Spo11 generates gaps through concerted cuts at sites of topological stress.

Meiotic recombination is essential for chromosome segregation at meiosis and fertility. It is initiated by programmed DNA double-strand breaks (DSBs) introduced by Spo11, a eukaryotic homologue of an archaeal topoisomerase (Topo VIA)1. Here we describe previously uncharacterized Spo11-induced lesions, 34 to several hundred base pair-long gaps, which are generated by coordinated pairs of DSBs termed double DSBs. Isolation and genome-wide mapping of the resulting fragments with single base-pair precision revealed enrichment at DSB hotspots but also a widely dispersed distribution across the genome. Spo11 prefers to cut sequences with similarity to a DNA-bending motif2, which indicates that bendability contributes to the choice of cleavage site. Moreover, fragment lengths have a periodicity of approximately (10.4n + 3) base pairs, which indicates that Spo11 favours cleavage on the same face of underwound DNA. Consistently, double DSB signals overlap and correlate with topoisomerase II-binding sites, which points to a role for topological stress and DNA crossings in break formation, and suggests a model for the formation of DSBs and double DSBs in which Spo11 traps two DNA strands. Double DSB gaps, which make up an estimated 20% of all initiation events, can account for full gene conversion events that are independent of both Msh2-dependent heteroduplex repair3,4 and the MutLγ endonuclease4. Because non-homologous gap repair results in deletions, and ectopically re-integrated double DSB fragments result in insertions, the formation of double DSBs is a potential source of evolutionary diversity and pathogenic germline aberrations.

Spo11-accessory proteins link double-strand break sites to the chromosome axis in early meiotic recombination.

Meiotic recombination between homologous chromosomes initiates via programmed DNA double-strand breaks (DSBs), generated by complexes comprising Spo11 transesterase plus accessory proteins. DSBs arise concomitantly with the development of axial chromosome structures, where the coalescence of axis sites produces linear arrays of chromatin loops. Recombining DNA sequences map to loops, but are ultimately tethered to the underlying axis. How and when such tethering occurs is currently unclear. Using ChIPchip in yeast, we show that Spo11-accessory proteins Rec114, Mer2, and Mei4 stably interact with chromosome axis sequences, upon phosphorylation of Mer2 by S phase Cdk. This axis tethering requires meiotic axis components (Red1/Hop1) and is modulated in a domain-specific fashion by cohesin. Loss of Rec114, Mer2, and Mei4 binding correlates with loss of DSBs. Our results strongly suggest that hotspot sequences become tethered to axis sites by the DSB machinery prior to DSB formation.

Shearing Liquid-Crystalline MXene into Lamellar Membranes with Super-Aligned Nanochannels for Ion Sieving.

Ion-selective membranes are crucial in various chemical and physiological processes. Numerous studies have demonstrated progress in separating monovalent/multivalent ions, but efficient monovalent/monovalent ion sieving remains a great challenge due to their same valence and similar radii. Here, this work reports a two-dimensional (2D) MXene membrane with super-aligned slit-shaped nanochannels with ultrahigh monovalent ion selectivity. The MXene membrane is prepared by applying shear forces to a liquid-crystalline (LC) MXene dispersion, which is conducive to the highly-ordered stacking of the MXene nanosheets. The obtained LC MXene membrane (LCMM) exhibits ultrahigh selectivities toward Li+ /Na+ , Li+ /K+ , and Li+ /Rb+ separation (≈45, ≈49, and ≈59), combined with a fast Li+ transport with a permeation rate of ≈0.35 mol m-2 h-1 , outperforming the state-of-the-art membranes. Theoretical calculations indicate that in MXene nanochannels, the hydrated Li+ with a tetrahedral shape has the smallest diameter among the monovalent ions, contributing to the highest mobility. Besides, the weakest interaction is found between hydrated Li+ and MXene channels which also contributes to the ultrafast permeation of Li+ through the super-aligned MXene channels. This work demonstrates the capability of MXene membranes in monovalent ion separation, which also provides a facile and general strategy to fabricate lamellar membranes in a large scale.

[Intervention effect of narrative therapy on non-suicidal self-injury in adolescents with depressive disorder: a prospective randomized controlled study]. / å™äº‹æ²»ç–—å¯¹é’å°‘å¹´æŠ‘éƒç—‡æ‚£è€ éžè‡ªæ€æ€§è‡ªä¼¤çš„å¹²é¢„æ•ˆæžœï¼šä¸€é¡¹å‰çž»æ€§éšæœºå¯¹ç §ç ”ç©¶.

OBJECTIVES: To study the intervention effect of narrative therapy on non-suicidal self-injury (NSSI), as well as anxiety and depression symptoms in adolescents with depressive disorder. METHODS: Sixty adolescents with depressive disorder and NSSI were randomly assigned to either the intervention group or the control group using coin flipping. The control group received conventional psychological support, while the intervention group received individual narrative therapy in addition to the conventional psychological support (twice a week, 60 minutes per session, for a total of 3 weeks). Assessment of treatment efficacy was conducted using the Adolescent Self-Harm Questionnaire, Children's Depression Inventory, and Children's Anxiety and Mood Scale before the intervention, at the end of the intervention, and one month after the intervention for both groups. RESULTS: A total of 26 adolescents in the intervention group and 29 adolescents in the control group completed the entire study. At the end of the intervention and one month after the intervention, the intervention group showed a significant reduction in the NSSI frequency score, NSSI level, anxiety score, and depression score compared to before the intervention (P<0.017). Moreover, at the end of the intervention and one month after the intervention, the intervention group exhibited significantly lower NSSI frequency score, NSSI severity score, NSSI level, anxiety score and depression score compared to the control group (P<0.05). CONCLUSIONS: Narrative therapy is effective in reducing NSSI frequency and alleviating NSSI severity, as well as anxiety and depression symptoms in adolescents with depressive disorder.

Efficient Visible-Light-Driven Tetracycline Degradation and Cr(VI) Reduction over a LaNi1-xFexO3 (0 ≤ x ≤ 1)/g-C3N4 Type-II Heterojunction Photocatalyst.

The development of efficient, stable, and visible-light-responsive photocatalysts is crucial to address the pollution of water bodies by toxic heavy metal ions and organic antibiotics. Herein, a series of LaNi1-xFexO3/g-C3N4 heterojunction photocatalysts are prepared by a simple wet chemical method. Moreover, LaNi0.8Fe0.2O3/g-C3N4 composites are characterized by various methods, including structure, morphology, optical, and electrochemical methods and tetracycline degradation and photocatalytic reduction of Cr(VI) under visible light irradiation. Then, the photocatalytic performance of as-prepared LaNi0.8Fe0.2O3/g-C3N4 composites is evaluated. Compared with pure LaNi0.8Fe0.2O3 and g-C3N4, the LaNi0.8Fe0.2O3/g-C3N4 composite photocatalysts exhibit excellent photocatalytic performance due to synergy of doping and constructing heterojunctions. The results show that the doping of Fe ions can increase the concentration of oxygen vacancies, which is ultimately beneficial to the formation of electron traps. Moreover, the type-II heterojunction formed between LaNi0.8Fe0.2O3 and g-C3N4 effectively strengthens the separation and transfer of photoinduced carriers, thereby promoting photocatalytic activity. Furthermore, the photocatalytic activity of the LaNi0.8Fe0.2O3/g-C3N4 photocatalyst remains almost unchanged after three cycles, indicating long-term stability. Ultimately, the photocatalytic mechanism of the LaNi0.8Fe0.2O3/g-C3N4 composites is proposed.

Challenges of delivering care to older persons in the intensive care unit: A qualitative study based on the third wave of COVID-19 in China.

BACKGROUND: With the aging population and the ongoing pandemic, older persons account for a large proportion of ICU admissions. Despite numerous studies on the impact of COVID-19 on older persons, there has been a small body of research investigating nursing practice with critically ill older patients admitted to ICU for COVID-19. AIMS: To explore current challenges in the nursing care of older persons with severe COVID-19 through the experience of frontline nurses. STUDY DESIGN: A qualitative descriptive design was used. In-depth and semi-structured interviews with 18 ICU nurses were conducted to explore the experience of providing care for older persons with severe COVID-19 in the Omicron wave. A content analysis approach was adopted to analyse qualitative data. FINDINGS: Three themes emerged as follows: (1) no plan survives first contact with the enemy, (2) expectations versus Reality and (3) difficulty in providing holistic care. CONCLUSIONS: Challenges could be encountered in different stages of providing care for older persons with severe COVID-19, including the preparation and training of knowledge and skills in the early stage, the challenges posed by old age in the diagnostic and treatment stage and the challenges of psychological care and rehabilitation care. RELEVANCE TO CLINICAL PRACTICE: With the regular prevention and control of COVID-19, our study provides guidance for establishing measures (training courses of ICU nurses) to improve the nursing quality of older persons with severe COVID-19.

MXene-based Membranes for Drinking Water Production.

The soaring development of industry exacerbates the shortage of fresh water, making drinking water production an urgent demand. Membrane techniques feature the merits of high efficiency, low energy consumption, and easy operation, deemed as the most potential technology to purify water. Recently, a new type of two-dimensional materials, MXenes as the transition metal carbides or nitrides in the shape of nanosheets, have attracted enormous interest in water purification due to their extraordinary properties such as adjustable hydrophilicity, easy processibility, antifouling resistance, mechanical strength, and light-to-heat transformation capability. In pioneering studies, MXene-based membranes have been evaluated in the past decade for drinking water production including the separation of bacteria, dyes, salts, and heavy metals. This review focuses on the recent advancement of MXene-based membranes for drinking water production. A brief introduction of MXenes is given first, followed by descriptions of their unique properties. Then, the preparation methods of MXene membranes are summarized. The various applications of MXene membranes in water treatment and the corresponding separation mechanisms are discussed in detail. Finally, the challenges and prospects of MXene membranes are presented with the hope to provide insightful guidance on the future design and fabrication of high-performance MXene membranes.

Effectiveness of micro-lecture based cardiac rehabilitation education on health status in individuals with coronary artery disease: A randomized clinical trial.

OBJECTIVE: To explore the effectiveness of the micro-lecture education on the ability of self-management and lifestyle changes in patients with coronary artery disease. DESIGN: A randomized control trial with a 12-week follow-up. SETTING: Cardiology wards of a large Chinese University Hospital. SUBJECTS: One hundred eligible inpatients with coronary artery disease were recruited. INTERVENTION: Intervention group received the micro-lecture education, while the control group received the traditional cardiac rehabilitation education. MAIN MEASURES: Primary outcome of the ability of coronary self-management was assessed by the Coronary self-management scaleat baseline, 12-week after discharge. Secondary outcomes of smoking status, exercise status, and six-minute walk distance were evaluated at the baseline, week4 and week 12 after discharge. The chi-square test,Fisher's exact test, group t-test and the repeated measure variance were used for the data analysis. RESULTS: Eighty-nine of 100 eligible participants responded, and mean age was 60.2 ± 11.3 years.After the intervention, the mean score of the coronary self-management scale (3.84 ± 0.36) was higher than that in the control group (2.78 ± 0.57).At week 12, the rate of re-smoked in the intervention group (6%) was significantly lower than that in the control group (43%),the frequency of the exercise (85%), and the 6MWD (495.55 ± 85.94) in the intervention group were better than the control group. CONCLUSION: Micro-lecture education program presented a positive effect on promoting the ability of self-management, and apotential effect on the therapeutic lifestyle changes for the coronary artery disease patients.

Gene Networks Involved in Plant Heat Stress Response and Tolerance.

Global warming is an environmental problem that cannot be ignored. High temperatures seriously affect the normal growth and development of plants, and threaten the development of agriculture and the distribution and survival of species at risk. Plants have evolved complex but efficient mechanisms for sensing and responding to high temperatures, which involve the activation of numerous functional proteins, regulatory proteins, and non-coding RNAs. These mechanisms consist of large regulatory networks that regulate protein and RNA structure and stability, induce Ca2+ and hormone signal transduction, mediate sucrose and water transport, activate antioxidant defense, and maintain other normal metabolic pathways. This article reviews recent research results on the molecular mechanisms of plant response to high temperatures, highlighting future directions or strategies for promoting plant heat tolerance, thereby helping to identify the regulatory mechanisms of heat stress responses in plants.

New compounds from the seeds of Psoralea corylifolia with their protein tyrosine phosphatase 1B inhibitory activity.

Two new flavonoids, 5,4'-dihydroxy-6,7-furanbavachalcone (1), 1″-methoxy-6,7-furanflavanone (2), together with five known compounds (3-7), were isolated from the seeds of Psoralea corylifolia. Their structures were elucidated by IR, UV, NMR, HRESMS experiments, and comparison of their NMR data with previously reported data. All compounds were evaluated for in vitro inhibitory activity against PTP1B. Additionally, the isolated compounds (1-6) displayed moderate inhibitory effects against PTP1B with IC50 values ranging from 10.3 ± 0.9 to 25.1 ± 1.6 µM.

[Demands for cardiac rehabilitation information in patients with coronary atherosclerotic heart disease and influential factors].

OBJECTIVE: To investigate the demands for cardiac rehabilitation information in patients with coronary atherosclerotic heart disease (CHD) and influential factors. 
 Methods: Information demands for cardiac rehabilitation in CHD patients were surveyed by questionnaire and the influential factors were analyzed by one-way ANOVA and multi-factor analysis of variance.
 Results: The score of demands for cardiac rehabilitation information in CHD patients was 3.86±0.53. Among them, the most urgent top 5 items were: drug knowledge, diagnosis and treatment, basic knowledge of the heart, emergency and safety and nutrition knowledge. The top 3-demand modes were: communication with medical workers, movies or videos to take home, and lectures. The score of demands for cardiac rehabilitation information was different in different age groups. The highest score was in the patients with age less than 60. There were different demands in different characteristic groups.
 Conclusion: The most urgent need and mode are drug knowledge and communication with medical workers, respectively. With the age increase, the demands for patients' cardiac rehabilitation information decrease. An individualized health education strategy should be developed according to the characteristics of CHD patients.

Mapping genomic hotspots of DNA damage by a single-strand-DNA-compatible and strand-specific ChIP-seq method.

Spontaneous DNA damage may occur nonrandomly in the genome, especially when genome maintenance mechanisms are undermined. We developed single-strand DNA (ssDNA)-associated protein immunoprecipitation followed by sequencing (SPI-seq) to map genomic hotspots of DNA damage. We demonstrated this method with Rad52, a homologous recombination repair protein, which binds to ssDNA formed at DNA lesions. SPI-seq faithfully detected, in fission yeast, Rad52 enrichment at artificially induced double-strand breaks (DSBs) as well as endogenously programmed DSBs for mating-type switching. Applying Rad52 SPI-seq to fission yeast mutants defective in DNA helicase Pfh1 or histone H3K56 deacetylase Hst4, led to global views of DNA lesion hotspots emerging in these mutants. We also found serendipitously that histone dosage aberration can activate retrotransposon Tf2 and cause the accumulation of a Tf2 cDNA species bound by Rad52. SPI-seq should be widely applicable for mapping sites of DNA damage and uncovering the causes of genome instability.

Smc5/6-Mms21 prevents and eliminates inappropriate recombination intermediates in meiosis.

Repairing broken chromosomes via joint molecule (JM) intermediates is hazardous and therefore strictly controlled in most organisms. Also in budding yeast meiosis, where production of enough crossovers via JMs is imperative, only a subset of DNA breaks are repaired via JMs, closely regulated by the ZMM pathway. The other breaks are repaired to non-crossovers, avoiding JM formation, through pathways that require the BLM/Sgs1 helicase. "Rogue" JMs that escape the ZMM pathway and BLM/Sgs1 are eliminated before metaphase by resolvases like Mus81-Mms4 to prevent chromosome nondisjunction. Here, we report the requirement of Smc5/6-Mms21 for antagonizing rogue JMs via two mechanisms; destabilizing early intermediates and resolving JMs. Elimination of the Mms21 SUMO E3-ligase domain leads to transient JM accumulation, depending on Mus81-Mms4 for resolution. Absence of Smc6 leads to persistent rogue JMs accumulation, preventing chromatin separation. We propose that the Smc5/6-Mms21 complex antagonizes toxic JMs by coordinating helicases and resolvases at D-Loops and HJs, respectively.

Image and pathological features of Ewing's sarcoma in the oral and maxillofacial region.

OBJECTIVE: To systematically evaluate the image and pathological features of Ewing's sarcoma (ES) in the oral and maxillofacial region.
 METHODS: Eight patients with ES in the oral and maxillofacial region were enrolled for this study. The X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) of ES and the pathological data were systematically evaluated.
 RESULTS: X-ray image showed a diffuse radiolucency with cystic component and ill-defined borders for bone lesion. CT showed that there was osteolytic mass with extensive bone destruction and soft tissue infiltration, but no periosteal reactions were observed. MRI demonstrated that ES showed an inhomogeneous structure and blurred borders with invasion to adjacent soft tissue for bone lesion. Similar manifestation also showed in MRI images for patients with soft tissues. Histologically, ES composed of small round cells, and expressed CD99, neuron specific enolase (NSE) and vimentin (Vim) in all patients. Desmin (Des), CD34, epithelial membrane antigen (EMA), chromogranin A (ChgA), etc, were negatively expressed in ES cells.
 CONCLUSION: X-ray, CT, and MRI are helpful to determine the property, extent and the relationship of ES with the surrounding tissues. Immunohistochemical stain of CD99, NSE, and Vim are helpful to confirm the pathological diagnosis of ES.

Temporal and Functional Relationship between Synaptonemal Complex Morphogenesis and Recombination during Meiosis.

During prophase of meiosis I, programmed double strand breaks (DSBs) are processed into crossovers, a critical requirement for segregation of homologous chromosomes (homologs) and genome haploidization in sexually reproducing organisms. Crossovers form via homologous recombination in close temporospatial association with morphogenesis of the synaptonemal complex (SC), a proteinaceous structure that connects paired homologs along their length during the pachytene stage. Synapsis and recombination are a paradigm for the interplay between higher order chromosome structure and DNA metabolism, yet their temporal and functional relationship remains poorly understood. Probing linkage between these processes in budding yeast, we show that SC assembly is associated with a distinct threshold number of unstable D-loops. The transition from bona fide paranemic D-loops to plectonemic DSB single end invasions (SEIs) is completed during midpachynema, when the SC is fully assembled. Double Holliday junctions (dHJs) form at the time of desynapsis and are resolved into crossovers during diplonema. The SC central element component Zip1 shepherds recombination through three transitions, including DSB first end strand exchange and second end capture, as well as dHJ resolution. Zip1 mediates SEI formation independent of its polymerization whereas precocious Zip1 assembly interferes with double Holliday junction resolution. Together, our findings indicate that the synaptonemal complex controls recombination while assembled but also beyond its disassembly, possibly by establishing spatial constraints at recombination sites.

Molecular mechanism of GSDMD mediated glomerular endothelial cells pyroptosis: An implying in the progression of diabetic nephropathy.

Diabetic nephropathy (DN), a chronic progressive kidney disease, is the most prevalent microvascular complication associated with diabetes which causes the end-stage renal disease. Glomerular endothelial cells (GECs) are one of the inherent cells of the glomerulus and are particularly susceptible to be damaged by glucose, lipids and inflammatory factors. Numerous studies indicated that GECs injury was a critical pathological event in the early stages of DN. Previous studies have shown that podocyte pyroptosis occurred through the classical caspase-1 pathway, leading to kidney injury. However, the occurrence of pyroptosis in GECs and the underlying mechanism remain unclear. In this study, we investigated the pyroptosis of GECs during DN and its underlying mechanism. Upon stimulation with high glucose (HG), we observed the upregulation of GSDMD and cleaved N-terminus, disruption of cell membrane integrity, and an increase in IL-18 inflammatory cytokines. Also, we found that the expression of caspase-11, GSDMD and GSDMD-N were increased in C57BL/6J mice induced by STZ combined with high sugar and fat. In addition, the pathological results of kidney showed a significant thickening of the glomerular basement membrane, abnormal increasement of extracellular matrix and hyperplasia with blurred boundaries of glomerulus. Furthermore, interfering the expression of GSDMD improved the pathological degree of kidney. These findings indicated that the pyroptosis of GECs during DN was facilitated by the non-classical pathway of caspase-11/GSDMD, ultimately leading to GECs injury and further aggravating the progression of DN. This work highlights the potential of GSDMD as a therapeutic target for the treatment of DN.

Cellulose nanofiber/MXene/luffa aerogel for all-weather and high-efficiency cleanup of crude oil spills.

The remediation of heavy crude oil spills is a global challenge because frequent crude oil spills cause long-term damage to local living beings and marine ecosystems. Herein, a solar-driven and Joule-driven self-heated aerogel were developed as an all-weather adsorbent to efficiently absorb crude oil by obviously decreasing the viscosity of crude oil. The cellulose nanofiber (CNF)/MXene/luffa (CML) aerogel was fabricated via a simple freeze-drying method using CNF, MXene, and luffa as raw materials, and then coated with a layer of polydimethylsiloxane (PDMS) to make it hydrophobic and further increase oil-water selectivity. The aerogel can quickly reach 98 °C under 1 sun (1.0 kW/m2), which remains saturated temperature after 5 times photothermal heating/cooling cycles, indicating that the aerogel has great photothermal conversation capability and stability. Meanwhile, the aerogel can also rapidly rise to 110.8 °C with a voltage of 12 V. More importantly, the aerogel achieved the highest temperature of 87.2 °C under outdoor natural sunlight, providing a possibility for promising applications in practical situations. The remarkable heating capability enables the aerogel to decrease the viscosity of crude oil substantially and increase the absorption rate of crude oil by the physical capillary action. The proposed all-weather aerogel design provides a sustainable and promising solution for cleaning up crude oil spills.

Multifunctional MXene Conductive Zwitterionic Hydrogel for Flexible Wearable Sensors and Arrays.

Conductive hydrogels have good prospects in the fields of flexible electronic devices and artificial intelligence due to their biocompatibility, durability, and functional diversity. However, the process of hydrogel polymerization is time-consuming and energy-consuming, and freezing at zero temperature is inevitable, which seriously hinders its applications and working life. Herein, zwitterionic conductive hydrogels with self-adhesive and antifreeze properties were prepared in one minute by introducing two-dimensional (2D) MXene nanosheets into the autocatalytically enhanced system composed of tannic acid-modified cellulose nanofibers and zinc chloride. The system has strong environmental applicability (-60 to 40 °C), good stretchability (ductility ≈ 980%), durable adhesion (even after 30 days of exposure to air), and strong electrical conductivity (20 °C, 30 mS cm-1). By virtue of these advantages, the prepared zwitterionic hydrogels can be developed into flexible strain sensors to monitor large human movements and subtle physiological signals over a wide temperature range and to capture signals from handwriting and voice recognition. In addition, multiple flexible sensors can be assembled into a three-dimensional (3D) array, which can detect the magnitude and spatial distribution of strain or force. These results demonstrate that the prepared zwitterionic hydrogels have promising applications in the fields of medical monitoring and artificial intelligence.

Relationships Between Mental Health, Emotion Regulation, and Meaning in Life of Frontline Nurses During the COVID-19 Outbreak.

Background: The sporadic outbreak of COVID-19 and the constant mutation of the virus have put the public in panic. Frontline nurses' appropriate emotional regulation and mental health are the key to win the victory of fighting against the epidemic. The relationships between these variables directly influence the availability of human resources to combat COVID-19. Objective: To investigate the relationship between meaning in life, emotional regulation, and mental health of frontline nurses during the Delta virus epidemic. Methods: A cross-sectional survey was conducted in August 2021 among 105 nurses from the Second Xiangya Hospital, Central South University, Changsha, China, who were deployed at the COVID-19 units in Zhangjiajie People's Hospital. The Chinese Meaning in Life Questionnaire, Emotion Regulation Questionnaire, and Psychological Questionnaire for Emergent Events of Public Health were used to evaluate their meaning in life, emotion regulation, and mental health. Their correlation and the moderating effect of emotion regulation were conducted. Results: In total, 105 (100%) nurses responded. There were 14 men and 91 women and the mean age was (30.295 ± 4.653) years. The average score of meaning in life and mental health of frontline nurses was 49.971 ± 6.386 and 2.755 ± 2.580, respectively. The meaning in life of frontline nurses was positively correlated with cognitive reappraisal and negatively correlated with expressive suppression and mental health. Mental health was negatively correlated with cognitive reappraisal and positively correlated with expressive suppression. The emotional regulation of frontline nurses has a moderating effect between meaning in life and mental health. Conclusion: Meaning in life and emotion regulation of frontline nurses were significantly correlated with mental health under the effects of the COVID-19 pandemic. Changing the emotion regulation of frontline nurses, strengthening cognitive reappraisal, and weakening expressive suppression could reduce the predictive effect of meaning in life on mental health.

Relationships between sexual function, mental health, and quality of life of female patients with pulmonary arterial hypertension associated with congenital heart disease.

In recent years, the treatment of pulmonary arterial hypertension (PAH) has gradually increased, including new drugs and surgical methods, the mortality rate of PAH patients has significantly decreased, and the average survival rate has significantly improved. However, there was no obvious improvement in sexual health, mental health, and quality of life (QoL) in patients with PAH. Although an important dimension of QoL, little is known about sexual health and sexual health-related QoL of patients with PAH in China. In this study, the female sexual function index (FSFI) scale, the Symptom Checklist-90 (SCL-90), and emPHasis-10 were used to evaluate PAH associated with congenital heart disease (CHD-PAH) patients' sexual function, mental health, and QoL. The score of sexual function in female CHD-PAH patients ranged from 4.40 to 34.80 points, and the average score was 26.80 (19.00-27.80) points. The detection rate of sexual dysfunction was 48.30%. The FSFI score of all dimensions of the sexual dysfunction group was significantly lower than that of the nonsexual dysfunction group. In addition, the scores of SCL-90 and emPHasis-10 were significantly higher than that of the nonsexual dysfunction group (p < 0.01). The sexual function was negatively correlated with mental health (r = -0.58, p < 0.01) and QoL (r = -0.62, p < 0.01) in female CHD-PAH patients. The sexual function of female patients with CHD-PAH is not optimistic. Sexual health may impact mental health and overall QoL in female PAH patients. Reasonable intervention measures should be taken to improve their sexual health, so as to improve their overall QoL.