Objectives:This study aimed to generate a theoretical framework based on empirical data to explain the behavioral patterns closely related to young and middle-aged patients with lymphoma throughout the disease.Methods...Objectives:This study aimed to generate a theoretical framework based on empirical data to explain the behavioral patterns closely related to young and middle-aged patients with lymphoma throughout the disease.Methods:This study followed the classic grounded theory methodology,involving procedures such as theoretical sampling,substantive coding,theoretical coding,constant comparison,and memo writing and sorting.Multiple data types were used based on the principle of“all is data,”including 34 participants providing interview data along with observation notes and 40 relevant secondary texts from the“Lymphoma House”network platform and the“Lymphoma House 086”public account.Two autobiographical books written by lymphoma patients were also selected as data resources.Data collection and analysis were conducted in an iterative process until theoretical saturation was reached.The COREQ checklist was followed to report this study.Results:The main concern of middle-aged and young patients with lymphoma was identifiedas restoring normality,while managing uncertainty was the main behavioral pattern for restoring normality.Uncertainty consists of two interrelated types:inherent uncertainty of illness and perceived uncertainty of patients.Four strategies are used to manage uncertainty:reconstructing certainty,adaptive coping,defensive buffering,and compensatory changing.Managing uncertainty is influenced by disease characteristics and perceptions,social resources,and cultural concepts.The consequence of managing uncertainty is reaching a new normality.Conclusions:Pervasive uncertainty significantly affects the daily lives of young and middle-aged patients with lymphoma.Consequently,strategies for managing disease-related uncertainty to sustain normality are commonly observed in this population.This theoretical framework for addressing uncertainty can serve as a foundation for understanding and developing tailored interventions to manage uncertainty.Future research should focus on managing uncertainty to help patients restore normality.展开更多
BACKGROUND Breast cancer(BC)is the second most common malignancy globally.Young and middle-aged patients face more pressures from diagnosis,treatment,costs,and psychological issues like self-image concerns,social barr...BACKGROUND Breast cancer(BC)is the second most common malignancy globally.Young and middle-aged patients face more pressures from diagnosis,treatment,costs,and psychological issues like self-image concerns,social barriers,and professional challenges.Compared to other age groups,they have higher recurrence rates,lower survival rates,and increased risk of depression.Research is lacking on factors influencing depressive symptoms and predictive models for this age group.AIM To analyze factors influencing depressive symptoms in young/middle-aged BC patients and construct a depression risk predictive model.METHODS A total of 360 patients undergoing BC treatment at two tertiary hospitals in Jiangsu Province,China from November 2023 to April 2024 were included in the study.Participants were surveyed using a general information questionnaire,the patient health questionnaire depression scale,the visual analog scale for pain,the revised family support scale,and the long form of the international physical activity questionnaire.Univariate and multivariate analyses were conducted to identify the factors affecting depression in middle-aged and young BC patients,and a predictive model for depression risk was developed based on these findings.RESULTS Among the 360 middle-aged and young BC patients,the incidence rate of depressive symptoms was 38.61%(139/360).Multivariate analysis revealed that tumor grade,patient’s monthly income,pain score,family support score,and physical activity score were factors influencing depression in this patient group(P<0.05).The risk prediction model constructed based on these factors yielded an area under the receiver operating characteristic curve of 0.852,with a maximum Youden index of 0.973,sensitivity of 86.80%,specificity of 89.50%,and a diagnostic odds ratio of 0.552.The Hosmer-Lemeshow test for goodness of fit indicated an adequate model fit(χ^(2)=0.360,P=0.981).CONCLUSION The constructed predictive model demonstrates good predictive performance and can serve as a reference for medical professionals to early identify high-risk patients and implement corresponding preventive measures to decrease the incidence of depressive symptoms in this population.展开更多
Objective:This study aims to assess the influence of Metabolic Syndrome(MS)on the risk and severity of Coronary Artery Disease(CAD)in middle-aged and elderly women(40-75 years old),to inform evidence-based prevention ...Objective:This study aims to assess the influence of Metabolic Syndrome(MS)on the risk and severity of Coronary Artery Disease(CAD)in middle-aged and elderly women(40-75 years old),to inform evidence-based prevention and management strategies for this population.Methods:A retrospective study enrolled 200 middle-aged and elderly female patients(aged 40-75 years)who underwent coronary angiography(CAG)at our hospital between January 2024 and March 2025.Participants were divided into an MS group(n=88)and a non-MS group(n=112)based on meeting MS diagnostic criteria.General clinical data including age,body mass index[BMI],blood pressure,blood glucose,blood lipids,and more were collected for both groups.The severity of coronary artery lesions was quantified using the Gensini score.Differences in the positive rate of coronary artery lesions,the number of diseased vessel segments,and Gensini scores between the two groups were compared.Results:Patients in the MS group exhibited a significantly higher prevalence of coronary artery lesions(79.55%vs.48.21%,p<0.001),a greater proportion of multivessel disease(46.59%vs.18.75%,p<0.05),and higher Gensini scores(25.72±14.28 vs.16.35±9.86,p<0.05)compared to the non-MS group.Conclusion:Metabolic syndrome is a significant risk factor for coronary artery disease in middle-aged and elderly women,substantially increasing both the incidence and severity of coronary lesions.Clinical efforts should focus on enhancing screening and comprehensive intervention for metabolic syndrome in this population to reduce the risk of coronary heart disease.展开更多
AIM:To evaluate the prevalence of early post-traumatic stress disorder(PTSD)among young and middle-aged patients who have suffered open globe injuries,and to identify the psychosocial factors influencing PTSD in these...AIM:To evaluate the prevalence of early post-traumatic stress disorder(PTSD)among young and middle-aged patients who have suffered open globe injuries,and to identify the psychosocial factors influencing PTSD in these patients.METHODS:A total of 280 patients who underwent ocular trauma surgery between January 2023 and January 2024 were selected through convenience sampling.Data were collected using a custom-designed demographic questionnaire,the Connor-Davidson Resilience Scale(CDRISC),the Cognitive Emotion Regulation Questionnaire(C-ERRI),and the PTSD Checklist-Civilian Version(PCL-C).Univariate analysis and stepwise multiple linear regression analysis were performed to determine the factors affecting PTSD in these patients.RESULTS:The average PTSD score for the patients was 33.22±13.48.The scores for individual PTSD dimensions,ranked from highest to lowest,were recurrent traumatic experiences,heightened arousal,avoidance reactions,and social dysfunction.Positive PTSD symptoms were observed in 85 patients(30.36%).Univariate analysis indicated that gender,postoperative vision,marital status,psychological resilience,and rumination were significant factors affecting PTSD symptoms(χ^(2)/t=6.53,17.88,8.83,2.17,and 14.1,respectively;all P<0.05).Pearson correlation analysis showed a positive correlation between rumination and PTSD symptoms(r=0.73,P<0.01)and a negative correlation between psychological resilience and PTSD symptoms(r=-0.14,P<0.05).Stepwise multiple linear regression analysis identified postoperative vision(notably eye removal),rumination levels,and psychological resilience(optimism)as major factors influencing PTSD in these patients(R^(2)=0.57,P<0.001).CONCLUSION:Young and middle-aged patients with open globe injuries have a high incidence of PTSD.Significant risk factors for early PTSD include primary enucleation,high levels of rumination,and low psychological resilience(optimism).Conversely,patients with good postoperative vision recovery,low rumination levels,and high levels of optimism are less likely to develop PTSD.Healthcare providers should pay special attention to patients who undergo primary enucleation,strive to reduce their rumination levels,and enhance their psychological resilience,thereby promoting a positive and optimistic attitude towards their condition and reducing the incidence of PTSD.展开更多
[Objectives]To systematically evaluate the impact of interventions based on the Common Sense Model of Self-Regulation(CSM)on the psychosocial adaptation of young and middle-aged patients with acute coronary syndrome(A...[Objectives]To systematically evaluate the impact of interventions based on the Common Sense Model of Self-Regulation(CSM)on the psychosocial adaptation of young and middle-aged patients with acute coronary syndrome(ACS),providing evidence-based support for clinical practice.[Methods]A systematic review was conducted using a literature search method,systematically searching through Chinese and English databases such as PubMed,Embase,Cochrane Library,CINAHL,China National Knowledge Infrastructure(CNKI),Wanfang Database,and VIP Database,from the database inception to December 31,2024.The search focused on studies related to the impact of the CSM on the psychosocial adaptation of young and middle-aged ACS patients.Two researchers independently performed literature screening,quality assessment,and data extraction.[Results]A total of 18 studies were included,comprising 12 randomized controlled trials,4 quasi-experimental studies,and 2 cohort studies,involving 2847 young and middle-aged ACS patients.Interventions based on the CSM significantly improved patients disease perception,emotional regulation,self-efficacy,and quality of life.Patients in the intervention group showed significant reductions in anxiety and depression levels,cardiac-related fear,and improvements in disease perception accuracy,treatment adherence,and social function recovery.[Conclusions]Interventions based on the CSM can effectively promote the psychosocial adaptation of young and middle-aged ACS patients,improve their disease perception and emotional state,and enhance their quality of life.It is recommended that this model be widely applied in the clinical care of young and middle-aged ACS patients.展开更多
Objective: To explore the association between cardiometabolic multimorbidity and frailty among middle- aged and older adults in China. Methods: Data were derived from the 2013 wave of the China Longitudinal Healthy Lo...Objective: To explore the association between cardiometabolic multimorbidity and frailty among middle- aged and older adults in China. Methods: Data were derived from the 2013 wave of the China Longitudinal Healthy Longevity Survey, including a total of 6,179 individuals aged 45 years and above with complete follow-up records. Basic demographic information was collected, and frailty status was assessed using a physical frailty scale. Generalized linear models were employed to analyze the association between the number and combinations of cardiometabolic conditions- such as hypertension, diabetes, heart disease, and stroke-and frailty. Results: The prevalence of cardiometabolic multimorbidity among middle-aged and older adults was 14.23%. After adjusting for sociodemographic covariates, individuals with cardiometabolic multimorbidity had a significantly increased risk of frailty compared to those without such conditions (OR = 1.78, 95% CI: 1.45-2.19), along with higher frailty scale scores (β = 0.26, 95% CI: 0.19-0.34). Compared to individuals without cardiometabolic diseases, those with both hypertension and stroke (OR = 1.18, 95% CI: 1.06-1.31) and those with hypertension, heart disease, and stroke (OR = 1.46, 95% CI: 1.24-1.73) exhibited notably higher frailty risks. Conclusion: There is a significant association between cardiometabolic multimorbidity and frailty in middle- aged and older adults in China, particularly for comorbidity patterns involving hypertension. These findings provide evidence for developing targeted health interventions for aging populations.展开更多
This article reviews the characteristics of psychological disorders in young and middle-aged acute coronary syndrome(ACS)patients,the mechanisms and effects of various psychological intervention strategies,factors inf...This article reviews the characteristics of psychological disorders in young and middle-aged acute coronary syndrome(ACS)patients,the mechanisms and effects of various psychological intervention strategies,factors influencing return to work,and current research problems and development trends,to provide scientific evidence for psychological rehabilitation and social function recovery of young and middle-aged ACS patients.展开更多
Objective:To explore the application effect of the hospital-community-family model-based combined rehabilitation exercise intervention on middle-aged and elderly patients with chronic kidney disease.Methods:Using the ...Objective:To explore the application effect of the hospital-community-family model-based combined rehabilitation exercise intervention on middle-aged and elderly patients with chronic kidney disease.Methods:Using the convenience sampling method,80 patients in the stable stage of CKD who were treated in the nephrology department of a tertiary hospital from May 2022 to June 2023 were selected as the research subjects.They were divided into the experimental group(40 cases)and the control group(40 cases)by random number table method.The control group received conventional exercise intervention plus telephone follow-up,while the experimental group received combined hospital-community-family modelbased exercise intervention in addition to the control group,using remote medical guidance and monitoring of the application effect of exercise rehabilitation on middle-aged and elderly patients with chronic kidney disease.The glomerular filtration rate,6-minute walking distance,fatigue and social support scores of the two groups of patients were measured before the intervention,4 weeks after the intervention,and 12 weeks after the intervention.Results:Before the intervention,there were no statistically significant differences in glomerular filtration rate,6-minute walking distance,fatigue and social support scores between the two groups(p>0.05).After 12 weeks of intervention,the glomerular filtration rate,6-minute walking distance and social support scores of the experimental group were higher than those of the control group;the differences were statistically significant(p<0.05).The behavioral,emotional,sensory and cognitive scores of the Piper-Fatigue Revised Scale of the experimental group were lower than those of the control group,and the differences were statistically significant(p<0.05).Conclusion:Based on the hospital-community-family model combined rehabilitation exercise,using remote medical guidance for the continuous care of middle-aged and elderly patients in the stable stage of chronic kidney disease can effectively improve the exercise endurance and social support level of patients,improve the fatigue condition,and the implementation effect is positively correlated with the intervention time.展开更多
Objective:To analyze the impact and mechanism of the SOC model intervention on improving health literacy and reducing disease uncertainty among young and middle-aged patients with coronary heart disease.Methods:A hund...Objective:To analyze the impact and mechanism of the SOC model intervention on improving health literacy and reducing disease uncertainty among young and middle-aged patients with coronary heart disease.Methods:A hundred young and middle-aged patients with coronary heart disease from our hospital between March and October 2024 were randomly divided into an observation group and a control group,with 50 patients in each group.Both groups received routine nursing intervention,while the observation group also received intervention based on the Stages of Change(SOC)model.The intervention period was 30 days.Changes in self-efficacy,health literacy,and disease uncertainty were compared between the two groups before and after the intervention.Results:After the intervention,the self-efficacy scores of both groups increased significantly,and the observation group had higher self-efficacy scores than the control group,with a significant difference(P<0.05).Additionally,the observation group showed significantly higher levels of health literacy than the control group(P<0.001).Furthermore,the observation group had significantly lower scores for disease uncertainty compared to the control group(P<0.001).Conclusion:The SOC model,in addition to routine nursing,significantly affects self-efficacy,disease uncertainty,and health literacy among young and middle-aged patients with coronary heart disease.It helps to enhance patients’knowledge of coronary heart disease,improve health literacy levels,and reduce disease uncertainty,making it worthy of clinical promotion and application.展开更多
Objective:To explore the current status of social alienation and its influencing factors among young and middle-aged stroke patients in Dali.Methods:A convenience sampling method was used to survey 385 young and middl...Objective:To explore the current status of social alienation and its influencing factors among young and middle-aged stroke patients in Dali.Methods:A convenience sampling method was used to survey 385 young and middle-aged stroke patients in a tertiary hospital in Dali from December 2024 to July 2025.Questionnaires including general demographic information,the General Alienation Scale,the Athens insomnia scale,and others were administered.Results:The social alienation score of young and middle-aged stroke patients in Dali was(35.67±3.46).Univariate analysis showed that general demographic factors[education level,monthly household income,whether it was the first onset,presence of sequelae,disease duration,activities of daily living(ADL,Barthel Index)],social support,stigma,self-perceived burden,anxiety and depression,and sleep status were influencing factors of social alienation(P<0.05).Regression analysis indicated that social support,anxiety and depression,disease duration,stigma,presence of sequelae,and self-care ability were significant influencing factors of social alienation(P<0.01),explaining 65.3%of the total variance.Conclusion:The level of social alienation among young and middle-aged stroke patients in Dali is relatively low.Special attention should be paid to patients with a disease duration of<7 days,those with sequelae,moderate-to-severe dependence in self-care,low social support,high stigma,and high levels of anxiety and depression,to effectively reduce their social alienation.展开更多
In order to promote the growth of mid-aged Pinus elliottii plantation, the effects of different fertilizing amounts of formula fertilizer were studied on the growth, the soil and cost-benefit of 9 year-old Pinus el/io...In order to promote the growth of mid-aged Pinus elliottii plantation, the effects of different fertilizing amounts of formula fertilizer were studied on the growth, the soil and cost-benefit of 9 year-old Pinus el/iottii plantations in the north- ern part of Hunan, China. Three years after fertilization, the results showed that the increments of DBH, height, individual volume and stock volume of stand, and the fertilizer benefit of the different fertilization treatments were higher than the control to varying degrees, and among them, 700 g/tree was the best for promoting the growth of Pinus elliottii. Two years fertilization, the soil nutrients were improved compared with before, pH values of different layers decreased, organic matter and rapid available K contents increased, and rapid available N content increased dra- matically with the upper layer having an increase higher than the lower one; rapid available P decreased at different levels with the upper layer having a decrease lower than the lower one; and proper application of fertilizer could promote the growth of Pisolithus tinctofius, and 7 months after fertilization, the number of Pisolithus fruiting body generally increased with the increase of the fertilizer within 100-800 g/tree. The yield and benefit per unit area could be increased by fertiliza- tion for 1 time in middle-aged Pinus elliottii plantations, and the best fertilizing amount was N-P-K fertilizer 700 g/tree.展开更多
This study sought to investigate late-onset hypogonadism （LOH） in old and middle-aged males in Shanghai communities, using symptom score evaluation systems and measurements of sex hormone levels. One thousand cases ...This study sought to investigate late-onset hypogonadism （LOH） in old and middle-aged males in Shanghai communities, using symptom score evaluation systems and measurements of sex hormone levels. One thousand cases of males aged 40-70 years were investigated. The aging male symptoms （AMS） scale and androgen deficiency in aging males （ADAM） questionnaire were used at the beginning of the investigation, followed by measurement of the sex hormone-related factors （total testosterone （TT）, free testosterone （fT）, sex hormone-binding globulin （SHBG） and bioavailability of testosterone （Bio-T））. There were 977 valid questionnaires. The LOH-positive rates shown by AMS and ADAM were 59.88% and 84.65%, respectively; values increased with the age of the patients. There were 946 results related to sex hormone measurements, which showed the following results： TT was not related to aging （P〉O.05）; levels of SHBG increased with age; and fT and Bio-T decreased with age. There was a significant difference in fT between LOH-positive and LOH-negative patients, as shown by the ADAM. In summary, TT levels were not related to aging, even though SHBG did increase while fT and Bio-T decreased with aging. Clinically, the diagnosis of LOH cannot be based on serum TT level.展开更多
This study aimed to propose an operational definition of late-onset hypogonadism(LOH)that incorporates both clinical symptoms and serum testosterone measurements to evaluate the prevalence of LOH in aging males in Chi...This study aimed to propose an operational definition of late-onset hypogonadism(LOH)that incorporates both clinical symptoms and serum testosterone measurements to evaluate the prevalence of LOH in aging males in China.A population-based sample of 6296 men aged 40 years-79 years old was enrolled from six representative provinces in China.Serum total testosterone(TT),sex hormone-binding globulin(SHBG),and luteinizing hormone(LH)were measured and free testosterone(cFT)was calculated.The Aging Males’Symptoms(AMS)scale was used to evaluate the LOH symptoms.Finally,5078 men were included in this analysis.The TT levels did not decrease with age(P=0.59),and had no relationship with AMS symptoms(P=0.87 for AMS total score,P=0.74 for≥3 sexual symptoms).The cFT levels decreased significantly with age(P<0.01)and showed a negative association with the presence of≥3 sexual symptoms(P=0.03).The overall estimated prevalence of LOH was 7.8%(395/5078)if a cFT level<210 pmol l−1 combined with the presence of≥3 sexual symptoms was used as the criterion of LOH.Among them,26.1%(103/395)and 73.9%(292/395)had primary and secondary hypogonadism,respectively.After adjustment for confounding factors,primary and secondary hypogonadism was positively related to age and comorbidities.Body mass index was an independent risk factor for secondary hypogonadism.The results suggest that the AMS total score is not an appropriate indicator for decreased testosterone,and that the cFT level is more reliable than TT for LOH diagnosis.Secondary hypogonadism is the most common form of LOH.展开更多
In this study, we investigated the essential criteria for late-onset hypogonadism （LOH） syndrome based on the presence of symptoms associated with low testosterone levels in Han Chinese men. Blood tests for total te...In this study, we investigated the essential criteria for late-onset hypogonadism （LOH） syndrome based on the presence of symptoms associated with low testosterone levels in Han Chinese men. Blood tests for total testosterone （TT） and sex hormone-binding globulin （SHBG） were performed, and the aging male symptoms （AMS） questionnaire was conducted in a randomly selected cohort composed of 944 Chinese men aged 40 to 79 years from nine urban communities. Three sexual symptoms （decreased ability/frequency of sexual activity, decreased number of morning erections, and decreased libido） were confirmed to be related to the total and free testosterone levels. The thresholds for TT were approximately 12.55 nmol l^-1 for a decreased ability/frequency to perform sex, 12.55 nmol l^-1 for decreased frequency of morning erections, and 14.35 nmol l^-1 for decreased sexual desire. The calculated free testosterone （CFT） thresholds for these three sexual symptoms were 281.14, 264.90, and 287.21 pmol l^-1, respectively. TT 〈13.21 nmol l^-1 （OR =1.4, 95%Ch 1.0-1.9, P= 0.037） or CFT 〈268.89 pmol l^-1 （OR - 1.5, 95%Ch 1.1-20, P=0.020） was associated with an increase in the aforementioned three sexual symptoms. The prevalence of LOH was 9.1% under the criteria, including all three sexual symptoms with TT levels 〈13.21 nmol l^-1 and CFT levels 〈268.89 pmol l^-1. Our results may improve the diagnostic accuracy of LOH in older men.展开更多
A 36-year-old woman was admitted to our department for close examination of a liver tumor that was found during a medical checkup. Abdominal US, CT and MRI showed a tumor in segment 7 (S7) of the liver. Although imagi...A 36-year-old woman was admitted to our department for close examination of a liver tumor that was found during a medical checkup. Abdominal US, CT and MRI showed a tumor in segment 7 (S7) of the liver. Although imaging suggested hepatocellular carcinoma, laboratory tests showed no abnormality in liver function, hepatitis virus markers were negative, and tumor markers including protein induced by vitamin K absence or antagonist Ⅱ (PIVKA-Ⅱ), α-fetoprotein (AFP), carbohydrate antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA) were all within normal ranges. Upon aspiration biopsy of the liver, the histopathological diagnosis was moderately differentiated hepatocellular carcinoma. Therefore, right hepatectomy was performed. Although a part of the tumor was necrotic, about 60% of the viable part showed a clear-cell variant. Consequently, it was diagnosed as clear-cell hepatocellular carcinoma. It was noted that the background liver tissue was normal. This case is worthy of reporting because development of clear-cell hepatocellular carcinoma in the normal liver of a middle-aged woman is rarely seen.展开更多
Self-medication is an increasingly frequent phenomenon worldwide and has an important influence on health.In this study,we analyzed the self-medication prevalence rate in Chinese middle-aged and elderly people,and exp...Self-medication is an increasingly frequent phenomenon worldwide and has an important influence on health.In this study,we analyzed the self-medication prevalence rate in Chinese middle-aged and elderly people,and explored the influence factors.The data from China Health and Retirement Longitudinal Study(CHARLS)in 2011,2013 and 2015 were used.Self-medication prevalence was calculated as the number of whole people divided by the number of people taking self-medication.The influence factors of self-medication were analyzed by panel data random effect model.We excluded observations with missing values in our analysis,leaving 16 962,17 876 and 19 572 observations in 2011,2013 and 2015,respectively.The average 3-year self-medication prevalence was 45.52%.Moreover,11.70%of respondents practiced self-medication with prescription medicine in 2011,2013 and 2015.Respondents living in non-rural areas(P=0.009)and western region(P=0.000)took more self-medication.Self-medication was a common phenomenon among middle-aged and elderly population in China.The government should strengthen the guidance for the middle-aged and elderly people who took more self-medication,such as those living in urban and western region.展开更多
Objective The association of metabolic syndrome （MetS） with cardiovascular diseases （CVD） has not been adequately explored in middle-aged and elderly Chinese. This study aimed to investigate MetS＇ prevalence and ...Objective The association of metabolic syndrome （MetS） with cardiovascular diseases （CVD） has not been adequately explored in middle-aged and elderly Chinese. This study aimed to investigate MetS＇ prevalence and its impact on the CVD incidence in this specific population group. Methods A data set of a community-based prospective cohort study was analyzed. A total of 2300 subjects aged 40-94 years were followed up for the CVD events. MetS defined according to the JCDCG criteria was assessed at baseline, and the middle-aged and elderly groups were classified by the WHO definition. Results As compared with the middle-aged group, the prevalence of MetS increased by 0.6 times （34.6% vs. 21.3%） and the incidence density of CVD increased by 4.9 times in the elderly group （52.3/1000 person-year vs. 8.9/1000 person-year）. Furthermore, the multivariate Cox regression revealed that the risk to CVD incidence was independently related to increased waist circumference in the middle-aged group （HR=2.23, P〈0.01） and to elevated blood glucose in the elderly group （HR=1.39, P〈O.01）. Conclusion MetS was highly prevalent in middle-aged and elderly Chinese. MetS significantly increased the risk to OdD incidence in the elderly. All individuals with metabolic disorders should receive active clinical care to reduce the incidence of CVD.展开更多
Objective Central obesity is considered to be a central component of metabolic syndrome. Waist circumference （WC） has been widely used as a simple indicator of central obesity. This study is aimed to evaluate the se...Objective Central obesity is considered to be a central component of metabolic syndrome. Waist circumference （WC） has been widely used as a simple indicator of central obesity. This study is aimed to evaluate the sensitivity of WC cut-off values for predicting metabolic risk factors in middle-aged Chinese. Methods The study involved 923 subjects aged according to the Chinese Joint Committee for 40-65 years. The metabolic risk factors were defined Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. WC cut-off 85-90 cm and 〉90 cm were used as cut-off values of central pre-obesity and central obesity in males, respectively, while WC 80-85 cm and 〉85 cm were used as cut-off values of central pre-obesity and central obesity in females. Results First, WC values corresponding to body mass index （BMI） 24 kg/m2 and visceral fat area （VFA） 80 cm2 were 88.55 cm and 88.51 cm in males, and 82.46 cm and 82.52 cm in females respectively. Second, receiver operating characteristic curves showed that the optimal WC cut-off of value was 88.75 cm in males, higher than that in females （81.75 cm）. Third, the subjects with higher WC values were more likely to have accumulating metabolic risk factors. The prevalence of metabolic risk factors increased linearly and significantly in relation to WC levels. Conclusion WC cut-off values of central pre-/central obesity are optimal to predict multiple metabolic risk factors.展开更多
This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to Feb...This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to February 2022,620 participants(320 rural and 300 urban residents)from three provinces of China were selected by con-venience sampling.A general data questionnaire,mental health literacy scale,perceived social support scale and subjective well-being scale were administered.The mental health literacy scores of urban residents were 3.34±0.57 and those of rural residents were 2.73±0.79.The results of multiple regression analysis showed that the mental health literacy scores of rural residents were more significant than those of urban residents in terms of sex and age,while urban residents’mental health literacy scores were more significant than those of rural resi-dents in terms of monthly income.Mental health literacy,perceived social support and subjective well-being of young and middle-aged urban and rural residents were all positively correlated(P<0.01).While the level of mental health literacy is better among urban residents than rural residents,perceived social support plays a partial mediating role between mental health literacy and subjective well-being of both urban and rural residents,and should be the focus of researchers seeking to improve the level of well-being of residents.展开更多
AIM:To quantitatively examine the impacts of an easyto-measure parameter-weight gain-on metabolic syndrome development among middle-aged adults. METHODS:We conducted a five-year interval observational study.A total of...AIM:To quantitatively examine the impacts of an easyto-measure parameter-weight gain-on metabolic syndrome development among middle-aged adults. METHODS:We conducted a five-year interval observational study.A total of 1384 middle-aged adults not meeting metabolic syndrome(MetS)criteria at the initial screening were included in our analysis.Baseline data such as MetS-components and lifestyle factors were collected in 2002.Body weight and MetS-components were measured in both 2002 and 2007.Participants were classified according to proximal quartiles of weight gain(WG)in percentages(%WG≤1%,1%< %WG≤5%,5%<%WG≤10%and%WG>10%, defined as:control,mild-WG,moderate-WG and severe-WG groups,respectively)at the end of the follow-up. Multivariate models were used to assess the association between MetS outcome and excessive WG in the total population,as well as in both genders. RESULTS:In total,175(12.6%)participants fulfilled MetS criteria within five years.In comparison to the control group,mild-WG adults had an insignificant risk for MetS development while adults having moderate-WG had a 3.0-fold increased risk for progression to MetS [95%confidence interval(CI),1.8-5.1],and this risk was increased 5.4-fold(95%CI,3.0-9.7)in subjects having severe-WG.For females having moderate-and severe-WG,the risk for developing MetS was 3.6(95% CI,1.03-12.4)and 5.5(95%CI,1.4-21.4),respectively. For males having moderate-and severe-WG,the odds ratio for MetS outcome was respectively 3.0(95%CI, 1.6-5.5)and 5.2(95%CI,2.6-10.2). CONCLUSION:For early-middle-aged healthy adults with a five-year weight gain over 5%,the severity of weight gain is related to the risk for developing metabolic syndrome.展开更多
基金supported by the Postgraduate Supervision Fund within the School of Nursing at Fujian Medical University(No.110013)。
文摘Objectives:This study aimed to generate a theoretical framework based on empirical data to explain the behavioral patterns closely related to young and middle-aged patients with lymphoma throughout the disease.Methods:This study followed the classic grounded theory methodology,involving procedures such as theoretical sampling,substantive coding,theoretical coding,constant comparison,and memo writing and sorting.Multiple data types were used based on the principle of“all is data,”including 34 participants providing interview data along with observation notes and 40 relevant secondary texts from the“Lymphoma House”network platform and the“Lymphoma House 086”public account.Two autobiographical books written by lymphoma patients were also selected as data resources.Data collection and analysis were conducted in an iterative process until theoretical saturation was reached.The COREQ checklist was followed to report this study.Results:The main concern of middle-aged and young patients with lymphoma was identifiedas restoring normality,while managing uncertainty was the main behavioral pattern for restoring normality.Uncertainty consists of two interrelated types:inherent uncertainty of illness and perceived uncertainty of patients.Four strategies are used to manage uncertainty:reconstructing certainty,adaptive coping,defensive buffering,and compensatory changing.Managing uncertainty is influenced by disease characteristics and perceptions,social resources,and cultural concepts.The consequence of managing uncertainty is reaching a new normality.Conclusions:Pervasive uncertainty significantly affects the daily lives of young and middle-aged patients with lymphoma.Consequently,strategies for managing disease-related uncertainty to sustain normality are commonly observed in this population.This theoretical framework for addressing uncertainty can serve as a foundation for understanding and developing tailored interventions to manage uncertainty.Future research should focus on managing uncertainty to help patients restore normality.
基金Supported by Jiangsu Provincial Cadre Healthcare Scientific Research Grant Project,No.BJ23019Jiangsu Provincial Association of Maternal and Child Healthcare Scientific Research Grant Project,No.FYX202350+2 种基金Special Fund for the Project of Enhancing Academic Capability of Integrative Nursing,No.ZXYJHHL-K-2023-M20Jiangsu Provincial Graduate Student Practice and Innovation Program Project,No.SJCX24_0833the Training Project for Backbone Talents in Traditional Chinese Medicine Nursing in Nanjing Region,No.Ningwei Zhongyi[2023]No.8.
文摘BACKGROUND Breast cancer(BC)is the second most common malignancy globally.Young and middle-aged patients face more pressures from diagnosis,treatment,costs,and psychological issues like self-image concerns,social barriers,and professional challenges.Compared to other age groups,they have higher recurrence rates,lower survival rates,and increased risk of depression.Research is lacking on factors influencing depressive symptoms and predictive models for this age group.AIM To analyze factors influencing depressive symptoms in young/middle-aged BC patients and construct a depression risk predictive model.METHODS A total of 360 patients undergoing BC treatment at two tertiary hospitals in Jiangsu Province,China from November 2023 to April 2024 were included in the study.Participants were surveyed using a general information questionnaire,the patient health questionnaire depression scale,the visual analog scale for pain,the revised family support scale,and the long form of the international physical activity questionnaire.Univariate and multivariate analyses were conducted to identify the factors affecting depression in middle-aged and young BC patients,and a predictive model for depression risk was developed based on these findings.RESULTS Among the 360 middle-aged and young BC patients,the incidence rate of depressive symptoms was 38.61%(139/360).Multivariate analysis revealed that tumor grade,patient’s monthly income,pain score,family support score,and physical activity score were factors influencing depression in this patient group(P<0.05).The risk prediction model constructed based on these factors yielded an area under the receiver operating characteristic curve of 0.852,with a maximum Youden index of 0.973,sensitivity of 86.80%,specificity of 89.50%,and a diagnostic odds ratio of 0.552.The Hosmer-Lemeshow test for goodness of fit indicated an adequate model fit(χ^(2)=0.360,P=0.981).CONCLUSION The constructed predictive model demonstrates good predictive performance and can serve as a reference for medical professionals to early identify high-risk patients and implement corresponding preventive measures to decrease the incidence of depressive symptoms in this population.
文摘Objective:This study aims to assess the influence of Metabolic Syndrome(MS)on the risk and severity of Coronary Artery Disease(CAD)in middle-aged and elderly women(40-75 years old),to inform evidence-based prevention and management strategies for this population.Methods:A retrospective study enrolled 200 middle-aged and elderly female patients(aged 40-75 years)who underwent coronary angiography(CAG)at our hospital between January 2024 and March 2025.Participants were divided into an MS group(n=88)and a non-MS group(n=112)based on meeting MS diagnostic criteria.General clinical data including age,body mass index[BMI],blood pressure,blood glucose,blood lipids,and more were collected for both groups.The severity of coronary artery lesions was quantified using the Gensini score.Differences in the positive rate of coronary artery lesions,the number of diseased vessel segments,and Gensini scores between the two groups were compared.Results:Patients in the MS group exhibited a significantly higher prevalence of coronary artery lesions(79.55%vs.48.21%,p<0.001),a greater proportion of multivessel disease(46.59%vs.18.75%,p<0.05),and higher Gensini scores(25.72±14.28 vs.16.35±9.86,p<0.05)compared to the non-MS group.Conclusion:Metabolic syndrome is a significant risk factor for coronary artery disease in middle-aged and elderly women,substantially increasing both the incidence and severity of coronary lesions.Clinical efforts should focus on enhancing screening and comprehensive intervention for metabolic syndrome in this population to reduce the risk of coronary heart disease.
文摘AIM:To evaluate the prevalence of early post-traumatic stress disorder(PTSD)among young and middle-aged patients who have suffered open globe injuries,and to identify the psychosocial factors influencing PTSD in these patients.METHODS:A total of 280 patients who underwent ocular trauma surgery between January 2023 and January 2024 were selected through convenience sampling.Data were collected using a custom-designed demographic questionnaire,the Connor-Davidson Resilience Scale(CDRISC),the Cognitive Emotion Regulation Questionnaire(C-ERRI),and the PTSD Checklist-Civilian Version(PCL-C).Univariate analysis and stepwise multiple linear regression analysis were performed to determine the factors affecting PTSD in these patients.RESULTS:The average PTSD score for the patients was 33.22±13.48.The scores for individual PTSD dimensions,ranked from highest to lowest,were recurrent traumatic experiences,heightened arousal,avoidance reactions,and social dysfunction.Positive PTSD symptoms were observed in 85 patients(30.36%).Univariate analysis indicated that gender,postoperative vision,marital status,psychological resilience,and rumination were significant factors affecting PTSD symptoms(χ^(2)/t=6.53,17.88,8.83,2.17,and 14.1,respectively;all P<0.05).Pearson correlation analysis showed a positive correlation between rumination and PTSD symptoms(r=0.73,P<0.01)and a negative correlation between psychological resilience and PTSD symptoms(r=-0.14,P<0.05).Stepwise multiple linear regression analysis identified postoperative vision(notably eye removal),rumination levels,and psychological resilience(optimism)as major factors influencing PTSD in these patients(R^(2)=0.57,P<0.001).CONCLUSION:Young and middle-aged patients with open globe injuries have a high incidence of PTSD.Significant risk factors for early PTSD include primary enucleation,high levels of rumination,and low psychological resilience(optimism).Conversely,patients with good postoperative vision recovery,low rumination levels,and high levels of optimism are less likely to develop PTSD.Healthcare providers should pay special attention to patients who undergo primary enucleation,strive to reduce their rumination levels,and enhance their psychological resilience,thereby promoting a positive and optimistic attitude towards their condition and reducing the incidence of PTSD.
基金Supported by Philosophy and Social Sciences Research Project of Hubei Provincial Department of Education(22Q149,19Y090).
文摘[Objectives]To systematically evaluate the impact of interventions based on the Common Sense Model of Self-Regulation(CSM)on the psychosocial adaptation of young and middle-aged patients with acute coronary syndrome(ACS),providing evidence-based support for clinical practice.[Methods]A systematic review was conducted using a literature search method,systematically searching through Chinese and English databases such as PubMed,Embase,Cochrane Library,CINAHL,China National Knowledge Infrastructure(CNKI),Wanfang Database,and VIP Database,from the database inception to December 31,2024.The search focused on studies related to the impact of the CSM on the psychosocial adaptation of young and middle-aged ACS patients.Two researchers independently performed literature screening,quality assessment,and data extraction.[Results]A total of 18 studies were included,comprising 12 randomized controlled trials,4 quasi-experimental studies,and 2 cohort studies,involving 2847 young and middle-aged ACS patients.Interventions based on the CSM significantly improved patients disease perception,emotional regulation,self-efficacy,and quality of life.Patients in the intervention group showed significant reductions in anxiety and depression levels,cardiac-related fear,and improvements in disease perception accuracy,treatment adherence,and social function recovery.[Conclusions]Interventions based on the CSM can effectively promote the psychosocial adaptation of young and middle-aged ACS patients,improve their disease perception and emotional state,and enhance their quality of life.It is recommended that this model be widely applied in the clinical care of young and middle-aged ACS patients.
文摘Objective: To explore the association between cardiometabolic multimorbidity and frailty among middle- aged and older adults in China. Methods: Data were derived from the 2013 wave of the China Longitudinal Healthy Longevity Survey, including a total of 6,179 individuals aged 45 years and above with complete follow-up records. Basic demographic information was collected, and frailty status was assessed using a physical frailty scale. Generalized linear models were employed to analyze the association between the number and combinations of cardiometabolic conditions- such as hypertension, diabetes, heart disease, and stroke-and frailty. Results: The prevalence of cardiometabolic multimorbidity among middle-aged and older adults was 14.23%. After adjusting for sociodemographic covariates, individuals with cardiometabolic multimorbidity had a significantly increased risk of frailty compared to those without such conditions (OR = 1.78, 95% CI: 1.45-2.19), along with higher frailty scale scores (β = 0.26, 95% CI: 0.19-0.34). Compared to individuals without cardiometabolic diseases, those with both hypertension and stroke (OR = 1.18, 95% CI: 1.06-1.31) and those with hypertension, heart disease, and stroke (OR = 1.46, 95% CI: 1.24-1.73) exhibited notably higher frailty risks. Conclusion: There is a significant association between cardiometabolic multimorbidity and frailty in middle- aged and older adults in China, particularly for comorbidity patterns involving hypertension. These findings provide evidence for developing targeted health interventions for aging populations.
基金Supported by Humanities and Social Sciences Project of Hubei Provincial Department of Education(22Q149&19Y090).
文摘This article reviews the characteristics of psychological disorders in young and middle-aged acute coronary syndrome(ACS)patients,the mechanisms and effects of various psychological intervention strategies,factors influencing return to work,and current research problems and development trends,to provide scientific evidence for psychological rehabilitation and social function recovery of young and middle-aged ACS patients.
基金2024 Annual Medical Science Research Project of Hebei Province,Research on the Rehabilitation Effect of Joint Exercise Intervention Based on Hospital-Community-Family Model for Elderly Patients with Chronic Diseases(Project No.:20240083)。
文摘Objective:To explore the application effect of the hospital-community-family model-based combined rehabilitation exercise intervention on middle-aged and elderly patients with chronic kidney disease.Methods:Using the convenience sampling method,80 patients in the stable stage of CKD who were treated in the nephrology department of a tertiary hospital from May 2022 to June 2023 were selected as the research subjects.They were divided into the experimental group(40 cases)and the control group(40 cases)by random number table method.The control group received conventional exercise intervention plus telephone follow-up,while the experimental group received combined hospital-community-family modelbased exercise intervention in addition to the control group,using remote medical guidance and monitoring of the application effect of exercise rehabilitation on middle-aged and elderly patients with chronic kidney disease.The glomerular filtration rate,6-minute walking distance,fatigue and social support scores of the two groups of patients were measured before the intervention,4 weeks after the intervention,and 12 weeks after the intervention.Results:Before the intervention,there were no statistically significant differences in glomerular filtration rate,6-minute walking distance,fatigue and social support scores between the two groups(p>0.05).After 12 weeks of intervention,the glomerular filtration rate,6-minute walking distance and social support scores of the experimental group were higher than those of the control group;the differences were statistically significant(p<0.05).The behavioral,emotional,sensory and cognitive scores of the Piper-Fatigue Revised Scale of the experimental group were lower than those of the control group,and the differences were statistically significant(p<0.05).Conclusion:Based on the hospital-community-family model combined rehabilitation exercise,using remote medical guidance for the continuous care of middle-aged and elderly patients in the stable stage of chronic kidney disease can effectively improve the exercise endurance and social support level of patients,improve the fatigue condition,and the implementation effect is positively correlated with the intervention time.
基金Handan City Science and Technology Research and Development Program Project Application(Project No.:23422083096ZC)。
文摘Objective:To analyze the impact and mechanism of the SOC model intervention on improving health literacy and reducing disease uncertainty among young and middle-aged patients with coronary heart disease.Methods:A hundred young and middle-aged patients with coronary heart disease from our hospital between March and October 2024 were randomly divided into an observation group and a control group,with 50 patients in each group.Both groups received routine nursing intervention,while the observation group also received intervention based on the Stages of Change(SOC)model.The intervention period was 30 days.Changes in self-efficacy,health literacy,and disease uncertainty were compared between the two groups before and after the intervention.Results:After the intervention,the self-efficacy scores of both groups increased significantly,and the observation group had higher self-efficacy scores than the control group,with a significant difference(P<0.05).Additionally,the observation group showed significantly higher levels of health literacy than the control group(P<0.001).Furthermore,the observation group had significantly lower scores for disease uncertainty compared to the control group(P<0.001).Conclusion:The SOC model,in addition to routine nursing,significantly affects self-efficacy,disease uncertainty,and health literacy among young and middle-aged patients with coronary heart disease.It helps to enhance patients’knowledge of coronary heart disease,improve health literacy levels,and reduce disease uncertainty,making it worthy of clinical promotion and application.
基金Scientific Research Fund Project of Yunnan Provincial Education Department(Project No.:2024J0832)。
文摘Objective:To explore the current status of social alienation and its influencing factors among young and middle-aged stroke patients in Dali.Methods:A convenience sampling method was used to survey 385 young and middle-aged stroke patients in a tertiary hospital in Dali from December 2024 to July 2025.Questionnaires including general demographic information,the General Alienation Scale,the Athens insomnia scale,and others were administered.Results:The social alienation score of young and middle-aged stroke patients in Dali was(35.67±3.46).Univariate analysis showed that general demographic factors[education level,monthly household income,whether it was the first onset,presence of sequelae,disease duration,activities of daily living(ADL,Barthel Index)],social support,stigma,self-perceived burden,anxiety and depression,and sleep status were influencing factors of social alienation(P<0.05).Regression analysis indicated that social support,anxiety and depression,disease duration,stigma,presence of sequelae,and self-care ability were significant influencing factors of social alienation(P<0.01),explaining 65.3%of the total variance.Conclusion:The level of social alienation among young and middle-aged stroke patients in Dali is relatively low.Special attention should be paid to patients with a disease duration of<7 days,those with sequelae,moderate-to-severe dependence in self-care,low social support,high stigma,and high levels of anxiety and depression,to effectively reduce their social alienation.
基金Supported by Basic Scientific Research Business Expense Project for Public-interest Scientific Institute of Sichuan Province(ZL2014-13)~~
文摘In order to promote the growth of mid-aged Pinus elliottii plantation, the effects of different fertilizing amounts of formula fertilizer were studied on the growth, the soil and cost-benefit of 9 year-old Pinus el/iottii plantations in the north- ern part of Hunan, China. Three years after fertilization, the results showed that the increments of DBH, height, individual volume and stock volume of stand, and the fertilizer benefit of the different fertilization treatments were higher than the control to varying degrees, and among them, 700 g/tree was the best for promoting the growth of Pinus elliottii. Two years fertilization, the soil nutrients were improved compared with before, pH values of different layers decreased, organic matter and rapid available K contents increased, and rapid available N content increased dra- matically with the upper layer having an increase higher than the lower one; rapid available P decreased at different levels with the upper layer having a decrease lower than the lower one; and proper application of fertilizer could promote the growth of Pisolithus tinctofius, and 7 months after fertilization, the number of Pisolithus fruiting body generally increased with the increase of the fertilizer within 100-800 g/tree. The yield and benefit per unit area could be increased by fertiliza- tion for 1 time in middle-aged Pinus elliottii plantations, and the best fertilizing amount was N-P-K fertilizer 700 g/tree.
文摘This study sought to investigate late-onset hypogonadism （LOH） in old and middle-aged males in Shanghai communities, using symptom score evaluation systems and measurements of sex hormone levels. One thousand cases of males aged 40-70 years were investigated. The aging male symptoms （AMS） scale and androgen deficiency in aging males （ADAM） questionnaire were used at the beginning of the investigation, followed by measurement of the sex hormone-related factors （total testosterone （TT）, free testosterone （fT）, sex hormone-binding globulin （SHBG） and bioavailability of testosterone （Bio-T））. There were 977 valid questionnaires. The LOH-positive rates shown by AMS and ADAM were 59.88% and 84.65%, respectively; values increased with the age of the patients. There were 946 results related to sex hormone measurements, which showed the following results： TT was not related to aging （P〉O.05）; levels of SHBG increased with age; and fT and Bio-T decreased with age. There was a significant difference in fT between LOH-positive and LOH-negative patients, as shown by the ADAM. In summary, TT levels were not related to aging, even though SHBG did increase while fT and Bio-T decreased with aging. Clinically, the diagnosis of LOH cannot be based on serum TT level.
文摘This study aimed to propose an operational definition of late-onset hypogonadism(LOH)that incorporates both clinical symptoms and serum testosterone measurements to evaluate the prevalence of LOH in aging males in China.A population-based sample of 6296 men aged 40 years-79 years old was enrolled from six representative provinces in China.Serum total testosterone(TT),sex hormone-binding globulin(SHBG),and luteinizing hormone(LH)were measured and free testosterone(cFT)was calculated.The Aging Males’Symptoms(AMS)scale was used to evaluate the LOH symptoms.Finally,5078 men were included in this analysis.The TT levels did not decrease with age(P=0.59),and had no relationship with AMS symptoms(P=0.87 for AMS total score,P=0.74 for≥3 sexual symptoms).The cFT levels decreased significantly with age(P<0.01)and showed a negative association with the presence of≥3 sexual symptoms(P=0.03).The overall estimated prevalence of LOH was 7.8%(395/5078)if a cFT level<210 pmol l−1 combined with the presence of≥3 sexual symptoms was used as the criterion of LOH.Among them,26.1%(103/395)and 73.9%(292/395)had primary and secondary hypogonadism,respectively.After adjustment for confounding factors,primary and secondary hypogonadism was positively related to age and comorbidities.Body mass index was an independent risk factor for secondary hypogonadism.The results suggest that the AMS total score is not an appropriate indicator for decreased testosterone,and that the cFT level is more reliable than TT for LOH diagnosis.Secondary hypogonadism is the most common form of LOH.
文摘In this study, we investigated the essential criteria for late-onset hypogonadism （LOH） syndrome based on the presence of symptoms associated with low testosterone levels in Han Chinese men. Blood tests for total testosterone （TT） and sex hormone-binding globulin （SHBG） were performed, and the aging male symptoms （AMS） questionnaire was conducted in a randomly selected cohort composed of 944 Chinese men aged 40 to 79 years from nine urban communities. Three sexual symptoms （decreased ability/frequency of sexual activity, decreased number of morning erections, and decreased libido） were confirmed to be related to the total and free testosterone levels. The thresholds for TT were approximately 12.55 nmol l^-1 for a decreased ability/frequency to perform sex, 12.55 nmol l^-1 for decreased frequency of morning erections, and 14.35 nmol l^-1 for decreased sexual desire. The calculated free testosterone （CFT） thresholds for these three sexual symptoms were 281.14, 264.90, and 287.21 pmol l^-1, respectively. TT 〈13.21 nmol l^-1 （OR =1.4, 95%Ch 1.0-1.9, P= 0.037） or CFT 〈268.89 pmol l^-1 （OR - 1.5, 95%Ch 1.1-20, P=0.020） was associated with an increase in the aforementioned three sexual symptoms. The prevalence of LOH was 9.1% under the criteria, including all three sexual symptoms with TT levels 〈13.21 nmol l^-1 and CFT levels 〈268.89 pmol l^-1. Our results may improve the diagnostic accuracy of LOH in older men.
文摘A 36-year-old woman was admitted to our department for close examination of a liver tumor that was found during a medical checkup. Abdominal US, CT and MRI showed a tumor in segment 7 (S7) of the liver. Although imaging suggested hepatocellular carcinoma, laboratory tests showed no abnormality in liver function, hepatitis virus markers were negative, and tumor markers including protein induced by vitamin K absence or antagonist Ⅱ (PIVKA-Ⅱ), α-fetoprotein (AFP), carbohydrate antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA) were all within normal ranges. Upon aspiration biopsy of the liver, the histopathological diagnosis was moderately differentiated hepatocellular carcinoma. Therefore, right hepatectomy was performed. Although a part of the tumor was necrotic, about 60% of the viable part showed a clear-cell variant. Consequently, it was diagnosed as clear-cell hepatocellular carcinoma. It was noted that the background liver tissue was normal. This case is worthy of reporting because development of clear-cell hepatocellular carcinoma in the normal liver of a middle-aged woman is rarely seen.
文摘Self-medication is an increasingly frequent phenomenon worldwide and has an important influence on health.In this study,we analyzed the self-medication prevalence rate in Chinese middle-aged and elderly people,and explored the influence factors.The data from China Health and Retirement Longitudinal Study(CHARLS)in 2011,2013 and 2015 were used.Self-medication prevalence was calculated as the number of whole people divided by the number of people taking self-medication.The influence factors of self-medication were analyzed by panel data random effect model.We excluded observations with missing values in our analysis,leaving 16 962,17 876 and 19 572 observations in 2011,2013 and 2015,respectively.The average 3-year self-medication prevalence was 45.52%.Moreover,11.70%of respondents practiced self-medication with prescription medicine in 2011,2013 and 2015.Respondents living in non-rural areas(P=0.009)and western region(P=0.000)took more self-medication.Self-medication was a common phenomenon among middle-aged and elderly population in China.The government should strengthen the guidance for the middle-aged and elderly people who took more self-medication,such as those living in urban and western region.
基金supported by the Major Program of Shanghai Municipality for Basic Research (08dj1400601)Shanghai Key Laboratory of Diabetes Mellitus (08DZ2230200)supported by the Key Project of Science and Technology of Shanghai (09DZ1950202)
文摘Objective The association of metabolic syndrome （MetS） with cardiovascular diseases （CVD） has not been adequately explored in middle-aged and elderly Chinese. This study aimed to investigate MetS＇ prevalence and its impact on the CVD incidence in this specific population group. Methods A data set of a community-based prospective cohort study was analyzed. A total of 2300 subjects aged 40-94 years were followed up for the CVD events. MetS defined according to the JCDCG criteria was assessed at baseline, and the middle-aged and elderly groups were classified by the WHO definition. Results As compared with the middle-aged group, the prevalence of MetS increased by 0.6 times （34.6% vs. 21.3%） and the incidence density of CVD increased by 4.9 times in the elderly group （52.3/1000 person-year vs. 8.9/1000 person-year）. Furthermore, the multivariate Cox regression revealed that the risk to CVD incidence was independently related to increased waist circumference in the middle-aged group （HR=2.23, P〈0.01） and to elevated blood glucose in the elderly group （HR=1.39, P〈O.01）. Conclusion MetS was highly prevalent in middle-aged and elderly Chinese. MetS significantly increased the risk to OdD incidence in the elderly. All individuals with metabolic disorders should receive active clinical care to reduce the incidence of CVD.
基金supported by the Major Science and Technology Project of Zhejiang Province(Grant NO.2009C03010-4)the National Key Technology R&D Program of China(Grants No.2012BAI02B03 and No.2009BAI80B00)
文摘Objective Central obesity is considered to be a central component of metabolic syndrome. Waist circumference （WC） has been widely used as a simple indicator of central obesity. This study is aimed to evaluate the sensitivity of WC cut-off values for predicting metabolic risk factors in middle-aged Chinese. Methods The study involved 923 subjects aged according to the Chinese Joint Committee for 40-65 years. The metabolic risk factors were defined Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. WC cut-off 85-90 cm and 〉90 cm were used as cut-off values of central pre-obesity and central obesity in males, respectively, while WC 80-85 cm and 〉85 cm were used as cut-off values of central pre-obesity and central obesity in females. Results First, WC values corresponding to body mass index （BMI） 24 kg/m2 and visceral fat area （VFA） 80 cm2 were 88.55 cm and 88.51 cm in males, and 82.46 cm and 82.52 cm in females respectively. Second, receiver operating characteristic curves showed that the optimal WC cut-off of value was 88.75 cm in males, higher than that in females （81.75 cm）. Third, the subjects with higher WC values were more likely to have accumulating metabolic risk factors. The prevalence of metabolic risk factors increased linearly and significantly in relation to WC levels. Conclusion WC cut-off values of central pre-/central obesity are optimal to predict multiple metabolic risk factors.
基金supported by the Philosophy and Social Science Planning Project of Henan Province(2020BSH015).
文摘This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to February 2022,620 participants(320 rural and 300 urban residents)from three provinces of China were selected by con-venience sampling.A general data questionnaire,mental health literacy scale,perceived social support scale and subjective well-being scale were administered.The mental health literacy scores of urban residents were 3.34±0.57 and those of rural residents were 2.73±0.79.The results of multiple regression analysis showed that the mental health literacy scores of rural residents were more significant than those of urban residents in terms of sex and age,while urban residents’mental health literacy scores were more significant than those of rural resi-dents in terms of monthly income.Mental health literacy,perceived social support and subjective well-being of young and middle-aged urban and rural residents were all positively correlated(P<0.01).While the level of mental health literacy is better among urban residents than rural residents,perceived social support plays a partial mediating role between mental health literacy and subjective well-being of both urban and rural residents,and should be the focus of researchers seeking to improve the level of well-being of residents.
文摘AIM:To quantitatively examine the impacts of an easyto-measure parameter-weight gain-on metabolic syndrome development among middle-aged adults. METHODS:We conducted a five-year interval observational study.A total of 1384 middle-aged adults not meeting metabolic syndrome(MetS)criteria at the initial screening were included in our analysis.Baseline data such as MetS-components and lifestyle factors were collected in 2002.Body weight and MetS-components were measured in both 2002 and 2007.Participants were classified according to proximal quartiles of weight gain(WG)in percentages(%WG≤1%,1%< %WG≤5%,5%<%WG≤10%and%WG>10%, defined as:control,mild-WG,moderate-WG and severe-WG groups,respectively)at the end of the follow-up. Multivariate models were used to assess the association between MetS outcome and excessive WG in the total population,as well as in both genders. RESULTS:In total,175(12.6%)participants fulfilled MetS criteria within five years.In comparison to the control group,mild-WG adults had an insignificant risk for MetS development while adults having moderate-WG had a 3.0-fold increased risk for progression to MetS [95%confidence interval(CI),1.8-5.1],and this risk was increased 5.4-fold(95%CI,3.0-9.7)in subjects having severe-WG.For females having moderate-and severe-WG,the risk for developing MetS was 3.6(95% CI,1.03-12.4)and 5.5(95%CI,1.4-21.4),respectively. For males having moderate-and severe-WG,the odds ratio for MetS outcome was respectively 3.0(95%CI, 1.6-5.5)and 5.2(95%CI,2.6-10.2). CONCLUSION:For early-middle-aged healthy adults with a five-year weight gain over 5%,the severity of weight gain is related to the risk for developing metabolic syndrome.
