Objective:To explore the potential categories of psychological distress in spousal caregivers of stroke patients and differences in quality of life between categories, in order to provide a theoretical basis for early clinical identification and provision of individualized and targeted interventions for psychological distress in spousal caregivers of stroke patients and improvement of their quality of life.Methods:A total of 207 spouse caregivers of stroke patients hospitalized in three class 1-Grade A hospitals in Yinchuan city of Ningxia Hui Autonomous Region, who met the inclusion and exclusion criteria were selected from December 2020 to July 2021 by convenience sampling method as study subjects. The general information questionnaire, Kessler Psychological Distress Scale, and the Mos 36-Item Short from Health Survey were used for a cross-sectional survey.Results:A total of 203 spousal caregivers of stroke patients were finally investigated, 46 males and 157 females with a age of (58.65 ± 9.66) years. Psychological distress among spousal caregivers of stroke patients was categorized into 3 potential categories:no distress group (40%, 81/203), listlessness group (45%, 91/203) and helplessness and restlessness group (15%, 31/203). The psychological distress subgroup was a factor influencing the quality of life of spousal caregivers of stroke patients ( t=-10.03, P<0.05), explaining 33.0% of the variance in quality of life. Conclusions:Psychological distress in spousal caregivers of stroke patients is significantly heterogeneous. Those in the helplessness and restlessness group have the lowest quality of life and should be given focused attention and early intervention.

Objective:To explore the potential categories of resourcefulness in primary caregivers of stroke patients and analyze the differences in the characteristics of different types of caregivers, so as to provide basis for clinical construction of effective intervention plans.Methods:The 308 primary caregivers of stroke patients who met the research standards in the Department of Neurology of General Hospital of Ningxia Medical University, People′s Hospital of Ningxia Hui Autonomous Region, the First People′s Hospital of Yinchuan from December 2020 to August 2021 were selected as the research objects by convenient sampling method.The general information questionnaire, Resourcefulness Scale and Social Support Revalued Scale were used for cross-sectional investigation.Results:The resourcefulness of the primary caregivers of stroke patients were divided into 2 potential categories: low resourcefulness group (62.7%, 193/308) and high resourcefulness group (37.3%, 115/308). Uni-variate analysis showed that there were differences between potential categories: age and education level of stroke patients, whether there was long-term medication history, number of other chronic diseases, had there been any complications due to illness, age, education level and occupation of caregivers, average daily care duration, family relations, and social support ( χ2 values were -3.34 - 23.62, all P<0.05). Logistic regression analysis showed that social support and education level of caregivers were the influencing factors of caregiver resourcefulness ( P<0.05). Conclusions:The resourcefulness in the primary caregivers of stroke patients has certain characteristics. Clinically, targeted intervention measures should be formulated according to the different types of caregiver resourcefulness characteristics of caregivers and their influencing factors to improve the caregiver resourcefulness of stroke patients.

Objective:To construct a conceptual framework of burnout among primary caregivers of stroke patients based on grounded theory.Methods:According to the characteristics of age, gender, relationship with patients, length of care and other characteristics of purpose sampling method, from December 2021 to March 2022, 31 primary caregivers of stroke patients were selected for semi-structured interviews in two second-class hospitals, a first-class hospitals and a community health service station in Wuzhong city and Yinchuan city. The data were analyzed in procedural grounded theory method.Results:A total of 29 primary categories and 9 secondary categories were formed. The conceptual framework of burnout among primary caregivers of stroke patients was finally established, which consisted of four main categories (role burnout, physical burnout, psychological burnout and social burnout) and a core category (burnout of primary caregivers of stroke patients).Conclusions:The conceptual framework of burnout among primary caregivers of stroke patients constructed in this study elaborates the connotation of burnout of primary caregivers of stroke patients from four aspects, which can provide a basis for the development of assessment tools and the formulation of intervention measures in the future.

Objective:To understand the mediating role of resourcefulness between perceived stress and depression in primary caregivers of stroke patients.Methods:The primary caregivers of 311 inpatients with stroke in three Class Ⅲ Grade A hospitals in Yinchuan from December 2020 to August 2021 were selected by convenience sampling and investigated with the general information form, Resourcefulness Scale (RS) , Chinese Perceived Stress Scale (CPSS) and Self-Rating Depression Scale (SDS) . SPSS 25.0 and PROCESS were used to analyze the relationship between the three, and to explore the mediating role of resourcefulness between perceived stress and depression in the primary caregivers of stroke patients.Results:In this study, 311 questionnaires were distributed, 311 questionnaires were recovered, and 308 questionnaires were valid. The primary caregivers of stroke patients scored (24.98±6.38) for perceived stress, (83.98±12.85) for resourcefulness, and (44.35±8.40) for depression. Resourcefulness was negatively correlated with perceived stress and depression scores ( r=-0.313, -0.317; P <0.01) , and perceived stress was positively correlated with depression ( r=0.425, P<0.01) . The Bootstrap method further validated that resourcefulness played a partial mediating role between perceived stress and depression, and the mediating effect accounted for 14.95% of the total effect. Conclusions:Resourcefulness is a mediating variable between the perceived stress and depression of the primary caregivers of stroke patients, and resourcefulness plays a partial mediating role between perceived stress and depression.

Objective:To analyse the current status of parturients' readiness for discharge, family functioning and psychological consistency, and to explore the relationship readiness for discharge, family functioning and psychological consistency.Methods:This was a cross-sectional study. Using the convenient sampling method, a total of 429 parturient women admitted to Obstetrics Department in two ClassⅢ Grade A hospitals in Yinchuan City from March to July 2022 were selected as the research objects. General Information Questionnaire, Family Assessment Device (FAD) , Readiness for Hospital Discharge Study-New Mother Form (RHDS-NMF) and Sense of Coherence-13 (SOC-13) were used to investigate the patients. A total of 429 questionnaires were sent out in this study, and 418 questionnaires were effectively collected, with an effective recovery rate of 97.44% (418/429) .Results:The total score of RHDS-NMF in 418 parturient women was (131.18±24.96) , the total score of FAD was (127.76±15.57) , and the total score of SOC-13 was (54.59±7.22) . The discharge readiness of parturient women was negatively correlated with family function ( r=-0.332, P<0.01) , while discharge readiness was positively correlated with psychological consistency ( r=0.253, P<0.01) . The mediation effect analysis results showed that psychological consistency played a partial mediating role between family function and discharge readiness in parturient women, with a mediation effect value of -1.105 ( P<0.05) , accounting for 27.1% of the total effect. Conclusions:Psychological consistency plays a partial mediating role between family function and discharge readiness in parturient women. Medical staff should pay attention to the evaluation and intervention of parturients' psychological consistency, enhance their level of psychological consistency and improve readiness for discharge.

There are many bidirectional communication and crosstalk between microbes and host plants. The plant-pathogen interaction directly affects the survival of host plants, while the interaction between plants and their probiotics benefits both. Plant miRNA responds quickly to pathogenic or beneficial microbes when they enter the plant tissues, while microbes also produce miRNA-like RNA (milRNA) to affect plant health. These means miRNA or milRNA is an important fast-responding molecular mediator in plant-microbe interactions, and these internal mechanisms have been better understood in recent years. This review summarized the regulatory roles of miRNA in plant-pathogens and plant-probiotics interaction. The regulatory role of miRNA in disease resistance of host plants during plant-pathogens interaction, and the regulatory role of miRNA in promoting host growth and development during plant-probiotics interaction, as well as the cross-kingdom regulatory role of milRNA in host plants, were discussed in-depth.
Disease Resistance ; MicroRNAs/genetics* ; Microbial Interactions ; Plants/genetics*

Objective:To investigate the clinical effect of fingertip reconstruction using the toenail osteocutaneous flap without vascular anastomosis.Methods:From January 2015 to October 2020, the clinical data of patients with fingertip injuries were analyzed retrospectively, which were treated with the toenail osteocutaneous flap without vascular anastomosis in Chang’an Xin’an Hospital. The donor site was closed primarily or covered by a local flap. The appearance and function of the patients’ fingers were followed up. All cases were evaluated by the standard of thumb finger reconstruction function evaluation of the Chinese Medical Association of Hand Surgery. Appearance and function of nail bed after reconstruction was evaluated from four aspects.Results:A total of 11 cases (12 fingers) were enrolled, including eight males and three females. The average age was 35.6 years (range, 17-50 years). The etiologies included crush-related injury, cutting injury, mangled injury, and chemical corrosion injury. The injuries were found in thumb, index finger, middle finger, ring finger, or combined with multiple fingers. All fingertip defects were located distal to the nail root, including the defects distal to lunula in four cases, the defects distal to middle of the nail in five fingers , and the defects distal to 1/3 of the nail in three cases. Elective surgery was performed in 7 cases and emergency surgery in 4 cases. The defects ranged from 0.2 cm/0.5 cm/0.5 cm to 0.6 cm/0.8 cm/1.0 cm (phalanx/nail/finger pulp). The size of the toenail osteocutaneous flap ranged from 0.2 cm/0.5 cm/0.7 cm to 0.6 cm/0.8 cm/1.0 cm (phalanx/nail/flap). The defects length of the finger pulp were less than 1.0 cm. All reconstructed fingers survived, and the follow-up was 6-30 months (average, 12.5 months). The appearances of the reconstructed fingers were pulmp and ruddy, and the nails were flat. There was no dysfunction in the donor site. The average healing time of bone was 2.1 months (range, 1.5-3.0 months). According to the evaluation of index function, seven cases were excellent, four cases were good. The appearance and function of the nail bed were excellent in six fingers, good in five fingers, and poor in one finger.Conclusion:It is a simple and effective way to reconstruct the fingertip using the toenail osteocutaneous flap without vascular anastomosis.

Objective:To investigate the clinical effect of fingertip reconstruction using the toenail osteocutaneous flap without vascular anastomosis.Methods:From January 2015 to October 2020, the clinical data of patients with fingertip injuries were analyzed retrospectively, which were treated with the toenail osteocutaneous flap without vascular anastomosis in Chang’an Xin’an Hospital. The donor site was closed primarily or covered by a local flap. The appearance and function of the patients’ fingers were followed up. All cases were evaluated by the standard of thumb finger reconstruction function evaluation of the Chinese Medical Association of Hand Surgery. Appearance and function of nail bed after reconstruction was evaluated from four aspects.Results:A total of 11 cases (12 fingers) were enrolled, including eight males and three females. The average age was 35.6 years (range, 17-50 years). The etiologies included crush-related injury, cutting injury, mangled injury, and chemical corrosion injury. The injuries were found in thumb, index finger, middle finger, ring finger, or combined with multiple fingers. All fingertip defects were located distal to the nail root, including the defects distal to lunula in four cases, the defects distal to middle of the nail in five fingers , and the defects distal to 1/3 of the nail in three cases. Elective surgery was performed in 7 cases and emergency surgery in 4 cases. The defects ranged from 0.2 cm/0.5 cm/0.5 cm to 0.6 cm/0.8 cm/1.0 cm (phalanx/nail/finger pulp). The size of the toenail osteocutaneous flap ranged from 0.2 cm/0.5 cm/0.7 cm to 0.6 cm/0.8 cm/1.0 cm (phalanx/nail/flap). The defects length of the finger pulp were less than 1.0 cm. All reconstructed fingers survived, and the follow-up was 6-30 months (average, 12.5 months). The appearances of the reconstructed fingers were pulmp and ruddy, and the nails were flat. There was no dysfunction in the donor site. The average healing time of bone was 2.1 months (range, 1.5-3.0 months). According to the evaluation of index function, seven cases were excellent, four cases were good. The appearance and function of the nail bed were excellent in six fingers, good in five fingers, and poor in one finger.Conclusion:It is a simple and effective way to reconstruct the fingertip using the toenail osteocutaneous flap without vascular anastomosis.

Objective:To investigate the clinical effect of free anterior tibial artery proximal periosteal perforator bone-skin flap for repairing phased thumb defect.Methods:Eight patients of phased defect of thumb were repaired from March, 2013 to January, 2019 utilizing proximal tibial artery periosteal perforator bone and skin flap. Of which, 2 cases suffered defects at interphalangeal joint of thumb, 3 in proximal phalanx, and 3 at thenar muscle and metacarpale. There were 4 cases with tendon defect, 6 cases with other finger injuries.The areas of soft tissue defect was 4.5 cm×2.5 cm to 7.2 cm×4.0 cm, and the length of metacarpale bone defect was 1.2 to 2.5 cm. The flap size ranged from 5.0 cm×3.0 cm to 7.5 cm×4.5 cm, and the bone flap size was 1.2 cm×1.0 cm×0.8 cm to 2.5 cm×1.0 cm×1.0 cm. Six cases received direct suture or local skin metastasis in anterior tibial region and 2 cases with skin grafting. All patients were followed-up by clinic visits, telephone or WeChat reviews, and home visits.Results:All the flaps survived after surgery. A 6 to 24 months followed-up showed that the flaps were normal in colour with good texture and moderate thickness. TPD of the flaps ranged from 7 to 10 mm. The donor site of the shank had good appearance and were in normal function, and the walking were not affected. Healing time of transplanted bone flaps ranged from 2.0 to 4.0 months, with an average of 2.6 months. According to the Evaluation Criteria of Upper Limb Function of the Hand Surgery Society of Chinese Medical Association, the results were excellent in 7 thumbs and good in 1 thumb. According to Michigan Hand Function Evaluation Criteria, 8 thumbs scored 81.3 to 91.8 points, with an average of 83.6 points.Conclusion:The reconstruction of phased defect of thumb with proximal tibial artery periosteal perforator bone-skin flap can restore the appearance and function of thumb to the greatest extent, and the affect to donor site is minimum. It is an effective surgical method for repairing phased defect of thumb.

Objective:To investigate the clinical effect on bridging replantation of defective severed fingers with the anterior tibial artery perforator bone-skin flap.Methods:In the Department of Hand and Foot Microsurgery of Dongguan Chang’an Xin’an Hospital, 6 cases of finger defect were repaired and replanted utilizing proximal tibial artery perforator bone-skin flap from March, 2015 to December, 2019. There were 5 males and 1 female with an average age of 35.8 years (range, 16-55 years). Among them, there were 2 cases with crush injury, 1 case with wringer injury, 1 case of with thermal crush injury, 1 case with power saw injury and 1 case of traffic accident injury. Of which, 3 cases of middle phalanx defect and 3 cases of proximal phalanx defect. 1 case of thumb and ring finger, respectively, 2 cases of index and middle finger. 2 cases of left hand and 4 cases of right hand/side. There were 6 cases with tendon defect and 3 cases with other finger injury. Soft tissue defect area: 5.5 cm × 2.0 cm to 6.0 cm × 3.0 cm. The length of phalangeal defect: 1.5 cm to 2.2 cm. The area of flap: 6.5 cm × 2.0 cm to 7.0 cm × 3.0 cm. The size of bone-flap: 1.8 cm × 1.0 cm × 0.8 cm to 2.2 cm × 1.0 cm × 1.0 cm. The donor site was either directly sutured or covered by transposing local flap. Follow-up plan was setafter operation. All patients were followed-up by outpatient service telephone, wechat and home visit etc. The dimensions of follow-up included the appearance, function, living and working conditions regarding the injured finger after operation. The evaluation was carried out according to the evaluation criteria of the society of hand surgery, Chinese Medical Association and the Michigan hand function evaluation criteria.Results:All the flaps survived. The flaps were followed-up for 9 to 24 months, with a small amount of pigmentation, good texture, moderate thickness and the two-point discrimination of the flaps ranged from 8 to 11 mm. There was no functional effect on the lower leg. The healing time of transplanted bone flaps ranged from 2.0 to 4.0 months, with an average of 2.6 months. According to the evaluation criteria of upper limb function of Hand Surgery Society of Chinese Medical Association, the results were as follows: excellent 3 fingers, good 3 finger, excellent rate was 100%. According to Michigan Hand Function Evaluation Criteria, 6 fingers scored from 71.5 to 91.8 points, with an average of 80.6 points.Conclusions:Using the anterior tibial artery perforator bone-skin flap to bridge the defect and replantation can restore the appearance and function of the fingers to a large extent, with little damage to the donor site. It is an effective surgical method to repair bone-skin defects and restore the length in the replantation of defective severed fingers.