With the accelerating global trend of population aging, health issues among the elderly have garnered increasing attention. Cognitive frailty and depressive symptoms, are common health concerns in this population, significantly impacting mental health and quality of life, and are closely linked to a range of adverse health outcomes. This article provides an updated review of recent advances in research on depressive symptoms in the elderly with cognitive frailty, focusing on clinical epidemiology, shared pathophysiological mechanisms, and key influencing factors. The aim is to offer robust theoretical foundations and practical guidance for the optimization of elderly health services and policy development, and ultimately achieve the goals of healthy aging and improvement of quality of life for the elderly.

Objective:To analyze trends in urticaria incidence among children aged 0 - 14 years in China from 1990 to 2021, to explore its changing patterns in different age, period, and cohort groups, and to investigate the impact of age and air pollutants on the incidence trends.Methods:Data were obtained from the Global Burden of Disease Database (GBD2021) , including the number of urticaria cases, crude incidence rates, and age-standardized incidence rates among children aged 0 - 14 years of different genders in China from 1990 to 2021. The Joinpoint regression model was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to assess temporal trends in incidence rates. An age-period-cohort model was applied to assess the effects of age, period, and cohort on urticaria incidence. Data on the annual emissions of 4 air pollutants (SO 2, CO, PM 2.5, and PM 10) in China from 1990 to 2021 were obtained from the Emissions Database for Global Atmospheric Research (EDGAR) , and a multivariable meta-regression model was used to explore the relationship between air pollutants and urticaria incidence. Results:From 1990 to 2021, the age-standardized incidence rate of urticaria among children aged 0 - 14 years in China demonstrated a slight overall downward trend (AAPC = -0.03%, P < 0.01) . The incidence rate was generally higher in female children than in male children, and the decline in incidence rates was greater in female children than in male children (female AAPC = -0.02%, male AAPC = -0.01%, both P < 0.01) . The age-period-cohort model indicated that the risk of urticaria decreased with advancing age: with the age group of 0 - 4 years as the reference ( RR = 1.000) , the risk of urticaria significantly decreased in the age group of 5 - 9 years ( RR = 0.790, 95% CI: 0.789 - 0.791) and further declined in the age group of 10 - 14 years ( RR = 0.711, 95% CI: 0.710 - 0.711) ; the period effect analysis showed that the risk of urticaria gradually decreased after the baseline period of 1992 - 1996 ( RR = 1.000) , and dropped to 0.995 (95% CI: 0.994 - 0.997) in the period of 2017 - 2021; in the cohort effect analysis of the overall population aged 0 - 14 years, with the 1988 - 1992 birth cohort as the base cohort, an earlier birth cohort 1978 - 1982 exhibited the highest risk of urticaria ( RR = 1.006, 95% CI: 1.004 - 1.009) , while the 2013 - 2017 cohort showed the lowest risk ( RR = 0.996, 95% CI: 0.994 - 0.997) . The multivariable meta-regression analysis indicated a significant association between PM 2.5 exposure and urticaria incidence ( β = 0.319, 95% CI: 0.022 - 0.616, P = 0.033) , although this association was not statistically significant in different age groups. Conclusions:From 1990 to 2021, children aged 0 - 4 years in China were the highest-risk group for urticaria; the decline in the incidence rate of urticaria was more pronounced in female children than in male children, and earlier birth cohorts exhibited higher risks of urticaria. Exposure to PM 2.5 appeared to be associated with the incidence of urticaria.

Concepts are the cornerstone of the development of disciplines. The concepts of TCM present that a superior concept contains more subordinate concepts. The superordinate concepts are often used to refer to different subordinate concepts, which can refer to both superior concepts themselves and non-specific subordinate concepts, that is, the characteristics of subordinate coverage and indefinite reference, which cause confusion in concept meaning, concept relationships, reasoning logic, and other problems. Nowadays, the TCM scholars pay little attention to this characteristic. Therefore, this article analyzed this characteristic, discussed its impact on the inheritance and development of TCM, and proposed that starting from the anchoring of concepts and entities to clarify the connotation of concepts, looking forward to provide new ideas for the definition of the concepts of TCM and the development of the discipline.

Objective:To analyze the risk factors of anxiety and depression in elderly bronchiectasis patients and establish a nomogram model.Methods:A total of 90 elderly patients with bronchiectasis who were treated in Sichuan Santai County People′s Hospital from January 2020 to January 2023 were selected as the research subjects. The incidence of anxiety and depression in patients was observed, influencing factors were analyzed by univariate and multivariate Logistic regression analysis, and a predictive risk column chart model was established.Results:In 90 elderly patients, 40 patients experienced anxiety and depression, with an incidence rate of 44.44%. Univariate and multivariate Logistic regression analysis showed that hospitalization frequency, hemoptysis, educational level, arterial partial oxygen pressure (PaO 2), severity of the condition, copper green colonization, length of hospital stay, monthly family income, and family happiness index were risk factors for anxiety and depression in elderly patients with bronchiectasis ( P<0.05). A column line prediction model for anxiety and depression in elderly patients with bronchiectasis based on 9 independent risk factors was drawn. The calibration verification result show that the predicted values of the model had a high degree of fit with the measured values. The internal validation result of bootstrap showed that the C-index was 0.724 (95% CI 0.670 -0.779). Conclusions:The occurrence of anxiety and depression in elderly patients with bronchiectasis can be influenced by various factors. The model has high predictive performance.

Objective:To analyze the risk factors of anxiety and depression in elderly bronchiectasis patients and establish a nomogram model.Methods:A total of 90 elderly patients with bronchiectasis who were treated in Sichuan Santai County People′s Hospital from January 2020 to January 2023 were selected as the research subjects. The incidence of anxiety and depression in patients was observed, influencing factors were analyzed by univariate and multivariate Logistic regression analysis, and a predictive risk column chart model was established.Results:In 90 elderly patients, 40 patients experienced anxiety and depression, with an incidence rate of 44.44%. Univariate and multivariate Logistic regression analysis showed that hospitalization frequency, hemoptysis, educational level, arterial partial oxygen pressure (PaO 2), severity of the condition, copper green colonization, length of hospital stay, monthly family income, and family happiness index were risk factors for anxiety and depression in elderly patients with bronchiectasis ( P<0.05). A column line prediction model for anxiety and depression in elderly patients with bronchiectasis based on 9 independent risk factors was drawn. The calibration verification result show that the predicted values of the model had a high degree of fit with the measured values. The internal validation result of bootstrap showed that the C-index was 0.724 (95% CI 0.670 -0.779). Conclusions:The occurrence of anxiety and depression in elderly patients with bronchiectasis can be influenced by various factors. The model has high predictive performance.

Objective:To analyze trends in urticaria incidence among children aged 0 - 14 years in China from 1990 to 2021, to explore its changing patterns in different age, period, and cohort groups, and to investigate the impact of age and air pollutants on the incidence trends.Methods:Data were obtained from the Global Burden of Disease Database (GBD2021) , including the number of urticaria cases, crude incidence rates, and age-standardized incidence rates among children aged 0 - 14 years of different genders in China from 1990 to 2021. The Joinpoint regression model was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to assess temporal trends in incidence rates. An age-period-cohort model was applied to assess the effects of age, period, and cohort on urticaria incidence. Data on the annual emissions of 4 air pollutants (SO 2, CO, PM 2.5, and PM 10) in China from 1990 to 2021 were obtained from the Emissions Database for Global Atmospheric Research (EDGAR) , and a multivariable meta-regression model was used to explore the relationship between air pollutants and urticaria incidence. Results:From 1990 to 2021, the age-standardized incidence rate of urticaria among children aged 0 - 14 years in China demonstrated a slight overall downward trend (AAPC = -0.03%, P < 0.01) . The incidence rate was generally higher in female children than in male children, and the decline in incidence rates was greater in female children than in male children (female AAPC = -0.02%, male AAPC = -0.01%, both P < 0.01) . The age-period-cohort model indicated that the risk of urticaria decreased with advancing age: with the age group of 0 - 4 years as the reference ( RR = 1.000) , the risk of urticaria significantly decreased in the age group of 5 - 9 years ( RR = 0.790, 95% CI: 0.789 - 0.791) and further declined in the age group of 10 - 14 years ( RR = 0.711, 95% CI: 0.710 - 0.711) ; the period effect analysis showed that the risk of urticaria gradually decreased after the baseline period of 1992 - 1996 ( RR = 1.000) , and dropped to 0.995 (95% CI: 0.994 - 0.997) in the period of 2017 - 2021; in the cohort effect analysis of the overall population aged 0 - 14 years, with the 1988 - 1992 birth cohort as the base cohort, an earlier birth cohort 1978 - 1982 exhibited the highest risk of urticaria ( RR = 1.006, 95% CI: 1.004 - 1.009) , while the 2013 - 2017 cohort showed the lowest risk ( RR = 0.996, 95% CI: 0.994 - 0.997) . The multivariable meta-regression analysis indicated a significant association between PM 2.5 exposure and urticaria incidence ( β = 0.319, 95% CI: 0.022 - 0.616, P = 0.033) , although this association was not statistically significant in different age groups. Conclusions:From 1990 to 2021, children aged 0 - 4 years in China were the highest-risk group for urticaria; the decline in the incidence rate of urticaria was more pronounced in female children than in male children, and earlier birth cohorts exhibited higher risks of urticaria. Exposure to PM 2.5 appeared to be associated with the incidence of urticaria.

Objective:To investigate the regulatory mechanism of myoepithelial cells on glandular epithelial cells during the invasive process of ductal carcinoma in situ of breast.Methods:A total of 157 patients with ductal carcinoma in situ of breast,treated at the Tianjin Medical University Cancer Hospital from May 2008 to July 2010,were randomly selected(including 63 high nuclear grade patients,51 middle nuclear grade patients,and 43 low nuclear grade patients).Immunohistochemical staining for epithelial-mesenchymal transition(EMT)-related markers(Snail and ZEB1)was performed on tumor tissue specimens from these patients to explore the correlation between tumor cell nuclear grade,EMT process,and expression status of myoepithelial cells.To further investigate the regulatory role of myoepithelial cells on glandular epithelial cells during the invasive process of ductal carcinoma in situ of breast,a co-culture model of human myoepithelial cell line Hs578Bst and adenomatous epithelial cell line MCF-7 was established using Transwell chambers.Experimental,blank control,positive control,and negative control groups were designed by combining co-cultured Hs578Bst and MCF-7 cells with exogenous TGFβ1 and TGFβ1 inhibitors.After 72 hours of culture,morphological changes,migration and proliferation capabilities of MCF-7,as well as the changes in protein and mRNA expression levels of EMT-related genes(Snail and ZEB1),were observed in each group.Results:Immunohistochemical staining results demonstrated a positive correlation between tumor nuclear atypia,EMT activation,and myoepithelial cell expression in ductal carcinoma in situ tissues.The model of ductal carcinoma in situ of breast demonstrated that myoepithelial cells Hs578Bst promoted morphological changes in glandular epithelial cells MCF-7 by stimulating TGFβ1 expression.Wound healing and cell proliferation assays revealed that myoepithelial cells Hs578Bst can enhance migration and proliferation of glandular epithelial cells MCF-7 via TGFβ1 activation.Western blot and real-time quantitative PCR confirmed that myoepithelial cells Hs578Bst can upregulate the protein and mRNA expression levels of EMT-related genes(Snail and ZEB1)in glandular epithelial cells MCF-7 by through TGFβ1 stimulation.Conclusion:Breast myoepithelial cells promote EMT in glandular epithelial cells by secreting/stimulating TGFβ1,thereby contributing to the occurrence of invasion in ductal carcinoma in situ of the breast.

Objective To investigate the effect of spleen on hepatic macrophages mediated activation of hepatic stellate cells(HSCs)in mice with liver fibrosis.Methods Eighteen male C57BL/6 mice were randomly divided into three groups.Mice in Group A and Group B were injected intraperitoneally with CCl4 to establish liver fibrosis mouse model,while those in Group C were injected with corn oil as normal control.Four weeks later,mice with liver fibrosis received splenectomy(Spx)or sham operation(Sham),respectively.After continuous injection for 2 weeks,liver homogenates(L-Homo)were prepared and liver cells were isolated from the three groups.Expressions of IL-1β,IL-13,TGF-β,TNF-α,PDGF-β and VEGF in the liver homogenates of the three groups were detected by Luminex multifactor analysis.The expressions of these cytokines in liver macrophages(L-Mψ)and other non-parenchymal cells of Sham and Spx mice were analyzed by Real-time quantitative PCR(RT-qPCR)and flow cytometry.Macrophage cell line RAW264.7 or bone marrow-derived macrophages(BMDMs)were treated with liver homogenates from the Sham and Spx groups.Then the differently treated RAW264.7 cells were analyzed for mRNA expressions of cytokines and glutamine metabolism-related molecules by RT-qPCR,or transwell co-cultured with hepatic stellate cell line JS1.After co-culture,the survival and extracellular matrix expression of JS1 cells were analyzed.For comparison,Student's t test(between two groups)or one-way analysis of variance(among multiple groups)were used.Results Compared with normal control group,the concentrations of IL-1β,IL-13,TGF-β and TNF-α in the L-Homo of model group were significantly increased and showed higher levels in Sham group than in Spx group.Moreover,the hepatic macrophages were indicated as the major source of these cytokines.Consistently,macrophages treated with liver homogenate of Sham mice had increased expressions of IL-1β,TGF-β and TNF-α and glutaminase(GLS).After co-culture with macrophages treated with liver homogenate of Sham group rather than Spx group,JS1 expressed higher expressions of α-SMA and collagens.Conclusion The spleen is involved in regulating the secretion of cytokines by hepatic macrophages and enhancing their ability to activate hepatic stellate cells.

Objective To address the quality problems caused by high porosity in the preparation of dental cobalt-chrome alloy prosthetics based on selective laser melting(SLM)technology,we investigated the influence mechanism of different forming process parameters on the microstructure and properties of the materials.Moreover,the range of form-ing process parameters that can effectively reduce defects was precisely defined.Methods The effects of laser power,scanning speed,and scanning distance on the pore properties,surface roughness,and hardness of dental cobalt-chrome al-loy were investigated by adjusting the printing parame-ters in the process of SLM.Through metallographic anal-ysis,image analysis,and molten pool simulation,the pore formation mechanism was revealed,and the relation-ship between the porosity and energy density of SLM dental cobalt-chrome alloy was elucidated.Results When the linear energy density was higher than 0.18 J/mm,the po-rosity defect easily appeared at the bottom of the molten pool.When the laser energy density was lower than 0.13 J/mm,defects occurred in the gap of the molten pool due to insufficient melting of powder.In particular,when the linear energy density exceeded the threshold of 0.30 J/mm or was below 0.12 J/mm,the porosity increased significantly to more than 1%.In addition,we observed a negative correlation between free surface roughness and energy density and an inverse re-lationship between macroscopic hardness and porosity.Conclusion On the basis of the conditions of raw materials and molding equipment used in this study,the key process parameters of SLM of molding parts with porosity lower than 1%were successfully determined.Specifically,these key parameters included the line energy density,which ranged from 0.13 J/mm to 0.30 J/mm,and the scan spacing should be strictly controlled below 90 μm.

Background Arsenic, cobalt, barium, and other individual metal exposure have been confirmed to be associated with the incidence of kidney stones. However, there are few studies on the association between mixed metal exposure and kidney stones, especially in occupational groups. Objective To investigate the association between mixed metal exposure and kidney stones in an occupational population from a metal smelting plant. Methods A questionnaire survey was conducted to collect sociodemographic characteristics, medical history, and lifestyle information of 1158 mixed metal-exposed workers in a metal smelting plant in Guangdong Province from July 2021 to January 2022. Midstream morning urine samples were collected from the workers, the concentrations of 18 metals including lithium, vanadium, chromium, manganese, cobalt, nickel, copper, zinc, arsenic, selenium, strontium, molybdenum, cadmium, cesium, barium, tungsten, titanium, and lead were measured by inductively coupled plasma mass spectrometry, and the urinary mercury levels were measured by cold atomic absorption spectroscopy. Based on predetermined inclusion criteria, a total of 919 mixed metal-exposed workers were included in the study, including 117 workers in the kidney stone group and 802 workers in the non-kidney stone group. With a detection rate of urinary metals greater than 80% as entry criterion, 16 eligible metals were finally included for further analysis. Parametric or non-parametric methods were used to compare the differences between continuous or categorical variables of the non-kidney stone group and the kidney stone group. Logistic regression models were constructed to explore the association between individual metal exposures and kidney stones. Weighted quantile sum (WQS) regression models were used to evaluate the association between mixed metal exposure and kidney stones, as well as the weights of each metal on kidney stones. Then Bayesian kernel machine regression (BKMR) models were used to explore the overall effect of mixed metal exposure on renal calculi and the potential interactions between metals. Results We found that there were significant differences in sex, age, length of service, and body mass Index (BMI) between the non-kidney stone group and the kidney stone group (P<0.05). The urinary concentrations of molybdenum and barium in the kidney stone group were higher than those in the non-kidney stone group, and the differences were statistically significant (P<0.05). The logistic regression models demonstrated that urinary cobalt, arsenic, molybdenum, and barium were positively correlated with the risk of kidney stones (P_trend<0.05). The WQS regression models showed that the mixed exposure to vanadium, cobalt, arsenic, molybdenum, and barium was positively associated with the risk of kidney stones (P<0.05). Among them, molybdenum, arsenic, and barium accounted for 0.391, 0.337, and 0.154, respectively. The BKMR results revealed a positive association between metal mixture exposure and the risk of kidney stones (P<0.05). When other metals were fixed at the 25th, 50th, or 75th percentile, arsenic, molybdenum, cobalt, and barium exhibited significant positive effects on the risk of kidney stones (P<0.05), while vanadium showed a significant negative effect (P<0.05). The interaction analysis demonstrated interactions between barium and cobalt, as well as between vanadium and cobalt (P<0.05). Conclusion In the occupational population of this smelter, occupational mixed metal exposure could increase the risk of kidney stones, and the main metals are molybdenum, arsenic, barium, and cobalt.