Objective:To explore the interactive relationship between health-related quality of life (HRQOL) and anxiety, depression, and fear of progression in patients with advanced prostate cancer and their spouses, providing a basis for developing targeted psychological interventions and improving quality of life.Methods:Convenience sampling was used to select 113 pairs of patients with advanced prostate cancer and their spouses at the First Affiliated Hospital with Nanjing Medical University from September 2023 to August 2024 for the study. General Information Questionnaire, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30), Patient Health Questionnaire-4 (PHQ-4), and Fear of Progression Questionnaire were used to conduct a survey on research subjects. The interactive relationship between variables was analyzed using R software based on the actor-partner interdependence model.Results:A total of 226 questionnaires were distributed and 226 valid questionnaires were recovered, with a valid recovery rate of 100.00%. The PHQ-4 anxiety score, Fear of Progression Questionnaire, and EORTC QLQ-C30 scores of spouses of 113 patients with advanced prostate malignancy were 3.35 (2.25, 4.22), (34.07±9.86), and (57.20±19.48), respectively, which were higher than 2.50 (1.52, 4.45), (30.87±8.85), and (55.47±22.58) of 113 patients, and the differences were statistically significant ( P<0.05). PHQ-4depression scores of the patients and spouses were 2.24 (1.25, 3.57) and 2.56 (1.55, 3.62), respectively, the difference was not statistically significant ( P>0.05). The fitting results based on the actor-partner interdependence model showed that for the subject effect, anxiety (β'=-0.441, -0.452; P<0.01), depression (β'=-0.574, -0.574; P<0.01), and fear of progression (β'=-0.253, -0.435, P<0.05) in patients with advanced prostate cancer patients and their spouses were all predictors of HRQOL, and the differences were all statistically significant. For the object effect, spousal anxiety (β'=-0.372, P<0.01) and fear of progression (β'=-0.312, P<0.01) predicted patients' HRQOL, with statistically significant differences. Conclusions:Spouses of patients with advanced prostate cancer had higher levels of anxiety, fear of progression. Anxiety, depression, and fear of progression all have a negative subject effect on HRQOL for patients and spouses, and spousal anxiety and fear of progression have a negative object effect on HRQOL for patients. Providing effective psychological interventions to address spouses' anxiety and fear of progression can improve HRQOL of patients with advanced prostate cancer and their spouses.

Objective:To explore the interactive relationship between health-related quality of life (HRQOL) and anxiety, depression, and fear of progression in patients with advanced prostate cancer and their spouses, providing a basis for developing targeted psychological interventions and improving quality of life.Methods:Convenience sampling was used to select 113 pairs of patients with advanced prostate cancer and their spouses at the First Affiliated Hospital with Nanjing Medical University from September 2023 to August 2024 for the study. General Information Questionnaire, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30), Patient Health Questionnaire-4 (PHQ-4), and Fear of Progression Questionnaire were used to conduct a survey on research subjects. The interactive relationship between variables was analyzed using R software based on the actor-partner interdependence model.Results:A total of 226 questionnaires were distributed and 226 valid questionnaires were recovered, with a valid recovery rate of 100.00%. The PHQ-4 anxiety score, Fear of Progression Questionnaire, and EORTC QLQ-C30 scores of spouses of 113 patients with advanced prostate malignancy were 3.35 (2.25, 4.22), (34.07±9.86), and (57.20±19.48), respectively, which were higher than 2.50 (1.52, 4.45), (30.87±8.85), and (55.47±22.58) of 113 patients, and the differences were statistically significant ( P<0.05). PHQ-4depression scores of the patients and spouses were 2.24 (1.25, 3.57) and 2.56 (1.55, 3.62), respectively, the difference was not statistically significant ( P>0.05). The fitting results based on the actor-partner interdependence model showed that for the subject effect, anxiety (β'=-0.441, -0.452; P<0.01), depression (β'=-0.574, -0.574; P<0.01), and fear of progression (β'=-0.253, -0.435, P<0.05) in patients with advanced prostate cancer patients and their spouses were all predictors of HRQOL, and the differences were all statistically significant. For the object effect, spousal anxiety (β'=-0.372, P<0.01) and fear of progression (β'=-0.312, P<0.01) predicted patients' HRQOL, with statistically significant differences. Conclusions:Spouses of patients with advanced prostate cancer had higher levels of anxiety, fear of progression. Anxiety, depression, and fear of progression all have a negative subject effect on HRQOL for patients and spouses, and spousal anxiety and fear of progression have a negative object effect on HRQOL for patients. Providing effective psychological interventions to address spouses' anxiety and fear of progression can improve HRQOL of patients with advanced prostate cancer and their spouses.

Objective:To investigate the efficacy of fibrosis-4 index (FIB-4), NAFLD fibrosis score (NFS), aspartate aminotransferase to platelet count ratio (APRI), liver stiffness value (LSM), and Agile 3+ score and their combined model in predicting advanced-stage liver fibrosis in patients with chronic hepatitis B (CHB) combined with metabolic-associated fatty liver disease (MAFLD).Methods:A multicenter retrospective cohort study was conducted on the BMOVE population.Nine hundred twenty CHB cases combined with MAFLD who underwent liver biopsy at seven medical centers in China from April 2006 to December 2023 were included. The patients were divided into advanced-stage liver fibrosis (159 cases) and non-advanced-stage liver fibrosis (761 cases) according to the Scheuer's scoring system.The area under the receiver operating characteristic curve (AUROC), decision curve, and calibration curve analysis were used to evaluate the efficacy of the firbrosis-4 index (FIB-4) score, NFS score, APRI index, LSM, and Agile 3+ score and their combined model in predicting advanced-stage fibrosis. The liver fibrosis grade of all patients was diagnosed by liver biopsy. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each scoring model and combined model, as well as the proportion of correctly classified patients, were calculated based on different cutoff values.Results:AUROC analysis showed that Agile 3+ (0.814, 95% CI: 0.787-0.838) and LSM (0.805, 95% CI: 0.778-0.829) had similar accuracy and were superior to FIB-4 (0.721, 95% CI: 0.691-0.749), NFS (0.687, 95% CI: 0.656-0.716) and APRI ( 0.689, 95% CI: 0.658-0.718); however, HBV DNA level and HBV e antigen status had no effect on this outcome. Decision curve analysis showed that interventions based on LSM and Agile 3+ had provided higher net benefits compared with serological scores. Calibration curves showed that Agile 3+ had better predicitive accuracy than all other models. Agile 3+ had the highest PPV (0.54), minimal uncertainty interval (11.6%), and the highest proportion of correctly classified patients (76%); followed by LSM (PPV: 0.43, uncertainty interval: 15.5%, correct classification rate: 66%), and FIB-4 (PPV: 0.42, uncertainty interval: 26.1%, correct classification rate: 62.6%) in terms of identifying advanced-stage liver fibrosis. Combined model analysis demonstrated that FIB-4 combined with Agile 3+ had improved the correct classification rate and reduced the proportion of missed patients compared with FIB-4 combined with LSM. Conclusion:The Agile 3+ score is superior than LSM, FIB-4, NFS, and APRI index at identifying advanced-stage fibrosis in patients with CHB combined with MAFLD. This study supports the use of FIB-4 index combined with Agile 3+ for risk stratification in patients with CHB combined with MAFLD.

Objective:To investigate the efficacy of fibrosis-4 index (FIB-4), NAFLD fibrosis score (NFS), aspartate aminotransferase to platelet count ratio (APRI), liver stiffness value (LSM), and Agile 3+ score and their combined model in predicting advanced-stage liver fibrosis in patients with chronic hepatitis B (CHB) combined with metabolic-associated fatty liver disease (MAFLD).Methods:A multicenter retrospective cohort study was conducted on the BMOVE population.Nine hundred twenty CHB cases combined with MAFLD who underwent liver biopsy at seven medical centers in China from April 2006 to December 2023 were included. The patients were divided into advanced-stage liver fibrosis (159 cases) and non-advanced-stage liver fibrosis (761 cases) according to the Scheuer's scoring system.The area under the receiver operating characteristic curve (AUROC), decision curve, and calibration curve analysis were used to evaluate the efficacy of the firbrosis-4 index (FIB-4) score, NFS score, APRI index, LSM, and Agile 3+ score and their combined model in predicting advanced-stage fibrosis. The liver fibrosis grade of all patients was diagnosed by liver biopsy. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each scoring model and combined model, as well as the proportion of correctly classified patients, were calculated based on different cutoff values.Results:AUROC analysis showed that Agile 3+ (0.814, 95% CI: 0.787-0.838) and LSM (0.805, 95% CI: 0.778-0.829) had similar accuracy and were superior to FIB-4 (0.721, 95% CI: 0.691-0.749), NFS (0.687, 95% CI: 0.656-0.716) and APRI ( 0.689, 95% CI: 0.658-0.718); however, HBV DNA level and HBV e antigen status had no effect on this outcome. Decision curve analysis showed that interventions based on LSM and Agile 3+ had provided higher net benefits compared with serological scores. Calibration curves showed that Agile 3+ had better predicitive accuracy than all other models. Agile 3+ had the highest PPV (0.54), minimal uncertainty interval (11.6%), and the highest proportion of correctly classified patients (76%); followed by LSM (PPV: 0.43, uncertainty interval: 15.5%, correct classification rate: 66%), and FIB-4 (PPV: 0.42, uncertainty interval: 26.1%, correct classification rate: 62.6%) in terms of identifying advanced-stage liver fibrosis. Combined model analysis demonstrated that FIB-4 combined with Agile 3+ had improved the correct classification rate and reduced the proportion of missed patients compared with FIB-4 combined with LSM. Conclusion:The Agile 3+ score is superior than LSM, FIB-4, NFS, and APRI index at identifying advanced-stage fibrosis in patients with CHB combined with MAFLD. This study supports the use of FIB-4 index combined with Agile 3+ for risk stratification in patients with CHB combined with MAFLD.

Objective:To study the long-term prognostic outcomes of antiviral therapy in patients with chronic hepatitis B (CHB) accompanied with normal alanine aminotransferase (ALT), mild or slight inflammation, and/or liver fibrosis.Methods:A retrospective study method was used. Patients with CHB who underwent liver biopsy at Zhenjiang Third People's Hospital, affiliated with Jiangsu University, from January 2005 to July 2022 were included. Baseline data, clinical data, and clinical outcome events at the end of follow-up were collected. Cox proportional hazards regression and Kaplan-Meier survival analysis were used to assess the risk of clinical events.Results:A total of 149 CHB cases with normal ALT with mild or slight inflammation or fibrosis were included. Eighty-six cases were treated with antiviral therapy, while 63 were not. The median follow-up time was 82.00 (45.50,153.00) months. In the follow-up endpoint events, four cases (4.65%, 4/86) in the antiviral group had liver cirrhosis, while none had progressed to hepatocellular carcinoma. Five cases (7.94%, 5/63) in the non-antiviral group had liver cirrhosis, and two cases (3.17%, 2/63) had hepatocellular carcinoma. Kaplan-Meier survival analysis showed that the cumulative risk of clinical events did not significantly increase in the non-antiviral group ( P>0.05). The presence of liver fibrosis with high-normal ALT levels at baseline were associated with an increased risk of clinical events ( P<0.05). Cox analysis showed that baseline age, high ALT level, and presence of liver fibrosis were independent risk factors for clinical events. The two groups differed significantly in terms of the proportion of HBVDNA below the detection value and ALT normalization rate at the endpoint ( P<0.05). However, there was no significant difference in the HBsAg negative conversion rate between the two groups at the end ( P>0.05). Conclusion:The occurrence risk of long-term liver adverse events was not significantly improved by antiviral treatment in patients with chronic hepatitis B accompanied by normal ALT levels, mild or slight inflammation, and/or liver fibrosis. However, clinical outcomes were associated with baseline age, higher ALT levels, and liver fibrosis, suggesting that these factors are independent risk factors for the occurrence of clinical events.

Objective:To study the long-term prognostic outcomes of antiviral therapy in patients with chronic hepatitis B (CHB) accompanied with normal alanine aminotransferase (ALT), mild or slight inflammation, and/or liver fibrosis.Methods:A retrospective study method was used. Patients with CHB who underwent liver biopsy at Zhenjiang Third People's Hospital, affiliated with Jiangsu University, from January 2005 to July 2022 were included. Baseline data, clinical data, and clinical outcome events at the end of follow-up were collected. Cox proportional hazards regression and Kaplan-Meier survival analysis were used to assess the risk of clinical events.Results:A total of 149 CHB cases with normal ALT with mild or slight inflammation or fibrosis were included. Eighty-six cases were treated with antiviral therapy, while 63 were not. The median follow-up time was 82.00 (45.50,153.00) months. In the follow-up endpoint events, four cases (4.65%, 4/86) in the antiviral group had liver cirrhosis, while none had progressed to hepatocellular carcinoma. Five cases (7.94%, 5/63) in the non-antiviral group had liver cirrhosis, and two cases (3.17%, 2/63) had hepatocellular carcinoma. Kaplan-Meier survival analysis showed that the cumulative risk of clinical events did not significantly increase in the non-antiviral group ( P>0.05). The presence of liver fibrosis with high-normal ALT levels at baseline were associated with an increased risk of clinical events ( P<0.05). Cox analysis showed that baseline age, high ALT level, and presence of liver fibrosis were independent risk factors for clinical events. The two groups differed significantly in terms of the proportion of HBVDNA below the detection value and ALT normalization rate at the endpoint ( P<0.05). However, there was no significant difference in the HBsAg negative conversion rate between the two groups at the end ( P>0.05). Conclusion:The occurrence risk of long-term liver adverse events was not significantly improved by antiviral treatment in patients with chronic hepatitis B accompanied by normal ALT levels, mild or slight inflammation, and/or liver fibrosis. However, clinical outcomes were associated with baseline age, higher ALT levels, and liver fibrosis, suggesting that these factors are independent risk factors for the occurrence of clinical events.

Objective: To study the effect of Musashi-2 ( MSI2 ) overexpression on the imbalance of proliferation and apoptosis of human ovarian granulosa cell line (KGN) induced by dihydrotestosterone (DHT) ． Methods: The gene expression profiles of human ovarian granulosa cells ( GCs) in primary culture were statistically analyzed to screen the differentially expressed genes．pcDNA3. 1-MSI2 eukaryotic expression plasmid was constructed and transiently transfected into the KGN cells，and the overexpression effect of MSI2 was detected by Quantitative Real-time PCR (RT-qPCR) and Western blot．After overexpressing MSI2 in DHT induced KGN cells，MTT colorimetry and Edu staining were used to detect the proliferation of cells in each group，and flow cytometry ( FCM) was further used to detect the apoptosis of cells in each group. Results: The mRNA expression level of MSI2 gradually decreased during the primary culture of human ovarian GCs．And pcDNA3. 1-MSI2 was successfully constructed and transfected into KGN cells to improve the mRNA and protein expression levels of MSI2．Then MTT，EdU and FCM results showed that compared with the blank group，DHT induction could significantly reduce the proliferation rate and increase the apoptosis rate of KGN cells (P ＜0. 05) ．However，after MSI2 overexpression，the proliferation rate of KGN cells increased and the apoptosis rate decreased (P ＜0. 05) ，which were close to the blank group. Conclusion Overexpression of MSI2 can effectively alleviate the imbalance of proliferation and apoptosis of KGN cells induced by DHT，indicating that MSI2 plays an important role in GCs growth and follicle development.

The residents who had lived for at least 5 years and aged over 20 years old were sampled from urban to rural districts of Jiangsu Province with a stratified cluster sampling technique. B mode ultrasonography and thyroid function determination were carried out in 6 128 persons. The location, diameter, number, boundary, and calcification in thyroid nodules were described by using 7.5 MHz/50 mm transducer of thyroid ultrasonography. TSH was measured by chemiluminescence immunoassay. Free triiodothyronine(FT3)and free thyroxin(FT4)were measured when TSH was abnormal. The crude prevalence of thyroid nodules was 21.12% in total population, 14.55% in male, and 25.24% in female. The standardized prevalence was 15.69%, 11.20%, and 20.40%, respectively. The prevalence was lower in male than in female, and increased with age(P＜0.05). Thyroid nodules in Jiangsu Province were highly prevalent and more attention should be paid to the follow-up, early diagnosis, and treatment.

Objective To study the liver histological changes in chronic hepaitits B (CHB) patients with normal serum alanine aminotransferase (ALT) levels and the related factors. Methods Six hundred and thirty-two CHB patients with normal ALT levels had undergone ultrasound guided percutaneous liver biopsies. All specimen were examined by HE staining, collagen fiber Masson staining and immunohistochemical staining for hepatitis B surface antigen (HBsAg) and hepatitis B core antigen (HBcAg). The Knodell inflammation score and Ishak fibrosis score were both calculated and the relationship with age, serum levels of ALT and hepatitis B virus (HBV) DNA, hepatic expressions of HBsAg and HBcAg were analyzed. The means between two groups were compared by t test and those among groups were compared by one-factor analysis of variance and q test. Enumeration data were analyzed by x2 test. Results Among 632 CHB patients with normal ALT levels, 167 (26.4%) showed moderate necrotic inflammation in liver tissues and 26 (4.1%) showed severe necrotic inflammation; 217 (34. 3 % ) showed moderate fibrosis and 52 (8. 2 % ) showed severe fibrosis (cirrhosis). The Knodell inflammation score and Ishak fibrosis score in high ALT group were higher than low ALT group, those in female high ALT group were higher than male high ALT group and those in patients ＞ 40 years old were higher than ≤20 years old (q= 19.63, P＜0. 05). The liver injuries in patients with active HBV replication were more severe than those with undetectable HBV DNA levels (Knodell score, q=3.87, 2.87, 6.34; Ishak score, q=2.64,2. 64,5.54, all P＜0. 05),while there was no significant difference between patients with high levels and low levels of HBV DNA (F= 1.35, P＞0. 05). There was no significant difference between expressions of HBsAg (F= 1.65,0. 73,respectively; both P＞0. 05) and HBcAg in liver tissues and Knodell inflammation score and Ishak fibrosis score (F=0. 17, 1.29, respectively; both P＞0. 05). Conclusions Liver biopsies should be considered in CHB patients with normal ALT levels and detectable HBV DNA levels, especially those ＞ 40 years old and with ALT of (0.75-1.00) × upper limits of normal (ULN).