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.

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 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 investigate the efficacy of color Doppler ultrasound-guided percutaneous nephrostomy in the treatment of anastomotic leakage after laparoscopic pyeloplasty.Methods:A retrospective analysis was performed for the data of 15 children with peritoneal irritation after LP who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2023, of which 10 cases were anastomotic leaks and 5 cases were with renal pelvic blood clots. There were 12 males and 3 females. Age (4.2±2.7) years. The lesions were located on the left side of 11 cases and on the right side of 4 cases. All 15 cases had varying degrees of nausea, vomiting, abdominal pain and other symptoms. Physical examination: the children all showed painful faces and tense abdominal muscles. 15 patients had a preoperative pain score of 9.5 (8, 10). Ultrasound examination showed that the anterior and posterior diameters of renal pelvis separation were (34.93±4.86) mm, the anterior and posterior diameter/renal parenchymal thickness of renal pelvis separation was 15.66±1.02, renal dynamic nuclear imaging shows the renal function of the affected side was (29.69±1.71)%. Thirteen cases had the above symptoms before the abdominal drainage tube was removed, and the time of symptom onset was (3.3±1.1) days after surgery, of which 8 cases had a large increase in abdominal drainage, and color Doppler ultrasonography showed a large amount of fluid in the intra-abdominal intestinal space (about 500 ml). In 5 cases, the intraperitoneal drainage volume did not increase, and color Doppler ultrasonography showed strong echo in the renal pelvis, and blood clots were considered. All 13 patients were placed in the prone position under local anesthesia and underwent color Doppler ultrasound-guided percutaneous nephrostomy. The remaining 2 cases had abdominal drainage tube removed on the 3rd day after surgery, and peritoneal irritation signs appeared on the 4th and 6th days after surgery, respectively. Color Doppler ultrasonography showed that there was a large amount of fluid in the intra-abdominal intestinal space, and color Doppler ultrasound-guided peritoneal puncture and drainage + prone percutaneous nephrostomy was performed in the supine position under local anesthesia, and the biochemical analysis of the peritoneal puncture drainage fluid was confirmed to be anastomotic urine leakage. The drainage volume and urine output of 15 cases of peritoneal puncture drainage and pyelostomy were recorded, and the relief of nausea and vomiting symptoms and the score of postoperative pain after percutaneous nephrostomy were recorded. The changes of hydronephrosis and renal function before and after percutaneous nephrostomy were compared.Results:In this study, 15 patients underwent percutaneous nephrostomy with a duration of (16.8±1.9) min. The symptoms of nausea and vomiting disappeared after operation, and the pain scores were 3.2(2, 4) and 0.4(0, 2) at 2 h and 12 h after operation, respectively, which were statistically significant compared with those before operation ( P<0.01). In 13 children with simple percutaneous nephrostomy, the abdominal drainage tube was removed on (3.6±0.8) days and (8.6±1.0) days after percutaneous nephrostomy. In 2 children with peritoneal puncture and drainage plus percutaneous nephrostomy, the abdominal drainage tube was removed 3 days after the fistula operation, and the pyelostomy tube was removed 8 days after the fistula operation. The anterior and posterior diameters of renal pelvis separation were (10.87±4.05), (10.13±3.50) and (9.13±3.11) mm by color Doppler ultrasound at 3, 6 and 12 months after LP operation, respectively, and there were statistically significant differences compared with preoperative comparisons ( P<0.01).The diameter before and after renal pelvis separation was (7.60±2.86) mm, the diameter before and after renal pelvic separation/renal parenchymal thickness was 1.97±0.22, and the renal function was (39.23±2.66)% at 24 months after operation, which was statistically significant compared with that before operation ( P<0.01). Conclusions:Color Doppler ultrasound-guided percutaneous nephrostomy can effectively alleviate symptoms in the early stage, which could help to the healing of ureteral anastomosis, and has less trauma and short operation course.