Objective: To explore the association between time to first cigarette (TTFC) and expiratory airflow limitation, so as to provide a reference for the prevention and control of pulmonary function decline. Methods: Based on the baseline survey of the China Multi-Ethnic Cohort (CMEC), the demographic, lifestyle behavior, smoking behavior, and TTFC data of permanent residents aged 30 to 79 years in Chengdu City were collected from 2018 to 2019. The TTFC was divided into ≤5, 6-30, 31-60, and >60 minutes. Expiratory airflow limitation was determined when the proportion of the measured peak expiratory flow to the predicted value was less than 80%. The association between TTFC and expiratory airflow limitation was analyzed using a multivariable logistic regression model, and subgroup analyses were conducted according to smoking cessation, age of starting smoking, smoking duration, average daily smoking volume, and the habit of deep inhalation into the lungs. Results: A total of 6 766 residents were investigated, among whom 6 402 were males, accounting for 94.62%. The median age was 52 (interquartile range, 19) years. A total of 2 468 residents were detected with expiratory airflow limitation, with a detection rate of 36.48%. Multivariable logistic regression analysis showed that after adjusting for demographics, lifestyle behavior, smoking cessation, age of starting smoking, smoking duration, average daily smoking volume, and the habit of deep inhalation into the lungs, TTFC ≤5 minutes (OR=1.203, 95%CI: 1.035-1.397) and 6-30 minutes (OR=1.174, 95%CI: 1.002-1.374) were associated with an increased risk of expiratory airflow limitation. Subgroup analyses showed that there was no interaction between smoking behavior and TTFC on the risk of expiratory airflow limitation (all P>0.05). Conclusion A shorter TTFC is associated with an increased risk of expiratory airflow limitation among residents aged 30 to 79 years, and the association is not affected by snoking behaviors such as smoking cessation, age of starting smoking, smoking duration and average daily smoking volume.

[This corrects the article DOI: 10.1016/j.apsb.2022.05.019.].

Objective:To analyze the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with main splenic artery embolization in the treatment of patients with portal hypertension upper gastrointestinal bleeding complicated with extensive portal vein thrombosis (PVT).Methods:This study was a prospective, single-center, open-label, single-arm clinical trial. In the first phase, 81 patients with portal hypertension upper gastrointestinal bleeding who were admitted to Beijing Shijitan Hospital, Capital Medical University from January 2018 to December 2018 were consecutively enrolled, including 57 males and 24 females, with the age of (51.3±10.4) years. During TIPS surgery, the pressure of the portal vein before and after the balloon blocking the splenic artery was measured to clarify the contribution of the splenic artery to portal hypertension. In the second stage, from January 2019 to December 2022, 104 patients with portal hypertension upper gastrointestinal bleeding complicated with extensive PVT were re-enrolled, including 71 males and 33 females, with the age of (50.9±12.5) years. TIPS combined with main splenic artery embolization was performed, and portal vein pressure was measured before and after embolization. Follow up on the postoperative esophageal and gastric varices of the patients in the second stage.Results:The portal vein pressures before and after the first stage of balloon occlusion of the splenic artery were (35.2±8.4) mmHg (1 mmHg=0.133 kPa) and (24.2±6.3) mmHg, respectively. The pressure after occlusion was lower than that before occlusion, and the difference was statistically significant ( t=10.54, P<0.001). The portal vein pressures before and after the second stage embolization were (36.1±9.5) mmHg and (21.1±4.7) mmHg respectively. The pressure after embolization was lower than that before embolization, and the difference was statistically significant ( t=13.47, P<0.001). In the second stage, among the 104 patients, the proportion of those whose varicose veins disappeared or improved 6 months after the operation was 43.3%(45/104) and 51.0%(53/104), respectively. There were no patients with aggravation or rebleeding due to rupture. One year later, 8 patients (7.7%) had aggravated or ruptured esophageal and gastric varices with bleeding. Two years later, 12 patients (11.5%) had aggravated or bleeding. Conclusion:TIPS combined with main splenic artery embolization can effectively reduce the portal vein pressure in patients with portal hypertension upper gastrointestinal bleeding complicated with extensive PVT, improve the degree of esophageal and gastric varices, and reduce the risk of gastrointestinal bleeding.

Objective This study aims to investigate the current status and determinants of compassion fatigue symptoms among orthopedic nurses,and to analyze the interrelationships among these determinants to provide references for targeted intervention development.Methods From May to June 2024,a convenience sampling method was employed to recruit orthopedic nurses from 20 tertiary hospitals across 14 provinces and cities in China.The survey instruments encompassed the general demographic information sheet,the Compassion Fatigue Scale,the Social Support Rating Scale,the Nurses' Psychological Capital Questionnaire,and the Professional Identity Questionnaire.The data were analyzed using univariate analysis,Spearman correlation analysis,and multiple linear regression analysis.A structured equation model was also developed.Results Totally 1 397 valid questionnaires were collected,and the effective response rate was 96.94％(1 397/1 441).The average score of compassion fatigue symptoms was 47.41±12.16.The multiple linear regression analysis indicated that professional identity,social support,psychological capital,length of service,and frequency of night shifts per week were independent determinants of compassion fatigue symptoms(P＜0.05).The path analysis demonstrated a good fit with the specified indicators.Psychological capital exhibited a direct mediating effect on compassion fatigue symptoms(β=-0.15,P＜0.05).Furthermore,professional identity(β=1.46,P＜0.001;β=-0.38,P＜0.001)and social support(β=0.14,P＜0.001;β=-0.99,P＜0.001)served as mediators in the relationship between psychological capital and compassion fatigue symptoms.Conclusion The compassion fatigue symptoms among orthopedic nurses are relatively severe.It is imperative for nursing managers to address associated factors of compassion fatigue symptoms among orthopedic nurses and implement effective preventive strategies to mitigate its level.

Objective:To understand the species of mosquitoes and the status of important mosquito-borne viruses in the Ningxia surveyed regions, to identify the dominant mosquito species and virus types, and to analyze their genetic characteristics, providing a scientific basis for predicting and controlling mosquito-borne infectious diseases.Methods:Mosquitoes were collected using light traps in Yinchuan and Wuzhong cities of the Ningxia Hui Autonomous Region, and the collected mosquitoes were classified and identified. Real-time polymerase chain reaction (PCR) was used to detect the Japanese encephalitis virus (JEV), West Nile virus (WNV), Chikungunya virus (CHIKV), Sindbis virus (SINV) carried by mosquitoes. The positive sample was subjected to sequencing the whole genome, and the phylogenetic tree of virus strains was constructed using bioinformatics methods.Results:From June to August 2023, a total of 8 561 mosquitoes of 3 genera and 6 species were collected in Yinchuan and Wuzhong cities, Ningxia, among which Culex pipiens pallens was the dominant species with 3 050 individuals, accounting for 35.63%; Anopheles sinensis with 2 379 individuals, accounting for 27.79%; Culex tritaeniorhynchus with 1 489 individuals, accounting for 17.39%; Caspian Aedes with 1 468 individuals, accounting for 27.79%; Aedes vexans with 152 individuals, accounting for 1.78%; and Culex modestus with 23 individuals, accounting for 0.27%. JEV GIb type was detected in the specimens of Culex tritaeniorhynchus collected in Qingtongxia city. Conclusions:The dominant mosquito species in the surveyed areas of Ningxia are primarily Culex pipiens pallens, and JEV GIb virus was detected in Culex tritaeniorhynchus in Qingtongxia city. This study provides basic data for understanding the current status of mosquitoes and mosquito-borne viruses in the Ningxia region and offers scientific guidance for further public health prevention and control measures.

Gastric cancer with peritoneal metastasis (GCPM) is a common and lethal manifestation of advanced gastric cancer, with a median survival of only 5-11 months. This consensus was developed by 30 experts from Asia (China, Japan, Korea, and Singapore) using the Delphi method and the GRADE evidence grading system. A total of 29 statements were formulated, covering the diagnosis and assessment of GCPM, indications for laparoscopic exploration and NIPS (normothermic intraperitoneal and systemic treatment), treatment regimens, prevention and management of complications, criteria for conversion surgery, and postoperative intraperitoneal therapy. The consensus aims to standardize clinical practice and improve the prognosis of patients with GCPM.

Objective To investigate the expression and clinical significance of Claudin-6(CLDN6),tripartite motif-containing protein 59(TRIM59)and chemokine-like factor-like MARVEL transmembrane domain containing member 6(CMTM6)in nasopharyngeal carcinoma(NPC)tissue.Methods A total of 135 NPC patients were selected as the study objects,and cancer tissue(observation group)and para-cancer tissue(control group)of all patients were collected.All patients were followed up for 3 years.According to the follow-up results,93 surviving patients were included in the survival group and 42 dead patients were included in the death group.The mRNA expressions of CLDN6,TRIM59 and CMTM6 were determined by fluorescence quantitative PCR.Multivariate Cox regression was used to analyze the influencing factors of death in NPC patients.Kaplan-Meier method was used to analyze the relationship between the expression levels of CLDN6,TRIM59,CMTM6 and the prognosis of NPC patients.Results Compared with the control group,mRNA expressions of CLDN6,TRIM59 and CMTM6 were increased in the observation group(P＜0.05).There were no significant differences in age,sex,body mass index,TNM stage,bone metastasis,smoking history,drinking history and hypertension history between the survival group and the death group.Compared with the survival group,the proportion of NPC family history and the mRNA expression of CLDN6,TRIM59 and CMTM6 in cancer tissue were increased in the death group(P<0.05).Multivariate Cox regression analysis showed that the increased levels of CLDN6,TRIM59 and CMTM6 in cancer tissue were influential factors for death of NPC patients(P＜0.05).According to the mean expression levels of CLDN6,TRIM59 and CMTM6 mRNA in cancer tissue,patients were divided into the low expression group and the high expression group.The 3-year survival rate of the high expression group was significantly lower than that of the low expression group(P＜0.05).Conclusion The mRNA expressions of CLDN6,TRIM59 and CMTM6 in NPC tissue are significantly increased,which is a risk factor for death in NPC patients,and the mRNA expressions of CLDN6,TRIM59 and CMTM6 are correlated with the prognosis of patients.

Objective:To explore the current status of lumbar paraspinal muscle functional exercise in patients undergoing lumbar fusion surgery, and to analyze the facilitators and barriers affecting these exercises in order to provide a theoretical basis for developing targeted interventions.Methods:This qualitative study was guided by the Information-Motivation-Behavioral Skills (IMB) model. Semi-structured interviews were conducted between September and November 2024 with 13 postoperative patients, 13 medical staff from the spine surgery ward, and four family caregivers at Beijing Jishuitan Hospital, Capital Medical University. Data were orgznized, analyzed and coded using Colaizzi's seven-step method.Results:A total of three major themes and 14 subthemes were identified. The first major theme highlighted various facilitating factors, including perceived benefits of rehabilitation, a trusting physician-patient relationship, strong motivation for recovery, and patient preference in exercise choices. The second major theme revealed several barriers, including residual postoperative symptoms, psychological burden, lack of awareness, limited access to information, uncomfortable experiences during exercise, and negative family support. The third major theme described the current issues of clinical implementation, including unclear role definitions among healthcare staff, inefficient exercise models, lack of standardized protocols and guidelines, and the need to establish a support and follow-up system.Conclusions:The implementation of lumbar paraspinal muscle functional exercises post-lumbar fusion surgery is influenced by multiple facilitating and hindering factors. Healthcare professionals should leverage facilitators and overcome barriers by adopting targeted strategies to optimize postoperative rehabilitation care practices.

Objective To investigate the expression and clinical significance of Claudin-6(CLDN6),tripartite motif-containing protein 59(TRIM59)and chemokine-like factor-like MARVEL transmembrane domain containing member 6(CMTM6)in nasopharyngeal carcinoma(NPC)tissue.Methods A total of 135 NPC patients were selected as the study objects,and cancer tissue(observation group)and para-cancer tissue(control group)of all patients were collected.All patients were followed up for 3 years.According to the follow-up results,93 surviving patients were included in the survival group and 42 dead patients were included in the death group.The mRNA expressions of CLDN6,TRIM59 and CMTM6 were determined by fluorescence quantitative PCR.Multivariate Cox regression was used to analyze the influencing factors of death in NPC patients.Kaplan-Meier method was used to analyze the relationship between the expression levels of CLDN6,TRIM59,CMTM6 and the prognosis of NPC patients.Results Compared with the control group,mRNA expressions of CLDN6,TRIM59 and CMTM6 were increased in the observation group(P＜0.05).There were no significant differences in age,sex,body mass index,TNM stage,bone metastasis,smoking history,drinking history and hypertension history between the survival group and the death group.Compared with the survival group,the proportion of NPC family history and the mRNA expression of CLDN6,TRIM59 and CMTM6 in cancer tissue were increased in the death group(P<0.05).Multivariate Cox regression analysis showed that the increased levels of CLDN6,TRIM59 and CMTM6 in cancer tissue were influential factors for death of NPC patients(P＜0.05).According to the mean expression levels of CLDN6,TRIM59 and CMTM6 mRNA in cancer tissue,patients were divided into the low expression group and the high expression group.The 3-year survival rate of the high expression group was significantly lower than that of the low expression group(P＜0.05).Conclusion The mRNA expressions of CLDN6,TRIM59 and CMTM6 in NPC tissue are significantly increased,which is a risk factor for death in NPC patients,and the mRNA expressions of CLDN6,TRIM59 and CMTM6 are correlated with the prognosis of patients.

Objective:To analyze the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with main splenic artery embolization in the treatment of patients with portal hypertension upper gastrointestinal bleeding complicated with extensive portal vein thrombosis (PVT).Methods:This study was a prospective, single-center, open-label, single-arm clinical trial. In the first phase, 81 patients with portal hypertension upper gastrointestinal bleeding who were admitted to Beijing Shijitan Hospital, Capital Medical University from January 2018 to December 2018 were consecutively enrolled, including 57 males and 24 females, with the age of (51.3±10.4) years. During TIPS surgery, the pressure of the portal vein before and after the balloon blocking the splenic artery was measured to clarify the contribution of the splenic artery to portal hypertension. In the second stage, from January 2019 to December 2022, 104 patients with portal hypertension upper gastrointestinal bleeding complicated with extensive PVT were re-enrolled, including 71 males and 33 females, with the age of (50.9±12.5) years. TIPS combined with main splenic artery embolization was performed, and portal vein pressure was measured before and after embolization. Follow up on the postoperative esophageal and gastric varices of the patients in the second stage.Results:The portal vein pressures before and after the first stage of balloon occlusion of the splenic artery were (35.2±8.4) mmHg (1 mmHg=0.133 kPa) and (24.2±6.3) mmHg, respectively. The pressure after occlusion was lower than that before occlusion, and the difference was statistically significant ( t=10.54, P<0.001). The portal vein pressures before and after the second stage embolization were (36.1±9.5) mmHg and (21.1±4.7) mmHg respectively. The pressure after embolization was lower than that before embolization, and the difference was statistically significant ( t=13.47, P<0.001). In the second stage, among the 104 patients, the proportion of those whose varicose veins disappeared or improved 6 months after the operation was 43.3%(45/104) and 51.0%(53/104), respectively. There were no patients with aggravation or rebleeding due to rupture. One year later, 8 patients (7.7%) had aggravated or ruptured esophageal and gastric varices with bleeding. Two years later, 12 patients (11.5%) had aggravated or bleeding. Conclusion:TIPS combined with main splenic artery embolization can effectively reduce the portal vein pressure in patients with portal hypertension upper gastrointestinal bleeding complicated with extensive PVT, improve the degree of esophageal and gastric varices, and reduce the risk of gastrointestinal bleeding.