Objective: To develop a prediction model for mild cognitive impairment (MCI) risk among the elderly, so as to provide a tool for MCI early screening. Methods : From July 2022 to September 2024, a multi-stage stratified random cluster sampling method was used to recruit permanent residents aged ≥65 years from the Xinjiang Uygur Autonomous Region as study participants. Data on sociodemographic characteristics, nutritional status, body composition indices, bone mineral density, and handgrip strength were collected through questionnaires and physical examinations. Sarcopenia was defined based on appendicular skeletal muscle index and handgrip strength. MCI was assessed using the Mini-Mental State Examination, with adjustments for educational level. Participants were randomly divided into a training set and a validation set in a 7∶3 ratio. LASSO regression and multivariable logistic regression models were employed to screen for predictors and construct an MCI risk prediction model. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve and decision curve analysis (DCA). Results: A total of 1 641 participants were surveyed, including 755 males (46.01%) and 886 females (53.99%). The majority of participants were aged 65-<75 years, comprising 1 154 individuals (70.32%). MCI was detected in 517 participants, corresponding to a detection rate of 31.51%. Resultsfrom LASSO regression and multivariate logistic regression analysis showed that residence (rural, OR = 2.323, 95% CI: 1.682-3.210), age (75-<85 years, OR = 1.405, 95% CI: 1.019-1.937; ≥85 years, OR = 3.655, 95% CI: 1.696-7.875), educational level (primary school, OR = 0.341, 95% CI: 0.247-0.472; junior high school, OR = 0.255, 95% CI: 0.160-0.408; high school, OR = 0.286, 95% CI: 0.154-0.531; bachelor's degree or above, OR = 0.120, 95% CI: 0.041-0.351), history of alcohol consumption (yes, OR = 3.216, 95% CI: 2.164-4.779), risk of malnutrition (yes, OR = 1.464, 95% CI: 1.064-2.014), sarcopenia (yes, OR = 3.197, 95% CI: 2.332-4.385), and waist-to-hip ratio (abnormal, OR = 1.540, 95% CI: 1.159-2.048) were identified as predictive factors for MCI among the elderly. In the training set, the area under the ROC curve, sensitivity, and specificity were 0.788, 0.719, and 0.712, respectively. In the validation set, the corresponding values were 0.784, 0.913, and 0.542, respectively. DCA demonstrated that the model provided a higher clinical net benefit for predicting MCI risk when the risk threshold probability ranged from 0.124 to 0.764. Conclusion The prediction model developed in this study demonstrates good discriminative ability and clinical utility, indicating its substantial value for predicting the MCI risk among the elderly.

Patients with lung cancer experience a heavy symptom burden during the perioperative period, which seriously affects their recovery and quality of life. Traditional symptom management models rely mainly on scheduled ward rounds during hospitalization and outpatient follow-up after discharge. However, they have limitations such as delayed symptom recognition, lack of post-discharge monitoring, and non-quantitative symptom assessment, which often lead to delayed interventions and low patient satisfaction. In recent years, the symptom management model based on electronic patient-reported outcomes (ePRO) has been increasingly valued in clinical practice. Existing high-level evidence from both domestic and international studies indicates that, through proactive monitoring, real-time alerts, and remote interventions, this model enables dynamic and continuous symptom management and helps improve patient recovery and healthcare experience. As a supplement to routine medical care, the ePRO-based symptom management model aims to enhance the quality of care rather than replace existing medical processes. To promote the standardized application of this model in perioperative lung cancer care, this consensus integrates domestic and international evidence. After multiple rounds of voting by more than 50 experts, it formulates 12 consensus statements covering the three core components, symptom monitoring, alerting, and intervention, to provide scientific and practical recommendations for clinical practice.

Objective:To explore the impact of general self-efficacy on the work immersion experience and the mediating effect of resilience in intern nursing students, so as to provide a basis for the development of interventions.Methods:Convenience sampling was used to select 210 intern nursing students in the Shandong Provincial Third Hospital from January to September 2024 for the study. Nursing students were surveyed using the General Information Questionnaire, Work Immersion Experience Scale, Medical Staff Resilience Scale, and General Self-Efficacy Scale. The mediating effects test was performed using the Process plug-in in SPSS 26.0.Results:A total of 210 questionnaires were distributed and 204 valid questionnaires were recovered, with a valid recovery rate of 97.14%. The total scores of the Work Immersion Experience Scale, Medical Staff Resilience Scale, and General Self-Efficacy Scale were (107.33±17.06) , (63.12±12.96) and (25.65±4.60) , respectively. General self-efficacy was a positive predictor of the work immersion experience ( β=0.321) of intern nursing students. Resilience partially mediated the effect between general self-efficacy and the work immersion experience of intern nursing students, with an effect size of 0.126 and a 95% confidence interval of (0.050, 0.211) , which accounted for 28.19% (0.126/0.447) of the total effect. Conclusions:Intern nursing students with high general self-efficacy have good work immersion experiences, and resilience partially mediates the effect between self-efficacy and work immersion experiences. Nursing educators and administrators can improve the work immersion experience of intern nursing students by designing targeted training courses, providing adequate practice opportunities, and conducting psychotherapy to enhance their self-efficacy and resilience.

Objective To investigate the effect of quercetin on paraptosis induced by low-concentration hydrogen peroxide(H2O2)in human lens epithelial cells(LECs).Methods The human lens epithelial cell line SRA01/04 was cul-tured in vitro and randomly divided into the following groups:control group,H2O2 group(50 μmol·L-1 H2O2),and H2O2+Quercetin group(50 μmol·L-1 H2O2 and 20 μmol·L-1 quercetin).The area and number of endoplasmic reticulum vacuoles in the cells were observed using transmission electron microscopy and super-resolution laser confocal microscopy.Intracellular reactive oxygen species(ROS)levels were detected using the DCFH-DA fluorescent probe.Western blot was performed to detect the expression levels of the following proteins:insulin-like growth factor 1 receptor(IGF1R),phos-phorylated IGF1R(p-IGF1R),ALG-2-interacting protein X(ALIX),glucose-regulated protein 78(GRP78),extracellular signal-regulated kinase(ERK),phosphorylated ERK(p-ERK),P38,and phosphorylated P38(p-P38).Additionally,len-ses from 8-week-old Sprague-Dawley rats were subjected to ex vivo culture and divided into the normal group,the H2O2 treatment group(50 μmol·L-1 H2O2),and the combination treatment group(50 μmol·L-1 H2O2 and 20 μmol·L-1 quer-cetin).The degree of lens opacity was observed under a stereomicroscope,and the area of lens opacity was quantified.The ultrastructure of the endoplasmic reticulum in the rat LECs was observed by transmission electron microscopy.Western blot was used to detect the expression levels of the aforementioned proteins in the rat LECs.Results Compared with the control group,the H2O2 group exhibited significant increases in the area and number of endoplasmic reticulum vacuoles,ROS levels,and the relative protein expression levels of p-IGF1R,p-ERK,p-P38,and GRP78,while the relative expression of ALIX protein was decreased(all P＜0.001).Compared with the H2 O2 group,the H2O2+quercetin group showed signifi-cant reductions in the area and number of endoplasmic reticulum vacuoles,ROS levels,and the relative expression levels of p-IGF1R,p-ERK,p-P38,and GRP78,while the relative expression of ALIX protein was increased(all P＜0.01).In the ex vivo cultured rat lens model,compared with the normal group,the H2O2 group displayed a significant increase in lens opac-ity area,expanded endoplasmic reticulum area in LECs,elevated relative expression levels of p-IGF1R,p-ERK,p-P38,and GRP78 proteins,and decreased ALIX expression(all P＜0.000 1).In contrast,the combination treatment group showed significantly reduced lens opacity area,decreased endoplasmic reticulum area in LECs,lower relative expression of p-IGF1R,p-ERK,p-P38,and GRP78,and increased ALIX expression compared to the H2O2 group(all P＜0.01).Conclu-sion Quercetin inhibits activation of the IGF1R/MAPK signaling pathway and alleviates endoplasmic reticulum stress,thereby effectively attenuating paraptosis in lens epithelial cells.These findings provide a novel strategy for the prevention and treatment of early age-related cataract.

Objective To investigate the effects of Jiuwei Jianbu Drink on oxidative stress and inflammatory injury in rats with knee osteoarthritis via the high mobility group box-1 protein(HMGB1)/receptor for advanced glycation endproducts(RAGE)/phosphatidyli-nositol 3-kinase(PI3K)/protein kinase B(Akt)signaling pathway.Methods A total of 60 rats were randomly divided into six groups according to the random number table method:blank control group,model group,positive drug group,and Jiuwei Jianbu Drink low-,medium-,and high-dose groups,with 10 rats in each group.Except for the blank control group,knee osteoarthritis models were estab-lished in the other groups,which were then subjected to corresponding treatments.Knee joint diameter and mechanical pain and thermal pain threshold changes were observed.Hematoxylin-eosin staining and safranin O/fast green staining were used to assess pathological changes in cartilage tissue.Oxidative stress markers and inflammatory factor levels in knee joint cartilage tissue of each group were meas-ured.Western blot was used to detect the expression of proteins related to the HMGB1/RAGE/PI3 K/Akt signaling pathway in knee joint tissues.Results Compared with the blank control group,the model group exhibited increased knee joint diameter and decreased mechan-ical pain and thermal pain threshold.Jiuwei Jianbu Drink at all doses groups and the positive control group significantly improved these in-dicators in a dose-dependent manner(P＜0.05).Additionally,the Mankin score and Osteoarthritis Research Society International(OARSI)score in the model group were significantly higher than those in the blank control group,while Jiuwei Jianbu Drink intervention significantly reduced the OARSI score,with the best effect observed in the high-dose group(P＜0.05).Compared with the blank con-trol group,the model group showed increased levels of nitric oxide(NO)and malondialdehyde(MDA),decreased levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px),and significantly elevated levels of tumor necrosis factor-alpha(TNF-α)and interleukin-1β(IL-1β).Compared with the model group,Jiuwei Jianbu Drink significantly inhibited oxidative stress and inflam-matory responses,especially at high doses(P＜0.05).Moreover,the expression of HMGB1,RAGE,p-PI3K/PI3K,and p-Akt/Akt in the model group was higher than that in the blank control group,while Jiuwei Jianbu Drink intervention dose-dependently downregulat-ed the expression of these proteins(P＜0.05).Conclusion Jiuwei Jianbu Drink alleviates oxidative stress and inflammatory injury in rats with knee osteoarthritis by inhibiting the HMGB1/RAGE/PI3K/Akt signaling pathway,thereby improving cartilage pathological chan-ges and demonstrating potential therapeutic value.

Objective To evaluate the diagnostic value of prostate health index(PHI)and prostate health index density(PHID)in identifying intermediate-to high-risk prostate cancer(PCa).Methods Clinical data of 160 treatment-na?ve patients with highly suspected PCa,who underwent initial prostate biopsy in our hospital during Jul.2022 and Feb.2024,were retrospectively analyzed.Data included age,body mass index(BMI),prostate volume(PV),total prostate-specific antigen(tPSA),free PSA(fPSA),[-2]proPSA(p2PSA),PHI and PHID.Biopsy-positive results were stratified according to the EAU D'Amico risk criteria.Receiver operating characteristic(ROC)curve and multivariate logistic regression analysis were employed to assess the diagnostic performance of PHI and PHID in predicting PCa and identifying intermediate-to high-risk PCa.Results There were statistically significant differences in tPSA,p2PSA,PHI and PHID between the negative and positive groups,as well as among the low-,medium-and high-risk groups(P＜0.01).Both PHI and PHID demonstrated good diagnostic performance in predicting PCa(AUC=0.820 8 and 0.875 7,respectively;all P＜0.001),and in identifying intermediate-to high-risk PCa(AUC=0.838 0 and 0.878 3,respectively;all P＜0.001).Compared to the baseline model,the incorporation of PHI and PHID individually into the multivariate model significantly improved the screening performance for PCa(AUC=0.910 and 0.898,respectively;all P＜0.001).Conclusion PHI and PHID exhibit high diagnostic efficacy in screening PCa,particularly in identifying intermediate-to high-risk disease.

Objective To investigate the causal relationship between circulating white blood cells(WBC)and juvenile idiopathic arthritis(JIA)using a two-sample Mendelian randomization(MR)analysis,and to provide a reference for the treatment strategy of JIA.Methods Relevant data of WBC and JIA were extracted from the public data of genome-wide association studies.Then,bidirectional MR analysis was conducted using the inverse variance weighted method(IVW),MR-Egger regression method,mixed contamination method,and Bayesian weighted Mendelian randomization.A series of sensitivity analyses were used to verify the robustness of the results.Results After MR analysis,false discovery rate(FDR)correction and sensitivity verification,calculations using IVW as the main method showed that neutrophils could reduce the risk of JIA(OR=0.752,95%CI:0.622,0.908,P=0.003,PFDR=0.003),and that JIA could lead to increased monocyte counts(bete=0.015,95%CI:0.007,0.022,P=1.90E-04,PFDR=1.14E-03).Conclusion A bidirectional causal association is identified between WBC and the risk of JIA occurrence.

Objective:To investigate the effect of left colonic artery (LCA) preservation on rectal cancer patients' short-term postoperative anal function and quality of life.Methods:Two-hundred ninty-two patients with rectal cancer at the Department of Gastrointestinal Surgery of Peking University First Hospital between Jan 2022 and Dec 2023 were enrolled . The patients were divided into two groups according to whether the LCA was preserved during surgery or not. The LARS scale and EORTC QLQ-CR29 quality of life questionnaire were used to assess postoperative anal function and quality of life.Results:There were no significant differences between the two groups in terms of the amount of surgical blood loss and the number of lymph node dissections in the root No. 253 group and the time to postoperative voiding (all P>0.05). However, the LARS scores at 1 and 3 months postoperatively were significantly lower in the preserved LCA group than in the LCA nonpreserved group, especially for gas incontinence, loose stool leakage, and number of bowel movements (all P<0.05). The EORTC QLQ-CR29 scores showed that the LCA preserved group recovered significantly better than the non-preserved group in terms of postoperative voiding dysfunction ( P=0.007), urinary incontinence ( P=0.006), mucus discharge ( P=0.009), and fecal incontinence symptoms ( P<0.001). Male sexual dysfunction recovery was quicker in the preserved LCA group ( P=0.043), but there was no significant difference between the two groups at 3 months postoperatively( P>0.05). Conclusion:Preservation of the left colonic artery in low anterior resection of rectal cancer helps to reduce the incidence of postoperative low anterior resection syndrome, improve genitourinary symptoms, and improve patients' quality of life.

Objective:Analyze the risk factors of gastrointestinal perforation caused by foreign body and summarize the experience of surgical treatment of foreign bodies.Method:From Jan 2008 to Dec 2023, 89 patients with foreign bodies in the digestive tract were admitted to the Department of Gastrointestinal Surgery, Peking University First Hospital. Relevant data were collected and binary logistic regression was used to analyze the independent risk factors for intestinal perforation, resection and anastomosis of intestine or enterostomy/colostomy.Results:The mean age of 89 patients was (60.1±16.2) years old, 65 patients (73%) had unintentionally ingested foreign bodies. The most common foreign bodies were jujube pits (40 cases). Thirty-nine patients diagnosed with gastrointestinal perforation. Binary Logistic regression analysis showed that the total number of leukocytes ( OR=4.085, 95% CI: 1.214-13.745, P=0.023), sharp foreign body ( OR=26.124, 95% CI: 5.194-131.392, P<0.001), and the location of foreign body ( OR=3.980, 95% CI: 1.178-13.465, P=0.026) were the independent risk factors for gastrointestinal perforation. Thirty-three patients underwent gastrointestinal repair surgery, and 36 patients underwent resection and anastomosis of intestine or enterostomy/colostomy. Binary Logistic regression analysis showed that the foreign body located in the colorectum ( OR=71.928, 95% CI: 4.646-1 113.479, P=0.002) and the length of the foreign body ≤2.5 cm ( OR=5.791, 95% CI: 1.606-20.882, P=0.007) were the independent risk factors for resection and anastomosis of intestine or enterostomy/colostomy. Conclusions:Leukocyte count ≥10×10 9/L, sharp foreign body, and location of foreign body are independent risk factors for gastrointestinal perforation. Foreign body located in the colorectum and foreign body length ≤2.5 cm are risk factors for resection and anastomosis of intestine or enterostomy/colostomy.

Objective The study aimed to investigate whether montelukast sodium could alleviate airway inflammatory responses in asthmatic mice by affecting the PHD2/HIF-1α pathway.Methods An allergic asthma model was established by ovalbumin(OVA)induction,and 18 female BALB/c mice were randomly divided into a control group(Con group),an asthma group(OVA group),and an asthma group with montelukast sodium intervention(30 mg/kg montelukast sodium by oral administration 1 h before OVA challenge,Mon group).HE staining was used to analyze the pathological changes in the lungs of mice.Blood cell analyzer and kits were used to determine the number of inflammatory cells and the levels of cytokines,the content of lactic acid and pyruvic acid in the lungs,respectively.RT-PCR and Western blot were used to detect the mRNA and protein expression of HIF-1α,PHD2,E-cad and p120 in the lungs of mice.Results Compared with the Con group,there was a significant increase in the number of eosinophils,lymphocytes,neutrophils and monocytes,the levels of IL-5,IL-13,complement factor D(CFD)and contents of lactate and pyruvate in the lungs of mice in the OVA group.Lung HIF-1α,PHD2,p120 and E-cad mRNA levels were reduced,meanwhile HIF-1α and PHD2 protein expression were upregulated but E-cad and p120 protein expression were downregulated(all with P<0.05).After montelukast sodium intervention,the number of eosinophils and monocytes and CFD expression were significantly decreased in the lungs of Mon group,the contents of lactate and pyruvate were basically restored to normal,and the mRNA and protein expression of HIF-1α,PHD2,p120 and E-cad were effectively improved.Conclusion Montelukast sodium could alleviate the airway inflammatory responses in the lungs of asthmatic mice by regulating the PHD2/HIF-1α signaling pathway.