摘要：
Older stroke survivors usually experience various psychology disorders, such as post-stroke depression (PSD), which may be associated with high experiential avoidance (EA) and can seriously affect their quality of life. To date, the efficacy of group-based acceptance and commitment therapy (ACT) for older stroke survivors has not been established. The aim of this study is to investigate the effectiveness of group-based ACT on EA, PSD, psychological distress, and quality of life in older stroke survivors after group-based ACT. This study is a randomized, single-blind, wait-list controlled, parallel-arm trial. A total of 66 stroke survivors will be randomly assigned to wait-list control group or intervention group. Participants in wait-list control group will receive treatment as usual (TAU), while the intervention group will receive group-based ACT once a week for eight weeks. The primary outcome measure being EA, and the secondary outcome measures being PSD, psychological distress, and quality of life. Results of the two groups will be blindly assessed by professional evaluators at baseline (T0), post-treatment (T1), and one-month follow up (T2). The results of this study will provide the first evidence for the effectiveness of a group-based ACT intervention in reducing EA, PSD, psychological stress, and improving quality of life for post-stroke survivors. ChiCTR2200066361. No study has explored the EA in older stroke survivors and related factors at present. Group-based ACT has been shown to have a positive impact on anxiety and depressive symptoms in stroke survivors, but no studies have explored the effect of group-based ACT on the psychological status in older stroke survivors. Based on the previously published randomized controlled trials, this study used the group-based ACT to compare the effects of intervention on the psychological status of stroke survivors at different time points. This study met the gold standard for clinical trial delivery and provided additional evidence for group-based ACT, which also helped to lay the foundation for the feasibility and effectiveness of group-based ACT for older stroke survivors. The study had a short follow-up period. In addition, its clinical nature prevents blinding of the participants and therapists.
期刊：
INTERNATIONAL JOURNAL OF BIOCHEMISTRY & CELL BIOLOGY,2023年157:106392 ISSN：1357-2725
通讯作者：
Yuping Chen
作者机构：
[Chen, Yuping; Zhang, Jie; Xun, Min] Univ South China, Inst Pharm & Pharmacol, Sch Pharmaceut Sci, Hengyang 421001, Peoples R China.;[Chen, Yuping; Wu, Meichun] Univ South China, Hengyang Med Sch, Hengyang 421001, Peoples R China.;[Wu, Meichun] Univ South China, Sch Nursing, Hengyang 421001, Peoples R China.;[Chen, Yuping] Univ South China, Sch Pharmaceut Sci, 28 West Changsheng Rd, Hengyang 421001, Hunan, Peoples R China.
通讯机构：
[Yuping Chen] I;Institute of Pharmacy & Pharmacology, School of Pharmaceutical Science, University of South China, Hengyang 421001, China<&wdkj&>Hengyang Medical School, University of South China, Hengyang 421001, China
摘要：
The active proliferation and migration of vascular smooth muscle cells supports the healing of vessel damage while their abnormal aggression or destitution contribute to the aberrant intima-medial structure and function in various cardiovascular diseases, so the understanding of the proliferation disorders of vascular smooth muscle cell and the related mechanism is the basis of effective intervention and control for cardiovascular diseases. Recently, long non-coding RNAs have stood out as upstream switchers for multiple proliferative signaling pathways and molecules, and many of them have been shown to conduce to the dysregulated proliferation and apoptosis of vascular smooth muscle cells under various pathogenic stimuli. This article discusses the long non-coding RNAs disclosed and linked to atherosclerosis, pulmonary hypertension, and aneurysms, and focuses upon their modulation of vascular smooth muscle cell population affecting three deadly cardiovascular diseases.
作者机构：
[Qin, Xiao; Bi, Guoshan; Chen, Jie] Guangxi Med Univ, Affiliated Hosp 1, Dept Vasc Surg, 6 Shuangyong Rd, Nanning 530000, Guangxi, Peoples R China.;[Bi, Guoshan; Chen, Jie] Univ South China, Hengyang Med Sch, Affiliated Hosp 2, Dept Vasc Surg, 35 Jiefang Rd, Hengyang 421001, Hunan, Peoples R China.;[Wu, Fei] Univ South China, Sch Nursing, 28 Changsheng Rd, Hengyang 421001, Hunan, Peoples R China.
通讯机构：
[Xiao Qin] D;Department of Vascular Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
摘要：
Direct oral anticoagulants (DOACs) are widely used to treat venous thromboembolism (VTE) in adults. Little attention is given to pediatric VTE (PVTE). The objective of this study is to study the efficacy and safety of DOACs in published PVTE randomized control trials (RCTs). PubMed, Embase, China National Knowledge Infrastructure, the Cochrane Library, SinoMed, and ClinicalTrials.gov were searched until 2021, to identify RCTs that enrolled patients with VTE <18 years of age who received DOACs versus standard anticoagulation. Outcomes were evaluated using the Mantel-Haenszel method of random-effects model. Our study evaluated seven RCTs that included 1139 cases of PVTE, which had a low risk of publication and assessment bias. Compared with standard anticoagulation, patients receiving DOACs presented a lower rate of recurrent VTE (relative risk [RR], 0.42 [confidence interval {CI}, 0.20 to 0.89]), similar mortality rate (RR, 0.50 [CI, 0.07 to 3.57]), major bleeding (RR, 0.46 [CI, 0.14 to 1.57]), and higher clinically relevant nonmajor bleeding (RR, 2.71 [CI, 1.05 to 7.02]) with low heterogeneity. Limiting to subgroups, dabigatran and rivaroxaban yielded similar findings, except for a higher incidence of nonmajor bleeding during rivaroxaban use. DOACs could be an alternative to standard anticoagulation in PVTE. Dabigatran and rivaroxaban have similar effects. Impact In venous thromboembolism (VTE), direct oral anticoagulants (DOACs) are widely used as a substitution for standard anticoagulation in most situations for adults; however, little attention is paid to the pediatric population. For pediatric VTE, previous meta-analyses have emphasized the epidemiology, risk factors, and the use of traditional anticoagulants, and seldom reported the use of novel oral anticoagulants. This is the first meta-analysis of randomized controlled trials that focuses on the efficacy outcomes and safety endpoints of DOACs compared with standard anticoagulation in pediatric VTE.
作者机构：
[Wu, Lirong; Yin, Jinzhi; Zhou, Hui] Univ South China, Sch Nursing, Hengyang Med Sch, Hengyang 421001, Hunan, Peoples R China.;[Wu, Lirong; Yin, Jinzhi; Zhou, Hui] Univ South China, Affiliated Changsha Cent Hosp, Hengyang Med Sch, Changsha 410013, Hunan, Peoples R China.;[Liu, Minhui; Huang, Chongmei] Cent South Univ, Nursing Sch, Changsha 410013, Peoples R China.;[Hu, Hongjuan] Univ South China, Affiliated Hosp 1, Dept Publ Serv, Nursing Dept,Hengyang Med Sch, Hengyang 421001, Hunan, Peoples R China.
通讯机构：
[Hongjuan Hu] T;The First Affiliated Hospital, Department of Public Service/Nursing department, Hengyang Medical School, University of South China, Hengyang, China
摘要：
Using accurate assessment tools to assess patients in clinical practice is important to mining influencing factors and implementing interventions. However, most evaluation tools for the self-management of elderly patients with hypertension lack a theoretical basis and wide applicability, which makes the intervention effect insignificant. Based on the Capability, Opportunity, and Motivation-Behaviour (COM-B) model, combined with literature review and qualitative research, a questionnaire item pool was initially formulated; then the initial items were screened and adjusted through expert consultation and pre-testing to form an initial scale. A field survey of 450 elderly hypertensive patients was then performed using the initial scale to test the reliability and validity of the scale. Cronbach’s alpha, test–retest reliability and composite reliability were used to test the reliability of the scale, and the validity of the scale was evaluated from two aspects: content validity and construct validity. The evaluation results of the content validity of the scale by experts were used as the content validity index; the results of exploratory factor analysis and confirmatory factor analysis were used as the structural validity index to further verify the model structure of the scale and develop a formal scale. The final self-management scale included 4 dimensions and 33 items. The Scale-Content Validity Index was 0.920. Exploratory factor analysis extracted four factors that explained 71.3% of the total variance. Cronbach’s alpha of the formal scale was 0.867, test–retest reliability was 0.894, and composite reliability of the 4 dimensions were within 0.943 ~ 0.973. Confirmatory factor analysis showed the scale had good construct validity. The Self-management Capability, Support and Motivation-Behaviour scale for elderly hypertensive patients has good reliability and validity, providing a tool for medical staff to evaluate the self-management level of elderly hypertensive patients.
作者机构：
[Chen, Yuping; Wu, Meichun; Chen, YP] Univ South China, Hengyang Med Sch, Hengyang 410001, Hunan, Peoples R China.;[Wu, Meichun] Univ South China, Sch Nursing, Hengyang 410001, Hunan, Peoples R China.;[Chen, Yuping; Xun, Min; Chen, YP] Univ South China, Inst Pharm & Pharmacol, Sch Pharmaceut Sci, Hengyang 410001, Hunan, Peoples R China.
通讯机构：
[Chen, YP ] U;Univ South China, Hengyang Med Sch, Hengyang 410001, Hunan, Peoples R China.;Univ South China, Inst Pharm & Pharmacol, Sch Pharmaceut Sci, Hengyang 410001, Hunan, Peoples R China.
关键词：
biodegradable metal stents;vascular smooth muscle cell;stent implantation;vascular microenvironment;atherosclerosis;restenosis
摘要：
Iron-, magnesium-, or zinc-based metal vessel stents support vessel expansion at the period early after implantation and degrade away after vascular reconstruction, eliminating the side effects due to the long stay of stent implants in the body and the risks of restenosis and neoatherosclerosis. However, emerging evidence has indicated that their degradation alters the vascular microenvironment and induces adaptive responses of surrounding vessel cells, especially vascular smooth muscle cells (VSMCs). VSMCs are highly flexible cells that actively alter their phenotype in response to the stenting, similarly to what they do during all stages of atherosclerosis pathology, which significantly influences stent performance. This Review discusses how biodegradable metal stents modify vascular conditions and how VSMCs respond to various chemical, biological, and physical signals attributable to stent implantation. The focus is placed on the phenotypic adaptation of VSMCs and the clinical complications, which highlight the importance of VSMC transformation in future stent design.
摘要：
Purpose: Nurses play an important role in ensuring patient rehabilitation and are involved in all aspects of multidimensional rehabilitation. Therefore, strengthening rehabilitation nursing education is vital to ascertain high-quality rehabilitation and optimum outcomes. This study examined the effectiveness of a new teaching reform-a modified Six-Sigma-based training program-against a conventional educational program on rehabilitation specialist nurses' core competencies, post-training performance, and satisfaction. Methods: A quasi-randomized controlled trial was conducted to assess the effectiveness of the modified training program. We recruited 56 learners from the 2020 training course at the Hunan Rehabilitation Specialist Nurse Training Base as the control group. Sixty learners from the base's 2021 training course were recruited as the intervention group. Data were collected in a consistent manner from both groups after the training program was implemented. Results: Those who underwent the modified training program showed better improvement in all core competencies than those who underwent the conventional training program (p < .05); the scores for theoretical knowledge, clinical nursing lectures, reviews, and nursing case management improved significantly following the teaching reform (p < 0.05). Further, overall satisfaction as well as base management and theoretical teaching satisfaction improved significantly (p < .05). Conclusion: The modified training program strengthens rehabilitation nurses' base management abilities; enhances their core competencies; expands their interest in and breadth, depth, and practicability of theoretical courses; and updates the teaching methods.
