Objective:To explore the longitudinal changes of symptom clusters and quality of life in young and middle-aged postoperative patients with cervical cancer during chemotherapy, and to clarify the correlation between the two, in order to provide reference for clinical staff symptom management and improvement of patients′ quality of life.Methods:A longitudinal study was conducted, a total of 252 young and middle-aged who underwent chemotherapy after radical cervical cancer surgery in the gynecological ward of Henan Provincial People′s Hospital from December 2022 to August 2023 were selected as the investigation objects by convenient sampling method. Data were collected at 2 d before chemotherapy (T1), 1 week after the first chemotherapy (T2), 1 week after the third chemotherapy (T3), and 1 week after the sixth chemotherapy (T4), using the general data questionnaire, the Chinese version of the Memorial Symptom Assessment Scale and the Functional Assessment of Cancer Therapy-Cervix. Exploratory factor analysis was used to extract symptom clusters from the data. The generalized estimation equation model was used to analyze the dynamic change trend and correlation between symptom clusters and quality of life.Results:A total of 221 patients with cervical cancer aged 18-59 (46.85 ± 6.50) years old were included. At T1 and T2, there were 4 symptom clusters, which were psychological symptom cluster, gastrointestinal symptom cluster, disease behavior symptom cluster and perimenopausal symptom cluster. T3 and T4 increased the neurological symptom cluster and self-image disorder symptom cluster, a total of 6 symptom clusters. The higher score of each symptom cluster, the lower total score of quality of life (Wald χ2 values were 8.08-62.70, all P<0.01). Conclusions:Young and middle-aged postoperative patients with cervical cancer suffered from multiple symptom clusters during chemotherapy, which not only remained relatively stable, but also showed a constantly changing trend. Effective dynamic management of symptoms clusters in young and middle-aged postoperative patients with cervical cancer during chemotherapy is expected to improve their quality of life.

Cohort study is one of the important research methods in analytical epidemiology because of its clear time sequence relationship, which is better than other observational studies in demonstrating causal association. However, screening diagnosis or other methods are often used to exclude the individuals with outcome events during the enrollment process of the subjects in cohort studies. The accuracy of screening diagnosis and the effectiveness of exclusion will affect the accuracy of the baseline status assessment of the subjects included in the study, which may lead to the causal time sequence reversal of exposure-outcome in the estimation of causal effect. Landmark analysis can be used to control reverse causality by excluding subjects with potentially unknown expose-outcome timing. In this paper, we describe the basic principles and analytical steps of landmark analysis, and use data from the Chinese Longitudinal Healthy Longevity Survey to explore the relationship between physical activity and frailty, and introduce the specific application of landmark analysis for the purpose of facilitating its application and inferring causal effects more accurately in cohort studies.

With completing a baseline survey of a large natural population cohort, conducting regular follow-up has become a key factor in further improving the quality of cohort construction and ensuring its sustainable development. Typical cohort follow-up methods include repeat surveys, routine monitoring, and community-oriented surveillance. However, in practical applications, there are often issues such as high costs, difficulty, and high error rates. Telephone follow-up is an important supplementary method to the methods mentioned above, as it has the characteristics of low cost, fast response, and high quality. However, the with difficult organization, quality control is challenging, response rates are low, and management levels vary widely, which limits its widespread use in large-scale population cohort studies. Given the above problems, this study draws on customer relationship management based on the actual needs of the China Northwest Cohort follow-up. It relies on the REDCap electronic data collection platform to build a telephone follow-up management and quality control system. Targeted solutions are provided for key issues in telephone follow-up implementation, including organizational structure, project management, data collection, and process quality control, to improve the quality control level of telephone follow-up comprehensively and thereby enhance the quality and efficiency of follow-up. We hope to provide standardized follow-up programs and efficient quality control tools for newly established and existing cohort studies.

Objective To investigate the influence of blood glucose fluctuation on ser202 phosphorylation sites of tau protein( p-Tau) in hippocampus of diabetic rats; to explore the possible mechanism of blood glucose fluctuation impacting on tau protein hyperphosphorylation. Methods Healthy male Sprague Dawley rats were randomly divided into normal control group ( NC group ) and diabetes group. After diabetic rats model was established, all the diabetic rats were randomly divided into diabetic continuous hyperglycemia group (DC group) and diabetic blood glucose fluctuant group ( DF group). Rats in DF group were given glucose solution intraperitoneal injection twice at regular time everyday. 30 minutes after each intraperitoneal injection, insulin subcutaneously injections were given. Rats in the NC group and DC groups were given the same volume of saline subcutaneous injection. Specimens were collected in 8 weeks, the levels of p-Tau and total tau in rat hippocampus were detected by immunohistochemical staining and Western blotting. The immunoreactive positive products were analyzed by image analysis system. Glycogen synthase kinase-3β(GSK-3β) mRNA was detected by realtime PCR. Results (1) Blood glucose fluctuation of rats in DC and DF group were greater than NC group. And the mean blood glucose, standard deviation of mean blood glucose (SDBG), and large amplitude of glycemic excursion (LAGE) levels were increased significantly compared to NC group, the difference has statistical significance ( all P < 0. 05). Compared with DC group, SDBG and LAGE levels of DF group were higher (both P<0. 05). HbA1C and insulin levels were no difference (P>0. 05). (2) Compared with NC group, the hippocampal p-Tau level of DC group and DF group were increased (P < 0. 05 ); Compared with DC group, the hippocampal p-Tau expression of DF group was increased ( P <0. 05). Compared with DC group, a higher hippocampal GSK-3β mRNA level was found in DF group ( P <0. 05). Conclusions On the basis of diabetes animal model, giving glucose solution intraperitoneal injection and insulin subcutaneously injection 30 minutes later twice at regular time everyday could establish experimental model of diabetic blood glucose fluctuation. Blood glucose fluctuation may aggravate the diabetic rats hippocampal p-Tau. The possible mechanism seems to be an up regulation of the GSK-3β.