Functional damage of endothelial progenitor cells is attenuated by 14-3-3-n through inhibition of mitochondrial injury and oxidative stress.

Endothelial progenitor cells (EPCs) are precursor cells of vascular endothelial cells, which are widely involved in the pathological process of cardiovascular diseases. EPCs apoptosis could accelerate the process of cardiovascular diseases. 14-3-3-η protein has been proved to be a potent antiapoptosis molecule. However, inhibition of EPCs apoptosis by 14-3-3-η and further specific mechanism have not been investigated. EPCs were isolated from human cord blood, and identified using VEGFR2 and CD34. 14-3-3-η overexpression model in vitro was established. Cell invasion, apoptosis, and proliferation were measured by transwell, flow cytometry, and Cell Counting Kit-8, respectively. Expression of 14-3-3-η, Bcl-2, and voltage-dependent anion channel 1 (VDAC1) were measured using quantitative real-time polymerase chain reaction and western blot analysis. Reactive oxygen species (ROS) intensity was measured using 2'-7' dichlorofluorescin diacetate probe. Mitochondrial membrane potential was detected using JC-1 dye. Overexpression of 14-3-3-η significantly promoted invasion and proliferation, but suppressed apoptosis of EPCs. Overexpression of 14-3-3-η remarkably inhibited ROS and promoted antioxidant enzyme levels in EPCs. 14-3-3-η might inhibit apoptosis of EPCs through attenuating mitochondrial injury. This study might provide a new target, 14-3-3-η, for the prevention and treatment of cardiovascular diseases through targeting EPCs.

Formulation and application of the "hospital-to-home + online-to-offline" treatment scheme in caring for and supporting vulnerable patients with chronic heart failure.

BACKGROUND: Chronic heart failure (CHF) is the terminal stage of cardiovascular disease. OBJECTIVE: In this study, the "hospital-to-home + online-to-offline" (H2H + O2O) care scheme was implemented for patients with CHF during vulnerable periods, and its effect was evaluated. METHODS: Patients with CHF in the cardiovascular department of a Class III/Grade A hospital in Jiangxi Province from January to December 2020 were selected using a convenience sampling method and randomly divided into a control and intervention group (n= 100 each). The patients in the control group received routine in-hospital treatment and out-of-hospital follow-up, while in the intervention group, a multi-disciplinary cooperation team with CHF specialist nurses evaluated and stratified the patients before discharge and formulated individualized prescriptions and care plans. Based on the "Health & Happiness" chronic disease follow-up application designed for this study, the specialist nurses provided patients with one-to-one guidance. After three months, the cardiac function, heart failure knowledge, self-care behavior, and re-hospitalization rate of the patients were compared between the two groups. Cardiac function was evaluated by the serum B-type natriuretic peptide (BNP), the left ventricular ejection fraction (LVEF), and a six-minute walking test (6MWT). Heart failure knowledge and self-care behavior was assessed using specific questionaries. RESULTS: The level of cardiac function in the intervention group was significantly higher than that in the control group, and the difference was statistically significant (P< 0.001). The mastery of heart failure knowledge and self-care behavior in the intervention group were significantly higher than those in the control group, and the differences were statistically significant (P< 0.05). The re-hospitalization rate due to CHF in the intervention group was 21.0%, which was lower than that in the control group (35.0%), and the difference was statistically significant (P< 0.05). CONCLUSION: The H2H + O2O care scheme can be used for the transition of vulnerable patients with CHF from the hospital to family care to improve the patients' level of cardiac function, elevate their knowledge level and self-care abilities, and improve their overall health outcomes.

Experiences of nurses working in nurse-led clinics in Traditional Chinese Medicine hospitals: A focused ethnographic study.

BACKGROUND: Traditional Chinese Medicine (TCM) nurse-led clinics (NLC) is an innovative working model in China, representing the specialization and extension of nurses' role. However, as a pioneer in TCM nursing, this new model of working is facing both opportunities and challenges because it is known little about the operational status of NLCs. AIMS: To explore the experiences of nurses who work in NLC in TCM hospitals. MATERIALS & METHODS: A focused ethnographic study was conducted in three TCM hospitals affiliated with Guangzhou University of Chinese Medicine. We interviewed eleven nurses in those hospitals and observed seven of them working with patients. We used snowball sampling for data collection including interview, non-participant observation and documents from medical records. All the data were processed as following steps: (a) coding for descriptive labels; (b) sorting for patterns; (c) identifying outliers or negative cases; (d) generalizing with construction and theories and (e) noting reflective remarks. RESULTS: Nurse-led clinics help nurses develop their skills and knowledge that are highly recognized by public since they meet the growing needs of patients and also relieve the workload of physicians in the hospitals. However, lack of specialization is still a major challenge in NLCs due to insufficiency of full-time staff with specialized education, nurse-led practice without standardized guidelines, restrictions on prescription right of nurses, and also inadequate support from hospitals. DISCUSSIONS: As a revolutionary innovation of working model for nurses in TCM hospitals, NLCs could improve quality of care and lead to a comprehensive promotion of nursing career. However, there are several challenges on providing high quality care for patients whilst improving educational development of nurses. This study suggests that nurses, hospital administration and the government should cooperate with each other to develop standard nursing programs for NLCs. CONCLUSIONS: It is imperative to identify nursing roles, collect available resources, and develop supportive policies and training programs to enhance the quality of NLCs.

Development and psychometric evaluation of public stigma of stroke scale (PSSS).

Stroke patients suffer from public stigma because strokes cause visible disability and heavy social burden. However, existing tools measuring stroke-related stigma do not consider public stigma. The aim of this study was to develop and evaluate a public stigma of stroke scale (PSSS). This cross-sectional study recruited 730 participants, aged above 18 years, with no diagnosis of stroke before. Scale items were generated after reviewing relevant literature and conducting interviews. An expert panel evaluated the validity and reliability of a preliminary scale. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), bifactor CFA (B-CFA), Exploratory structural equation modelling (ESEM), bifactor-ESEM (B-ESEM) were performed to extract factors and evaluate fit on the factor structures. The Omega coefficient was 0.93, and the test-retest reliability coefficient was 0.721. The EFA extracted four factors: inherent ideology, aesthetic feelings, avoidance behaviour, and policy attitudes. These explained 61.57% of the total variance in the data. The four-factor model was confirmed by B-CFA, and met the fitness criteria. The PSSS yields satisfactory psychometric properties and can be used to assess stroke-related public stigma.

Psychometric Evaluation of the Disaster Preparedness Evaluation Tool© (DPET) on Emergency Nurses in Mainland China: Two Cross-Sectional Studies.

BACKGROUND: Emergency nurses play a major role in disaster relief in mainland China, but there is no valid instrument to measure the extent of their disaster preparedness. The Disaster Preparedness Evaluation Tool© is a reliable instrument to assess the disaster preparedness of nurse practitioners. The tool has been translated and validated in Saudi Arabia, Taiwan, China and the United States of America. OBJECTIVES: This study aimed at translating and adapting the Disaster Preparedness Evaluation Tool© (DPET) for emergency nurses in mainland China and determining its psychometric properties. DESIGN, SETTINGS AND PARTICIPANTS: A total of 2 cross-sectional online surveys were conducted in the emergency departments of 26 public grade III-A hospitals in Guangdong, mainland China. In the first study, 633 emergency nurses were recruited from May to August, 2018. In the second study, 205 were recruited in April 2019. METHODS: The instrument was adapted through rigorous forward-backward translation, face validity, and pre-test processes. Exploratory factor and parallel analyses were used in the first study. Confirmatory factor analysis, internal consistency and split-half reliability were used in the second study. RESULTS: Exploratory factor and parallel analyses extracted a 5-factor solution comprising of 34 items that accounted for 64.06% of the total variance. The fit indices indicated a good model fit. The reliability was good, as indicated by a Cronbach's alpha of 0.97 and a split-half reliability coefficient of 0.97. CONCLUSION: The mainland China version of the DPET (DPET-MC) was a reliable and valid instrument and can be used in practice.

Disaster Preparedness and Associated Factors Among Emergency Nurses in Guangdong Province, China: A Descriptive Cross-Sectional Study.

OBJECTIVE: The purpose of this study was to examine the prevalence of disaster preparedness and to explore associated factors among emergency nurses in Guangdong Province, China. METHODS: In this descriptive, cross-sectional study, the mainland China version of the Disaster Preparedness Evaluation Tool was used to collect data from 633 nurses working in 26 emergency departments, in August 2018. Descriptive analyses were used to examine the disaster preparedness, and multiple linear regression analysis was used to investigate associated factors. RESULTS: The perceived disaster preparedness of emergency nurses was at a moderate level. Among the 5 dimensions, the score for disaster management was lowest. Emergency nurses' disaster training (r = .26; P < 0.001) and drill experiences (r = .22; P < 0.001) were significantly correlated with disaster preparedness. Six significant factors associated with disaster preparedness were identified in this study: age, gender, disaster training experience, disaster drill experience, willingness, and educational level (R2 = .14; F = 18.20; P < 0.001). CONCLUSIONS: Hospitals and nurse managers should carry out interdisciplinary and multidisciplinary cooperation to improve emergency nurses' disaster preparedness, especially disaster management. Organizing disaster simulation exercises, providing psychological support and safety considerations, and formulating disaster nursing training programs may be beneficial for emergency nurses' disaster preparedness.

The Impact on Blood Pressure of a Short-Term Change in Indoor Temperature.

OBJECTIVE: The aim of this study is to evaluate the impact on blood pressure (BP) of a 10°C change in room temperature (between 18°C and 28°C). METHODS: A total of 112 volunteers, 56 males and 56 females, 55 with and 57 without hypertension, were enrolled in the study. First, the participants were placed in a 25°C room. Second, they were randomly assigned to either a 28°C (group A) or an 18°C room (group B). Finally, they were moved from the 28°C to the 18°C room, or vice versa. They stayed in each room for 20 minutes. Seated BP was measured at the 17th and 19th minute in each room, and the average was used. The difference in the subject's BP between the second two rooms was recorded as delta BP. RESULTS: The baseline systolic BP (SBP), age, gender distribution, and incidence of hypertension were similar between the two groups. In group A, the decrease in room temperature of 10°C induced a mean rise in SBP of 4.1 mmHg. In group B, the increase of 10°C caused SBP to decrease by 4.0 mmHg. When compared with the group without hypertension, the group with hypertension had a significantly higher rise in mean SBP (6.8 vs 1.2 mmHg) as a result of the decrease in temperature and a significantly higher drop in SBP (7.3 vs 1.2 mmHg) as a result of the increase in temperature. The participants in the group with hypertension were older. CONCLUSION: A 10°C change in room temperature, from 18°C to 28°C, for 20 min can cause a significant change in SBP. The extent of this change is more obvious in the older group.