1.Construction of Laboratory Animal Science and Technology Ethics Governance System in China and Its Preliminary Practice in Guangdong Province
Xiaoqin LI ; Wenlan YU ; Yizhu DUAN ; Zhonghua LIU ; Guodong WU ; Wenqi SHI ; Hongkun FU
Laboratory Animal and Comparative Medicine 2026;46(1):127-137
The welfare and ethics of laboratory animals are the ethical principles and behavioral norms that need to be followed in conducting animal-based scientific research, breeding and managing laboratory animals, and supervising and regulating such activities. The level of protection of laboratory animal welfare and ethics is closely related to the development of science and technology, which has become a widely recognized international consensus. At present, Guangdong Province is accelerating the construction of a high-level science and technology innovation province and the Guangdong-Hong Kong-Macao Greater Bay Area International Science and Technology Innovation Center. Guangdong Province should rely on its advanced governance capacity in the field of laboratory animal science and technology ethics to promote the high-quality development of its laboratory animal science and technology sector. Based on the management laws, regulations, and institutional mechanisms of laboratory animals in China, this paper explores the optimization of the laboratory animal science and technology ethics governance system, which includes the institutional guarantees, responsibility systems, ethical review and supervision mechanisms, and education and outreach. Through methods such as literature research, questionnaire surveys, and interview investigations, an empirical study of the laboratory animal science and technology ethics governance system in Guangdong Province has been conducted. Analysis of literature and research results shows that Guangdong Province has basically established a laboratory animal management system, collaboration mechanism, supervision mechanism, and education and training system that meet the current requirements of the laboratory animal science and technology ethics governance system in China. However, there are still problems such as an incomplete laboratory animal science and technology ethics supervision mechanism, an underdeveloped operation mechanism of review institutions, insufficient attention paid by laboratory animal units to the ethical review of animal experiments, inconsistent ethical review standards, and a lack of professional ethical education and training for ethics review personnel. Therefore, optimization measures such as improving the laboratory animal science and technology ethics review system, strengthening supervision and inspection, further strengthening the accountability of responsible entities, formulating review norms, and enhancing hierarchical and classified education and training are proposed, to provide a theoretical basis for promoting the normalized and long-term governance of laboratory animal science and technology ethics in Guangdong Province.
2.Impact of hepatocellular carcinoma on the prognosis of patients with liver cirrhosis undergoing emergency endoscopic therapy due to esophagogastric variceal bleeding
Xiaoqin ZHU ; Na WEI ; Yong XIAO ; Baoping YU
Journal of Clinical Hepatology 2025;41(2):277-283
ObjectiveTo investigate the impact of hepatocellular carcinoma (HCC) on the prognosis of patients with liver cirrhosis undergoing emergency endoscopic therapy for esophagogastric variceal bleeding, as well as independent influencing factors for the prognosis of liver cirrhosis patients without HCC after emergency endoscopic therapy for esophagogastric variceal bleeding. MethodsA total of 117 liver cirrhosis patients without HCC and 119 liver cirrhosis patients with HCC who underwent emergency endoscopic therapy for esophagogastric variceal bleeding in Renmin Hospital of Wuhan University from January 2017 to July 2023 were enrolled. Basic information including age and sex was collected from all patients, as well as the presence or absence of chronic diseases such as hypertension, diabetes, and coronary heart disease, the time of emergency endoscopy after admission, and liver function parameters including international normalized ratio, albumin, creatinine, sodium, total bilirubin, alanine aminotransferase, and aspartate aminotransferase (AST). The independent-samples t test was used for comparison of normally distributed continuous variables between two groups, and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous variables between two groups; the chi-square test was used for comparison of categorical variables between groups. The covariance analysis and the multivariate logistic regression analysis were used for comparison of outcome variables after control of baseline variables, and the Kaplan-Meier survival curve was plotted for each group. The univariate and multivariate Cox regression analyses were performed for survival time in the non-HCC group to investigate the independent influencing factors for survival time, and then the Kaplan-Meier curve analysis and the log-rank test were performed to validate such independent influencing factors and analyze the independent influencing factors for secondary outcomes. ResultsCompared with the non-HCC group, the HCC group had significantly higher red blood cell transfusion units (6.00[2.00~9.00] vs 4.00[1.75~7.00], Z=-2.050, P=0.040, F=4.869, adjusted P=0.028), a significantly shorter survival time (29.77±16.01 days vs 38.07±11.43 days, t=4.574, P<0.001, F=17.294, adjusted P<0.001), and a significantly higher 5-day rebleeding rate (22.69% vs 6.84%, χ2=11.736, P<0.001, adjusted P=0.021). The Kaplan-Meier curve analysis showed that the risk of 42-day mortality in the HCC group was 3.897 (95% confidence interval [CI]: 2.338 — 6.495, P<0.001) times that in the non-HCC group. The multivariate Cox regression analysis of the non-HCC group showed that the total length of hospital stay (hazard ratio [HR]=0.793, 95%CI: 0.644 — 0.976, P=0.029) was an independent protective factor for 42-day survival. The Kaplan-Meier curve analysis showed that a length of hospital stay of >9 days was beneficial for the prognosis of patients (HR=4.302, 95%CI: 1.439 — 12.870, P=0.037). Blood sodium level (odds ratio [OR]=0.523, 95%CI: 0.289 — 0.945, P=0.032) and MELD-Na score (OR=0.495, 95%CI: 0.257 — 0.954, P=0.036) were independent protective factors against 5-day rebleeding, while AST level was an independent risk factor for 5-day rebleeding (OR=1.023, 95%CI: 1.002 — 1.043, P=0.028) and in-hospital death (OR=1.036, 95%CI: 1.001— 1.073, P=0.045). ConclusionLiver cirrhosis patients with variceal bleeding and HCC tend to have a worse prognosis, and for the non-HCC group, in-hospital mortality rate increases with the increase in AST level. The total length of hospital stay is an independent protective factor for survival time in the non-HCC group, and it is recommended to appropriately prolong the length of hospital stay for such patients.
3.Effect of Dingzhi Xiaowan on PI3K/Akt/mTOR/HIF-1α Pathway in Post-stroke Cognitive Impairment Model Mice
Han ZHANG ; Yu WANG ; Xiaoqin ZHONG ; Zhenqiu NING ; Dafeng HU ; Minzhen DENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):1-11
ObjectiveTo investigate the effect of Dingzhi Xiaowan (DZXW) in post-stroke cognitive impairment (PSCI) model mice. MethodsThe cerebral ischemia-reperfusion injury model of mice was established by using the middle cerebral artery occlusion method. Forty C57BL/6 male mice were randomly divided into the sham operation group, model group, low-dose DZXW group (1.43 g·kg-1), and high-dose DZXW group (2.56 g·kg-1), with 10 mice in each group. Both the sham operation group and the model group were treated with equal amounts of normal saline by gavage, and the above four groups of mice were gavaged once a day for 30 consecutive days. Morris water maze test was used to evaluate the learning memory ability of mice. Serum levels of amyloid precursor protein (APP), amyloid 42 (Aβ42), acetylcholinesterase (AChE), and superoxide dismutase (SOD) were measured by enzyme-linked immunosorbent assay (ELISA). Deoxyribonucleotide end transferase-mediated nick end labelling (TUNEL) assay was applied to detect the degree of apoptosis in the mouse's hippocampal neurons. Western blot was used to detect the protein expression of phosphoinositol-3 kinase (PI3K), protein kinase B (Akt), mammalian target of rapamycin (mTOR), hypoxia-inducible factor 1-alpha (HIF-1α), B-cell lymphoma 2 (Bcl-2) homologous structural domain protein (Beclin1), sequestosome 1 (p62), microtubule-associated protein light chain 3 (LC3), Bcl-2, and Bcl-2-associated X protein (Bax) in hippocampal tissue. Prussian blue staining was used to detect iron deposition in hippocampal tissue. Transmission electron microscopy was taken to observe the ultrastructure of the mouse's hippocampal neurons. ResultsCompared with the sham operation group, the latency, APP, Aβ42, AChE, TUNEL positivity, ferric ion deposition, HIF-1α, Beclin1, Bax, and LC3Ⅱ/Ⅰ were significantly increased in the model group (P<0.01), while the number of crossing platforms, SOD, p-PI3K, p-Akt, p-mTOR, p62, and Bcl-2 were significantly decreased (P<0.01). Compared with the model group, the latency, APP, Aβ42, AChE, TUNEL positivity rate, ferric ion deposition, HIF-1α, Beclin1, Bax, and LC3Ⅱ/Ⅰ were significantly reduced in the DZXW groups (P<0.05), while the number of crossing platforms, SOD, p-PI3K, p-Akt, p-mTOR, p62, and Bcl-2 were significantly higher (P<0.05). ConclusionDZXW can alleviate cognitive impairment induced by oxidative stress-aggravated hippocampal neuronal damage in PSCI model mice by modulating the PI3K/Akt/mTOR/HIF-1α autophagy signalling pathway.
4.Oral health-related quality of life status and risk factors in patients with mental disorders.
Xuemei YANG ; Hongyu WANG ; Yonghua TANG ; Chengjun YIN ; Jingya YU ; Xiaoqin BI
West China Journal of Stomatology 2025;43(1):84-91
OBJECTIVES:
This study aims to explore the current status and risk factors of oral health-related quality of life OHRQoL in patients with mental disorders and provide evidence for effective intervention measures.
METHODS:
A total of 397 patients diagnosed with mental illness were selected by convenience sampling, and investigation was carried out using general data questionnaire, health literacy in dentistry-14 (HeLD-14), oral health impact profile-14 (OHIP-14), and oral health status checklist.
RESULTS:
The total score of OHIP-14 in patients with mental disorders was 8(2, 14). The score of HeLD-14 was negatively correlated with the score of OHIP-14 (r=-0.142, P<0.01). The results of multiple linear regression showed that six variables including annual family income, schizophrenia, sweets, frequency of visits to the dentist, dental caries, and missing teeth affected OHRQoL of patients with mental disorders (P<0.05).
CONCLUSIONS
The poor OHRQoL of psychiatric patients is associated with many factors. Medical personnel should pay attention to their oral health problems and develop targeted oral care programs throughout the course of disease to improve oral health and related quality of life of patients.
Humans
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Quality of Life
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Oral Health
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Mental Disorders
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Risk Factors
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Surveys and Questionnaires
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Male
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Female
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Dental Caries
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Adult
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Middle Aged
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Schizophrenia
5.Impact of intraoperative platelet and cryoprecipitate transfusion strategies on perioperative transfusion and outcomes in orthotopic heart transplant patients
Rui ZHANG ; Xiaoqin LUO ; Mei ZHOU ; Fengxiu YU ; Baohua QIAN ; Haihui GU
Chinese Journal of Blood Transfusion 2025;38(10):1313-1319
Objective: To retrospectively compare the impact of different intraoperative transfusion strategies for platelets and cryoprecipitate on perioperative blood usage and clinical outcomes in patients undergoing orthotopic heart transplant (OHT), thereby providing a reference for perioperative patient blood management. Methods: The clinical data of 65 patients who had undergone OHT at our hospital between 2020 and 2025 were retrospective collected. Patient demographics, underlying chronic conditions, and perioperative (preoperative, intraoperative, and postoperative) laboratory blood test results were analyzed. The transfusion volumes of intraoperative red blood cells, plasma, platelets, and cryoprecipitate were examined. Univariate and multivariate logistic regression models were employed to identify factors associated with perioperative outcomes. Results: A total of 65 patients received allogeneic blood transfusion during the perioperative period. The ultilization of intraoperative platelets and cryoprecipitate was as follows: simultaneous transfusion of both platelets and cryoprecipitate (at a 1∶1 ratio) was administered in 42 patients (64.62%), platelets alone in 12 patients (18.46%), and cryoprecipitate alone in 11 patients (16.92%). Patients who received simultaneous transfusion of platelets and cryoprecipitate (1∶1) (n=42) had a shorter ICU length of stay (32.45±10.18 d), while those who received either platelets or cryoprecipitate alone (n=23) had a significantly longer ICU length of stay (68±15.97 d). Patients receiving simultaneous intraoperative transfusion of platelets and cryoprecipitate also required fewer units of allogeneic red blood cells intraoperatively (median=4 units) and had a lower mortality rate (16.7%) than those receiving either product alone (26.1%), with a statistically significant difference (P=0.023). Multivariate logistic regression analysis indicated that the volume of cryoprecipitate transfused was an independent protective factor against postoperative allogeneic red blood cell transfusion (OR=0.344, 95% CI [0.177, 0.829], P=0.0159). Multivariate logistic regression also identified cryoprecipitate transfusion volume as an independent protective factor for ICU length of stay (OR=0.877, 95% CI [0.719, 0.986], P=0.0008), which was in line with the multivariate Cox regression results. Conclusion: In patients undergoing OHT, the intraoperative transfusion strategy for platelets and cryoprecipitate influences the volume of perioperative allogeneic red blood cell transfusion and patient mortality. Intraoperative cryoprecipitate transfusion volume is an independent protective factor against both postoperative allogeneic red blood cell transfusion and prolonged ICU length of stay. The establishment of a multidisciplinary collaborative blood management model, combined with the modification of perioperative blood utilization practices and the implementation of a comprehensive patient blood management strategy, can holistically ensure perioperative patient safety.
6.Diagnostic value of amide proton imaging for clinically significant prostate cancer in prostate imaging reporing and data system 3-5 grade lesions
Hongkun FANG ; Shuhai ZHANG ; Shoubin LI ; Xiaoqin LIU ; Yongqiang YU ; Weishu HOU
Journal of Practical Radiology 2025;41(5):795-800
Objective To explore the diagnostic value of amide proton transfer weighted imaging(APTWI)in conjunction with prostate-specific antigen density(PSAD)for detecting clinically significant prostate cancer(csPCa)within prostate imaging reporting and data system(PI-RADS)v2.13-5 grade lesions.Methods A retrospective analysis was conducted on the clinical and imaging data of 88 patients diagnosed with PI-RADS 3-5 grade prostate lesions.There were 59 patients with prostate cancer(PCa)and 29 with benign prostate lesion(BPL).The PCa group was divided into csPCa group(44 cases)and clinically insignificant prostate cancer(ciPCa)group(15 cases)according to Gleason score(GS).Spearman rank correlation analysis was used to analyze the correlation between APTWI-related parameters and GS in PCa.Comparative analyses were conducted to identify statistical discrepancies in APTWI and prostate-specific antigen(PSA)-related parameters across various groups.Subsequently,both solitary and combined diagnostic models were developed,and the receiver operating characteristic(ROC)curve were utilized to evaluate the diagnostic efficacy.Results APTmax and APTmean were moderately positively correlated with GS(r=0.683,r=0.705,respectively),and APTmin was weakly positively correlated with GS(r=0.547).APTWI and PSA-related parameters were significantly higher in the PCa group than in the BPL group,and APTmin had the highest efficacy in diagnosing PCa[area under the curve(AUC)=0.855].APTWI and PSA-related parameters differed among the BPL,ciPCa and csPCa groups(P<0.05).Among the groups,statistically significant differences were observed in each parameter of APTWI and PSA-related indices between the BPL group and the csPCa group,as well as between the ciPCa group and the csPCa group(P<0.05).In contrast,only APTmin and PSAD exhibited significant differ-ences between the BPL group and the ciPCa group(P<0.05).The results of the combined diagnosis showed that APTmin+PSAD had the highest diagnostic efficacy for diagnosing PCa(AUC=0.899),and APTmean+PSAD had the highest diagnostic efficacy for diagnosing csPCa(AUC=0.838).Conclusion In PI-RADS 3-5 grade prostate lesions,APTWI and PSA-related parameters are statisti-cally different in the BPL,ciPCa,and csPCa groups.Notably,the combination of APTmean and PSAD exhibit the highest diagnostic efficacy for csPCa.
7.Clinical features of chronic hepatitis C patients with genotype 3 infection:A multicenter retrospective cohort study
Jingyi XIE ; Yujia JING ; Yishan LIU ; Manling BAI ; Zhangqian CHEN ; Qiang XU ; Hong DU ; Yuxiu MA ; Liting ZHANG ; Shanshan ZHU ; Xiaoqin GAO ; Xinggang BAI ; Guoying YU ; Jianqi LIAN ; Xiaozhong WANG ; Yongping ZHANG ; Jiuping WANG ; Fanpu JI ; Jianjun FU ; Ning GAO
Journal of Clinical Hepatology 2025;41(8):1533-1540
Objective To investigate the clinical features of chronic hepatitis C(CHC)patients with hepatitis C virus genotype 3(HCV GT3)infection and the risk factors for disease progression.Methods A multicenter retrospective cohort study was conducted among 1 002 CHC patients from 11 clinical centers in Northwest China from December 2017 to November 2023,and according to their genotype,they were divided into GT1,GT2,GT3,and GT6 groups.Clinical features were compared between the patients with different genotypes.The one-way analysis of variance was used for comparison of normally distributed continuous data between groups,and the Scheffe test was used for further comparison between two groups.The Kruskal-Wallis H test was used for comparison of data with skewed distribution between groups;the chi-square test or Fisher test was used for comparison of categorical data between groups.The multivariate logistic regression analysis was used to explore the influencing factors for the progression of CHC to liver cirrhosis.Results In terms of the genotype,there were 427 patients with GT1 infection,242 with GT2 infection,299 with GT3 infection(210 patients with GT3a infection,87 with GT3b infection,and 2 with unclassified genotype),and 34 with GT6 infection.The patients with GT3 infection had a significantly younger age than those with GT1 infection(51.3±0.5 years vs 53.2±0.6 years,P<0.05)or GT2 infection(51.3±0.5 years vs 53.7±0.8 years,P<0.05),and for the patients with liver cirrhosis,the patients with GT3 infection had a significantly younger age than those with GT1 infection(52.1±0.5 years vs 59.4±0.9 years,P<0.001)or GT2 infection(52.1±0.5 years vs 58.1±1.1 years,P<0.001).Among the patients with GT3 infection,male patients accounted for 77.9%and the patients with liver cirrhosis accounted for 46.2%,which were significantly higher than those among the patients with GT1,GT2 or GT6 infection(all P<0.001).At baseline,the patients with GT3 infection had significantly higher levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)than those with GT1 or GT2 infection,significantly higher aspartate aminotransferase-to-platelet ratio index(APRI)and fibrosis-4(FIB4)than those with GT1,GT2 or GT6 infection,a significantly lower platelet count(PLT)than those with GT2 or GT6 infection,a significantly higher level of alpha-fetoprotein than those with GT2 or GT6 infection,and a significantly lower level of albumin(Alb)than those with GT6 infection(all P<0.05).There were no significant differences between the patients with GT3a infection and those with GT3b infection in age,sex,the proportion of patients with liver cirrhosis,comorbidities,HCV RNA quantification,PLT,ALT,AST,alkaline phosphatase,Alb,APRI,and FIB-4(all P>0.05).The multivariate logistic regression analysis showed that PLT≤150×109/L(odds ratio[OR]=10.72,95%confidence interval[CI]:5.76-35.86,P<0.001)and Alb≤35 g/L(OR=3.74,95%CI:1.22-11.45,P=0.021)were risk factors for liver cirrhosis.Conclusion Most CHC patients with GT3 infection are male in Northwest China,and compared with the patients with other genotypes,such patients tend to have a younger age of onset and higher degrees of liver inflammation activity and fibrosis.Low PLT and a low level of Alb are risk factors for progression to liver cirrhosis in CHC patients with GT3 infection.
8.Motor imagery electroencephalogram signal recognition based on mutual information and adaptive graph convolution
Yelan WU ; Pugang CAO ; Meng XU ; Yue ZHANG ; Xiaoqin LIAN ; Chongchong YU
Chinese Journal of Medical Physics 2025;42(2):232-239
To address the challenges of extracting nonlinear features from motor imagery electroencephalogram(EEG)signals and effectively capturing functional connectivity between EEG channels,a classification and recognition method for motor imagery EEG signals is proposed based on mutual information and adaptive graph convolutional network.The proposed method extracts frequency domain information by sub-frequency banding on the original motor imagery EEG signals,uncovers the nonlinear relationships within EEG signals by an adjacency matrix constructed with mutual information neural estimation method,and finally achieve null-frequency feature extraction by capturing the dynamic correlation strength between channels with an adaptive graph convolutional network incorporating convolutional block attention module.On the BCI Competition Ⅳ 2a and BCI Competition Ⅲ 3a datasets,the proposed method has average accuracies of 83.14%and 88.19%,respectively,demonstrating that it can effectively reveal functional connectivity between EEG channels,providing a new approach for decoding motor imagery EEG signals.
9.Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury (version 2025)
Aijun XU ; Shuixia LI ; Bo CHEN ; Mengyuan YE ; Lejiao LANG ; Ning NING ; Lin ZHANG ; Changqing LIU ; Zhonglan CHEN ; Weihu MA ; Weishi LI ; Xiaoning WANG ; Dongmei BIAN ; Jiancheng ZENG ; Xin WANG ; Yuan GAO ; Yaping CHEN ; Jiali CHEN ; Yun HAN ; Xiuting LI ; Yang ZHOU ; Xiaojing SU ; Qiong ZHANG ; Tianwen HUANG ; Ping ZHANG ; Hua LIN ; Xingling XIAO ; Ruifeng XU ; Fanghui DONG ; Bing HAN ; Luo FAN ; Yanling PEI ; Suyun LI ; Xiaoju TAN ; Rongchen GUO ; Yefang ZOU ; Xiaoyun HAN ; Junqin DING ; Yi WANG ; Shuhua DENG ; Jinli GUO ; Yinhua LIANG ; Yuan CEN ; Xiaoqin LIU ; Junru CHEN ; Haiyang YU ; Lunlan LI ; Ying REN ; Yunxia LI ; Jianli LU ; Ying YING ; Lan WEI ; Yin WANG ; Qinhong XU ; Yanqin ZHANG ; Yang LYU ; Shijun ZHANG ; Sui WENJIE ; Sanlian HU ; Shuhong YANG ; Guoqing LI ; Jingjing AN ; Baorong HE ; Leling FENG
Chinese Journal of Trauma 2025;41(6):530-541
Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.
10.Reliability and validity of the Chinese version of the Consultation and Relational Empathy (CARE) measure in Mandarin speaking population
Feiyue WANG ; Yun WEI ; Haiyan YU ; Yanli LIU ; Yali ZHAO ; Xiaoqin LU ; Guanghui JIN
Chinese Journal of General Practitioners 2025;24(6):713-721
Objective:To evaluate the reliability and validity of the Chinese version of Consultation and Relational Empathy (CARE) Measure in the Mandarin speaking population.Methods:From March to June 2018, patient interviews and expert consultations were conducted to explore problems of CARE in Mandarin context and preliminary revisions were made to the measure, then the final adapted tool was developed. A questionnaire survey on the validity of the measure was conducted from July to August 2018, among 373 patients from three community health service centers in Beijing Chaoyang District, selected by convenience sampling. The questionnaire included general information of participants and the revised CARE measure. The results of the survey were analyzed for the reliability and validity of Chinese version of CARE measure.Results:In the culture adaptation stage, 30 word-changes and 13 phrase-changes were made to improve the cultural adaptation of CARE. A total of 373 valid questionnaires were were collected with a valid recovery rate of 100.0%. The participants had a mean age of (60.8±13.12) years, with females of 68.6% (256/373), junior high school or high school education of 58.7% (219/373), and retirees of 71.3% (266/373). The results showed that there was a significant difference in scores of each item between the high group (top 27%) and the low group (bottom 27%) ( P<0.001). There was a positive correlation between each item and the total score, with a correlation coefficient between 0.817 and 0.868 ( P<0.001). The reliability analysis results show that the Cronbach′s α of the revised CARE was 0.960. In the content validity analysis, among the 10 items, the proportion of patients who considered the item "not applicable" was between 1.1% and 4.8%, and the proportion who considered the item "important" was between 92.8% and 96.2%. In exploratory factor analysis, KMO=0.944 and Bartlett′s sphericity test P<0.001. One common factor with an eigenvalue>1 was extracted, and the cumulative variance explained by which was 73.85%, with the load value of each item of 0.815-0.909. Conclusion:The revised Chinese version of CARE measure shows good reliability and validity and it can be applied in primary care settings for Mandarin speaking population.

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