Objective:To analyze the current health status of elderly adults with chronic diseases in Chongqing and the influencing factors,in order to provide a reference basis for improving the health status of the elderly.Methods:Multi-stage stratified random sampling was used to select elderly adults with chronic diseases in Chongqing to conduct the questionnaire survey,and to analyze the current health status of chronically ill older adults and the factors influencing their differences on the basis of logistic regression,the differences in the health status of older adults were further decomposed and analyzed by using Oaxaca-Blinder decomposition method.Results:The health impairment rate of the elderly adults with chronic diseases in Chongqing was 17.14%.Health impairment was lower among the elderly adults with chronic diseases who had a personal monthly income of 6 500 yuan or more,were married,had very good sleep quality,were involved in social activities,had urban household registration,had college education or higher,had no loneliness,had not had a fall in the past year,and had seen an outpatient clinic in the past year.Health impairment was higher among chronically ill older adults whose life satisfaction was bad,whose self-rated health was poor,and who had been poor.Conclusion:Life satisfaction,self-assessed health,personal monthly income,whether has been a poor household,marital status,whether one has fallen in the past year,and whether one has visited an outpatient clinic in the past year are the main factors affecting the health impairment of older adults with chronic diseases in Chongqing.By prioritizing interventions and implementing precise health management in improving life satisfaction,strengthening self-assessed health perceptions,and preventing falls among older adults,it could reduce the differences in health impairment among older adults with chronic diseases,and contribute to China's active response to healthy aging and the promotion of a proactive health strategy.

OBJECTIVE To investigate the ultrasound characteristics of category 4 thyroid nodules in the Chinese version of the Thyroid Imaging Reporting and Data System(C-TI-RADS),and to analyze the value of ultrasonography combined with elastography scoring in the correction of nodule properties.METHODS Data from 80 patients with 105 nodules from April 2020 to December 2023 were retrospectively analyzed.Fine-needle aspiration biopsy or surgical pathology was used as the gold standard.The Kappa test was employed to evaluate diagnostic consistency,while the receiver operating characteristic(ROC)curve was utilized to assess the differentiation and accuracy of the diagnostic methods.RESULTS Sixty-eight malignant nodules and 37 benign nodules were confirmed by surgical pathology or puncture biopsy.After enhancement by ultrasonography,the percentage of malignant nodules with low intensity,centripetal enhancement,inhomogeneous enhancement,blurred boundary of enhanced nodules,enlarged enhanced nodules,and irregular enhanced nodules was significantly higher than that of the benign group,while the percentage of circumferential enhancement was lower than that of the benign group(P<0.05).The overall compliance rate of ultrasonography scoring in diagnosing C-TI-RADS category 4 thyroid nodules was 83.81%(88/105),and when compared with the pathological gold standard,the Kappa value was 0.644.The ROC curve analysis showed that the sensitivity of ultrasonography scoring in diagnosing benign and malignant nodules was 84.51%,the specificity was 82.35%,the correctness index was 0.669,the negative likelihood ratio was 0.188,and the positive likelihood ratio was 4.789.The overall compliance rate of elastography score in diagnosing C-TI-RADS category 4 thyroid nodules was 85.71%(90/105),and when compared with the pathological gold standard,the Kappa value was 0.689.The ROC curve analysis revealed that the sensitivity of elastography score in diagnosing benign and malignant nodules was 88.24%,the specificity was 81.08%,the correctness index was 0.693,the negative likelihood ratio was 0.145,and the positive likelihood ratio was 4.664.Ultrasonography enhancement features,along with the combination of ultrasonography score and elastography score,had an AUC=0.922(0.876-0.968),with an accuracy of 92.91%,demonstrating a strong ability to identify truly malignant nodules versus benign nodules.CONCLUSION Ultrasonography combined with elastography scoring is valuable in the correction of C-TI-RADS category 4 nodules in the thyroid gland and helps to improve diagnostic accuracy.

Objective:To analyze the current health status of elderly adults with chronic diseases in Chongqing and the influencing factors,in order to provide a reference basis for improving the health status of the elderly.Methods:Multi-stage stratified random sampling was used to select elderly adults with chronic diseases in Chongqing to conduct the questionnaire survey,and to analyze the current health status of chronically ill older adults and the factors influencing their differences on the basis of logistic regression,the differences in the health status of older adults were further decomposed and analyzed by using Oaxaca-Blinder decomposition method.Results:The health impairment rate of the elderly adults with chronic diseases in Chongqing was 17.14%.Health impairment was lower among the elderly adults with chronic diseases who had a personal monthly income of 6 500 yuan or more,were married,had very good sleep quality,were involved in social activities,had urban household registration,had college education or higher,had no loneliness,had not had a fall in the past year,and had seen an outpatient clinic in the past year.Health impairment was higher among chronically ill older adults whose life satisfaction was bad,whose self-rated health was poor,and who had been poor.Conclusion:Life satisfaction,self-assessed health,personal monthly income,whether has been a poor household,marital status,whether one has fallen in the past year,and whether one has visited an outpatient clinic in the past year are the main factors affecting the health impairment of older adults with chronic diseases in Chongqing.By prioritizing interventions and implementing precise health management in improving life satisfaction,strengthening self-assessed health perceptions,and preventing falls among older adults,it could reduce the differences in health impairment among older adults with chronic diseases,and contribute to China's active response to healthy aging and the promotion of a proactive health strategy.

We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.
Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Dactinomycin/adverse effects* ; Female ; Gestational Trophoblastic Disease/drug therapy* ; Humans ; Methotrexate/therapeutic use* ; Pregnancy ; Retrospective Studies