs stimulated with 50 mmol·L-1 glucose were significantly reduced compared with the blank group. Moreover, the expression levels of angiogenesis-related cytokines, vascular endothelial growth factor (VEGF) and fibroblast growth factor 2 (FGF2), and CD31 secretion were significantly down-regulated. However, after intervention with compound prescriptions ① to ④, compound prescriptions ① and ③ significantly improved the biological functions of HUVECs induced by 50 mmol·L-1 glucose. Further analysis of the regression coefficients of compound prescriptions ① and ③, and the relative dose ratios of each monomer component, indicated that abietic acid, quercetin, and boswellic acid promoted angiogenesis of HUVECs in the high glucose environment, with a major effect (positive partial correlation coefficients, all > 0.9). Abietic acid and boswellic acid, as well as kaempferol and boswellic acid, promoted angiogenesis in HUVECs through interaction (positive partial correlation coefficients). ConclusionCompound prescriptions ① and ③ are the optimal combinations. They can reverse the inhibitory effects of high glucose, stimulate the proliferation, migration, and tube formation abilities of HUVECs in a high glucose environment, and promote the expression of vascular endothelial growth factorA(VEGFA), FGF2, and CD31, thereby promoting angiogenesis and facilitating DU wound healing. This finding not only confirms the good reproducibility and feasibility of compound prescriptions ① and ③ but also provides new insights and methods for the rational construction of mathematical models to further study the compatibility theory of Chinese medicine.
3.Expression and Clinical Significance of PLCβ4 Gene in Hepatocellular Carcinoma Analyzed Based on TCGA Database and Experimental Validation
Limei WEN ; Yali GUO ; Qiang HOU ; Dongxuan ZHENG ; Wu DAI ; Xiang GAO ; Jianhua YANG ; Junping HU
Cancer Research on Prevention and Treatment 2025;52(6):502-510
Objective To analyze the PLCβ4 gene mRNA expression and its clinical significance in hepatocellular carcinoma (HCC) based on TCGA database. Methods Based on the data on 424 clinical samples (including 374 cases of HCC tissues and 50 cases of nontumor liver tissues) in the TCGA database, Kaplan–Meier method, Cox regression analysis, and immune infiltration analysis were performed to evaluate the relationship between PLCβ4 gene and the clinical characteristics and survival prognosis of HCC patients. Correlation analysis between PLCβ4 gene and 24 types of immune cells was applied to investigate the relationship between PLCβ4 gene and immune cell infiltration and mRNA expression level of TP53 gene, a high-frequency mutation gene in HCC. In addition, paraffin sections of highly, moderately, and poorly differentiated tumor tissues and normal liver tissues from HCC patients were collected. The histopathological observation was carried out via HE staining method, and the expression levels of PLCβ4 and Ki-67 proteins in each clinical sample were verified through the immunohistochemical method. Results The expression level of PLCβ4 gene in HCC was significantly higher than that in normal tissues (P<0.01), and all patients in the PLCβ4 high-expression group had a significantly longer overall survival than those in the low-expression group (P<0.05), which suggested that PLCβ4 substantially affected the prognosis of HCC patients. Correlation analysis showed that the expression level of PLCβ4 gene was highly correlated with immune cell infiltration and the expression level of TP53 gene. As verified by clinical sample experiments, HE staining experiments and immunohistochemical results revealed that PLCβ4 gene expression in HCC tissue samples was significantly higher than that in normal tissues (P<0.001), and it was negatively correlated with the degree of differentiation. Conclusion PLCβ4 may serve as an independent prognostic factor in HCC and is expected to be a novel molecular target for HCC treatment.
4.Neuroplasticity Mechanisms of Exercise-induced Brain Protection
Li-Juan HOU ; Lan-Qun MAO ; Wei CHEN ; Ke LI ; Xu-Dong ZHAO ; Yin-Hao WANG ; Zi-Zheng YANG ; Tian-He WEI
Progress in Biochemistry and Biophysics 2025;52(6):1435-1452
Neuroscience is a significant frontier discipline within the natural sciences and has become an important interdisciplinary frontier scientific field. Brain is one of the most complex organs in the human body, and its structural and functional analysis is considered the “ultimate frontier” of human self-awareness and exploration of nature. Driven by the strategic layout of “China Brain Project”, Chinese scientists have conducted systematic research focusing on “understanding the brain, simulating the brain, and protecting the brain”. They have made breakthrough progress in areas such as the principles of brain cognition, mechanisms and interventions for brain diseases, brain-like computation, and applications of brain-machine intelligence technology, aiming to enhance brain health through biomedical technology and improve the quality of human life. Due to limited understanding and comprehension of neuroscience, there are still many important unresolved issues in the field of neuroscience, resulting in a lack of effective measures to prevent and protect brain health. Therefore, in addition to actively developing new generation drugs, exploring non pharmacological treatment strategies with better health benefits and higher safety is particularly important. Epidemiological data shows that, exercise is not only an indispensable part of daily life but also an important non-pharmacological approach for protecting brain health and preventing neurodegenerative diseases, forming an emerging research field known as motor neuroscience. Basic research in motor neuroscience primarily focuses on analyzing the dynamic coding mechanisms of neural circuits involved in motor control, breakthroughs in motor neuroscience research depend on the construction of dynamic monitoring systems across temporal and spatial scales. Therefore, high spatiotemporal resolution detection of movement processes and movement-induced changes in brain structure and neural activity signals is an important technical foundation for conducting motor neuroscience research and has developed a set of tools based on traditional neuroscience methods combined with novel motor behavior decoding technologies, providing an innovative technical platform for motor neuroscience research. The protective effect of exercise in neurodegenerative diseases provides broad application prospects for its clinical translation. Applied research in motor neuroscience centers on deciphering the regulatory networks of neuroprotective molecules mediated by exercise. From the perspectives of exercise promoting neurogenesis and regeneration, enhancing synaptic plasticity, modulating neuronal functional activity, and remodeling the molecular homeostasis of the neuronal microenvironment, it aims to improve cognitive function and reduce the incidence of Parkinson’s disease and Alzheimer’s disease. This has also advanced research into the molecular regulatory networks mediating exercise-induced neuroprotection and facilitated the clinical application and promotion of exercise rehabilitation strategies. Multidimensional analysis of exercise-regulated neural plasticity is the theoretical basis for elucidating the brain-protective mechanisms mediated by exercise and developing intervention strategies for neurological diseases. Thus,real-time analysis of different neural signals during active exercise is needed to study the health effects of exercise throughout the entire life cycle and enhance lifelong sports awareness. Therefore, this article will systematically summarize the innovative technological developments in motor neuroscience research, review the mechanisms of neural plasticity that exercise utilizes to protect the brain, and explore the role of exercise in the prevention and treatment of major neurodegenerative diseases. This aims to provide new ideas for future theoretical innovations and clinical applications in the field of exercise-induced brain protection.
5.Effects of Exercise Training on The Behaviors and HPA Axis in Autism Spectrum Disorder Rats Through The Gut Microbiota
Xue-Mei CHEN ; Yin-Hua LI ; Jiu-Gen ZHONG ; Zhao-Ming YANG ; Xiao-Hui HOU
Progress in Biochemistry and Biophysics 2025;52(6):1511-1528
ObjectiveThe study explores the influence of voluntary wheel running on the behavioral abnormalities and the activation state of the hypothalamic-pituitary-adrenal (HPA) axis in autism spectrum disorder (ASD) rats through gut microbiota. MethodsSD female rats were selected and administered either400 mg/kg of valproic acid (VPA) solution or an equivalent volume of saline via intraperitoneal injection on day 12.5 of pregnancy. The resulting offspring were divided into 2 groups: the ASD model group (PASD, n=35) and the normal control group (PCON, n=16). Behavioral assessments, including the three-chamber social test, open field test, and Morris water maze, were conducted on postnatal day 23. After behavioral testing, 8 rats from each group (PCON, PASD) were randomly selected for serum analysis using enzyme-linked immunosorbent assay (ELISA) to measure corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and corticosterone (CORT) concentration, to evaluate the functional state of the HPA axis in rats. On postnatal day 28, the remaining 8 rats in the PCON group were designated as the control group (CON, n=8), and the remaining 27 rats in the PASD group were randomly divided into 4 groups: ASD non-intervention group (ASD, n=6), ASD exercise group (ASDE, n=8), ASD fecal microbiota transplantation group (FMT, n=8), and ASD sham fecal microbiota transplantation group (sFMT, n=5). The rats in the ASD group and the CON group were kept under standard conditions, while the rats in the ASDE group performed 6 weeks of voluntary wheel running intervention starting on postnatal day 28. The rats in the FMT group were gavaged daily from postnatal day 42 with 1 ml/100 g fresh fecal suspension from ASDE rats which had undergone exercise for 2 weeks, 5 d per week, continuing for 4 weeks. The sFMT group received an equivalent volume of saline. After the interventions were completed, behavioral assessments and HPA axis markers were measured for all groups. ResultsBefore the intervention, the ASD model group exhibited significantly reduced social ability, social novelty preference, spontaneous activity, and exploratory interest, as well as impaired spatial learning, memory, and navigation abilities compared to the normal control group (P<0.05). Serum concentration of corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and corticosterone (CORT) in the PASD group were significantly higher than those in the PCON group (P<0.05). Following 6 weeks of voluntary wheel running, the ASDE group showed significant improvements in social ability, social novelty preference, spontaneous activity, exploratory interest, spatial learning, memory, and navigation skills compared to the ASD group (P<0.05), with a significant decrease in serum CORT concentration (P<0.05), and a downward trend in CRH and ACTH concentration. After 4 weeks of fecal microbiota transplantation in the exercise group, the FMT group showed marked improvements in social ability, social novelty preference, spontaneous activity, exploratory interest, as well as spatial learning, memory, and navigation abilities compared to both the ASD and sFMT groups (P<0.05). In addition, serum ACTH and CORT concentration were significantly reduced (P<0.05), and CRH concentration also showed a decreasing trend. ConclusionExercise may improve ASD-related behaviors by suppressing the activation of the HPA axis, with the gut microbiota likely playing a crucial role in this process.
6.The Mechanisms of Action and Clinical Application Progress of Autophagy Activators
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(3):371-383
Autophagy is a highly conserved cellular self-regulatory mechanism, which primarily occurs in the lysosomes or vacuoles of mammalian and yeast cells and plays a critical role in maintaining cellular homeostasis and metabolic balance. When cells encounter stress conditions like nutrient deprivation, physical or chemical stimuli, infections, and oxidative stress, or when damaged or aging organelles accumulate in the cytoplasm, the autophagic process is activated. This process degrades and recycles damaged proteins and organelles, removes potentially harmful substances, in which the degradation products are used for energy supply and macromolecule resynthesis, thereby help maintain the cellular homeostasis. Autophagy activators are compounds or drugs that can promote the cellular self-clearance process (such as mTOR inhibitors, AMPK activators, SIRT1 activators, lysosome enhancers, etc.). They enhance autophagy activity by acting on autophagy-related signaling pathways or proteins, thereby regulating cellular and metabolic processes, and consequently exerting an impact on the organism. With the deepening of research, more and more small molecule compounds with autophagic activity have been discovered. As autophagy activators, these small molecule compounds have shown great application potential in the treatment of malignant tumors, nervous system diseases, metabolic diseases, etc. Some related drugs have even entered the clinical trial stage and achieved good efficacy. This article discusses the mechanisms of various types of autophagy activators and their potential applications in diseases, aiming to provide a reference for the further development and application of autophagy activators in diseases.
7.Effect of Spraying Nano-calcium Carbonate and Calcium Nitrate Tetrahydrate on Characters, Carbohydrate Components and Endogenous Hormones of Dendrobium officinale
Jing LI ; Rong ZHOU ; Yingyue HOU ; Wei CAI ; Xiaoyan ZHANG ; Shuang ZHANG ; Guangying DU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(15):208-216
ObjectiveTo investigate the effects of foliar fertilizer of nano-calcium carbonate and calcium nitrate tetrahydrate on the agronomic traits, carbohydrate and endogenous hormone contents of Dendrobium officinale planted for 1 year under greenhouse cultivation, in order to provide scientific basis for fertilization to improve the yield and quality of D. officinale. MethodsSingle-factor experimental design was adopted. Starting from early spring, D. officinale was treated with foliar spraying according to corresponding fertilizers. Three treatment groups were established based on different fertilizers, namely, a blank group(clear water), a nano-calcium carbonate group(0.727 g·L-1 nano-calcium carbonate water-soluble fertilizer), and a calcium nitrate tetrahydrate group(1.091 g·L-1 calcium nitrate tetrahydrate water-soluble fertilizer). The frequency of spraying was three times per month, and the entire treatment process lasted for nine months. The effects of various treatments on the traits and relative chlorophyll content of D. officinale were dynamically monitored. Sampling was conducted at three specific time points:August 2, 2023, September 8, 2023, and November 1, 2023, respectively. The contents of glucose and mannose in D. officinale stems were determined by high performance liquid chromatography(HPLC), the content of soluble sugars in D. officinale stems and leaves was determined by phenol method, and enzyme-linked immunosorbent assay(ELISA) was used to detect the concentrations of cytokinin and auxin. ResultsCompared with the blank group, the treatments with nano-calcium carbonate and calcium nitrate tetrahydrate could significantly increase stem length, stem node number, leaf number, and tiller number. Among them, during the harvesting period in November, the stem length and tiller number, which are indicators related to the yield of D. officinale, increased by 60.85% and 19.23% after treatment with calcium nitrate tetrahydrate, and by 32.54% and 28.85% after treatment with nano-calcium carbonate, respectively. Compared with the blank group, treatments with nano-calcium carbonate and calcium nitrate tetrahydrate could promote the accumulation of sucrose in the stems and leaves of D. officinale to varying degrees, as well as the accumulation of polysaccharides, mannose, and glucose in the stems. In addition, nano-calcium carbonate treatment also facilitated the accumulation of fructose in the stems and leaves of D. officinale. Specifically, during the harvesting period in November, polysaccharides and mannose, which were the main active ingredients in D. officinale stems, increased by 28.48% and 29.36% after treatment with calcium nitrate tetrahydrate, and by 39.91% and 82.62% after treatment with nano-calcium carbonate, respectively. In addition, compared with the blank group, the concentrations of auxin in the stems and leaves of D. officinale were significantly increased after treatment with calcium nitrate tetrahydrate(P<0.05). Similarly, the concentrations of cytokinin and auxin in the stems of D. officinale were also elevated after treatment with nano-calcium carbonate. Correlation analysis further indicated that elongation growth and tillering of D. officinale stems after foliar spraying of nano-calcium carbonate and calcium nitrate tetrahydrate might be related to the accumulation of carbohydrates in the stems and leaves and the synergistic effect of auxin and cytokinin. ConclusionIn production practice, spraying nano-calcium carbonate and calcium nitrate tetrahydrate can promote the accumulation of cytokinin, auxin, and carbohydrate contents in the stems and leaves of D. officinale, and promote tillering and elongation growth of the stems.
8.Age-period-cohort analysis of disease burden of depressive disorders in the Chinese population
Ying WANG ; Yuwei HOU ; Zhe ZHANG
Sichuan Mental Health 2025;38(3):254-260
BackgroundMental health issues have become increasingly prominent amid rising societal pressure. Depressive disorders, characterized as chronic and recurrent conditions, adversely affect patients' physical and mental well-being while imposing a significant economic burden. Previous studies on depressive disorders in China have relied on cross-sectional surveys, capturing prevalence at specific time points, but lacking systematic analyses across age, period, and cohort dimensions. ObjectiveTo analyze long-term trends in the disease burden of depressive disorder in the Chinese population from 1990 to 2021, and to provide references to inform prevention and treatment strategies. MethodsData on the disease burden of depressive disorders in China were obtained from the Global Burden of Disease Study 2021 (GBD 2021) database. A joinpoint regression model was used to analyze trends in the disease burden. An age-period-cohort model, implemented in Stata 17.0, was applied to assess variations in incidence and disease burden attributable to age, period and cohort effects. ResultsFrom 1990 to 2021, the disability-adjusted life year (DALY) rate for depressive disorders in China decreased by an average of 0.27% annually, while the incidence rate decreased by an average of 0.24% annually. Females had higher incidence and DALY rates than those of males. The age-period-cohort model analysis revealed that age effects on incidence and disease burden steadily increased, period effects declined over time, and cohort effects initially increased and then declined. ConclusionFrom 1990 to 2021, both the incidence and DALY rates of depressive disorders in China showed a declining trend. Females experienced a higher burden compare to males. Additionally, incidence and DALY rates increased with age but declined over time.
9.Analysis of prognostic risk factors for chronic active antibody-mediated rejection after kidney transplantation
Yu HUI ; Hao JIANG ; Zheng ZHOU ; Linkun HU ; Liangliang WANG ; Hao PAN ; Xuedong WEI ; Yuhua HUANG ; Jianquan HOU
Organ Transplantation 2025;16(4):565-573
Objective To investigate the independent risk factors affecting the prognosis of chronic active antibody-mediated rejection (caAMR) after kidney transplantation. Methods A retrospective analysis was conducted on 61 patients who underwent renal biopsy and were diagnosed with caAMR. The patients were divided into caAMR group (n=41) and caAMR+TCMR group (n=20) based on the presence or absence of concurrent acute T cell-mediated rejection (TCMR). The patients were followed up for 3 years. The value of 24-hour urinary protein and estimated glomerular filtration rate (eGFR) at the time of biopsy in predicting graft loss was assessed using receiver operating characteristic (ROC) curves. The independent risk factors affecting caAMR prognosis were analyzed using the LASSO-Cox regression model. The correlation between grouping, outcomes, and Banff scores was compared using Spearman rank correlation matrix analysis. Kaplan-Meier analysis was used to evaluate the renal allograft survival rates of each subgroup. Results The 3-year renal allograft survival rates for the caAMR group and the caAMR+TCMR group were 83% and 79%, respectively. The area under the ROC curve (AUC) for predicting 3-year renal allograft loss was 0.83 [95% confidence interval (CI) 0.70-0.97] for eGFR and 0.78 (95% CI 0.61-0.96) for 24-hour urinary protein at the time of biopsy. LASSO-Cox regression analysis and Kaplan-Meier analysis showed that eGFR≤25.23 mL/(min·1.73 m²) and the presence of donor-specific antibody (DSA) against human leukocyte antigen (HLA) class I might be independent risk factors affecting renal allograft prognosis, with hazard ratios of 7.67 (95% CI 2.18-27.02) and 5.13 (95% CI 1.33-19.80), respectively. A strong correlation was found between the Banff chronic lesion indicators of renal interstitial fibrosis and tubular atrophy (P<0.05). Conclusions The presence of HLA class I DSA and eGFR≤25.23 mL/(min·1.73 m²) at the time of biopsy may be independent risk factors affecting the prognosis of caAMR.
10.The chain mediating role of personal resourcefulness and adversity appraisal between the post competency and public health emergency response ability among critical care nurses
Maitiniyazi GULIJIANITI· ; Fang HOU ; Yisi XIE
China Occupational Medicine 2025;52(2):166-170
Objective To explore the mediating effects of personal resourcefulness and adversity appraisal between post competency and public health emergency (PHE) response ability among critical care nurses. Methods A total of 430 critical care nurses were selected as the research subjects using the convenience sampling method. The questionnaire survey was conducted using ICU Nurse Core Competency Scale, Resourcefulness Scale, Adversity Appraisal Scale, and Public Health Emergency Response Ability Questionnaire for Nurses. The structural equation model and the Bootstrap method was used to test the chain mediating effect of personal resourcefulness and adversity appraisal between post competency and the ability to respond to PHE. Results The scores of post competency, personal resourcefulness, adversity appraisal and PHE response ability were (67.5±13.3), (90.7±14.5), (44.2±7.9) and (62.4±8.0), respectively. The post competency score was positively correlated with personal resourcefulness, adversity appraisal and PHE response ability [correlation coefficient (r) was 0.763, 0.685 and 0.720, all P<0.01]. The personal resourcefulness score was positively correlated with adversity appraisal and PHE response ability (r was 0.629 and 0.716, all P<0.01). The adversity appraisal score was positively correlated with PHE response ability (r was 0.707, P<0.01). The total effect of post competency on PHE response ability was 0.551. Personal resourcefulness and adversity appraisal played a partial mediating role in the effect of post competency on PHE response ability, and the mediating effect accounted for 27.2% and 18.0% respectively. Their combined chain mediating effect accounted for 17.2% of the total effect. Conclusion Post competency not only directly predicts PHE response ability but also indirectly influences it through the chain mediation of personal resourcefulness and adversity appraisal in critical care nurses.


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