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Background There were 28.76 million stroke patients in China, with 3.94 million new strokes annually. Around 70% of survivors live with varying degrees of permanent disability, placing a heavy burden on families and society. Stroke patients have a complex and high need for continuing care services after discharge from the hospital. The study was to evaluate the effectiveness of the continuing care program on the activity of daily life, the degree of disability, stroke recurrence and readmission in patients with stroke, based on the long-term care insurance policy. Methods Eighty-eight stroke patients were recruited from February 2021 to January 2022. They were allocated to either intervention group (N = 44) or control group (N = 44) based on whether the long-term care insurance application was successful. The intervention consisted of discharge education, 3-month in-home care and remote counseling. The activity of daily life, disability, recurrence and readmission of patients were evaluated between the groups before the intervention, at 1, 2, 3 and 6 months after discharge. Results There were no statistically significant differences between the groups in clinical characteristics at baseline. We detected significant interaction effects between time and group (p χ2 = 6.040, p = 0.014; χ2 = 7.216, p = 0.007) at 1 and 2 months after discharge, but no significant difference was found at 3 and 6 months after discharge. At follow-up, there was no significant difference between groups regarding stroke recurrence rates (p > 0.05). Conclusions This study demonstrates the positive effects of a continuing care program based on the long-term care insurance policy on activity of daily life and disability in people with stroke. The effectiveness and feasibility of this intervention program suggest that its application should be promoted to promote the care and rehabilitation of stroke patients. Trail registration: The trail was not registered as a quasi-experimental trail.

Aims Pre-hospital delay refers to the time span from the onset of symptoms to arrival at a hospital ≥ 3 h and is the main limitation of stroke reperfusion therapies. Family factors and stroke-related stigma may influence pre-hospital delay. However, few studies have confirmed the influence of stigma on pre-hospital delay or explored the relationships between family function, stigma, and pre-hospital delay among patients with recurrent stroke. This study aimed to explore the relationship between family function and pre-hospital delay among patients with recurrent stroke and examine the mediation role of stigma in this relationship. Methods and results A cross-sectional study was performed at the neurology departments of two hospitals in Guangzhou, China between July 2021 and April 2022. A total of 115 patients with recurrent stroke completed questionnaires and were included in the analysis. Data were collected using the Short Form Family Assessment Device, the Stroke Stigma Scale, and the Stroke Knowledge Questionnaire. Spearman’s correlation and a structural equation model were used for data analysis. Family function directly influenced pre-hospital delay [β=0.27, P = 0.033, 95%CI = (0.02–0.51)] and indirectly influenced pre-hospital delay [β=0.17, P = 0.038, 95%CI = (0.02–0.34)] through stigma. Moreover, stigma partially mediated the effect of family function on pre-hospital delay. Conclusion Family function and stigma directly and indirectly influenced pre-hospital delay among patients with recurrent stroke. Future health education and interventions need to focus on strengthening and improving emotional support from family members to improve family function and reduce stigma, thereby reducing pre-hospital delay among patients with recurrent stroke.

BACKGROUND: Patients with hypertension are at a high risk for stroke, but a healthy lifestyle can greatly reduce the risk of stroke. However, there has been no research on the change in prestroke health behaviors in Chinese patients with hypertensive stroke over a decade. OBJECTIVES: The aims of this study were to determine whether prestroke health behaviors of patients with hypertensive stroke changed over a decade and to explore the predictors of prestroke health behaviors over a decade. METHODS: This study used data from 2 cross-sectional studies conducted in the neurology departments of 3 hospitals in Guangzhou, China. In total, 110 hypertensive stroke patients were recruited in stage I (2008-2009), and 119 hypertensive stroke patients were recruited in stage II (2018-2019). Patients' stroke knowledge was measured by the Stroke Knowledge Questionnaire. Patients' prestroke health behavior was measured by the Health Behavior Scale for Stroke Patients. RESULTS: The total score of prestroke health behaviors significantly increased over the decade (P < .001), but the scores of the subcategories of low-fat diet, low-sugar diet, and blood pressure checkups decreased over the decade (P < .05). Stroke knowledge was a significant predictor of prestroke health behaviors in stage I (P < .05). Besides stroke knowledge, sex and age were significant predictors of prestroke health behaviors in stage II (P < .05). CONCLUSIONS: Prestroke health behaviors of hypertensive stroke patients significantly improved over the decade. Moreover, prestroke health behaviors were significantly influenced by stroke-related knowledge over the decade. Healthcare providers should focus in particular on assisting patients who are male, young, and middle-aged, and lack stroke-related knowledge to improve their prestroke health behaviors, especially in terms of adherence to a low-fat/low-sugar diet and regular blood pressure checks.

The effect of carburization and reduction degree on H2O oxidation behaviour for the iron carbides in Fe-based FTS catalyst were firstly investigated using a combination method including X-ray diffraction (XRD), Raman and temperature-programmed-hydrogenation (TPH). The relationship between carbon species transformation and H2O oxidation behaviour of iron carbides was investigated simultaneously. Based on these observations, the influence of typical promoters like K and SiO2 on the structure and H2O oxidation behaviour of Fe-based FTS catalysts was further studied. The results indicated that, for the iron catalyst, the stability of iron carbides against H2O oxidation was increased with the increase of iron carbides content, and the H2O oxidation process led to the formation of more graphitic carbon. The carburization ability was effectively enhanced when certain amount of K promoter was incorporated. Addition of K into Fe-based FTS catalyst increased the number of graphitic carbons, which increased the stability of iron carbides toward H2O oxidation ultimately. It was also found that promotion of SiO2 greatly degraded the carburization degree of the catalyst, while their tendency to be oxidized to form Fe3O4 in the H2O atmosphere was obviously hindered.

Genomic sequencing analysis of tumors provides potential molecular therapeutic targets for precision medicine. However, identifying a key driver gene or mutation that can be used for hepatocellular carcinoma (HCC) treatment remains difficult. Here, we performed whole-exome sequencing on genomic DNA obtained from six pairs of HCC and adjacent tissues and identified two novel somatic mutations of UBE2S (p. Gly57Ala and p. Lys63Asn). Predictions of the functional effects of the mutations showed that two amino-acid substitutions were potentially deleterious. Further, we observed that wild-type UBE2S, especially in the nucleus, was significantly higher in HCC tissues than that in adjacent tissues and closely related to the clinicopathological features of patients with HCC. Functional assays revealed that overexpression of UBE2S promoted the proliferation, invasion, metastasis, and G1/S phase transition of HCC cells in vitro, and promoted the tumor growth significantly in vivo. Mechanistically, UBE2S interacted with TRIM28 in the nucleus, both together enhanced the ubiquitination of p27 to facilitate its degradation and cell cycle progression. Most importantly, the small-molecule cephalomannine was found by a luciferase-based sensitive high-throughput screen (HTS) to inhibit UBE2S expression and significantly attenuate HCC progression in vitro and in vivo, which may represent a promising strategy for HCC therapy.

BackgroundSomatic mutations are involved in hepatocellular carcinoma (HCC) progression, but the genetic mechanism associated to hepatocarcinogenesis remains poorly understood. We report that Eyes absent homolog 2 (EYA2) suppresses the HCC progression, while EYA2(A510E) mutation identified by exome sequencing attenuates the tumor-inhibiting effect of EYA2.MethodsWhole-exome sequencing was performed on six pairs of human HCC primary tumors and matched adjacent tissues. Focusing on EYA2, expression level of EYA2 in human HCC samples was evaluated by quantitative real-time PCR, western blot and immunohistochemistry. Loss- and gain-of-function studies, hepatocyte-specific deletion of EYA2 (Eya2−/−) in mice and RNA sequencing analysis were used to explore the functional effect and mechanism of EYA2 on HCC cell growth and metastasis. EYA2 methylation status was evaluated using Sequenom MassARRAY and publicly available data analysis.ResultsA new somatic mutation p.Ala510Glu of EYA2 was identified in HCC tissues. The expression of EYA2 was down-regulated in HCC and associated with tumor size (P = 0.001), Barcelona Clinic Liver Cancer stage (P = 0.016) and tumor differentiation (P = 0.048). High level of EYA2 was correlated with a favorable prognosis in HCC patients (P = 0.003). Results from loss-of-function and gain-of-function experiments suggested that knockdown of EYA2 enhanced, while overexpression of EYA2 attenuated, the proliferation, clone formation, invasion, and migration of HCC cells in vitro. Delivery of EYA2 gene had a therapeutic effect on inhibition of orthotopic liver tumor in nude mice. However, EYA2(A510E) mutation led to protein degradation by unfolded protein response, thus weakening the inhibitory function of EYA2. Hepatocyte-specific deletion of EYA2 in mice dramatically promoted diethylnitrosamine-induced HCC development. EYA2 was also down-regulated in HCC by aberrant CpG methylation. Mechanically, EYA2 combined with DACH1 to transcriptionally regulate SOCS3 expression, thus suppressing the progression of HCC via SOCS3-mediated blockade of the JAK/STAT signaling pathway.ConclusionsIn our study, we identified and validated EYA2 as a tumor suppressor gene in HCC, providing a new insight into HCC pathogenesis.

Background. An increasing number of systematic reviews/meta-analyses (SRs/MAs) of clinical trials have begun to investigate the effects of traditional Chinese medicine (TCM) nursing in patients with stroke. To systematically appraise and synthesize these results, we conducted an overview of SRs/MAs. Methods. Eight databases from their inception to April 2020 were searched to include all SRs/MAs on TCM nursing for stroke. Methodological quality assessment was performed using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) and evidence quality assessment was performed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results. Eleven SRs/MAs regarding TCM nursing for stroke were included. The assessments with AMSTAR-2 indicated that the methodological quality of all included SRs/MAs was critically low. According to the evaluation results of GRADE, 10 (40%) outcomes were rated as critically low-quality evidence, 7 (28%) low-quality evidence, and 8 (32%) moderate-quality evidence. Descriptive analysis results showed that TCM nursing was effective for stroke. Conclusions. All included SRs/MAs suggested positive findings of TCM nursing for stroke, but the credibility of the results is limited. Studies with methodologically rigorous and adequately powered are still needed in this field.

Background Dysphagia is common after stroke. Patients with dysphagia have a higher risk of stroke-associated pneumonia (SAP) and poor outcomes. Early detection of dysphagia is necessary to identify and manage patients at high risk of aspiration. The aim of the study was to assess the impact of the systematic administration of the volume-viscosity swallow test (V-VST) in patients with acute ischaemic stroke. Methods This was a retrospective observational study that enrolled patients with acute ischaemic stroke in two consecutive time periods: pre-V-VST, when the 30-mL water-swallowing test (WST) was systematically administered, and V-VST, when all patients underwent the WST and the V-VST test was systematically administered if the patient failed the WST. Results Two hundred and 42 patients were enrolled. The mean age of the participants was 68.8 ± 10.88 years, 61.2% were male, and the median National Institutes of Health Stroke Scale score was 3 (IQR, 1–6). A total of 147 patients were enrolled during the pre-V-VST period and 95 were enrolled during the V-VST period. There was a significant difference in the occurrence of SAP (21.8% vs. 10.5%, p = 0.024) and the rate of nasogastric tube feeding (25.9% vs. 14.7%, p = 0.040) between the two groups, and no differences were found in the length of hospital stay (p = 0.277) or the total cost of hospitalization (p = 0.846). Conclusions The V-VST was a better clinical screening tool, and it can also provide detailed suggestions regarding dietary modifications to prevent aspiration and SAP.

It has been reported that zerumbone (ZER) has marked effects on the regulation of cell proliferation and migration in multiple types of cancer, and has anti-cancer effects on various types of malignant cell. However, the effects and underlying molecular mechanisms of treatment with ZER on melanoma cells remain unclear. In the present study, the effect of treatment with ZER on the proliferation, migration and mitochondrial function of the human melanoma cell line CHL-1 was investigated. The results of the present study indicated that treatment with ZER significantly inhibited CHL-1 cell proliferation (P

Bromate formation has been identified as a significant barrier in the application of ozone during water treatment the downstream region of the Pearl River Basin that contains high levels of bromide. Seawater intrusion will increase bromide concentration in the inshore surface water. In this study, seawater intrusion in the Pearl River Basin was surveyed and modeling bromate formation during ozonation of the raw water affected by seawater intrusion was studied. Bromate formation models were developed to simulate the effects of the characteristics of water quality and the operating parameters of treatment processes on bromate formation during preozonation process and postozonation process. The results show that the downstream of the Pearl River Basin is affected seriously by seawater intrusion and the bromide mainly comes from seawater. Some empirical models were developed to estimate the concentration of bromate in ozonated surface raw water affected by seawater intrusion during the treatment process.

To assess the efficacy of combining radioimmunoconjugate [(131)I] metuximab with radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) treatment compared with RFA alone, a single-center randomized controlled trial was conducted on 127 patients with Barcelona Clinic Liver Cancer staging system (BCLC) classifications of 0-B stage. Patients received either RFA followed by [(131)I] metuximab (n = 62) or RFA alone (n = 65). The primary outcome was overall tumor recurrence. Statistical tests were two-sided. The one- and two-year recurrence rates in the combination group were 31.8% and 58.5%, whereas those in the RFA group were 56.3% and 70.9%, respectively. The median time to overall tumor recurrence was 17 months in the combination group and 10 months in the RFA group (P = .03). The RFA-[(131)I] metuximab treatment showed a greater antirecurrence benefit than RFA in the metuximab target (ie, CD147)-positive subpopulation (P = .007). [(131)I] metuximab may yield prevention of tumor recurrence after RFA.

BP gets local minimization too easily and converges slowly and could not get the global optima. To solve these problems, this paper proposes GA-BP algorithm to predict the purity of vitamin E in obtaining the purity of vitamin E with molecular distillation. The genetic algorithm is applied to optimize the weights of BP neural network and the combination of the advantages of two arithmetic improves the response time efficiently and forecast precision. The simulation results show that this algorithm can get an ideal result on the both, so which has a high application value.

In order to deal with the defects of the poor convergences and easily immerging in partial minimum frequently, a new algorithm is proposed based on the combination of genetic algorithm and BP neural network, which is called GA- BP algorithm. This algorithm is applied to optimization of initial weights of BP Network, the structure and learn rule. It searches through the total solution space and can find the optimal solution globally over a domain. In this paper, GA- BP algorithm is applied to the production practice of molecular distillation to purify essential oils in schisandra chinensis. The result shows that this algorithm greatly increases convergent speed and convergence accuracy comparing with the simplex BP algorithm, and could achieve better results.

Xijiang River, the main stream of Pearl River Basin, suffered a lot from flood and the frequency and magnitude of flood increased obviously due to intensive human activities in recent years. In order to know the flood evolution law and its mechanism, hydrological variation diagnosis system was applied to analyze variation towards annual maximum peak flow and highest water level in middle reach of Xijiang River Basin. Hydrological variation diagnosis system is composed of three parts, namely primary diagnosis, detailed diagnosis and comprehensive diagnosis. It can solve the problems that single diagnosis method may give unreasonable result on occasion and the results of variant methods may be inconsistent. The results of variation diagnosis in Xijiang River shows that: annual maximum peak flow and highest water level mostly have medium jump at 1991 of Wuxuan, Dahuangjiangkou and Wuzhou station, which are located at mainstream. Except for a medium jump at 1993 of Taiping station, there are no variations or weak variations in tributary. The correlation analysis results indicate that water level closely relate to flood flow, thus flood flow variations lead to water level variations at mainstream. The consistent results of variations in mainstream and no variation in tributary reveal that the relationship of flood variation in mainstream are close, whereas floods in tributary have little influence on floods in mainstream. Analyses of physical causes show that climate change has little influence on flood variations in Xijiang River. Human activities have changed flood encounter of mainstream and tributary, laws of runoff yield and concentration, and flood returning channel. Thus, these are the main causes of flood variation in Xijiang River.

East River, one of the three main river networks of Pearl River Basin, runs through Jiangxi, Guangdong province and provides drinking water to Hongkong, thus it's great important for the water supply and flood control to the above three regions. Using Hydrological Variation Diagnosis System, the article diagnosed multi-time-scale runoff series from the year 1954 to 2005 of four main stations, namely Longchuan, Heyuan, Lingxia and Boluo station on the trunk stream of East River, so as to detect the variation relationship among series at the scale of month, flood season/non-flood season and year. It found out that: 1) the runoff series at month scale of the four stations mostly varied from April to May in flood season and from November to March of the next year in non-flood season, and the change-point mostly located around the year of 1973. The majority of series at month scale in flood season took on no variations, so the minority's variation didn't affect the variation status of the whole flood season, and the series at flood season scale took on no variation. While the majority of series in non-flood season varied, and they contributed a lot to the variation of the non-flood season series. 2) At Longchuan, Heyuan and Lingxia station, the variation situation at year scale was consistent with that at non-flood season scale, and the change-point located respectively in the year of 1972 and 1973, which indicated that the variation situation at non-flood season scale contributed a great deal to that at year scale for those three stations. But at Boluo Station downstream, the variation situation at year scale didn't accord with that at non-flood season scale. Causes analysis showed that no change-point was detected in the precipitation series in East River Basin, thus it contributed little to the variation of runoff series at different scale; while the possible causes would lie in the reservoir constructions (Fengshuba reservoir e.g.), the changes of land use and cover, levee constructions, riverbed undercutting and other human activities affecting the underlying surface.

To observe the effects of fasudil, a Rho/ROCK signaling pathways inhibitor, on adhesion, migration and proliferation of hepatic stellate cells (HSCs).Cultured HSCs were divided into 5 groups. Fasudil was added to 4 groups in a concentration of 12.5, 25, 50, and 100 micromol/L, respectively. A group without fasudil added served as untreated controls. The adhesive inhibition effect of fasudil on HSCs was examined by toluidine blue colorimetric assay, the inhibition of migration of HSCs was evaluated by a modified Boyden chamber, and cell proliferation was assessed by MTT assay. The protein levels of RhoA, p-MLC (Thr18/Ser19) and alpha-SMA were assayed by Western blot.Fasudil inhibited HSC adhesion, proliferation and LPA-induced migration in a concentration-dependent manner; the protein expressions of alpha-SMA and p-MLC (Thr18/Ser19) were significantly decreased in the presence of fasudil.Fasudil can inhibit HSC adhesion, migration and proliferation by suppressing the cytoskeleton regulation function of Rho/ROCK signaling pathways.

In view of basic BP network lower convergence rate and easily to sink into the partial minimum insufficiency, this paper combines GA with BP to establish the model. The model makes use of GA are powerful approaches to solve global optimization problems, and construct anagenesis neural networks model. Based on the characteristics of the purification of materials, this method about GA-BP network is proposed to predict the purification of materials, test results show that it has better local approximation and generalization capabilities when appropriate numbers and parameters of the GA-BP are chosen.

In order to obtain the optimum craft parameters and improve the product purity and yield,a new optimization design method based on NN and GA is proposed. The neural network is used to build the model of target function, namely, a mapping relationship from craft parameters to purity and yield is established. Taking many craft parameters(feed rate,vacuum, and temperature) as optimal variables, purity and yield as optimization target,the optimization model is build and advance optimizing quality and decrease the number of times of numerical simulation. In this article, the essential oil of schisandra chinensis was produced according to the technology of molecular distillation. The technological parameters were optimized. The process and result prove that this method is effective.