Objective:To explore the effect and correlation of long non-coding RNA (lncRNA) IDI2-AS1/microRNA-33b-5p (miR-33b-5p)/nuclear receptor-associated protein NR4A2 competitive endogenous RNA (ceRNA) regulatory network on acute myocardial infarction (AMI), and to verify whether IDI2-AS1 regulates NR4A2 through miR-33b-5p to affect the occurrence and development of myocardial infarction.Methods:The miRNA and mRNA expression chips related to myocardial infarction were obtained from gene expression omnibus (GEO), and the differential expression was analyzed. The upstream regulatory mechanism of NR4A2 was predicted using TargetScan database. Thirty-two male C57/BL6 mice were divided into Sham group, AMI model group, miR-33b-5p mimic group [miR-33b-5p mimic lentivirus (5×10 7 TU) was injected locally into the heart tissue during ligation] and miR-33b-5p inhibitor group [miR-33b-5p inhibitor lentivirus (5×10 7 TU) was injected locally into the heart tissue during ligation] according to random number table method, with 8 mice per group. Left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were asseessed by echocardiography, left ventricular fractional shortening (LVFS) and left ventricular ejection fraction (LVEF) were calculated. After the last weighing, the anesthetized mice were sacrificed and the heart tissues were taken. Masson staining of the heart tissues was observed under light microscope, myocardial collagen volume fraction (CVF) and infarct size were calculated. Cardiomyocytes of SPF grade SD rats were collected. They were divided into normal control group (control group), ischemia-hypoxia model group, miR-33b-5p mimic transfection group (miR-33b-5p mimic transfection group before ischemia and hypoxia treatment) and miR-33b-5p inhibitor transfection group (miR-33b-5p inhibitor transfection group before ischemia and hypoxia treatment). The activity of caspase-3/7 in cardiomyocytes was measured. The levels of interleukins (IL-1β, IL-6) and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA). The levels of malondialdehyde (MDA), superoxide dismutase (SOD), creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB) and lactate dehydrogenase (LDH) were detected by colorimetry. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression of apoptosis-related proteins Bax and Bcl-2, cytochrome C (Cyt C) and IDI2-AS1/miR-33b-5p/NR4A2 regulatory axis genes. Results:The myocardial infarction microarray analysis showed that NR4A2 expression was significantly up-regulated in myocardial infarction, with predicted upstream regulatory mechanisms indicating its possible influence through the IDI2-AS1/miR-33b-5p/NR4A2 regulatory axis. Echocardiographic detection showed that compared with AMI model group and miR-33b-5p inhibitor group, LVEF and LVFS in the heart tissue of mice in miR-33b-5p mimic group were significantly increased, while the levels of LVEDD, LVESD, CK, CK-MB and LDH were significantly decreased, with statistical significance. Light microscope showed myocardial fibrosis and myocardial infarction in AMI model group and miR-33b-5p inhibitor group. In the miR-33b-5p mimic group, the degree of myocardial fibrosis was decreased and the myocardial infarction size was significantly reduced. Compared with AMI model group and miR-33b-5p inhibitor group, the levels of MDA, IL-1β, IL-6, TNF-α and the expressions of Bax and Cyt C in the heart tissue of mice in miR-33b-5p mimic group were significantly decreased, while the levels of SOD and Bcl-2 expression were significantly increased, and the differences were statistically significant. The expressions of IDI2-AS1 and NR4A2 in the heart tissue of mice in miR-33b-5p mimic group were significantly lower than those in AMI model group and miR-33b-5p inhibitor group [IDI2-AS1 (2 -ΔΔCt): 1.96±0.08 vs. 2.73±0.08, 3.10±0.05, NR4A2 (2 -ΔΔCt): 2.36±0.07 vs. 3.16±0.08, 3.80±0.08, all P < 0.01]. The expression of miR-33b-5p was significantly higher than that of AMI model group and miR-33b-5p inhibitor group (2 -ΔΔCt: 0.88±0.07 vs. 0.57±0.07, 0.23±0.01, both P < 0.01). The cell experiment results showed that the caspase-3/7 activity of rat neonatal cardiomyocytes in the miR-33b-5p mimic transfection group was significantly lower than that in the ischemia-hypoxia model group and the miR-33b-5p inhibitor transfection group, suggesting that miR-33b-5p can significantly reduce the apoptosis level of the ischemia-hypoxia model. The levels of peroxidation and inflammation indexes, important genes of apoptosis pathway and the expression of IDI2-AS1/miR-33b-5p/NR4A2 regulatory axis of rat neonatal cardiomyocytes in all groups were consistent with the above. Conclusion:IDI2-AS1 can regulate NR4A2 through miR-33b-5p, thus affecting the occurrence and development of AMI.

Objective:To explore the effect of variable priority cognitive-motor dual-task training in aged cognitive frailty patients with type 2 diabetes mellitus.Methods:From September 2022 to September 2023, a total of 108 aged cognitive frailty patients with type 2 diabetes mellitus were selected in the Department of Endocrinology of North China University of Science and Technology Affiliated Hospital as research subjects.The subjects were divided into three groups in the order of admission, with 36 people in each group.Three groups of patients were intervened for 8 weeks using variable priority cognitive-motor dual-task training (VP group), exercise combined cognitive intervention with sequential task (ST group), and endocrinology routine treatment and nursing (control group), respectively.The scores of mini-mental state examination(MMSE), frailty phenotype(FP) and Berg balance scale(BBS) were compared among the three groups before and after the intervention.Repeated measurement variance analysis was used to compare scale results by SPSS 22.0.Results:(1)The MMSE score of patients before and after intervention had significant interaction effect between time and groups ( F=69.929, P<0.05).The MMSE scores of the VP group and ST group after 8 weeks of intervention were higher than those before intervention and after 4 weeks of intervention, and the MMSE scores of the two groups after 4 weeks of intervention were also higher than those before intervention (all P<0.05).After 4 weeks and 8 weeks of intervention, the MMSE score of the VP group was higher than that of the ST group and the control group, and the MMSE score of the ST group was higher than that of the control group after 8 weeks of intervention(all P<0.05).(2)The FP score of patients before and after intervention had a significant interaction effect between time and groups ( F=46.425, P<0.05).The FP score of the VP group at 8 weeks of intervention (2.64±0.59) was lower than that after 4 weeks of intervention (3.28±0.51) and before intervention (3.56±0.61), and the FP score after 4 weeks of intervention was lower than before intervention (all P<0.05).The FP score of the ST group after 8 weeks of intervention (3.44±0.56) was lower than before the intervention (3.59±0.56) ( P<0.05); After 4 weeks of intervention, the FP score of the VP group was lower than that of the control group (3.36±0.54) ( P<0.05).After 8 weeks of intervention, the FP score of the VP group was lower than that of the ST group and the control group (3.39±0.55) (both P<0.05).(3)The FP score of patients before and after intervention had a significant interaction effect between time and groups ( F=135.791, P<0.05).The BBS scores of the VP group and ST group after 8 weeks of intervention were higher than those before and after 4 weeks of intervention, and the BBS scores after 4 weeks of intervention were also higher than those before intervention (all P<0.05).After 4 weeks of intervention, the BBS score of the VP group was higher than that of the control group ( P<0.05).After 8 weeks of intervention, the BBS score of the VP group was higher than that of the ST group and the control group, and the BBS score of the ST group was also higher than that of the control group (all P<0.05). Conclusion:The variable priority cognitive-motor dual-task training can improve the cognitive function, physical frailty and balance function in aged cognitive frailty patients with type 2 diabetes mellitus, and the intervention effect is better than that of exercise combined cognitive intervention with sequential task and endocrinology routine treatment and nursing.

Five universities with health policy and management ranked top level worldwide, including Harvard University, John Hopkins University, Stanford University, University of North Carolina at Chapel Hill and National University of Singapore were selected in our study. From above universities, we found that the curriculum of PHD students was focused on research concentration, methodology courses, and numerous elective courses. Hence, in China, the curriculum of PHD students should be improved with emphasis on course studying, management courses and highlighting curriculum content according to research area to enhance the quality of doctoral education.

Objective:To explore the clinical effect of Bobath manipulation combined with traditional Chinese medicine fumigation and intradermal acupuncture on shoulder hand syndrome(SHS) after stroke.Methods:From April 2017 to August 2019, 80 patients with SHS after stroke admitted to the People's Hospital of Deqing County were selected, and they were divided into control group and observation group according to the random digital table method, with 40 cases in each group.The control group was treated by Bobath therapy, and the observation group was treated by Bobath therapy combined with acupuncture(intradermal acupuncture) and traditional Chinese medicine fumigation.After 8 weeks of treatment, the ROM scale, FMA scale, BI scale and VAS scores were used to evaluate the improvement in the mobility of the shoulder and wrist joints, motor function of the upper limbs, quality of life and pain, and the clinical efficacy of the two groups was compared.Results:Compared with before treatment, the ROM scale score of all dimensions of shoulder and wrist mobility, FMA scale score and BI scale score of all patients after treatment increased significantly, and the VAS score decreased significantly, the differences were statistically significant(all P<0.05). Compared with the control group after treatment, the improvement of the indicators mentioned above of the observation group were better[shoulder joint flexion ROM score: (154.83±25.63)points vs.(133.82±22.03)points; shoulder joint abduction ROM score: (152.36±25.68)points vs.(133.35±19.96 )points; shoulder joint external rotation ROM score: (75.87±14.69)points vs.(60.82±16.57 )points; wrist joint palm flexion ROM score: (73.94±14.37)points vs.(57.37±9.47)points; wrist joint back extension ROM score: (60.83±7.61)points vs.(42.27±6.37 )points; FMA scale score: (45.74±6.82)points vs.(34.19±4.07)points; BI scale score: (70.36±12.09)points vs.(58.70±12.53)points; VAS score: (1.05±0.49)points vs.(3.37±1.14)points, t=3.703, 3.715, 3.257, 5.576, 7.964, 3.037, 8.746, 3.153, all P<0.05]. The total effective rate of the observation group was significantly higher than that of the control group[97.5%(39/40) vs.62.5%(25/40), χ 2=15.313, P<0.05)]. Conclusion:The combination of Bobath therapy with traditional Chinese medicine fumigation and intradermal acupuncture can improve the pain degree, joint mobility disorder, upper limb motor function and quality of life of SHS patients, the efficacy is better than single Bobath therapy.The clinical effect is accurate, and it is worthy of further promotion and application.

Based on participatory idea, we constructed a novelty model of participatory health edu-cation, which was based on participatory research as the module, participatory role-playing as the core mod-ule, participatory review as enhanced module (abbreviation to as "3-PR"). We applied it to pre-selected health officer health promotion activities, and randomized controlled trials were designed. The results showed that "3-PR" model of participatory health education might be more effective in promoting health literacy than conventional health education methods. "3-PR" health education model has the advantages of participation, practicality, fun and flexibility, integration and education, which has certain reference signifi-cance for exploring health education methods and improving the health of the whole people.

Objective To translate the English version of Comprehensive Frailty Assessment Instrument (CFAI) into Chinese and evalu-ate its reliability and validity. Methods CFAI was translated into Chinese with the Brislin's translation mode. From May to July, 2015, 200 community aged people in Shijiazhuang, China were assessed with the Chinese version of CFAI and World Health Organization Quality of Life-BREF (WHOQOL-BREF), and 30 of them were assessed with CFAI again after a week. The content validity was rated by six experts of gereology. The total scores of CFAI and WHOQOL-BREF were analyzed with Pearson's correlation, as well as the scores of CFAI test and retest. The CFAI were analyzed with Factor Analysis. The Cronbach's α was tested. Results There were 23 items in 4 dimensions. The content validity index was 0.782. Six factors were extracted by Factor Analysis and the cumulated variance was 64.05%. The total score of CFAI correlated with the score of WHOQOL-BREF (r=-0.764, P<0.001). The Cronbach's α was 0.704~0.897 in dimensions (P<0.001), and the r= 0.604~0.941 (P<0.001) between test and retest. Conclusion The Chinese version of CFAI is reliable and valid, that can be applied to evaluate frailty in community aged people.

Objective To observe the intervention effect of Forbrain speech auditory feedback training on cognitive dysfunction in patients with stroke.methods 120 patients with cognitive dysfunction after stroke were divided into experimental group 1(n=40),experimental group 2 (n=40)and control group(n=40).The control group accepted conventional rehabilitation,while the experimental group 1 received Forbrain speech auditory feedback training additionally,and the experimental group 2 received the non-standard Forbrain speech auditory feedback training additionally.All the cases were assessed with Montreal cognitive assessment scale (MoCA)before and 10 weeks after intervention.Result sAfter 10-week intervention,the scores of structure skills(2.05±0.50),attention and concentration(2.15±0.36),memory(2.18±0.59) and the total score of MoCA(17.53±2.41) in experimental group 1 were higher than those in experimental group 2 (1.80±0.46,1.90±0.44,1.90±0.55,17.53±2.41) and control group(1.78±0.53),1.85±0.36,1.70±0.56,17.18±2.37) (all P<0.05).The Scores of language in experimental group 1(2.03±0.48)and experimental group 2(1.85±0.53) were higher than those in control group(1.70±0.46) (all P<0.05).Conclusion Forbrain speech auditory feedback training can improve cognitive function of patients with stroke.

Objective To understand the loneliness of elderly people,and to analyze the correlation between frailty,family social support and loneliness.Methods The elderly people aged 75 and over from 10 community health service centers in Tangshan were selected and evaluated with the CFAI comprehensive e-valuation tool and the loneliness scale.Results The frailty rate was 100% in 3 448 elderly people.The score of the frailty of elderly was(47.27±0.77),and the degree of frailty was increased with the increase of age. The social support level of general and below accounted for 95.92%.The total average score of social support for the elderly was(32.72±6.21);and the medium or above loneliness accounted for 68.94%.The total aver-age score of loneliness in the elderly was(40.24± 10.23).The most needed caregiver was the children and their daughters. Multivariate analysis showed that the degree of education,the degree of frailty,family support (the relationship with children,with the children who do not support the elderly,communicating with chil-dren,taking the views of the elderly,importance of being at home and the visiting frequency of the children), community support(received the services provided by the neighborhood committee,often keep up with rela-tives and friends,the frequency of neighborhood interaction,have received community psychological counse-ling and have received volunteer service)and social support entered the regression equation.The regression coefficient were -0.084,1.167,1.016,1.212,0.914,1.029,1.025,1.264,1.400,0.889,1.053,1.307,1.466, 1.332,-0.405,respectively.Conclusion Frailty,family function and community social support are important factors of loneliness among the elderly.The support system construction should be strengthened to reduce the loneliness of the elderly,and improve the quality of life.

Objective To investigate the efficacy of BrainHQ visual training in rehabilitating memory function among stroke survivors.Methods Sixty stroke patients with memory disorders were recruited from the rehabilitation center of Tangshan Workers' Hospital.They were randomly assigned to a control group or an intervention group,each of 30.Both groups accepted conventional rehabilitation,while the intervention group was additionally given BrainHQ visual training five times a week for 30 minutes,lasting four weeks.Before and after the treatment,both groups completed the Rivermead behavioral memory test.Results After the 4 weeks of treatment,the average scores in recalling full names,recalling hidden items,recalling appointments,recognizing pictures,recognizing faces,recalling a story immediately,delayed story recall,recalling a route promptly,delayed route recall and the average total score in both groups were all significantly higher than before the treatment.The treatment group scored significantly better than the control group except in recalling hidden items,and recognizing faces and pictures.Conclusion BrainHQ visual training can improve the memory of stroke survivors.

Objective To investigate the effect of obstructive sleep apnea hypoxia on learning memory capacity in rat after ischemia.Methods Eighty healthy male wister rats were randomly divided into:sham operation group (SO group,n =20),merely ischemia group (I/R group,n =20),and obstructive sleep apnea hypoxia for 7 days ischemia group (IH7 + I/R group,n =20),obstructive sleep apnea hypoxia for 21 days ischemia group (IH21 + I/R group,n =20).Obstructive sleep apnea hypoxia ischemia groups were respectively given obstructive sleep apnea hypoxia for 7 days and 21 days.Ischemia animals were prepared cerebral ischemia-reperfusion model by improved pulsinelli four vessels block (4-VO),the morphological changes of hippocampus nerve cells of rat brain were detected with HE,neuron pathology in hippocampal regin was observed using electron microscope,and learning memory capacity of rats were assessed by the Morris water maze test.Results Compared with the SO group,the I/R group demonstrated shortened escaping latency,increased frequency of crossing the platform in the water maze test,decreased survival rate of neurons,and increased apoptotic cells and ultrastructure damages (P ＜ 0.05).Compared with the I/R group,obstructive sleep apnea hypoxia ischemia groups showed shortened escaping latency,increased frequency of crossing the platform,decreased survival rate of neurons,and increased apoptotic cells and ultrastructure damages (P ＜ 0.05),especially in the IH21 + I/R group (P ＜ 0.05).Conclusions Obstructive sleep apnea hypoxia can increase the damage of learning memory capacity.This damage is related to hippocampus nerve loss and ultrastructure injury from obstructive sleep apnea hypoxia.