Quantitative assessment of self-management in patients with nonalcoholic fatty liver disease: An unmet clinical need

In this editorial we comment on the article titled“Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease”by Zeng et al published in a recent issue of the World Journal of Gastroenterology.Non-alcoholic fatty liver disease(NAFLD)represents one of the current challenges in hepatology and public health,due to its continuous growing prevalence and the rising incidence of NAFLD-related fibrosis,non-alcoholic steatohepatitis and cirrhosis.The only effective therapeutic strategy for this dis-ease is represented by encouraging patients to improve their lifestyle through the modification of dietary intake and increased physical exercise,but the effective application of such modifications is often limited by various factors such as lack of information,psychological barriers or poor social support.While poor adherence to a healthy lifestyle can be decisive in determining the clinical outcome,in daily practice there is a lack of quantitative instruments aimed at identifying patients with the lowest adherence to lifestyle changes and higher risk of disease progre-ssion in the course of follow-up.In this article,Zeng et al propose a quantitative scale to assess the grade of adherence of patients with NAFLD to hea-lthy lifestyle intervention,called the Exercise and Diet Adherence Scale(EDAS).This scale,consisting of 33 items divided into 6 dimensions which relates to six subjective aspects in the self-management of NAFLD,has shown a good correlation with the identification of the sub-cohort of patients with the highest reduction in caloric intake,increase in physical exercise,probability of a reduction in liver stiffness measurement and alanine aminotransferase levels.The cor-relation among clinical outcomes and specific dimensions of this scale also highlights the pivotal role of a good and confidential doctor-patient relationship and of an effective communication.There is an urgent need for practical and effective instruments to assess the grade of self-management of NAFLD patients,together with the development of multidisciplinary teams with the aim of applying structured behavioral interventions.

Effect of Diabetes Self-Management Education on Glycaemic Control in Sudanese Adults with Type 2 Diabetes

Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social Sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m2 (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management behaviors. Patient education plays a critical role in enhancing glycemic control and self-management behaviors. It is essential for healthcare providers to adopt a patient-centered approach, taking into account the individual's beliefs, attitudes, and knowledge about their illness and treatment. Overcoming these challenges necessitates a comprehensive approach, including enhancing healthcare professionals’ knowledge and communication skills, offering accessible and culturally sensitive diabetes education programs, and addressing barriers to resources and support for self-management.

Assessing the relationship between health literacy intervention and hypertension self-management:A 7-year systematic review from January 2016 to December 2022

Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.

Application Effect of WeChat Platform Continuity of Care Model Based on KAP Theory on Self-Management of Stroke Patients with Hypertension

Objective: To explore the impact of the WeChat platform continuity of care model based on the KAP (knowledge, attitudes, and practices) theory on the self-management of stroke patients with hypertension after discharge from the hospital. Methods: 62 stroke patients with hypertension discharged from the rehabilitation department of a tertiary A hospital in Nanning City, Guangxi Zhuang Autonomous Region, from October 2022 to April 2023 were sampled by convenience sampling method. Patients discharged from Rehabilitation I were included in the control group, and conventional nursing care was used;while patients discharged from Rehabilitation II were included in the observation group, and WeChat platform continuity of nursing care model based on the KAP theory was implemented. The intervention effect of the two groups was compared. Results: After 4 and 12 weeks of intervention, the diastolic and systolic blood pressure of the patients in the observation group were lower than those in the control group (P < 0.05);after 12 weeks of intervention, the rate of medication adherence and the score of adherence to hypertension treatment in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion: The application of the WeChat platform continuity of care model based on KAP theory to stroke patients with hypertension can improve blood pressure, medication adherence rate, hypertension treatment adherence, and overall enhance the self-management level of these patients.

Self-management in patients with diabetic foot ulcer:a concept analysis

Objective:This paper presents an analysis of the concept of patient outcomes.Methods:The present study conducted searches on various databases,including Wanfang,Sinomed,CNKI,Pub Med,Cochrane Library,Embase,Web of Science,and Ovid.The paper followed the Walker and Avant concept-analysis approach.Results:Initially,899 pieces of literature were identified through the search process,and after screening,41 of them were ultimately included in the analysis.The identified attributes of the concept included(1)capability,(2)decision making,and(3)action.These antecedents were shaped by factors such as illness perception,self-efficacy,and family and social.The consequences included(1)physiological effects,(2)psychological effects,and(3)social influence.Conclusions:The concept analysis of self-management in patients with diabetic foot ulcers(DFUs)not only aids in clinical practice and suppor ts interventions,but also contributes to the development of self-management theory.The common goal of clinical medical staff is to assist DFU patients in improving cognitive ability,making correct self-management decisions,and enhancing self-management behavior.

Conceptual Analysis of Self-Management in Patients with Hypertension

Objective:To clarify the concept of self-management in hypertensive patients by analyzing the definition,attributes,and measurement tools through a literature review.Methods:An Internet-based search of the databases was conducted using Academic Search Complete,Medical Line,CINAHL,Health Source:Nursing/Scholarly Edition,and Google Scholar.In the search process,keywords or free text were combined by using Boolean operators,with the search terms“self of management”or“self-management,”“concept*analysis”or“concept*definition,”and Walker and Avant’s concept analysis method was used.Results:Analysis of relevant literature summarized the conceptual attributes of self-management in hypertensive patients as the active participation of patients in the treatment process;the presence of interaction provided by patients and health care providers;the use of certain health management tools;and the aim of maintaining and improving the health status and living capacity of hypertensive patients.Conclusion:The concept of self-management for hypertensive patients was clarified,which helps to promote the application of hypertensive self-management in clinical work and improve outcomes and quality of life for patients with hypertension.

Characteristics and control factors of feldspar dissolution in gravity flow sandstone of Chang 7 Member,Triassic Yanchang Formation,Ordos Basin,NW China

To clarify the formation and distribution of feldspar dissolution pores and predict the distribution of high-quality reservoir in gravity flow sandstone of the 7^(th) member of Triassic Yanchang Formation(Chang 7 Member)in the Ordos Basin,thin sections,scanning electron microscopy,energy spectrum analysis,X-ray diffraction whole rock analysis,and dissolution experiments are employed in this study to investigate the characteristics and control factors of feldspar dissolution pores.The results show that:(1)Three types of diagenetic processes are observed in the feldspar of Chang 7 sandstone in the study area:secondary overgrowth of feldspar,replacement by clay and calcite,and dissolution of detrital feldspar.(2)The feldspar dissolution of Chang 7 tight sandstone is caused by organic acid,and is further affected by the type of feldspar,the degree of early feldspar alteration,and the buffering effect of mica debris on organic acid.(3)Feldspars have varying degrees of dissolution.Potassium feldspar is more susceptible to dissolution than plagioclase.Among potassium feldspar,orthoclase is more soluble than microcline,and unaltered feldspar is more soluble than early kaolinized or sericitized feldspar.(4)The dissolution experiment demonstrated that the presence of mica can hinder the dissolution of feldspar.Mica of the same mass has a significantly stronger capacity to consume organic acids than feldspar.(5)Dissolution pores in feldspar of Chang 7 Member are more abundant in areas with low mica content,and they improve the reservoir physical properties,while in areas with high mica content,the number of feldspar dissolution pores decreases significantly.

Factors related to self-management behavior among persons with mild-to-moderate chronic obstructive pulmonary disease in Wenzhou,China

Objective:To describe the self-management(SM)behavior among persons with mild-to-moderate chronic obstructive pulmonary disease(COPD),and it examines the correlation between COPD knowledge,self-efficacy,perceived social support,and SM behavior among persons with mild-to-moderate COPD in Wenzhou,China.Methods:A simple random sampling technique was used to recruit 121 persons with mild-to-moderate COPD who visited the respiratory outpatient department of the First Affiliated Hospital of Wenzhou Medical University in Wenzhou,China.Research instruments include a demographic data questionnaire,COPD SM scale,COPD knowledge questionnaire,6-item chronic disease self-efficacy scale,and perceived social suppor t scale.Descriptive statistics and Pearson's Correlation were used for data analysis.Results:The findings show that the mean score of COPD SM scale was 2.70(SD=0.45).The Pearson correlation analysis revealed that the COPD knowledge(r=0.47,P<0.001),self-efficacy(r=0.28,P=0.001),and perceived social support(r=0.48,P<0.001)were positively correlated to the COPD SM behavior among persons with mild-to-moderate COPD in Wenzhou,China.Conclusions:The findings indicate that disease knowledge,self-efficacy,and perceived social support were related to SM behavior in persons with mild-to-moderate COPD,which provides a theoretical basis for developing SM interventions for persons with mildto-moderate COPD and improving this population's SM behavior.

Tanshinone ⅡA improves Alzheimer’s disease via RNA nuclearenriched abundant transcript 1/microRNA-291a-3p/member RAS oncogene family Rab22a axis

BACKGROUND Alzheimer’s disease(AD)is a neurodegenerative condition characterized by oxidative stress and neuroinflammation.Tanshinone ⅡA(Tan-ⅡA),a bioactive compound isolated from Salvia miltiorrhiza plants,has shown potential neuroprotective effects;however,the mechanisms underlying such a function remain unclear.AIM To investigate potential Tan-ⅡA neuroprotective effects in AD and to elucidate their underlying mechanisms.METHODS Hematoxylin and eosin staining was utilized to analyze structural brain tissue morphology.To assess changes in oxidative stress and neuroinflammation,we performed enzyme-linked immunosorbent assay and western blotting.Additionally,the effect of Tan-ⅡA on AD cell models was evaluated in vitro using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay.Genetic changes related to the long non-coding RNA(lncRNA)nuclear-enriched abundant transcript 1(NEAT1)/microRNA(miRNA,miR)-291a-3p/member RAS oncogene family Rab22a axis were assessed through reverse transcription quantitative polymerase chain reaction.RESULTS In vivo,Tan-ⅡA treatment improved neuronal morphology and attenuated oxidative stress and neuroinflammation in the brain tissue of AD mice.In vitro experiments showed that Tan-ⅡA dose-dependently ameliorated the amyloid-beta 1-42-induced reduction of neural stem cell viability,apoptosis,oxidative stress,and neuroinflammation.In this process,the lncRNA NEAT1-a potential therapeutic target-is highly expressed in AD mice and downregulated via Tan-ⅡA treatment.Mechanistically,NEAT1 promotes the transcription and translation of Rab22a via miR-291a-3p,which activates nuclear factor kappa-B(NF-κB)signaling,leading to activation of the pro-apoptotic B-cell lymphoma 2-associated X protein and inhibition of the anti-apoptotic B-cell lymphoma 2 protein,which exacerbates AD.Tan-ⅡA intervention effectively blocked this process by inhibiting the NEAT1/miR-291a-3p/Rab22a axis and NF-κB signaling.CONCLUSION This study demonstrates that Tan-ⅡA exerts neuroprotective effects in AD by modulating the NEAT1/miR-291a-3p/Rab22a/NF-κB signaling pathway,serving as a foundation for the development of innovative approaches for AD therapy.

Survey on hospice care attitude of family members of advanced cancer patients at different ages

BACKGROUND Hospice care plays an important role in improving the quality of life of advanced cancer patients,but controversy remains over whether age affects the attitudes of family members toward hospice care.AIM To investigate the attitudes of family members of advanced cancer patients of different ages toward hospice care.METHODS The study participants were 175 family members of patients with advanced cancer from January 2020 and October 2022.The participants were divided into youth(<40 years,n=65),middle-aged(40–60 years,n=59),and elderly(>60 years,n=51)groups.Researchers investigated and compared the degree of awareness regarding hospice care,attitudes,and whether the family members of patients would choose hospice care.RESULTS Among the family members of 175 patients,approximately 28%(49/175)were aware of hospice care.Awareness of hospice care,the proportion of hospice care acceptance and adaptation attitudes,and the proportion of those who chose hospice care in the youth group were higher in the middle-aged and elderly groups(P<0.05).No statistically significant difference was found in these three indicators between the middle-aged and elderly groups(P>0.05).Hospice care was chosen mainly to relieve pain and reduce unnecessary treatment,whereas the reasons for not choosing hospice care were mainly distrust and ethical concerns.CONCLUSION The family members of patients with advanced cancer had relatively low awareness of hospice care,while youth had a higher awareness of hospice care,acceptance,and adaptation attitudes,and were more willing to choose hospice care.

Depositional model of the Member Deng-2 marginal microbial mound-bank complex of the Dengying Formation in the southwestern Sichuan Basin, SW China: Implications for the Ediacaran microbial mound construction and hydrocarbon exploration

Recent advances in hydrocarbon exploration have been made in the Member Deng-2 marginal microbial mound-bank complex reservoirs of the Dengying Formation in the western Sichuan Basin, SW China,where the depositional process is regarded confusing. The microfacies, construction types, and depositional model of the Member Deng-2 marginal microbial mound-bank complex have been investigated using unmanned aerial vehicle photography, outcrop section investigation, thin section identification,and seismic reflections in the southwestern Sichuan Basin. The microbialite lithologic textures in this region include thrombolite, dendrolite, stromatolite, fenestral stromatolite, spongiostromata stone,oncolite, aggregated grainstone, and botryoidal grapestone. Based on the comprehensive analysis of“depositional fabrics-lithology-microfacies”, an association between a fore mound, mound framework,and back mound subfacies has been proposed based on water depth, current direction, energy level and lithologic assemblages. The microfacies of the mound base, mound core, mound flank, mound cap, and mound flat could be recognized among the mound framework subfacies. Two construction types of marginal microbial mound-bank complex have been determined based on deposition location, mound scale, migration direction, and sedimentary facies association. Type Jinkouhe microbial mound constructions(TJMMCs) develop along the windward margin owing to their proximity to the seaward subfacies fore mound, with a northeastwardly migrated microbial mound on top of the mud mound,exhibiting the characteristics of large-sized mounds and small-sized banks in the surrounding area. Type E'bian microbial mound constructions(TEMMCs) primarily occur on the leeward margin, resulting from the presence of onshore back mound subfacies, with the smaller southwestward migrated microbial mounds existing on a thicker microbial flat. The platform margin microbial mound depositional model can be correlated with certain lateral comparison profile and seismic reflection structures in the 2D seismic section, which can provide references for future worldwide exploration. Microbial mounds with larger buildups and thicker vertical reservoirs are typically targeted on the windward margin, while small-sized microbial mounds and flats with better lateral connections are typically focused on the leeward margin.

Types,composition and diagenetic evolution of authigenic clay minerals in argillaceous limestone of sepiolite-bearing strata:A case study of Mao-1 Member of Middle Permian Maokou Formation,eastern Sichuan Basin,SW China

The types,occurrence and composition of authigenic clay minerals in argillaceous limestone of sepiolite-bearing strata of the first member of the Middle Permian Maokou Formation(Mao-1 Member)in eastern Sichuan Basin were investigated through outcrop section measurement,core observation,thin section identification,argon ion polishing,X-ray diffraction,scanning electron microscope,energy spectrum analysis and laser ablation-inductively coupled plasma-mass spectrometry.The diagenetic evolution sequence of clay minerals was clarified,and the sedimentary-diagenetic evolution model of clay minerals was established.The results show that authigenic sepiolite minerals were precipitated in the Si4+and Mg2+-rich cool aragonite sea and sepiolite-bearing strata were formed in the Mao-1 Member.During burial diagenesis,authigenic clay minerals undergo two possible evolution sequences.First,from the early diagenetic stage A to the middle diagenetic stage A1,the sepiolite kept stable in the shallow-buried environment lack of Al3+.It began to transform into stevensite in the middle diagenetic stage A2,and then evolved into disordered talc in the middle diagenetic stage B1and finally into talc in the period from the middle diagenetic stage B2to the late diagenetic stage.Thus,the primary diagenetic evolution sequence of authigenic clay minerals,i.e.sepiolite-stevensite-disordered talc-talc,was formed in the Mao-1 Member.Second,in the early diagenetic stage A,as Al3+carried by the storm and upwelling currents was involved in the diagenetic process,trace of sepiolite started to evolve into smectite,and a part of smectite turned into chlorite.From the early diagenetic stage B to the middle diagenesis stage A1,a part of smectite evolved to illite/smectite mixed layer(I/S).The I/S evolved initially into illite from the middle diagenesis stage A2to the middle diagenesis stage B2,and then totally into illite in the late diagenesis stage.Thus,the secondary diagenetic evolution sequence of authigenic clay minerals,i.e.sepiolite-smectite-chlorite/illite,was formed in the Mao-1 Member.The types and evolution of authigenic clay minerals in argillaceous limestone of sepiolite-bearing strata are significant for petroleum geology in two aspects.First,sepiolite can adsorb and accumulate a large amount of organic matters,thereby effectively improving the quality and hydrocarbon generation potential of the source rocks of the Mao-1 Member.Second,the evolution from sepiolite to talc is accompanied by the formation of numerous organic matter pores and clay shrinkage pores/fractures,as well as the releasing of the Mg2+-rich diagenetic fluid,which allows for the dolomitization of limestone within or around the sag.As a result,the new assemblages of self-generation and self-accumulation,and lower/side source and upper/lateral reservoir,are created in the Middle Permian,enhancing the hydrocarbon accumulation efficiency.

Aldo-keto reductase family member C3(AKR1C3)promotes hepatocellular carcinoma cell growth by producing prostaglandin F2α

Hepatocellular carcinoma(HCC)is a leading cause of death worldwide.Current therapies are effective for HCC patients with early disease,but many patients suffer recurrence after surgery and have a poor response to chemotherapy.Therefore,new therapeutic targets are needed.We analyzed gene expression profiles between HCC tissues and normal adjacent tissues from public databases and found that the expression of genes involved in lipid metabolism was significantly different.The analysis showed that AKR1C3 was upregulated in tumors,and high AKR1C3 expression was associated with a poorer prognosis in HCC patients.In vitro,assays demonstrated that the knockdown of AKR1C3 or the addition of the AKR1C3 inhibitor indomethacin suppressed the growth and colony formation of HCC cell lines.Knockdown of AKR1C3 in Huh7 cells reduced tumor growth in vivo.To explore the mechanism,we performed pathway enrichment analysis,and the results linked the expression of AKR1C3 with prostaglandin F2 alpha(PGF2a)downstream target genes.Suppression of AKR1C3 activity reduced the production of PGF2a,and supplementation with PGF2a restored the growth of indomethacin-treated Huh7 cells.Knockdown of the PGF receptor(PTGFR)and treatment with a PTGFR inhibitor significantly reduced HCC growth.We showed that indomethacin potentiated the sensitivity of Huh7 cells to sorafenib.In summary,our results indicate that AKR1C3 upregulation may promote HCC growth by promoting the production of PGF2α,and suppression of PTGFR limited HCC growth.Therefore,targeting the AKR1C3-PGF2a-PTGFR axis may be a new strategy for the treatment of HCC.

Potential role of transmembrane 9 superfamily member 1 as a biomarker in urothelial cancer

Bladder cancer is a urological tumor with high rates of recurrence despite recent advances in novel therapies.Many proteins involved in the molecular mechanisms are currently an enigma,especially the transmembrane 9 superfamily member 1 which has an unclear function.Wei et al published the function and mechanism of this protein,and showed that it could participate in the proliferation,migration and invasion of tumor cells in bladder cancer,therefore treatments directed against this protein may be beneficial in avoiding this condition.

MiRNA-145-5p inhibits gastric cancer progression via the serpin family E member 1-extracellular signal-regulated kinase-1/2 axis

BACKGROUND MicroRNAs(miRNAs)regulate gene expression and play a critical role in cancer physiology.However,there is still a limited understanding of the function and regulatory mechanism of miRNAs in gastric cancer(GC).AIM To investigate the role and molecular mechanism of miRNA-145-5p(miR145-5p)in the progression of GC.METHODS Real-time polymerase chain reaction(RT-PCR)was used to detect miRNA expression in human GC tissues and cells.The ability of cancer cells to migrate and invade was assessed using wound-healing and transwell assays,respectively.Cell proliferation was measured using cell counting kit-8 and colony formation assays,and apoptosis was evaluated using flow cytometry.Expression of the epithelial-mesenchymal transition(EMT)-associated protein was determined by Western blot.Targets of miR-145-5p were predicated using bioinformatics analysis and verified using a dual-luciferase reporter system.Serpin family E member 1(SERPINE1)expression in GC tissues and cells was evaluated using RT-PCR and immunohistochemical staining.The correlation between SERPINE1 expression and overall patient survival was determined using Kaplan-Meier plot analysis.The association between SERPINE1 and GC progression was also tested.A rescue experiment of SERPINE1 overexpression was conducted to verify the relationship between this protein and miR-145-5p.The mechanism by which miR-145-5p influences GC progression was further explored by assessing tumor formation in nude mice.RESULTS GC tissues and cells had reduced miR-145-5p expression and SERPINE1 was identified as a direct target of this miRNA.Overexpression of miR-145-5p was associated with decreased GC cell proliferation,invasion,migration,and EMT,and these effects were reversed by forcing SERPINE1 expression.Kaplan-Meier plot analysis revealed that patients with higher SERPINE1 expression had a shorter survival rate than those with lower SERPINE1 expression.Nude mouse tumorigenesis experiments confirmed that miR-145-5p targets SERPINE1 to regulate extracellular signal-regulated kinase-1/2(ERK1/2).CONCLUSION This study found that miR-145-5p inhibits tumor progression and is expressed in lower amounts in patients with GC.MiR-145-5p was found to affect GC cell proliferation,migration,and invasion by negatively regulating SERPINE1 levels and controlling the ERK1/2 pathway.

Understanding the role of transmembrane 9 superfamily member 1 in bladder cancer pathogenesis

In this editorial we comment on the article by Wei et al,published in the recent issue of the World Journal of Clinical Oncology.The authors investigated the role of Transmembrane 9 superfamily member 1(TM9SF1)protein in bladder cancer(BC)carcinogenesis.Lentiviral vectors were used to achieve silencing or overexpression of TM9SF1 gene in three BC cell lines.These cell lines were then subject to cell counting kit 8,wound-healing assay,transwell assay,and flow cytometry.Proliferation,migration,and invasion of BC cells were increased in cell lines subjected to TM9SF1 overexpression.TM9SF1 silencing inhibited proliferation,migration and invasion of BC cells.The authors conclude that TM9SF1 may be an oncogene in bladder cancer pathogenesis.

Analysis of the Current Status and Influencing Factors of Family Members’Collateral Stigma in Schizophrenia Patients

Objective: To investigate the associated collateral stigma of the family members of schizophrenia patients and analyze its current status and influencing factors. Methods: The Link Depreciation-Discrimination Perception Scale was used to investigate the status quo of the associated stigma of the family members of 169 schizophrenia patients diagnosed in 4 hospitals in a certain province. The results of the investigation were analyzed and summarized. Results: The detection rate of stigma associated with the family members of schizophrenia patients was 72.78%, with a score of 28.41 ± 3.92 points. The main influencing factors were the family member’s education level, the patient’s illness duration, the family member’s occupation, and the family-patient relationship. Conclusion: The detection rate of stigma associated with schizophrenia was relatively high. This requires increased attention and appropriate nursing intervention.

Impact of chronic disease self-management programs on type 2 diabetes management in primary care

AIM: To assess the effectiveness of the Chronic Disease Self-Management Program(CDSMP) on glycated hemoglobin A1c(HbA1c) and selected self-reported measures.METHODS: We compared patients who received a diabetes self-care behavioral intervention, the CDSMP developed at the Stanford University, with controls whoreceived usual care on their HbA1c and selected self-reported measures, including diabetes self-care activities, health-related quality of life(HRQOL), pain and fatigue. The subjects were a subset of participants enrolled in a randomized controlled trial that took place at seven regional clinics of a university-affiliated integrated healthcare system of a multi-specialty group practice between January 2009 and June 2011. The primary outcome was change in HbA1c from randomization to 12 mo. Data were analyzed using multilevel statistical models and linear mixed models to provide unbiased estimates of intervention effects.RESULTS: Demographic and baseline clinical characteristics were generally comparable between the two groups. The average baseline HbA1c values in the CDSMP and control groups were 9.4% and 9.2%, respectively. Significant reductions in HbA1c were seen at 12 mo for the two groups, with adjusted changes around 0.6%(P < 0.0001), but the reductions did not differ significantly between the two groups(P = 0.885). Few significant differences were observed in participants' diabetes self-care activities. No significant differences were observed in the participants' HRQOL, pain, or fatigue measures.CONCLUSION: The CDSMP intervention may not lower HbA1c any better than good routine care in an integrated healthcare system. More research is needed to understand the benefits of self-management programs in primary care in different settings and populations.

Self-management of coronary heart disease in older patients after elective percutaneous transluminal coronary angioplasty

Objective To explore how older patients self-manage their coronary heart disease （CHD） aider undergoing elective percutaneous transluminal coronary angioplasty （PTCA）. Methods This mixed methods study used a sequential, explanatory design and recruited a convenience sample of patients （n = 93） approximately three months after elective PTCA. The study was conducted in two phases. Quantitative data collected in Phase 1 by means of a self-administered survey were subject to univariate and bivariate analysis. Phase 1 findings in- formed the purposive samplhag for Phase 2 where ten participants were selected from the original sample for an in-depth interview. Qualita- tive data were analysed using thematic analysis. This paper will primarily report the findings from a sub-group of older participants （n = 47） classified as 65 years of age or older. Results 78.7% （n = 37） of participants indicated that they would manage recurring angina symptoms by taking glyceryl trinitrate and 34% （n = 16） thought that resting would help. Regardless of the duration or severity of the symptoms 40.5% （n = 19） would call their general practitioner or an emergency ambulance for assistance during any recurrence of angina symptoms. Older participants weighed less （P = 0.02） and smoked less （P = 0.01） than their younger counterparts in the study. Age did not seem to affect PTCA patients＇ likelihood of altering dietary factors such as fruit, vegetable and saturated fat consumption （P = 0.237）. Conclusions The findings suggest that older people in the study were less likely to know how to correctly manage any recurring angina symptoms than their younger counterparts but they had fewer risk factors for CHD. Age was not a factor that influenced participants＇ likelihood to alter lifestyle factors.

Development and validation of a self-management behavior questionnaire for Chinese enterostomy patients

Objectives:This study aimed to develop a self-management behavior questionnaire for Chinese enter-ostomy patients and examine its reliability and validity.Methods:Guided by the theory of self-management,an initial questionnaire was generated through literature review,group meetings,and two rounds of an expert consultation.Finally,the reliability and validity of the questionnaire were validated through a questionnaire survey of 200 enterostomy patients were selected from the Affiliated Hospital of Medical University from June 2016 to March 2017.Results:The content validity index was 0.80e1.00.The exploratory factor analysis yielded a five-factor(dietary behavior,psychosocial behavior,symptom management behavior,medical compliance behavior,information management behavior),consisting of 40 items.The cumulative variance contri-bution rate was 65.42%.The Cronbach’s a coefficient for the total questionnaire was 0.972,and for the five factors ranged from 0.797 to 0.939,indicating a good internal consistency.The test-retest reliability was 0.867(P<0.01).The self-management behavior questionnaire score was negatively related to the Ostomy Skin Tool score(r=-0.800,P<0.01).Conclusions:The self-management behavior questionnaire developed in this study showed good reli-ability and validity and can be used to assess the self-management behavior of Chinese enterostomy patients.