Chinese People Research Articles

Negotiating Between Belief and Custom: The Encounters of Han Muslim Converts in China

ABSTRACT The conversion of Han Chinese in the Peoples Republic of China (PRC) to Islam is a complex and dynamic process that goes beyond the mere adoption of a new faith. Potential converts undergo a multifaceted journey involving learning about Islam, reflecting on Hui and Han ethnic cultures and customs, and understanding the historical relationship between Islam as a religion and ethnic Hui Chinese people. Through this process, Han converts gradually develop a pluralistic and multilayered identity that encompasses their Han ethnicity and Muslim faith. The article emphasizes the importance of daily inter-group interactions and the use of various strategies to resolve conflicts while adhering to Islamic beliefs. It introduces a theoretical framework consisting of discursive, local, and configurable values to analyze the nuances of everyday experiences among Han converts. This framework provides a structured approach to understanding the complexities of identity formation and enrich ongoing discussions within the Islamic anthropological research community.

Longitudinal correlation between poverty and mental health trajectories among low-income populations in China: a group-based dual trajectory model analysis

ABSTRACT This study aims to explore the long-term correlations between poverty and depression among low-income Chinese people. We utilise data from the China Family Panel Study 2010–2018. A group-based dual trajectory model was employed to examine the relationship between poverty and depression trajectories. The results indicate a bi-directional relationship between the distribution of poverty and depression. Moreover, there is a diversity of dynamics associated with poverty and depression. Furthermore, a stronger influence of depression on poverty changes in the interactive relationship. These findings suggest the need to develop targeted policy programmes based on the characteristics of poverty and depression trajectory patterns.

Effects of a culturally tailored low-glycaemic index dietary educational intervention on reducing cardiometabolic risk among Chinese adults with obesity: a randomised controlled trial.

An assessor-blinded randomised controlled trial was conducted to assess the effect of a culturally tailored low-glycaemic index (GI) dietary educational intervention on body mass index and cardiometabolic risks for Chinese people with obesity in Hong Kong. A total of 166 Chinese adults in Hong Kong with obesity were randomised to the intervention group (n=83) or the control group (n=83). The intervention group received the culturally sensitive low-GI dietary educational intervention based on the Health Belief Model, consisting of an educational booklet, one individual interactive educational session, and three follow-up telephone calls. The control group received general advice on a healthy diet, including a pamphlet, one individual education session, and three follow-up telephone calls. Outcome measures included body mass index, cardiometabolic risk-factors, dietary intake variables and sense of satiety. Data collection was conducted at baseline and post-intervention at 12-week. Generalized estimating equation model was used to compare the difference in changes in outcome variables between groups. Compared with the control group, the intervention group exhibited a significant reduction in dietary glycaemic load (β=-6.963, p=0.026) at post intervention. No significant effects were found on other outcomes. A 12-week culturally tailored and Health Belief Model-based low-GI dietary educational intervention significantly reduced the dietary glycaemic load and showed the feasibility of the low-GI dietary intervention in Chinese adults in Hong Kong with obesity. A longer intervention period and follow-up might be required to achieve improvements in reducing cardiometabolic risk factors in people with obesity. ClinicalTrials.gov Identifier: NCT04152213.

Comparison of Partial Upper Sternotomy Versus Median Sternotomy for Total Arch Replacement in Patients With Type A Aortic Dissection

Objective: Comparative studies of median sternotomy and partial upper sternotomy in total arch replacement for type A aortic dissection are rare, and the safety and benefits of partial upper sternotomy need further evaluation. This study aimed to explore the effectiveness and prognosis of partial upper sternotomy in total arch replacement among patients with type A aortic dissection. Methods: This is a retrospective study of patients who underwent total arch replacement for type A aortic dissection at the First Medical Center of Chinese People’s Liberation Army General Hospital between January 2016 and December 2019. They were grouped into the median sternotomy and partial upper sternotomy groups according to the different treatment methodologies. The intra-operative and prognostic indicators were compared between both groups. Results: Forty-nine patients were included: 31 in the median sternotomy group and 18 in the partial upper sternotomy group. The partial upper sternotomy group had a shorter incision ((9.0 ± 0.8) cm vs. (25.5 ± 1.3) cm, P = 0.02) and smaller postoperative total drainage volume (885 mL vs. 1,820 mL, P = 0.03) than the median sternotomy group. The differences between the 2 groups with respect to other intra-operative indicators such as operation duration, cardiopulmonary bypass duration, aortic occlusion duration, hypothermic circulatory arrest duration, and intra-operative blood loss, and prognostic indicators such as red blood cell infusion, ventilator aid duration, cardiac intensive care unit stay, postoperative hospital stay, and postoperative complications were not significantly different (all P > 0.05). Conclusions: The utilization of partial upper sternotomy in patients with type A aortic dissection resulted in a smaller incision and more aesthetically pleasing scar, along with reduced drainage volume compared to median sternotomy.

Prognosis of patients with advanced bile tract carcinoma: assessment using the modified-Gustave Roussy Immune Score (mGRIm-s) as a clinico-immunological tool

BackgroundThe emergence of immune checkpoint inhibitors (ICIs) has enhanced survival outcomes for certain patients with advanced biliary tract carcinoma (BTC). Pinpointing those who would benefit most from immunotherapy remains elusive. We investigated the predictive value of the modified Gustave Roussy Immune Score (mGRIm-s) in BTC patients treated with ICIs.MethodsData from 110 patients at Chinese People's Liberation Army General Hospital, spanning September 2015 to April 2021, were analyzed. The median follow-up duration was 38.7 months as of December 2023. Risk factors included low albumin, high lactate dehydrogenase, and an elevated neutrophil–lymphocyte ratio. Patients were stratified into low (patients with no risk factors) and high (patients with at least one risk factor) mGRIm-s groups based on these factors.ResultsSurvival outcomes post-immunotherapy favored the low mGRIm-s group, with significantly improved progression-free survival (PFS) and overall survival (OS) (8.50 months vs. 3.70 months and 21.60 months vs. 8.00 months). COX regression confirmed an elevated risk in the high mGRIm-s group. Subgroup analysis highlighted a notable survival advantage for low mGRIm-s patients receiving first-line immunotherapy.ConclusionsThis study underscores mGRIm-s's potential in predicting immunotherapy response in BTC, paving the way for more targeted approaches.

The combined effect of handgrip strength and obesity phenotype on the risk of stroke in Chinese middle-aged and elderly: A cohort study

ObjectiveThe aim of this study was to investigate the combined effect of handgrip strength (HGS) and obesity phenotype on the risk of stroke in Chinese middle-aged and elderly people. MethodsThe data was used from the China Health and Retirement Longitudinal Study (CHARLS). Middle-aged and older adults who participated in surveys between 2011 and 2018 were included in the study. They were divided into 4 different types of obesity phenotypes based on obesity and metabolic status: metabolically healthy non-overweight/obesity (MHNO), metabolically healthy overweight/obesity (MHO), metabolically abnormal non-overweight/obesity (MANO), and metabolically abnormal overweight/obesity (MAO). The HGS level was divided into low and high groups according to the median values. Cox proportional risk regression model was used to analyze the joint effect of HGS and obesity phenotype on the risk of stroke among participants. ResultsA total of 7904 participants aged 58.89±9.08 years were included in this study. After adjusting for potential confounders, high HGS&MHO (HR=1.86, 95 % CI=1.12–3.09), high HGS&MANO (HR=2.01, 95 %CI=1.42–2.86), high HGS&MAO (HR=2.01, 95 % CI=1.37–2.93), low HGS&MHNO (HR=1.57, 95 % CI=1.00–2.46), low HGS&MHO (HR=2.09, 95 % CI=1.29–3.38), low HGS&MANO (HR=2.02, 95 % CI=1.35–3.03), and low HGS&MAO (HR=2.48, 95 % CI=1.72–3.58) group had significantly higher risks of stroke than the high HGS&MHNO group. ConclusionThe coexistence of metabolically unhealthy and low HGS can synergistically increase the risk of stroke in Chinese middle-aged and elderly people.

Analysis for Causes of Corneal Melt After the Boston Keratoprosthesis Type I: The Chinese People's Liberation Army General Hospital Experience.

The purpose of this study was to evaluate the long-term incidence, risk factors, and the management of corneal melt following Boston type I keratoprosthesis (B-KPro I) implantation. This is a retrospective observational case series. Data were collected regarding demographics, preoperative characteristics, incidence, and outcomes of corneal melt in 102 patients who underwent B-KPro I in the Chinese PLA General Hospital between 2011 and 2018, with a follow-up period ranging from 4 to 11 years. Chemical burn was the most common indication for B-KPro I (n = 56; 53.8%), followed by ocular trauma (n = 26; 25.0%). During the follow-up period (107 ± 25.7 months), corneal melt occurred in 60 cases among 37 eyes (35.6%), with an incidence of 20.2% at 1 year after surgery. Fourteen cases presented with recurrent corneal melt. Patients with multiple corneal allograft failures had a higher risk of corneal melt. Thermal burns, compared with alkali burns, significantly elevated the odds ratio (OR) of corneal melt (OR, 5.11; 95% confidence interval, 1.05-24.86; P = 0.043). Corneal melt significantly reduced the retention time of KPro (P < 0.01), and its coexistence with other complications further shortened the retention time. A specific pattern of corneal melt occurrence was identified, with a peak incidence at 1 year postoperatively. Our findings suggest variations in the risk of corneal melt among different indications, with thermal burns carrying the highest OR. Moreover, each previous failed keratoplasty doubled the risk of corneal melt after B-KPro I.

Evaluating the integration of traditional gong methods in smart home environment for the recovery of health functions of stroke patients

Since the 21st century, network and mobile communication technology are gradually entering the medical and health services field. Combining body area networks, broad-generation mobile communications, and cloud platforms has made various medical applications for large-scale populations possible. The development of digital medical technology, especially digital telemedicine, is increasingly proving to be an important means of significantly reducing the cost of medical care and access, changing the distribution of medical resources, and improving the overall level of care. To observe the effects of traditional Chinese medicine gongfu combined with rehabilitation therapy on mild depression, anxiety, and functional recovery of activities of daily living (ADL) in patients recovering from stroke, and to provide new treatment methods to improve the function and daily living ability of the group who develop mild depression and anxiety after stroke. In this paper, the digital medical engineering application combining information technology and medical treatment integrates various high-end information technologies such as body domain network and cloud computing to solve the difficulties in the current application one by one, to provide the national people with the system provides “timely”, “local” and “bottomless” remote digital health services to the Chinese people.

Effect of social participation on the trajectories of activities of daily living disability among community-dwelling older adults: a 7-year community-based cohort

IntroductionStudies examining the effects of social participation on activities of daily living (ADL) disability are still scarce.AimTo assess the reciprocal relationship between ADL disability trajectories and social participation among older Chinese people aged ≥ 60 years.MethodsThis study included 2976 participants aged ≥ 60 years in six waves of a community-based survey from 2015 to 2022. Basic activities of daily living (BADL) and instrumental activities of daily living (IADL) were used to assess the ADL disability in each survey. Social participation was assessed by involvement in four social activities and an extensive social participation score. Group-based trajectory modeling was used to identify potential heterogeneity in longitudinal changes over 7 years and explore associations between baseline predictors of group membership and these trajectories.ResultsTwo BADL disability trajectories were identified: stable (94.8%) and increase (5.2%). Additionally, three IADL disability trajectories were distinguished: stable (73.2%), moderate (20.2%), and increase (6.6%). After controlling for the potential covariates, each point increase in the extensive social participation score correlated with a 17% decrease in the odds of older individuals belonging to the increase BADL trajectory group (OR = 0.83, 95% CI = 0.68–1.00). For IADL, it decreased the odds of being assigned to the moderate trajectory group by 16% (OR = 0.84, 95% CI = 0.75–0.95) and to the increase trajectory group by 23% (OR = 0.77, 95% CI = 0.64–0.93).ConclusionsHigher levels of social participation among older individuals were more likely to be classified as stable trajectories in both BADL and IADL. Increased participation in social activities by community-dwelling elderly adults may promote healthy aging.

A Frontier Review of Nutraceutical Chinese Yam

Yams are the edible subterranean rhizomes, or tubers, of plants from the genus Dioscorea. There are approximately 600 species of yam plants in the world, with more than 90 of these growing in East Asia. One particular species, Dioscorea opposita Thunb., is highly praised as “the Chinese yam”. This distinction arises from millennia of storied history, both as a nutritional food source and as a principal ingredient in traditional Chinese medicine. Among the many cultivars of Dioscorea opposita Thunb., Huai Shanyao has been widely regarded as the best. This review surveyed the historical background, physiochemical composition, applications as food and medicine, and research prospects for the Chinese yam. Modern science is finally beginning to confirm the remarkable health benefits of this yam plant, long-known to the Chinese people. Chinese yam promises anti-diabetic, anti-oxidative, anti-inflammatory, immunomodulatory, anti-hyperlipidemic, anti-hypertensive, anti-cancer, and combination treatment applications, both as a functional food and as medicine.

Analysis of the virulence and genetic differences of carbapenem-resistant Acinetobacter baumannii epidemic clones

Objective: To evaluate the virulence levels of carbapenem-resistant Acinetobacter baumannii ST191, ST195, and ST208, and to analyze the differences in virulence factors among these epidemic clones. Methods: The study involved the genomic sequencing of 233 Acinetobacter baumannii strains that were isolated from the Fifth Medical Center of the Chinese People's Liberation Army General Hospital (North Hospital) between 2011 and 2019. The genomic data was cross-referenced with the Virulence Factor Database (VFDB) to examine the presence of virulence genes in the strains. Furthermore, a Galleria mellonella infection survival model was used to evaluate the virulence levels of the strains, and the association between virulence levels and virulence genes was analyzed. Results: The study included 38 strains of the ST191 clone, 104 strains of the ST195 clone, and 91 strains of the ST208 clone. In the Galleria mellonella infection survival experiment, the average mortality rate for ST191 was 23.0%, with 3 (7.9%) highly virulent strains. For ST195, the average mortality rate was 53.0%, with 34 (32.7%) highly virulent strains. For ST208, the average mortality rate was 47.0%, with 20 (21.9%) highly virulent strains. There was a significant statistical difference in mortality rates between ST191 and ST195 (χ2=13.9, P<0.001) as well as between ST191 and ST208 (χ2=15.2, P<0.001). A comparison of the strains with the VFDB revealed significant differences in the virulence genes carried by the clones. Specifically, the type Ⅵ secretion system-related genes (clpV/tssH, hcp/tssD, tagX, tssA, tssB, tssC, tssE, tssF, tssG, tssK, ssL, tssM) and the sugar transferase gene ACICU_RS00475 were found to be universally absent in ST191 strains (0%) while being prevalent in ST195 (100.0%) and ST208 (>82.0%) strains. Statistical analysis revealed an association between the mortality rate of the clones and the presence of virulence genes(clpV/tssH P<0.001, hcp/tssD P=0.001, tagX P<0.001, tssA P<0.001, tssB P=0.001, tssC P=0.001, tssE P=0.001, tssF P=0.001, tssG P<0.001, tssK P<0.001, tssL P<0.001, tssM P=0.001, ACICU_RS00475 P=0.001). Conclusion: Among the carbapenem-resistant epidemic clones of Acinetobacter baumannii, the ST191 clone shows lower mortality rates in Galleria mellonella, possibly because of the lack of type Ⅵ secretion system and sugar transferase genes.

APOE ε4 allele modifies the associations of toxic metals and their mixture with cognitive impairment among older adults

BackgroundThe evidence of interactive effect of the toxic metal (TM) mixture and apolipoprotein E (APOE) ε4 gene on cognitive impairment in older adults is scarce. We aimed to explore whether the associations of single TMs and their mixture with cognitive impairment depend on APOE ε4 in Chinese community-dwelling older people. MethodsA total of 1148 older adults from a subset of the baseline survey of a cohort study were included. Blood arsenic (As), cadmium (Cd), lead (Pb), strontium (Sr), and vanadium (V) were detected by inductively coupled plasma mass spectrometry. APOE gene (rs429358, rs7412) polymorphisms were analyzed by the Polymerase Chain Reaction instrument. Mixed effects logistic regression was applied to estimate the relationships of single TMs and APOE genotype with cognitive impairment. Weighted Quantile Sum (WQS) and Bayesian kernel machine regression (BKMR) models were performed to examine joint impacts of the TM mixture, as well as the interaction of the TM mixture with APOE ε4 genotype on cognitive impairment. ResultsPb displayed a significant linear association with an increased odds of cognitive impairment after adjustment for covariates (Ptrend = 0.045). While APOE genotype did not show a significant correlation with cognitive impairment. WQS showed that the TM mixture was associated with an increased risk of cognitive impairment by 31.0% (OR=1.31, 95% CI: 0.92, 1.87) while no significance was found. BKMR exhibited a significant linear association between the TM mixture and cognitive impairment. Moreover, both WQS and BKMR indicated that Pb contributed the most to cognitive impairment within the mixture. Significant interactions of Pb or the TM mixture and APOE genotype on cognitive impairment were observed, contributing to 38.1% and 38.2% of total effects, respectively. ConclusionsAPOE ε4 allele amplifies the associations of single Pb or the TM mixture with cognitive impairment. These findings may help to develop precision prevention.

Investigating psychometric properties of short versions of the depressive experiences questionnaire: Findings from a representative large sample of Chinese adolescents

BackgroundAdolescence involves a period of swift change, including the development of personality vulnerabilities (i.e., dependency and self-criticism) that act as transdiagnostic factors to psychopathology. Over the past several decades, numerous short revisions have condensed the Depressive Experiences Questionnaire (DEQ) into more efficient measures of personality vulnerability. Prior research has investigated the psychometric properties of the short DEQs in adult and clinical samples. However, there has been insufficient exploration within adolescents, who are in addition marked by fluctuating personality vulnerabilities. MethodA representative large sample of adolescents and emerging adults in China aged 10 to 25 (N = 23,953) was administered five short DEQs, including the Revised DEQ (RevDEQ), Reconstructed DEQ (RecDEQ), Theoretical DEQ-21/12 (TDEQ-21/12) and adolescent DEQ (DEQ-A). The data was evaluated for internal consistency and criterion-related validity, while factor structure and measurement invariances across gender and age groups were analyzed by confirmatory factor analysis (CFA). A subset of the original sample (N = 2874) was retested after six months and analyzed for test-retest reliability and cross-time invariance. ResultCFA of the TDEQ-21/12 and RecDEQ supported the intended two-factor model. Good criterion-related validity, internal consistency and test-retest reliability for these three versions were found. Satisfying measurement invariances across gender, time, and age groups were established. LimitationThe study's scope was confined to non-clinical adolescent populations within China, highlighting a gap in cross-cultural and clinical applicability. ConclusionThe present study supports the use of the TDEQ-21/12 and RecDEQ as valid and concise instruments for measuring Chinese adolescent personality vulnerability.

The ethnic aspect of the Yuan Empire’s liquidation

This paper examines the importance of Chinese ethnicity through the example of the historically first dynasty named the Yuan Dynasty, where the rulers were nomadic conquerors and not of Han descent. The aim of the paper is to explore the ethnic aspect of the process of liquidating the Yuan Empire and the importance of the unity of the Chinese people. The methodology of the paper includes the use of different resources, including chronicles, historical research and sources showing the realities not only from the Chinese side, but also from the Mongol side. This approach makes it possible to consider the issue from both sides and obtain more objective conclusions. The results show that the importance of the unity of the Chinese people became evident as early as the Han era, when the concept of "Han man" became politically significant. For the first time, cultural attributes were no longer the only factor uniting people, and nationality became crucial to the unity of the state. The scope of the work includes the study of Chinese history, ethnic relations and nationality issues. The novelty of the work lies in the use of different sources and consideration of the issue from different angles, which allows for a more complete picture of historical process. The conclusions of the paper emphasise the importance of nationality as a sign for state unity and show that national problems can become a factor that can weaken and destroy even the most powerful states.

Dissipation behavior and risk assessment of imidacloprid and its metabolites in apple from field to products

Pesticides play vital roles in controlling pests and boosting crop yields. Imidacloprid is widely used all over the world and may form in agricultural products. The presence of pesticide residues in apples raises serious health concerns. Understanding the residual fate of imidacloprid is critical for food safety and human health. In this study, the dissipation behavior, metabolism, household processing and risk assessment of imidacloprid and its metabolites in apple were investigated from filed to table. Field results suggested that the half-lives of imidacloprid at 5 times the recommended dosage was 1.5 times that of the standard dosage. And the final residues of imidacloprid were less than the established maximum residue limits (MRLs). Clarification and simmering had little effect on the reduction the residues of imidacloprid and its metabolites. The calculated processing factors were lower than 1 for imidacloprid and its metabolites, implying that the residual ratios of imidacloprid and its metabolites in each steps of the food processing were reduced. The risk quotients were < 1 for all Chinese people, indicating that acceptable risks associated with dietary exposure to imidacloprid in apple. However, the higher risks were observed in young people than adults, and females faced higher risks than males. Given high residue levels in pomace, imidacloprid and its metabolites should be further studied in commercial byproducts.

Meat substitutes in Media Discourse

Shifting from meat consumption is critical for future dietary evolution. Mainstream newspapers and social media are the leading platforms for expressing this opinion. By analysing the media discourse, the proponents of the shift from meat, to plant-based meat and cultured meat were identified. The objectives were: a) to identify themes, word frequencies, and sentiment related to meat substitutes, b) to determine Chinese perceptions of the two meat substitutes, and c) to determine which food functions are of concern to Chinese consumers. Between July 2016 and July 2022, the researcher gathered data from People’s Daily and China Daily online outlets and user comments. 574 news articles and 2,345 online comments were extracted. Three techniques were applied: sentiment analysis, thematic analysis, and word cloud analysis. The results revealed that newspapers reported positively on meat substitutes, yet user comments showed negative public perception. Chinese people held positive attitudes toward plant-based meat and negative attitudes toward cultured meat. Thus, the insights from the media discourse provided valuable indicators for stakeholders to develop sustainable food education and consumption strategies.

Digital resources in teaching Russian to Chinese students outside of the language environment

Introduction. Relations between China and Russia are becoming increasingly close, resulting in a high demand for Russian language specialists in the labor market. The lack of a language environment in Chinese universities is a pressing problem that teachers would like to solve. Therefore, the active implementation of digital technologies will undoubtedly compensate for this deficiency. The purpose of the study is to analyze the use of Chinese internet resources in teaching Russian language in Chinese universities. Materials and Methods. The study involved undergraduate, postgraduate and doctoral students studying in the fields of "Russian as a Foreign Language", "Philology", "Linguistics" and "Russian Literature". A total of 117 respondents from nine higher education institutions in Russia and China. These institutions include Heilongjiang Institute of Foreign Languages, RUDN, Moscow State University, Moscow State Pedagogical University, Institute of China and Modern Asia of the Russian Academy of Sciences, Bauman Moscow State Technical University, Russian State University of Tourism and Service, Inner Mongolia University, and Yili Pedagogical University. The research methods employed in the study were analysis of scientific and scientific-methodological literature, observational (monitoring of online and distance learning), diagnostic (interviews with teachers, student surveys), and statistical analysis. Results. It was found that Chinese students do not know which form of education is most preferable outside of the Russian-speaking environment (35.9% – online, 37.61% – in-person, 38.46% – blended). However, respondents (67%) stated that various online resources provide significant help in learning the Russian language. The most popular programs and platforms were Chinese Dingding and Tencent Meeting, international Microsoft Teams and Zoom. Not all Russian-language dictionaries are available online for Chinese people, which is why the share of translation programs assisting in learning Russian language has increased (over 70%). The most frequently used Chinese dictionary was "Qianyiciba" (62%), and the most popular websites include Google Translate, Yudao Translator, Baidu Translate, and Bilibili. It has been proven that among the main problems hindering the process of learning Russian language in online and distance learning formats, psychological discomfort, lack of communication, increase in independent work, and individualization in learning considering the personal needs of students should be highlighted. Conclusion. The results obtained make it possible to determine the prospects for using digital resources in teaching Russian as a foreign language to Chinese students outside of the language environment.

The Prolonged Path of Indigenization: A Study on German Protestant Missionary Ernst Faber’s Chinese Literary Works

Ernst Faber’s 34 years of literary missionary works reveal his commitment to refining his approach to indigenizing Christianity in China. Employing three linguistic and cultural adaptation strategies—translation and commentary of the Bible, examination and analysis of missionary practical outcomes in Western society, and the revision and reinterpretation of Chinese classics incorporating Christian insights—Faber adapted his methods gradually into China’s specific conditions, indicating a prolonged path of indigenization. Despite expressing appreciation for Chinese culture, a critical examination reveals the preservation of his cultural biases and an unwavering commitment to Christianity as a means of purifying and enriching the spirit of the Chinese people. Rooted in the political context of his time and confidence in European historical world missions, Faber’s indigenization strategy in his Chinese literary works represents an interplay of cultural adaptation and resistance.

[A retrospective study of postoperative adjuvant therapy following immunotherapy combined with targeted therapy and sequential curative surgical procedures for initially unresectable hepatocellular carcinoma].

Objective: To report the clinical efficacy of adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical procedures in patients with initially unresectable hepatocellular carcinoma. Methods: This is a retrospective case series study. Data from 100 patients who underwent adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical procedures with long-term survival were collected from December 2018 to December 2022 at the Faculty of Hepato-Pancreato-Biliary Surgery, First Medical Center, Chinese People's Liberation Army General Hospital. According to inclusion and exclusion criteria, 47 cases were included, among which patients who met the discontinuation criteria and maintained a drug-free tumor-free status. Thirty-nine male and eight female patients were included, with an age of (54.2±18.8)years(range:38 to 73 years) at initial diagnosis. At the time of initial diagnosis, 43 cases (91.5%) were classified as Barcelona Clinic Liver Cancer(BCLC) stage C. Survival curves were made using Kaplan Meier method. Results: Forty-seven patients underwent R0 resection, all achieved a drug-free tumor-free state through postoperative adjuvant therapy based on pathological examination results. Thirty-six patients(76.6%) maintained a drug-free tumor-free survival status for more than 6 months,28 patients(59.6%) for more than 12 months,and 8 patients(17.0%) for more than 24 months. The longest drug-free tumor-free survival in this cohort reached 48 months. The median follow-up time in this study was 32 months. After diagnosis, the overall survival rates at 1- and 3- years were 97.7%(95%CI:93.4% to 100%) and 90.7%(95%CI:82.5% to 99.8%). The postoperative recurrence-free survival rates at 1- and 3- years were 91.0%(95%CI:83.0% to 99.8%) and 71.3%(95%CI:58.7% to 86.5%). Conclusions: The adjuvant therapy based on pathological results following immunotherapy combined with targeted therapy and sequential curative surgical approach provides long-term survival benefits for patients with initially unresectable hepatocellular carcinoma. Standardized adjuvant therapy maybe sustain long-term tumor-free status,and achieve drug-free tumor-free survival.

Projections of functional dependence among the late middle-aged and older population from 2018-2048 in China: a dynamic microsimulation

BackgroundThe population of China is aging rapidly. However, the long-term trajectories of functionally dependent late middle-aged and older Chinese people are currently absent. The present study aimed to estimate the population size and proportion of late middle-aged and older adults with difficulties and dependence on activities of daily living (ADL) and instrumental activities of daily living (IADL) in China from 2018 to 2048.MethodsWe constructed a dynamic microsimulation model to project the population size and proportions of late middle-aged and older Chinese people who have difficulty and dependence in ADL and IADL from 2018-2048. The model was populated with a representative sample of the target population and allowed individual-level interaction between risk factors, diseases, and health outcomes. Analyses by socioeconomic subgroups were also conducted.ResultsAlmost 25% and 38% of late middle-aged and older people in China will become ADL- and IADL-dependent by 2048, respectively. Also, 17% of the target population will be severely ADL-disabled by 2048. The inequity in functional status across subgroups by sex, educational level, and urban/rural residency will become substantial.ConclusionsThe numbers and percentages of China's functionally difficult and dependent late middle-aged and older population will increase by magnitudes as of the mid-21st century, the pressure of which is compounded by its disproportionate distribution across subgroups. To alleviate the overwhelming challenge, efforts to improve the functional status of the underserved subpopulation should also be iterated.