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IntroductionAtherosclerosis is the main pathological change in diabetic angiopathy, and vascular inflammation plays an important role in early atherosclerosis. Extracellular heat shock protein 90 (eHsp90) is secreted into the serum and is involved in various physiological and pathophysiological processes. However, the specific mechanism of eHsp90 in early atherosclerosis remains unclear. This study explored the relationship between Hsp90 and diabetic lower extremity arterial disease and investigated the expression of eHsp90 in vascular endothelial cells under environmental stimulation and the function and mechanism of eHsp90α involved in diabetic atherosclerosis.Research design and methodsOne hundred and three selected patients were divided into three groups: the diabetes mellitus group (n=27), the diabetic lower extremity arterial disease group (n=46), and the diabetic critical limb ischemia group (n=30). The relationships among serum Hsp90, oxidative stress indexes, and patient outcomes and the correlations among the indexes were analyzed. H&E staining and immunohistochemistry were used to observe the vasculature of amputated feet from patients with diabetic foot. An oxidative stress endothelial injury model was established under high glucose in vitro to explore the role of eHsp90 release in atherosclerosis progression.ResultsThe level of serum Hsp90 was upregulated with aggravation of diabetic vascular disease. Hsp90α was correlated with malondialdehyde to some extent and was an independent risk factor in the progression of diabetic vascular disease, with predictive ability. The expression area of Hsp90α was consistent with the area of inflammatory infiltration in the vessel lumen. Vascular endothelial cells were found to increase eHsp90α secretion under stress. Then inhibition of eHsp90α can reduce the degree of cellular inflammation and damage. Endothelial cell-conditioned medium and recombinant human Hsp90α increased monocyte migration via the low-denisity lipoprotein receptor-related protein 1 (LRP1) receptor to promote disease progression.ConclusionseHsp90α plays a critical role in the early inflammatory injury stage of atherosclerosis.Trial registration numberNCT04787770.

Additional file 1: Fig S1. Original results of western blot assays in the laboratory

Objective: To investigate the effects of nursing based on Orem’s self-care model on self-care efficacy, quality of life (QOL) and adverse emotions of patients with advanced lung cancer (ALC) receiving chemotherapy. Methods: A total of 71 patients with ALC aged 50-70 years, from our hospital were selected as the study subjects and divided into the control group (CNG, n = 35) and the experimental group (EXG, n = 36) using the random number table method. The CNG was treated with conventional chemotherapy combined with conventional nursing, while the EXG was treated with conventional chemotherapy combined with nursing based on Orem’s self-care model. The effects on self-care efficacy, QOL and adverse emotions in the two groups were observed before and after nursing. The General Self-Efficacy Scale (GSES) was scored in both groups. The patients’ body, physiology, psychology, society and health were scored using the QOL questionnaire for Chinese cancer patients receiving chemotherapy (QLQ-CCC). The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) in the two groups were scored using the Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD). Results: The GSES scores in the EXG were remarkably higher than those in the CNG after intervention (P < 0.05). After intervention, the scores of the patients’ body, physiology, psychology, society and health in the EXG were higher than those in the CNG (P < 0.05). The scores of SAS and SDS in the EXG were lower than those in the CNG (P < 0.05). Conclusion: Nursing based on Orem’s self-care model can effectively improve the self-care efficacy and QOL, adverse emotions (e.g., anxiety and depression), and degree of pain of patients with ALC receiving chemotherapy. Therefore, it has a positive clinical significance.