Objective:To explore the health behavior of middle-aged and young stroke patients and analyze its influencing factors.Methods:From April to July 2023, convenience sampling was used to select 172 middle-aged and young stroke patients admitted to the First Affiliated Hospital of Naval Medical University as the research subject. A survey was conducted using the General Information Questionnaire, Health Behavior Scale for Stroke Patients, Health Belief Scale, and Multidimensional Scale of Perceived Social Support. Spearman correlation was used to analyze the correlation between health behavior, social support, and health beliefs among middle-aged and young stroke patients. Multiple linear regression was used to analysis the influencing factors of health behavior among middle-aged and young stroke patients. A total of 172 questionnaires were distributed, and 8 questionnaires with missing items and short response times were excluded, and 164 valid questionnaires were collected, with a valid response rate of 95.34%.Results:Among 164 middle-aged and young stroke patients, the total score of the Health Behavior Scale for Stroke Patients was 64.50 (57.00, 80.75), and the average score of the items was 2.58 (2.28, 3.23). Multiple linear regression analysis showed that factors affecting the health behavior of middle-aged and young stroke patients were whether it was the first onset, the time required to reach nearby medical institution, health belief, and social support ( P<0.05) . Conclusions:The health behavior of middle-aged and young stroke patients is above the medium level. In the process of intervening in the health behavior of middle-aged and young stroke patients, medical and nursing staff should pay attention to patients with recurrent stroke and poor access to medical services, while also improving patients' health belief and social support to promote patients' health behavior and reduce stroke recurrence.

Objective:To explore the mediating effect of coping style on disease perception and pre-hospital delayed behavioral intention in patients with acute ischemic stroke.Methods:This study was a cross-sectional study. From February to July 2023, convenience sampling was used to select 205 patients with acute ischemic stroke admitted to the First Affiliated Hospital of Naval Medical University as the study subject. The survey was conducted using the General Information Questionnaire, Stroke Pre-Hospital Delay Behavior Intention, Brief Illness Perception Questionnaire, and Simplified Coping Style Questionnaire.Results:205 questionnaires were filled out, 195 valid questionnaires, and the validity rate of the questionnaire was 95.1%. The Stroke Pre-Hospital Delay Behavior Intention score of patients with acute ischemic stroke was (63.61±16.12). Pre-hospital delayed behavioral intention in patients with acute ischemic stroke was positively correlated with disease perception and negative coping ( r=0.360, 0.266; P<0.01), and negatively correlated with positive coping ( r=-0.279, P<0.01). The mediating effects of positive and negative coping on disease perception and pre-hospital delayed behavioral intention in ischemic stroke patients were 0.111 and 0.097, respectively, accounting for 26.89% and 23.49% of the total effect. Conclusions:There is a partial mediating effect of coping strategies between disease perception and pre-hospital delayed behavioral intention in ischemic stroke patients. In the process of stroke management, medical and nursing staff can reduce pre-hospital delayed behavioral intentions by improving disease cognition and coping style.

By referring to the relevant literature on the application of positive psychology in patients with cognitive impairment at home and abroad, this paper reviews the measurement tools, interrelationships and intervention status of positive psychology in patients with cognitive impairment, and explores the prospects of its application in this population. The aim is to provide a basis for nursing decision-making in patients with cognitive impairments.

Chinese medicine self-assembly nano-strategies（CSAN） is to utilize the self-assembly property of Chinese medicine components， so that the Chinese medicine components can self-assemble to form structurally stable nano-preparations through non-covalent interactions. The formation of Chinese medicine self-assembly nano-preparations is often a synergistic result of a variety of non-covalent interactions， and many Chinese medicine monomers are susceptible to self-assembly due to their structural characteristics， and the phenomenon of self-assembly of Chinese medicine is also common in the decoction of single or compound Chinese medicine， which has attracted the attention of researchers. It is found that CSAN can improve the solubility and bioavailability of active components in Chinese medicine， which is of positive significance for the development and application of insoluble components of Chinese medicine. The self-assembly phenomenon of Chinese medicine decoction is closely related to the therapeutic efficacy， and the study of self-assembly phenomenon of Chinese medicine will bring a new perspective for the explanation of the mechanism of Chinese medicine decoction. At the same time， traditional Chinese medicine（TCM） has unique advantages in the field of anti-tumor. The application of CSAN in the field of oncology can not only exert the anti-tumor effect of the active components of Chinese medicine directly， but also act as a natural nano-carrier to carry chemotherapy drugs for combination chemotherapy， improve the targeting of drugs， enhance the anti-tumor efficacy， and reduce the side effects of chemotherapy， which has excellent anti-tumor potential. The preparation method of Chinese medicine self-assembly nano-preparations is simple， low cost， and has better safety than traditional nano-preparations， which is conducive to the promotion of the clinical transformation of nano-preparations， and also helps to provide new strategies and perspectives for promoting the modernization of TCM. Therefore， based on a large number of researches in this field in recent years， this paper reviewed the formation mechanism， different assembly forms， formation conditions and stability of Chinese medicine self-assembly nano-preparations by searching databases such as China national knowledge infrastructure（CNKI）， PubMed， WanFang data and VIP， and summarized the application of CSAN in different tumor therapies， providing a reference for further research on CSAN.

Objective:To investigate the impact of " staging" hybrid coronary artery revascularization (HCR) on the short-and long-term efficacy of patients with multiple coronary artery lesions.Methods:A retrospective case-control study was conducted. Eighty patients with multiple coronary artery lesions admitted to the Baoding Second Central Hospital from January 2017 to October 2018 were selected and divided into two groups according to different surgical methods. Forty patients were treated with " staging" HCR and were designated as the HCR group, and 40 patients were treated with off-pump coronary artery bypass grafting (OPCAB) and were designated as the OPCAB group. The perioperative related indicators and perioperative serious complications were compared between the two groups. The serum myocardial injury marker levels were detected preoperatively and 48 hours postoperatively, including heart-type fatty acid binding protein (H-FABP) and troponin I (cTnI). All subjects were followed up for at least 3 years to calculate the incidence of major adverse cardiovascular and cerebrovascular events (MACCE).Results:The bypass surgery time, mechanical ventilation time, ICU stay time, and total hospital stay time in the HCR group were all less than those in the OPCAB group (all P<0.05), and the incision length in the HCR group was shorter than that in the OPCAB group ( P<0.05). The intraoperative bleeding volume, postoperative 24-hour drainage volume, red blood cell transfusion volume, and plasma transfusion volume in the HCR group were all less than those in the OPCAB group (all P<0.05). Forty-eight hours after surgery, the serum H-FABP and cTnI levels in both groups were significantly higher than those preoperatively (all P<0.05), but the increase was more significant in the OPCAB group (all P<0.05). The perioperative serious complication rate in the HCR group was 2.50%(1/40), which was significantly lower than that in the OPCAB group [20.00%(8/40)] ( P<0.05). During the 3-year follow-up after surgery, the MACCE incidence in the HCR group was 12.50%(5/40), and that in the OPCAB group was 22.50%(9/40). There was no significant difference in the long-term MACCE incidence between the two groups ( P>0.05). Conclusions:" Staging" HCR treatment for multiple coronary artery lesions can achieve ideal surgical results. Compared with OPCAB, its short-term efficacy is more significant, and long-term efficacy is equivalent.

The aluminum stress in acidic soil areas of China is an important abiotic stress factor that hampers the normal growth and development of plants and seriously affects the agricultural yield. The forms of plant resistance to aluminum stress are complex and diverse, which include secretion of organic acids, increase of rhizosphere pH, secretion of mucus, cell wall fixation of Al³⁺, organic acid chelation of Al³⁺ in cell solute, and vacuolar area isolation. Most of studies focus on analyzing conventional physiological characteristics, but in-depth molecular biological analyses are lacking. This review summarizes the mechanisms how plants adapt to acidic aluminum stress. This includes the effect of acid aluminum stress on plant growth and physiological metabolism, the two main physiological mechanisms of plant adaptation to acid aluminum stress (aluminum exclusion mechanism, aluminum tolerance mechanism), and the aluminum resistance related genes. Finally, this paper puts forward some prospects for further revealing the mechanism of plant adaptation to acid aluminum stress and excavating high-quality crops suitable for cultivation in acidic soils.
Acids ; Adaptation, Physiological ; Aluminum ; Crops, Agricultural/genetics* ; Gene Expression Regulation, Plant ; Plant Roots ; Soil/chemistry*

Objective:To evaluate the correlation of active inflammatory changes of the symphysis pubis on magnetic resonance imaging (MRI) scans with clinical factors in patients with axial spondyloarthritis.Methods:We retrospectively evaluated 112 patients with axial spondyloarthritis (ax-SpA) in our hospital from February 2014 to November 2020. Patients were divided into 4 groups: symphysis pubis + sacroiliac arthritis, symphysis pubis + non-sacroiliac arthritis, non-symphysis pubis + sacroiliac arthritis, and non symphysis pubis + non-sacroiliac arthritis group. Intra-group correlation coefficient ( ICC) was used to analyze the correlation between MRI active inflammation of the symphysis pubis and the sacroilioarthritis. Age, sex, symptom duration, smoking, body mass index, human leukocyte antigen (HLA)-B27 positive rate, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) among the four groups were compared by one-way analysis of variance (ANOVA) and Chi-square test. Results:The proportion of active inflammation of the symphysis pubis was 35.7% (40/112). There was no correlation between active inflammation of the symphysis pubis and sacroilioarthritis ( r=-0.06, P=0.559). Twenty-four patients of the 69 patients with sacroilioarthritis had active inflammation of the symphysis pubis, 16 patients of the 43 patients without sacroilioarthritis had active inflammation of the symphysis pubis. In patients without active inflammation of the sacroiliac joint, the CRP and ESR of the active inflammation of the symphysis pubis group was (49±60) mg/L, (40±19) mm/1 h, statistically higher than that of the non-active inflammation group (19±22) mg/L, (22±37) mm/1 h ( t=2.36, P=0.023; t=2.88, P=0.006). In patients who had active inflammation of the symphysis pubis, the symptom duration of the non-active inflammation of the sacroiliac joint, was (14±9) years, which was significantly longer than that of the active inflammation group (5±4) years ( t=4.07, P=0.001). Conclusion:There is no correlation between active inflammatory changes of the symphysis pubis and bone marrow edema of the sacroiliac joint. Therefore, in ax-SpA patients with inflammatory low back pain and/or hip/groin pain, and also with high levels of CRP, ESR, but no active inflammatory changes of the sacroiliac joint on MRI scans, active inflammation of the symphysis pubis should be considered.

OBJECTIVE：To prov ide a reference for the diagnosis and treatment of invasive fungal infection in children. METHODS：Four male children with invasive fungal infection in critical condition ，aged from 3 months to 17 years，were treated in our hospital. The types of diseases included pneumonia ，endocarditis，meningitis and pulmonary infection. The pathogens involved Trichosporon asahii ，Candida portugal ，Malassezia globosa ，Pichia guilliermondii ，Alternaria alternate and Candida krusei. Clinical pharmacists comprehensively followed up the treatment and reviewed the literature to assist doctors in formulating treatment plans. They provided Fluconazole sodium chloride injection （6 mg/kg，ivgtt，qd），Caspofungin acetate for injection （loading dose 32 mg，maintenance dose 25 mg，ivgtt，qd），Fluconazole capsules （400 mg，p.o.，qd）and Voriconazole for injection（200 mg，i.v.，q12 h）+Capofungin acetate for injection （loading dose 70 mg，maintenance dose 50 mg，i.v.，qd）and other symptomatic treatment ，and closely monitored the changes of relevant indicators and the occurrence of ADR during the treatment of children. RESULTS ：The doctor adopted the clinical pharmacist ’s suggestion ，three cases were relieved and one was not cured. No serious ADR was found. CONCLUSIONS ：Once similar infections are found in clinic ，timely targeted treatment should be given in combination with the types of pathogens and drug resistance characteristics ，so as to effectively control the disease. The real cases provided in this article can provide evidence for the treatment of children with fungal infection.

OBJECTIVE： To re-evaluate t he methodology quality of published systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression. METHODS ：Retrieved from Cochrane Library ，PubMed，Embase， SinoMed，CNKI，Wanfang database ，VIP，CBM and other databases ，systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression were collected during the inception to Dec. 2019. After literature screening and data extraction ， methodology quality of included literatures were evaluated by using the AMSTAR scale. RESULTS ：A total of 33 systematic reviews/Meta-analysis were included ，involving 523 RCTs and 41 020 patients. Average score of AMSTAR methodological quality evaluation was 6.76. Citalopram ，duloxetine and paroxetine were effective for the therapy of post-stroke depression ，but the conclusions about the effectiveness among antide-pressants were not consistents. The ADR incidence of Paroxetine was low. It was not clear that sertraline and citalopram may improve the neurological function of patients. CONCLUSIONS ：The methodological quality of systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression is medium ，and the conclusions about the effectiveness of antidepressants ，improvement of daily life ability and the recovery of neurological function are still controversial.

Objective To assess the safety and feasibility of video electroencephalographic (VEEG) monitoring in preterm infants and critically ill neonates in neonatal intensive care unit (NICU). Method From December 2017 to June 2018, high risk infants were prospectively enrolled and received VEEG monitoring in our NICU. Their basic information, adverse events and disturbances of any procedure during VEEG monitoring were collected by specially-trained nurses. Result A total of 245 times of VEEG were recorded. The average gestational age (GA) was (32.1 ± 3.6) weeks, the birth weight (BW) was (1879 ± 757) g, the corrected GA (cGA) at VEEG monitoring was (33.8±3.3) weeks, and the average weight at VEEG monitoring was (2008±716) g. The earliest cGA at VEEG monitoring was 25+5 weeks, and the lowest weight at VEEG monitoring was 520 g. The average monitoring duration was (4.9±2.4) h, ranging from 3 to 20 hours. During VEEG monitoring, 80 cases (32.7％) received noninvasive ventilation, 43 cases (17.6％) mechanical ventilation. The adverse events during electrodes placement were oxygen desaturation in 8(3.3％) cases. During VEEG monitoring, local skin erythema were found in 4 cases (1.6％), and electrodes displacement in 2(0.8％) cases. The disturbances of any clinical procedures were reported in 18(7.3％) cases. No severe adverse events such as displacement of endotracheal tube nor events requiring cardiopulmonary resuscitation occurred during VEEG monitoring. Conclusion It is feasible and safe for trained NICU nurses to place electrodes for high risk neonates.