Latest ArticlesThe self-management of patients with multiple chronic conditions has more complex characteristics and needs than those of single chronic diseases and plays a central role in healthy disease regression. This paper focuses on the characteristics, current status, barriers and challenges of self-management in patients with multiple chronic conditions, and suggests that self-management of multiple chronic conditions should be viewed from a dynamic and developmental perspective. When providing self-management support to patients, it should be based on their complex self-management needs, identifying specific barriers to the self-management process, establishing self-management links between multiple chronic conditions, and developing personalised self-management support content and methods based on patients' preferences, goals, and available resources, to improve their self-management abilities and health outcomes.
To explore the relationship between retinol and TTR protein, and to provide ideas for preventing Hereditary vitreous amyloidosis (HVA).
Twenty Gly83Arg mutant mice were constructed and bred (reference construction [2]) as the mutant group. After the irregular turbidity in the vitreous of the mutant mice eyeball was observed under slit lamp, the lens camera was used for photography, and B-ultrasound examination was conducted, and white clump-like turbidity was found in the posterior ocular region. After the turbidity in the vitreous cavity of the mice was confirmed, the mice were killed by cervical vertebrae dislocation, and DNA in liver cells was extracted and sequenced to confirm the successful construction of mutant mice. At the same time, 20 wild type C57BL/6 mice were fed as the control group, 4 mice in the mutant group and 4 mice in the control group were randomly selected from the number table, and the retinol concentration was determined by high performance liquid chromatography combined with mass spectrometry. Three mice in the mutant group and three mice in the control group were selected from a random number table. After grinding the eyeball tissues, RNA and protein were extracted. TTR gene mRNA expression, SDS-PAGE protein gel color development was detected by fluorescent quantitative PCR, and TTR gene protein expression was detected by Western Blot. The difference at P < 0.05 was statistically significant.
The mutation site was consistent with the site successfully modeled by our research group in the previous stage. Heterozygous mutation occurred at the G base at the 107th position of exon 3 (C.107G →C), and the codon of the amino acid at the 83rd position was mutated from GGC to CGC (Gly83Arg). The concentration of retinol in eye of mutant mice was lower than that of normal mice in control group, the content of retinol in liver tissue of mutant mice was higher than that in control group, and the content of retinol in blood of mutant mice was lower than that in control group (eyeball: t=6.600, P=0.022; liver: t=9.045, P<0.001; blood: t=4.343, P=0.012). Fluorescence quantitative PCR results showed that mRNA expression in eyeball tissue of mutant group was lower than that of control group (t=5.764,P=0.004). SDS-PAGE protein gel color showed that protein bands appeared in the mutant group near 11kD. Western Blot showed that TTR gene protein expression in mutant group was lower than that in control group (t=37.48,P<0.001).
The deposition of vitreous amyloid protein in the eyeball tissue of Gly83Arg mutant mice may be related to the increase of mutant TTR protein and the decrease of retinol, which has important significance for future prevention and treatment.
To investigate the prevalence of chronic pain in the elderly in Nanshan Pastoral area of Xinjiang, explore the influence of chronic pain degree on cognitive function, and the mediating role of depression and frailty.
From June 2022 to February 2023, 1 045 elderly patients ≥60 in Nanshan Pastoral area of Xinjiang were selected by multi-stage random cluster sampling method. The General Information Questionnaire, Pain Numerical Rating Scale, Geriatric Depression Assessment Scale, Tilburg Frailty Scale and Montreal Cognitive Assessment Scale were used to conduct the questionnaire survey.
The prevalence rate of chronic pain in the elderly in Nanshan pastoral area of Xinjiang was 67.27% (703/1 045). The degree of chronic pain was positively correlated with depression and frailty (r=0.472, 0.512, P<0.01), and negatively correlated with cognitive function (r=-0.432, P<0.01). Depression and frailty had significant mediating effect between chronic pain degree and cognitive function. The intermediate effects were -0.134 (95% CI:-0.194--0.074) and -0.145 (95% CI: -0.193--0.101), respectively. The mediating effect of depression-debilitation chain was also significant, and the mediating effect size was -0.121 (95% CI:-0.165--0.083). The total indirect effect of depression and frailty on the degree of chronic pain and cognitive function was -0.400, accounting for 53.33% of the total effect.
The degree of chronic pain not only directly affects the cognitive function of the elderly in Nanshan pastoral area of Xinjiang, but also indirectly affects the cognitive function through the independent mediating effect of depression and frailty and the chain mediating effect of depression and frailty.
The purpose of this study was to investigate loneliness and its influencing factors among female migrant elderly following children (MEFC) in Jinan City, based on which to recommend suggestions to alleviate the loneliness of female MEFC.
The data came from a survey conducted in 2020 in Jinan City, on the MEFC, and 418 valid samples were obtained by using multistage cluster sampling. The ULS-8 scale was used to measure the loneliness of female MEFC, and the Social Support Rating Scale (SSRS) was used to measure the social support status. t-test and one-way ANOVA were used to test the differences in loneliness of female MEFC with different characteristics, and multiple linear regression models were used to investigate the influencing factors of the loneliness of female MEFC.
371 (88.8%) female MEFC came from rural areas, 369 (88.3%) of them moved to take care of their grandchildren, the social support score of female MEFC was (39.5±6.0), the loneliness score was (12.9±4.0), and the factors influencing loneliness included: personal monthly income(β=-0.17, P<0.001,95% CI:-3.337--1.007), type of household registration (β=-0.12, P=0.008, 95% CI:-2.523--0.385), year of migration (β=-0.09, P=0.042, 95% CI: -2.155--0.038), perception of being a local (β=-0.17, P=0.018, 95% CI: 0.267-2.840), the frequency of participation in community square dance (β=-0.18, P<0.001, 95% CI: -3.614--1.092) and community-organized activities (β=-0.13, P=0.013, 95% CI: -2.636--0.306), and social support (β=-0.19, P<0.001, 95% CI: -0.186- -0.064).
The level of loneliness among female MEFC was lower than that of female empty nesters but higher than that of male elderly. To alleviate the loneliness of female MEFC, joint efforts are needed from the communities where female MEFC live, family members of female MEFC, and female MEFC themselves.
To explore the impact of health checkups on the utilization of inpatient services for patients with chronic diseases to promote the utilization of health checkups and alleviate the burden of hospitalization.
Utilizing data from four waves of the China Health and Retirement Longitudinal Study conducted in 2011, 2013, 2015, and 2018, this study employed coarsened exact matching (CEM) and the difference-in-difference(DID)and BK method to analyze the impact of health checkups on the utilization of inpatient services for patients with chronic diseases, along with examining its influencing mechanisms.
Health checkups were found to increase the probability of hospitalization by 34.4% (β=0.344, 95% CI: 0.132-0.556) and reduce hospitalization costs by 3 145 yuan (β=-3 145.470, 95% CI: -6 074.532--216.407) for patients with chronic diseases. Exercise was identified as mediating the association between health checkups and hospitalization (β=-0.184, 95% CI: -0.323--0.045). Age was observed to negatively moderate the relationship between health checkups and hospitalization (β=-0.531, 95% CI: -0.804--0.258). Patients with multiple chronic diseases and groups with health insurance were more significantly affected by health checkups.
Health checkups increase the likelihood of hospitalization and reduce hospitalization costs for individuals with chronic diseases. Promoting healthy lifestyles among those with chronic conditions is essential, with a specific focus on groups susceptible to health risk shocks.
Quality of life and survival time are important contents of palliative care services for patients with advanced cancer. Therefore, investigating the measurement method of quality-adjusted life years for patients with advanced cancer could provide a basis for the evaluation of palliative care services for this population.
The relative importance of each index in the Quality-of-Life Scale of Cancer Patients was compared by expert consultation method and hierarchical analysis was used to obtain the weight of each index.
In the Quality-of-Life Scale of Cancer Patients, the weights of primary indicators from high to low included physical symptoms, mental psychology, and social relations. The weights of physical symptoms from high to low included pain, side effects of treatment, sleep, daily life, appetite, fatigue, and facial expression. The weights of mental psychology from high to low included their cognition of disease, attitude, and spirit to treatment. The weights of social relations included the care and understanding of family and the understanding and cooperation of colleagues.
The weights of each quality of life scale indicator are obtained by hierarchical analysis. Then the different quality-of-life survival time is converted into quality-adjusted life years, which can provide a basis for the influence of palliative care services on the quality-adjusted life years of patients with advanced cancer.
To discuss the risk factors of imported food through the multi-dimensional comparative analysis of the food information published by the General Administration of Customs and to provide data reference for supervisors, and to improve the supervision of imported food.
This paper mainly collected and summarized the 48 periods of non-permitted entry food data released by the Import and Export Food Safety Bureau of the General Administration of Customs during 2019-2022 and made a comparative analysis of the sources of non-permitted entry food, food production enterprises, product types, non-permitted entry facts and other dimensions.
From 2019-2022, there were a total of 9 506 batches of food that were not allowed to enter the country, and the food that was not allowed to enter the country came from 112 countries and regions, with the highest proportion of food batches from Japan. The food came from 3 941 production enterprises, where11 countries or regions holding non-permitted entry food production enterprises, accounting for more than 50% of the total number of enterprises. According to the HS code, there were six categories and 21 chapters of non-permitted entry products, and the main non-permitted entry foods were HS03, 21, 19 and 22 products, more than 60% of the total unqualified. According to the analysis of the causes of nonconformity, there were 15 kinds, and the top 6 nonconformity causes accounted for 86% of the total nonconformity batches. There was a total of 268 types of unqualified items related to quality and safety, totaling 3 469 items.
The overall number of batches of unauthorized imported food during the period of 2019-2022 is a rising and then falling trend, and the unauthorized imported food is more concentrated in the countries of origin, manufacturers, categories of unauthorized food, reasons for failure, and quality-related unqualified items. The multi-dimensional comparative analysis provides data reference for regulators and consumers and helps the government to improve the regulation of imported food.
To explore the role and mechanism of ferroptosis in exacerbating airway inflammation in asthmatic mice exposed to traffic-related PM2.5.
Fifty BALB/c mice were randomly divided into five groups: saline (NS), asthma (ovalbumin, OVA), and OVA combined with low, medium, and high exposure to traffic-derived PM2.5 (1.8, 3.6, and 7.2 mg/kg·bw, respectively). The levels of IL-6 and TNF-α in lung tissue were measured using ELISA kits. The concentrations of reduced glutathione (GSH), malondialdehyde (MDA), and Fe2+ in lung homogenate supernatants were assessed by colorimetry. Protein expressions of prostaglandin-endoperoxide synthase 2 (PTGS2), acyl-CoA synthetase long chain family member 4 (ACSL4), glutathione peroxidase 4 (GPX4), tumor protein p53 (p53), phospho-p53 (p-p53), spermidine/spermine N1-acetyltransferase 1 (SAT1), and arachidonate 15-lipoxygenase (ALOX15) were detected using western blot. mRNA expressions of PTGS2, ACSL4, GPX4, p53, SAT1, and ALOX15 were examined by qRT-PCR. One-way ANOVA was used for multi-group data comparison, followed by Tukey’s HSD for further multiple comparisons.
PM2.5 exposure significantly increased IL-6 and TNF-α levels in asthmatic mouse lung tissues, especially in the high PM2.5 exposure group (FIL-6=17.910, P<0.001; FTNF-α=5.414, P<0.05). All PM2.5 exposure groups showed a reduction in GSH, most notably in the high exposure group (FGSH=13.560, P<0.001). MDA and Fe2+ levels were significantly higher in the medium and high PM2.5 groups compared to the OVA group (FMDA=55.230, P<0.001; FFe=17.660, P<0.001). PM2.5 exposure also elevated the protein and mRNA expressions of PTGS2, ACSL4, and ALOX15, while reducing GPX4 expression. The protein and mRNA expression levels of p53, SAT1, and ALOX15 showed a clear dose-response to PM2.5, with p-p53 following a similar trend as p53 protein expression.
Traffic-related PM2.5 may induce ferroptosis in the lungs of asthmatic mice and exacerbate asthma inflammation through the p53/SAT1/ALOX15 pathway.
To analyze the treatment outcomes and influencing factors among pulmonary tuberculosis patients in Guizhou Province from 2017 to 2022, and to improve a basis for enhancing tuberculosis prevention and control strategies.
Individual cases of pulmonary tuberculosis patients in Guizhou Province from 2017 to 2022 were obtained from The Tuberculosis Information Management System. The distribution characteristics of treatment success were described using percentages (%), and the Chi-square test and binary logistic regression model were utilized to analyze the factors influencing treatment outcomes.
During the period of 2017 to 2022, the annual average registration rate of pulmonary tuberculosis patients in Guizhou Province was 97.27/100 000 population, exhibiting a consistent downward trend (trend χ2=2 230.684, P<0.001). Meanwhile, the treatment success rate among the patients during the same time period was 92.89%, demonstrating a steady increase (trend χ2=51.800, P<0.001). Analysis results of influencing factors showed that compared with female, age group <20 years old, cadres and staff, physical examination, negative etiological results, initial treatment, no comorbidities, no other tuberculosis, and negative HIV test results, male (OR=0.736, 95% CI:0.709-0.765), ≥60 years old age group (OR=0.360, 95% CI:0.323-0.402), farmers (OR=0.591, 95% CI:0.468-0.747), medical treatment due to illness (OR=0.716, 95% CI: 0.599-0.855), retreatment (OR=0.570, 95% CI:0.540-0.602), complications (OR=0.789, 95% CI:0.752-0.827), other tuberculosis (OR=0.685, 95% CI:0.542-0.867) and positive HIV test results (OR=0.387, 95% CI:0.342-0.437) were risk factors for successful treatment(P<0.05).
Overall, the treatment outcomes of pulmonary tuberculosis patients in Guizhou Province are highly positive. However, it is essential to recognize that there are disparities in the distribution of treatment outcomes across various population groups. Hence, it is recommended to prioritize the treatment concerns of specific demographics, including male patients, the elderly population, individuals residing in Bijie city, patients with positive microbiological results, HIV=positive patients, individuals requiring retreatment, and those with comorbidities or concurrent tuberculosis. By focusing on these groups, targeted interventions and tailored approaches can be implemented to ensure that all individuals receive optimal treatment and care.
To investigate the cognitive function of the elderly with different exercise frequencies, and to analyze the effect of exercise frequency on the cognitive function of the elderly.
By using the method of stratified proportional sampling, 4 414 people aged 60 and above were selected from the streets of Yinzhou district of Ningbo. Mini-mental state examination (MMSE) was used to screen the cognitive function of the elderly in the community, and the generalized linear model was used to analyze the influence of exercise frequency and other factors on the cognitive function of the elderly.
The average MMSE score of 4 414 elderly people was 27.05±3.25. The MMSE scores of the elderly who never exercised, rarely exercised, and exercised regularly were 26.03±3.82, 27.04±3.19, and 27.53±2.88, respectively, and the difference was statistically significant (F=72.596, P < 0.001). There were significant differences in cognitive function among the elderly with different exercise frequencies in the fields of orientation, memory, attention and calculation, recall, and language ability (F=13.120, F=13.309, F=33.508, F=32.575, and F=65.312, P<0.01). The results of generalized linear model analysis showed that after controlling other factors, compared with never exercise, the MMSE scores of rare exercise and regular exercise were 2.291 times (95%CI: 1.808-2.904) and 2.470 times (95%CI: 1.973-3.094), respectively.
Exercise frequency is closely related to the cognitive function of the elderly aged 60 and above in the community. Exercise can alleviate the cognitive dysfunction of the elderly in the community and actively mobilize the whole body to prevent Alzheimer’s disease. The elderly should be encouraged to participate in more exercises suitable for them.