Background: In China, mental health services do not currently meet the needs of bereaved people with symptoms of prolonged grief disorder (PGD). Internet-based grief interventions may help fill this gap, but such programmes have not yet been developed or evaluated in China. The proposed study aims to investigate the effectiveness, acceptability, and feasibility of an online self-help intervention programme named Healing Grief for bereaved Chinese with prolonged grief, and to explore the psychological mechanisms of potential improvements.Methods: We designed a two-arm randomised controlled trial. At least 128 participants will be randomly assigned to either an Internet-based intervention group or a waitlist-control group. The Internet-based intervention will be developed based on the dual process model, integrating techniques of psychoeducation, behavioural activation, cognitive reappraisal, and meaning reconstruction, and will be delivered via expressive writing. The intervention comprises six modules, with two sessions in each module, and requires participants to complete two sessions per week and complete the intervention in 6 weeks. The primary outcomes include effectiveness, acceptability, and feasibility. The effectiveness will be assessed by measures of prolonged grief, posttraumatic stress, anxiety, and depressive symptoms. Acceptability and feasibility will be evaluated using survey and interview on user experience characteristics. Secondary outcomes include moderators and mediators, such as dual process coping, grief rumination, mindfulness, and continuing bond, to explore the psychological mechanisms of potential improvement. Assessments will take place at pre-intervention, post-intervention, and 3-month follow-up.Conclusion: The proposed study will determine the effectiveness, acceptability, and feasibility of the newly developed online self-help intervention for bereaved Chinese with prolonged grief and clarify how the intervention helps with symptom improvements. Such an intervention may play an important role in easing the imbalance between the delivery and receipt of bereavement psychological services in China.
In China, mental health services are not widely available for bereaved people.The proposed study will be the first one to develop and evaluate an Internet-based self-help grief intervention for bereaved Chinese with prolonged grief.The proposed study will determine whether and how the intervention helps to improve the mental health of bereaved Chinese with prolonged grief.

BACKGROUND: We aimed to assess whether early life exposure to the Chinese famine (1959-1961) modifies the association between type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) in adulthood.
METHODS: Data from 4247 adults born between 1954 and 1964 from the 2011 and 2015 China Health and Retirement Longitudinal Study (CHARLS) were analyzed. CVD in 2011 and 2015 was based on self-reported doctor\'s diagnosis of cardiac events (heart attack, coronary heart disease, angina, congestive heart failure, or other heart problems) and stroke. Diabetes in 2011 was defined by fasting blood glucose, HbA1C, or known diabetes.
RESULTS: Diabetes in 2011 was cross-sectionally associated with an increase of CVD risk in 2011 (OR 1.91, 95%CI 1.53-2.40, P < 0.001) after adjusting for age and gender. Famine exposure changed the association between diabetes and CVD in areas severely affected by famine. The odds ratios (OR) of diabetes in 2011 for CVD in 2015 were 1.24 (95%CI 0.73-2.10), 1.27 (95%CI 0.72-2.24), 2.25 (95%CI 1.29-3.91), 4.31 (95%CI 2.07-8.97) and 1.72 (95%CI 0.84-3.51) among adults in late childhood-, mid-childhood-, early childhood-, fetal-, and nonexposed cohorts in severe famine areas, respectively.
CONCLUSIONS: T2DM is associated with the risk of CVD among Chinese adults. Fetal and early childhood exposure to the Chinese famine exacerbated the associated risk.
背景: 本研究旨在评估早年生活经历过中国饥荒(1959-1961年)是否会影响成年以后2型糖尿病(type 2 diabetes mellitus, T2DM)与心血管疾病(cardiovascular disease, CVD)之间的相关性。 方法: 分析了2011年至2015年中国健康与退休纵向研究(CHARLS)中4247名1954年至1964年间出生的成人的数据。根据自我报告医生诊断的心血管事件(心脏病发作、冠心病、心绞痛、充血性心力衰竭或其它心脏病)和卒中来确认2011年与2015年的CVD。2011年的糖尿病诊断是基于空腹血糖、HbA1C或已知糖尿病。 结果: 校正年龄与性别后, 发现2011年的糖尿病诊断与2011年CVD风险增加之间具有横向相关性(OR 1.91, 95% CI 1.53-2.40, P<0.001)。在遭受饥荒严重影响的地区, 经历过饥荒会改变糖尿病与CVD之间的相关性。在遭受过严重饥荒的地区, 儿童晚期、儿童中期、儿童早期、胎儿时期遭受过饥荒的队列和未遭受过饥荒的队列成年后在2011年的糖尿病诊断与2015年发生CVD的比值比(OR)分别为1.24(95% CI 0.73-2.10)、1.27(95% CI 0.72-2.24)、2.25(95% CI 1.29-3.91)、4.31(95% CI 2.07-8.97)和1.72(95% CI 0.84-3.51)。 结论: 中国成人中T2DM与CVD风险具有相关性。胎儿时期和儿童早期经历过中国饥荒可使相关风险加剧。.

Due to rapid nutrition transitions, the prevalence of cardiometabolic diseases, such as metabolic syndrome, type 2 diabetes, and cardiovascular diseases, has been increasing at an alarming rate in the Chinese population. Moreover, Asians, including Chinese, have been hypothesized to have a higher susceptibility to cardiometabolic diseases than Caucasians. Early prediction and prevention are key to controlling this epidemic trend; to this end, the identification of novel biomarkers is critical to reflect environmental exposure, as well as to reveal endogenous metabolic and pathophysiologic mechanisms. The emerging \"omics\" technologies, especially metabolomics, offer a unique opportunity to provide novel signatures or fingerprints to understand the effects of genetic and non-genetic factors on cardiometabolic health. During the past two decades, metabolomic approaches have been increasingly used in various epidemiological studies, primarily in Western populations. Although the field is still in its early stages, some studies have tried to identify novel compounds or confirm their metabolites and associations with cardiometabolic diseases in Chinese populations, including amino acids, fatty acids, acylcarnitines and other metabolites. Despite major efforts to discover novel biomarkers for disease prediction or intervention, the limits in current study design, analytical platforms, and data processing approaches are challenges in metabolomic research worldwide. Therefore, future research with more advanced technologies, rigorous study designs, standardized detection and analytic approaches, and integrated data from multiomics approaches are essential to evaluate the feasibility of using metabolomics in clinical settings. Finally, the functional roles and underlying biological mechanisms of metabolomic biomarkers should be elucidated by future mechanistic research.
摘要: 由于快速的营养变迁,  中国人群的心血管代谢疾病如代谢综合征、2型糖尿病和心血管疾病等的患病率急速攀升。而且,  与西方人群相比,  包括中国人在内的亚洲人群被认为具有较高的心血管代谢疾病易感性。早期预测和预防对于控制此类疾病的流行尤为重要,  基于此,  发现新的疾病生物标记物是反映环境暴露,  揭示机体代谢和致病机理的关键。新兴的组学技术,  尤其是代谢组学为探知心血管代谢健康的遗传和非遗传影响因素提供了发现新信号特征的机遇。在过去的20年间,  代谢组学技术已经在不同类型的流行病学研究中获得越来越多的应用,  尤其是在西方人群中开展的研究。尽管这一领域仍处于早期阶段,  一些在中国人群中开展的研究已经尝试去发现新的或验证已知的代谢标记物与心血管代谢疾病的关联,  包括氨基酸、脂肪酸、酰基肉碱和其他代谢物。尽管当前在寻找预测或干预疾病的新生物标记物方面投入巨大,  研究设计、检测平台和数据处理过程中存在的缺陷仍是全球代谢组学研究所面临的挑战。因此,  在未来的研究中,  更先进的检测技术,  严谨的研究设计,  标准化的检测分析流程和多组学数据的整合分析,  是评估将代谢组学技术应用于临床实践的可行性的必要环节。最后,  未来的机理研究也需要进一步阐明代谢组学生物标记物的功能和潜在机理。.

Rates of international migration are increasing, which raises the question of how migration might influence couple relationship standards and impact on the standards of migrants forming intercultural relationships. We compared relationship standards in n = 286 Chinese living in Hong Kong, China, with standards in n = 401 Chinese migrants to a Western country (Australia) by administering the Chinese-Western Intercultural Couple Standards Scale (CWICSS). We also compared these two groups to n = 312 Westerners living in Australia. We first tested the structural invariance of the CWICSS across the three samples with a multigroup confirmatory factor analysis. There was marginal but acceptable fit of a model of two positively correlated latent factors: Couple Bond (with four indicators, such as demonstration of love and caring) and Family Responsibility (also with four indicators, such as extended family relations and preserving face). Within the limitations of the study, results suggest migration is associated predominantly with differences in women\'s, but not men\'s, relationship standards. Migrant Chinese women show alignment of Couple Bond standards with Western standards, and divergence of Family Responsibility standards from Western standards. Discussion focused on how migration and intercultural relationship experiences might differentially influence various domains of relationship standards, gender differences in migration effects on standards, and the implications for working with culturally diverse couples.

BACKGROUND: Low-density lipoprotein receptor-related protein 5 (LRP5) plays an important role in glucose and cholesterol metabolism. The present cohort study evaluated associations of LRP5 variants with the incidence of type 2 diabetes mellitus (T2DM) in a rural adult Chinese population.
METHODS: In all, 7751 subjects aged ≥18 years without T2DM underwent genotyping at baseline; 6326 subjects (81.62%) were followed-up, and 5511 with a clear disease outcome were eligible for analysis. The same questionnaire was administered and the same anthropometric and blood biochemical examinations were performed at baseline and follow-up. Association analysis was performed for five single nucleotide polymorphisms and haplotypes of LRP5.
RESULTS: Cox proportional hazards testing of three different genetic models found no significant association between T2DM and LRP5 after adjusting for potential risk factors (P > 0.05). However, the incidence of T2DM in subjects with LRP5 mutational genotypes was higher in the overweight/obese than normal weight population. Under the dominant model, the risk of T2DM was increased with an interaction between rs11228303 and the waist-to-height ratio adjusted for baseline age, sex, and family history of T2DM (synergy index [SI] = 4.172; 95% confidence interval [CI] 1.014-17.166)], and body mass index (SI = 3.237; 95% CI 1.102-9.509). Furthermore, the A allele of rs3758644 was related to decreased fasting plasma insulin and homeostatic model assessment of β-cell function levels, whereas the T allele of rs12363572 was related to increased high-density lipoprotein cholesterol levels in new-onset diabetes patients (P < 0.05).
CONCLUSIONS: The risk of T2DM may be associated with interactions between the LRP5 gene and overweight and obesity. Polymorphisms of LRP5 are related to β-cell function and lipid metabolism.