Objective To establish and validate a risk model for predicting heart failure(HF)in patients with hypertension.Methods The clinical data of 1500 patients with hypertension in Department of Cardiology of Tianjin Union Medical Center from January 2019 to December 2021 were retrospectively collected.The dataset was randomly partitioned into a training set(n=1050)and a valida-tion set(n=450)at a ratio of 7∶3.Then,the patients of training set were segmented into heart failure group(n=144)or non-heart failure group(n=906).The univariate Logistic regression,least absolute shrinkage and selection operator(LASSO)regression model and multivariate Logistic regression analysis were used for screening the risk factors and developing model.The R software was used to con-struct a nomogram.The discrimination ability of the model was determined by the area under the receiver operating characteristic curve(AUC),the calibration degree was evaluated by the calibration plot and Hosmer-Lemeshow goodness-of-fit test.Decision curve analy-sis(DCA)was performed to assess the clinical utility.Results This study showed that age,coronary heart disease,uric acid(UA),red blood cell distribution width(RDW),blood urea nitrogen/albumin ratio(BAR)and neutrophil to lymphocyte ratio(NLR)are inde-pendent predictors of the development of HF in patients with hypertension.A predictive model was constructed using the above six predic-tive factors.In the training set,the model had an AUC value of 0.864(95％CI;0.831-0.896),Hosmer-Lemeshow goodness of fit test showedx2=10.29,P=0.25.In the validation set,the AUC value was 0.842(95％CI:0.794-0.891),Hosmer-Lemeshow goodness of fit test showedx2=10.48,P=0.23.The clinical decision analysis also showed that the nomogram model had a better clinical perform-ance and could bring net clinical benefits to the patients.Conclusion This study successfully constructs a predictive model for the risk of HF in adults with hypertension and it can effectively identify patients at high risk of HF and formulate targeted intervention measures,thereby providing a basis for performing early prevention and treatment and improving prognosis.

Objective:To analyze the burden and trends of noncommunicable chronic disease(NCD) attributable to metabolic factors in China from 1990 to 2021.Methods:Data from the Global Burden of Diseases(GBD) 2021 database were utilized to describe changes in mortality and disability-adjusted life years(DALYs) of NCD in China from 1990 to 2021. Stratified analyses were conducted by age, sex, sociodemographic index(SDI), and related risk factors. Statistical analyses and predictions were conducted using the age-period-cohort model and the Nordpred model.Results:In 2021, the age-standardized mortality rate and age-standardized DALYs rate of NCD attributable to metabolic factors in China were 227.56 per 100 000 and 4 829.39 per 100 000, respectively. Their average annual percentage changes were -0.76%( P<0.001) and -0.77%( P<0.001). Overall, the burden decreased progressively with higher SDI levels. Analysis using the age-period-cohort model indicated reduced birth cohort and period effects for metabolic factor-attributable NCD, while age effects rose significantly. The minimum relative risk( RR) value was observed in the 15-19 age group( RR=0.01), and the maximum RR value occurred in the 95-99 age group( RR=996.86). The overall rising mortality trend indicated that age effects are the predominant driver at present. Projections estimate that by 2046, deaths from metabolic factor-attributable NCD in China will reach 8 189 563, with an age-standardized mortality rate of 236.95 per 100 000. Conclusions:China continues to face a substantial burden of NCD linked to metabolic factors, with older adults, males, and individuals with hypertension, diabetes, and prediabetes identified as key populations requiring targeted interventions.

Objective To investigate the status and influencing factors of type 2 diabetes mellitus(T2DM)patients' fear of complications,and to provide a reference for formulating targeted intervention measures.Methods From April to November 2024,370 patients with T2DM in 2 tertiary general hospitals in Daqing City were selected by convenience sampling method.General data questionnaire,Fear of Complications Questionnaire,Self-Perceived Burden Scale,Psychological Capital Questionnaire,Mishel Uncertainty in Illness Scale and Family Apgar Index Questionnaire were used for investigation.Univariate analysis and binary Logistic regression were performed to analyze the influencing factors.Results A total of 364 valid questionnaires were collected,with an effective recovery rate of 98.38％.The score of Fear of Complications Questionnaire was(23.47±7.47),and the incidence of fear of complications was 22.25％.Logistic regression analysis showed that medical payment methods,the number of complications,positive psychological capital and family care were the influencing factors of FoC in T2DM patients.Conclusion The fear of complications in T2DM patients is at a moderate level.Nursing staff should pay attention to the early assessment of patients' fear of complications,promptly identify and take effective measures to reduce the level of patients' fear of complications,improve their quality of life.

Objective To establish and validate a risk model for predicting heart failure(HF)in patients with hypertension.Methods The clinical data of 1500 patients with hypertension in Department of Cardiology of Tianjin Union Medical Center from January 2019 to December 2021 were retrospectively collected.The dataset was randomly partitioned into a training set(n=1050)and a valida-tion set(n=450)at a ratio of 7∶3.Then,the patients of training set were segmented into heart failure group(n=144)or non-heart failure group(n=906).The univariate Logistic regression,least absolute shrinkage and selection operator(LASSO)regression model and multivariate Logistic regression analysis were used for screening the risk factors and developing model.The R software was used to con-struct a nomogram.The discrimination ability of the model was determined by the area under the receiver operating characteristic curve(AUC),the calibration degree was evaluated by the calibration plot and Hosmer-Lemeshow goodness-of-fit test.Decision curve analy-sis(DCA)was performed to assess the clinical utility.Results This study showed that age,coronary heart disease,uric acid(UA),red blood cell distribution width(RDW),blood urea nitrogen/albumin ratio(BAR)and neutrophil to lymphocyte ratio(NLR)are inde-pendent predictors of the development of HF in patients with hypertension.A predictive model was constructed using the above six predic-tive factors.In the training set,the model had an AUC value of 0.864(95％CI;0.831-0.896),Hosmer-Lemeshow goodness of fit test showedx2=10.29,P=0.25.In the validation set,the AUC value was 0.842(95％CI:0.794-0.891),Hosmer-Lemeshow goodness of fit test showedx2=10.48,P=0.23.The clinical decision analysis also showed that the nomogram model had a better clinical perform-ance and could bring net clinical benefits to the patients.Conclusion This study successfully constructs a predictive model for the risk of HF in adults with hypertension and it can effectively identify patients at high risk of HF and formulate targeted intervention measures,thereby providing a basis for performing early prevention and treatment and improving prognosis.

Objective To investigate the status and influencing factors of type 2 diabetes mellitus(T2DM)patients' fear of complications,and to provide a reference for formulating targeted intervention measures.Methods From April to November 2024,370 patients with T2DM in 2 tertiary general hospitals in Daqing City were selected by convenience sampling method.General data questionnaire,Fear of Complications Questionnaire,Self-Perceived Burden Scale,Psychological Capital Questionnaire,Mishel Uncertainty in Illness Scale and Family Apgar Index Questionnaire were used for investigation.Univariate analysis and binary Logistic regression were performed to analyze the influencing factors.Results A total of 364 valid questionnaires were collected,with an effective recovery rate of 98.38％.The score of Fear of Complications Questionnaire was(23.47±7.47),and the incidence of fear of complications was 22.25％.Logistic regression analysis showed that medical payment methods,the number of complications,positive psychological capital and family care were the influencing factors of FoC in T2DM patients.Conclusion The fear of complications in T2DM patients is at a moderate level.Nursing staff should pay attention to the early assessment of patients' fear of complications,promptly identify and take effective measures to reduce the level of patients' fear of complications,improve their quality of life.

Objective:To analyze the burden and trends of noncommunicable chronic disease(NCD) attributable to metabolic factors in China from 1990 to 2021.Methods:Data from the Global Burden of Diseases(GBD) 2021 database were utilized to describe changes in mortality and disability-adjusted life years(DALYs) of NCD in China from 1990 to 2021. Stratified analyses were conducted by age, sex, sociodemographic index(SDI), and related risk factors. Statistical analyses and predictions were conducted using the age-period-cohort model and the Nordpred model.Results:In 2021, the age-standardized mortality rate and age-standardized DALYs rate of NCD attributable to metabolic factors in China were 227.56 per 100 000 and 4 829.39 per 100 000, respectively. Their average annual percentage changes were -0.76%( P<0.001) and -0.77%( P<0.001). Overall, the burden decreased progressively with higher SDI levels. Analysis using the age-period-cohort model indicated reduced birth cohort and period effects for metabolic factor-attributable NCD, while age effects rose significantly. The minimum relative risk( RR) value was observed in the 15-19 age group( RR=0.01), and the maximum RR value occurred in the 95-99 age group( RR=996.86). The overall rising mortality trend indicated that age effects are the predominant driver at present. Projections estimate that by 2046, deaths from metabolic factor-attributable NCD in China will reach 8 189 563, with an age-standardized mortality rate of 236.95 per 100 000. Conclusions:China continues to face a substantial burden of NCD linked to metabolic factors, with older adults, males, and individuals with hypertension, diabetes, and prediabetes identified as key populations requiring targeted interventions.

Objective:Based on " the surveillance, epidemiology, and end results" (SEER) database, we constructed a nomogram model for predicting cancer-specific survival time (CSST) in patients with T2 stage gallbladder cancer.Methods:Clinical data on 486 patients with T2 stage gallbladder cancer between 2018 and 2020 were retrospectively collected from the SEER database. The cohort comprised 147 male and 339 female patients with the age at diagnosis of (70±13) years. Clinical information including age, gender, tumor size, tumor stage, surgical type, number of lymph node dissection, postoperative treatment, and patients prognosis were extracted from the SEER database. We analyzed the factors influencing CSST in patients with T2 stage gallbladder cancer using Cox risk-proportional regression. The nomogram model was constructed based on independent risk factors obtained from multivariate Cox regression analysis, and the area under curve (AUC) of receiver operating characteristic curves (ROC) were used to evaluate the predictive accuracy of the nomogram model, while calibration plots, decision curve analysis, and clinical impact curves were used to evaluate the model's practicality and effectiveness.Results:The results of multivariate Cox regression analysis showed that patients with tumor size ≥30 mm ( HR=1.775, 95% CI: 1.123-2.806), AJCC stage ⅢB ( HR=6.083, 95% CI: 2.961-12.495), 1-3 lymph node dissection ( HR=6.139, 95% CI: 2.876-13.106), no postoperative chemotherapy ( HR=1.743, 95% CI: 1.096-2.771) had a higher risk of short CSST (all P<0.05). A nomogram model for predicting CSST was constructed based on the above risk factors, and the AUC of the ROC of which for predicting 1-year and 2-year CSST in patients with T2 stage gallbladder cancer was 0.778 and 0.696, respectively. Calibration plots demonstrated excellent collinearity between predicted and actual probabilities. Decision curve analysis and clinical impact curves confirmed high net benefit and clinical validity of the nomogram model. Conclusions:The tumor size ≥30 mm, AJCC stage ⅢB, 1-3 lymph node dissection and no postoperative chemotherapy are risk factors for short CSST in patients with T2 gallbladder cancer. The nomogram model based on the above risk factors have excellent performance in predicting CSST in patients with T2 stage gallbladder cancer.

Objective:To understand the current status and analyze the factors of demoralization of patients with chronic heart failure (CHF), providing references for targeted psychological interventions of nursing staff.Methods:Using the cross-sectional survey method, from August 2022 to January 2023, 282 CHF patients who were followed up in the Cardiovascular Department of the First Affiliated Hospital of Zhengzhou University were selected as the study subjects. They were investigated using the General Information Questionnaire, Demoralization Scale Revised Mandarin Version, Brief Illness Perception Questionnaire (BIPQ), Fear of Progression Questionnaire-Short Form (FoP-Q-SF), and the factors influencing the demoralization of CHF patients were analyzed using univariate analysis and multiple linear regression.Results:Among 282 cases, male 172 cases, female 110 cases, aged (62.29±10.05) years old. The Demoralization Scale Revised Mandarin Version′s score of CHF patients was (30.30 ± 10.37) points; the score of BIPQ was (42.18 ± 13.94) points; the score of FoP-Q-SF was (35.41 ± 7.29)points, which were at high level. The results of multiple linear regression analysis showed that patient disease duration, disease stages, New York heart association cardiac function classification, the score of BIPQ, and the score of FoP-Q-SF were factors influencing the demoralization of CHF patients ( t values were 3.08 to 12.50, all P<0.05). Conclusions:There is an urgent need to focus on the current status of the demoralization of CHF patients. It is necessary to develop a systematic and effective intervention strategy for demoralization, to take into account patient disease duration, disease stages, illness perception, and fear of progression in a comprehensive manner.

Objective:To explore the mediating role of disease progression′s fear and positive affect in the relationship between disease perception and demoralization in patients with chronic heart failure. It provided a theoretical basis for targeted interventions for healthcare workers.Methods:From October 2022 to March 2023, 320 patients with chronic heart failure in the First Affiliated Hospital of Zhengzhou University were selected as the research objects by convenience sampling. The General Information Questionnaire, Demoralization Scale Redacted Mandarin Version, Brief Illness Perception Questionnaire, Fear of Progression Questionnaire-Short Form, Positive and Negative Affect Schedule (Positive Affect Schedule) were used to conduct the questionnaire survey exploring the mediating effects of fear of disease progression and positive emotions between disease perception and disorientation by construction structural equation model.Results:There were 268 valid questionnaires. Of the 268 patients, 168 were male and 100 were female, 3.36% (9/268) were ≤40 years old, 55.22% (148/268) were 41-65 years old, and 41.42% (111/268) were >65 years old. Correlation analysis showed that disease perception was positively correlated with disease progression ′s fear, and every dimension of demoralization ( r values were 0.300-0.586, all P<0.01), and negatively correlated with positive affect ( r=-0.374, P<0.01); disease progression′s fear was negatively correlated with positive affect ( r=-0.318, P<0.01), and positively correlated with every dimension of demoralization ( r values were 0.339-0.464, all P<0.01); positive affect was negatively correlated with every dimension of demoralization ( r values were -0.430--0.334, all P<0.01). Structural equation model analysis showed that the direct effect of disease perception on demoralization was significant ( β=0.407, P<0.01), and both mediating effects of disease progression ′s fear and positive affect between disease perception and demoralization in patients with chronic heart failure were significant ( β=0.074, 0.079, both P<0.01). The chain mediating effect of disease progression ′s fear and positive effect was also significant ( β=0.019, P<0.01). Conclusions:Disease perception could directly predict the demoralization of patients with chronic heart failure and indirectly predict the demoralization of patients with chronic heart failure through the mediating effect of disease progression ′s fear, positive affect, and the chain mediating effect of disease progression ′s fear and positive affect.

Objective:Based on " the surveillance, epidemiology, and end results" (SEER) database, we constructed a nomogram model for predicting cancer-specific survival time (CSST) in patients with T2 stage gallbladder cancer.Methods:Clinical data on 486 patients with T2 stage gallbladder cancer between 2018 and 2020 were retrospectively collected from the SEER database. The cohort comprised 147 male and 339 female patients with the age at diagnosis of (70±13) years. Clinical information including age, gender, tumor size, tumor stage, surgical type, number of lymph node dissection, postoperative treatment, and patients prognosis were extracted from the SEER database. We analyzed the factors influencing CSST in patients with T2 stage gallbladder cancer using Cox risk-proportional regression. The nomogram model was constructed based on independent risk factors obtained from multivariate Cox regression analysis, and the area under curve (AUC) of receiver operating characteristic curves (ROC) were used to evaluate the predictive accuracy of the nomogram model, while calibration plots, decision curve analysis, and clinical impact curves were used to evaluate the model's practicality and effectiveness.Results:The results of multivariate Cox regression analysis showed that patients with tumor size ≥30 mm ( HR=1.775, 95% CI: 1.123-2.806), AJCC stage ⅢB ( HR=6.083, 95% CI: 2.961-12.495), 1-3 lymph node dissection ( HR=6.139, 95% CI: 2.876-13.106), no postoperative chemotherapy ( HR=1.743, 95% CI: 1.096-2.771) had a higher risk of short CSST (all P<0.05). A nomogram model for predicting CSST was constructed based on the above risk factors, and the AUC of the ROC of which for predicting 1-year and 2-year CSST in patients with T2 stage gallbladder cancer was 0.778 and 0.696, respectively. Calibration plots demonstrated excellent collinearity between predicted and actual probabilities. Decision curve analysis and clinical impact curves confirmed high net benefit and clinical validity of the nomogram model. Conclusions:The tumor size ≥30 mm, AJCC stage ⅢB, 1-3 lymph node dissection and no postoperative chemotherapy are risk factors for short CSST in patients with T2 gallbladder cancer. The nomogram model based on the above risk factors have excellent performance in predicting CSST in patients with T2 stage gallbladder cancer.