Objective:To investigate the status quo of cognitive frailty in elderly patients with heart failure and analyze its influencing factors, so as to provide evidence for healthcare professionals to formulate effective intervention strategies.Methods:A total of 330 elderly patients with heart failure admitted to the First Affiliated Hospital of the University of South China and the Second Affiliated Hospital of the University of South China from October 2023 to January 2024 were selected as the study objects by convenience sampling method. General data questionnaire, Frailty Phenotype, Montreal Cognitive Assessment, Clinical Dementia Rating Scale, Geriatric Depression Scale-15 and Short Form Mini Nutritional Assessment were used for a sectional investigation. Random forest algorithm was used to rank the importance of variables and binary logistic regression was combined to explore the influencing factors of elderly patients with heart failure.Results:According to the evaluation criteria of cognitive frailty, 330 elderly patients with heart failure were divided into cognitive frailty group (124 cases) and non-cognitive frailty group (206 cases). The incidence of cognitive frailty was 37.6% (124/330). Among which, the median age of the cognitive frailty group was 73 years old, with 63 males and 61 females. The median age of the non-cognitive frailty group was 71 years old, with 117 males and 89 females. The random forest results showed that the top 7 variables in importance ranking were weekly intellectual activity, frequency of physical exercise, age, educational levels, depression status, cardiac function grade and risk of malnutrition. Binary logistic regression analysis showed that weekly intellectual activity ( OR=0.076, 95% CI 0.027-0.216), requency of physical exercise ( OR=0.184, 95% CI 0.079-0.430), age ( OR=1.173, 95% CI 1.077-1.277), educational levels ( OR=0.283, 95% CI 0.143-0.559), depression status ( OR=4.440, 95% CI 1.451-13.585), cardiac function grade ( OR=3.030, 95% CI 1.673-5.489) and risk of malnutrition ( OR=3.833, 95% CI 1.530-9.602) were the main influencing factors (all P<0.05). Conclusions:The incidence of cognitive frailty in elderly patients with heart failure is high. Healthcare professionals ought to focus on the screening and assessing of cognitive frailty in elderly patients with heart failure, and formulate effective intervention strategies by considering the above influencing factors to mitigate the occurrence of cognitive frailty.

Objective:To investigate the current status and related factors of antiviral treatment for chronic hepatitis B virus (HBV) infection in rural communities in China.Methods:In 2023, 866 chronic HBV-infected individuals from rural communities in Zhangqiu District, Jinan City, were included in the study. Basic information, disease status and antiviral treatment conditions of the infected individuals were collected through questionnaires, specimen collection and laboratory tests. Univariate and multivariate logistic regression were used to analyze the related factors of the antiviral treatment rate of those who met the indications for hepatitis B antiviral treatment.Results:The median age ( Q1, Q3) of subjects was 56 (48, 66) years old, among which 436 (50.4%) were males. There were 712 (82.2%) individuals who met the indications for hepatitis B antiviral treatment, and 110 individuals received antiviral treatment with a rate of 15.5%. Multivariate logistic regression analysis showed that compared with males, families with an average monthly income per capita of <1 000 yuan, no alcohol consumption, no smoking, and a family history of HBV infection, females ( OR=4.66, 95% CI: 2.88-7.53), families with an average monthly income per capita of 1 000-1 999 yuan ( OR=1.64, 95% CI: 1.00-2.68) and ≥2 000 yuan ( OR=2.78, 95% CI: 1.54-5.03), alcohol consumption ( OR=6.42, 95% CI: 2.80-14.7), smoking ( OR=1.98, 95% CI: 1.04-3.77), and no family history of HBV infection ( OR=1.90, 95% CI: 1.16-3.09) had a lower antiviral treatment rate for chronic HBV infection. Conclusion:The antiviral treatment rate of chronic HBV-infected individuals in rural communities of Zhangqiu District, Jinan City is low, and the related factors are female, high monthly income per capita, alcohol consumption, smoking, and no family history of HBV infection.

OBJECTIVE: To evaluate the effectiveness of Poster Fusion Cage combined with xenogeneic bone graft augmentation for bone defect management in distal radius fractures. METHODS: A retrospective analysis was conducted on 20 patients with bone defects complicating distal radius fractures who met the selection criteria and were treated between June 2022 and June 2024. The cohort comprised 2 males and 18 females, aged 54-87 years (mean, 63.3 years). Etiologies included falls in 17 cases, traffic accidents in 2 cases, and crush injury in 1 case. According to AO classification, there were 5 cases of type A, 8 cases of type B, and 7 cases of type C. The interval from injury to operation ranged from 2 to 10 days (mean, 5.8 days). All patients underwent volar plate fixation augmented with Poster Fusion Cage and demineralized xenogeneic bone matrix grafting. The operation time, intraoperative blood loss, fracture healing time, and postoperative complications were recorded. Radiographic parameters, including radial height, volar tilt, and ulnar deviation, were measured on standardized X-ray films obtained immediately postoperatively and at last follow-up, and whether secondary reduction loss occurred was judged. At last follow-up, wrist range of motion (extension, flexion, radial deviation, ulnar deviation, pronation, and supination) and grip strength (expressed as a percentage of the contralateral side) were measured. Wrist function was assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) score and Patient-Rated Wrist Evaluation (PRWE) score. RESULTS: The operation time was 70-200 minutes (mean, 116.4 minutes), and the intraoperative blood loss was 10-80 mL (mean, 36.5 mL). All surgical incisions healed by first intention, with no neurovascular complications documented. All patients were followed up 9-12 months (mean, 11.6 months). All fractures healed normally, with a healing time of 8-14 weeks (mean, 9.95 weeks). No significant difference was observed in radial height, volar tilt, or ulnar deviation between immediate postoperatively and last follow-up ( P>0.05). All fractures achieved satisfactory reduction, with no secondary loss of reduction or implant failure occurring during follow-up. At last follow-up, the range of motion of the affected wrist joint was 60°-65° (mean, 62.5°) in extension, 67°-75° (mean, 71.1°) in flexion, 18°-23° (mean, 20.4°) in radial deviation, 28°-33° (mean, 30.1°) in ulnar deviation, 69°-80° (mean, 74.7°) in pronation, and 69°-82° (mean, 75.6°) in supination. Grip strength recovered to 75%-85% (mean, 80%) of the contralateral side. Functional scores showed a DASH score of 5-15 (mean, 9.4) and PRWE score of 8.0-12.5 (mean, 10.2). CONCLUSION The combination of Poster Fusion Cage and xenogeneic bone graft augmentation provides a safe and effective treatment for bone defects in distal radius fractures.
Retrospective Studies ; Humans ; Male ; Female ; Middle Aged ; Aged ; Aged, 80 and over ; Treatment Outcome ; Wrist Fractures/surgery* ; Heterografts ; Transplantation, Heterologous/methods* ; Bone Transplantation/methods* ; Operative Time ; Blood Loss, Surgical ; Radius/surgery* ; Fracture Healing ; Time Factors ; Postoperative Complications/etiology* ; Range of Motion, Articular ; Follow-Up Studies ; Internal Fixators ; Fracture Fixation, Internal/methods* ; Combined Modality Therapy

Receptor-interacting protein kinase 1 (RIPK1) plays an essential role in regulating the necroptosis and apoptosis in cerebral ischemia-reperfusion (I/R) injury. However, the regulation of RIPK1 kinase activity after cerebral I/R injury remains largely unknown. In this study, we found the downregulation of protein arginine methyltransferase 1 (PRMT1) was induced by cerebral I/R injury, which negatively correlated with the activation of RIPK1. Mechanistically, we proved that PRMT1 directly interacted with RIPK1 and catalyzed its asymmetric dimethylarginine, which then blocked RIPK1 homodimerization and suppressed its kinase activity. Moreover, pharmacological inhibition or genetic ablation of PRMT1 aggravated I/R injury by promoting RIPK1-mediated necroptosis and apoptosis, while PRMT1 overexpression protected against I/R injury by suppressing RIPK1 activation. Our findings revealed the molecular regulation of RIPK1 activation and demonstrated PRMT1 would be a potential therapeutic target for the treatment of ischemic stroke.

Objective:To investigate the current status and related factors of antiviral treatment for chronic hepatitis B virus (HBV) infection in rural communities in China.Methods:In 2023, 866 chronic HBV-infected individuals from rural communities in Zhangqiu District, Jinan City, were included in the study. Basic information, disease status and antiviral treatment conditions of the infected individuals were collected through questionnaires, specimen collection and laboratory tests. Univariate and multivariate logistic regression were used to analyze the related factors of the antiviral treatment rate of those who met the indications for hepatitis B antiviral treatment.Results:The median age ( Q1, Q3) of subjects was 56 (48, 66) years old, among which 436 (50.4%) were males. There were 712 (82.2%) individuals who met the indications for hepatitis B antiviral treatment, and 110 individuals received antiviral treatment with a rate of 15.5%. Multivariate logistic regression analysis showed that compared with males, families with an average monthly income per capita of <1 000 yuan, no alcohol consumption, no smoking, and a family history of HBV infection, females ( OR=4.66, 95% CI: 2.88-7.53), families with an average monthly income per capita of 1 000-1 999 yuan ( OR=1.64, 95% CI: 1.00-2.68) and ≥2 000 yuan ( OR=2.78, 95% CI: 1.54-5.03), alcohol consumption ( OR=6.42, 95% CI: 2.80-14.7), smoking ( OR=1.98, 95% CI: 1.04-3.77), and no family history of HBV infection ( OR=1.90, 95% CI: 1.16-3.09) had a lower antiviral treatment rate for chronic HBV infection. Conclusion:The antiviral treatment rate of chronic HBV-infected individuals in rural communities of Zhangqiu District, Jinan City is low, and the related factors are female, high monthly income per capita, alcohol consumption, smoking, and no family history of HBV infection.

Objective This study aims to develop a guideline for assessing and maintaining intrinsic capacity in older adults,offer recommendations to professionals regarding these assessments,and encourage the implementation of evidence-based clinical practices across various settings,including communities,hospitals,nursing homes,and other geriatric care environments.Methods An evidence-based approach guided the collection of questions through a lit-erature review.Preliminary recommendations were developed through a systematic search of domestic and interna-tional guideline networks,professional association websites,and comprehensive databases.Subsequently,the recom-mendations were revised,and the consensus was achieved through a round of expert consensus meetings and 3 rounds of expert correspondence,culminating in the formation of the guidelines.Results The developed guideline encompasses 2 aspects and 5 dimensions of assessment and maintenance,comprising a total of 28 questions and 39 recommendations.Specifically,6 questions and 9 recommendations were formulated for the cognitive dimension,5 questions and 7 recommendations for the locomotion dimension,6 questions and 7 recommendations for the vitality dimension,6 questions and 9 recommendations for the psychological dimension,and 5 questions and 7 recommenda-tions for the sensory dimension.Among these,34 are classified as strong recommendations,while 5 are categorized as weak recommendations.Conclusion The guideline offers scientifically robust,acceptable,and comprehensible rec-ommendations that equip the professionals with a foundation for decision-making aiming at preserving the intrinsic capacity of older adults.

Objective This study aims to develop a guideline for assessing and maintaining intrinsic capacity in older adults,offer recommendations to professionals regarding these assessments,and encourage the implementation of evidence-based clinical practices across various settings,including communities,hospitals,nursing homes,and other geriatric care environments.Methods An evidence-based approach guided the collection of questions through a lit-erature review.Preliminary recommendations were developed through a systematic search of domestic and interna-tional guideline networks,professional association websites,and comprehensive databases.Subsequently,the recom-mendations were revised,and the consensus was achieved through a round of expert consensus meetings and 3 rounds of expert correspondence,culminating in the formation of the guidelines.Results The developed guideline encompasses 2 aspects and 5 dimensions of assessment and maintenance,comprising a total of 28 questions and 39 recommendations.Specifically,6 questions and 9 recommendations were formulated for the cognitive dimension,5 questions and 7 recommendations for the locomotion dimension,6 questions and 7 recommendations for the vitality dimension,6 questions and 9 recommendations for the psychological dimension,and 5 questions and 7 recommenda-tions for the sensory dimension.Among these,34 are classified as strong recommendations,while 5 are categorized as weak recommendations.Conclusion The guideline offers scientifically robust,acceptable,and comprehensible rec-ommendations that equip the professionals with a foundation for decision-making aiming at preserving the intrinsic capacity of older adults.

Objective:To investigate the status quo of cognitive frailty in elderly patients with heart failure and analyze its influencing factors, so as to provide evidence for healthcare professionals to formulate effective intervention strategies.Methods:A total of 330 elderly patients with heart failure admitted to the First Affiliated Hospital of the University of South China and the Second Affiliated Hospital of the University of South China from October 2023 to January 2024 were selected as the study objects by convenience sampling method. General data questionnaire, Frailty Phenotype, Montreal Cognitive Assessment, Clinical Dementia Rating Scale, Geriatric Depression Scale-15 and Short Form Mini Nutritional Assessment were used for a sectional investigation. Random forest algorithm was used to rank the importance of variables and binary logistic regression was combined to explore the influencing factors of elderly patients with heart failure.Results:According to the evaluation criteria of cognitive frailty, 330 elderly patients with heart failure were divided into cognitive frailty group (124 cases) and non-cognitive frailty group (206 cases). The incidence of cognitive frailty was 37.6% (124/330). Among which, the median age of the cognitive frailty group was 73 years old, with 63 males and 61 females. The median age of the non-cognitive frailty group was 71 years old, with 117 males and 89 females. The random forest results showed that the top 7 variables in importance ranking were weekly intellectual activity, frequency of physical exercise, age, educational levels, depression status, cardiac function grade and risk of malnutrition. Binary logistic regression analysis showed that weekly intellectual activity ( OR=0.076, 95% CI 0.027-0.216), requency of physical exercise ( OR=0.184, 95% CI 0.079-0.430), age ( OR=1.173, 95% CI 1.077-1.277), educational levels ( OR=0.283, 95% CI 0.143-0.559), depression status ( OR=4.440, 95% CI 1.451-13.585), cardiac function grade ( OR=3.030, 95% CI 1.673-5.489) and risk of malnutrition ( OR=3.833, 95% CI 1.530-9.602) were the main influencing factors (all P<0.05). Conclusions:The incidence of cognitive frailty in elderly patients with heart failure is high. Healthcare professionals ought to focus on the screening and assessing of cognitive frailty in elderly patients with heart failure, and formulate effective intervention strategies by considering the above influencing factors to mitigate the occurrence of cognitive frailty.

Periodontitis is a chronic inflammatory disease marked by a dysregulated immune microenvironment, posing formidable challenges for effective treatment. The disease is characterized by an altered glucose metabolism in macrophages, specifically an increase in aerobic glycolysis, which is linked to heightened inflammatory responses. This suggests that targeting macrophage metabolism could offer a new therapeutic avenue. In this study, we developed an immunometabolic intervention using quercetin (Q) encapsulated in bioadhesive mesoporous polydopamine (Q@MPDA) to treat periodontitis. Our results demonstrated that Q@MPDA could reprogram inflammatory macrophages to an anti-inflammatory phenotype (i.e., from-M1-to-M2 repolarization). In a murine periodontitis model, locally administered Q@MPDA reduced the presence of inflammatory macrophages, and decreased the levels of inflammatory cytokines (IL-1β and TNF-α) and reactive oxygen species (ROS) in the periodontium. Consequently, it alleviated periodontitis symptoms, reduced alveolar bone loss, and promoted tissue repair. Furthermore, our study revealed that Q@MPDA could inhibit the glycolysis of inflammatory macrophages while enhancing oxidative phosphorylation (OXPHOS), facilitating the shift from M1 to M2 macrophage subtype. Our findings suggest that Q@MPDA is a promising treatment for periodontitis via immunometabolic rewiring.

Background::Hepatic ischemia-reperfusion injury (HIRI) remains a common complication during liver transplantation (LT) in patients. As a key downstream effector of the Hippo pathway, Yes-associated protein (YAP) has been reported to be involved in various physiological and pathological processes. However, it remains elusive whether and how YAP may control autophagy activation during ischemia-reperfusion.Methods::Human liver tissues from patients who had undergone LT were obtained to evaluate the correlation between YAP and autophagy activation. Both an in vitro hepatocyte cell line and in vivo liver-specific YAP knockdown mice were used to establish the hepatic ischemia-reperfusion models to determine the role of YAP in the activation of autophagy and the mechanism of regulation. Results::Autophagy was activated in the post-perfusion liver grafts during LT in patients, and the expression of YAP positively correlated with the autophagic level of hepatocytes. Liver-specific knockdown of YAP inhibited hepatocytes autophagy upon hypoxia-reoxygenation and HIRI ( P <0.05). YAP deficiency aggravated HIRI by promoting the apoptosis of hepatocytes both in the in vitro and in vivo models ( P <0.05). Attenuated HIRI by overexpression of YAP was diminished after the inhibition of autophagy with 3-methyladenine. In addition, inhibiting autophagy activation by YAP knockdown exacerbated mitochondrial damage through increasing reactive oxygen species ( P <0.05). Moreover, the regulation of autophagy by YAP during HIRI was mediated by AP1 (c-Jun) N-terminal kinase (JNK) signaling through binding to the transcriptional enhanced associate domain (TEAD). Conclusions::YAP protects against HIRI by inducing autophagy via JNK signaling that suppresses the apoptosis of hepatocytes. Targeting Hippo (YAP)-JNK-autophagy axis may provide a novel strategy for the prevention and treatment of HIRI.