Coping review of dementia fear studies among middle-aged and elderly people in the community

This study used Arksey and O’Malley’s scoping review methodology as a framework and searched the following databases:PubMed,Embase,EBSCO,CINAHL,Web of Science,Cochrane Library,Scopus,CNKI,Wanfang,VIP,and the Chinese Biomedical Literature Database.The database is open to December 20,2023,and documents related to the fear of dementia among the elderly in the community are described and analyzed to provide a reference for future research in this field.At the same time,we screened,extracted,and summarized relevant information from 21 included documents(16 in English and 5 in Chinese),which consisted of 16 cross-sectional studies,2 quasi-experimental studies,2 randomized controlled studies,and 1 longitudinal study.Sixteen of the included documents mentioned the incidence or level of dementia fear among the elderly in the community,2 addressed the adverse effects of dementia fear,and 4 reported prevention and intervention measures for dementia fear.In total,there are 8 assessment tools,and the influencing factors are categorized into sociodemographic characteristics,psychological and behavioral characteristics,sociocultural background factors,and health and dementia-related factors.The final conclusion is that the fear of dementia is common among the elderly in the community.In the future,the application of research tools should be expanded among middle-aged individuals,with considerations for other types of dementia in mind.It is recommended to conduct large-scale,multi-center randomized controlled trials while confirming the intervention’s effect on different types of middle-aged and elderly individuals,focusing on the long-term impact of these intervention measures to promote healthy aging.

Cardiovascular health awareness,risk perception,behavioural intention and INTERHEART risk stratification among middle-aged adults in Malaysia

Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in Malaysia.Methods:A cross-sectional survey with convenience sampling was conducted during November 2022 and January 2023.Participants completed validated questionnaires assessing cardiovascular health awareness,risk perception of cardiovascular diseases,behavioural intention towards adopting healthy habits,and INTERHEART risk stratification score(IHRS)based on established risk factors.A total of 602 respondents were included in the final analysis.Data were analysed with independent t-test/one-way ANOVA or Mann-Whitney/Kruskal-Wallis to test the differences,Pearson correlation or linear regression test to analyze the association of independent and dependent variables.Results:There was a significant positive correlation between medical knowledge related to cardiovascular disease(CVD)and knowledge related to CVD risk prevention,risk perception,behavioural intention and IHRS(P<0.05,Pearson correlation).Notably,individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention,risk perception,and behavioural intention.Males,laborers,active/former smokers,individuals with lower household income and educational levels,those involved in occupations not related to the healthcare sector,and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge,risk perception,and poorer behavioural intention regarding cardiovascular health(P<0.05,one-way ANOVA).While educational level,smoking status,awareness about CVD poster,self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention,risk perception,behavioral intention and/or IHRS(P<0.05,linear regression).Conclusions:These findings underscore the importance of promoting cardiovascular health awareness and risk perception among middle-aged adults to foster positive BI and reduce CVD risk.Tailored interventions targeting specific risk factors identified by INTERHEART may enhance risk stratification accuracy and facilitate targeted preventive strategies.

The Relationship between Mental Health Literacy and Subjective Well-Being of Young and Middle-Aged Residents: Perceived the Mediating Role of Social Support and Its Urban-Rural Differences

This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to February 2022,620 participants(320 rural and 300 urban residents)from three provinces of China were selected by con-venience sampling.A general data questionnaire,mental health literacy scale,perceived social support scale and subjective well-being scale were administered.The mental health literacy scores of urban residents were 3.34±0.57 and those of rural residents were 2.73±0.79.The results of multiple regression analysis showed that the mental health literacy scores of rural residents were more significant than those of urban residents in terms of sex and age,while urban residents’mental health literacy scores were more significant than those of rural resi-dents in terms of monthly income.Mental health literacy,perceived social support and subjective well-being of young and middle-aged urban and rural residents were all positively correlated(P<0.01).While the level of mental health literacy is better among urban residents than rural residents,perceived social support plays a partial mediating role between mental health literacy and subjective well-being of both urban and rural residents,and should be the focus of researchers seeking to improve the level of well-being of residents.

Correlation between psychological traits and the use of smart medical services in young and middle-aged adults: An observational study

BACKGROUND Psychological problems affect economic development.However,there is a huge gap between mental health service resources and mental health service needs.Existing mental health service technology and platforms cannot meet all the diverse mental health needs of people.Smart medicine is a new medical system based online that can effectively improve the quality and efficiency of medical services and make mental health services accessible.AIM To explore the level of intelligent medical use among young and middle-aged people and its correlation with psychological factors.METHODS Convenience sampling was used to select 200 young and middle-aged patients with medical experience at the Third People's Hospital of Chengdu between January 2022 and January 2023 as the research subjects.The general condition Questionnaire,Eysenck Personality Questionnaire,Symptom Checklist-90,General Health Questionnaire,and Smart Medical Service Use Intention Questionnaire were used to collect data.Pearson’s correlation was used to analyze the correlation between the participants’willingness to use smart medical services and their personality characteristics,psychological symptoms,and mental health.RESULTS The results revealed that the mental health of young and middle-aged people was poor,and some had psycho-logical problems such as anxiety,depression,and physical discomfort.Familiarity,acceptance,and usage of smart healthcare in this population are at a medium level,and these levels correlate with psychological characteristics.Acceptance was positively correlated with E,and negatively correlated with P,anxiety,fear,anxiety/insomnia,and social dysfunction.The degree of use was negatively correlated with P,obsessive-compulsive symptoms,depression,anxiety,hostility,paranoia,and somatic symptoms.CONCLUSION The familiarity,acceptance,and usage of smart medical services among the middle-aged and young groups are related to various psychological characteristics.

Study on the association of multimorbidity with sleep and diet in young and middle-aged adults in Chongqing region,China

Background:The prevalence of multimorbidity is increasing,with a notable shift towards younger age groups.Methods:Convenience sampling was employed to select 15,988 young and middle-aged adults in Chongqing as the study population.The Apriori algorithm was used to identify the multimorbidity patterns within this population,while an unordered binary logistic regression model was applied to assess the association between sleep,diet and the risk of multimorbidity.Results:The study population had an average age of 39.2±10.1 years.Apriori association rules revealed that the most prevalent binary chronic disease multimorbidity pattern was dyslipidaemia+hypertension(14.78%),while the most common ternary chronic disease multimorbidity pattern was diabetes+dyslipidaemia+hypertension(9.66%).The logistic regression analysis revealed that a lower rating of sleep quality was associated with an elevated risk of multimorbidity(odds ratio(OR)=1.17,95%confidence interval(CI):1.01,1.36).Individuals who adhere to a meat-based diet(OR=1.45,95%CI:1.25,1.68)and those with elevated salt intake(OR=1.22,95%CI:1.01,1.47)were also observed to have an increased risk of multimorbidity.Additionally,a greater likelihood of multimorbidity was observed among those following a spicy diet(OR=1.3,95%CI:1.11,1.52)and consuming more oil(OR=1.16,95%CI:1.01,1.33).Conclusion:A poor sleep quality and a dietary preference for meat-based,salt,spicy and oils were found to be associated with an increased risk of multimorbidity progression among young and middle-aged populations.It is recommended that young and middle-aged adults should pay attention not only to sleep duration but also to sleep quality and improve dietary habits to reduce the likelihood of multimorbidity.

Effect of Age and Sex on Stroke Mortality of Young and Middle-aged Adults in China,2002–2019,and Predictions to 2030

Objective This study aimed to examine the trends in stroke mortality among young and middle-aged adults in China.Methods Data were obtained from the China national vital registration system.Significant changes in mortality were assessed by Joinpoint regression.Age-period-cohort analysis was used to explain the reasons for the changes.Future mortality and counts were predicted by the Bayesian age-period-cohort model.Results Between 2002 and 2019,a total of 6,253,951 stroke mortality in young and middle-aged adults were recorded.The age-adjusted mortality rates(AAMRs)of women showed a downward trend.The annual percent changes(APC)were-3.5%(-5.2%,-1.7%)for urban women and-2.8%(-3.7%,-1.9%)for rural women.By contrast,the AAMRs per 100,000 for rural men aged 25–44 years continued to rise from 9.40 to 15.46.The AAMRS for urban men aged 25–44 years and urban and rural men aged 45–64years did not change significantly.Between 2020 and 2030,the projected stroke deaths are 1,423,584 in men and 401,712 in women.Conclusion Significant sex and age disparities in the trends of stroke mortality among young and middle-aged adults were identified in China.Targeted health policy measures are needed to address the burden of stroke in the young generation,especially for rural men,with a focus on the prevention and management of high risk factors.

Relationship between Waist Circumference, Waist-Height Ratio, Body Fat Percentage, Visceral Fat and Bone Mineral Density in Middle-Aged and Elderly Zhuang of China

Objective: To understand the correlation between different degrees of obesity and bone mineral density (BMD). Methods: 772 cases (300 men and 472 females) of Zhuang over 40 years old were randomly selected. The BMD and T score were calculated by measuring the right heel bone using a quantitative-ultrasound densitometer. Body composition index of body weight, waist circumference (WC), waist height ratio (WtHR), body fat percentage (BFP) and visceral fat (VF) were measured using a bioelectrical impedance method. Results: The BMI, WC, and WtHR of the male osteoporosis group were lower than those of the normal bone mass (NBM) group (P Conclusion: BMI is positively correlated with BMD in Zhuang. BFP has a greater correlation with female BMD, and a small reduction in BFP can result in a significant decrease in BMD. BMD of male was positively correlated with abdominal obesity indicators (WC, WtHR, VF). However, abdominal obesity has no obvious effect on the promotion of BMD in women, and increased WtHR can lead to a decrease in BMD. Zhuang can appropriately increase the amount of fat within the normal weight range. At the same time, reasonable exercise and balanced nutrition to avoid excessive obesity or low body weight can reduce the incidence of osteoporosis and osteoporosis fractures.

Excessive 5-year weight gain predicts metabolic syndrome development in healthy middle-aged adults

AIM:To quantitatively examine the impacts of an easyto-measure parameter-weight gain-on metabolic syndrome development among middle-aged adults. METHODS:We conducted a five-year interval observational study.A total of 1384 middle-aged adults not meeting metabolic syndrome(MetS)criteria at the initial screening were included in our analysis.Baseline data such as MetS-components and lifestyle factors were collected in 2002.Body weight and MetS-components were measured in both 2002 and 2007.Participants were classified according to proximal quartiles of weight gain(WG)in percentages(%WG≤1%,1%< %WG≤5%,5%<%WG≤10%and%WG>10%, defined as:control,mild-WG,moderate-WG and severe-WG groups,respectively)at the end of the follow-up. Multivariate models were used to assess the association between MetS outcome and excessive WG in the total population,as well as in both genders. RESULTS:In total,175(12.6%)participants fulfilled MetS criteria within five years.In comparison to the control group,mild-WG adults had an insignificant risk for MetS development while adults having moderate-WG had a 3.0-fold increased risk for progression to MetS [95%confidence interval(CI),1.8-5.1],and this risk was increased 5.4-fold(95%CI,3.0-9.7)in subjects having severe-WG.For females having moderate-and severe-WG,the risk for developing MetS was 3.6(95% CI,1.03-12.4)and 5.5(95%CI,1.4-21.4),respectively. For males having moderate-and severe-WG,the odds ratio for MetS outcome was respectively 3.0(95%CI, 1.6-5.5)and 5.2(95%CI,2.6-10.2). CONCLUSION:For early-middle-aged healthy adults with a five-year weight gain over 5%,the severity of weight gain is related to the risk for developing metabolic syndrome.

The Moderating Effect of Health on the Relationship between Involvement in Housework of Parents’ and Parents-in-Law’s Families and Happiness of Middle-Aged Women in Taiwan

Background: This study aims to investigate the moderating effect of family health status on the relationship between involvement in housework of two-side parents’ families and happiness of middle-aged women in Taiwan. Methods: The data used in this study were gathered from the Ministry of Science and Technology’s program—“Intergenerational expectation and collaboration: an inquiry on a new mechanism of continued tradition across generations”. The subjects (n = 512) were restricted to aged 45 - 64 years old who live with spouses and have children, and one of whose parent or parent-in-law is still alive. Multiple regression analysis was used to investigate how family health status moderates the relationship between involvement in housework of parents’ families and parents-in-law’s families and the happiness of middle-aged women. Results: 1) Family health status is positively correlated with their happiness. 2) The parents’ health status can moderate the relationship between involvement in housework of parents’ families and happiness of the middle-aged women. 3) The middle-aged women’s health status can moderate the relationship between involvement in housework of parents-in-law’s families and those women’s happiness, and fathers-in-law’s health status can moderate the relationship between husbands’ involvement in housework of the women’s parents-in-law’s families and women’s happiness. Conclusions: In future, when policies and programs related to the well-being of middle-aged women are being planned, the effect of women’s health and family health status shall be considered as a key to improve those women’s quality of life.

MEN1在消化系统肿瘤中的研究进展

多发性内分泌腺肿瘤型1(MEN1)基因通过编码Menin调节细胞增殖和凋亡等过程,并且参与多个信号通路的调节,包括Wnt/β-catenin、Notch、Hedgehog/Dnmt1、Hippo等信号通路,这些都与肿瘤的发生、发展密切相关。因此,MEN1的突变或功能缺陷可能导致肿瘤发生的风险增加。以往关于MEN1的研究主要集中于神经内分泌肿瘤,MEN1在神经内分泌肿瘤中作为抑癌基因发挥作用,其缺失突变引起的基因功能丧失,参与了神经内分泌肿瘤的发生发展。但近年研究表明,MEN1在不同的肿瘤中发挥不同的作用,如在胃癌中通过抑制IQ基元GTP酶激活蛋白1(IQGAP1)表现为抑癌基因,在肝癌中则通过甲基化相关途径表现为癌基因,在结直肠癌中通过自噬相关机制也表现为癌基因;而在食管癌、胰腺癌中MEN1的作用尚存在争议。现就近年来MEN1在消化系统肿瘤中的研究进展做一综述。

Association of fatigue with short-term prognosis in young and middle-aged patients with coronary heart disease

Background:To investigate the effect of fatigue on the short-term prognosis of young and middle-aged patients with coronary heart disease(CHD).Methods:A cross-sectional,observational survey was distributed at a tertiary hospital in Suzhou,China.Patients were assessed for fatigue and their prognosis was assessed at 3 and 6 months after discharge.General Information Questionnaire,Fatigue Scale and Seattle Angina Questionnaire(SAQ)were used for the survey.The Cox proportional hazard model was used to analyze the impact of fatigue on the occurrence of major adverse cardiac events(MACEs)at 3 and 6 months after discharge.Multiple linear regression models were used to analyze the effect of fatigue on health-related quality of life(HRQoL)at 3 and 6 months after discharge.Results:199 patients were followed up with in the end.43 patients(21.6%)with MACE three months after discharge had a total SAQ score of(399.76±39.61).The overall SAQ score was(425.14±22.66)and 52 patients(26.1%)experienced MACE six months after discharge.Fatigue was identified as a risk factor for MACE 6 months after discharge by the Cox proportional hazard model(HR=2.939,95%CI:0.177~0.655,P=0.001)and as an independent risk factor for quality of life 3 and 6 months after discharge by multiple linear regression(P<0.001).Conclusions:In individuals who are young or middle-aged and have coronary heart disease,fatigue is a risk factor for the short-term prognosis.It is advised that clinical professionals prioritize patient fatigue assessment and improve management of fatigue symptoms.

Influencing factors of fatigue in young and middle-aged patients with coronary heart disease:a cross-sectional study

Objective:To examine the present state of fatigue in young and middle-aged patients with coronary heart disease(CHD)and to identify the elements that may be affecting it.Methods:From December 2020 to June 2021,240 young and middle-aged patients with CHD who were being treated in the cardiology department of a tertiary care hospital in Suzhou were chosen using a convenience sampling method in order to gather data on the patients’sociodemographic status,fatigue,social support,and stress.Results:Of the 240 disseminated questionnaires,220 valid responses were returned,resulting in an effective recovery rate of 91.67%.The frequency of exhaustion was 51.8%,and the fatigue score was(5.27±2.77).The stress score was(11.15±3.36),while the overall social support score was(39.13±4.72).Binary logistic regression analysis indicated that age,exercise,staying up late,stress,social support,high-sensitivity troponin T,high-density lipoprotein,and ejection fraction were independent risk factors for fatigue in young and middle-aged patients with CHD(P<0.05).Conclusions:Fatigue is more prevalent in young and middle-aged patients with CHD.Clinical nurses can create a unique management plan for patients based on their lifestyle and behavioral patterns,stress levels,social support,and clinical signs to reduce fatigue.

Epidemiological Profile of Men Who Have Sex with Men: First Data about Male Sex Workers in Central African Republic (CAR)

Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex workers (SW) among them, as well as the proportion of MSM who have been victims of gender-based violence (GBV). Material and Methods: A cross-sectional study coordinated by the Direction de la Médecine du Travail was carried out at the headquarters of the association ALTERNATIVES in Bangui Bangui from July 1 to October 31, 2021. Consenting MSM present during the study period were systematically included. Sociodemographic variables, those relating to the future vision of the activity and to GBV were collected and analyzed using Epi-Info version 7 software. Results: Forty MSM with an average age of 23 years and mainly secondary education (75.0%) were included. The vast majority of MSM were unemployed (85.0%). 45.0% had been victims of GBV and wanted to stop working as an MSM (47.5%), and almost 2/3 (65.0%) would accept another income-generating activity in exchange for the MSM. Violence was sexual (32.5%), economic (22.5%), physical (20.0%), verbal (12.5%) and psychological (12.5%). Conclusion: The MSM were mainly young, poorly educated, unemployed, and almost half were victims of GBV. The desire to change MSM activity to another income-generating activity alongside that of MSM shows that many of them are SW, workers in the informal sector. This must be taken into account in prevention activities, even if the data needs to be confirmed on a much larger sample.

MEN1基因在前列腺癌中生物学功能的研究进展

近二十年来,我国前列腺癌的发病率逐年攀升,已经成为泌尿外科三大恶性肿瘤中最常见的一种。当下我国前列腺癌患者中,初诊即晚期的比例相比于欧美日等发达国家仍然较高,且有超过70%的晚期前列腺癌病患发生转移,若出现远处转移,其患者生存率仅为30%。因此,进一步寻找新的诊疗分子靶点就具有更加重要的现实意义和理论价值。研究证实多发性内分泌肿瘤1型(MEN1)基因编码的menin蛋白参与前列腺癌的发生发展,同时menin是前列腺治疗潜在的新靶点。该文将对MEN1基因结构及menin在前列腺癌中的生物学功能进行概述,重点探讨menin调控前列腺癌细胞增殖、迁移与侵袭的分子机理。以期为MEN1基因及menin蛋白在前列腺癌中的深入研究提供参考。

MEN1基因阴性的多发性内分泌腺瘤1型合并2型糖尿病1例病例报道

多发性内分泌腺瘤病(MEN)是一组遗传性多种内分泌器官发生肿瘤综合征的总称,是指一个人同时或先后出现两个或两个以上的内分泌腺增生或肿瘤病变,可合并功能亢进[1]。多发性内分泌腺瘤1型(MEN1)是多发性内分泌腺瘤病的一种类型,是一种罕见的常染色体显性遗传综合征,又称为Weber综合征,以甲状旁腺肿瘤、胃肠胰腺神经内分泌肿瘤和垂体前叶肿瘤为特征[2]。MEN1也可累及肾上腺皮质和其他组织(如甲状腺、支气管、胸腺、脂肪等)[3]。MEN1临床上比较罕见,尤其是症状、体征不典型者,更容易漏诊、误诊。本科近期收治MEN1阴性的多发性内分泌腺瘤1型合并2型糖尿病1例,现报告如下,以提高临床医师对本病的认识。

Physiotherapist-led home-based physical activity program versus community group exercise for middle-aged adults: Quasi-experimental comparison

Objectives: Program method, program deliverer and participant preference may be important factors in increasing physical activity adherence and program effectiveness. To investigate this, we compared two physical activity interventions in middle-aged adults. Methods: Using a pragmatic quasi-experimental design, sedentary community dwelling 50 - 65 year olds (n = 2105) were recruited to a non-randomized 6-month community group exercise program (n = 93) or a physiotherapist-led home-based physical activity program (n = 65). The primary outcome was physical activity adherence derived from exercise diaries. Secondary outcomes included the Active Australia Survey, aerobic capacity (step- test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio (WHR) and body mass index. Results: Home-based participants were more likely to be younger, working full-time and not in a relationship (p Thirty-three percent of the group participants attended ≥ 70% of group exercise sessions. Ninety percent of home-based participants received ≥ 4 of the planned 6 telephone support calls. Intention-to-treat analysis found adherence to the physical activity sessions prescribed was the same for both interventions (26% ± 28% vs. 28% ± 35%). Both interventions significantly increased the number of participants achieving self-reported “sufficient” physical activity (p ≤ 0.001) and significantly decreased waist circumference (p < 0.001) and WHR (p 0.05). Conclusion: The physiotherapist- led home-based physical activity program, requiring few resources, appears to have increased the adoption of physical activity and adherence to physical activity program requirements for sedentary middle-aged adults. The home-based program, providing equivalent health benefits to the group exercise program, may be particularly suitable for those not interested in or unable to attend a group exercise program. Clinical Trial Registration number Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN126 1000890932.

Urethroplasty among Elderly Men, Surgical Techniques and Outcomes

Introduction: Urethroplasty remains the gold standard for the management of urethral stricture. However, the treatment of stricture disease in the elderly tends to be less invasive due to the presumption that they might not be able to stand long hours of surgery and might have higher rates of recurrence due to poor wound healing from microangiopathy. We present our experience with the outcomes of urethroplasty among elderly men seen at the Komfo Anokye Teaching Hospital from January 2012 to December 2021. Methods: This was a retrospective review of data captured in the urology database on all patients 65 years and above who underwent urethroplasty at the hospital over the study period. Data was obtained on patients’ demographics, stricture characteristics, urethroplasty technique, and outcome. A successful outcome was defined as peak flow rate > 15 mls/s, a patent urethra on retrograde urethrogram, patient satisfaction with urine stream, or restoration of the normal stream of urine with only one attempt at urethral calibration or internal urethrotomy postoperatively. Data was analyzed using PASW Statistics for Windows, Version 18.0. Results: Overall, 43 urethroplasties were done over the study period in elderly men. The age range was 65 to 87 years. The commonest aetiology was catheterization (62.79%) followed by urethritis (32.56%). Stricture length ranged from 0.5 cm to 16 cm with a mean of 3.93 cm. Most patients (60.46%) had bulbar urethral strictures. The repair methods employed were anastomotic urethroplasty (62.80%), fasciocutaneous flap (FCF) ventral onlay (13.95%), buccal mucosa graft (BMG) ventral onlay urethroplasty (4.65%), and staged urethroplasty (4.65%). Three of the patients (6.98%) had a combination of anastomotic and tissue transfer urethroplasty. The overall success rate was 88.37%. Complications included three surgical site infections, two urethral diverticula and one glans dehiscence. Conclusion: Elderly men tolerate urethroplasty well and the procedure should not be denied solely based on age.

Knowledge, Health Beliefs and Screening Status of Prostate Cancer among Middle-Aged and Elderly Men

Purpose: The aim of this study was to examine and evaluate the level of prostate cancer knowledge and health beliefs among middle-aged and elderly men. Methods: In this descriptive study carried out in December 20, 2015 through January 20, 2016, we enrolled 147 men aged 50 - 70 years old. Data were collected by using three questionnairs including knowledge, health beliefs, and screening status of prostate cancer. Results: Our findings showed that only 20.4% of interviewers had experience of digital rectal examination or prostatic specific antigen test for prostate cancer screening. The prostate cancer knowledge was found to be significantly high in prostate cancer examinees compared to non-examinees. The correct answer rate of prostate cancer knowledge was only 44.7% at average. Despite of good perceived seriousness about prostate cancer, the screening rate was only 20.4% and the examinees indicated significantly high perceived sensitivity compared to non-examinees. The level of the perceived barrier was lower in men who had experience in health examination or prostate cancer examination than without experience. Conclusion: The significant factors including age, educational level, income and cancer insurance status need to be considered in nursing education program in order to deliver accurate knowledge about prostate cancer. Also, the effective interventions are necessary to increase sensitivity and reduce barriers of prostate cancer and screening.

Effects of Fertilization on Growth and Soil of Middle-aged Slash Pine Forest

In order to promote the growth of mid-aged Pinus elliottii plantation, the effects of different fertilizing amounts of formula fertilizer were studied on the growth, the soil and cost-benefit of 9 year-old Pinus el/iottii plantations in the north- ern part of Hunan, China. Three years after fertilization, the results showed that the increments of DBH, height, individual volume and stock volume of stand, and the fertilizer benefit of the different fertilization treatments were higher than the control to varying degrees, and among them, 700 g/tree was the best for promoting the growth of Pinus elliottii. Two years fertilization, the soil nutrients were improved compared with before, pH values of different layers decreased, organic matter and rapid available K contents increased, and rapid available N content increased dra- matically with the upper layer having an increase higher than the lower one; rapid available P decreased at different levels with the upper layer having a decrease lower than the lower one; and proper application of fertilizer could promote the growth of Pisolithus tinctofius, and 7 months after fertilization, the number of Pisolithus fruiting body generally increased with the increase of the fertilizer within 100-800 g/tree. The yield and benefit per unit area could be increased by fertiliza- tion for 1 time in middle-aged Pinus elliottii plantations, and the best fertilizing amount was N-P-K fertilizer 700 g/tree.

Case of clear-cell hepatocellular carcinoma that developed in the normal liver of a middle-aged woman

A 36-year-old woman was admitted to our department for close examination of a liver tumor that was found during a medical checkup. Abdominal US, CT and MRI showed a tumor in segment 7 (S7) of the liver. Although imaging suggested hepatocellular carcinoma, laboratory tests showed no abnormality in liver function, hepatitis virus markers were negative, and tumor markers including protein induced by vitamin K absence or antagonist Ⅱ (PIVKA-Ⅱ), α-fetoprotein (AFP), carbohydrate antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA) were all within normal ranges. Upon aspiration biopsy of the liver, the histopathological diagnosis was moderately differentiated hepatocellular carcinoma. Therefore, right hepatectomy was performed. Although a part of the tumor was necrotic, about 60% of the viable part showed a clear-cell variant. Consequently, it was diagnosed as clear-cell hepatocellular carcinoma. It was noted that the background liver tissue was normal. This case is worthy of reporting because development of clear-cell hepatocellular carcinoma in the normal liver of a middle-aged woman is rarely seen.