Objective:To explore the relationship between risk perception and health promoting lifestyle profile in population with cardiovascular disease (CVD), and construct a prediction model for clinical screening and targeted intervention.Methods:A cross-sectional survey method was used to select 272 people at moderate and high risk of CVD from the Second Affiliated Hospital of Zhejiang University School of Medicine from March to August 2022. The general information questionnaire, Chinese version of Attitude and Beliefs about Cardiovascular Disease Knowledge and Risk Questionnaire (ABCD-C), and Health Promoting Lifestyle Profile-II (HPLP Ⅱ) were used. Based on multiple regression analysis, a nomogram model for health promoting lifestyle in high-risk CVD population was constructed.Results:Among 272 participants, male 150 cases, female 122 cases, aged (60.58 ± 10.64) years old. The total ABCD-C score was (56.57 ± 5.69), and the total HPLP Ⅱ score was (111.92 ± 12.47). ABCD-C score was significantly positively correlated with HPLP Ⅱ score ( r=0.556, P<0.01). The median of HPLP Ⅱ total score (111 points) was used as the cut-off point for low level of health-promoting lifestyle (≤111 points) and high level of health-promoting lifestyle (>111 points), and used it as the dependent variable, smoking ( OR=0.215, 95% CI 0.104-0.446) was a barrier factor for participants to adopt healthy lifestyle; being married ( OR=14.237, 95% CI 1.963-103.238), having a family average monthly income higher than 5 000 yuan ( OR=4.101, 95% CI 1.369-12.288), higher score of CVD prevention knowledge ( OR=1.660, 95% CI 1.373-2.007), perceived benefits and intention to change physical activity ( OR=1.445, 95% CI 1.255-1.663), perceived benefits and intention to change healthy diet ( OR=1.322, 95% CI 1.058-1.654) were promoting factors. Conclusions:The health-promoting lifestyle of populations at risk for CVD is above-average, influenced by factors such as smoking, marital and economic status, risk attitudes, and beliefs. Utilizing the nomogram model for early screening and targeted risk communication among key populations may contribute to improving their health behavior.

Objective:To explore the clinical and electrophysiological characteristics of peripheral neuropathy in prediabetic patients.Methods:Subjects aged 20-65 years with high-risk factors of impaired glycemia enrolled in Beijing Tiantan Hospital, Capital Medical University from 2019 to 2022 were recruited to conduct oral glucose tolerance test, after excluding other causes of neuropathy or radiculopathy. Patients with impaired fasting glucose or impaired glucose tolerance were defined by American Diabetes Association criteria. These patients were divided into clinical polyneuropathy (PN) and clinical non-PN groups, according to the 2010 Toronto consensus criteria and the presence of PN symptoms and signs or not. Nerve conduction studies (NCS), F wave, sympathetic skin response (SSR), R-R interval variation (RRIV) and current perception thresholds (CPT) were performed and the abnormal rate was compared between different electrodiagnostic methods and between clinical subgroups.Results:Among the 73 prediabetic patients ultimately enrolled, only 20 (27.4%) can be diagnosed as clinical PN according to the Toronto consensus criteria. The abnormal rate of CPT (68.5%, 50/73) was significantly higher than those of F wave (2.7%, 2/73), lower limb NCS (0, 0/73), upper limb NCS changes of carpal tunnel syndrome (26.0%, 19/73), SSR (6.8%, 5/73) and RRIV (5.5%, 4/73; McNemar test, all P<0.001). With sinusoid-waveform current stimuli at frequencies of 2 000 Hz, 250 Hz and 5 Hz, the CPT device was used to measure cutaneous sensory thresholds of large myelinated, small myelinated and small unmyelinated sensory fibers respectively. CPT revealed a 21.9% (16/73) abnormal rate of unmyelinated C fiber in the hands of prediabetic patients, significantly higher than that of large myelinated Aβ fibers [8.2% (6/73), χ2=5.352, P=0.021]. Both abnormal rates of small myelinated Aδ [42.5% (31/73)] and unmyelinated C fibers [39.7% (29/73)] in the feet of prediabetic patients were significantly higher than that of large myelinated Aβ fibers [11.0% (8/73), χ2=18.508, 15.965, both P<0.001]. Compared with the clinical non-PN group, the abnormal rates of CPT [90.0% (18/20) vs 60.4% (32/53), χ2=5.904, P=0.015] and SSR [20.0% (4/20) vs 1.9% (1/53), P=0.016) were significantly higher in the clinical PN group. Conclusions:Peripheral neuropathies in prediabetic patients are usually asymptomatic or subclinical, and predispose to affect unmyelinated and small myelinated sensory fibers. Selective electrodiagnostic measurements of small fibers help to detect prediabetic neuropathies in the earliest stages of the disease.

Background and purpose:For patients with human epidermal growth factor receptor 2(HER2)-positive metastatic breast cancer,trastuzumab treatment can prolong the overall survival and significantly improve the prognosis of patients.However,the reference original research trastuzumab(Herceptin?)is more expensive.Biosimilars have comparable efficacy and safety profiles while increasing patient access to treatment.This clinical trial aimed to evaluate the efficacy,pharmacokinetics,safety and immunogenicity of the trastuzumab biosimilar AK-HER2 compared to trastuzumab(Herceptin?)in patients with HER2-positive metastatic breast cancer.Methods:This multi-center,randomised,double-blind phase Ⅲ clinical trial was conducted in 43 subcenters in China.This study complied with the research protocol,the ethical principles stated in the Declaration of Helsinki and the quality management standards for drug clinical trials.It was approved by the hospital's medical ethics committee.The clinical trial registration agency is the State Food and Drug Administration(clinical trial approval number:2015L04224;clinical trial registration number:CTR20170516).Written informed consent was obtained from subjects before enrollment.Enrolled patients were randomly assigned to the AK-HER2 group and the control group,respectively receiving AK-HER2 or trastuzumab(initial loading dose 8 mg/kg,maintenance dose 6 mg/kg,every 3 weeks as a treatment cycle,total treatment time is 16 cycles)in combination with docetaxel(75 mg/m2,treatment duration is at least 9 cycles).The primary endpoint of this clinical trial was the objective response rate(ORR9)between the AK-HER2 group and the control group in the 9th cycle.Secondary efficacy endpoints included ORR16,disease control rate(DCR),clinical benefit rate(CBR),progression-free survival(PFS)and 1-year survival rate.In this study,100 subjects(AK-HER2 group to control group=1:1)were randomly selected for blood sample collection after the 6th cycle of medication,The collection time points were 45 minutes after infusion(the end of administration),4,8,24,72,120,168,336,and 504 hours after the end of administration.After collection,blood samples were analyzed by PK parameter set(PKPS).Other evaluation parameters included safety and immunogenicity assessment.Results:A total of 550 patients with HER2-positive metastatic breast cancer were enrolled in this clinical trial between Sep.2017 and Mar.2021.In the AK-HER2 group(n=237),129 subjects in the experimental group achieved complete response(CR)or partial response(PR),and the ORR9 was 54.4%.There were 134 subjects in the control group(n=241)who achieved CR or PR,and the ORR9 was 55.6%.The ORR9 ratio between the AK-HER2 group and the control group was 97.9%[90%confidence interval(CI):85.4%-112.2%,P=0.784],which was not statistically significant.In all secondary efficacy endpoints,no statistically significant differences were observed between the two groups.We conducted a mean ratio analysis of pharmacokinetics(PK)parameters between the AK-HER2 group and the control group,and the results suggested that the pharmacokinetic characteristics of the two drugs are similar.The incidence of treatment emergent adverse event(TEAE)leading to drug reduction or suspension during trastuzumab treatment was 3.6%(10 cases)in the AK-HER2 group and 8.1%(22 cases)in the control group.There was statistically significant difference between the two groups(P=0.027).The incidence rate was significantly lower in the AK-HER2 group than in the control group,and there was no statistically significant difference among the other groups.The differences in the positive rates of anti-drug antibodies(ADA)and neutralizing antibodies(NAB)between groups were of no statistical significance(P=0.385 and P=0.752).Conclusion:In patients with HER2-positive metastatic breast cancer,AK-HER2 was comparable to the trastuzumab(Herceptin?)in terms of drug efficacy,pharmacokinetics,safety and immunogenicity.

Objective To investigate the prevailing situation concerning psychological crisis intervention abilities of college staff,and provide countermeasures and suggestions for further strengthening the psychological crisis intervention abilities of college counselors.Methods A"Questionnaire on the Structure of Psychological Crisis Intervention Ability of College Counselors,"was conducted among 120 college counselors and 240 college students from eight colleges in Shenyang.A total of 92 counselors and 199 college students'responses were collected,with an effective recovery rate of 80.83%.Results There were statistical differences between male counselors and female counselors in personality trait dimension(t=-2.156,P＜0.05).There were also statistical differences between counselors who had dealt with students'psychological crises and those who had not in terms of the knowledge(t=-2.786,P＜0.01)and ability dimen-sions(t=-2.151,P＜0.05).Statistical differences were also observed in the evaluation of counselors'crisis intervention ability between students who had experienced psychological crisis events and those who had not.Lastly,there were statistical differences in the empathy(t=-3.176,P＜0.01)and personality trait dimensions(t=-2.424,P＜0.05)between counselors'self-evaluation and students'evaluation.Conclusion At present,college counselors have improved intervention capacity in dealing with students'psychological crises,but it is still necessary to strengthen the preventive role in psychological crisis intervention.Universities need to strengthen speciali-zed training on psychological crisis intervention and provide resources and support for counselors.

Objective:To analyze the effects of assisted intestinal fluid infusion on anal function, gastrointestinal function and nutritional status of patients with low rectal cancer after terminal ileostomy.Methods:Eighty patients with low rectal cancer admitted to Zhejiang Jinhua Guangfu Cancer Hospital from July 2021 to January 2023 were selected as the study objects, and 40 patients performed radical operation and terminal ileostomy(control group), 40 patients performed radical operation and terminal ileostomy and intestinal fluid infusion (experimental group). The anal function indexes, gastrointestinal hormone indexes, intestinal mucosal barrier function indexes and nutritional status indexes were compared before and after operation between the two groups.Results:After operation for 3 months, the maximum systolic pressure of anal canal, rectal compliance, maximum resting pressure of anal canal, rectal bowel inclination sensory volume in the experimental group were higher than those in the control group: (169.72 ± 12.04) mmHg (1 mmHg = 0.133 kPa) vs. (160.42 ± 11.58) mmHg, (4.88 ± 0.17) mmHg vs. (4.20 ± 0.14) mmHg, (40.73 ± 4.31) mmHg vs. (36.05 ± 4.09) mmHg, (80.31 ± 8.27) ml vs. (72.53 ± 7.39) ml, there were statistical differences ( P<0.05). After operation for 9 d, the levels of gastrin (GAS), motilin (MTL), prealbumin (PA), albumin (Alb) and hemoglobin (Hb) in the experimental group were higher than those in the control group: (260.59 ± 31.57) ng/L vs. (224.61 ± 25.01) ng/L, (91.73 ± 10.58) ng/L vs. (65.65 ± 7.01) ng/L, (167.89 ± 18.14) mg/L vs. (152.34 ± 16.01) mg/L, (24.58 ± 2.89) g/L vs.(21.49 ± 2.47) g/L, (79.84 ± 8.67) g/L vs. (70.59 ± 8.01) g/L, there were statistical differences ( P<0.05). The incidence of malnutrition in the experimental group was lower than that in the control group: 10.00%(4/40) vs. 27.50%(11/40), there was statistical difference ( χ2 = 4.02, P<0.05). Conclusions:The use of intestinal fluid infusion as an adjuvant therapy after distal ileostomy in patients with low rectal cancer can improve anal function, gastrointestinal function, and nutritional status.

Objective:To investigate associations of serum low-density lipoprotein cholesterol (LDL-C) with hematoma enlargement, early neurological deterioration (END), and outcome in patients with acute spontaneous intracerebral hemorrhage (ICH).Methods:"A multi-center registration study for spontaneous intracerebral hemorrhage in Inner Mongolia" (registration number: ChiCTR2000029494) database was used to include patients with ICH who completed their first head CT scan within 6 hours after onset, underwent blood lipid examination, CT follow-up within 24 hours of onset, and accurately measured hematoma volume using 3D Slicer software between June 2020 and September 2022. HE was defined as hematoma volume increasing >33% or >6 ml at 24 hours, or ventricular hematoma volume increasing ≥1 ml compared to the baseline. END was defined as an increase of ≥4 in the National Institutes of Health Stroke Scale (NIHSS) score from the baseline or death within 24 hours after onset. The follow-up was conducted at 3 months after onset, and the modified Rankin Scale score >2 was defined as poor outcome. Multivariate logistic analysis was used to determine the independent correlation between LDL-C and HE, END, and outcome. Results:A total of 338 patients with ICH were enrolled, including 206 males (60.9%). LDL-C was 2.39±1.22 mmol/L. Eighty-eight patients (26.0%) developed HE, 67 (19.8%) developed END, and 162 (47.9%) had poor outcome at 3 months. Multivariate logistic analysis showed that after adjusting for confounding factors, there was a significant independent negative correlation between LDL-C and HE (odds ratio 0.312, 95% confidence interval 0.208-0.467; P<0.001) and END (odds ratio 0.408, 95% confidence interval 0.275-0.606; P<0.001), but not with the outcome at 3 months. Conclusion:Lower LDL-C is associated with HE and END in patients with ICH, but not with the outcome.

Cardiovascular disease risk communication is an important tool to help risk individuals understand risk information and guide them to improve their health behaviors.Effective cardiovascular disease risk communication by nurses,who are the subjects of risk communication,is essential to reduce the growing burden of cardiovascular disease and the prevalence of cardiovascular disease.This article provides a 3-aspect overview of the concept and development of health risk communication,factors influencing cardiovascular disease risk communication,and recommendations for its development.It is suggested that when nursing staff carry out CVD risk communication,they should fully consider the actual situation and preference of the communication target and design a personalized risk communication program,to provide references for clinical nursing practice.

Objective: To assess the status of current e cigarette perception and its influencing factors among adolescents in Shanghai, so as to provide reference for the refinement of the prevention and control measures of teenagers e cigarette use. Methods: From May to June 2021, a stratified random cluster sampling was used to investigate 7 456 junior high and high school students in Shanghai. Harm and benefit perception of e cigarette as well as its social environment benefits were collected. Results: The rate of adolescents ever and current e cigarette use was 3.19% and 1.09%, respectively. The top four risk factors for low harm perception of e cigarette were adolescent e cigarette use( OR=2.74, 95%CI =2.10-3.59), high school students ( OR=1.47, 95%CI = 1.32 - 1.64 ), family members ( OR=1.45, 95%CI =1.24-1.70) and friends ( OR=1.36, 95%CI =1.20-1.54) using e cigarette. Adolescent ecigarette use ( OR=2.77, 95%CI =1.97-3.89), high school students( OR=2.11, 95%CI =1.89-2.36), friends ( OR= 1.63, 95%CI =1.42-1.87) and family members using e cigarette( OR=1.39, 95%CI =1.18-1.65) were the top four associated factors for high benefit perception of e cigarette. And, adolescent e cigarette use ( OR=1.95, 95%CI =1.47-2.59), high school students ( OR= 1.73, 95%CI =1.55-1.93), friends ( OR=1.60, 95%CI =1.40-1.82) and pocket money≥200 yuan using e cigarette( OR= 1.29 , 95%CI =1.17-1.43) were the top four risk factors for high social environmental benefit perception of e cigarette. Moreover, perception of e cigarette harm, benefit and social environmental benefit were associated with the risk of future use of e cigarette( OR = 0.78,1.44,1.21, P <0.01). Conclusion Being high school students and using e cigarette by oneself, friends, and family members are the important influencing factors for adolescents e cigarette perception. Both low harm and high benefit perception of e cigarette elevate the risk of future e cigarette use among adolescents, so effective measures should be taken to promote control education about e cigarette and smoke free environment construction.

Background At present, insufficient support for enterprise health environment and career development may lead to severe depressive emotion among occupational groups. Objective To investigate current state of depressive emotion and the relationship between health literacy and depressive emotion among occupational groups in Shanghai, and to provide evidence for formulating health management measures to alleviate depressive emotion among the occupational population. Methods This cross-sectional survey, using two-stage stratified sampling, was from December 2022 to February 2023, and selected 2548 active workers from 151 enterprises in Shanghai. A total of 2489 valid questionnaires were returned, with a recovery rate of 97.68%. Health literacy, internality health locus of control, and depressive emotion were evaluated by the Health Literacy Questionnaire, the Multidimensional Health Locus of Control Scale-Internality Health Locus of Control, and the Patient Health Questionnaire Depression Scale-9 item (PHQ-9), respectively. R 4.2.2 software was used for statistical analysis, binary logistic regression model was used to analyze the association between health literacy, internality health locus of control, and the risk of depressive emotion, and multiple linear model was used to analyze the correlation between health literacy, internality health locus of control, and PHQ-9 related indicators (total score, affective score, and somatic score). Results A total of 2489 workers aged 18 years and above in Shanghai were included in the analysis, 868 of them reported depressive emotion, and the positive rate of depressive emotion was 34.9%. The total score, affective score, and somatic score of PHQ-9 in M(P₂₅, P₇₅) were 3.00 (0.00, 6.00), 1.00 (0.00, 4.00), and 1.00 (0.00, 3.00), respectively. The results of binary multiple logistic regression analysis showed that after adjusting for selected confounders, no health literacy (OR=1.32, 95%CI: 1.10, 1.60; P=0.004) and low level of internality health locus of control (OR=1.66, 95%CI: 1.35, 2.05; P < 0.001) were associated with an increased risk of reporting depressive emotion. The results of multiple linear model showed that the lack of health literacy and low internality health locus of control were positively correlated with the total score, affective score, and somatic score of PHQ-9. Conclusion Depressive emotion among the working population in Shanghai is prominent, and more than 1/3 of them report depressive emotion. Lower health literacy and internality health locus of control are related to an increased risk of depressive emotion in the study population. Improving occupational health literacy and enhancing internality health locus of control are expected to prevent depressive emotion in occupational groups.

Objective:To validate the feasibility of the gamma analysis method in the study of prescription dose conversion between logistic nanodosimetry model (LNDM) and microdosimetric kinetic model (MKM) basing on the Chinese self-developed model LNDM by applying clinical experiences of National Institute of Radiological Science (NIRS).Methods:Physical dose distributions derived from the MKM- and LNDM-based carbon ion treatment plans were compared via the method of gamma analysis under the open-source treatment planning platform matRad. In this way, the prescribed dose conversion factor between the MKM- and LNDM-based treatment plans was obtained. Using water phantoms, the influence of geometric shape, size, depth of target volume (TV), prescribed dose and field setting on the conversion factor was investigated comprehensively. Moreover, preliminary verification of the acquired conversion factor was conducted on the C-shape model and a case of liver cancer patient.Results:The conversion factor depended on the field setting rather than the TV shape. Under the condition of single field, the conversion factor was positively correlated with the size and depth of TV, and the prescribed dose. Moreover, the conversion factor was successfully verified using the C-shape model and the patient with liver cancer, where the gamma passing rates (2%/2 mm) of the physical dose distribution generated by the MKM and LNDM treatment plans were 92.79% and 91.19%, respectively.Conclusions:The conversion factors (f=D LNDM/D MKM) obtained in this study might provide guidance for the prescribed dose setting during the carbon ion treatment planning based on the LNDM. Besides, the gamma analysis method could be used for the study of the prescribed dose conversion between different models.