Objective:To explore the spousal correlations of total cholesterol(TC),total triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C),and to investigate the reasons behind these spousal correlations.Methods:Participants and data were from the baseline survey of family-based cohort studies in Fangshan,Beijing and Tulou,Fujian.The ori-gin of spousal correlations were explored from perspectives of convergence,assortative mating,social ho-mogamy.Pearson's correlation and generalized linear models(GLM)were used to estimate the spousal correlation.Convergence was assessed by Pearson's correlation between the phenotypic differences be-tween couples and the duration of marriage,with GLM used for further validation.Pearson's correlation of genetic risk scores(GRS)and couple-specific Mendelian randomization(MR)were calculated to assess the genetic correlation and possible causal relationships between spouses.Two-independent-sample t-tests were used to compare GRS consistency across subgroups divided by education attainment,couple-specific MR and Q statistics used to test assortative mating in subgroups and intergroup differences.Results:In the study,342 couples(287 couples from Fangshan and 55 couples from Fujian)were included,with the average age of(64.91±8.76)years.Spousal correlations of TC,TG,HDL-C,and LDL-C showed statistically significant associations both before and after adjusting for covariates,with effect sizes of 0.229(95％CI:0.125-0.327),0.257(95％CI:0.155-0.354),0.179(95％CI:0.074-0.280),and 0.181(95％CI:0.076-0.282).For convergence,for each additional year of marriage,ΔTC increased by 0.016 mmol/L(95％CI:0.001-0.033 mmol/L),and ΔLDL-C increased by 0.017 mmol/L(95％CI:0.002-0.031 mmol/L).For assortative mating,GRS correlations and results of couple specific MR didn't show any statistical significance.For social homogamy,no differences in GRS or assortative mating were found between subgroups stratified by education attainment.Conclusion:The blood lipid in participants exhibit spousal phenotypic correlations,however,no effects of convergence,assortative mating or social homogamy were observed.More independent studies with larger sample sizes are warranted to further validate these findings in the future.

Objective:To retrieve, summarize and evaluate the best evidence for the non-pharmacological management of patients with cancer pain, so as to provide an evidence-based basis for the scientific management of cancer pain by healthcare professionals.Methods:A systematic search of the national and international literature on the non-pharmacological management of cancer pain was conducted, with a timeframe of January 2017 to January 2024. The quality of the included literature was evaluated, and evidence was extracted and summarized for those that met the quality criteria.Results:A total of 18 papers were included, including one clinical decision, seven guidelines, three expert consensus, and seven systematic reviews. Twenty-eight pieces of evidence were summarized around six themes of pain assessment, cognitive-behavioral interventions, physical therapy, interventional therapy and surgery, and self-management education and follow-up.Conclusions:Healthcare professionals should develop a patient-centered, appropriate and feasible non-pharmacological management plan for cancer pain with multiple agreements with patients and families, taking into account the clinical context and individual differences of patients in China, in order to improve the quality of life.

Objective To determine whether an intelligerct cloud platform follow-up model demonstrates superiority over conventional methods in enhancing follow-up quality,reducing costs,and improving functional recovery following total knee arthroplasty(TKA).Methods A retrospective cohort study was conducted on 260 patients undergoing TKA at our hospital from October 2022 to September 2023.According to the different postoperative follow-up methods,they were divided int a cloud platform group(n=130)and a traditional group(n=130).The baseline data,pre-and postoperative knee function scores,and follow-up costs were collected and compared between the 2 groups.Results The cloud platform group exhibited significantly higher rate of follow-up satisfaction,reduced resource utilization,shorter per-follow-up duration,fewer accompanying persons per visit,lower total follow-up expenditures,and decreased cumulative follow-up time when compared with the traditional group(P<0.05).At 6 weeks,3,6,and 12 months postoperatively,better range of motion(ROM)was observed in the cloud-based group than the traditional group(P<0.05),but no intergroup differences were seen in other knee function scores.Conclusion Cloud platform follow-up enhances early postoperative ROM(6 weeks to 12 months)and demonstrates marked cost-effectiveness when compared to the conventional mode.It represents a viable alternative for post-TKA rehabilitation surveillance.

Objective:Committee of Minimally Invasive Cardiovascular Surgery(CMICS) conducts an annual summary of minimally invasive cardiovascular surgery procedures performed throughout the country, which includes a comprehensive survey of the total number of minimally invasive procedures by region and the distribution of minimally invasive procedures by hospital. Since CMICS first published the 2018-2019 China Minimally Invasive Cardiovascular Surgery Data White Paper in 2020, the report has received great attention from peers within and outside the industry. In this statistical report, CMICS will focus on publishing the data related to minimally invasive cardiovascular surgery in China from 2021 to 2023 for reference and use by industry peers.

Objective:To analyze the efficacy of distal tibial osteotomy and bone transport in the treatment of infected bone defects at the proximal tibia.Methods:A retrospective study was conducted to analyze the clinical data of 25 patients with infected bone defects at the proximal tibia who had been treated by distal osteotomy and bone transport at Department of Microprosthetic Surgery, The First Hospital Affiliated to Xinjiang Medical University from May 2015 to June 2023. There were 20 males and 5 females with an age of (45.9±7.1) years. The length of bone defects was (7.5±3.9) cm, the number of operations 3 (2, 4) times, the distance from bone defects to the tibial plateau (4.1±1.9) cm, and the length of bone defects (7.5±3.9) cm. Six patients finished debridement and osteotomy in one operation. Staged surgery was conducted in 19 patients. At first, the original fixator was removed, followed by debridement and injection of the antibiotic bone cement. Next, the bone cement was removed to clean the lesion completely, and then the medullary cavity was penetrated by an electric drill to install an external fixator after flushing. Bone transport started 7 to 10 days later, at a speed of 1 mm/d, and was carried out in 4 times. The healing index, external fixation time, and external fixation index were recorded. The visual analog scale (VAS) for pain, knee range of motion (ROM), and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were compared between preoperation, 1-month postoperation, and the last follow-up. Fracture healing was evaluated using the Paley criteria, and complications were documented.Results:In this cohort, the healing index was (68.9±35.6) points, the external fixation time 13.0 (8.5, 21.8) months, and the external fixation index (2.43±1.24) points. All patients were followed up for 13.0 (8.5, 21.7) months. The VAS score, knee ROM, and AOFAS ankle-hindfoot score at the last follow-up were significantly improved compared with preoperation and 1-month postoperation ( P<0.05). According to the Paley criteria, fracture healing was excellent in 14, good in 9 and poor in 2 cases, giving an excellent and good rate of 92.0%. The incidences of ankle and knee movement limitations were 92.0% (23/25) and 76.0% (19/25), respectively, being the highest. The incidences of foot drop, clubfoot and claw toe were 68.0% (17/25), 24.0% (6/25) and 20.0% (5/25), respectively. The incidences of pin tract infection and nonunion at the junction were 56.0% (14/25) and 60.0% (15/25), respectively. All these complications were improved by dressing change or surgery. Conclusions:Distal tibial osteotomy and bone transport can effectively treat infected bone defects at the proximal tibia, and the complications during the treatment need to be treated accordingly.

BACKGROUND: Whether adherence to a healthy lifestyle is associated with a lower risk of developing pneumonia and a better long-term prognosis remains unclear. This study aimed to investigate associations of individual and combined lifestyle factors (LFs) with the incidence risk and long-term prognosis of pneumonia hospitalization. METHODS: Using data from the China Kadoorie Biobank study, we used the multistate models to investigate the role of five high-risk LFs, including smoking, excessive alcohol drinking, unhealthy dietary habits, physical inactivity, and unhealthy body shape, alone or in combination in the transitions from a generally healthy state at baseline to pneumonia hospitalization or cardiovascular disease (CVD, regarded as a reference outcome), and subsequently to mortality. RESULTS: Most of the five high-risk LFs were associated with increased risks of transitions from baseline to pneumonia and from pneumonia to death, but with different risk estimates. The greater the number of high-risk LFs, the higher the risk of developing pneumonia and long-term mortality risk after pneumonia, with the strength of associations comparable to that of LFs and CVD. Compared to participants with 0-1 high-risk LF, the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for transitions from baseline to pneumonia and from pneumonia to death in those with five high-risk LFs were 1.43 (1.28-1.60) and 1.98 (1.61-2.42), respectively. Correspondingly, the respective HRs (95% CIs) for transitions from baseline to CVD and from CVD to death were 2.00 (1.89-2.11) and 1.44 (1.30-1.59), respectively. The risk estimates changed slightly when further adjusting for the presence of major chronic diseases. CONCLUSION In this Chinese population, unhealthy LFs were associated with an increased incidence and long-term mortality risk of pneumonia.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Cardiovascular Diseases/etiology* ; China/epidemiology* ; Life Style ; Pneumonia/etiology* ; Prognosis ; Risk Factors ; Smoking

To investigate the characteristics and differences of immune cell infiltration between different SDHx gene expression and pheochromocytoma/paraganglioma(PPGL).

Twelve derivatives of asiatic acid were synthesized through acylation, alkylation, oxidative dehydrogenation and other reactions using asiatic acid from usoxane-type pentacyclic triterpenoids as the parent compound. Their structures were confirmed by 1H NMR and 13C NMR, and determined to be novel compounds never reported in literature. Through the MTT method, high-expression human cancer cells (A549 and SGC-7901) were selected for a preliminary in vitro anti-tumor activity study on these compounds. Among them, the IC50 of compound I1 were 11.39 and 9.08 μmol/L respectively, and those of compound I2 were 12.64 and 9.15 μmol/L respectively, which were close to those of sorafenib, a common drug for clinical use. The experimental results show that the synthesized asiatic acid derivatives have certain anti-proliferative effects on the two types of human cancer cells, A549 and SGC-7901, significantly higher than those of asiatic acid. Compounds I1 and I2 show quite strong anti-proliferative effects on human cancer cells A549 and SGC-7901.

Objective:To examine the safety and effectiveness of a novel domestic transcatheter aortic valve system in addressing severe aortic valve stenosis.Methods:This prospective, multicenter, single-arm target-value clinical trial enrolled patients with severe aortic stenosis meeting inclusion criteria from 13 Chinese centers between July 2021 and April 2022. The primary endpoint was all-cause mortality at 1-year post-procedure. Secondary endpoints included safety outcomes (30-day all-cause mortality, 1-year major adverse cardiovascular events, device success) and efficacy parameters (transvalvular pressure gradient, paravalvular leak severity, New York Heart Association(NYHA)class improvement, and quality of life). Survival analysis was performed using the Kaplan-Meier analysis.Results:The study included 134 patients, 85 males and 49 females, with an age of (73.6±5.6)years (range: 65.1 to 91.8 years). Bicuspid aortic valve morphology was present in 59.7% (80/134). Device success rate was 99.3%, with one case converted to open surgery due to coronary obstruction. All-cause mortality was 0.8% (95% CI: 0.1% to 5.3%) at both 30-day and 1-year follow-up, significantly lower than the 25% target value ( P<0.01). Permanent pacemaker implantation rates remained 2.2% (3/134) at both timepoints. Stroke incidence was 0.7% (1/134) at 30 days and 1.5% (2/134) at 1 year. Myocardial infarction rates were 0.7% (1/134) at both intervals. The postoperative transvalvular pressure gradient of the aortic valve was (6.6±3.1) mmHg(1 mmHg=0.133 kPa) (range: 4 to 8 mmHg). Among the patients, 32 cases (23.9%) had mild paravalvular leakage, 4 cases (3.0%) had moderate paravalvular leakage, and no severe paravalvular leakage was observed. NYHA class Ⅰ and Ⅱ patients increased from 18.7% preoperatively to 99.3% postoperatively. Conclusion:The novel domestic transcatheter aortic valve system demonstrates satisfactory 1-year safety and efficacy outcomes in treating severe aortic stenosis.

Objective:To investigate the correlation between the hemodynamic pattern of non-culprit vessel stenosis and long-term vessel-oriented composite outcome(VOCO) in patients with acute ST-segment elevation myocardial infarction (STEMI).Methods:From January 2019 to December 2021, 233 consecutive patients with STEMI and non-culprit vessel stenosis were prospectively enrolled at Shanghai East Hospital. The median follow-up duration was 3.9 years. The 367 non-culprit vessels of the 233 patients were divided into the VOCO group (33 vessels, 9.0%) and the non-VOCO group (334 vessels, 91.0%). Parameters pertaining to the hemodynamic pattern of non-culprit vessel stenosis between the two groups were compared. Receiver operating characteristic (ROC) curves were used to assess the correlation between hemodynamic pattern and VOCO, and Cox multivariate regression and logistic multivariate regression analyses were applied to identify independent predictors of VOCO.Results:The 233 enrolled patients were aged (62.5±12.9) years, with 193 males (82.8%). In the VOCO group, the maximum quantitative flow ratio (QFR) decreased within 20 mm of the QFR-assessed segment, the difference in QFR across the entire vessel, the length of functionally significant vessel, and the maximum gradient of QFR decrease (dQFR/dsmax) were significantly greater than those in the non-VOCO group. ROC curve analysis showed that the optimal threshold for predicting VOCO using dQFR/dsmax was 0.009 6 (area under the curve: 0.691, 95% CI: 0.606-0.775, P<0.001). Multivariable Cox regression analysis revealed that dQFR/dsmax was an independent predictor of VOCO ( HR=1.199, 95% CI: 1.070-1.343, P=0.002). When anatomical and functional stenosis severities were included in the model, a high pullback pressure gradient (PPG) index ( HR=1.572, 95% CI: 1.052-2.351, P=0.027) emerged as an independent predictor of VOCO. Multivariable logistic regression analysis revealed that a low PPG index( OR=2.851, 95% CI: 1.945-4.178, P<0.001) was an independent predictor of QFR≤0.80 without long-term VOCO. Conclusion:In patients with STEMI, localized hemodynamic patterns of coronary artery stenosis, characterized by high dQFR/dsmax and high PPG index, are associated with long-term VOCO.