Wound incidence and outcomes in atrial fibrillation: Comparing catheter ablation and anti-arrhythmic drug therapy.

The most prevalent form of cardiac arrhythmia is atrial fibrillation (AF), which is typically managed through catheter ablation or anti-arrhythmic drug therapy. We compared the incidence and outcomes of wound complications in patients with atrial fibrillation who were treated with catheter ablation as opposed to anti-arrhythmic drug therapy. From May to November 2023, 240 adult AF patients who were treated with catheter ablation or anti-arrhythmic medications participated in a 6-month retrospective cohort study at Sir Run Run Shaw Hospital in Hangzhou, China. An observation was made regarding 29 wound complications out of 240 patients. In comparison to drug therapy group, incidence of minor (8 vs. 11) and total complications (18 vs. 11) was greater in catheter ablation group. Significant adverse events occurred at higher rate in the catheter ablation group (6 versus 1) (p < 0.05). However, despite these patterns, there was no statistically significant difference in the rates of complications (total: p = 0.245; minor: p = 0.217; major: p = 0.128). Comparable treatment efficacy was observed across groups. In contrast to drug therapy, catheter ablation was associated with decreased probability of complications (odds ratio: 0.86), as determined by logistic regression; cardiac failure was a significant predictor of adverse outcomes. The study concluded that the risks of wound complications associated with catheter ablation and anti-arrhythmic drug therapy in patients with atrial fibrillation are comparable. Notwithstanding an elevated propensity for complications in ablation group, the statistical analysis indicated comparable safety profiles.

Andrographolide protects against atrial fibrillation by alleviating oxidative stress injury and promoting impaired mitochondrial bioenergetics / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia seen in clinical settings, which has been associated with substantial rates of mortality and morbidity. However, clinically available drugs have limited efficacy and adverse effects. We aimed to investigate the mechanisms of action of andrographolide (Andr) with respect to AF. We used network pharmacology approaches to investigate the possible therapeutic effect of Andr. To define the role of Andr in AF, HL-1 cells were pro-treated with Andr for 1 h before rapid electronic stimulation (RES) and rabbits were pro-treated for 1 d before rapid atrial pacing (RAP). Apoptosis, myofibril degradation, oxidative stress, and inflammation were determined. RNA sequencing (RNA-seq) was performed to investigate the relevant mechanism. Andr treatment attenuated RAP-induced atrial electrophysiological changes, inflammation, oxidative damage, and apoptosis both in vivo and in vitro. RNA-seq indicated that oxidative phosphorylation played an important role. Transmission electron microscopy and adenosine triphosphate (ATP) content assay respectively validated the morphological and functional changes in mitochondria. The translocation of nuclear factor erythroid 2-related factor 2 (Nrf2) to the nucleus and the molecular docking suggested that Andr might exert a therapeutic effect by influencing the Keap1-Nrf2 complex. In conclusions, this study revealed that Andr is a potential preventive therapeutic drug toward AF via activating the translocation of Nrf2 to the nucleus and the upregulation of heme oxygenase-1 (HO-1) to promote mitochondrial bioenergetics.

Analgesic effects of different acupuncture therapies on postherpetic neuralgia:a Bayes-ian network meta-analysis / 中国药理学与毒理学杂志

OBJECTIVE To assess the effi-cacy and safety of acupuncture-related treat-ments for postherpetic neuralgia(PHN),identify the most effective acupuncture and related treat-ments.METHODS PubMed,Cochrane Central Register of Controlled Trials,Embase,Web of Science,and four Chinese databases,a clinical research registration platform,and grey literature were searched.We evaluated the risk of bias and quality in the included studies and per-formed a Bayesian multiple network meta-analy-sis.RESULTS We included 29 randomized con-trolled trials comprising 1973 patients,of which approximately 17.24%showed a high risk of bi-as.According to the Jadad scale,2,16,and 11 studies were high,medium,and low quality,respectively.The pairwise meta-analysis results revealed that the efficacy of all acupuncture-related treatments for pain relief related to PHN showed the difference was statistically significant com-pared with that of antiepileptics.The network meta-analysis results showed that pricking and cupping plus antiepileptics were the most effec-tive,followed by electroacupuncture(EA)plus antiepileptics for pain relief in patients with PHN.EA plus antiepileptics ranked the best regarding reduced Pittsburgh Sleep Quality Index and Self-Rating Depression Scale scores in patients with PHN.No results were found regarding total response rate or quality of life among this study.Acupuncture-related treatments showed a lower incidence of adverse events than that of antiepi-leptics-related treatments.CONCLUSION Acu-puncture-related therapies may be potential treat-ment options for PHN and are relatively safe.Pricking and cupping plus antiepileptics are the most effective techniques for pain relief.EA plus antiepileptics is the best approach for improving insomnia and depression symptoms of PHN.

Efficacy of acupuncture on acute tonsillitis:a systematic review and meta-analysis / 中国药理学与毒理学杂志

OBJECTIVE To systematically assess the efficacy and safety of acupuncture in treating acute tonsillitis,providing a reference for clinical decision-making.METHODS We searched PubMed,CENTRAL,Embase,Web of Science,China National Knowledge Infrastruc-ture,China Biomedical,clinical research registra-tion platforms,grey literature,and the reference lists of the selected studies from inception to Oct.30,2022.The risk of bias assessment used Rev-Man.Meta-analysis was performed using STATA with Hedges' g value.In addition,we performed subgroup analysis,meta-regression,and publica-tion bias detection with Harbord's and Egger's tests.RESULTS We included 19 randomized controlled trials comprising 1701 patients,of which 1 study was assessed high risk of bias.The primary outcome,the response rate,revealed that acupuncture was more effective than antibi-otics.The secondary outcomes showed that the difference in the reduction of the VAS scores,sore throat time,and white blood cell counts was statistically significant with acupuncture compared to antibiotics.However,the difference in modulat-ing neutrophil percentage and C-reactive protein was not statistically significant.Besides,acupunc-ture treatments showed a lower incidence of adverse events than antibiotics.CONCLUSION Acupuncture therapy on acute tonsillitis is safe,and the response rate is superior to antibiotics.For alleviating sore throat symptoms,shortening sore throat time,and improving immune inflam-mation index,acupuncture has positive signi fi cance.Nevertheless,because of the limitations of this study,our conclusions should be inter-preted with caution.Future efforts still need more high-quality trials to improve the methodology and reporting quality.

Luteolin induces ferroptosis in adriamycin resistant K562/ADR cells through Nrf2/HO-1 signaling pathway / 肿瘤

Objective:To investigate the effect of luteolin(Lut)on the proliferation and ferroptosis of human adriamycin(ADR)resistant chronic myeloid leukemia(CML)K562/ADR cells and the underlying molecular mechanism. Methods:K562 and K562/ADR cells were treated with different concentrations of ADR.The sensitivity of K562 and K562/ADR cells to ADR was evaluated by CCK-8 assay;the effect of different concentrations of Lut on the proliferation of K562/ADR cells was assessed by CCK-8 assay,and the half inhibitory concentration(IC50)was calculated for subsequent experiments;the morphological changes of the cells were observed by an inverted microscope;CCK-8 assay was used to examine the sensitizing effect of Lut on ADR;FCM assay was used to study the effect of Lut on the apoptosis of K562/ADR cells;fluorescence probe DCFH-DA,Fe2+colorimetric assay and glutathione(GSH)kit were used to detect the content of reactive oxygen species(ROS),Fe2+and GSH in K562/ADR cells,respectively;Western blotting was used to examine the expression levels of glutathione peroxidase 4(GPX4),nuclear factor erythroid 2-related factor 2(Nrf2)and heme oxygenase-1(HO-1)in K562/ADR cells;the effects of Lut on the proliferation of K562/ADR cells,ROS content,GSH content,Fe2+content and GPX4 expression were studied after treatment with ferroptosis inhibitor Ferrostatin-1(Fer-1). Results:Compared with control group(cells treated with 0 μmol/L Lut),Lut significantly inhibited the proliferation of K562/ADR cells(P＜0.001),improved the chemosensitivity of K562/ADR cells to ADR(P＜0.05),increased apoptosis rate(P＜0.001)and ROS level(P＜0.05)of K562/ADR cells,reduced the GSH level(P＜0.001),and increase Fe2+content(P＜0.01).Compared with control group(cells treated with 0 μmol/L Lut),the protein expressions of GPX4,Nrf2 and HO-1 decreased with the increase of Lut concentration(P＜0.05).Compared with the Lut treatment alone,the inhibitory effect on the proliferation of K562/ADR cells induced by Lut was partially restored by Fer-1 intervention(P＜0.05),and intracellular ROS level was decreased(P＜0.001),GSH level was increased(P＜0.001),Fe2+content was decreased(P＜0.001)and the expression of GPX4 was increased(P＜0.01)in K562/ADR cells. Conclusion:Lut can inhibit the proliferation of K562/ADR cells through ferroptosis pathway,improve the chemosensitivity to ADR,and the potential mechanism may be related to the Nrf2/HO-1 signaling pathway,which provides experimental basis for the treatment of leukemia by ferroptosis.

A longitudinal study of trajectories of change in benefit finding among family caregivers of patients with lung cancer / 中国实用护理杂志

Objective:To explore the change trajectory and influencing factors of benefit finding of family caregivers of patients with lung cancer, so as to provide reference for formulating individualized intervention strategies.Methods:This study was a cross-sectional survey. From September 2021 to October 2022, 232 family caregivers of patients with lung cancer from General Hospital of PLA Central Theater Command and Tianyou Hospital affiliated to Wuhan University of Science and Technology were collected by convenience sampling method. The level of benefit finding of family caregivers was investigated at 1 month, 3 months and 6 month, after the patients were diagnosed. Growth Mixture Model was applied to identify distinct trajectory categories. Multinomial Logistic regressions were performed to analyze predictors of trajectory categories.Results:The overall level of benefit finding of family caregivers of lung cancer patients showed an upward trend over time ( F=83.06, P<0.01), from 1 month (47.02 ± 14.79) to 6 months (58.13 ± 13.18). Three categories of benefit finding trajectories were identified, named as "the high level-decline group" 12 cases, "the moderate level-stability group" 67 cases, and "the low level-elevation group" 153 cases. Univariate analysis showed that age and education level of family caregivers, average income per person in patient family, type of medical payment, whether the tumor was metastasized, the treatment method of the patient, whether they lived with the patient, and whether they had co-caregivers were related to the category of benefit finding trajectory ( χ2 values were 6.71-15.05, all P<0.05). Multivariate Logistic regression analysis showed that age and education level of family caregivers, average income per person in patient family, treatment method of the patient and whether they lived with the patients were the main influencing factors of benefit finding trajectory categories(all P<0.05). Conclusions:The benefit finding of family caregivers of lung cancer patients showed different trajectories with the time of diagnosis, and the overall level shows an upward trend. More than half of the family caregivers belong to the low level-elevation group. Medical staff should give family caregivers stage and specific nursing intervention according to the change trajectory of benefit finding and its influencing factors.

Study on the mechanism of luteolin reversing multidrug resistance in leukemia K562/ADR cells / 天津医药

Objective To investigate the mechanism of luteolin's(Lut)reversal effect on multidrug resistance of chronic myeloid leukemia K562/ADR cells.Methods CCK-8 assay was used to detect drug resistance in K562 and K562/ADR cells 24 hours after treatment with different doses of adriamycin(ADR).CCK-8 assay was used to assess the cytotoxicity and sensitizing effect of Lut on ADR after K562/ADR cells were treated with Lut alone or in combination with ADR for 24 hours.K562/ADR cells in logarithmic growth phase were separated into three group:0μmol/L Lut,2μmol/L and 4μmol/L Lut groups.ADR accumulation in cells was measured using flow cytometry.Nuclear factor erythroid-2-related factor 2(Nrf2),multidrug resistance associated protein 1(MRP1),P-glycoprotein(P-gp)and glutathione-S-transferase-PI(GST-pi)mRNA and protein expressions were identified using RT-PCR and Western blot assay.Glutathione(GSH)kit was used to detect intracellular GSH content.Results Compared with K562 cells,K562/ADR cell line was significantly resistant to ADR,and the drug resistance was 53.69 times.K562/ADR cell proliferation was decreased to variable degrees by different doses of Lut when compared to the 0μmol/L Lut group(P＜0.05).The proliferation inhibition rates of K562/ADR cells treated with 2 and 4μmol/L Lut were less than 10%,indicating that the concentration of Lut was non-toxic.Compared with the 0 μmol/L Lut group,the 2 μmol/L Lut group and the 4 μmol/L Lut group showed significantly increased ADR growth inhibition rate on K562/ADR and increased accumulation of ADR in cells,improved the reversal resistance fold,and decreased GSH content in cells.MRP1,P-gp,GST-pi and Nrf2 mRNA and protein expression were reduced in cells(P＜0.05).The effect of 4 mol/L Lut was greater than that of 2 mol/L Lut.Conclusion Lut may decrease K562/ADR cell proliferation and reverse ADR medication resistance.The mechanism could be connected to the downregulation of Nrf2,MRP1,P-gp and GST-pi expression,which leads to an increase in ADR accumulation in K562/ADR cells.

Global spatiotemporal trends and determinants of COVID-19 vaccine acceptance on Twitter: a multilingual deep learning study in 135 countries and territories

BackgroundCOVID-19 vaccination has faced a range of challenges from supply-side barriers such as insufficient vaccine supply and negative information environment and demand-side barriers centring on public acceptance and confidence in vaccines. This study assessed global spatiotemporal trends in demand- and supply-side barriers to vaccine uptake using COVID-19-related social media data and explored the country-level determinants of vaccine acceptance. MethodsWe accessed a total of 13,093,406 tweets sent between November 2020 and March 2022 about the COVID-19 vaccine in 90 languages from 135 countries using Meltwater(R) (a social listening platform). Based on 8,125 manually-annotated tweets, we fine-tuned multilingual deep learning models to automatically annotate all 13,093,406 tweets. We present spatial and temporal trends in four key spheres: (1) COVID-19 vaccine acceptance; (2) confidence in COVID-19 vaccines; (3) the online information environment regarding the COVID-19 vaccine; and (4) perceived supply-side barriers to COVID-19 vaccination. Using univariate and multilevel regressions, we evaluated the association between COVID-19 vaccine acceptance on Twitter(R) and (1) country-level characteristics regarding governance, pandemic preparedness, trust, culture, social development, and population demographics; (2) country-level COVID-19 vaccine coverage; and (3) Google(R) search trends on adverse vaccine events. FindingsCOVID-19 vaccine acceptance was high among Twitter(R) users in Southeast Asian, Eastern Mediterranean, and Western Pacific countries, including India, Indonesia, and Pakistan. In contrast, acceptance was relatively low in high-income nations like South Korea, Japan, and the Netherlands. Spatial variations were correlated with country-level governance, pandemic preparedness, public trust, culture, social development, and demographic determinants. At the country level, vaccine acceptance sentiments expressed on Twitter(R) predicted higher vaccine coverage. We noted the declining trend of COVID-19 vaccine acceptance among global Twitter(R) users since March 2021, which was associated with increased searches for adverse vaccine events. Interpretation In future pandemics, new vaccines may face the potential low-level and declining trend in acceptance, like COVID-19 vaccines, and early responses are needed. Social media mining represents a promising surveillance approach to monitor vaccine acceptance and can be validated against real-world vaccine uptake data. FundingNational Natural Science Foundation of China.

Research progress of ferroptosis in the treatment of leukemia / 国际肿瘤学杂志

Leukemia is a group of hematologic malignancie. Ferroptosis is a novel of cell death caused by iron-dependent lipid peroxidation accumulation, which participates in the occurrence and development of leukemia. Activation of different regulatory sites in the ferroptosis pathway can promote the death of leukemia cells. Therefore, it can provide a new direction for the treatment of leukemia by inducing ferroptosis of cells.

Posterior circulation ischemic stroke: emergency diagnosis errors and improvement strategies / 国际脑血管病杂志

Posterior circulation ischemic stroke (PCIS) is caused by the infarction of the blood supply area of vertebrobasilar artery system, accounting for about 20% of all ischemic strokes. The clinical manifestations of PCIS are different and usually lack specificity. The commonly used pre-hospital stroke scale can not fully reflect signs and symptoms of PCIS, and even imaging examination is not easy to detect PCIS. As a result, it is difficult to correctly identify PCIS in the early stage in emergency settings, and the rates of misdiagnosis and missed diagnosis are significantly higher than those of the anterior circulation ischemic stroke. Early and correct identification of PCIS is of great significance to improve the prognosis of patients. By summarizing the relevant literature at home and abroad, this article discusses the diagnostic error factors of PCIS in emergency room from different angles, and summarizes the strategies and methods to improve the speed and accuracy of PCIS recognition and early management.

Pure drug nano-assemblies: A facile carrier-free nanoplatform for efficient cancer therapy

Nanoparticulate drug delivery systems (Nano-DDSs) have emerged as possible solution to the obstacles of anticancer drug delivery. However, the clinical outcomes and translation are restricted by several drawbacks, such as low drug loading, premature drug leakage and carrier-related toxicity. Recently, pure drug nano-assemblies (PDNAs), fabricated by the self-assembly or co-assembly of pure drug molecules, have attracted considerable attention. Their facile and reproducible preparation technique helps to remove the bottleneck of nanomedicines including quality control, scale-up production and clinical translation. Acting as both carriers and cargos, the carrier-free PDNAs have an ultra-high or even 100% drug loading. In addition, combination therapies based on PDNAs could possibly address the most intractable problems in cancer treatment, such as tumor metastasis and drug resistance. In the present review, the latest development of PDNAs for cancer treatment is overviewed. First, PDNAs are classified according to the composition of drug molecules, and the assembly mechanisms are discussed. Furthermore, the co-delivery of PDNAs for combination therapies is summarized, with special focus on the improvement of therapeutic outcomes. Finally, future prospects and challenges of PDNAs for efficient cancer therapy are spotlighted.

Screening strategy on precision prevention strategies for three types of malignant tumors / 上海预防医学

Malignant tumors can be classified into three categories， rapidly progressing tumors， slowly progressing tumors， and "indolent" tumors. Rapidly progressing tumors （such as liver cancer， pancreatic cancer， and cholangiocarcinoma） have acute onset， shorter time duration from onset to death， and poorer treatment effects， which warrants primary prevention. Slowly progressing tumors （such as lung cancer， colorectal cancer， breast cancer， and gastric cancer） have slow onset， clear precancerous lesions， longer time duration from onset to death， and better therapeutic effects， which is accordingly suitable for secondary prevention. “Indolent” tumors （such as prostate and thyroid cancer） do not affect the life expectancy and are suitable for tertiary prevention. Early screening of “indolent” tumors may lead to overtreatment. Furthermore， early screening of rapidly progressing tumors is difficult to identify early cancers， which results in low cost-effectiveness. In contrast， for slowly progressing tumors suitable for secondary prevention， early screening may have cost-effectiveness， though there might be over-diagnosis. It is crucial to adopt appropriate prevention and treatment strategies for diverse types of tumors. Currently， large-scale cohort studies and randomized controlled clinical trials with complete follow-up may accurately evaluate the effect of cancer prevention strategies. This review discusses the significance of screening in precision prevention of tumors based on the characteristics of tumor progression and patients’ prognosis.

Monitoring global trends in Covid-19 vaccination intention and confidence: a social media-based deep learning study

BackgroundThis study developed deep learning models to monitor global intention and confidence of Covid-19 vaccination in real time. MethodsWe collected 6.73 million English tweets regarding Covid-19 vaccination globally from January 2020 to February 2021. Fine-tuned Transformer-based deep learning models were used to classify tweets in real time as they relate to Covid-19 vaccination intention and confidence. Temporal and spatial trends were performed to map the global prevalence of Covid-19 vaccination intention and confidence, and public engagement on social media was analyzed. FindingsGlobally, the proportion of tweets indicating intent to accept Covid-19 vaccination declined from 64.49% on March to 39.54% on September 2020, and then began to recover, reaching 52.56% in early 2021. This recovery in vaccine acceptance was largely driven by the US and European region, whereas other regions experienced the declining trends in 2020. Intent to accept and confidence of Covid-19 vaccination were relatively high in South-East Asia, Eastern Mediterranean, and Western Pacific regions, but low in American, European, and African regions. 12.71% tweets expressed misinformation or rumors in South Korea, 14.04% expressed distrust in government in the US, and 16.16% expressed Covid-19 vaccine being unsafe in Greece, ranking first globally. Negative tweets, especially misinformation or rumors, were more engaged by twitters with fewer followers than positive tweets. InterpretationThis global real-time surveillance study highlights the importance of deep learning based social media monitoring to detect emerging trends of Covid-19 vaccination intention and confidence to inform timely interventions. FundingNational Natural Science Foundation of China. Research in contextO_ST_ABSEvidence before this studyC_ST_ABSWith COVID-19 vaccine rollout, each country should investigate its vaccination intention in local contexts to ensure massive vaccination. We searched PubMed for all articles/preprints until April 9, 2021 with the keywords "("Covid-19 vaccines"[Mesh] OR Covid-19 vaccin*[TI]) AND (confidence[TI] OR hesitancy[TI] OR acceptance[TI] OR intention[TI])". We identified more than 100 studies, most of which are country-level cross-sectional surveys, and the largest global survey of Covid-19 vaccine acceptance only covered 32 countries to date. However, how Covid-19 vaccination intention changes over time remain unknown, and many countries are not covered in previous surveys yet. A few studies assessed public sentiments towards Covid-19 vaccination using social media data, but only targeting limited geographical areas. There is a lack of real-time surveillance, and no study to date has globally monitored Covid-19 vaccination intention in real time. Added value of this studyTo our knowledge, this is the largest global monitoring study of Covid-19 vaccination intention and confidence with social media data in over 100 countries from the beginning of the pandemic to February 2021. This study developed deep learning models by fine-tuning a Bidirectional Encoder Representation from Transformer (BERT)-based model with 8000 manually-classified tweets, which can be used to monitor Covid-19 vaccination beliefs using social media data in real time. It achieves temporal and spatial analyses of the evolving beliefs to Covid-19 vaccines across the world, and also an insight for many countries not yet covered in previous surveys. This study highlights that the intention to accept Covid-19 vaccination have experienced a declining trend since the beginning of the pandemic in all world regions, with some regions recovering recently, though not to their original levels. This recovery was largely driven by the US and European region (EUR), whereas other regions experienced the declining trends in 2020. Intention to accept and confidence of Covid-19 vaccination were relatively high in South-East Asia region (SEAR), Eastern Mediterranean region (EMR), and Western Pacific region (WPR), but low in American region (AMR), EUR, and African region (AFR). Many AFR countries worried more about vaccine effectiveness, while EUR, AMR, and WPR concerned more about vaccine safety (the most concerns with 16.16% in Greece). Online misinformation or rumors were widespread in AMR, EUR, and South Korea (12.71%, ranks first globally), and distrust in government was more prevalent in AMR (14.04% in the US, ranks first globally). Our findings can be used as a reference point for survey data on a single country in the future, and inform timely and specific interventions for each country to address Covid-19 vaccine hesitancy. Implications of all the available evidenceThis global real-time surveillance study highlights the importance of deep learning based social media monitoring as a quick and effective method for detecting emerging trends of Covid-19 vaccination intention and confidence to inform timely interventions, especially in settings with limited sources and urgent timelines. Future research should build multilingual deep learning models and monitor Covid-19 vaccination intention and confidence in real time with data from multiple social media platforms.

The psychological status of 8817 hospital workers during COVID-19 Epidemic: A cross-sectional study in Chongqing.

BACKGROUND: There was an outbreak of COVID-19 towards the end of 2019 in China, which spread all over the world rapidly. The Chinese healthcare system is facing a big challenge where hospital workers are experiencing enormous psychological pressure. This study aimed to (1) investigate the psychological status of hospital workers and (2) provide references for psychological crisis intervention in the future. METHOD: An online survey was conducted to collect sociodemographic features, epidemic-related factors, results of PHQ-9, GAD-7, PHQ-15, suicidal and self-harm ideation (SSI), and the score of stress and support scales. Chi-square test, t-test, non-parametric, and logistic regression analysis were used to detect the risk factors to psychological effect and SSI. RESULTS: 8817 hospital workers participated in this online survey. The prevalence of depression, anxiety, somatic symptoms, and SSI were 30.2%, 20.7%, 46.2%, and 6.5%, respectively. Logistic regression analysis showed that female, single, Tujia minority, educational background of junior or below, designated or county hospital, need for psychological assistance before or during the epidemic, unconfident about defeating COVID-19, ignorance about the epidemic, willingness of attending parties, and poor self-rated health condition were independent factors associated with high-level depression, somatic symptom, and SSI among hospital workers (P<0.05). LIMITATIONS: This cross-sectional study cannot reveal the causality, and voluntary participation could be prone to selection bias. A modified epidemic-related stress and support scale without standardization was used. The number of hospital workers in each hospital was unavailable. CONCLUSION: There were a high level of psychological impact and SSI among hospital workers, which needed to be addressed. County hospital workers were more severe and easier to be neglected. More studies on cognitive and behavioral subsequence after a public health disaster among hospital workers are needed.

Assessment of public attention, risk perception, emotional and behavioural responses to the COVID-19 outbreak: social media surveillance in China

BackgroundUsing social media surveillance data, this study aimed to assess public attention, risk perception, emotion, and behavioural response to the COVID-19 outbreak in real time. MethodsWe collected data from most popular social medias: Sina Weibo, Baidu search engine, and Ali e-commerce marketplace, from 1 Dec 2019 to 15 Feb 2020. Weibo post counts and Baidu searches were used to generate indices assessing public attention. Public intention and actual adoption of recommended protection measures or panic buying triggered by rumours and misinformation were measured by Baidu and Ali indices. Qualitative Weibo posts were analysed by the Linguistic Inquiry and Word Count text analysis programme to assess public emotion responses to epidemiological events, governments announcements, and control measures. FindingsWe identified two missed windows of opportunity for early epidemic control of the COVID-19 outbreak, one in Dec 2019 and the other between 31 Dec and 19 Jan, when public attention was very low despite the emerging outbreak. Delayed release of information ignited negative public emotions. The public responded quickly to government announcements and adopted recommended behaviours according to issued guidelines. We found rumours and misinformation regarding remedies and cures led to panic buying during the outbreak, and timely clarification of rumours effectively reduced irrational behaviour. InterpretationSocial media surveillance can enable timely assessments of public reaction to risk communication and epidemic control measures, and the immediate clarification of rumours. This should be fully incorporated into epidemic preparedness and response systems. FundingNational Natural Science Foundation of China.

Optimal blood pressure during peri-thrombolysis period of acute ischemic stroke / 中华神经医学杂志

Objective:To explore the influence of blood pressure during peri-thrombolysis period (from admission to 24 h after thrombolysis) in intracranial hemorrhage, improvement of neurological function, primary endpoint event (recurrence of symptomatic stroke) and secondary endpoint events (complex cardiovascular and cerebrovascular events, and all-cause death) in patients with acute ischemic stroke.Methods:A total of 422 patients with acute ischemic stroke who underwent intravenous thrombolysis with alteplase during hospitalization at National Center for Stroke in Lianyungang from January 2015 to March 2019 were followed up for 90 d. According to the quintile of mean systolic and diastolic blood pressures during peri-thrombolysis period, they were divided into group of blood pressure <130.00 mmHg (Q1), group of blood pressure of 130.00-140.49 mmHg (Q2), group of blood pressure of 140.50-147.99 mmHg (Q3), group of blood pressure of 148.00-158.00 mmHg (Q4), and group of blood pressure >158.00 mmHg (Q5), and group of blood pressure <71.30 mmHg (G1), group of blood pressure of 71.30-76.19 mmHg (G2), group of blood pressure of 76.20-81.89 mmHg (G3), group of blood pressure of 81.90-90.79 mmHg (G4), group of blood pressure >90.79 mmHg (G5). Univariate and multivariate Logistic regression analyse were used to evaluate the relations of blood pressure with postoperative intracranial hemorrhage and neurological function improvement. Kaplan-Meier curve, Log-rank test and multivariate Cox proportional risk model were used to evaluate the relations of blood pressure with primary endpoint event and secondary endpoint events.Results:(1) After adjusting for confounding factors, multivariate Logistic regression analysis showed that the risk of postoperative intracranial hemorrhage in patients from Q2 was significantly lower than that in patients from Q5 ( OR= 0.160, 95%CI: 0.031-0.827, P=0.029). (2) After adjusting for confounding factors, multivariate Logistic regression analysis showed that the probability of postoperative improvement of nerve function in patients from Q2 and Q3 was significantly higher than that in patients from Q5 ( OR=2.144, 95%CI: 1.043-4.407, P=0.038; OR=2.224, 95%CI: 1.105-4.479, P=0.025); the probability of postoperative improvement of nerve function in patients from G3 and G4 was significantly higher than that in patients from G5 ( OR= 2.153, 95%CI: 1.081-4.287, P=0.029; OR=2.182, 95%CI: 1.131-4.210, P=0.020). (3) After adjusting for confounding factors, multivariate Cox proportional risk model showed that the risk of primary endpoint event in patients from Q1 and Q2 was significantly lower than that in patients from Q5 ( HR=0.079, 95%CI: 0.010-0.613, P=0.015; HR=0.211, 95%CI: 0.062-0.724, P=0.013). (4) After adjusting for confounding factors, multivariate Cox proportional risk model showed that the risk of secondary endpoint events in patients from Q1, Q2, Q3 and Q4 was significantly lower than that in patients from Q5 ( HR=0.246, 95%CI: 0.100-0.607, P=0.002; HR=0.360, 95%CI: 0.177-0.732, P=0.005; HR=0.448, 95%CI: 0.246-0.817, P=0.009; HR=0.467, 95%CI: 0.252-0.867, P=0.016). Conclusion:The risks of postoperative intracranial hemorrhage, primary endpoint event and secondary endpoint events in patients with acute ischemic stroke decrease with the decrease of systolic blood pressure during peri-thrombolysis period; moderate blood pressures (systolic blood pressure: 130.00-147.99 mmHg; diastolic blood pressure:76.20-90.79 mmHg) are beneficial for improvement of neurological function.

The real experience of postoperative functional exercise in PICC patients: a qualitative research / 中国实用护理杂志

Objective@#To explore the real experience of functional exercise after PICC operation.@*Methods@#Phenomenological methods were used to conduct semi-structured interviews with 15 patients who had different functional exercises after PICC. Colaizzi phenomenological analysis was used to analyze the data.@*Results@#Through interviews, four themes were drawn: the exercise characteristics of different postoperative functional exercise, the benefits of postoperative functional exercise, the obstacles to postoperative functional exercise and the suggestions for education related to postoperative functional exercise.@*Conclusion@#The patients with PICC think that the postoperative functional exercise is safe and practical, but the recognition and compliance of the postoperative functional exercise are still limited. It is suggested that appropriate training should be carried out among medical staff, so as to rationally select the way of postoperative functional exercise, further promote the application of postoperative functional exercise, and improve the compliance and experience of patients.

The real experience of postoperative functional exercise in PICC patients: a qualitative research / 中国实用护理杂志

Objective:To explore the real experience of functional exercise after PICC operation.Methods:Phenomenological methods were used to conduct semi-structured interviews with 15 patients who had different functional exercises after PICC. Colaizzi phenomenological analysis was used to analyze the data.Results:Through interviews, four themes were drawn: the exercise characteristics of different postoperative functional exercise, the benefits of postoperative functional exercise, the obstacles to postoperative functional exercise and the suggestions for education related to postoperative functional exercise.Conclusion:The patients with PICC think that the postoperative functional exercise is safe and practical, but the recognition and compliance of the postoperative functional exercise are still limited. It is suggested that appropriate training should be carried out among medical staff, so as to rationally select the way of postoperative functional exercise, further promote the application of postoperative functional exercise, and improve the compliance and experience of patients.

Investigation on the acceptance of a mobile nursing application of clinical nurses and analysis of influencing factors / 中国实用护理杂志

Objective:To investigate the status quo of a mobile nursing application acceptance of nurses, and analyze the influencing factors, so as to promote the application of a mobile nursing APP in clinic.Methods:On the principle of convenience sampling, 1207 participants from Shandong province were recruited to complete the self-designed questionnaire, including demographic data, smartphone use behavior and acceptance evaluation of the mobile nursing APP.Results:Average score of nurses' acceptance of a mobile nursing APP was 4.16±0.69. Multiple regression results showed that duty, use experience, recognition, smartphone self-efficacy and daily use time were the main factors affecting the acceptance of a mobile nursing APP for nurses ( t value was -7.132-22.678, P<0.05 or 0.01) and explained 39.1% of the total variation of the acceptance of mobile nursing app ( P<0.01). Conclusions:The acceptability of mobile nursing APP of clinical nurses is at a medium and high level, and it is influenced by the use experience, smartphone self-efficacy and other aspects, suggesting that nursing managers attach importance to the behavioral differences of nurses in using a mobile nursing APP.

Impact of socioeconomic status on healthy sports behaviors among minority college students / 中国学校卫生

Objective@#To explore the impact of socioeconomic status on minority college students’ healthy sports behaviors, and to provide guidance for improving physical fitness among minority college students.@*Methods@#Binary Logistic regression and path analysis were used to analyze the path and effect of socioeconomic status on minority college students’ healthy sports behaviors, controlled for health status, academic pressure, sports attitude, sports venues, sports skills and health knowledge.@*Results@#Socioeconomic status was positively associated with students’ healthy sports behaviors (OR>1). With the potential variables controlled, the odds of participating in healthy sports activity among urban students, sophomores and female students was 2.10, 2.60 and 0.59 times higher than that of rural students, freshman and male students. Path analysis showed that the direct effect of socio-economic status on minority college students’ healthy sports behavior was 0.07, the indirect effect was 0.16, and the total effect was 0.23.@*Conclusion@#Socioeconomic status shows direct and indirect effect on healthy sports behaviors among college students, with the indirect effect being larger than direct effect. Apart from socioeconomic status, physical fitness education, as well as creating and maintaining a good physical exercise environment by schools and society should be encouraged to facilitate college students establishing healthy sports behaviors.