AIM: To investigate and evaluate the change in healthrelated quality of life (HRQoL) by tumor node metastasis (TNM) staging system in patients with hepatocellular carcinoma (HCC). METHODS: A total of 140 patients diag...AIM: To investigate and evaluate the change in healthrelated quality of life (HRQoL) by tumor node metastasis (TNM) staging system in patients with hepatocellular carcinoma (HCC). METHODS: A total of 140 patients diagnosed with HCC between June 2008 and April 2009 in our department were enrolled to this study. One hundred and thirty-five (96.5%) patients had liver cirrhosis secondary to hepatitis B virus (HBV) infection, 73 (54.07%) of them being HBV DNA positive; the other etiologies of liver cirrhosis were alcoholic liver disease (1.4%), hepatitis C (1.4%) or cryptogenic (0.7%). All subjects were fully aware of their diagnosis and provided informed consent. HRQoL was assessed before treatment using the functional assessment of cancer therapy-hepatobiliary (FACT-Hep) questionnaire. Descriptive statistics were used to evaluate demographics and disease-specific characteristics of the patients. One-way analysis of variance and independent samples t tests were used to compare the overall FACT-Hep scores and clinically distinct TNM stages. Scores for all FACT-Hep items were analyzed by frequency analyses. The mean scores obtained from the FACT-Hep in different Child-Pugh classes were also evaluated. RESULTS: The mean FACT-Hep scores were reduced significantly from TNM StageⅠto Stage Ⅱ, Stage ⅢA, Stage ⅢB group (687 ± 39.69 vs 547 ± 42.57 vs 387 ± 51.24 vs 177 ± 71.44, P = 0.001). Regarding the physical and emotional well-being subscales, scores decreased gradually from Stage Ⅰ to Stage ⅢB (P = 0.002 vs Stage Ⅰ; P = 0.032 vs Stage Ⅱ; P = 0.033 vs Stage ⅢA). Mean FACT-Hep scores varied by Child-Pugh class, especially in the subscales of physical well-being, functional well-being and the hepatobiliary cancer (P = 0.001 vs Stage I; P = 0.036 vs Stage Ⅱ; P = 0.032 vs Stage ⅢA). For the social and family well-being subscale, only Stage ⅢB scores were significantly lower as compared with Stage Ⅰ scores (P = 0.035). For the subscales of functional well-being and hepatobiliary cancer, there were 展开更多
AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily ad...AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily admitted to Cheng Hsin General Hospital for a paid physical check-up between January 2002 and December 2002. Blood samples and ultrasound sonography results were collected. RESULTS： The overall prevalence of GSD among this study-population was 5.3%, including 1.7% （n=40） having a single stone, 2.3% （n = 55） having multiple stones, and 1.3% （n = 31） having cholecystectomy. The prevalence revealed a statistically significant increase with increasing age （P〈 0.0001）. Females exhibited a greater prevalence of multiple stones than did males （3.0% vs 1.7%, P= 0.04）. Using multiple logistic regression analysis, the following appeared to be significantly related to the prevalence of GSD： older age （40-49 years vs 〈40 years, OR= 1.63 [95% CI： 0.76-3.48], 50-59 years vs 〈40 years, OR=4.93 [95% CI： 2.43-9.99], 60-69 years vs 〈40 years, OR = 6.82 [95% CI： 3.19-14.60], ≥70 years vs 〈40 years, OR= 10.65 [95% CI： 4.78-23.73]）, higher BMI （≥27 kg/m^2 vs 〈24 kg/m^2, adjusted OR= 1.74 [95% CI： 1.04-2.88]）, and higher FPG （≥ 126 mg/dL vs 〈110 mg/dL, OR= 1.71, 95% CI： 1.01-2.96）. CONCLUSION： Older age （≥50 years）, obesity （BMI ≥ 27 kg/m^2）, and type 2 diabetes （FPG ≥126 mg/dL） are associated with the prevalence of GSD.展开更多
Background:Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients,this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in ...Background:Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients,this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in the China trauma care training(CTCT)program in addition to their post-course test results to provide support for the development of trauma care training programs and trauma systems in China.Methods:A cross-sectional study was conducted by collecting demographic information,hospital-related information and trauma knowledge of the trainees from 19 regions in China.All participants were assessed by questionnaires collecting the socio-demographic data,the trauma care knowledge levels and the information of the hospitals.Results:There were 955 males(78.9%)and 256 females(21.1%)enrolled.Among them,854 were physicians(70.5%),357 were registered nurses(29.5%).In addition,64 of them also played an administrative role in the hospitals(5.3%).The score of the trainees who were members of the emergency department staff(72.59±14.13)was the highest among the scores of all the personnel surveyed,followed by those of the trainees from the intensive care unit(ICU)(71.17±12.72),trauma surgery department(67.26±13.81),orthopedics department(70.36±14.48),general surgery department(69.91±14.79)and other departments(69.93±16.91),P=0.031.The score of the professors(73.09±15.05)was higher than those of the associate professors(72.40±14.71),lecturers(70.07±14.25)and teaching assistants(67.58±15.16),P<0.0001.The score of the individuals who attended experts’trauma lectures(72.22±14.45)was higher than that of individuals who did not attend the lectures(69.33±15.17),P=0.001.The mean scores before and after the training were 71.02±14.82 and 84.24±13.77,respectively,P<0.001.The mean score of trauma knowledge after the training of trainees from different provinces and with different educational backgrounds was higher than that before the training,with a statistically significant difference(P<0.05).Conclusions:The lev展开更多
Background:Family clustering of esophageal cancer(EC)has been found in high-risk areas of China.However,the relationships between cancer family history and esophageal cancer and precancerous lesions(ECPL)have not been...Background:Family clustering of esophageal cancer(EC)has been found in high-risk areas of China.However,the relationships between cancer family history and esophageal cancer and precancerous lesions(ECPL)have not been comprehensively reported in recent years.This study aimed to provide evidence for identification of high-risk populations.Methods:This study was conducted in five high-risk areas in China from 2017 to 2019,based on the National Cohort of Esophageal Cancer.The permanent residents aged 40 to 69 years were examined by endoscopy,and pathological examination was performed for suspicious lesions.Information on demographic characteristics,environmental factors,and cancer family history was collected.Unconditional logistic regression was applied to evaluate odds ratios between family history related factors and ECPL.Results:Among 33,008 participants,6143(18.61%)reported positive family history of EC.The proportion of positive family history varied significantly among high-risk areas.After adjusting for risk factors,participants with a family history of positive cancer,gastric and esophageal cancer or EC had 1.49-fold(95%confidence interval[CI]:1.36-1.62),1.52-fold(95%CI:1.38-1.67),or 1.66-fold(95%CI:1.50-1.84)higher risks of ECPL,respectively.Participants with single or multiple first-degree relatives(FDR)of positive EC history had 1.65-fold(95%CI:1.47-1.84)or 1.93-fold(95%CI:1.46-2.54)higher risks of ECPL.Participants with FDRs who developed EC before 35,45,and 50 years of age had 4.05-fold(95%CI:1.30-12.65),2.11-fold(95%CI:1.37-3.25),and 1.91-fold(95%CI:1.44-2.54)higher risks of ECPL,respectively.Conclusions:Participants with positive family history of EC had significantly higher risk of ECPL.This risk increased with the number of EC positive FDRs and EC family history of early onset.Distinctive genetic risk factors of the population in high-risk areas of China require further investigation.Trial registration:ChiCTR-EOC-17010553.展开更多
BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even afte...BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological educatio展开更多
Background: Thyroid autoimmunity (TAI) is prevalent among women of reproductive age and associated with adverse pregnancy outcomes. This study aimed to investigate the association between iron nutritional status and t...Background: Thyroid autoimmunity (TAI) is prevalent among women of reproductive age and associated with adverse pregnancy outcomes. This study aimed to investigate the association between iron nutritional status and the prevalence of TAI in women during the first trimester of pregnancy and in non-pregnant women of childbearing age. Methods: Cross-sectional analysis of 7463 pregnant women during the first trimester of pregnancy and 2185 non-pregnant women of childbearing age nested within the sub-clinical hypothyroid in early pregnancy study, a prospective collection of pregnant and non-pregnant women’s data, was conducted in Liaoning province of China between 2012 and 2015. Serum thyrotropin, free thyroxine, thyroid peroxidase antibodies (TPOAbs), thyroglobulin antibodies (TgAbs), serum ferritin, and urinary iodine were measured. Iron deficiency (ID) was defined as serum ferritin <15 μg/L and iron overload (IO) was defined as ferritin >150 μg/L. TPOAb-positive was defined as >34 U/mL and TgAb-positive was defined as >115 U/mL. Multilevel logistic regression was conducted to examine the association between TAI and different iron nutritional status after adjusting for potential confounders. Results: The prevalence of isolated TPOAb-positive was markedly higher in women with ID than those without ID, in both pregnant and non-pregnant women (6.28% vs. 3.23%,χ^2 = 10.264, P = 0.002;6.25% vs. 3.70%,χ^2 = 3,791, P = 0.044;respectively). After adjusting for confounders and the cluster effect of hospitals, ID remained associated with TPOAb-positive in pregnant and non-pregnant women (odds ratio [OR]: 2.111, 95% confidence interval [CI]: 1.241–3.591, P = 0.006;and OR: 1.822, 95% CI: 1.011–3.282, P = 0.046, respectively). Conclusion: ID was associated with a higher prevalence of isolated TPOAbs-positive, but not with isolated TgAb-positive, in both pregnant women during the first trimester of pregnancy and non-pregnant women of childbearing age, while IO was not associated with either isolated TPOAb-positive or is展开更多
BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses met...BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.展开更多
BACKGROUND A body of evidence has suggested bidirectional relationships among gallstone disease(GSD),non-alcoholic fatty liver disease(NAFLD),and kidney stone disease(KSD).However,the results are inconsistent,and stud...BACKGROUND A body of evidence has suggested bidirectional relationships among gallstone disease(GSD),non-alcoholic fatty liver disease(NAFLD),and kidney stone disease(KSD).However,the results are inconsistent,and studies on this topic in China are relatively few.Our goal is to explore the bidirectional associations among these three diseases through a multicenter study,systematic review,and meta-analysis.AIM To explore the bidirectional associations among these three diseases through a multicenter study,systematic review,and meta-analysis.The results may help to investigate the etiology of these diseases and shed light on the individualized prevention of these three diseases.METHODS Subjects who participated in physical examinations in Beijing,Tianjin,Chongqing in China were recruited.Multivariable logistic regression was employed to explore the bidirectional relationships among GSD,KSD,and NAFLD.Systematic review and meta-analysis were initiated to confirm the epidemiologic evidence from previous observational studies.Furthermore,trial sequential analysis(TSA)was conducted to evaluate whether the evidence was sufficient and conclusive.RESULTS Significant bidirectional associations were detected among the three diseases,independent of potential confounding factors.The pooled results of the systematic review and meta-analysis also corroborated the aforementioned results.The combined evidence from the multicenter study and meta-analysis was significant[pooled odds ratio(OR)=1.42,95%CI:1.16-1.75,KSD→GSD;pooled OR=1.48,95%CI:1.31-1.67,GSD→KSD;pooled OR=1.31,95%CI:1.17-1.47,GSD→NAFLD;pooled OR=1.37,95%CI:1.26-1.50,NAFLD→GSD;pooled OR=1.28,95%CI:1.08-1.51,NAFLD→KSD;pooled OR=1.21,95%CI:1.16-1.25,KSD→NAFLD].TSA indicated that the evidence was sufficient and conclusive.CONCLUSION The present study presents relatively sufficient evidence for the positive bidirectional associations among GSD,KSD,and NAFLD.The results may provide clues for investigating the etiology of these three diseases and offer a guideline 展开更多
AIM:To determine the prevalence of some retinal pathologies in people over 60y and their association with demographic and ocular factors.METHODS:A cross-sectional study was conducted in Tehran using multistage cluster...AIM:To determine the prevalence of some retinal pathologies in people over 60y and their association with demographic and ocular factors.METHODS:A cross-sectional study was conducted in Tehran using multistage cluster sampling.After selecting subjects aged 60 and over,optometric,and ophthalmic examinations were done.For retinal examination,a 90 D lens was used and indirect ophthalmoscopy was performed after instilling tropicamide drops.Biometry was done using the IOL Master for all participants.RESULTS:Of 3791 people that were invited through cluster sampling,3310 participated in the study(response rate=82%).The prevalence of retinal pigmented epithelium(RPE)change,drusen,geographic atrophy(GA),hypertensive retinopathy(HTR),nonproliferative diabetic retinopathy(NPDR),proliferative diabetic retinopathy(PDR),choroidal neovascularization(CNV),central retinal artery occlusion(CRAO),myopic retinopathy(MR),branch retinal vein occlusion(BRVO),and central retinal vein occlusion(CRVO)was 27.42%,11.08%,4.52%,3.03%,4.05%,0.54%,0.82%,0.39%,0.20%,0.49%,and 0.19%,respectively.After removing the effect of age,the odds of NPDR were 1.68 times higher in women compared to men(P=0.014).After removing the effect of sex,the odds of drusen,RPE change,GA,CNV,BRVO,and CRVO increased with age.CONCLUSION:There is a higher prevalence of RPE change,drusen,GA,CNV and a lower prevalence of MR and CRAO in the elderly population of Tehran aged over 60y compared to global average values.Considering the correlation of most of the diseases with age and their effects on vision,attention should be paid to these diseases and the related screening programs to prevent vision impairment.展开更多
BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and const...BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and constipation,and the triglyceride glucose(TyG)index,a marker of IR,has not yet been investigated.AIM To investigate the potential association between TyG and the incidence of chronic diarrhea and constipation.METHODS This cross-sectional study enrolled 2400 participants from the National Health and Nutrition Examination Survey database from 2009-2010.TyG was used as an exposure variable,with chronic diarrhea and constipation as determined by the Bristol Stool Form Scale used as the outcome variables.A demographic investigation based on TyG quartile subgroups was performed.The application of multivariate logistic regression models and weighted generalized additive models revealed potential correlations between TyG,chronic diarrhea,and constipation.Subgroup analyses were performed to examine the stability of any potential associations.RESULTS In the chosen sample,chronic diarrhea had a prevalence of 8.00%,while chronic constipation had a prevalence of 8.04%.In multiple logistic regression,a more prominent positive association was found between TyG and chronic diarrhea,particularly in model 1(OR=1.45;95%CI:1.17-1.79,P=0.0007)and model 2(OR=1.40;95%CI:1.12-1.76,P=0.0033).No definite association was observed between the TyG levels and chronic constipation.The weighted generalized additive model findings suggested a more substantial positive association with chronic diarrhea when TyG was less than 9.63(OR=1.89;95%CI:1.05-3.41,P=0.0344),and another positive association with chronic constipation when it was greater than 8.2(OR=1.74;95%CI:1.02-2.95,P=0.0415).The results of the subgroup analyses further strengthen the extrapolation of these results to a wide range of populations.CONCLUSION Higher TyG levels were positively associated with abnormal bowel health.展开更多
Objective This study aimed to explore the relationships between residential greenness and cardiometabolic risk factors among rural adults in Xinjiang Uygur Autonomous Region(Xinjiang)and thus provide a theoretical bas...Objective This study aimed to explore the relationships between residential greenness and cardiometabolic risk factors among rural adults in Xinjiang Uygur Autonomous Region(Xinjiang)and thus provide a theoretical basis and data support for improving the health of residents in this region.Methods We recruited 9,723 adult rural residents from the 51st Regiment of the Third Division of the Xinjiang Production and Construction Corps in September 2016.The normalized difference vegetation index(NDVI)was used to estimate residential greenness.The generalized linear mixed model(GLMM)was used to examine the association between residential greenness and cardiometabolic risk factors.Results Higher residential greenness was associated with lower cardiometabolic risk factor prevalence.After adjustments were made for age,sex,education,and marital status,for each interquartile range(IQR)increase of NDVI500-m,the risk of hypertension was reduced by 10.3%(OR=0.897,95%CI=0.836-0.962),the risk of obesity by 20.5%(OR=0.795,95%CI=0.695-0.910),the risk of type 2 diabetes by 15.1%(OR=0.849,95%CI=0.740-0.974),and the risk of dyslipidemia by 10.5%(OR=0.895,95%CI=0.825-0.971).Risk factor aggregation was reduced by 20.4%(OR=0.796,95%CI=0.716-0.885)for the same.Stratified analysis showed that NDVI500-m was associated more strongly with hypertension,dyslipidemia,and risk factor aggregation among male participants.The association of NDVI500-m with type 2 diabetes was stronger among participants with a higher education level.PM10 and physical activity mediated 1.9%-9.2%of the associations between NDVI500-m and obesity,dyslipidemia,and risk factor aggregation.Conclusion Higher residential greenness has a protective effect against cardiometabolic risk factors among rural residents in Xinjiang.Increasing the area of green space around residences is an effective measure to reduce the burden of cardiometabolic-related diseases among rural residents in Xinjiang.展开更多
Background: The purpose of this study is to evaluate the quality of life(QoL) of hospitalized patients in China suffering from digestive system malignancies and to identify potential risk factors for a decrease in QoL...Background: The purpose of this study is to evaluate the quality of life(QoL) of hospitalized patients in China suffering from digestive system malignancies and to identify potential risk factors for a decrease in QoL.Methods: The European Organization for Research and Treatment Core Quality of Life questionnaire(EORTC QLQ-C30) was applied to evaluate the QoL of 23,519 patients with six digestive malignancies(esophageal cancer, gastric cancer, colorectal cancer, liver cancer, biliary tract cancer, and pancreatic cancer). A t test or analysis of variance was employed to analyze the total EORTC QLQ-C30 scale scores and domain scores of the EORTC QLQ-C30 scale among patients in different subgroups.Results: The average QoL score was 50.4 ± 10.8. The tumor type, age, sex, and TNM stage al had an impact on QoL ratings. Colorectal cancer patients had a better total QoL score(49.3 ± 10.3) and scores in the domains of functioning, with milder symptoms, except for diarrhea. Patients with biliary tract cancer(54.2 ± 12.3) and pancreatic cancer(54.2 ± 12.3) reported a poorer QoL, significant functional impairment, and more pronounced symptoms. Patients with esophageal cancer experienced the most severe financial difficulties(35.2 ± 27.5). Patients aged ≥65 years, women, and those with TNM stage Ⅲ/Ⅳ reported lower QoL. In addition, the disparities in total QoL scores and scores in specific domains were significant among patients with some types of tumors, and based on ethnicity, educational level, occupation, treatment(s) received, and place of residence.Conclusions: There is a need to focus on elderly individuals, those with low educational levels, and patients with progressive malignant tumors and to improve routine disease monitoring and symptom management to enhance the quality of life for patients with malignancies of the digestive system.展开更多
BACKGROUND Vascular and nerve infiltration are important indicators for the progression and prognosis of gastric cancer(GC),but traditional imaging methods have some limitations in preoperative evaluation.In recent ye...BACKGROUND Vascular and nerve infiltration are important indicators for the progression and prognosis of gastric cancer(GC),but traditional imaging methods have some limitations in preoperative evaluation.In recent years,energy spectrum computed tomography(CT)multiparameter imaging technology has been gradually applied in clinical practice because of its advantages in tissue contrast and lesion detail display.AIM To explore and analyze the value of multiparameter energy spectrum CT imaging in the preoperative assessment of vascular invasion(LVI)and nerve invasion(PNI)in GC patients.METHODS Data from 62 patients with GC confirmed by pathology and accompanied by energy spectrum CT scanning at our hospital between September 2022 and September 2023,including 46 males and 16 females aged 36-71(57.5±9.1)years,were retrospectively collected.The patients were divided into a positive group(42 patients)and a negative group(20 patients)according to the presence of LVI/PNI.The CT values(CT40 keV,CT70 keV),iodine concentration(IC),and normalized IC(NIC)of lesions in the upper energy spectrum CT images of the arterial phase,venous phase,and delayed phase 40 and 70 keV were measured,and the slopes of the energy spectrum curves[K(40-70)]from 40 to 70 keV were calculated.Arterial Core Tip:To investigate the application value of multiparameter energy spectrum computed tomography(CT)imaging in the preoperative assessment of vascular and nerve infiltration in patients with gastric cancer(GC).The imaging data of GC patients were retrospectively analyzed to evaluate the accuracy and sensitivity of CT for identifying and quantifying vascular and nerve infiltration and for comparison with postoperative pathological results.The purpose of this study was to verify the clinical feasibility and potential advantages of multiparameter energy spectrum CT imaging in guiding preoperative diagnosis and treatment decision-making and to provide a new imaging basis for improving the diagnostic accuracy and prognosis of GC patients.展开更多
Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Method...Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.展开更多
Summary:Nurses'work-related fatigue has been recognized as a threat to nurse health and patient safety.The aim of this study was to assess the prevalence of fatigue among first-line nurses combating with COVID-19 ...Summary:Nurses'work-related fatigue has been recognized as a threat to nurse health and patient safety.The aim of this study was to assess the prevalence of fatigue among first-line nurses combating with COVID-19 in Wuhan,China,and to analyze its influencing factors on fatigue.A multi-center,descriptive,cross-sectional design with a convenience sample was used.The statistical population consisted of the first-line nurses in 7 tertiary general hospitals from March 3,2020 to March 10,2020 in Wuhan of China.A total of 2667 samples from 2768 contacted participants completed the investgation,with a response rate of 96.35%.Social-demographic questionnaire,work-related questionnaire,Fatigue Scale-14,Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Chinese Perceived Stress Scale were used to conduct online survey.The descriptive statistic of nurses'social-demographic characteristics was conducted,and the related variables of work,anxiety,depression,perceived stress and fatigue were analyzed by Z-tests,nonparametric test and Pearson's correlation analysis.The significant factors which resulted in nurses'fatigue were further analyzed by multiple linear regression analysis.The median score for the first-line nurses'fatigue in Wuhan was 4(2,8).The median score of physical and mental fatigue of them was 3(1,6)and 1(0,3)respectively.According to the scoring criteria,35.06%nurses(w=935)of all participants were in the fatigue status,their median score of fatigue was 10(8,11),and the median score of physical and mental fatigue of them was 7(5,8)and 3(2,4)respectively.Multiple linear regression analysis revealed the participants in the risk groups of anxiety,depression and perceived stress had higher scores on physical and mental fatigue and the statistically significant positive correlation was observed between the variables and nurses'fatigue,the frequency of exercise and nurses'fatigue had a statistically significant negative correlation,and average daily working hours had a significantly positive correlation w展开更多
Objective This study aimed to reveal the insomnia burden and relevant influencing factors among informal caregivers(ICs)of hospitalized patients with lung cancer.Methods A cross-sectional study on ICs of hospitalized ...Objective This study aimed to reveal the insomnia burden and relevant influencing factors among informal caregivers(ICs)of hospitalized patients with lung cancer.Methods A cross-sectional study on ICs of hospitalized patients with lung cancer was conducted from December 31,2020 to December 31,2021.ICs’burden was assessed using the Caregiver Reaction Assessment(CRA),Hospital Anxiety and Depression Scale(HADS),and Insomnia Severity Index(ISI).Linear and logistic regression models were used to identify the influencing factors.Results Among 289 ICs of hospitalized patients with lung cancer,83(28.72%),53(18.34%),and 14(4.84%)ICs experienced mild,moderate,and severe insomnia,respectively.The scores concerning self-esteem,lack of family support,financial problems,disturbed schedule,and health problems were 4.32±0.53,2.24±0.79,2.84±1.14,3.63±0.77,and 2.44±0.95,respectively.ICs with higher Activities of Daily Living Scale(ADLS)scores were associated with a lower risk of insomnia,with an odd ratio(OR)and 95%confidence interval(CI)of 0.940(0.898–0.983).Among the ICs,female gender(OR=2.597),alcohol consumption(OR=3.745),underlying medical conditions(OR=11.765),long-term caregiving experience(OR=37.037),and higher monthly expenses(OR=5.714)were associated with a high risk of insomnia.Conclusion Of the hospitalized patients with lung cancer,51.9%experienced insomnia.Patients’ADL,ICs gender,alcohol consumption,underlying medical conditions,caregiving duration,and monthly expenses were influencing factors.Therefore,prompt screening and early intervention for ICs of patients with lung cancer is necessary.展开更多
This article delved into the comprehensive study by Jiang et al,which meticulously examined the bidirectional relationships among gallstone disease,nonalcoholic fatty liver disease,and kidney stone disease through a m...This article delved into the comprehensive study by Jiang et al,which meticulously examined the bidirectional relationships among gallstone disease,nonalcoholic fatty liver disease,and kidney stone disease through a multicenter study,systematic review,and meta-analysis.The study provides significant evidence supporting these associations,offering valuable insights into the etiology and potential prevention strategies for these interconnected conditions.The clinical significance of these bidirectional relationships is profound,as they underscore the importance of recognizing these conditions not only as isolated diseases but as part of a complex network that can influence each other.These results highlight the critical need for thorough screening and personalized prevention strategies for individuals with these interconnected conditions.Explicit implications for prevention strategies and early screening practices are crucial,as they can lead to early detection and intervention,significantly altering disease progression and outcomes.Furthermore,identifying potential therapeutic targets within these shared pathways may enhance treatment efficacy and patient outcomes,making this research highly relevant to clinical practice.By comprehending the common pathophysiological mechanisms and applying specific interventions,healthcare professionals can greatly enhance patient care and lessen the impact of these widespread diseases on global health.展开更多
Objective:The efficacy of medications for Parkinson’s disease(PD)tend to decline over time,which has a serious impact on patients’health and quality of life.To some extent,traditional Chinese medicine(TCM)can resolv...Objective:The efficacy of medications for Parkinson’s disease(PD)tend to decline over time,which has a serious impact on patients’health and quality of life.To some extent,traditional Chinese medicine(TCM)can resolve the distressing problem of ineffective dopaminergic medication in PD patients.The purpose of this study was to investigate the attitude,acceptance,and independent predictors of TCM in PD patients admitted to the outpatient department of a tertiary hospital.Methods:A cross-sectional study of PD patients was conducted in the outpatient department of a large tertiary hospital in Beijing from March 2022 to June 2023.A self-report questionnaire was developed to investigate PD patients’attitudes and acceptance of TCM based on the questionnaire.Multivariate logistic regression analyses were also performed to further clarify the independent predictors influencing patients’adoption of TCM therapy.Results:A total of 397 patients completed the questionnaire,of which 78.09%were willing to be treated with TCM and 21.91%indicated that they were not willing to use TCM.Multifactorial logistic regression analysis showed that several parameters were correlated with a patient’s willingness to include TCM in their therapeutic regime.These included education level of a bachelor’s degree(odds ratio[OR)=8.554;95%confidence interval[CI]:4.112–17.794;P<0.001,vs junior high school education),living in an urban setting(OR=8.022;95%CI:4.577–14.060;P<0.001,vs rural),having other underlying diseases(OR=5.126;95%CI:3.078–8.537;P<0.001,vs none),having previously used TCM(OR=3.083;95%CI:1.852–5.134;P<0.001,vs not used),believing that TCM therapy is safe(OR=3.530;95%CI:1.446–8.616;P=0.006,vs not thought),believing that TCM therapy is effective(OR=3.859;95%CI:1.482–10.047;P=0.006,vs not understood),and being willing to discuss ongoing TCM therapy with an attending physician(OR=62.468;95%CI:30.350–128.574;P<0.001,vs not informed).Conclusion:This study initially investigated the acceptance,attitude,and independ展开更多
基金Supported by Grants from the E-Institute of Shanghai Municipal Education Commission, No. E03008Shanghai Municipal Health Bureau of Traditional Chinese Medicine Research Project Fund 2010-2011, No. 2010L052B
文摘AIM: To investigate and evaluate the change in healthrelated quality of life (HRQoL) by tumor node metastasis (TNM) staging system in patients with hepatocellular carcinoma (HCC). METHODS: A total of 140 patients diagnosed with HCC between June 2008 and April 2009 in our department were enrolled to this study. One hundred and thirty-five (96.5%) patients had liver cirrhosis secondary to hepatitis B virus (HBV) infection, 73 (54.07%) of them being HBV DNA positive; the other etiologies of liver cirrhosis were alcoholic liver disease (1.4%), hepatitis C (1.4%) or cryptogenic (0.7%). All subjects were fully aware of their diagnosis and provided informed consent. HRQoL was assessed before treatment using the functional assessment of cancer therapy-hepatobiliary (FACT-Hep) questionnaire. Descriptive statistics were used to evaluate demographics and disease-specific characteristics of the patients. One-way analysis of variance and independent samples t tests were used to compare the overall FACT-Hep scores and clinically distinct TNM stages. Scores for all FACT-Hep items were analyzed by frequency analyses. The mean scores obtained from the FACT-Hep in different Child-Pugh classes were also evaluated. RESULTS: The mean FACT-Hep scores were reduced significantly from TNM StageⅠto Stage Ⅱ, Stage ⅢA, Stage ⅢB group (687 ± 39.69 vs 547 ± 42.57 vs 387 ± 51.24 vs 177 ± 71.44, P = 0.001). Regarding the physical and emotional well-being subscales, scores decreased gradually from Stage Ⅰ to Stage ⅢB (P = 0.002 vs Stage Ⅰ; P = 0.032 vs Stage Ⅱ; P = 0.033 vs Stage ⅢA). Mean FACT-Hep scores varied by Child-Pugh class, especially in the subscales of physical well-being, functional well-being and the hepatobiliary cancer (P = 0.001 vs Stage I; P = 0.036 vs Stage Ⅱ; P = 0.032 vs Stage ⅢA). For the social and family well-being subscale, only Stage ⅢB scores were significantly lower as compared with Stage Ⅰ scores (P = 0.035). For the subscales of functional well-being and hepatobiliary cancer, there were
文摘AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily admitted to Cheng Hsin General Hospital for a paid physical check-up between January 2002 and December 2002. Blood samples and ultrasound sonography results were collected. RESULTS： The overall prevalence of GSD among this study-population was 5.3%, including 1.7% （n=40） having a single stone, 2.3% （n = 55） having multiple stones, and 1.3% （n = 31） having cholecystectomy. The prevalence revealed a statistically significant increase with increasing age （P〈 0.0001）. Females exhibited a greater prevalence of multiple stones than did males （3.0% vs 1.7%, P= 0.04）. Using multiple logistic regression analysis, the following appeared to be significantly related to the prevalence of GSD： older age （40-49 years vs 〈40 years, OR= 1.63 [95% CI： 0.76-3.48], 50-59 years vs 〈40 years, OR=4.93 [95% CI： 2.43-9.99], 60-69 years vs 〈40 years, OR = 6.82 [95% CI： 3.19-14.60], ≥70 years vs 〈40 years, OR= 10.65 [95% CI： 4.78-23.73]）, higher BMI （≥27 kg/m^2 vs 〈24 kg/m^2, adjusted OR= 1.74 [95% CI： 1.04-2.88]）, and higher FPG （≥ 126 mg/dL vs 〈110 mg/dL, OR= 1.71, 95% CI： 1.01-2.96）. CONCLUSION： Older age （≥50 years）, obesity （BMI ≥ 27 kg/m^2）, and type 2 diabetes （FPG ≥126 mg/dL） are associated with the prevalence of GSD.
基金support by grants from the“Chongqing Science and Technology Benefiting project”(cstc2016kjhmpt1001)research project from the State Key Laboratory of Trauma,Burns and Combined Injury(SKLZZ201603)。
文摘Background:Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients,this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in the China trauma care training(CTCT)program in addition to their post-course test results to provide support for the development of trauma care training programs and trauma systems in China.Methods:A cross-sectional study was conducted by collecting demographic information,hospital-related information and trauma knowledge of the trainees from 19 regions in China.All participants were assessed by questionnaires collecting the socio-demographic data,the trauma care knowledge levels and the information of the hospitals.Results:There were 955 males(78.9%)and 256 females(21.1%)enrolled.Among them,854 were physicians(70.5%),357 were registered nurses(29.5%).In addition,64 of them also played an administrative role in the hospitals(5.3%).The score of the trainees who were members of the emergency department staff(72.59±14.13)was the highest among the scores of all the personnel surveyed,followed by those of the trainees from the intensive care unit(ICU)(71.17±12.72),trauma surgery department(67.26±13.81),orthopedics department(70.36±14.48),general surgery department(69.91±14.79)and other departments(69.93±16.91),P=0.031.The score of the professors(73.09±15.05)was higher than those of the associate professors(72.40±14.71),lecturers(70.07±14.25)and teaching assistants(67.58±15.16),P<0.0001.The score of the individuals who attended experts’trauma lectures(72.22±14.45)was higher than that of individuals who did not attend the lectures(69.33±15.17),P=0.001.The mean scores before and after the training were 71.02±14.82 and 84.24±13.77,respectively,P<0.001.The mean score of trauma knowledge after the training of trainees from different provinces and with different educational backgrounds was higher than that before the training,with a statistically significant difference(P<0.05).Conclusions:The lev
基金National Natural Science Foundation of China(Nos.81903402,81974493)the National Key R&D Program of China(Nos.2016YFC0901404,2018YFC1311704)the Chinese Academic of Medical Sciences Innovation Fund for Medical Sciences(No.2019-I2M-2-004)。
文摘Background:Family clustering of esophageal cancer(EC)has been found in high-risk areas of China.However,the relationships between cancer family history and esophageal cancer and precancerous lesions(ECPL)have not been comprehensively reported in recent years.This study aimed to provide evidence for identification of high-risk populations.Methods:This study was conducted in five high-risk areas in China from 2017 to 2019,based on the National Cohort of Esophageal Cancer.The permanent residents aged 40 to 69 years were examined by endoscopy,and pathological examination was performed for suspicious lesions.Information on demographic characteristics,environmental factors,and cancer family history was collected.Unconditional logistic regression was applied to evaluate odds ratios between family history related factors and ECPL.Results:Among 33,008 participants,6143(18.61%)reported positive family history of EC.The proportion of positive family history varied significantly among high-risk areas.After adjusting for risk factors,participants with a family history of positive cancer,gastric and esophageal cancer or EC had 1.49-fold(95%confidence interval[CI]:1.36-1.62),1.52-fold(95%CI:1.38-1.67),or 1.66-fold(95%CI:1.50-1.84)higher risks of ECPL,respectively.Participants with single or multiple first-degree relatives(FDR)of positive EC history had 1.65-fold(95%CI:1.47-1.84)or 1.93-fold(95%CI:1.46-2.54)higher risks of ECPL.Participants with FDRs who developed EC before 35,45,and 50 years of age had 4.05-fold(95%CI:1.30-12.65),2.11-fold(95%CI:1.37-3.25),and 1.91-fold(95%CI:1.44-2.54)higher risks of ECPL,respectively.Conclusions:Participants with positive family history of EC had significantly higher risk of ECPL.This risk increased with the number of EC positive FDRs and EC family history of early onset.Distinctive genetic risk factors of the population in high-risk areas of China require further investigation.Trial registration:ChiCTR-EOC-17010553.
文摘BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological educatio
文摘Background: Thyroid autoimmunity (TAI) is prevalent among women of reproductive age and associated with adverse pregnancy outcomes. This study aimed to investigate the association between iron nutritional status and the prevalence of TAI in women during the first trimester of pregnancy and in non-pregnant women of childbearing age. Methods: Cross-sectional analysis of 7463 pregnant women during the first trimester of pregnancy and 2185 non-pregnant women of childbearing age nested within the sub-clinical hypothyroid in early pregnancy study, a prospective collection of pregnant and non-pregnant women’s data, was conducted in Liaoning province of China between 2012 and 2015. Serum thyrotropin, free thyroxine, thyroid peroxidase antibodies (TPOAbs), thyroglobulin antibodies (TgAbs), serum ferritin, and urinary iodine were measured. Iron deficiency (ID) was defined as serum ferritin <15 μg/L and iron overload (IO) was defined as ferritin >150 μg/L. TPOAb-positive was defined as >34 U/mL and TgAb-positive was defined as >115 U/mL. Multilevel logistic regression was conducted to examine the association between TAI and different iron nutritional status after adjusting for potential confounders. Results: The prevalence of isolated TPOAb-positive was markedly higher in women with ID than those without ID, in both pregnant and non-pregnant women (6.28% vs. 3.23%,χ^2 = 10.264, P = 0.002;6.25% vs. 3.70%,χ^2 = 3,791, P = 0.044;respectively). After adjusting for confounders and the cluster effect of hospitals, ID remained associated with TPOAb-positive in pregnant and non-pregnant women (odds ratio [OR]: 2.111, 95% confidence interval [CI]: 1.241–3.591, P = 0.006;and OR: 1.822, 95% CI: 1.011–3.282, P = 0.046, respectively). Conclusion: ID was associated with a higher prevalence of isolated TPOAbs-positive, but not with isolated TgAb-positive, in both pregnant women during the first trimester of pregnancy and non-pregnant women of childbearing age, while IO was not associated with either isolated TPOAb-positive or is
基金Supported by Suzhou Municipal Science and Technology Program of China,No.SKJY2021012.
文摘BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.
基金Supported by National Natural Science Foundation of China,No.81802508 and No.81903398Chongqing Natural Science Foundation Program,No.CSTC2019JCYJ-MSXMX0466 and No.CSTB2022NSCQ-MSX0206+4 种基金The Research Start-up Fund for Introduction of Talents of Sichuan University,No.YJ2021112Medical Youth Innovation Research Project of Sichuan Province,No.Q21016Natural Science Foundation of Sichuan,No.2023NSFSC1927Sichuan Province Central Government Guide Local Science and Technology Development Project,No.2023ZYD0097"From 0 to 1"Innovation Project of Sichuan University,No.2023SCUH0026.
文摘BACKGROUND A body of evidence has suggested bidirectional relationships among gallstone disease(GSD),non-alcoholic fatty liver disease(NAFLD),and kidney stone disease(KSD).However,the results are inconsistent,and studies on this topic in China are relatively few.Our goal is to explore the bidirectional associations among these three diseases through a multicenter study,systematic review,and meta-analysis.AIM To explore the bidirectional associations among these three diseases through a multicenter study,systematic review,and meta-analysis.The results may help to investigate the etiology of these diseases and shed light on the individualized prevention of these three diseases.METHODS Subjects who participated in physical examinations in Beijing,Tianjin,Chongqing in China were recruited.Multivariable logistic regression was employed to explore the bidirectional relationships among GSD,KSD,and NAFLD.Systematic review and meta-analysis were initiated to confirm the epidemiologic evidence from previous observational studies.Furthermore,trial sequential analysis(TSA)was conducted to evaluate whether the evidence was sufficient and conclusive.RESULTS Significant bidirectional associations were detected among the three diseases,independent of potential confounding factors.The pooled results of the systematic review and meta-analysis also corroborated the aforementioned results.The combined evidence from the multicenter study and meta-analysis was significant[pooled odds ratio(OR)=1.42,95%CI:1.16-1.75,KSD→GSD;pooled OR=1.48,95%CI:1.31-1.67,GSD→KSD;pooled OR=1.31,95%CI:1.17-1.47,GSD→NAFLD;pooled OR=1.37,95%CI:1.26-1.50,NAFLD→GSD;pooled OR=1.28,95%CI:1.08-1.51,NAFLD→KSD;pooled OR=1.21,95%CI:1.16-1.25,KSD→NAFLD].TSA indicated that the evidence was sufficient and conclusive.CONCLUSION The present study presents relatively sufficient evidence for the positive bidirectional associations among GSD,KSD,and NAFLD.The results may provide clues for investigating the etiology of these three diseases and offer a guideline
基金Supported by National Institute for Medical Research Development(NIMAD)Affiliated with the Iranian Ministry of Health and Medical Education(No.963660).
文摘AIM:To determine the prevalence of some retinal pathologies in people over 60y and their association with demographic and ocular factors.METHODS:A cross-sectional study was conducted in Tehran using multistage cluster sampling.After selecting subjects aged 60 and over,optometric,and ophthalmic examinations were done.For retinal examination,a 90 D lens was used and indirect ophthalmoscopy was performed after instilling tropicamide drops.Biometry was done using the IOL Master for all participants.RESULTS:Of 3791 people that were invited through cluster sampling,3310 participated in the study(response rate=82%).The prevalence of retinal pigmented epithelium(RPE)change,drusen,geographic atrophy(GA),hypertensive retinopathy(HTR),nonproliferative diabetic retinopathy(NPDR),proliferative diabetic retinopathy(PDR),choroidal neovascularization(CNV),central retinal artery occlusion(CRAO),myopic retinopathy(MR),branch retinal vein occlusion(BRVO),and central retinal vein occlusion(CRVO)was 27.42%,11.08%,4.52%,3.03%,4.05%,0.54%,0.82%,0.39%,0.20%,0.49%,and 0.19%,respectively.After removing the effect of age,the odds of NPDR were 1.68 times higher in women compared to men(P=0.014).After removing the effect of sex,the odds of drusen,RPE change,GA,CNV,BRVO,and CRVO increased with age.CONCLUSION:There is a higher prevalence of RPE change,drusen,GA,CNV and a lower prevalence of MR and CRAO in the elderly population of Tehran aged over 60y compared to global average values.Considering the correlation of most of the diseases with age and their effects on vision,attention should be paid to these diseases and the related screening programs to prevent vision impairment.
文摘BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and constipation,and the triglyceride glucose(TyG)index,a marker of IR,has not yet been investigated.AIM To investigate the potential association between TyG and the incidence of chronic diarrhea and constipation.METHODS This cross-sectional study enrolled 2400 participants from the National Health and Nutrition Examination Survey database from 2009-2010.TyG was used as an exposure variable,with chronic diarrhea and constipation as determined by the Bristol Stool Form Scale used as the outcome variables.A demographic investigation based on TyG quartile subgroups was performed.The application of multivariate logistic regression models and weighted generalized additive models revealed potential correlations between TyG,chronic diarrhea,and constipation.Subgroup analyses were performed to examine the stability of any potential associations.RESULTS In the chosen sample,chronic diarrhea had a prevalence of 8.00%,while chronic constipation had a prevalence of 8.04%.In multiple logistic regression,a more prominent positive association was found between TyG and chronic diarrhea,particularly in model 1(OR=1.45;95%CI:1.17-1.79,P=0.0007)and model 2(OR=1.40;95%CI:1.12-1.76,P=0.0033).No definite association was observed between the TyG levels and chronic constipation.The weighted generalized additive model findings suggested a more substantial positive association with chronic diarrhea when TyG was less than 9.63(OR=1.89;95%CI:1.05-3.41,P=0.0344),and another positive association with chronic constipation when it was greater than 8.2(OR=1.74;95%CI:1.02-2.95,P=0.0415).The results of the subgroup analyses further strengthen the extrapolation of these results to a wide range of populations.CONCLUSION Higher TyG levels were positively associated with abnormal bowel health.
基金funded by the Science and Technology Project of the Xinjiang Production and Construction Corps(NO.2021AB030)the Innovative Development Project of Shihezi University(NO.CXFZ202005)the Non-profit Central Research Institute Fund of the Chinese Academy of Medical Sciences(2020-PT330-003).
文摘Objective This study aimed to explore the relationships between residential greenness and cardiometabolic risk factors among rural adults in Xinjiang Uygur Autonomous Region(Xinjiang)and thus provide a theoretical basis and data support for improving the health of residents in this region.Methods We recruited 9,723 adult rural residents from the 51st Regiment of the Third Division of the Xinjiang Production and Construction Corps in September 2016.The normalized difference vegetation index(NDVI)was used to estimate residential greenness.The generalized linear mixed model(GLMM)was used to examine the association between residential greenness and cardiometabolic risk factors.Results Higher residential greenness was associated with lower cardiometabolic risk factor prevalence.After adjustments were made for age,sex,education,and marital status,for each interquartile range(IQR)increase of NDVI500-m,the risk of hypertension was reduced by 10.3%(OR=0.897,95%CI=0.836-0.962),the risk of obesity by 20.5%(OR=0.795,95%CI=0.695-0.910),the risk of type 2 diabetes by 15.1%(OR=0.849,95%CI=0.740-0.974),and the risk of dyslipidemia by 10.5%(OR=0.895,95%CI=0.825-0.971).Risk factor aggregation was reduced by 20.4%(OR=0.796,95%CI=0.716-0.885)for the same.Stratified analysis showed that NDVI500-m was associated more strongly with hypertension,dyslipidemia,and risk factor aggregation among male participants.The association of NDVI500-m with type 2 diabetes was stronger among participants with a higher education level.PM10 and physical activity mediated 1.9%-9.2%of the associations between NDVI500-m and obesity,dyslipidemia,and risk factor aggregation.Conclusion Higher residential greenness has a protective effect against cardiometabolic risk factors among rural residents in Xinjiang.Increasing the area of green space around residences is an effective measure to reduce the burden of cardiometabolic-related diseases among rural residents in Xinjiang.
基金supported by the National KeyResearch and Development Program(No.2022YFC2009600 andNo.2022YFC2009601).
文摘Background: The purpose of this study is to evaluate the quality of life(QoL) of hospitalized patients in China suffering from digestive system malignancies and to identify potential risk factors for a decrease in QoL.Methods: The European Organization for Research and Treatment Core Quality of Life questionnaire(EORTC QLQ-C30) was applied to evaluate the QoL of 23,519 patients with six digestive malignancies(esophageal cancer, gastric cancer, colorectal cancer, liver cancer, biliary tract cancer, and pancreatic cancer). A t test or analysis of variance was employed to analyze the total EORTC QLQ-C30 scale scores and domain scores of the EORTC QLQ-C30 scale among patients in different subgroups.Results: The average QoL score was 50.4 ± 10.8. The tumor type, age, sex, and TNM stage al had an impact on QoL ratings. Colorectal cancer patients had a better total QoL score(49.3 ± 10.3) and scores in the domains of functioning, with milder symptoms, except for diarrhea. Patients with biliary tract cancer(54.2 ± 12.3) and pancreatic cancer(54.2 ± 12.3) reported a poorer QoL, significant functional impairment, and more pronounced symptoms. Patients with esophageal cancer experienced the most severe financial difficulties(35.2 ± 27.5). Patients aged ≥65 years, women, and those with TNM stage Ⅲ/Ⅳ reported lower QoL. In addition, the disparities in total QoL scores and scores in specific domains were significant among patients with some types of tumors, and based on ethnicity, educational level, occupation, treatment(s) received, and place of residence.Conclusions: There is a need to focus on elderly individuals, those with low educational levels, and patients with progressive malignant tumors and to improve routine disease monitoring and symptom management to enhance the quality of life for patients with malignancies of the digestive system.
文摘BACKGROUND Vascular and nerve infiltration are important indicators for the progression and prognosis of gastric cancer(GC),but traditional imaging methods have some limitations in preoperative evaluation.In recent years,energy spectrum computed tomography(CT)multiparameter imaging technology has been gradually applied in clinical practice because of its advantages in tissue contrast and lesion detail display.AIM To explore and analyze the value of multiparameter energy spectrum CT imaging in the preoperative assessment of vascular invasion(LVI)and nerve invasion(PNI)in GC patients.METHODS Data from 62 patients with GC confirmed by pathology and accompanied by energy spectrum CT scanning at our hospital between September 2022 and September 2023,including 46 males and 16 females aged 36-71(57.5±9.1)years,were retrospectively collected.The patients were divided into a positive group(42 patients)and a negative group(20 patients)according to the presence of LVI/PNI.The CT values(CT40 keV,CT70 keV),iodine concentration(IC),and normalized IC(NIC)of lesions in the upper energy spectrum CT images of the arterial phase,venous phase,and delayed phase 40 and 70 keV were measured,and the slopes of the energy spectrum curves[K(40-70)]from 40 to 70 keV were calculated.Arterial Core Tip:To investigate the application value of multiparameter energy spectrum computed tomography(CT)imaging in the preoperative assessment of vascular and nerve infiltration in patients with gastric cancer(GC).The imaging data of GC patients were retrospectively analyzed to evaluate the accuracy and sensitivity of CT for identifying and quantifying vascular and nerve infiltration and for comparison with postoperative pathological results.The purpose of this study was to verify the clinical feasibility and potential advantages of multiparameter energy spectrum CT imaging in guiding preoperative diagnosis and treatment decision-making and to provide a new imaging basis for improving the diagnostic accuracy and prognosis of GC patients.
文摘Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.
文摘Summary:Nurses'work-related fatigue has been recognized as a threat to nurse health and patient safety.The aim of this study was to assess the prevalence of fatigue among first-line nurses combating with COVID-19 in Wuhan,China,and to analyze its influencing factors on fatigue.A multi-center,descriptive,cross-sectional design with a convenience sample was used.The statistical population consisted of the first-line nurses in 7 tertiary general hospitals from March 3,2020 to March 10,2020 in Wuhan of China.A total of 2667 samples from 2768 contacted participants completed the investgation,with a response rate of 96.35%.Social-demographic questionnaire,work-related questionnaire,Fatigue Scale-14,Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Chinese Perceived Stress Scale were used to conduct online survey.The descriptive statistic of nurses'social-demographic characteristics was conducted,and the related variables of work,anxiety,depression,perceived stress and fatigue were analyzed by Z-tests,nonparametric test and Pearson's correlation analysis.The significant factors which resulted in nurses'fatigue were further analyzed by multiple linear regression analysis.The median score for the first-line nurses'fatigue in Wuhan was 4(2,8).The median score of physical and mental fatigue of them was 3(1,6)and 1(0,3)respectively.According to the scoring criteria,35.06%nurses(w=935)of all participants were in the fatigue status,their median score of fatigue was 10(8,11),and the median score of physical and mental fatigue of them was 7(5,8)and 3(2,4)respectively.Multiple linear regression analysis revealed the participants in the risk groups of anxiety,depression and perceived stress had higher scores on physical and mental fatigue and the statistically significant positive correlation was observed between the variables and nurses'fatigue,the frequency of exercise and nurses'fatigue had a statistically significant negative correlation,and average daily working hours had a significantly positive correlation w
基金supported by Technical field fund of the basic strengthening plan of the military science and Technology Commission[2021-JCJQ-JJ-0528]The Project of Beijing Science and Technology“capital characteristics”[Z181100001718007]+1 种基金Construction project of military medical teaching at PLA Medical College[145bxl090009000x]Central Military Health Care Commission[20BJZ46].
文摘Objective This study aimed to reveal the insomnia burden and relevant influencing factors among informal caregivers(ICs)of hospitalized patients with lung cancer.Methods A cross-sectional study on ICs of hospitalized patients with lung cancer was conducted from December 31,2020 to December 31,2021.ICs’burden was assessed using the Caregiver Reaction Assessment(CRA),Hospital Anxiety and Depression Scale(HADS),and Insomnia Severity Index(ISI).Linear and logistic regression models were used to identify the influencing factors.Results Among 289 ICs of hospitalized patients with lung cancer,83(28.72%),53(18.34%),and 14(4.84%)ICs experienced mild,moderate,and severe insomnia,respectively.The scores concerning self-esteem,lack of family support,financial problems,disturbed schedule,and health problems were 4.32±0.53,2.24±0.79,2.84±1.14,3.63±0.77,and 2.44±0.95,respectively.ICs with higher Activities of Daily Living Scale(ADLS)scores were associated with a lower risk of insomnia,with an odd ratio(OR)and 95%confidence interval(CI)of 0.940(0.898–0.983).Among the ICs,female gender(OR=2.597),alcohol consumption(OR=3.745),underlying medical conditions(OR=11.765),long-term caregiving experience(OR=37.037),and higher monthly expenses(OR=5.714)were associated with a high risk of insomnia.Conclusion Of the hospitalized patients with lung cancer,51.9%experienced insomnia.Patients’ADL,ICs gender,alcohol consumption,underlying medical conditions,caregiving duration,and monthly expenses were influencing factors.Therefore,prompt screening and early intervention for ICs of patients with lung cancer is necessary.
基金Supported by Basic Science Research Program Through the National Research Foundation of Korea funded by the Ministry of Education,No.RS-2023-00237287Local Government-University Cooperation-Based Regional Innovation Projects,No.2021RIS-003.
文摘This article delved into the comprehensive study by Jiang et al,which meticulously examined the bidirectional relationships among gallstone disease,nonalcoholic fatty liver disease,and kidney stone disease through a multicenter study,systematic review,and meta-analysis.The study provides significant evidence supporting these associations,offering valuable insights into the etiology and potential prevention strategies for these interconnected conditions.The clinical significance of these bidirectional relationships is profound,as they underscore the importance of recognizing these conditions not only as isolated diseases but as part of a complex network that can influence each other.These results highlight the critical need for thorough screening and personalized prevention strategies for individuals with these interconnected conditions.Explicit implications for prevention strategies and early screening practices are crucial,as they can lead to early detection and intervention,significantly altering disease progression and outcomes.Furthermore,identifying potential therapeutic targets within these shared pathways may enhance treatment efficacy and patient outcomes,making this research highly relevant to clinical practice.By comprehending the common pathophysiological mechanisms and applying specific interventions,healthcare professionals can greatly enhance patient care and lessen the impact of these widespread diseases on global health.
基金supported by the Young Scientists Fund of the National Natural Science Foundation of China(Grant No.82205231)。
文摘Objective:The efficacy of medications for Parkinson’s disease(PD)tend to decline over time,which has a serious impact on patients’health and quality of life.To some extent,traditional Chinese medicine(TCM)can resolve the distressing problem of ineffective dopaminergic medication in PD patients.The purpose of this study was to investigate the attitude,acceptance,and independent predictors of TCM in PD patients admitted to the outpatient department of a tertiary hospital.Methods:A cross-sectional study of PD patients was conducted in the outpatient department of a large tertiary hospital in Beijing from March 2022 to June 2023.A self-report questionnaire was developed to investigate PD patients’attitudes and acceptance of TCM based on the questionnaire.Multivariate logistic regression analyses were also performed to further clarify the independent predictors influencing patients’adoption of TCM therapy.Results:A total of 397 patients completed the questionnaire,of which 78.09%were willing to be treated with TCM and 21.91%indicated that they were not willing to use TCM.Multifactorial logistic regression analysis showed that several parameters were correlated with a patient’s willingness to include TCM in their therapeutic regime.These included education level of a bachelor’s degree(odds ratio[OR)=8.554;95%confidence interval[CI]:4.112–17.794;P<0.001,vs junior high school education),living in an urban setting(OR=8.022;95%CI:4.577–14.060;P<0.001,vs rural),having other underlying diseases(OR=5.126;95%CI:3.078–8.537;P<0.001,vs none),having previously used TCM(OR=3.083;95%CI:1.852–5.134;P<0.001,vs not used),believing that TCM therapy is safe(OR=3.530;95%CI:1.446–8.616;P=0.006,vs not thought),believing that TCM therapy is effective(OR=3.859;95%CI:1.482–10.047;P=0.006,vs not understood),and being willing to discuss ongoing TCM therapy with an attending physician(OR=62.468;95%CI:30.350–128.574;P<0.001,vs not informed).Conclusion:This study initially investigated the acceptance,attitude,and independ
