This study aims to describe the population and regional distribution characteristics of smoking behavior among adult twins in the China Twin Registry (CNTR), as well as the concordance rates for smoking behavior in monozygotic and dizygotic twins, and estimate the heritability. The study population included adult twins in CNTR who had smoking questionnaire data. A random-effects regression model was used to describe the distribution of smoking behavior among different subgroups based on various characteristics. The concordance of smoking behavior between different zygosity groups was calculated, and heritability was estimated. A total of 28 444 twin pairs were included in this study, with an average age of (36.6±12.0) years. Among male twins, 41.2% were current smokers, while only 1.2% of females smoked. Higher smoking rates were observed among male smokers in the 50-59 age group ( z=23.0, P<0.001), northern regions ( z=2.9, P<0.01), rural areas ( z=-5.2, P<0.001), those who were divorced/widowed ( z=3.8, P<0.001), and first-born twins ( z=-4.3, P<0.001), while lower smoking rates were found in those with higher education ( z=-16.1, P<0.001) and unmarried individuals ( z=-16.0, P<0.001). The smoking concordance rate for male monozygotic twins was 69.6%, significantly higher than the 57.3% concordance rate for dizygotic twins ( χ 2=105.0, P<0.05). The heritability of smoking behavior in male twins was estimated at 28.9% (95% CI: 24.3%-33.4%). Stratified analyses showed differences in heritability across regions and age groups: the heritability in northern regions was 32.6% (95% CI: 27.3%-38.0%), higher than the 21.0% (95% CI: 12.4%-29.5%) observed in southern regions; the highest heritability of 35.1% (95% CI: 26.3%-43.9%) was found in the 18-29 age group, with heritability decreasing with age. In conclusion, the smoking rate and influencing factors in the twin population are similar to those in the general population, with unique characteristics, such as higher smoking rates in first-born twins. Genetic factors have a significant impact on smoking behavior.

This study aims to describe the population and regional distribution characteristics of smoking behavior among adult twins in the China Twin Registry (CNTR), as well as the concordance rates for smoking behavior in monozygotic and dizygotic twins, and estimate the heritability. The study population included adult twins in CNTR who had smoking questionnaire data. A random-effects regression model was used to describe the distribution of smoking behavior among different subgroups based on various characteristics. The concordance of smoking behavior between different zygosity groups was calculated, and heritability was estimated. A total of 28 444 twin pairs were included in this study, with an average age of (36.6±12.0) years. Among male twins, 41.2% were current smokers, while only 1.2% of females smoked. Higher smoking rates were observed among male smokers in the 50-59 age group ( z=23.0, P<0.001), northern regions ( z=2.9, P<0.01), rural areas ( z=-5.2, P<0.001), those who were divorced/widowed ( z=3.8, P<0.001), and first-born twins ( z=-4.3, P<0.001), while lower smoking rates were found in those with higher education ( z=-16.1, P<0.001) and unmarried individuals ( z=-16.0, P<0.001). The smoking concordance rate for male monozygotic twins was 69.6%, significantly higher than the 57.3% concordance rate for dizygotic twins ( χ 2=105.0, P<0.05). The heritability of smoking behavior in male twins was estimated at 28.9% (95% CI: 24.3%-33.4%). Stratified analyses showed differences in heritability across regions and age groups: the heritability in northern regions was 32.6% (95% CI: 27.3%-38.0%), higher than the 21.0% (95% CI: 12.4%-29.5%) observed in southern regions; the highest heritability of 35.1% (95% CI: 26.3%-43.9%) was found in the 18-29 age group, with heritability decreasing with age. In conclusion, the smoking rate and influencing factors in the twin population are similar to those in the general population, with unique characteristics, such as higher smoking rates in first-born twins. Genetic factors have a significant impact on smoking behavior.

Objective:To describe the distribution characteristics of alcohol consumption in adult twins in the Chinese National Twin Registry (CNTR), and further explore the influence of genetic factors on alcohol consumption in adult twins.Methods:The subjects of the study were twins registered by CNTR in 11 project areas across China from 2010 to 2018. A total of 56 966 twins (28 483 pairs) aged 18 years and above who answered questions about drinking behavior were included, and the random effect model was used to describe the population and regional distribution characteristics of alcohol consumption. Intra-pair analysis was performed to calculate the concordance rate and heritability of their alcohol consumption.Results:The age of all subjects was (36.6±12.0) years, and current drinkers accounted for 16.6% (9 461/56 966) of all subjects. In men, those aged 50-59 years, those in northern China, those living in rural area, those with low education level and those with high BMI, the proportions of current drinkers were higher. After excluding 468 pairs of twins who had stopped alcohol use and 21 764 pairs of twins who had no drink or had small amount drink, an intra-pair analysis was conducted in 4 929 pairs of same-sex twins, and found that the concordance rate of alcohol consumption was 64.0% (2 059/3 215) in monozygotic twins, and 52.6% (902/1 714) in dizygotic twins, the difference was significant ( P<0.001), and the heritability of alcohol consumption was 24.1% (95% CI: 18.9%- 29.3%). The further stratified analysis found that in southern men, the heritability was highest in those aged 40-49 years (36.1%, 95% CI: 21.6%-50.7%), while in northern men, the heritability was highest in those aged 50-59 years (34.2%, 95% CI: 18.1%-50.3%). Conclusions:In adult twins in China, there were population and regional differences in the distribution of alcohol consumption behavior, and alcohol consumption was influenced by genetic factors, and gender, age and region had potential modifying effects.

Objective:To explore the impact of endoscopic retrograde cholangiopancreatography (ERCP) combined with electrohydraulic lithotripsy on liver function and energy metabolism in patients with extrahepatic biliary stones.Methods:A prospective study was conducted on 85 patients with extrahepatic biliary stones treated in four tertiary grade A hospitals (the First Affiliated Hospital of Air Force Medical University, Baoji Central Hospital, Xi′an No. 1 Hospital Wenli Hospital, and Affiliated Hospital of North China University of Science and Technology) from January 2020 to January 2024. They were divided into a control group ( n=43, treated with ERCP) and a combined group ( n=42, treated with ERCP combined with electrohydraulic lithotripsy) using a random number table. The main evaluation indicators included liver function, energy metabolism parameters, stress levels, and postoperative complications. Results:There were no statistically significant differences in liver function indicators, energy metabolism parameters, or stress levels between the two groups before surgery (all P>0.05). At 3 days after surgery, liver function indicators in both groups were lower than those before surgery, and the liver function indicators in the combined group were all lower than those in the control group (all P<0.05). At 1 day after surgery, REE in both groups was higher than that before surgery, and RQ was lower than that before surgery; the REE in the combined group was lower than that in the control group, and the RQ in the combined group was higher than that in the control group (all P<0.05). At 3 days after surgery, the levels of Cor and ACTH in both groups were higher than those before surgery, and the Cor and ACTH in the combined group were lower than those in the control group (all P<0.05). The incidence of postoperative complications in the combined group was significantly lower than that in the control group ( P<0.05). Conclusions:ERCP combined with electrohydraulic lithotripsy can effectively improve liver function and energy metabolism, reduce inflammatory response in patients with extrahepatic biliary stones, and is safe for treatment, which is suitable for clinical promotion and application.

Objective:To explore the population heterogeneity of discharge readiness of patients with type 2 diabetes mellitus (T2DM) treated with insulin for the first time, and to analyze its population characteristics and influencing factors.Methods:From January to May 2024, 240 patients with T2DM admitted to the Department of Endocrinology of the First Affiliated Hospital and the Second Affiliated Hospital of Anhui Medical University for their first insulin treatment were selected for the study by convenience sampling method. Patients were surveyed using the General Information Questionnaire, Discharge Readiness Assessment Scale of Adult Patients with Type 2 Diabetes, Insulin Use Knowledge-Behavior Questionnaire, Readiness for Hospital Discharge Scale, Attitudes toward Insulin Scale, and Family Adaptation, Partnership, Growth, Affection, Resolve (APGAR) Questionnaire. Heterogeneity was tested using latent class analysis to explore the latent class of the discharge readiness. Factors influencing the latent classes were analyzed using unordered multinomial Logistic regression.Results:A total of 240 questionnaires were distributed, 15 questionnaires with regular answers or logical errors were excluded, 225 valid questionnaires were recovered, and the valid recovery rate was 93.75% (225/240) . Three latent classes of discharge readiness existed in 225 first-time insulin-treated T2DM patients, including negative discharge readiness, ordinary discharge readiness, and active discharge readiness. Unordered multinomial Logistic regression analysis showed that work status, whether or not it was the first hospitalization, insulin use knowledge-behavior, and psychological insulin resistance were influencing factors of discharge readiness in first-time insulin-treated patients with T2DM ( P<0.05) . Conclusions:Three latent classes of discharge readiness exist in first-time insulin-treated T2DM patients, with differences in discharge readiness between classes. Nurses should focus on patients with negative discharge readiness and develop targeted interventions to improve their readiness for discharge and reduce readmission rates and the risk of adverse events.

Objective:To describe the distribution characteristics of alcohol consumption in adult twins in the Chinese National Twin Registry (CNTR), and further explore the influence of genetic factors on alcohol consumption in adult twins.Methods:The subjects of the study were twins registered by CNTR in 11 project areas across China from 2010 to 2018. A total of 56 966 twins (28 483 pairs) aged 18 years and above who answered questions about drinking behavior were included, and the random effect model was used to describe the population and regional distribution characteristics of alcohol consumption. Intra-pair analysis was performed to calculate the concordance rate and heritability of their alcohol consumption.Results:The age of all subjects was (36.6±12.0) years, and current drinkers accounted for 16.6% (9 461/56 966) of all subjects. In men, those aged 50-59 years, those in northern China, those living in rural area, those with low education level and those with high BMI, the proportions of current drinkers were higher. After excluding 468 pairs of twins who had stopped alcohol use and 21 764 pairs of twins who had no drink or had small amount drink, an intra-pair analysis was conducted in 4 929 pairs of same-sex twins, and found that the concordance rate of alcohol consumption was 64.0% (2 059/3 215) in monozygotic twins, and 52.6% (902/1 714) in dizygotic twins, the difference was significant ( P<0.001), and the heritability of alcohol consumption was 24.1% (95% CI: 18.9%- 29.3%). The further stratified analysis found that in southern men, the heritability was highest in those aged 40-49 years (36.1%, 95% CI: 21.6%-50.7%), while in northern men, the heritability was highest in those aged 50-59 years (34.2%, 95% CI: 18.1%-50.3%). Conclusions:In adult twins in China, there were population and regional differences in the distribution of alcohol consumption behavior, and alcohol consumption was influenced by genetic factors, and gender, age and region had potential modifying effects.

Objective:To explore the impact of endoscopic retrograde cholangiopancreatography (ERCP) combined with electrohydraulic lithotripsy on liver function and energy metabolism in patients with extrahepatic biliary stones.Methods:A prospective study was conducted on 85 patients with extrahepatic biliary stones treated in four tertiary grade A hospitals (the First Affiliated Hospital of Air Force Medical University, Baoji Central Hospital, Xi′an No. 1 Hospital Wenli Hospital, and Affiliated Hospital of North China University of Science and Technology) from January 2020 to January 2024. They were divided into a control group ( n=43, treated with ERCP) and a combined group ( n=42, treated with ERCP combined with electrohydraulic lithotripsy) using a random number table. The main evaluation indicators included liver function, energy metabolism parameters, stress levels, and postoperative complications. Results:There were no statistically significant differences in liver function indicators, energy metabolism parameters, or stress levels between the two groups before surgery (all P>0.05). At 3 days after surgery, liver function indicators in both groups were lower than those before surgery, and the liver function indicators in the combined group were all lower than those in the control group (all P<0.05). At 1 day after surgery, REE in both groups was higher than that before surgery, and RQ was lower than that before surgery; the REE in the combined group was lower than that in the control group, and the RQ in the combined group was higher than that in the control group (all P<0.05). At 3 days after surgery, the levels of Cor and ACTH in both groups were higher than those before surgery, and the Cor and ACTH in the combined group were lower than those in the control group (all P<0.05). The incidence of postoperative complications in the combined group was significantly lower than that in the control group ( P<0.05). Conclusions:ERCP combined with electrohydraulic lithotripsy can effectively improve liver function and energy metabolism, reduce inflammatory response in patients with extrahepatic biliary stones, and is safe for treatment, which is suitable for clinical promotion and application.

Objective:To explore the population heterogeneity of discharge readiness of patients with type 2 diabetes mellitus (T2DM) treated with insulin for the first time, and to analyze its population characteristics and influencing factors.Methods:From January to May 2024, 240 patients with T2DM admitted to the Department of Endocrinology of the First Affiliated Hospital and the Second Affiliated Hospital of Anhui Medical University for their first insulin treatment were selected for the study by convenience sampling method. Patients were surveyed using the General Information Questionnaire, Discharge Readiness Assessment Scale of Adult Patients with Type 2 Diabetes, Insulin Use Knowledge-Behavior Questionnaire, Readiness for Hospital Discharge Scale, Attitudes toward Insulin Scale, and Family Adaptation, Partnership, Growth, Affection, Resolve (APGAR) Questionnaire. Heterogeneity was tested using latent class analysis to explore the latent class of the discharge readiness. Factors influencing the latent classes were analyzed using unordered multinomial Logistic regression.Results:A total of 240 questionnaires were distributed, 15 questionnaires with regular answers or logical errors were excluded, 225 valid questionnaires were recovered, and the valid recovery rate was 93.75% (225/240) . Three latent classes of discharge readiness existed in 225 first-time insulin-treated T2DM patients, including negative discharge readiness, ordinary discharge readiness, and active discharge readiness. Unordered multinomial Logistic regression analysis showed that work status, whether or not it was the first hospitalization, insulin use knowledge-behavior, and psychological insulin resistance were influencing factors of discharge readiness in first-time insulin-treated patients with T2DM ( P<0.05) . Conclusions:Three latent classes of discharge readiness exist in first-time insulin-treated T2DM patients, with differences in discharge readiness between classes. Nurses should focus on patients with negative discharge readiness and develop targeted interventions to improve their readiness for discharge and reduce readmission rates and the risk of adverse events.

Objective:To provide data references for psychological selection of student pilots by verifying the predictive validity of the total score of psychological selection (TSPS) in primary training stage.Methods:A systematic evaluation study was conducted. A cluster sampling of student pilots graduated from an academy in recent years was performed. The total scores that represented the comprehensive level of the students in primary training stage and their scores of college entrance examination in recruitment stage were collected and converted (standard deviation standardization) into flight performance (FP) and standardized scores of college entrance examination (SSCEE). TSPS was extracted and its 3 sub-scores, such as basic cognitive ability scores (BCAS), flight special ability scores (FSAS) and interview performance scores (IPS), were processed to 9-point scale. According to standard deviation, SSCEE was divided into high score group (≥1.0 point), medium score group (-1.0-1.0 point) and low score group (≤-1.0 point). TSPS was divided into high score group (≥6.5 points), medium score group (4.5-6.5 points) and low score group (≤4.5 points) according to the classification method of enrollment stage. The FP differences were compared among different student pools, SSCEE and TSPS. The correlation between FP and SSCEE, TSPS, BCAS, FSAS and IPS was analyzed respectively. By taking BCAS, FSAS, IPS and SSCEE as the independent variables and FP as the dependent variable, the regression equation was constructed. According to the prediction results of correlation analysis and regression analysis, the optimal weights of BCAS, FSAS and IPS composed in TSPS model were calculated.Results:A total of 267 student pilots were selected, and TSPS, BCAS, FSAS and IPS all showed positive correlations with FP ( r=0.440, 0.160, 0.303, 0.380, all P<0.001). There was a significant difference in FP among different TSPS group ( H=55.37, P<0.001). There were significant differences in FP and TSPS among different student pool groups ( H=7.26 , F=7.43, P=0.039,<0.001). There was no significant difference in FP and TSPS among different SSCEE groups ( P>0.05). TSPS calculated based on correlation coefficient and regression coefficient was positively correlated with FP ( r=0.450, 0.452, both P<0.001). The prediction validity of each model was better than that of the existing model (0.440). Conclusions:In psychological selection, IPS and FSAS positively contribute to the predictions of the training efficiency of student pilots. Among which, IPS and FSAS take relative higher weights in TSPS model. It is suggested that the psychological selection should be managed upon scientific scheduling, as well as the dynamic optimization and effective evaluation mechanism.