Objective To investigate the current status of sleep disorders in patients with Alzheimer’s disease (AD) and its relationship with physical activity, and analyze the intervention effect of light therapy. Methods A total of 345 patients with AD admitted to the First Affiliated Hospital of Air Force Medical University from June 2020 to June 2025 were included. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep disorders, and the Physical Activity Scale for the Elderly (PASE) was applied to evaluate the physical activity. Pearson correlation analysis model was adopted to analyze the correlation between PSQI and PASE in patients with AD. 345 patients with AD were treated with light therapy intervention for 4 weeks. The changes of PSQI and PASE scores were compared before and after intervention. Results Among the 345 patients with AD, 251 cases had sleep disorders, accounting for 72.75% (251/345), and the PSQI score was (9.87±2.95) points. The scores of leisure activity, housework and occupation-related activity of PASE were (25.81±6.12) points, (78.15±12.93) points, and (45.31±8.74) points, respectively. Pearson correlation analysis model revealed that the leisure activity score of PASE was negatively correlated with the PSQI score (P<0.05), and the scores of housework and occupation-related activity were not significantly correlated with the PSQI score (P>0.05). After 4 weeks of light therapy intervention, the score of leisure activity of patients was increased significantly (P<0.05), while the scores of housework and occupation-related activity did not change significantly (P>0.05), and the PSQI scores were decreased significantly (P<0.05). Conclusion There is a correlation between sleep disorders and leisure time and physical activity in patients with Alzheimer's disease. The implementation of light therapy intervention can effectively improve sleep disorders in AD patients.

AIM:To compare the clinical efficacy of phacoemulsification with 2.2 mm versus 3.0 mm clear corneal incisions in patients with age-related cataract(ARC).

METHODS: ARC patients treated in the Ophthalmology Department of the hospital from January 2025 to November 2025 were retrospectively enrolled and divided into two groups according to the corneal incision size: the observation group underwent 2.2 mm clear corneal incision, while the control group underwent 3.0 mm clear corneal incision. The two groups were compared in terms of intraoperative parameters, pre- and postoperstive best-corrected visual acuity(BCVA), surgically induced astigmatism(SIA)at 1 wk, 1 and 3 mo postoperatively, inflammatory response(anterior chamber flare value and anterior chamber inflammatory cell count)at 1 and 3 d postoperatively, corneal endothelial cell parameters \〖corneal endothelial cell density(CECD), hexagonal cell ratio(HEX), coefficient of variation(CV)of cell area, and corneal endothelial cell loss rate\〗 measured preoperatively and at 3 mo postoperatively, and the incidence of complications within 3 mo after surgery.

RESULTS:A total of 120 ARC patients(120 eyes for patients with bilateral eyes meeting the inclusion criteria, only the right eye was enrolled)were enrolled, with 60 patients(60 eyes)in the observation group(31 males and 29 females, mean 68.93±6.01 y)and 60 patients(60 eyes)in the control group(28 males and 32 females, mean 69.25±5.73 y). No statistically significant differences were observed in preoperative baseline data between the two groups(all P>0.05). The mean intraoperative ultrasound time, mean phacoemulsification energy, cumulative dissipated energy, and volume of irrigation fluid used in the observation group were significantly lower than those in the control group(all P<0.01. At 1 d and 1 wk postoperatively, BCVA in the observation group was significantly better than that in the control group(both P<0.05). At 1 and 3 mo postoperatively, there was no statistically significant difference in BCVA between the two groups(both P>0.01). At 1 wk, 1 and 3 mo postoperatively, SIA in the observation group was significantly lower than that in the control group, and the change in astigmatism axis at 3 mo postoperatively was also significantly smaller in the observation group(P<0.01). At 1 and 3 d postoperatively, the anterior chamber flare value and inflammatory cell count in the observation group were significantly lower than those in the control group(all P<0.05). At 3 mo postoperatively, CECD and HEX in the observation group were significantly higher than those in the control group, while CV and endothelial cell loss rate were significantly lower(all P<0.05). The total incidence of postoperative complications in the observation group was 11.7%, which was significantly lower than that in the control group(26.7%, P<0.05).

CONCLUSION:Compared with the 3.0 mm clear corneal incision, the 2.2 mm clear corneal incision phacoemulsification for ARC can significantly improve phacoemulsification efficiency, reduce early postoperative inflammatory response and SIA, accelerate visual recovery, better preserve the morphology and function of corneal endothelial cells in the short term, and lower the incidence of complications.

Objective:To explore the categories and influencing factors of depression in mild cognitive impairment (MCI) patients, so as to provide a reference for formulating precise interventions for depression in MCI patients.Methods:A cross-sectional investigation was conducted. Patients with MCI admitted to the Department of Neurology, The First Affiliated Hospital of Nanchang University from December 2022 to December 2023 were selected as the investigation objects by convenience sampling method. The general data questionnaire, Hamilton Depression Rating Scale-17, Montreal Cognitive Assessment Scale and Lubben Social Network Scale-6 were used to conduct a survey. Latent profile analysis and multiple Logistic regression analysis were used to explore the categories and influencing factors of depression.Results:A total of 537 patients with MCI were included, including 335 females and 202 males, aged (65.72 ± 9.53) years old. MCI patients scored (22.67 ± 4.68) points on the Montreal Cognitive Assessment Scale, (13.27 ± 5.73) points on the Lubben Social Network Scale-6, and 9.00 (5.00, 13.00) points on the Hamilton Depression Rating Scale-17. The depression in MCI patients could be divided into three categories: low risk depression (67.8%, 364/537), low depression-sleep disorder (20.1%, 108/537), and high depression-anxiety (12.1%, 65/537). The multiple Logistic regression analysis showed that gender, education, living style, social isolation and cognitive function were the influencing factors for different categories of depression ( OR values were 0.443-2.921, all P<0.05). Conclusions:There are individual differences in depression in patients with MCI, and precise intervention should be implemented according to the characteristics of different categories of depression.

Objective To explore latent classes of behavioural and psychological symptoms in the patients with Alzheimer's disease(AD)and to identify the factors influencing the latent classes and provide a basis for fomulating personalized nursing measures.Methods Convenience sampling was employed to recruit 361 AD inpatients from our hospital between November 2023 and May 2024 for this cross-sectional study.A general data questionnaire,the neuropsychiatric inventory questionnaire,Monteria cognitive assessment scale,activity of daily life scale,and mini-nutritional assessment scale were used in the survey.Latent class analysis was conducted to analyse the data acquired from the survey.Univariate analysis and multiple Logistic regression analysis were used to identify the factors influencing latent classes.Results Toally 346 patients finished the study.It was found that a 72.5%of AD patients developed behavioural and psychological symptoms.The symptoms were categorised into three classes:low symptom-apathy,middle symptom-emotional disturbance and high symptom-behaviour disorder.The course of disease,cognitive function,daily living ability and nutritional status were identified as the factors that influenced the latent classes(all P<0.05).Conclusion AD patients with low cognitive function,poor daily living ability,malnutrition and a course of disease over 5 years are at high risks of behavioural and psychological symptoms which are heterogeneous.Care providers are advised to propose personalised care strategies to improve the behavioural and psychological symptoms.

Objective To explore the early detection value of estimated glucose disposal rate(eGDR)for non-alcoholic fatty liver disease(NAFLD),providing a simple tool for precise clinical intervention.Methods A cross-sectional analysis was conducted on totally 3 262 participants with complete data from the National Health and Nutrition Survey Database of the United States from 2007 to 2018.Univariate regression and multivariate logistic regression analyses were used to explore the correlation between the estimated glucose treatment rate and the incidence of non-alcoholic fatty liver disease.Subgroup analysis,restricted cubic spline and threshold effect analysis were conducted to investigate the potential factor influences and nonlinear relationships.Result Among all the included populations,948 cases(25.29%)were diagnosed with NAFLD,and the number gradually decreased with the increase of the estimated glucose treatment rate(P<0.001).Multivariate logistic regression showed that the estimated grape processing rate was negatively correlated with non-alcoholic fatty liver disease(OR=0.86,95%CI:0.83～0.88,P<0.001),and when the estimated glucose processing rate was≥10.246,it could significantly reduce the risk of non-alcoholic fatty liver disease(OR=0.20,95%CI:0.10～0.39,P<0.001),and stratified analysis further confirmed this result.Conclusion The eGDR is significantly associated with the incidence risk of NAFLD.A higher eGDR indicates a lower risk of NAFLD.This implies that in clinical practice,the risk of disease detection can be quantified through this indicator,thereby identifying potential patients earlier and initiating intervention.Countermeasures As decision-makers,they should strengthen public health education on non-alcoholic fatty liver disease,reduce health risks by promoting healthy diets and lifestyle interventions,and pay attention to the cardiovascular health of high-risk groups for non-alcoholic fatty liver disease.At the same time,promote the research and application of drugs,and dynamically adjust policies through continuous disease monitoring to comprehensively reduce the burden of non-alcoholic fatty liver disease.

Objective:To explore the prognostic value of serum free light chain in chronic lymphocytic leukemia patients.Methods:Retrospective cohort study was conducted. One hundred and fifty-six newly diagnosed chronic lymphocytic leukemia(CLL) patients in the first affiliated hospital of Nanjing Medical University from January 2016 to December 2020 were included in the retrospective analysis. Among them, there were 106 males and 50 females, with a median age of 60.7 (53.4, 66.0) years old.Serum sample was collected, serum free light chains were detected, and patients were divided into a treatment group (106 cases) and a follow-up group (50 cases) based on the presence of treatment indications.The threshold of serum free light chain(sFLC) was defined by the reference range of the instruction manual and ROC curve. Three indicators were used, including sFLCR, sFLC(κ+λ) and sFLC(κ-λ). Patients were divided into normal sFLCR group ( n=61)and abnormal group( n=95), as well as sFLC (κ+λ) low value group ( n=88) and high value group ( n=68), and sFLC (κ-λ) low value group ( n=64) and high value group ( n=92).The abnormal group and high value group were enrolled as the experimental group, while the normal group and low value group were enrolled as control group. Chi-square test and Fisher′s exact test were used to compare the clinical data, cytogenetics, and molecular biology characteristics of patients in two groups, Kaplan-Meier method was used to analyze the median treatment-free survival (TFS) of the patients, and Cox regression was used to screen the prognostic factors of the patients. Results:The proportion of Rai stage Ⅰ-Ⅳ ( χ2=8.16, P<0.05 and χ2=7.63, P<0.05 and χ2=5.45, P<0.05), Binet stage B-C( χ2=4.11, P<0.05 and χ2=9.43, P<0.05 and χ2=7.34, P<0.05), β 2-microglobulin>3.5 mg/L( χ2=5.13, P<0.05 and χ2=18.3, P<0.05 and χ2=12, P<0.05), ATM gene mutation rate( χ2=6.21, P<0.05 and χ2=4.88, P<0.05 and χ2=5.19, P<0.05), and immunoglobulin heavy chain variable region (IGHV) mutation free rate ( χ2=18.9, P<0.05 and χ2=24.6, P<0.05 and χ2=10.4, P<0.05)in the experimental group were significantly higher than that in control group 1 ( P<0.05). Multivariate analysis indicated that sFLC(κ+λ) ( HR=1.615,95% CI 1.012-2.576, P=0.044), β 2-microglobulin>3.5 mg/L( HR=2.103,95% CI 1.356-3.262, P=0.001) and TP53 deletion and/or mutation( HR=1.892,95% CI 1.082-3.308, P=0.025) were independent prognostic factors affecting the patients time to first treatment(TFT). Conclusions:Serum free light chains can predict the risk of early treatment and have good prognostic significance in newly diagnosed CLL patients.

Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.

Objective:To explore the categories and influencing factors of depression in mild cognitive impairment (MCI) patients, so as to provide a reference for formulating precise interventions for depression in MCI patients.Methods:A cross-sectional investigation was conducted. Patients with MCI admitted to the Department of Neurology, The First Affiliated Hospital of Nanchang University from December 2022 to December 2023 were selected as the investigation objects by convenience sampling method. The general data questionnaire, Hamilton Depression Rating Scale-17, Montreal Cognitive Assessment Scale and Lubben Social Network Scale-6 were used to conduct a survey. Latent profile analysis and multiple Logistic regression analysis were used to explore the categories and influencing factors of depression.Results:A total of 537 patients with MCI were included, including 335 females and 202 males, aged (65.72 ± 9.53) years old. MCI patients scored (22.67 ± 4.68) points on the Montreal Cognitive Assessment Scale, (13.27 ± 5.73) points on the Lubben Social Network Scale-6, and 9.00 (5.00, 13.00) points on the Hamilton Depression Rating Scale-17. The depression in MCI patients could be divided into three categories: low risk depression (67.8%, 364/537), low depression-sleep disorder (20.1%, 108/537), and high depression-anxiety (12.1%, 65/537). The multiple Logistic regression analysis showed that gender, education, living style, social isolation and cognitive function were the influencing factors for different categories of depression ( OR values were 0.443-2.921, all P<0.05). Conclusions:There are individual differences in depression in patients with MCI, and precise intervention should be implemented according to the characteristics of different categories of depression.

Objective Using Meta-analysis to systematically evaluate the incidence and risk factors of pulmonary infection occurring in patients with acute ischemic stroke(AIS)after receiving mechanical thrombectomy.Methods A computerized retrieval of academic papers concerning the case-control study and cohort study of lung infection in patients with AIS after mechanical thrombectomy from the databases of PubMed,Web of Science,Embase,Cochrane Library,China Knowledge Network,Wanfang Data Knowledge Service Platform,and Wipro.com databases was conducted by two independent investigators.The retrieval time period was from the establishment of the database to December 2023.STAT A 16.0 software was used to make the Meta-analysis of the extracted literature.Results A total of 10 literature were included,with a combined sample size of 6 149 cases and 2 076 cases occurring lung infections.Meta-analysis revealed that the pulmonary infection in patients after mechanical thrombectomy for AIS showed a high degree of heterogeneity in the included studies(I2=97.87％,P＜0.001),and a random-effects model yielded an incidence of 31.8％for pulmonary infection.Risk factors for the occurrence of postoperative lung infection included atrial fibrillation(OR=1.33,95％CI:1.10-1.6,P=0.004),dysphagia(OR=3.83,95％CI:2.43-6.05,P＜0.001),high NIHSS score(OR=1.43,95％CI:1.05-1.94,P=0.023),impaired consciousness(OR=2.29,95％CI:1.38-3.81,P＜0.001),and intraoperative use of sedative drugs(OR=3.21,95％CI:2.91-3.54,P＜0.001).Conclusion The existing evidences indicate that patient's age ≥60 years,atrial fibrillation,dysphagia,impaired consciousness,high NIHSS score,and intraoperative use of sedative drugs are risk factors for the occurrence of pulmonary infection in AIS patients after receiving mechanical thrombectomy.In clinical practice,these risk factors should be highly valued,and these risk factors should be included in the postoperative comprehensive assessment and intervention strategies for patients so as to reduce the incidence of pulmonary infection.

Objective To evaluate the risk factors for pulmonary infection in patients with acute ischemic stroke after receiving mechanical thrombectomy and to construct a risk prediction model based on machine-learning algorithm technology.Methods A total of 315 patients with acute ischemic stroke,who received mechanical thrombectomy at the Kunming Yan'an Hospital and Kunming Municipal First People's Hospital,were enrolled in this study.The 315 patients who were admitted to the hospital between January 2019 and December 2023 were collected as the modeling group,and other 73 patients who were admitted to the hospital between January 2024 and September 2024 were collected as the validation group.The demographic materials and the clinical diagnosis and treatment data were collected within 24 h after admission,and the risk factors for pulmonary infection after mechanical thrombectomy were analyzed.A total of seven machine learning algorithms were employed to establish a predictive model for pulmonary infection in patients with large-vessel occlusive stroke after receiving mechanical thrombectomy.Based on the accuracy,recall,precision,F1 index,and area under the receiver operating characteristic curve(AUC),the performance of model was evaluated.Results The comprehensive performance in accuracy,recall,precision,F1 index and AUC of the gradient boosting classifier in both the modeling group and the validation group are all excellent.Conclusion The risk prediction model constructed on the basis of machine-learning algorithm technology can early identify lung infection and discover the risk factors in patients with acute ischemic stroke after receiving mechanical thrombectomy,therefore,the prevention and control measures can be promptly taken,the incidence of lung infection can be effectively decreased.