Objective:To explore the spousal correlations of total cholesterol(TC),total triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C),and to investigate the reasons behind these spousal correlations.Methods:Participants and data were from the baseline survey of family-based cohort studies in Fangshan,Beijing and Tulou,Fujian.The ori-gin of spousal correlations were explored from perspectives of convergence,assortative mating,social ho-mogamy.Pearson's correlation and generalized linear models(GLM)were used to estimate the spousal correlation.Convergence was assessed by Pearson's correlation between the phenotypic differences be-tween couples and the duration of marriage,with GLM used for further validation.Pearson's correlation of genetic risk scores(GRS)and couple-specific Mendelian randomization(MR)were calculated to assess the genetic correlation and possible causal relationships between spouses.Two-independent-sample t-tests were used to compare GRS consistency across subgroups divided by education attainment,couple-specific MR and Q statistics used to test assortative mating in subgroups and intergroup differences.Results:In the study,342 couples(287 couples from Fangshan and 55 couples from Fujian)were included,with the average age of(64.91±8.76)years.Spousal correlations of TC,TG,HDL-C,and LDL-C showed statistically significant associations both before and after adjusting for covariates,with effect sizes of 0.229(95％CI:0.125-0.327),0.257(95％CI:0.155-0.354),0.179(95％CI:0.074-0.280),and 0.181(95％CI:0.076-0.282).For convergence,for each additional year of marriage,ΔTC increased by 0.016 mmol/L(95％CI:0.001-0.033 mmol/L),and ΔLDL-C increased by 0.017 mmol/L(95％CI:0.002-0.031 mmol/L).For assortative mating,GRS correlations and results of couple specific MR didn't show any statistical significance.For social homogamy,no differences in GRS or assortative mating were found between subgroups stratified by education attainment.Conclusion:The blood lipid in participants exhibit spousal phenotypic correlations,however,no effects of convergence,assortative mating or social homogamy were observed.More independent studies with larger sample sizes are warranted to further validate these findings in the future.

Objective:To investigate the prognosis of postoperative adjuvant therapy for hepatocellular carcinoma after conversion therapy of combined targeted therapy and immunotherapy followed by sequential hepatectomy.Methods:The retrospective cohort study was conducted. The clinicopathological data of 103 patients with initially unresectable hepatocellular carcinoma (HCC) who were admitted to 11 medical centers in China, including Mengchao Hepatobiliary Hospital of Fujian Medical University et al, from November 2019 to May 2023 were collected. There were 83 males and 20 females, aged (54±12)years. All 103 patients underwent conversion therapy of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) successfully followed by sequential hepatectomy, of which 72 patients undergoing postoperative adjuvant therapy were divided into the adjuvant therapy group, and 31 patients undergoing postoperative follow-up monitoring were divided into the follow-up monitoring group. Observation indicators: (1) follow-up and postoperative condi-tions; (2) analysis of factors influencing recurrence-free survival time of patients; (3) stratified ana-lysis. Comparison of count data between group was conducted using the chi-square test or Fisher exact probability. The R software was used to draw survival curves, and the Log-rank test was used for survival analysis. Univariate and multivariate analyses were conducted using the Cox proportional hazard model. Results:(1) Follow-up and postoperative conditions. All 103 patients were followed up for 21.0(range, 1.9?47.2)months, with the median recurrence-free survival time of 28.7 months and the 1-, 2-, 3-year recurrence-free survival rates of 68.6%, 55.6%, 41.2%. The median overall survival time of 103 patients was unreached, and the 1-, 2-, 3-year overall survival rates were 90.9%, 82.1%, 69.6%, respectively. The median recurrence-free survival time was 33.1 months in patients of the adjuvant therapy group, with the 1-, 2-year recurrence-free survival rates as 77.2%, 61.5%. The median recurrence-free survival time was 11.1 months in patients of the follow-up monitoring group, with the 1-, 2-year recurrence-free survival rates as 46.6%, 40.8%. There was a significant difference in recurrence-free survival between the two groups of patients ( χ2=5.492, P<0.05). (2) Analysis of factors influencing recurrence-free survival time of patients. Results of multivariate analy-sis showed that pathologic complete response and postoperative adjuvant therapy were independent factors influencing recurrence-free survival time of HCC patients undergoing conversion therapy of combined targeted therapy and immunotherapy followed by sequential hepatectomy ( hazard ratio=0.297, 0.492, 95% confidence interval as 0.137?0.647, 0.268?0.903, P<0.05). (3) Stratified analysis. Of the 71 patients with non-pathologic complete response, the median recurrence-free survival time of 48 patients in the adjuvant therapy group was 24.0 months, with the 1-, 2-year recurrence-free survival rates as 67.4%, 48.8%. The median recurrence-free survival time of 23 patients with non-pathological complete response in the follow-up monitoring group was 7.4 months, with the 1-, 2-year recurrence-free survival rates as 35.0%, 26.3%. There was a significant difference in recurrence-free survival between the 48 patients with non-pathologic complete response in the adjuvant therapy group and the 23 patients with non-pathologic complete response in the follow-up monitoring group ( χ2=5.241, P<0.05). Conclusion:For HCC patients with conversion therapy of TKIs and ICIs followed by sequential hepatectomy, postoperative adjuvant therapy, compared to postoperative follow-up monitoring, can prolong the recurrence-free survival time of patients, of whom cases with non-pathologic complete response can benefit from adjuvant therapy.

Objective:To explore the necessity and basic connotation of building an integrated eye health service system and propose a systematic const ruction pathway.Methods:A multi-dimensional analytical framework for an integrated eye health service system was constructed using literature review,interviews,and the rainbow model theory.Results:Considering the current state of eye disease prevention and control in China,along with the practical need to address the imbalance in the supply and demand structure of ophthalmic resources,it is necessary to build an integrated eye health service system that is fair,accessible,systematic,continuous,high-quality and efficient.Conclusion:It is needed to further improve the top-level design framework,enhance system integration,consolidate the service network at the grassroots level,strengthen organizational coordination,establish specialized eye health prevention and treatment centers,promote professional collaboration,deliver integrated and proactive service models,optimize service integration,and reinforce enabling factors through functional unification and standardized protocols.

Objective To translate the good death inventory-short form(GDI-SF)into Chinese and test its reliability and validity among bereaved family members of cancer patients.Methods A Chinese version of GDI-SF was created through translation,reconciliation,back translation,expert panel review and pilot testing.Then the inventory was administered to 699 bereaved family members of cancer patients recruited by convenience sampling.Reliability and validity were assessed.Results Toally 305 family members finished the study.The item-level content validity index(I-CVI)and average content validity index(S-CVI/Ave)were both 1.00.Exploratory factor analysis yielded 5 common factors:professional medical care(6 items),preparation for farewell(4 items),dignity and life value(4 items),natural death and moral support(2 items),and physical and mental comfort(2 items).These factors explained 52.176%of total variance.Overall Cronbach α coefficient of the Chinese version GDI-S was 0.779,and split-half reliability was 0.731.The Pearson correlation coefficient range between the score of each item of the Chinese version of GDI-SF and the score of its corresponding dimension was 0.591 to 0.769(P<0.01).Conclusion The Chinese version GDI-SF exhibits acceptable reliability and validity assessment of the quality of good dying in cancer patients from the perspective of bereaved family members.

Objective To analyze the latent classes of social alienation in colorectal cancer patients and further explore the influencing factors and cumulative effects of risk factors across different classes,thereby providing a reference for individualized interventions.Methods Convenience sampling was used to select colorectal cancer patients hospitalized in the gastrointestinal surgery and oncology departments of 3 tertiary-level hospitals in Shandong Province from January to June 2023 as the study subjects.A questionnaire survey was conducted using the General Information Questionnaire,Social Avoidance Scale,Social Anxiety Scale,UCLA Loneliness Scale,Sense of Coherence Scale,Family Cohesion Scale,and Social Support Rating Scale.Data analysis was performed using latent profile analysis and multivariate logistic regression analysis.Results A total of 292 questionnaires were distributed,with 270 valid responses collected,yielding a response rate of 92.47％.The results of the latent profile analysis indicated that social alienation among colorectal cancer patients could be categorized into 3 latent groups:the"low alienation group"(42.59％),the"high alienation-high social avoidance group"(14.08％),and the"moderate alienation-high social anxiety group"(43.33％).Results of logistic regression analysis revealed that employment status,stoma status,metastasis,sense of coherence,family cohesion,and social support were influencing factors across different categories.Moreover,a cumulative effect of sense of coherence,family cohesion,and social support on distinct categories was observed(P＜0.05).Conclusion Social alienation among colorectal cancer patients exhibits group heterogeneity.Healthcare professionals should identify the characteristic differences among patients,prioritise those with multiple risk factors,and develop targeted intervention measures to help them better integrate into society.

Patients' nutritional information needs and treatment outcomes are closely associated with quality of life. However, most colorectal cancer patients have unmet needs for nutritional information, which may negatively affect prognosis and health outcomes. This review summarizes the content of nutritional information needs, influencing factors, forms of support, and related outcomes among colorectal cancer patients. It aims to provide a reference for developing personalized and targeted nutritional information support interventions for this population.

Time-dependent toxicity refers to the significant cost of time spent by cancer patients during treatment due to frequent appointments, treatment, and subsequent rehabilitation. This paper reviews the concept, measurement, influencing factors, and hazards of time-dependent toxicity in cancer patients, and proposes interventions to reduce time-dependent toxicity, with a view to providing references for healthcare professionals in China to understand cancer time-dependent toxicity and to carry out research related to time-dependent toxicity.

Objective To investigate whether there are gender differences in the relationship between fast-ing blood glucose levels and non-alcoholic fatty liver disease(NAFLD).Methods A retrospective analysis was conducted on 1,584 participants aged≥40 who underwent health screening at Wuhan Union Hospital between January 2020 and November 2021.The cohort included 1,143 men and 441 women.Health screening indicators,including general demographic information and routine biochemical test data,were collected.Based on routine abdominal B-ultrasound scan results,participants were classified into NAFLD and non-NAFLD groups.The gener-alized additive model based on smooth curve fitting was used to describe the dose-response relationship between fasting blood glucose(FBG)and the risk of NAFLD in different genders.A two-stage logistic model was employed to reveal potential non-linear relationships,and threshold effect analysis was performed to determine the non-linear inflection point.Results FBG levels were significantly higher in the NAFLD group compared to the non-NAFLD group for both men and women.After adjusting for covariates such as age,BMI,smoking,alcohol consumption,hypertension,ALT,AST,TC,TG,HDL-C,and LDL-C,a positive linear correlation between FBG and NAFLD was observed in women,indicating that increased FBG was associated with a higher risk of NAFLD(OR=1.29,95%CI:1.02～1.64).In men,the relationship between FBG and NAFLD was non-linear.When FBG was≤5.61 mmol/L,increased FBG was associated with a higher risk of NAFLD(OR=1.58,95%CI:1.17～2.13).However,when FBG exceeded 5.61 mmol/L,the risk of NAFLD plateaued.Conclusion There is a positive association between FBG and NAFLD in women.In men,NAFLD risk increases with FBG levels up to 5.61 mmol/L,beyond which the risk stabilizes,indicating a saturation effect.

Purpose To quantitatively evaluate the change of left ventricular myocardial work in well-functioning bicuspid aortic valves(BAV)by using left ventricular pressure-strain ring technology,and to explore the correlation between aortic dilation and myocardial work.Materials and Methods A total of 65 patients with well-functioning BAVs admitted to General Hospital of Ningxia Medical University from June 2022 to June 2023 were selected and divided into two groups according to the adjusted inner diameter of the aorta by body surface area:aortic undilated group(35 cases,theaortic diameter<40 mm or aortic size index<22 mm/m2)and aortic dilation group(30 cases,aortic diameter≥40 mm or aortic size index>22 mm/m2),34 healthy patients were enrolled in our study as the control group.The study subjects were analyzed by echocardiography to obtain the left ventricular myocardial work[global longitudinal strain(GLS),global work index(GWI),global constructive work(GCW),global work efficiency(GWE),global wasted work(GWW)]and conventional two-dimensional ultrasound parameters,and the parameters between the three groups were compared and analyzed.Results Compared with the control group,the absolute value of GLS and GWE in the non-dilated aortic group and the aortic dilated group decreased,and the GWI,GCW,GWW,ascending aortic inner diameter and ascending aortic stiffness index were significantly increased(P<0.05).Compared with the non-dilated aortic group,the absolute value of GLS and GWE in the aortic dilation group decreased,and the aortic stiffness index and GWW increased,and the difference was statistically significant(t=-3.567,-2.219,5.266,3.339,all P<0.05).The internal diameter of the ascending aorta was negatively correlated with the absolute value of GLS and GWE(r=-0.219,-0.324,both P<0.001),and positively correlated with GWI,GCW,GWW and ascending aortic stiffness index(r=0.178,0.229,0.315,0.529,all P<0.001).Conclusion Myocardial work is a new method for early detection of subclinical left ventricular myocardial dysfunction in well-functioning BAV,and has potential application value for evaluating the changes in left ventricular myocardial work under the progression of aortic disease in BAV patients.