Uncovering the risk factors of pulmonary hypertension and its mechanisms is crucial for the prevention and treatment of the disease.In the current study,we showed that experimental periodontitis,which was established by ligation of molars followed by orally smearing subgingival plaques from patients with periodontitis,exacerbated hypoxia-induced pulmonary hypertension in mice.Mechanistically,periodontitis dysregulated the pulmonary microbiota by promoting ectopic colonization and enrichment of oral bacteria in the lungs,contributing to pulmonary infiltration of interferon gamma positive(IFNγ+)T cells and aggravating the progression of pulmonary hypertension.In addition,we identified Prevotella zoogleoformans as the critical periodontitis-associated bacterium driving the exacerbation of pulmonary hypertension by periodontitis,and the exacerbation was potently ameliorated by both cervical lymph node excision and IFNγ neutralizing antibodies.Our study suggests a proof of concept that the combined prevention and treatment of periodontitis and pulmonary hypertension are necessary.

Objective:To investigate the value of radiomics based on three-dimensional high resolution MR vessel wall imaging (3D HRMR-VWI) for identifying culprit plaques in symptomatic patients with middle cerebral atherosclerosis.Methods:The clinical and imaging features of 117 patients (139 middle cerebral artery plaques) with cerebrovascular diseases in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from October 2018 to October 2020 were respectively reviewed. Stratified random sampling was used to divide 139 plaques into training set (97 plaques) and validation set (42 plaque) at the ratio of 7∶3. The plaques were divided into 69 culprit plaques and 70 non-culprit plaques based on plaque MR features and clinical symptoms. The clinical and imaging characteristics of culprit plaques and non-culprit plaques were compared by independent sample t-test, Mann-Whitney U test and χ 2 test, and factors with significant difference between two groups in univariate analysis were further analyzed by multivariate logistic regression to find out the independent predictors of culprit plaques. Radiomics features were extracted, screened and radiomics model was constructed using pre-and post-contrast 3D HRMR-VWI based on the training set. The combined model was constructed by combining the independent predictors and radiomics model. Receiver operating characteristic curve and area under curve (AUC) were used to evaluate the efficacy of each model, and DeLong test was used to compare the efficacy of different models. Results:Significant difference was found in intraplaque hemorrhage, lumen area of stenosis, stenosis diameter, stenosis rate, plaque burden and enhancement rate between culprit and non-culprit plaques (all P<0.05). Multivariate logistic regression analysis confirmed that only intraplaque hemorrhage was the independent predictor for culprit plaques (OR=7.045,95%CI 1.402-35.397, P=0.018). In the validation set, the AUC of the pre-contrast 3D HRMR-VWI model was lower than that of the post-contrast 3D HRMR-VWI model ( Z=-2.01, P=0.044). The AUC of pre+post-contrast 3D HRMR-VWI model was not significantly different from that of post-contrast 3D HRMR-VWI model ( Z=0.79, P=0.427). The AUC showed no significant difference between combined model and pre+post-contrast 3D HRMR-VWI model ( Z=-0.59, P>0.05). The combined model showed the best performance in predicting culprit plaques of middle cerebral artery (AUC=0.939), with the sensitivity, specificity and accuracy of 95.24%, 76.19% and 85.71%. Conclusion:Radiomics based on 3D HRMR-VWI has potential values in identifying culprit plaques in symptomatic patients with middle cerebral atherosclerosis.

Objective: To develop a model incorporating radiomic features and clinical factors to accurately predict acute ischemic stroke (AIS) outcomes. Materials and Methods: Data from 522 AIS patients (382 male [73.2%]; mean age ± standard deviation, 58.9 ± 11.5 years) were randomly divided into the training (n = 311) and validation cohorts (n = 211). According to the modified Rankin Scale (mRS) at 6 months after hospital discharge, prognosis was dichotomized into good (mRS ≤ 2) and poor (mRS > 2); 1310 radiomics features were extracted from diffusion-weighted imaging and apparent diffusion coefficient maps. The minimum redundancy maximum relevance algorithm and the least absolute shrinkage and selection operator logistic regression method were implemented to select the features and establish a radiomics model. Univariable and multivariable logistic regression analyses were performed to identify the clinical factors and construct a clinical model. Ultimately, a multivariable logistic regression analysis incorporating independent clinical factors and radiomics score was implemented to establish the final combined prediction model using a backward step-down selection procedure, and a clinical-radiomics nomogram was developed. The models were evaluated using calibration, receiver operating characteristic (ROC), and decision curve analyses. Results: Age, sex, stroke history, diabetes, baseline mRS, baseline National Institutes of Health Stroke Scale score, and radiomics score were independent predictors of AIS outcomes. The area under the ROC curve of the clinical-radiomics model was 0.868 (95% confidence interval, 0.825–0.910) in the training cohort and 0.890 (0.844–0.936) in the validation cohort, which was significantly larger than that of the clinical or radiomics models. The clinical radiomics nomogram was well calibrated (p > 0.05). The decision curve analysis indicated its clinical usefulness. Conclusion The clinical-radiomics model outperformed individual clinical or radiomics models and achieved satisfactory performance in predicting AIS outcomes.

Objective:To explore the effect of Teach-Back model on oral health behavior among the middle-aged and aged.Methods:From March 2017 to June 2018, 150 middle-aged and elderly patients undergoing oral examinations from the Department of Preventive Dentistry, Hospital of Stomatology, Sun Yat-sen University were selected as the survey subject by convenience sampling. Patients were divided into experimental group ( n=70) and control group ( n=80) . Control group was given regular oral health guidance, and experimental group implemented Teach-Back nursing care on the basis of control group. After 6 months of intervention, we compared the cognition of periodontal disease, oral health behavior, and periodontal health status of middle-aged and elderly patients between two groups. Results:After 6 months of intervention, the scores of daily oral hygiene habits, periodontal disease cognition and periodontal disease treatment behavior of experimental group were higher than those of control group, and the differences were statistically significant ( P<0.05) . The Debris Index-Simplified (DI-S) , Calculus Index-Simplified (CI-S) , Gingival Index (GI) , Bleeing Index (BI) and Depth of Periodontal Pocket (PD) of experimental group were lower than those of control group with statistical differences ( P<0.05) . Conclusions:Middle-aged and elderly people have poor periodontal disease cognition and need nursing intervention. Teach-Back model can improve the daily oral hygiene habits of middle-aged and elderly patients, improve their correct understanding of periodontal disease, and improve their oral health behavior and quality of life.

MicroRNA is a class of short-chain non-coding RNA that regulates gene expression at post-transcriptional level.It can participate in the pathophysiology processes of tumor regulation,neurodegenerative disease,and cardiovascular disease.Recent studies have shown that microRNA can play a reguhtory role in ischemic brain damage through autophagy.This article reviews the effect of microRNA on autophagy after cerebral ischamia and its possible mechanisms.

Objective To evaluate the attitudes of clinical nurses toward caring for the dying patients, and possible influencing factors concerning the attitudes were investigated, so as to provide a scientific basis for further intervention, thus improving the positive attitudes toward care of the dying patients in the future research. Methods A convenience sampling method was used to recruit 770 nurses from 15 hospitals located in 5 provinces in China. A demographic survey, Chinese version of Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B-C) and Chinese version Death Attitude Profile-Revised were employed in the survey. Results FATCOD-B-C scale was used to evaluate the attitudes of nurses toward caring for dying patients, with the mean score of all FATCOD-B-C item being 95.62 ± 7.45. To analyze relationship among demographic variables and the total score of FATCOD-B-C. Univariate analysis revealed that age group (F=2.285), years employed as a nurse (F=3.353), educational background (F=5.581), technical title (F=5.692), level of hospital (t=2.058), religious beliefs (t=-2.788), previous education on death and dying(F=9.743), previous experience in dealing with terminally ill persons (t=2.761) had significant influence on the nurses' attitudes toward caring for dying patients and families(P<0.05). Multiple linear regression analysis indicated that nurses' attitudes toward caring for dying patients had been affected by those factors, among which the most influential factor was educational background. Conclusions It shows that nurses'FATCOD-B-C scores are at a low level. It is suggested to improve nurses' positive attitudes of caring for dying patients and their families by making the specific methods based on the influencing factors, thus improving the development of palliative care.

Objective To explore the protective mechanism of HSP70 protein in traumatic brain injury (TBI)‐related acute gastric mucosal lesions in mice .Methods Forty adult male Balb/c mice were randomly divided into sham (A) ,TBI (B) ,TBI+ geranylgeranylacetone (GGA) (C) ,and TBI+saline (D) groups .TBI was induced via the Feeney impact model .GGA (800 mg/kg) was administered via oral tube beginning before the model was built in group C .The expressions of HSP70 protein in brain and gastric mucosa were determined by immunohistochemistry , and the apoptotic index was detected by TUNEL method .Results The injury area in mouse brain and gastric mucosa was greater in group B than in groups A and C (P<0 .05) .After model induction ,the content of HSP70 protein in group B was markedly higher in the brain and gastric mucosa ,which was notably higher than in group A (P<0 .05) .Obviously apoptotic cells were observed in groups B and D ,which were significantly higher than in groups A and C .GGA pretreatment enhanced the up‐regulated expression of HSP70 and decreased the apoptotic index distinctly ;HSP70 expression was higher in group C than in groups B and D ,but the apoptotic index was lower (P<0 .05) .Conclusion GGA can induce HSP70 protein expression in mouse brain and gastric mucosa .HSP70 is involved in the process of apoptosis inhibition .GGA can be used in the prevention and therapy of TBI‐related acute gastic mucosal lesions .

Objective To explore the current status of nursing students′ empathy ability in adult education, and analyze its influencing factors, so as to provide references for the reform of further nursing education. Methods Totally 718 nursing students from two campuses of Guangdong Medical University were selected by convenience cluster sampling method, and were investigated in May 2014 by general situation questionnaire and clinical nurses empathy ability assessment scale. The general information of nursing students in adult education were analyzed by univariate analysis. Results The results of investigation showed that: the average total score of empathy ability among nursing students in adult education was (107.68±13.71), the score among adult nursing students of college was (106.31±12.95), and the score among undergraduate nursing students was (108.69±14. 18) (t=-2.22,P<0.05). There were significant differences in the scores of empathy ability among nursing students with different age, working years, marital status, professional titles and jobs (P<0.05). Conclusions The scores of empathy ability score among undergraduates nursing students is slightly higher than that among nursing students of college. Age, working years, marital status, professional title and job are important influencing factors of empathy ability. We should strengthen the cultivation of humanistic care in nursing continuing education, to raise the adult nursing students′empathy ability.

Objective To explore the effect of creatine phosphate combined with salvia miltiorrhiza polyphe-nols acid salt in treatment of coronary heart disease heart failure.Methods 114 cases of patients with coronary heart disease heart failure were selected as research objectives,who were treated in our hospital from August 2012 to August 2014.And they were randomly divided into control group(55 cases)and research group(59 cases)according to the number table method.Routine therapy of heart failure were given in both groups and the research group were added creatine phosphate combined with salvia miltiorrhiza polyphenols acid salt.The clinical efficacy of two groups of patients were observed and compared.Results The total effective rate in research group was 96.61%(57 /59), significantly higher than 85.45%(47 /55)in control group,the difference was statistically significant(χ2 =4.427, P =0.035).Before treatment,the left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter(LVESD)and 6min walking distance between two groups had no sig-nificant difference(P >0.05).After treatment,the LVEDD and LVESD of research group were decreased and LVEF and 6 minutes walking distance of two groups were increased,the difference was statistically significant(P <0.05), the LVEDD and LVESD of research group were lower than that of the control group and LVEF and 6 minutes walking distance were higher than that of control group,the difference was statistically significant(P <0.05).No complications or side effects related to the treatment were found in both groups.Conclusion On the basis of routine therapy of heart failure,the effect of creatine phosphate sodium combined with salvia miltiorrhiza polyphenols acid salt in treat-ment of coronary heart disease heart failure can improve cardiac function of the patients with the indicators,and the clinical effect is obvious,and side effects is rarely observed.

Objective To investigate the relationship of carotid artery intima-media thickness(IMT) and blood pressure variation in patients with prehypertension. Methods Three hundred and ninety-two patients were selected as our subjects. Artery IMT was measured by Doppler ultrasonography. All patients were divided into carotid artery IMT group( n = 204 ),not carotid artery IMT group( n = 188 ) based on carotid IMT. Meanwhile,all patients were monitored by ambulatory blood pressure. Results (1)The indices of 24 h mean systolic blood pressure,systolic blood pressure variability and diastolic blood pressure variability in patients of carotid artery IMT group were(136. 85 ± 9. 67)mmHg,(4. 13 ± 0. 67)% ,(2. 97 ± 0. 45)% respectively, higher than those of Not carotid artery IMT group((121. 92 ± 6. 54)mmHg,(2. 64 ± 0. 86)% ,(2. 06 ± 0. 36)% ;t = 21. 08,5. 97,3. 32;P < 0. 05).(2)The rate of the carotid artery thickness increased with systolic blood pressure variability increasing( P = 0. 001). There were no significant correlations between rate of the carotid artery thickness and diastolic blood pressure variability,24 h mean diastolic blood pressure(P = 0. 435, 0. 126). The IMT thickening rate was higher when the average systolic blood pressure was greater(P = 0. 013). (3)Regression analysis indicated that carotid artery IMT was positively related with systolic blood pressure variability,high-sensitivity C-reactive protein,24 h mean systolic blood pressure,2-hour postprandial blood glouse. Conclusion Carotid artery IMT is independently associated with variation of blood pressure,especially with systolic blood pressure variability in prehypertension patients.