Objective:To explore the level of positive psychological capital and its trends in traumatic lower limb amputation patients during the 15 months after surgery, and to identify the time period when the patients' level of positive psychological capital is weak, so as to provide a basis for interventions.Methods:This study was a prospective longitudinal study. Convenience sampling was used to select 143 patients with traumatic lower limb amputation admitted to the Department of Emergency Medicine of the First Affiliated Hospital of Zhengzhou University from January 2021 to November 2022 for the study. General information questionnaire, Positive Psychological-Capital Questionnaire (PPQ) were used on the third postoperative day (T1) , on the day of discharge (T2) , 1 month (T3) , 2 months (T4) , 3 months (T5) , 6 months (T6) , 9 months (T7) , 12 months (T8) , and 15 months (T9) after discharge for a total of nine time points to administer the questionnaire to the patients. One-way repeated-measures ANOVA and plotting of results were performed on the nine time-point data using Graph Pad prism 9.5 software and SPSS 21.0 software, and the data were compared two-by-two using the Bonferroni multiple comparison test.Results:There were 143, 139, 132, 129, 122, 120, 119, 118, and 116 patients who participated in the survey from T1 to T9 time points, with a loss to follow-up rate of 18.88% (27/143) . PPQ scores of 116 traumatic lower limb amputation patients at nine time points were (103.25±9.03) , (108.53±9.32) , (104.38±9.60) , (99.71±9.61) , (95.82±9.55) , (91.49±9.41) , (93.34±9.29) , (93.53±9.14) , (93.62±9.05) , and the mean PPQ scores were lower than the theoretical mean (104) at all time points except T2 and T3 time points. One-way repeated-measures ANOVA showed that the difference in the change in the level of positive psychological capital of patients after traumatic lower limb amputation from postoperative day 3 to 15 months after discharge was statistically significant ( F=990.144, P<0.01) . Bonferroni's multiple comparison test showed that there was no statistically significant difference in two-by-two comparisons between T7, T8, and T9 time points with each other ( P>0.05) , and the rest of the two-by-two comparisons were statistically significant ( P<0.05) . Changes in the total PPQ score and the curves of the self-efficacy dimension, resilience dimension, hope dimension, and optimism dimension scores all showed a trend of a brief increase, followed by a continuous decrease, and then a slow increase to a plateau. Conclusions:Traumatic lower limb amputation patients show a wide range of changes in positive psychological capital levels from postoperative day 3 to 15 months after discharge, with a trend of a brief increase at discharge, followed by a steady decline, and then a slow increase to a plateau. Healthcare professionals should pay dynamic attention to the psychological state and psychological strength of patients after traumatic lower limb amputation and provide targeted interventions at different stages after discharge.

Objective To investigate the current status of frailty in lung cancer patients undergoing radiotherapy and analyze its influencing factors.Methods The convenience sampling method was used to select 241 lung cancer patients admitted to the radiation therapy department of a tertiary Grade A tumor specialty hospital in Yunnan Province from January to December 2023.A questionnaire survey was conducted using the General Information Survey Questionnaire,Fried Weakness Scale,Anderson Symptom Assessment Scale(MDASI),Hospital Anxiety and Depression Scale(SDS),Nutrition Risk Screening 2002,and Barthel Index Scale.Results The frailty in lung cancer patients undergoing radiotherapy was 55.19%,with a total frailty score of 3.00(1.00,4.00)points.The results of logistic regression analysis showed that age,number of radiotherapy sessions,hemoglobin count,Barthel index,Anderson symptom assessment score,and anxiety score were the influencing factors of frailty in lung cancer patients undergoing radiotherapy(P<0.05).Conclusion The incidence of frailties in patients with lung cancer radiotherapy is high.Age,radiotherapy frequency,hemoglobin count,Barthel index,Anderson symptom rating and anxiety score are the factors affecting frailties in patients with lung cancer radiotherapy.Clinical medical staff should promptly evaluate the frailty of lung cancer radiotherapy patients and identify their risk factors,and actively take intervention measures to prevent or control the occurrence and development of frailty.

Pelvic organ prolapse (POP), whose etiology is influenced by genetic and clinical risk factors, considerably impacts women's quality of life. However, the genetic underpinnings in non-European populations and comprehensive risk models integrating genetic and clinical factors remain underexplored. This study constructed the first polygenic risk score (PRS) for POP in the Chinese population by utilizing 20 disease-associated variants from the largest existing genome-wide association study. We analyzed a discovery cohort of 576 cases and 623 controls and a validation cohort of 264 cases and 200 controls. Results showed that the case group exhibited a significantly higher PRS than the control group. Moreover, the odds ratio of the top 10% risk group was 2.6 times higher than that of the bottom 10%. A high PRS was significantly correlated with POP occurrence in women older than 50 years old and in those with one or no childbirths. As far as we know, the integrated prediction model, which combined PRS and clinical risk factors, demonstrated better predictive accuracy than other existing PRS models. This combined risk assessment model serves as a robust tool for POP risk prediction and stratification, thereby offering insights into individualized preventive measures and treatment strategies in future clinical practice.
Humans ; Female ; Pelvic Organ Prolapse/epidemiology* ; Middle Aged ; Risk Assessment/methods* ; China/epidemiology* ; Multifactorial Inheritance ; Aged ; Risk Factors ; Genome-Wide Association Study ; Genetic Predisposition to Disease ; Case-Control Studies ; Adult ; Polymorphism, Single Nucleotide ; Genetic Risk Score ; East Asian People

Objective:To explore the level of positive psychological capital and its trends in traumatic lower limb amputation patients during the 15 months after surgery, and to identify the time period when the patients' level of positive psychological capital is weak, so as to provide a basis for interventions.Methods:This study was a prospective longitudinal study. Convenience sampling was used to select 143 patients with traumatic lower limb amputation admitted to the Department of Emergency Medicine of the First Affiliated Hospital of Zhengzhou University from January 2021 to November 2022 for the study. General information questionnaire, Positive Psychological-Capital Questionnaire (PPQ) were used on the third postoperative day (T1) , on the day of discharge (T2) , 1 month (T3) , 2 months (T4) , 3 months (T5) , 6 months (T6) , 9 months (T7) , 12 months (T8) , and 15 months (T9) after discharge for a total of nine time points to administer the questionnaire to the patients. One-way repeated-measures ANOVA and plotting of results were performed on the nine time-point data using Graph Pad prism 9.5 software and SPSS 21.0 software, and the data were compared two-by-two using the Bonferroni multiple comparison test.Results:There were 143, 139, 132, 129, 122, 120, 119, 118, and 116 patients who participated in the survey from T1 to T9 time points, with a loss to follow-up rate of 18.88% (27/143) . PPQ scores of 116 traumatic lower limb amputation patients at nine time points were (103.25±9.03) , (108.53±9.32) , (104.38±9.60) , (99.71±9.61) , (95.82±9.55) , (91.49±9.41) , (93.34±9.29) , (93.53±9.14) , (93.62±9.05) , and the mean PPQ scores were lower than the theoretical mean (104) at all time points except T2 and T3 time points. One-way repeated-measures ANOVA showed that the difference in the change in the level of positive psychological capital of patients after traumatic lower limb amputation from postoperative day 3 to 15 months after discharge was statistically significant ( F=990.144, P<0.01) . Bonferroni's multiple comparison test showed that there was no statistically significant difference in two-by-two comparisons between T7, T8, and T9 time points with each other ( P>0.05) , and the rest of the two-by-two comparisons were statistically significant ( P<0.05) . Changes in the total PPQ score and the curves of the self-efficacy dimension, resilience dimension, hope dimension, and optimism dimension scores all showed a trend of a brief increase, followed by a continuous decrease, and then a slow increase to a plateau. Conclusions:Traumatic lower limb amputation patients show a wide range of changes in positive psychological capital levels from postoperative day 3 to 15 months after discharge, with a trend of a brief increase at discharge, followed by a steady decline, and then a slow increase to a plateau. Healthcare professionals should pay dynamic attention to the psychological state and psychological strength of patients after traumatic lower limb amputation and provide targeted interventions at different stages after discharge.

Objective:To investigate the status quo of preoperative decisional conflict in patients with traumatic amputation, analyze its influencing factors, and provide a reference for the development of targeted decision-making support programs.Methods:Totally 189 patients with traumatic amputation hospitalized in the Emergency Department of the First Affiliated Hospital of Zhengzhou University from January 2022 to October 2023 were selected by convenience sampling. Data were collected using a sociodemographic questionnaire, the Chinese version of the Decision Conflict Scale (DCS), the Control Preference Scale (CPS), and the Perceived Social Support Scale (PSSS). Data analysis was performed using SPSS 25.0.Results:A total of 196 questionnaires were distributed, with 189 valid responses, yielding an effective response rate of 96.4%. The average preoperative decisional conflict score among the 189 patients was (44.32 ± 9.27). During the decision-making process, 69 patients (36.5%) preferred a shared decision-making model, but 100 patients (52.9%) experienced a passive role. Multiple stepwise regression analysis indicated that the primary factors influencing decisional conflict were age, educational level, occupation, family income, actual participation role, family support (adjusted R2=0.799, P<0.01) . Conclusions:There is a discrepancy between the expected and actual participation roles in the decision-making process among patients with traumatic amputation, leading to a high level of preoperative decisional conflict. Several factors contribute to this conflict. Healthcare providers should pay particular attention to peasants, older patients, those with lower education and family income, respect patients' control preferences, and provide appropriate decision-making support.

Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization(TACE)followed by hepatic arterial infusion chemotherapy(HAIC)combined with TKI drugs and PD-1 inhibitors as the first-line treatment for advanced hepatocellular carcinoma(HCC).Methods We retrospectively analyzed the data of 70 patients with advanced HCC treated in the Department of Oncology of Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine between July,2020 and June,2023.23 of the patients received TACE combined with HAIC and TKI(TACE+HAIC+TKI group)and 47 received TACE combined with HAIC,PD-1 inhibitors and TKI(TACE+HAIC+PD-1+TKI group).The clinical characteristics,laboratory test results,efficacy,outcomes and adverse events of the patients were compared between the two groups.Results The TACE+HAIC+TKI and TACE+HAIC+PD-1+TKI groups had significantly different objective remission rates(ORR;60.87%vs 36.17%,P=0.031),comparable disease control rates(95.65%vs 93.62%,P=0.068),and different median progression-free survival(PFS)time(10.2 vs 11.8 months,P=0.003)and median overall survival(OS)time(15.7 vs 19.5 months,P=0.035).After propensity score matching(PSM),the median PFS and OS time of the two groups was 10.1 vs 14.5 months(P=0.024)and 14.2 vs 21.2 months(P=0.221),respectively.The 1-year PFS rates of the 2 groups were 24.0%vs 52.2%,and the 1-,2-and 3-year OS rates were 72.3%vs 93.1%,23.9%vs 63.8%,and 23.9%vs 36.5%,respectively.The incidence of proteinuria was significantly higher in TACE+HAIC+PD-1+TKI group than in TACE+HAIC+TKI group(21.28%vs 0,P=0.025),but the incidences of grade 3-4 treatment-related adverse events were all similar between the two groups.Conclusion The first-line treatment with TACE+HAIC+PD-1+TKI is safe and effective for advanced HCC and can significantly prolong the survival of the patients.

N6-methyladenosine(m6A)modification is one of the most abundant epitranscriptomic modifications in eukaryotic mRNA,with dynamic and reversible properties.This modification process is coordinated by methyltransferases,demethylases,and related m6A binding proteins,which in turn affect mRNA metabolism and function.Increasing evi-dence has indicated that the m6A RNA modification plays an important role in the occurrence and development of athero-sclerosis(As)and other related diseases.This paper provide a comprehensive review of the relationship between m6A RNA modification and As.The entire manuscript summarizes the m6A RNA modification mechanism and its roles in As-related cells including endothelial cells,macrophages,and smooth muscle cells,and discusses the association of m6A RNA modification with risk factors of As such as high-fat diet,ischemia/hypoxia,oscillatory stress,and hypertension.Finally,this review summarizes researches on drug intervention targeting m6A RNA methylation to mitigate As.These studies pro-vide important references for exploring new targets for early diagnosis and treatment of As.

Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization(TACE)followed by hepatic arterial infusion chemotherapy(HAIC)combined with TKI drugs and PD-1 inhibitors as the first-line treatment for advanced hepatocellular carcinoma(HCC).Methods We retrospectively analyzed the data of 70 patients with advanced HCC treated in the Department of Oncology of Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine between July,2020 and June,2023.23 of the patients received TACE combined with HAIC and TKI(TACE+HAIC+TKI group)and 47 received TACE combined with HAIC,PD-1 inhibitors and TKI(TACE+HAIC+PD-1+TKI group).The clinical characteristics,laboratory test results,efficacy,outcomes and adverse events of the patients were compared between the two groups.Results The TACE+HAIC+TKI and TACE+HAIC+PD-1+TKI groups had significantly different objective remission rates(ORR;60.87%vs 36.17%,P=0.031),comparable disease control rates(95.65%vs 93.62%,P=0.068),and different median progression-free survival(PFS)time(10.2 vs 11.8 months,P=0.003)and median overall survival(OS)time(15.7 vs 19.5 months,P=0.035).After propensity score matching(PSM),the median PFS and OS time of the two groups was 10.1 vs 14.5 months(P=0.024)and 14.2 vs 21.2 months(P=0.221),respectively.The 1-year PFS rates of the 2 groups were 24.0%vs 52.2%,and the 1-,2-and 3-year OS rates were 72.3%vs 93.1%,23.9%vs 63.8%,and 23.9%vs 36.5%,respectively.The incidence of proteinuria was significantly higher in TACE+HAIC+PD-1+TKI group than in TACE+HAIC+TKI group(21.28%vs 0,P=0.025),but the incidences of grade 3-4 treatment-related adverse events were all similar between the two groups.Conclusion The first-line treatment with TACE+HAIC+PD-1+TKI is safe and effective for advanced HCC and can significantly prolong the survival of the patients.

Objective:To investigate the status quo of preoperative decisional conflict in patients with traumatic amputation, analyze its influencing factors, and provide a reference for the development of targeted decision-making support programs.Methods:Totally 189 patients with traumatic amputation hospitalized in the Emergency Department of the First Affiliated Hospital of Zhengzhou University from January 2022 to October 2023 were selected by convenience sampling. Data were collected using a sociodemographic questionnaire, the Chinese version of the Decision Conflict Scale (DCS), the Control Preference Scale (CPS), and the Perceived Social Support Scale (PSSS). Data analysis was performed using SPSS 25.0.Results:A total of 196 questionnaires were distributed, with 189 valid responses, yielding an effective response rate of 96.4%. The average preoperative decisional conflict score among the 189 patients was (44.32 ± 9.27). During the decision-making process, 69 patients (36.5%) preferred a shared decision-making model, but 100 patients (52.9%) experienced a passive role. Multiple stepwise regression analysis indicated that the primary factors influencing decisional conflict were age, educational level, occupation, family income, actual participation role, family support (adjusted R2=0.799, P<0.01) . Conclusions:There is a discrepancy between the expected and actual participation roles in the decision-making process among patients with traumatic amputation, leading to a high level of preoperative decisional conflict. Several factors contribute to this conflict. Healthcare providers should pay particular attention to peasants, older patients, those with lower education and family income, respect patients' control preferences, and provide appropriate decision-making support.

Objective:To understand the continuing care needs of patients based on the App and "hospital-community-home" linkage.Methods:With descriptive qualitative research, a semi-structured in-depth interview was conducted in 15 patients with type 2 diabetes in Gongli Hospital, Pudong New Area, Shanghai City, and community hospital from January to February 2020. Thematic analysis and the software NVivo 10.0 were used for data analysis.Results:Five themes were extracted: desire a "hospital-led,community-implemented, family-supported" model of continuing care; desire an appropriate, convenient and personalized access to information and follow-up; expect continuous, comprehensive, professional health guidance; expect to receive continuing care service led by specialized nurses and managed by multidisciplinary team; expect diabetes App to be simple and practical, satisfying various needs such as post-hospitalization condition monitoring, assessment feedback, health education and health intervention,ensure information security and free use.Conclusions:Patients have a strong willingness to receive continuing care based on the App and "hospital-community-family" linkage. A mechanism of "hospital-community-family" linkage continuing care service with clear division of labor should be established, multidisciplinary cooperation should be strengthened, and team advantages should be utilized. Providing comprehensive, professional and evidence-based continuing care services for patients, while further optimizing software functions and focusing on information security construction and following evidence-based guidelines to standardize App content in order to adapt to more patient characteristics and needs.