Objective:To investigate the self-care contribution and binary coping level of spouse caregivers for middle-aged and young stroke patients and explore the relationship between the two, in order to improve the quality of self-care contribution of spouse caregivers to middle-aged and young stroke patients.Methods:A cross-sectional survey was conducted among 200 middle-aged and young stroke patients ′ spouse caregivers in the People ′s Hospital of Xinjiang Uygur Autonomous Region from January to June 2023 by the general data questionnaire, the Caregiver Contribution to Self-care of Stroke Patient Scale, the Dyadic Coping Inventory. The correlation between self-care contributions and binary coping strategies of spousal caregivers was analyzed, and the factors that affect their self-care contributions were screened. Results:Finally, 192 middle-aged and young stroke patients ′ spouse caregivers were included, including 70 males and 122 females, aged 18-59 years old. The total score of self-care contribution of spousal caregivers of middle-aged and young stroke patients was (75.43 ± 6.80) points, and the total score of binary coping was (117.12 ± 9.59) points, both of which were positively correlated ( r=0.691, P<0.05). Hierarchical regression analysis showed that after controlling for the influence of general data, binary coping could explain 28.4% variation in the self-care contribution of spouse caregivers of middle-aged and young stroke patients ( P<0.05). Conclusions:The duality coping level positively predicts the quality of spouse caregivers ′ self-care contribution to middle-aged and young stroke patients. Medical staff should assess the dual coping level of middle-aged and young stroke patients and their spouses, and carry out targeted dual intervention measures to improve the quality of caregivers' contribution to stroke patients ′ self-care.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Objective:To translate the Family Caregiver Conflict Scale (FCCS) into Chinese and test its reliability and validity.Methods:Based on the Brislin model, the Chinese version of FCCS was formed by conducting proper translation, back translation, proofreading, expert consultation, and pre-investigation. From January to May 2023, convenience sampling was used to select 240 caregivers of stroke inpatients in the Neurology Department of Xinjiang Uygur Autonomous Region People's Hospital as the research subject to test the reliability and validity of the scale. After 14 days, 30 caregivers were randomly selected for retesting. A total of 240 questionnaires were distributed, and 232 valid questionnaires were collected, with an effective response rate of 96.667%.Results:The Chinese version of FCCS consisted of 15 items. The item-level content validity index were 0.833 to 1.000, and the scale-level content validity index was 0.933. Exploratory factor analysis extracted three common factors, with a cumulative variance contribution rate of 74.668%. The total Cronbach's α coefficient of the scale was 0.920, with Cronbach's α coefficients for each dimension ranging from 0.823 to 0.951. The Guttman half coefficient was 0.821. The test-retest reliability coefficient of the total scale was 0.882, and the test-retest reliability coefficients for each dimension ranged from 0.622 to 0.825.Conclusions:The Chinese version of FCCS has good reliability and validity, and can be used as an assessment tool for family conflicts in caregivers of stroke patients.

Objective:To explore the mediating effect of expectations regarding aging between social support and frailty in elderly patients with chronic obstructive pulmonary disease (COPD), so as to promote better health education among medical staff and improve patients′ ability to cope with frailty.Methods:This was a cross-sectional study, the convenience sampling method was used to select 258 elderly COPD patients hospitalized in the Department of Respiratory Medicine and Geriatrics of Xinjiang Uygur Autonomous Region People′s Hospital from November 2021 to April 2022. They were investigated by the general information questionnaire, Fried Scale, Social Support Scale and Expectations Regarding Aging-21. Analyzed the correlation among social support, expectations regarding aging and frailty. AMOS 26.0 was used to investigate the mediating effect of expectations regarding aging between social support and frailty in elderly COPD patients.Results:The score of social support, expectations regarding aging and frailty in elderly patients with COPD was (30.45 ± 5.57), (35.25 ± 6.28) and (2.34 ± 1.71)points, respectively. There was negative correlation between social support and frailty in elderly COPD patients ( r=-0.541, P<0.01), while positive correlation between social support and expectations regarding aging ( r=0.477, P<0.01). The negative correlation between social support and expectations regarding aging ( r=-0.536, P<0.01). Expectations regarding aging played a partial mediating role between social support and frailty, with mediating effect value of -0.229, accounting for 35.39% of the total effect. Conclusions:Expectations regarding aging is a mediator variable between social support and frailty in elderly COPD patients. Health care providers can alleviate or even reverse patients' debilitating condition by improving their expectations regarding aging and social support.

Objective:To evaluate the optimized effect of infiltration between the popliteal artery and the capsule of the knee (IPACK)-adductor canal block (ACB) combined with general anesthesia when used for the total knee arthroplasty.Methods:Sixty patients of both sexes, aged 18-64 yr, with body mass index of 18-24 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective unilateral total knee arthroplasty, were divided into 2 groups ( n=30 each) using a random number table method: IPACK-ACB combined with general anesthesia group (group IA) and conventional anesthesia femoral nerve block-popliteal superior sciatic nerve block combined with general anesthesia group (group C). Before induction of general anaesthesia, 0.375% ropivacaine 15 ml was injected for IPACK and 0.375% ropivacaine 25 ml for ACB under the ultrasound guidance in group IA, femoral nerve block and popliteal superior sciatic nerve block was performed under the guidance of ultrasound combined with a nerve stimulator and 0.375% ropivacaine 20 ml was injected in group C. After confirming the efficacy of nerve block, total intravenous anesthesia was carried out to maintain bispectral index values at 40-60.Patient-controlled intravenous analgesia was performed with sufentanil after operation, and the visual analog scale score was maintained ≤ 3.The quadriceps muscle strength score was recorded when discharge from postanesthesia care unit and at 24, 48 and 72 h after surgery.The first postoperative off-bed time and development of foot drop in awake patients after surgery, requirement for rescue analgesia and adverse reactions were recorded.The postoperative length of hospital stay and score for patients′ satisfaction with postoperative recovery were also recorded. Results:Compared with group C, the postoperative quadriceps muscle strength scores and score for patients′ satisfaction with postoperative recovery were significantly increased, the incidence of postoperative foot drop was decreased, and the length of hospital stay and first postoperative off-bed time were shortened in group IA ( P<0.05). Conclusion:IPACK-ACB combined with general anesthesia may be an optimized strategy which is helpful for outcomes after total knee arthroplasty.

Objective To evaluate initial results of Ivor Lewis minimally invasive esophagectomy (MIE) for esophageal carcinoma using a diamond-shaped anastomosis with 45 mm linear-stapler.Methods Clinical data of 12 patients diagnosed middle to distal esophageal carcinoma and undergoing Ivor Lewis minimally invasive esophagetomy using a diamond-shaped anastomosis technique during Dec.2015 and Nov.2016 in Peking Union Medical College Hospital were collected and analyzed retrospectively.Results The mean operation time was (378 ± 56) min,the mean blood loss was (280 ± 120) ml,and the mean postoperative hospital stay was (12.2 ± 2.0) days.No positive margin,no peri-operative death occurred.Postoperative complication included atelectasis and pulmonary infection in 1 patient,paresis of left recurrent laryngeal nerve in 1 patient.No anastomotic leak or constriction occurred.Median follow up was 7 months,11 patients had no evidence of disease progress,1 patient had subcutanecous metastasis and was reoperated.Conclusion The diamond anastomosis technique utilizing in Ivor Lewis MIE for esophageal carcinoma is feasible,easy to manipulate,safe and reliable.

Objective To explore the predictive value of soluble growth STimulation expressed gene 2(sST2) on major adverse cardiovascular events(MACE) of acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods The study included 148 patients with first episode of AMI admitted from January 2015 to May 2016 in the heart center of the First Hospital of Lanzhou University.Serum sST2 level before PCI was tested and all patients were followed up clinically for 6 months after PCI.Results 1.MACEs were found in 23 patients during follow up.The sST2 leveles were significantly higher in patients with MACEs than the non-MACE group [(44.50 ±5.32) ng/ml vs.(23.59±1.15) ng/ml, P=0.001].Pearson correlation analysis showed that serum sST2 were positively correlated with MACE and type Ⅲ procollagen amine terminal peptide (PⅢNP) but was not correlated with NT-proBNP.2.Serum sST2 found to be correlated with the body mass index, blood pressure, triglycerides, aspartate aminotransferase, left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF).3.The area under the ROC curve of sST2 to predict the occurrence of MACE after PCI was 0.787 which was higher than that of NT-proBNP.The area under curve of sST2 combined with NT-proBNP was 0.820.4.The survival rate of patients with serum sST2 level ≤29 ng/ml was higher than patients with sST2>29 ng/ml in 6 months after PCI.Conclusions sST2 is affected by a variety of factors.sST2 combined with NT-proBNP can improve the predictive value of MACE after PCI, and higher the level of sST2, higher the mortality rate in 6 months after PCI.

BACKGROUNDSleep deprivation (SD) has been used in treatment of depression disorder, and could effectively improve the patients' depressive symptoms.The aim of the study was to explore the effects of SD on electroencephalographic (EEG) and executive function changes in patients with depression.

METHODSEighteen depression patients (DPs) and 21 healthy controls (HCs) were enrolled in the present study. The whole night polysomnography (PSG) was recorded by Neurofax-1518K (Nihon Kohden, Japan) system before and after 36 hours of SD. The level of subjects' depression state was assessed by Visual Analogue Scale (VAS), and the executive function was assessed by Wisconsin Card Sorting Test (WCST).

RESULTSSignificantly decreased sleep latency (SL; before SD: (31.8 ± 11.1) minutes, after SD: (8.8 ± 5.2) minutes, P < 0.01) and REM sleep latency (RL; before SD: (79.8 ± 13.5) minutes, after SD: (62.9 ± 10.2) minutes, P < 0.01) were found after SD PSG in depression patients. Decreased Stage 1 (S1; before SD: (11.7 ± 2.9)%, after SD: (7.3 ± 1.1)%, P < 0.01) and Stage 2 (S2, before SD: (53.8 ± 15.5)%, after SD: (42.3 ± 14.7)%, P < 0.05) of non-rapid eye movement (NREM) sleep, and increased Stage 3 (S3, before SD: (11.8 ± 5.5)%, after SD: (23.6 ± 5.8)%, P < 0.01) and Stage 4 (S4, before SD: (8.8 ± 3.3)%, after SD: (27.4 ± 4.8)%, P < 0.01) NREM sleep were also found. After SD, the depression level in patients decreased from 6.7 ± 2.1 to 2.9 ± 0.7 (P < 0.01). In WCST, the patients showed significantly decreased Response errors (Re, before SD: 22.3 ± 2.4, after SD: 18.3 ± 2.7, P < 0.01) and Response preservative errors (Rpe, before SD: 11.6 ± 3.6, after SD: 9.3 ± 2.9, P < 0.05). Depression patients' RE (t = 2.17, P < 0.05) and Rpe (t = 2.96, P < 0.01) also decreased significantly compared to healthy controls.

CONCLUSIONSD can improve depression symptom and executive function in depression patients.

Adult ; Depression ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Polysomnography ; methods ; Sleep Deprivation ; physiopathology

This study was aimed to determine effect of Bu-Shen Kang-Shuai (BSKS) Tablet on HO-1 mRNA and its associated oxidative stress levels among atherosclerotic rabbits. A total of 56 rabbits were randomly divided into the normal group (8 rabbits) and the experimental group (48 rabbits). Normal diet was given to the normal group. Atherosclerotic rabbits models were established in the experimental group. At the eighth week, rabblits in the experi-mental group were randomly divided into the model group, BSKS Tablet group and simvastatin group. Blood samples were collected before medication, 8-, 12-, 16-week after medication from rabbits of each group. Rabbits were sacri-ficed under aseptic conditions at the last blood collection. Expressions of aortic HO-1 mRNA and PPARα mRNA were measured by Q-PCR method. The level of MMP-9 was measured by immunohistochemical assay. Serum HbCO, COX-2 activity and cGMP level were measured by ELISA assay. The results showed that after the intervention of BSKS Tablet, serum HbCO level decreasd, cGMP was obviously increased. However, there was no obvious change on the COX-2 activity. The immunohistochemical assay showed that BSKS Tablet obviously reduced MMP-9 level of rabbits. There was only small amount of aortic HO-1 mRNA expression in the normal group. However, the expres-sion of aortic HO-1 mRNA in the atherosclerosis group was increased. After intervention of BSKS Tablet, the ex-pression of HO-1 mRNA was increased with statistical significance (P < 0.05). Simvastatin had similar antioxidant effect. It was concluded that the compound preparation of traditional Chinese medicine (TCM) BSKS Tablets had an important antioxidant effect in treatment of atherosclerosis. Its protective mechanism may be through the regulation of HO-1 mRNA gene expression and effects of HO-1/CO-cGMP pathway activities of related enzymes while peroxida-tion stability of atherosclerotic plaque.

OBJECTIVETo assess the effect of platelet rich plasma (PRP) on proliferation and differentiation of human MG63 osteoblast-like cells and the biological function of PRP in vitro.

METHODSPRP was obtained from venous blood of a health volunteer by two step centrifugation. CaCl2 and thrombin were used to activate PRP. The differentiation of MG63 cells, which were exposed to various concentrations of PRP (0, 1%, 2%, 3%) was detected by alkaline phosphatase (ALP) activity. Propidium iodide (PI) fluorescent coloration staining was used to observe the morphology of cells. Immunocytochemistry was used to evaluate the expression level of transforming growth factor-beta (TGF-beta) in MG63 cells in different concentration of PRP. The cells adhered to calcium phosphate material was observed by scanning electron microscopy (SEM). The proliferation was evaluated by cell counting kit-8 (CCK-8) proliferation assay. The cell cycle assay was performed by low cytometry (FCM) to detect the effect of PRP on MG63 cells in different time points. The mRNA level of Col-I in MG63 cells cultured under different concentration PRP was checked by reverse transcription polymerase chain reaction (RT-PCR).

RESULTSALP activity experiment demonstrated that the maximum effect was got in 3% PRP group. PRP had a positive effect on the proliferation of MG63 cells but cells also presented disengage phenomena from the glass slides. The PI staining showed that PRP improved fluorescent intensity of cell nucleus. Immunocytochemistry showed that TGF-beta expression level was significantly enhanced on 3% PRP group (P<0.05). SEM showed that cells grew well on material in PRP group. The results of CCK-8 showed that the mean absorbency number A(450 nm) of 4.8% PRP was significantly higher than that of control group (P<0.05). FCM showed that S period cells percentage of PRP group was higher than that of control group in the 2nd day (P<0.05); G0/G1 period cells percentage of PRP group was significant increased than that of control group in the 10th day (P<0.05); G2/M period cells percentage of PRP group was higher than that of control group except the 6th day. PRP promoted the expression of Col- I in MG63 cells by RT-PCR.

CONCLUSIONThese data suggest that PRP has a positive influence on MG63 proliferation, transference and the expression of relative protein and gene in an appropriated concentration. The findings of this study also demonstrated that PRP may play a beneficial role of unifying and modulating the biological behavior of MG63 cells.

Alkaline Phosphatase ; Cell Differentiation ; Humans ; In Vitro Techniques ; Osteoblasts ; Platelet-Rich Plasma ; Transforming Growth Factor beta