ObjectiveTo develop a community-family management model for older adults with mild cognitive impairment (MCI) and to formulate detailed application specifications, and to fully leverage the initiative of communities and families under limited resource conditions, for achieving community-based early detection and early intervention for older adults with MCI. MethodsA systematic literature review was conducted to identify pertinent publications. Corpus-based research methodologies were employed to extract, refine, integrate and synthesize management elements, thereby establishing the specific content and service processes for each stage of the management model. Utilizing the 5W2H analytical framework, essential elements such as management stakeholders, target populations, content and methods for each stage were delineated. The model and its application guidelines were finalized through expert consultation and demonstration. ResultsAn expert evaluation of the management model yielded mean scores of 4.84, 4.32 and 4.84 for acceptability, feasibility and systematicity, respectively. By integrating the identified core elements with expert ratings and feedback, the final iteration of the community-family management model for older adults with MCI was formulated. This model comprised of five stages: screening and identification, comprehensive assessment, intervention planning, monitoring and referral pathways to ensure implementation, and enhanced support for communities, family members and caregivers. Additionally, it included 18 specific application guidelines. ConclusionThe proposed management model may theoretically help delay cognitive decline, improve cognitive function and potentially promote reversal from MCI to normal cognition. It may also enhance the awareness and coping capacity of older adults and their families, strengthen community healthcare professionals' ability to early identify and manage MCI.

ObjectiveTo evaluate the clinical efficacy and safety of Xiaozhen Formula （消疹方） in preventing skin toxicity induced by epidermal growth factor receptor inhibitors （EGFRIs） in patients with EGFR-mutant non-small cell lung cancer （NSCLC）. MethodsA randomized， double-blind， placebo-controlled， multicenter clinical study was conducted. A total of 120 patients with EGFR-mutant NSCLC from seven centers were enrolled and randomly assigned to a treatment group （60 cases） or a control group （60 cases）. On the basis of EGFRI-targeted therapy， patients in the treatment group received Xiaozhen Formula granules， whereas those in the control group received Xiaozhen Formula placebo granules， both at 10 g twice daily for 4 consecutive weeks. The primary outcomes were the grading of skin toxicity evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events （NCI-CTCAE） version 5.0 and the incidence of rash. Secondary outcomes included the time to onset and time to resolution of the highest-grade rash， the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 （EORTC QLQ-C30） scores， the Hospital Anxiety and Depression Scale （HADS） scores， and disease control rate， together with safety assessments. ResultsBased on the full analysis set （FAS）， the incidence of skin toxicity in the treatment group was 18.33% （11/60）， significantly lower than 45.00% （27/60） in the control group （P＜0.01）， with the highest severity of skin toxicity in both groups was grade 2. Among patients who developed rash， the resolution rate in the treatment group was 90.91% （10/11）， higher than that 33.33% （9/27） in the control group. The median time to resolution was 15 days （95%CI： 8-17 days） in the treatment group and it was not reached in the control group； the distribution of time to resolution differed significantly between groups （P＜0.001）. After treatment， the treatment group had higher EORTC QLQ-C30 functional scale and global health status/quality-of-life scores， and lower symptom scale， single-item scores， as well as HADS-A， and HADS-D scores than the control group （P＜0.05）. In the FAS analysis， the disease control rate （DCR） was 85.0% （51/60） in the treatment group， lower than 100.0% （60/60） in the control group （P=0.003）， whereas no significant between-group difference was observed in the per-protocol set （PPS） analysis （P=0.464）. The incidence of adverse events did not differ significantly between the two groups （P＞0.05）， and no definite safety signals related to the investigational drug were observed. ConclusionXiaozhen Formula can reduce the incidence of EGFRI-induced skin toxicity， and improve the outcome of rash regression， the patients' quality of life and psychological status in EGFR-mutant NSCLC patients.

Objective: To analyze serum anti-Müllerian hormone (AMH) level and its influencing factors among female undergoing premarital and preconception examinations, so as to provide the evidence for optimizing reproductive health management measures. Methods: Female who received free premarital and preconception examinations and voluntarily underwent serum AMH testing at Women and Children's Health Center of Gongshu District, Hangzhou City from January 2022 to April 2025 were selected as study subjects. Demographic information and reproductive history were collected through questionnaire survey. Venous blood was collected to detect thyroid-stimulating hormone (TSH), alanine aminotransferase, hemoglobin (Hb), and AMH levels. The original AMH values did not follow a normal distribution, but followed a normal distribution after natural logarithm transformation, recorded as ln (AMH). Pearson correlation analysis was used to analyze the correlation between variables, and multiple linear regression model was used to analyze the influencing factors for ln (AMH) levels among female undergoing premarital and preconception examinations. Results: A total of 1 073 females undergoing premarital and preconception examinations were surveyed, with a mean age of (29.43±3.30) years. There were 959 females without pregnancy (89.38%) and 1 042 females without full-term live birth history (97.11%). The median AMH level was 3.85 (interquartile range, 3.63) ng/mL, and the mean ln (AMH) level was 1.27±0.75. The ln (AMH) levels were higher in females without pregnancy and without full-term live birth history (both P<0.05). The ln (AMH) level was negatively correlated with age (r=-0.260) and TSH (r=-0.093), and positively correlated with Hb (r=-0.260, -0.093, and 0.073, all P<0.05). Multiple linear regression analysis showed that age (β′=-0.253) and TSH (β′=-0.103) were statistically associated with ln (AMH) levels among female undergoing premarital and preconception examinations (both P<0.05). The associations of other variables with ln (AMH) levels were not statistically significant (all P>0.05). Conclusions Age and TSH level are influencing factors for AMH levels among female undergoing premarital and preconception examinations. AMH levels among female undergoing premarital and preconception examinations decrease with increasing age and increasing TSH level.

Objective:To investigate the anti-inflammatory effects of Duhuo Jisheng Decoction on type Ⅱ collagen emulsion induced arthritis (CIA) model rats from the perspective of M1/M2 macrophage balance mediated development of rheumatoid arthritis.Methods:SD rats were divided into a normal group of 8 and a model group of 32. The CIA model was established using collagen antibody induction method for modeling. The successfully modeled rats were randomly divided into model group, methotrexate group, and Duhuo Jisheng Decoction medium- and high-dosage groups using a random number table method, with 8 rats in each group. Duhuo Jisheng Decoction medium- and high-dosage groups were orally administered with Duhuo Jisheng Decoction at dosages of 13.5 and 27.0 g/kg, once a day; methotrexate group received oral administration of 2.0 mg/kg methotrexate twice a week; normal group and model group were given equal volumes of physiological saline by gavage once a day for 28 consecutive days. The general condition of each group of rats was observed, the degree of swelling in the right knee joint was measured, and the arthritis index was scored; HE was used to observe pathological changes in synovial tissue; immunofluorescence was used to detect the expressions of markers CD86 and CD206 in synovial macrophages; Real time PCR was used to detect the mRNA levels of IL-6, TNF-α, IL-10, and TGF-β in synovial tissue.Results:Duhuo Jisheng Decoction could significantly improve the mental state of the rats and reduced the swelling of the knee joints and the arthritis index ( P<0.01). Compared with the model group, the cartilage structure in the knees of rats in the Duhuo Jisheng Decoction group was more intact and clearer. The expression level of the M1 macrophage marker CD86 significantly decreased, and the expression level of the M2 macrophage marker CD206 significantly increased; the mRNA expressions of IL-6 and TNF-α in the knee joint synovial tissue were significantly reduced ( P<0.05), while IL-10 and TGF-β levels significantly increased ( P<0.05). Conclusion:Duhuo Jisheng Decoction may promote macrophage polarization towards M2 type, thereby achieving M1/M2 macrophage balance, alleviating inflammatory response in rheumatoid arthritis rats, and exerting therapeutic effects on rheumatoid arthritis.

Objective To explore the clinical experience of Professor Wang Yan'gang in treating gastroesophageal reflux disease(GERD)using data mining methods.Methods SPSS 23.0 was used to statistically analyze the frequency,properties,flavors,and meridian tropism of Chinese herbal medicines in the prescriptions of effective GERD cases treated by Professor Wang Yan'gang in outpatient clinics from January 2020 to December 2022.Cluster analysis,factor analysis,and association rule analysis were performed on the relevant drugs.Results A total of 294 outpatient prescriptions for the treatment of GERD were collected,including 174 Chinese herbal medicines.The top 10 frequently-used drugs were Sepiae Endoconcha(Haipiaoxiao),Fritillariae Thunbergii Bulbus(Zhebeimu),Scutellariae Radix(Huangqin),Coptidis Rhizoma(Huanglian),Pinelliae Rhizoma Praeparatum Cum Alumine(Qingbanxia),Arecae Semen Tostum(Chaobinglang),Artemisiae Scopariae Herba(Yinchen),Gypsum Fibrosum(Shigao),Aurantii Fructus Immaturus(Zhishi),and Magnoliae Officinalis Cortex(Houpo).After cluster analysis,factor analysis,and association rule analysis,16 commonly-used herb pairs,such as Huangqin-Huanglian,Citri Reticulatae Pericarpium(Chenpi)-Zhuru(Bambusae Caulis in Taenia),Haipiaoxiao-Zhebeimu,Shichangpu(Acori Tatarinowii Rhizoma)-Yujin(Curcumae Radix),and Zhishi-Houpo were identified,and 9 herb groups such as"Huangqin,Huanglian,Yinchen"and"Chenpi,Zhuru,Qingbanxia"were obtained.Factor analysis was performed on 22 drugs with a usage frequency more than 110 times,and then 6 common factors were extracted after principal component analysis.Conclusion In differentiating and treating GERD,Professor Wang Yan'gang suggests that stagnated heat injuring yin should be taken as the core pathogenesis,and therapy of clearing heat and nourishing yin should be used as the core treatment method.Additionally,auxiliary methods such as soothing the throat,regulating the liver and stomach,and nourishing the heart and spirit can be adopted according to the accompanying symptoms during the disease progression.

Objective To investigate the acquisition of the"standard for intubation and maintenance of nasointestinal tube in adult patients"of Chinese Nursing Association,and its influencing factors,so as to provide a basis for targeted training programs.Methods A multi-centered,cross-sectional study was performed in 31 provinces from September to November 2023,and nurses from different departments which use nasointestinal tubes like intensive care units,gastroenterology,neurology,geriatrics were included by a convenient sampling method.The tool was a self-designed questionnaire based on the group standard and the survey was conducted.Multiple linear regression analysis was used to explore the influencing factors of nurses'knowledge of nasointestinal tubes intubation and maintenance.Results 1 350 valid questionnaires were collected.Only 61.63％of the respondents knew about the publishing of the standard.The score of knowledge of tube intubation and maintenance was(61.09±13.56).The results of multiple linear regression analysis showed the influencing factors of the score of knowledge of intubation and maintenance were as follows:education level,professional title,job position,intubation experience within half a year,and corresponding achievements(P＜0.05).Conclusion The acqui-sition level of nurses for the standard calls for continuous promotion.Nursing managers should establish targeted training programs based on the related influencing factors,so as to advance the implementation of the group standard.

Objective:To investigate the association between hearing loss and the type of indoor fuel applications in Chinese middle-aged and elderly people through longitudinal cohort study.Methods:Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), including adults aged 45 years and older enrolled in 2011, with follow-up for cooking and heating analyses extending to 2018 and 2015, respectively. The study calculated the incidence of hearing loss based on an indoor cooking or heating fuel type and expressed in terms of per 100 person-years. The Cox proportional hazard model was used to assess the association between solid fuel use and hearing loss, and covariates such as gender, education, and economy were controlled. We also analyzed the impact of indoor fuel type and its switching on hearing loss.Results:A total of 6, 772 participants using household fuels for cooking (2011-2018) and 4, 618 for heating (2011-2015) were included. Those using solid fuels for cooking [(58.0±8.2) years] and heating [(58.1±8.5) years] were generally slightly older than that of those who used clean fuels. In the cooking analysis, the overall incidence of hearing loss was higher among solid fuel users compared to clean fuel users (Clean fuel: 2.6 cases per 100 person-years; solid fuel: 3.6 cases per 100 person-years; the difference between the two was statistically significant, P<0.05). However, no significant difference was observed in the heating analysis ( P>0.05). Further classification of fuel-type use revealed that the incidence of hearing loss was the highest among people who had been using solid fuels consistently. Compared to the clean fuel group, the fully adjusted hazard ratio (HR) was 1.5 (95% CI: 1.3-1.7) in the cooking analysis and 1.5 (95% CI: 1.1-2.0) in the heating analysis. Compared with using clean fuels, switching from clean fuels to solid fuels increased the risk of hearing loss both during cooking and heating processes. Conclusion:In the CHARLS database, individuals who use solid fuels for indoor cooking and heating are older than those who use clean fuels. Compared with clean fuel use, the use of solid fuels increases the risk of hearing loss in middle-aged and elderly people. Reducing the use of solid fuels, choosing clean fuels as substitutes for solid fuels, and avoiding the switch from clean fuels to solid fuels will help protect the hearing health of middle-aged and elderly individuals.

[Purpose]To analyze the trends of incidence and age at onset of leukemia in Jiangsu cancer registration areas from 2009 to 2019.[Methods]The continuous monitoring data of leukemia from 2009 to 2019 were collected from 16 cancer registries in Jiangsu Province.All datasets were checked and evaluated based on data quality control criteria and were included in the analysis.Crude incidence rate(CIR),age-standardized incidence rate by Chinese standard population(ASIRC),the average annual percentage change(AAPC),the standardized average age at onset,the changes in the age structure of incidence and the changes in the birth cohort by year were calculated.[Results]The incidence rate of leukemia significantly increased from 5.22/105 in 2009 to 7.88/105 in 2019,with a significant upward trend(for CIR,AAPC=4.95％,95％CI:3.82％～6.09％;for ASIRC,AAPC=2.97％,95％CI:1.52％～4.43％).The incidence rates were in-creased in all age groups and increased with the birth cohort by years.There was a tendency of backward shift for the age composition of the population,with the increasing of composition for those over 60 years old.The mean age at onset increased from 48.62 years old in 2009 to 57.96 years old in 2019,with a backward shift in the mean age(β=0.773,P＜0.001),and the mean age at onset increased with the year only in rural areas after standardization(β=0.428,P=0.017).[Conclusion]Leukemia incidence rate in Jiangsu Province increased from 2009 to 2019,and the age at onset has shifted backwards.It's important to strengthen the early prevention and control of leukemia.

Objective:To investigate the clinical application effect of Zishen Yutai Pill in patients with repeated implantation failure (RIF) undergoing frozen-thawed embryo transfer (FET) cycles.Methods:A retrospective case-control study was conducted, selecting 744 cycles of patients with RIF at the Department of Female Reproductive Medicine,State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong University from October 2017 to April 2023. The patients were divided into experimental group (treated with Zishen Yutai Pill, n=279) and control group (treated without Zishen Yutai Pill, n=465) based on whether Zishen Yutai Pill was added to luteal support. The pregnancy outcomes between the two groups were compared. Based on the different endometrial preparation protocols in the FET cycles, the patients were used down-regulation protocol ( n=271) or non-down-regulation protocol ( n=473). The pregnancy outcomes of the two groups in each protocol were compared. Results:There were no statistically significant differences between the two groups in terms of biochemical pregnancy rate, clinical pregnancy rate, embryo implantation rate, early miscarriage rate, late miscarriage rate, and live birth rate (all P>0.05). However, the biochemical pregnancy rate [69.0% (58/84)], clinical pregnancy rate [59.5% (50/84)], and embryo implantation rate [59.4% (57/96)] in the experimental group of the down-regulated protocol were significantly higher than those in control group [56.1% (105/187), P=0.045; 46.5% (87/187), P=0.048; 44.9% (92/205), P=0.019], with statistically significant differences. In the non-down-regulated protocol, there were no statistically significant differences in pregnancy outcomes between the two groups (all P>0.05). Conclusion:In the FET down-regulated protocol, Zishen Yutai Pill can significantly improve the clinical pregnancy rate and the embryo implantation rate in patients with RIF, thereby improving pregnancy outcomes.

ObjectiveTo investigate the effect and potential mechanism of caffeic acid （CA） on severe acute pancreatitis （SAP） induced by caerulein combined with lipopolysaccharide （LPS）， and to provide a basis for the research on novel drugs for the treatment of SAP. MethodsC57BL/6J mice， aged 6 weeks， were divided into control group， model group， CA group， and octreotide acetate （OA） group， with 6 mice in each group. The mice in the control group were given injection of normal saline， and those in the other groups were given intraperitoneal injection of caerulein combined with LPS to establish a mouse model of SAP. At 1 hour after the first injection of caerulein， the mice in the CA group and the OA group were given intraperitoneal injection of CA or subcutaneous injection of OA at an interval of 8 hours. The general status of the mice was observed after 24 hours of modeling， and serum， pancreas， lung， and colon samples were collected. HE staining was used to observe the histopathological changes of the pancreas and lungs， and the serum levels of α-amylase， lipase， tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， alanine aminotransferase， aspartate aminotransferase， and creatinine were measured. RT-PCR was used to measure the expression of proinflammatory factors in the pancreas and lungs； myeloperoxidase （MPO） immunohistochemistry was used to observe the degree of neutrophil infiltration； Western blot was used to measure the activation of nuclear factor-kappa B （NF-κB） and the level of citrullinated histone H3 （CitH3）， a marker for the formation of neutrophil extracellular traps （NETs）， in the pancreas and lungs， as well as the expression level of ZO-1 in colon tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the Dunnett’s t-test was used for further comparison between two groups. ResultsCompared with the control group， the model group had severe injury in the pancreas and lungs and significant increases in the activity of serum α- amylase and lipase and the levels of the proinflammatory cytokines IL-6， interleukin-1β （IL-1β）， and TNF-α in serum and lung tissue （all P<0.05）， as well as significant increases in NF-κB activation， neutrophil infiltration， and the formation of NETs in the pancreas and lungs （all P<0.05）. Compared with the model group， the CA group had alleviated pathological injury of the pancreas and lungs and significant reductions in the activity of serum α-amylase and the levels of the proinflammatory cytokines IL-6， IL-1β， and TNF-α in serum and lung tissue （all P<0.05）， as well as significant reductions in NF-κB activation， neutrophil infiltration， and the formation of NETs in the pancreas and lungs （all P<0.05）. ConclusionCA can alleviate SAP induced by caerulein combined with LPS in mice， possibly by inhibiting neutrophil recruitment and the formation of NETs.