Neuropsychiatric disorders arise from complex interactions between genetic and environmental factors. DNA methylation, a reversible and environmentally responsive epigenetic regulatory mechanism, serves as a crucial bridge linking environmental exposure, gene expression regulation, and neurobehavioral outcomes. During long-duration deep-space missions, astronauts face multiple stressors-including microgravity, cosmic radiation, circadian rhythm disruption, and social isolation, which can induce alterations in DNA methylation and increase the risk of neuropsychiatric disorders. Genome-wide DNA methylation research can be divided into 3 major methodological stages: Study design, sample preparation and detection, and data analysis, each of which can be applied to astronaut neuropsychiatric health monitoring. Systematic comparison of the Illumina MethylationEPIC array and whole-genome bisulfite sequencing reveals their complementary strengths in terms of genomic coverage, resolution, cost, and application scenarios: the array method is cost-effective and suitable for large-scale population studies and longitudinal monitoring, whereas sequencing provides higher resolution and coverage and is more suitable for constructing detailed methylation maps and characterizing individual variation. Furthermore, emerging technologies such as single-cell methylation sequencing, nanopore long-read sequencing, and machine-learning-based multi-omics integration are expected to greatly enhance the precision and interpretability of epigenetic studies. These methodological advances provide key support for establishing DNA-methylation-based monitoring systems for neuropsychiatric risk in astronauts and lay an epigenetic foundation for safeguarding neuropsychiatric health during future long-term deep-space missions.
{"title":"A comprehensive guide to genome<b>-</b>wide DNA methylation research in neuropsychiatric disorders and its implications for deep<b>-</b>space environments.","authors":"Sheng Xu, Shishi Min, Haixia Gu, Xueying Wang, Chao Chen","doi":"10.11817/j.issn.1672-7347.2025.250387","DOIUrl":"10.11817/j.issn.1672-7347.2025.250387","url":null,"abstract":"<p><p>Neuropsychiatric disorders arise from complex interactions between genetic and environmental factors. DNA methylation, a reversible and environmentally responsive epigenetic regulatory mechanism, serves as a crucial bridge linking environmental exposure, gene expression regulation, and neurobehavioral outcomes. During long-duration deep-space missions, astronauts face multiple stressors-including microgravity, cosmic radiation, circadian rhythm disruption, and social isolation, which can induce alterations in DNA methylation and increase the risk of neuropsychiatric disorders. Genome-wide DNA methylation research can be divided into 3 major methodological stages: Study design, sample preparation and detection, and data analysis, each of which can be applied to astronaut neuropsychiatric health monitoring. Systematic comparison of the Illumina MethylationEPIC array and whole-genome bisulfite sequencing reveals their complementary strengths in terms of genomic coverage, resolution, cost, and application scenarios: the array method is cost-effective and suitable for large-scale population studies and longitudinal monitoring, whereas sequencing provides higher resolution and coverage and is more suitable for constructing detailed methylation maps and characterizing individual variation. Furthermore, emerging technologies such as single-cell methylation sequencing, nanopore long-read sequencing, and machine-learning-based multi-omics integration are expected to greatly enhance the precision and interpretability of epigenetic studies. These methodological advances provide key support for establishing DNA-methylation-based monitoring systems for neuropsychiatric risk in astronauts and lay an epigenetic foundation for safeguarding neuropsychiatric health during future long-term deep-space missions.</p>","PeriodicalId":39801,"journal":{"name":"中南大学学报(医学版)","volume":"50 8","pages":"1320-1336"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Objectives: </strong>In the early stage of central cervical disc herniation, clinical symptoms may be mild. However, as the spinal cord becomes compressed by herniated nucleus pulposus tissue, progressive edema and degeneration may occur, resulting in more severe clinical manifestations, including limb weakness, bladder and bowel dysfunction, spastic paraplegia of the lower extremities, and even respiratory difficulty. The spinal endoscopic Key-hole technique is widely applied in treating radiculopathic cervical spondylosis and has demonstrated good clinical outcomes. This study aims to analyze and summarize the technical points and therapeutic efficacy of the far lateral Key-hole technique in the treatment of central cervical disc herniation, providing reference for clinical application.</p><p><strong>Methods: </strong>Eight patients with central cervical disc herniation treated with the far lateral Key-hole technique were included as the experimental group. Another 8 patients who underwent single-level anterior cervical diskectomy and fusion (ACDF) during the same period were selected as the control group. Data collected included gender, age, intraoperative blood loss, incision length, and length of hospitalization. Pain severity was evaluated using the Visual Analogue Scale (VAS); cervical function was assessed using the Japanese Orthopaedic Association (JOA) score; and cervical disability was measured by the neck disability index (NDI). Radiological outcomes were assessed using disc height index (DHI), cervical Cobb angle, and operative segment Cobb angle.</p><p><strong>Results: </strong>Compared with the control group, the experimental group had significantly less intraoperative blood loss, shorter incision length, and shorter hospital stay (all <i>P</i><0.05), while there was no significant difference in operation time (<i>P</i>>0.05). Postoperative VAS and NDI scores in both groups were significantly lower than preoperative values, and JOA scores significantly improved (<i>P</i><0.05). No significant differences were noted between the two groups preoperatively (<i>P</i>>0.05). Postoperatively, the experimental group showed significantly lower VAS and NDI scores and higher JOA scores than the control group (<i>P</i><0.05). There was no statistical significance in DHI before and after surgery in the experimental group (<i>P</i>>0.05), while the DHI increased significantly postoperatively in the control group (<i>P</i><0.05). Postoperative DHI in the experimental group was significantly lower than in the control group (<i>P</i><0.05). No significant differences were observed in the cervical Cobb angle either within or between groups (all <i>P</i>>0.05). The operative segment Cobb angle increased significantly after surgery in the control group (<i>P</i><0.05), while no other operative segment angle changes were statistically significant (all <i>P</i>>0.05).</p><p><strong>Conclusions: </strong>The far lateral Key-hole technique offe
{"title":"[Efficacy of the far lateral Key-hole technique in the treatment of central cervical disc herniation].","authors":"Zhenyu Meng, Jingbo Xue, Xuelin Li, Zhun Xu, Jinghua Tan, Yong Xie, Yiguo Yan","doi":"10.11817/j.issn.1672-7347.2025.250139","DOIUrl":"10.11817/j.issn.1672-7347.2025.250139","url":null,"abstract":"<p><strong>Objectives: </strong>In the early stage of central cervical disc herniation, clinical symptoms may be mild. However, as the spinal cord becomes compressed by herniated nucleus pulposus tissue, progressive edema and degeneration may occur, resulting in more severe clinical manifestations, including limb weakness, bladder and bowel dysfunction, spastic paraplegia of the lower extremities, and even respiratory difficulty. The spinal endoscopic Key-hole technique is widely applied in treating radiculopathic cervical spondylosis and has demonstrated good clinical outcomes. This study aims to analyze and summarize the technical points and therapeutic efficacy of the far lateral Key-hole technique in the treatment of central cervical disc herniation, providing reference for clinical application.</p><p><strong>Methods: </strong>Eight patients with central cervical disc herniation treated with the far lateral Key-hole technique were included as the experimental group. Another 8 patients who underwent single-level anterior cervical diskectomy and fusion (ACDF) during the same period were selected as the control group. Data collected included gender, age, intraoperative blood loss, incision length, and length of hospitalization. Pain severity was evaluated using the Visual Analogue Scale (VAS); cervical function was assessed using the Japanese Orthopaedic Association (JOA) score; and cervical disability was measured by the neck disability index (NDI). Radiological outcomes were assessed using disc height index (DHI), cervical Cobb angle, and operative segment Cobb angle.</p><p><strong>Results: </strong>Compared with the control group, the experimental group had significantly less intraoperative blood loss, shorter incision length, and shorter hospital stay (all <i>P</i><0.05), while there was no significant difference in operation time (<i>P</i>>0.05). Postoperative VAS and NDI scores in both groups were significantly lower than preoperative values, and JOA scores significantly improved (<i>P</i><0.05). No significant differences were noted between the two groups preoperatively (<i>P</i>>0.05). Postoperatively, the experimental group showed significantly lower VAS and NDI scores and higher JOA scores than the control group (<i>P</i><0.05). There was no statistical significance in DHI before and after surgery in the experimental group (<i>P</i>>0.05), while the DHI increased significantly postoperatively in the control group (<i>P</i><0.05). Postoperative DHI in the experimental group was significantly lower than in the control group (<i>P</i><0.05). No significant differences were observed in the cervical Cobb angle either within or between groups (all <i>P</i>>0.05). The operative segment Cobb angle increased significantly after surgery in the control group (<i>P</i><0.05), while no other operative segment angle changes were statistically significant (all <i>P</i>>0.05).</p><p><strong>Conclusions: </strong>The far lateral Key-hole technique offe","PeriodicalId":39801,"journal":{"name":"中南大学学报(医学版)","volume":"50 8","pages":"1408-1417"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-28DOI: 10.11817/j.issn.1672-7347.2025.250121
Zhengzong Liu, Yanjun Chen, Jin Liu, Xiaotian Zhao, Yumeng Ju, Bangshan Liu, Yan Zhang, Jiao Cheng
Objectives: Mobile phone dependence has become increasingly prominent among university students, posing significant risks to their social functioning and mental health. Previous studies suggest that perfectionistic personality traits may be key psychological predictors of mobile phone dependence, but the underlying mechanisms remain unclear. This study aims to identify core symptoms of mobile phone dependence among university students and to examine the pattern of associations between different dimensions of perfectionism and mobile phone dependence.
Methods: A cross-sectional questionnaire survey was conducted among 1404 university students nationwide. The Mobile Phone Involvement Questionnaire (MPIQ) and the Forst Multidimensional Perfectionism Scale (FMPS) were used to assess mobile phone use and perfectionism traits. The EBIC-GLASSO network model was constructed to analyze the network structure linking perfectionism and mobile phone dependence.
Results: A total of 56.48% of university students in the sample met the criteria for mobile phone dependence. The total FMPS score was positively correlated with the total MPIQ score (r=0.47, P<0.001). Results of multiple linear regression controlling for demographic variables showed that dimensions of FMPS score significantly predicted MPIQ score (all P<0.05). Network analysis revealed that the central dimension in perfectionism is "organization" (expected influence=2.69) and the core symptom of mobile phone dependence was "I lose track of how much I am using my smartphone" (expected influence= 0.78). Bridge centrality analysis identified "organization" as a key bridging factor linking perfectionism and mobile phone dependence (bridge strength=1.96). Among the symptom-to-symptom connections, "parental expectations" showed the strongest positive association with "arguments have arisen with others because of my mobile phone use" (partial correlation coefficient=0.15), serving as a risk factor. In contrast, "organization" was most strongly negatively associated with the same symptom (partial correlation coefficient=-0.13), serving as a protective factor, suggesting a protective effect.
Conclusions: Mobile phone dependence is common among college students and is primarily characterized by a lack of self-control in phone use. Although perfectionism is generally positively associated with mobile phone dependence, its internal dimensions appear to exert a dual effect. Specifically, "parental expectations" and "doubt over actions" may increase the risk of mobile phone dependence, whereas "organization" serves as a protective factor, particularly against interpersonal conflicts related to phone dependency.
{"title":"[Network analysis of the relationship between perfectionism traits and mobile phone dependence among Chinese university students].","authors":"Zhengzong Liu, Yanjun Chen, Jin Liu, Xiaotian Zhao, Yumeng Ju, Bangshan Liu, Yan Zhang, Jiao Cheng","doi":"10.11817/j.issn.1672-7347.2025.250121","DOIUrl":"10.11817/j.issn.1672-7347.2025.250121","url":null,"abstract":"<p><strong>Objectives: </strong>Mobile phone dependence has become increasingly prominent among university students, posing significant risks to their social functioning and mental health. Previous studies suggest that perfectionistic personality traits may be key psychological predictors of mobile phone dependence, but the underlying mechanisms remain unclear. This study aims to identify core symptoms of mobile phone dependence among university students and to examine the pattern of associations between different dimensions of perfectionism and mobile phone dependence.</p><p><strong>Methods: </strong>A cross-sectional questionnaire survey was conducted among 1404 university students nationwide. The Mobile Phone Involvement Questionnaire (MPIQ) and the Forst Multidimensional Perfectionism Scale (FMPS) were used to assess mobile phone use and perfectionism traits. The EBIC-GLASSO network model was constructed to analyze the network structure linking perfectionism and mobile phone dependence.</p><p><strong>Results: </strong>A total of 56.48% of university students in the sample met the criteria for mobile phone dependence. The total FMPS score was positively correlated with the total MPIQ score (<i>r</i>=0.47, <i>P</i><0.001). Results of multiple linear regression controlling for demographic variables showed that dimensions of FMPS score significantly predicted MPIQ score (all <i>P<</i>0.05). Network analysis revealed that the central dimension in perfectionism is \"organization\" (expected influence=2.69) and the core symptom of mobile phone dependence was \"I lose track of how much I am using my smartphone\" (expected influence= 0.78). Bridge centrality analysis identified \"organization\" as a key bridging factor linking perfectionism and mobile phone dependence (bridge strength=1.96). Among the symptom-to-symptom connections, \"parental expectations\" showed the strongest positive association with \"arguments have arisen with others because of my mobile phone use\" (partial correlation coefficient=0.15), serving as a risk factor. In contrast, \"organization\" was most strongly negatively associated with the same symptom (partial correlation coefficient=-0.13), serving as a protective factor, suggesting a protective effect.</p><p><strong>Conclusions: </strong>Mobile phone dependence is common among college students and is primarily characterized by a lack of self-control in phone use. Although perfectionism is generally positively associated with mobile phone dependence, its internal dimensions appear to exert a dual effect. Specifically, \"parental expectations\" and \"doubt over actions\" may increase the risk of mobile phone dependence, whereas \"organization\" serves as a protective factor, particularly against interpersonal conflicts related to phone dependency.</p>","PeriodicalId":39801,"journal":{"name":"中南大学学报(医学版)","volume":"50 8","pages":"1418-1427"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-28DOI: 10.11817/j.issn.1672-7347.2025.250268
Shuang Hu, Haojun You, Jing Lei
Exercise-induced analgesia (EIA) refers to the elevation of pain thresholds and reduction in sensitivity to noxious stimuli achieved through exercise training. As a non-pharmacological treatment strategy, exercise therapy has demonstrated positive effects on both acute and chronic pain. Increasing evidence indicates that modulation of glial cell activity is an important mechanism underlying analgesia. Spinal glial cells contribute to the development and maintenance of pathological pain by promoting pain signal transmission through inflammatory responses and synaptic remodeling. Exercise can differentially regulate microglia and astrocyte activity, inhibiting multiple inflammatory signaling pathways, such as P2X4/P2X7 purinergic receptors, brain-derived neurotrophic factor (BDNF)/phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR), interleukin (IL)-6/Janus kinase (JAK) 2/signal transducer and activator of transcription 3 (STAT3), p38-mitogen-activated protein kinases (MAPK), and Toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB), thereby reducing the release of pro-inflammatory cytokines, decreasing inflammatory and nociceptive hypersensitivity, and alleviating pathological pain. This review also summarized the effects of different exercise intensities, durations, and frequencies on glial cell responses in order to provide a theoretical foundation for optimizing exercise-based interventions for pathological pain conditions.
{"title":"[Mechanisms of spinal microglia and astrocytes in exercise-induced analgesia].","authors":"Shuang Hu, Haojun You, Jing Lei","doi":"10.11817/j.issn.1672-7347.2025.250268","DOIUrl":"10.11817/j.issn.1672-7347.2025.250268","url":null,"abstract":"<p><p>Exercise-induced analgesia (EIA) refers to the elevation of pain thresholds and reduction in sensitivity to noxious stimuli achieved through exercise training. As a non-pharmacological treatment strategy, exercise therapy has demonstrated positive effects on both acute and chronic pain. Increasing evidence indicates that modulation of glial cell activity is an important mechanism underlying analgesia. Spinal glial cells contribute to the development and maintenance of pathological pain by promoting pain signal transmission through inflammatory responses and synaptic remodeling. Exercise can differentially regulate microglia and astrocyte activity, inhibiting multiple inflammatory signaling pathways, such as P2X4/P2X7 purinergic receptors, brain-derived neurotrophic factor (BDNF)/phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR), interleukin (IL)-6/Janus kinase (JAK) 2/signal transducer and activator of transcription 3 (STAT3), p38-mitogen-activated protein kinases (MAPK), and Toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB), thereby reducing the release of pro-inflammatory cytokines, decreasing inflammatory and nociceptive hypersensitivity, and alleviating pathological pain. This review also summarized the effects of different exercise intensities, durations, and frequencies on glial cell responses in order to provide a theoretical foundation for optimizing exercise-based interventions for pathological pain conditions.</p>","PeriodicalId":39801,"journal":{"name":"中南大学学报(医学版)","volume":"50 8","pages":"1455-1464"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-28DOI: 10.11817/j.issn.1672-7347.2025.250243
Yangyiyi Yu, Jiale Liu, Pu Peng, Ting Yuan, Jinrong Zeng, Jianyun Lu
<p><strong>Objectives: </strong>Depressive and anxiety disorders are among the most common mental disorders worldwide and are associated with unhealthy lifestyle behaviors. The Life's Simple 7 (LS7) guideline proposed by the American Heart Association aims to reduce cardiovascular risk by improving behaviors such as diet and physical activity, but its impact on mental health is not yet fully clear. This study examined the association between LS7 scores and symptoms of anxiety and depression in adults undergoing routine health examinations.</p><p><strong>Methods: </strong>Data were collected from individuals who underwent health examinations from May 2015 to December 2024 at the Health Management Center of the Third Xiangya Hospital. All participants completed the LS7 assessments, the Self-Rating Depression Scale (SDS), and the Self-Rating Anxiety Scale (SAS). Participants were categorized into 4 LS7 score groups: Low (≤7), average (8-9), good (10), and excellent (11-14). Those with SDS or SAS≥50 were classified as having mental disorder symptoms; with this group, SAS≥50 indicated anxiety, SDS≥50 indicated depression, and SDS and SAS≥50 indicated comorbid anxiety-depression. Binary logistic regression was used to assess associations between LS7 score and mental symptoms, calculating odds ratio (<i>OR</i>) and 95% confidence interval (<i>CI</i>). A restricted cubic spline (RCS) regression model was used to analyze the dose-response relationship between LS7 score (continuous variable) and the risk of mental symptoms. Nodes were set at the 5th, 35th, 65th, and 95th percentiles of the LS7 score, with the 5th percentile as the reference point. All models were adjusted for covariates such as gender, age, living alone, drinking status, education level, and sleep quality. Logistic regression framework was used to fit and calculate the adjusted <i>OR</i> (a<i>OR</i>) and 95% <i>CI</i>. Nonlinear relationship tests were also conducted. Subgroup analysis was performed to explore the interaction between gender, age, drinking habits, education level, and other factors and the LS7 score in influencing the risk of mental symptoms.</p><p><strong>Results: </strong>A total of 5 449 participants were included; 1 363 (25.01%) had depressive symptoms, 398 (7.30%) had anxiety symptoms, and 259 (4.75%) had comorbid anxiety-depression. The prevalence of mental symptoms decreased significantly as LS7 scores increased. Univariate and multivariate Logistic regression indicated that LS7 score≥8 was protective against mental symptoms. Multivariate Logistic regression demonstrated moderate discriminative ability (AUC=0.672). Among individuals with anxiety, depression, or comorbid symptoms, LS7 score distributions showed a graded decrease from poor to excellent groups. After adjustment, an excellent LS7 score was associated with a 39% lower risk of depression (<i>aOR</i>=0.61, 95% <i>CI</i> 0.47 to 0.78, <i>P</i><0.001), a 63% lower risk of anxiety (<i>aOR</i>=0.37, 95% <i>CI</
目的:抑郁症和焦虑症是世界范围内最常见的精神障碍之一,与不健康的生活方式行为有关。美国心脏协会提出的简单生活7 (LS7)指南旨在通过改善饮食和体育活动等行为来降低心血管风险,但其对心理健康的影响尚不完全清楚。本研究考察了接受常规健康检查的成年人的LS7评分与焦虑和抑郁症状之间的关系。方法:收集2015年5月至2024年12月在湘雅第三医院健康管理中心进行健康检查的个体数据。所有参与者完成了LS7、抑郁自评量表(SDS)和焦虑自评量表(SAS)。参与者被分为4个LS7评分组:低(≤7),平均(8-9),良好(10)和优秀(11-14)。SDS或SAS≥50的患者被归类为精神障碍症状;本组SAS≥50为焦虑,SDS≥50为抑郁,SDS和SAS≥50为焦虑抑郁共病。采用二元逻辑回归评估LS7评分与精神症状之间的关联,计算优势比(OR)和95%置信区间(CI)。采用限制性三次样条(RCS)回归模型分析LS7评分(连续变量)与精神症状风险之间的剂量-反应关系。节点设置在LS7评分的第5、35、65、95百分位,以第5百分位为参考点。所有模型都对协变量进行了调整,如性别、年龄、独居、饮酒状况、教育水平和睡眠质量。采用Logistic回归框架拟合并计算调整后的OR (aOR)和95% CI。并进行了非线性关系检验。通过亚组分析,探讨性别、年龄、饮酒习惯、文化程度等因素与LS7评分对精神症状发生风险的影响。结果:共纳入受试者5449人;有抑郁症状者1 363例(25.01%),有焦虑症状者398例(7.30%),有焦虑抑郁共存者259例(4.75%)。随着LS7评分的增加,精神症状的患病率显著降低。单因素和多因素Logistic回归显示,LS7评分≥8分对精神症状有保护作用。多因素Logistic回归显示出中等的判别能力(AUC=0.672)。在有焦虑、抑郁或共病症状的个体中,LS7评分分布显示从差组到优组逐渐下降。调整后,优秀的LS7评分与抑郁风险降低39%相关(aOR=0.61, 95% CI 0.47 ~ 0.78, PaOR=0.37, 95% CI 0.22 ~ 0.59, PaOR=0.34, 95% CI 0.17 ~ 0.62, P=0.001)。焦虑模型、抑郁模型和共病焦虑抑郁模型的AUC值分别为0.632、0.672和0.619。所有模型都表现出中等的区分能力,这在统计上是显著的,但它们区分病例和非病例的能力有限。RCS分析证实LS7评分与精神症状风险呈线性负相关。不吸烟和有规律的体育锻炼是最强的保护行为。亚组分析显示,男性、年轻人(≤60岁)、不饮酒者和受教育程度较高的人群具有更强的保护作用,并发现酒精使用与LS7评分之间存在显著的相互作用(相互作用P =0.021),表明饮酒可能削弱LS7的保护作用。结论:理想的健康生活方式行为,如较高的LS7分数所反映的,与成人焦虑和抑郁的风险较低相关。在临床和日常生活中,推广以l7为基础的生活方式可以作为预防和管理焦虑和抑郁的一种实用有效的策略。
{"title":"[A cross-sectional study on healthy lifestyle and the risk of anxiety and depression among adults undergoing health examinations].","authors":"Yangyiyi Yu, Jiale Liu, Pu Peng, Ting Yuan, Jinrong Zeng, Jianyun Lu","doi":"10.11817/j.issn.1672-7347.2025.250243","DOIUrl":"10.11817/j.issn.1672-7347.2025.250243","url":null,"abstract":"<p><strong>Objectives: </strong>Depressive and anxiety disorders are among the most common mental disorders worldwide and are associated with unhealthy lifestyle behaviors. The Life's Simple 7 (LS7) guideline proposed by the American Heart Association aims to reduce cardiovascular risk by improving behaviors such as diet and physical activity, but its impact on mental health is not yet fully clear. This study examined the association between LS7 scores and symptoms of anxiety and depression in adults undergoing routine health examinations.</p><p><strong>Methods: </strong>Data were collected from individuals who underwent health examinations from May 2015 to December 2024 at the Health Management Center of the Third Xiangya Hospital. All participants completed the LS7 assessments, the Self-Rating Depression Scale (SDS), and the Self-Rating Anxiety Scale (SAS). Participants were categorized into 4 LS7 score groups: Low (≤7), average (8-9), good (10), and excellent (11-14). Those with SDS or SAS≥50 were classified as having mental disorder symptoms; with this group, SAS≥50 indicated anxiety, SDS≥50 indicated depression, and SDS and SAS≥50 indicated comorbid anxiety-depression. Binary logistic regression was used to assess associations between LS7 score and mental symptoms, calculating odds ratio (<i>OR</i>) and 95% confidence interval (<i>CI</i>). A restricted cubic spline (RCS) regression model was used to analyze the dose-response relationship between LS7 score (continuous variable) and the risk of mental symptoms. Nodes were set at the 5th, 35th, 65th, and 95th percentiles of the LS7 score, with the 5th percentile as the reference point. All models were adjusted for covariates such as gender, age, living alone, drinking status, education level, and sleep quality. Logistic regression framework was used to fit and calculate the adjusted <i>OR</i> (a<i>OR</i>) and 95% <i>CI</i>. Nonlinear relationship tests were also conducted. Subgroup analysis was performed to explore the interaction between gender, age, drinking habits, education level, and other factors and the LS7 score in influencing the risk of mental symptoms.</p><p><strong>Results: </strong>A total of 5 449 participants were included; 1 363 (25.01%) had depressive symptoms, 398 (7.30%) had anxiety symptoms, and 259 (4.75%) had comorbid anxiety-depression. The prevalence of mental symptoms decreased significantly as LS7 scores increased. Univariate and multivariate Logistic regression indicated that LS7 score≥8 was protective against mental symptoms. Multivariate Logistic regression demonstrated moderate discriminative ability (AUC=0.672). Among individuals with anxiety, depression, or comorbid symptoms, LS7 score distributions showed a graded decrease from poor to excellent groups. After adjustment, an excellent LS7 score was associated with a 39% lower risk of depression (<i>aOR</i>=0.61, 95% <i>CI</i> 0.47 to 0.78, <i>P</i><0.001), a 63% lower risk of anxiety (<i>aOR</i>=0.37, 95% <i>CI</","PeriodicalId":39801,"journal":{"name":"中南大学学报(医学版)","volume":"50 8","pages":"1428-1442"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-28DOI: 10.11817/j.issn.1672-7347.2025.240242
Xiulan Zhang, Liping Zhu, Xiaoling Zeng, Zhaoxue Liu, Shuo Yang, Hong Zhang, Wenguang Yan, Xuhong Li
Objectives: Stress urinary incontinence (SUI) is a common condition among women that severely impairs quality of life. Pelvic floor proprioceptive training (PFPT) has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms. This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture, electrical stimulation, and biofeedback therapy versus conventional therapy consisting of electroacupuncture, electrical stimulation, and biofeedback alone in women with SUI, and to explore the role of PFPT in improving symptom and functional outcomes.
Methods: In this randomized controlled trial, 72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital, Central South University, between December 2021 and October 2023. Participants were randomly assigned to an experimental group (n=36) or a control group (n=36). Both groups received health education. The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy, while the experimental group additionally received PFPT 3 times per week for 4 weeks. The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Secondary outcomes included pelvic floor muscle strength, bladder neck mobility, and balance ability. The ICIQ-SF was reassessed at 1, 3, 6, and 12 months post-treatment.
Results: Both groups showed statistically significant improvements in all parameters after treatment (all P<0.05). However, there were no statistically significant differences between groups in most measures (all P>0.05). The experimental group demonstrated longer single-leg stance duration with eyes closed than the control group (left leg: P=0.026; right leg: P=0.006), with a significant increase from baseline (P<0.001). At 6 months post-treatment, the cure rate in the experimental group was significantly higher than that in the control group (P=0.037).
Conclusions: Conventional therapy effectively improves SUI symptoms, but adding PFPT provides notable additional benefits, including enhanced balance ability and sustained mid-term cure rates. These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.
{"title":"Additional benefits of pelvic floor proprioceptive training combined with conventional therapy in the treatment of female stress urinary incontinence.","authors":"Xiulan Zhang, Liping Zhu, Xiaoling Zeng, Zhaoxue Liu, Shuo Yang, Hong Zhang, Wenguang Yan, Xuhong Li","doi":"10.11817/j.issn.1672-7347.2025.240242","DOIUrl":"10.11817/j.issn.1672-7347.2025.240242","url":null,"abstract":"<p><strong>Objectives: </strong>Stress urinary incontinence (SUI) is a common condition among women that severely impairs quality of life. Pelvic floor proprioceptive training (PFPT) has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms. This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture, electrical stimulation, and biofeedback therapy versus conventional therapy consisting of electroacupuncture, electrical stimulation, and biofeedback alone in women with SUI, and to explore the role of PFPT in improving symptom and functional outcomes.</p><p><strong>Methods: </strong>In this randomized controlled trial, 72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital, Central South University, between December 2021 and October 2023. Participants were randomly assigned to an experimental group (<i>n</i>=36) or a control group (<i>n</i>=36). Both groups received health education. The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy, while the experimental group additionally received PFPT 3 times per week for 4 weeks. The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Secondary outcomes included pelvic floor muscle strength, bladder neck mobility, and balance ability. The ICIQ-SF was reassessed at 1, 3, 6, and 12 months post-treatment.</p><p><strong>Results: </strong>Both groups showed statistically significant improvements in all parameters after treatment (all <i>P</i><0.05). However, there were no statistically significant differences between groups in most measures (all <i>P</i>>0.05). The experimental group demonstrated longer single-leg stance duration with eyes closed than the control group (left leg: <i>P</i>=0.026; right leg: <i>P</i>=0.006), with a significant increase from baseline (<i>P</i><0.001). At 6 months post-treatment, the cure rate in the experimental group was significantly higher than that in the control group (<i>P</i>=0.037).</p><p><strong>Conclusions: </strong>Conventional therapy effectively improves SUI symptoms, but adding PFPT provides notable additional benefits, including enhanced balance ability and sustained mid-term cure rates. These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.</p>","PeriodicalId":39801,"journal":{"name":"中南大学学报(医学版)","volume":"50 8","pages":"1385-1397"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-28DOI: 10.11817/j.issn.1672-7347.2025.250443
Yifei Xie, Jinrong Zeng
With the continuous advancement of deep space exploration missions, maintaining astronaut skin health has become a critical medical issue affecting the safety and effectiveness of long-duration missions. Deep space environmental stressors, including microgravity, ionizing radiation, lunar dust exposure, and microbiome dysbiosis, can synergistically disrupt the skin barrier structure, leading to immune homeostasis imbalance and impaired wound healing. In recent years, research on skin protection in deep space has gradually evolved into a systematic "multi-dimensional integrated protective" framework. From the engineering protection perspective, optimization of multi-layer composite spacesuit structures, the use of hydrogen-rich and boron-containing shielding materials, as well as cabin temperature-humidity regulation and debris-resistant technologies, have greatly enhanced environmental defense capacity. From the biomedical protection perspective, functional hydrogels, antimicrobial dressings, and active compounds derived from traditional Chinese medicine have demonstrated remarkable potential in repairing the skin barrier, modulating immunity, and providing antioxidant defense. Meanwhile, the development of skin microecological interventions and wearable physiological monitoring systems has fostered a trend toward personalized health management. Future research should focus on elucidating the interactive mechanisms among the space environment, skin, and immune barrier, while exploring intelligent monitoring and nanotechnology-based protection strategies. Establishing a predictive and preventive skin health safeguarding system will provide comprehensive medical support for future deep space missions.
{"title":"[Mechanisms and protective strategies for astronaut skin injury in deep space environments].","authors":"Yifei Xie, Jinrong Zeng","doi":"10.11817/j.issn.1672-7347.2025.250443","DOIUrl":"10.11817/j.issn.1672-7347.2025.250443","url":null,"abstract":"<p><p>With the continuous advancement of deep space exploration missions, maintaining astronaut skin health has become a critical medical issue affecting the safety and effectiveness of long-duration missions. Deep space environmental stressors, including microgravity, ionizing radiation, lunar dust exposure, and microbiome dysbiosis, can synergistically disrupt the skin barrier structure, leading to immune homeostasis imbalance and impaired wound healing. In recent years, research on skin protection in deep space has gradually evolved into a systematic \"multi-dimensional integrated protective\" framework. From the engineering protection perspective, optimization of multi-layer composite spacesuit structures, the use of hydrogen-rich and boron-containing shielding materials, as well as cabin temperature-humidity regulation and debris-resistant technologies, have greatly enhanced environmental defense capacity. From the biomedical protection perspective, functional hydrogels, antimicrobial dressings, and active compounds derived from traditional Chinese medicine have demonstrated remarkable potential in repairing the skin barrier, modulating immunity, and providing antioxidant defense. Meanwhile, the development of skin microecological interventions and wearable physiological monitoring systems has fostered a trend toward personalized health management. Future research should focus on elucidating the interactive mechanisms among the space environment, skin, and immune barrier, while exploring intelligent monitoring and nanotechnology-based protection strategies. Establishing a predictive and preventive skin health safeguarding system will provide comprehensive medical support for future deep space missions.</p>","PeriodicalId":39801,"journal":{"name":"中南大学学报(医学版)","volume":"50 8","pages":"1346-1354"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-28DOI: 10.11817/j.issn.1672-7347.2025.250533
Lei Tang, Qiaoling Tang, Ye Li, Li Wang, Feng Zhang, Xiangbin Zhang, Ran Liu, Le Zhang
As human deep space exploration enters a practical phase, ensuring astronaut health and safety has become a critical determinant of mission success. The cerebrovascular system, essential for maintaining brain function, is highly sensitive to environmental changes. Cerebrovascular diseases represent one of the characteristic adverse effects of deep space conditions such as microgravity and high-energy radiation, and have emerged as a frontier challenge in space medicine. Based on experiences from manned space missions, major research challenges persist, particularly the lack of experimental data specific to the lunar environment and the unclear threshold for low-dose radiation-induced injury. Elucidating the mechanisms and multifactorial interactions by which deep space environments impact cerebrovascular structure and function, and summarizing the key risk factors, pathological processes, and recent advances in monitoring and early-warning technologies for cerebrovascular diseases in lunar astronauts, and of crucial importance. A comprehensive understanding of the interplay between deep space environmental stressors and cerebrovascular injury, as well as the development of personalized prevention and intervention strategies, will provide both theoretical and practical foundations for safeguarding cerebrovascular health in future Chinese deep space missions, while promoting progress in related biomedical research, technological innovation, and international collaboration.
{"title":"[Risks, mechanisms, and prevention strategies for cerebrovascular diseases in lunar astronauts under deep].","authors":"Lei Tang, Qiaoling Tang, Ye Li, Li Wang, Feng Zhang, Xiangbin Zhang, Ran Liu, Le Zhang","doi":"10.11817/j.issn.1672-7347.2025.250533","DOIUrl":"10.11817/j.issn.1672-7347.2025.250533","url":null,"abstract":"<p><p>As human deep space exploration enters a practical phase, ensuring astronaut health and safety has become a critical determinant of mission success. The cerebrovascular system, essential for maintaining brain function, is highly sensitive to environmental changes. Cerebrovascular diseases represent one of the characteristic adverse effects of deep space conditions such as microgravity and high-energy radiation, and have emerged as a frontier challenge in space medicine. Based on experiences from manned space missions, major research challenges persist, particularly the lack of experimental data specific to the lunar environment and the unclear threshold for low-dose radiation-induced injury. Elucidating the mechanisms and multifactorial interactions by which deep space environments impact cerebrovascular structure and function, and summarizing the key risk factors, pathological processes, and recent advances in monitoring and early-warning technologies for cerebrovascular diseases in lunar astronauts, and of crucial importance. A comprehensive understanding of the interplay between deep space environmental stressors and cerebrovascular injury, as well as the development of personalized prevention and intervention strategies, will provide both theoretical and practical foundations for safeguarding cerebrovascular health in future Chinese deep space missions, while promoting progress in related biomedical research, technological innovation, and international collaboration.</p>","PeriodicalId":39801,"journal":{"name":"中南大学学报(医学版)","volume":"50 8","pages":"1337-1345"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-28DOI: 10.11817/j.issn.1672-7347.2025.250040
Rongcui Chen, Wei Wang
In recent years, pyroptosis, an inflammatory form of programmed cell death, has gained increasing attention in the field of metabolic disease research. Pyroptosis is closely associated with inflammatory responses. A growing body of evidence suggests that pyroptosis not only plays a critical role in regulating inflammation but can also influence metabolic status, cellular function, and tissue damage through multiple pathways, thereby either exacerbating or alleviating the progression of metabolic diseases. However, the precise molecular mechanisms of pyroptosis and its roles across different metabolic diseases remain unclear, and investigations into related therapeutic targets are still in early stages. Systematically elucidating the mechanisms by which pyroptosis contributes to metabolic diseases and exploring its potential roles in inflammation and pathophysiology may provide new insights and strategies for the prevention and treatment of metabolic disorders, and further promote advances in this research field.
{"title":"[Mechanisms of pyroptosis in metabolic diseases].","authors":"Rongcui Chen, Wei Wang","doi":"10.11817/j.issn.1672-7347.2025.250040","DOIUrl":"10.11817/j.issn.1672-7347.2025.250040","url":null,"abstract":"<p><p>In recent years, pyroptosis, an inflammatory form of programmed cell death, has gained increasing attention in the field of metabolic disease research. Pyroptosis is closely associated with inflammatory responses. A growing body of evidence suggests that pyroptosis not only plays a critical role in regulating inflammation but can also influence metabolic status, cellular function, and tissue damage through multiple pathways, thereby either exacerbating or alleviating the progression of metabolic diseases. However, the precise molecular mechanisms of pyroptosis and its roles across different metabolic diseases remain unclear, and investigations into related therapeutic targets are still in early stages. Systematically elucidating the mechanisms by which pyroptosis contributes to metabolic diseases and exploring its potential roles in inflammation and pathophysiology may provide new insights and strategies for the prevention and treatment of metabolic disorders, and further promote advances in this research field.</p>","PeriodicalId":39801,"journal":{"name":"中南大学学报(医学版)","volume":"50 8","pages":"1465-1474"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-28DOI: 10.11817/j.issn.1672-7347.2025.250141
Zhige Yan, Jun Zhou, Xing Chen, Yao Wang
<p><strong>Objectives: </strong>Older adults in rural areas with multiple chronic conditions (MCC) generally exhibit poorer medication adherence than the general elderly population. Considering individual heterogeneity helps to design precise subgroup-based interventions. This study aims to identify latent profile types of medication adherence mechanisms among rural older adults with MCC based on the capability-opportunity-motivation-behavior (COM-B) model, and to explore factors influencing medication adherence.</p><p><strong>Methods: </strong>A multistage sampling method was used to recruit 349 rural older adults with MCC from 10 administrative villages in Jianghua County, Yongzhou City, Hunan Province, between July and September, 2024. Participants were surveyed using a general information questionnaire, the Health Literacy Scale for Chronic Patients, the Beliefs about Medicines Questionnaire-Specific, the Multidimensional Scale of Perceived Social Support, and the Morisky Medication Adherence Scale. Latent profile analysis based on the COM-B model was conducted to identify subgroups of medication adherence mechanisms. Univariate and Logistic regression analyses were used to identify influencing factors associated with different latent profiles and adherence levels.</p><p><strong>Results: </strong>Among the participants, 33.5% demonstrated good medication adherence. The 5 most prevalent chronic diseases were hypertension (86.5%), diabetes (36.7%), arthritis or rheumatism (34.4%), stroke (21.8%), and heart disease (17.5%). Overall, rural older adults with MCC exhibited relatively good medication capability, opportunity, and motivation. Their medication adherence mechanisms were classified into 3 latent profiles: "family-support restrained type" (5.2%), "family-support driven type" (52.1%), and "comprehensive advantage type" (42.7%). Significant differences were observed among the three profiles in terms of education level, marital status, living arrangement, and per capita monthly household income (all <i>P</i><0.05). Multivariate Logistic regression revealed that higher education level was a protective factor for belonging to the "comprehensive advantage type" rather than the "family-support driven type" [<i>OR</i>=0.277, 95% <i>CI</i> (PL) 0.126 to 0.614, <i>P</i>=0.002]. Furthermore, significant differences in education level, self-rated health status, and latent profile type were found between participants with good and poor adherence (<i>P</i><0.05). Binary Logistic regression indicated that with each one-level increase in self-rated health status, the risk of poor adherence increased by 293.9% [<i>OR</i>=3.939, 95% <i>CI</i> (PL) 1.610 to 9.636, <i>P</i>=0.003]. Compared with the "family-support restrained type", individuals classified as the "comprehensive advantage type" had a 96.8% [<i>OR</i>=0.032, 95% <i>CI</i> (PL) 0.008 to 0.123, <i>P</i><0.001] lower risk of poor medication adherence.</p><p><strong>Conclusions: </strong>The mechan
目的:农村地区患有多种慢性疾病(MCC)的老年人通常比一般老年人表现出更差的药物依从性。考虑个体异质性有助于设计精确的基于亚组的干预措施。本研究旨在基于能力-机会-动机-行为(COM-B)模型,识别农村老年MCC患者的药物依从机制的潜在特征类型,并探讨影响药物依从性的因素。方法:采用多阶段抽样方法,于2024年7 - 9月在湖南省永州市江华县10个行政村招募349名患有MCC的农村老年人。采用一般信息问卷、慢性病患者健康素养量表、药物信念问卷、感知社会支持多维度量表和莫里斯基药物依从性量表对参与者进行调查。基于COM-B模型进行潜在分析,以确定药物依从性机制的亚组。采用单变量和逻辑回归分析来确定与不同潜在特征和依从性水平相关的影响因素。结果:33.5%的参与者表现出良好的药物依从性。最常见的5种慢性病是高血压(86.5%)、糖尿病(36.7%)、关节炎或风湿病(34.4%)、中风(21.8%)和心脏病(17.5%)。总体而言,农村老年MCC患者表现出相对较好的用药能力、用药机会和用药动机。其药物依从机制可分为“家庭支持抑制型”(5.2%)、“家庭支持驱动型”(52.1%)和“综合优势型”(42.7%)3种潜在特征。在教育水平、婚姻状况、生活安排和人均家庭月收入方面,三种情况存在显著差异(POR=0.277, 95% CI (PL) 0.126 ~ 0.614, P=0.002)。此外,依从性好和依从性差的受试者在教育水平、自评健康状况和潜在特征类型方面存在显著差异(POR=3.939, 95% CI (PL) 1.610 ~ 9.636, P=0.003)。与“家庭支持约束型”个体相比,“综合优势型”个体的依从性为96.8% [OR=0.032, 95% CI (PL) 0.008 ~ 0.123]。结论:农村老年MCC患者的依从性机制存在明显的异质性。初级卫生保健提供者应重点关注“家庭支持受限型”亚组,加强社会支持网络,并实施有针对性的干预措施,以提高药物依从性。
{"title":"[Latent profile types and influencing factors of medication adherence mechanisms among rural older adults with multiple chronic conditions].","authors":"Zhige Yan, Jun Zhou, Xing Chen, Yao Wang","doi":"10.11817/j.issn.1672-7347.2025.250141","DOIUrl":"10.11817/j.issn.1672-7347.2025.250141","url":null,"abstract":"<p><strong>Objectives: </strong>Older adults in rural areas with multiple chronic conditions (MCC) generally exhibit poorer medication adherence than the general elderly population. Considering individual heterogeneity helps to design precise subgroup-based interventions. This study aims to identify latent profile types of medication adherence mechanisms among rural older adults with MCC based on the capability-opportunity-motivation-behavior (COM-B) model, and to explore factors influencing medication adherence.</p><p><strong>Methods: </strong>A multistage sampling method was used to recruit 349 rural older adults with MCC from 10 administrative villages in Jianghua County, Yongzhou City, Hunan Province, between July and September, 2024. Participants were surveyed using a general information questionnaire, the Health Literacy Scale for Chronic Patients, the Beliefs about Medicines Questionnaire-Specific, the Multidimensional Scale of Perceived Social Support, and the Morisky Medication Adherence Scale. Latent profile analysis based on the COM-B model was conducted to identify subgroups of medication adherence mechanisms. Univariate and Logistic regression analyses were used to identify influencing factors associated with different latent profiles and adherence levels.</p><p><strong>Results: </strong>Among the participants, 33.5% demonstrated good medication adherence. The 5 most prevalent chronic diseases were hypertension (86.5%), diabetes (36.7%), arthritis or rheumatism (34.4%), stroke (21.8%), and heart disease (17.5%). Overall, rural older adults with MCC exhibited relatively good medication capability, opportunity, and motivation. Their medication adherence mechanisms were classified into 3 latent profiles: \"family-support restrained type\" (5.2%), \"family-support driven type\" (52.1%), and \"comprehensive advantage type\" (42.7%). Significant differences were observed among the three profiles in terms of education level, marital status, living arrangement, and per capita monthly household income (all <i>P</i><0.05). Multivariate Logistic regression revealed that higher education level was a protective factor for belonging to the \"comprehensive advantage type\" rather than the \"family-support driven type\" [<i>OR</i>=0.277, 95% <i>CI</i> (PL) 0.126 to 0.614, <i>P</i>=0.002]. Furthermore, significant differences in education level, self-rated health status, and latent profile type were found between participants with good and poor adherence (<i>P</i><0.05). Binary Logistic regression indicated that with each one-level increase in self-rated health status, the risk of poor adherence increased by 293.9% [<i>OR</i>=3.939, 95% <i>CI</i> (PL) 1.610 to 9.636, <i>P</i>=0.003]. Compared with the \"family-support restrained type\", individuals classified as the \"comprehensive advantage type\" had a 96.8% [<i>OR</i>=0.032, 95% <i>CI</i> (PL) 0.008 to 0.123, <i>P</i><0.001] lower risk of poor medication adherence.</p><p><strong>Conclusions: </strong>The mechan","PeriodicalId":39801,"journal":{"name":"中南大学学报(医学版)","volume":"50 8","pages":"1443-1454"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}