The aging process in China is accelerating, and geriatric care is facing daunting challenges. This paper reviews the concept, component factors, measurement methods of cognitive reserve, and its role in geriatric nursing, and elaborates on the necessity of personalized cognitive reserve intervention for the aged, so as to promote the application of cognitive reserve in geriatric nursing.

Objective:To investigate the potential mechanism of electroacupuncture(EA)at bilateral Fengchi(GB20)in treating cerebral ischemia-reperfusion injury and to provide a scientific basis for future experimental research and clinical applications. Methods:Forty male specific-pathogen-free Sprague-Dawley rats were randomly divided into four groups:a normal group,a normal with EA group,a model group,and a model with EA group,with 10 rats in each group.The normal group received no intervention.The normal with EA group received EA at bilateral Fengchi(GB20).The model group underwent middle cerebral artery occlusion(MCAO)using the suture.The model with EA group underwent MCAO and received EA at bilateral Fengchi(GB20).Cerebral blood flow was monitored using a laser Doppler cerebral blood flow meter.Neurologic damage was assessed using the neurologic deficit score,and motor ability was observed using the CatWalk gait system.The expression of glial fibrillary acidic protein(GFAP)and neuronal nuclei(NeuN)protein,the neuron markers,was detected by Western blotting.The protein expression levels of GFAP and NeuN,as well as the number of positive cells in the motor cortex,were detected using immunofluorescence. Results:Compared to the normal group,the cerebral blood flow values in the model group and the model with EA group decreased by more than 50%during the modeling process(P<0.01)and returned to pre-modeling levels after reperfusion(P>0.05).The neurologic deficit score increased(P<0.05),the average motor velocity decreased(P<0.05),GFAP protein expression and the number of positive cells in the motor cortex increased(P<0.05),and the NeuN protein expression and the number of positive cells decreased(P<0.05)in the model group.Compared to the model group,the neurologic deficit score decreased(P<0.05),the average motor velocity accelerated(P<0.05),GFAP and NeuN protein expression and the number of positive cells in the motor cortex increased(P<0.01)in the model with EA group. Conclusion:EA at bilateral Fengchi(GB20)can reduce neuronal loss and increase GFAP and NeuN protein expression in the motor cortex of rats after ischemia-reperfusion,improve the motor function after ischemic stroke,and accelerate the recovery of balance and stability of the affected limbs.

Objective:To evaluate the efficacy and safety of hypomethylating agents (HMA) in patients with myelodysplastic syndromes (MDS) .Methods:A total of 409 MDS patients from 45 hospitals in Zhejiang province who received at least four consecutive cycles of HMA monotherapy as initial therapy were enrolled to evaluate the efficacy and safety of HMA. Mann-Whitney U or Chi-square tests were used to compare the differences in the clinical data. Logistic regression and Cox regression were used to analyze the factors affecting efficacy and survival. Kaplan-Meier was used for survival analysis. Results:Patients received HMA treatment for a median of 6 cycles (range, 4-25 cycles) . The complete remission (CR) rate was 33.98% and the overall response rate (ORR) was 77.02%. Multivariate analysis revealed that complex karyotype ( P=0.02, OR=0.39, 95% CI 0.18-0.84) was an independent favorable factor for CR rate. TP53 mutation ( P=0.02, OR=0.22, 95% CI 0.06-0.77) was a predictive factor for a higher ORR. The median OS for the HMA-treated patients was 25.67 (95% CI 21.14-30.19) months. HMA response ( P=0.036, HR=0.47, 95% CI 0.23-0.95) was an independent favorable prognostic factor, whereas complex karyotype ( P=0.024, HR=2.14, 95% CI 1.10-4.15) , leukemia transformation ( P<0.001, HR=2.839, 95% CI 1.64-4.92) , and TP53 mutation ( P=0.012, HR=2.19, 95% CI 1.19-4.07) were independent adverse prognostic factors. There was no significant difference in efficacy and survival between the reduced and standard doses of HMA. The CR rate and ORR of MDS patients treated with decitabine and azacitidine were not significantly different. The median OS of patients treated with decitabine was longer compared with that of patients treated with azacitidine (29.53 months vs 20.17 months, P=0.007) . The incidence of bone marrow suppression and pneumonia in the decitabine group was higher compared with that in the azacitidine group. Conclusion:Continuous and regular use of appropriate doses of hypomethylating agents may benefit MDS patients to the greatest extent if it is tolerated.

Objective To study the mechanism of changes of brain gut peptides in the serum of sleep deprived rats in the pathogenesis of laryngopharyngeal reflux.Methods Forty healthy adult male SD rats were selected and divided into the experimental group and the control group.The control group slept normally.The experimental group was divided into three subgroups,each with 10 rats.The improved multi-platform water environment method was used to deprive 8 hours of daytime sleep for 1,2,and 3 months,respectively.Detection of motilin(MTL)and somatostatin(SS)concentrations in peripheral blood was completed using ELISA,and detection of gastrin(GAS)concentrations in peripheral blood was conducted using radioimmunoassay.The differences among the groups were compared.Results The GAS concentration in the 2-month group was significantly lower than that in the control group,while the GAS concentration in the 3-month group was significantly higher than that in the 1-month and 2-month groups(P＜0.05).There was no statistically significant difference between the MTL concentration in the three experimental groups and the control group pairwise(P＞0.05),but the MTL concentration in the 2-month group was significantly higher than that in the 3-month group(P＜0.01).There was no statistical difference be-tween the SS concentration in the three experimental groups and the control group,as well as among the three ex-perimental groups.Conclusion Sleep deprivation may be associated with the occurrence of laryngopharyngeal reflux by affecting the secretion of GAS and MTL.

Objective To investigate vascular remodeling and low-density lipoprotein(LDL)deposition,the growth and development trends of lateral branch plaques in bifurcated vessels,and the potential locations of subsequent plaque growth due to the presence of plaques.Methods An idealized model of bifurcated vessels was established and the distribution of wall shear stress before and after the growth of edge-branch plaques was obtained using computational fluid dynamics.Seven sections were intercepted in the areas of low shear stress:planes 1-3 were the low shear stress areas on the lateral branch before plaque formation,planes 4-5 were the proximal and distal edges of the plaque,and planes 6-7 were the lower shear stress areas of the plaque.Vascular remodeling and LDL deposition in the cross section were simulated.The growth and development trends of plaques are also discussed.Results Among planes 1-3,plane 2 produced obvious negative remodeling and the highest concentration of LDL deposition(102.266 mmol/L),thereby indicating that this was the initial location of the atherosclerotic plaque.Compared to plane 4,plane 5 produced more pronounced vascular remodeling,lumen narrowing,and the highest deposition concentration(110.17 mmol/L)after plaque formation,which indicated that the patch had a tendency for eccentric growth downstream.Compared to plane 6,plane 7(blood flow separation reattachment site)produced more negative remodeling and the highest deposition concentration(93.851 mmol/L),thereby indicating the possibility of new plaque formation near the reattachment point of blood flow separation.Conclusions Obvious vascular remodeling at low shear stress in the lateral branches leads to lumen stenosis and high LDL deposition,thus,forming atherosclerotic plaques.The lateral wall of the bifurcated blood vessels is the initial location of atherosclerotic plaque growth.After growth,the plaque tends to develop downstream,and subsequent plaques may form at the flow separation and reattachment points.

Objective To conduct a systematic study on the potential impact of long-term specialized golf training on the three-dimensional structure of the spine in adolescent children,and to reveal the biomechanical adaptation mechanism of children's spine,providing a theoretical basis for preventing potential sports injuries caused by golf training.Methods A longitudinal observational design was adopted,with 15 male adolescent children from a golf training center selected as research subjects.Three-dimensional spinal image data were collected using digital radiography at baseline,3 months and 6 months,and dynamic monitoring and analysis were performed.Results Golf training led to a series of adaptive changes in the three-dimensional structure of children's spine,mainly reflected in significant changes in pelvic tilt distance,vertebral body offset,vertebral rotation angle,pelvic rotation angle,and pelvic torsion angle.These changes exhibited a time-effect characteristic,indicating the strong adaptability of biomechanical system of children's spine.Conclusion Golf training can cause adaptive changes in the three-dimensional structure of children's spine,highlighting the need to maintain biomechanical balances of the spine and pelvis,and to take intervention measures such as symmetrical training to prevent sports injuries,improve training quality,and prolong athletic careers.

Objective The aim of this study was to screen and verify the proteins interacting with Vimentin,investigate the regulatory relationship between FABP5 and candidate proteins,and further explore the mechanism of FABP5 in hepatocellular carcinoma.Methods Immunoprecipitation combined with tandem mass spectrometry(IP-MS)was used to screen the proteins that bind to FABP5.The binding relationship between FABP5 and candi-date interacting proteins was verified from the exogenous and endogenous levels by Co-immune precipitation assay(Co-IP).RT-qPCR,Western blot and immunofluorescence were used to observe the effect of knockdown FABP5 on the transcription and translation of Vimentin in HCC cells.The effect of overexpressing FABP5 on the cytoskeleton of HCC cell was observed by phalloidin staining.Results 336 potential target proteins that bind to FABP5 were identi-fied through IP-MS.Based on literature,five candidate proteins related to tumors were selected,namely PRDX1,PRSS3,PKM,HSP90AA1,and Vimentin.The binding relationship between FABP5 and Vimentin protein was con-firmed through both exogenous and endogenous Co-IP.Knockdown FABP5 has no significant effect on the expression of Vimentin mRNA,but it can inhibit the expression of Vimentin protein,and overexpression of FABP5 can affect the cytoskeleton of HCC cell.Conclusions FABP5 promotes the migration and invasion of HCC cells by the regula-tion of Vimentin and the influence of cytoskeletal remodeling,and thus it is expected to be a potential target for anti-HCC and provide new ideas for the treatment of HCC.

Objective:To investigate the variations in infrared radiation at Taichong(LR3),Taixi(KI3),and control points before and after menstruation and to examine the infrared radiation patterns associated with Yuan-primordial points of Zang-Fu organs during the physiological menstrual cycle. Methods:Using a point infrared radiation spectrum detection system,we detected the infrared radiation spectra of Taichong(LR3),Taixi(KI3),and the control points located 1 cm away from the two points,in a range of 1.50-18.00 μm wavelengths during the premenstrual,menstrual,and postmenstrual phases in 32 healthy adult women.Subsequently,data mining and analysis were conducted. Results:Before,during,and after menstruation,the infrared spectral shapes of bilateral Taichong(LR3),Taixi(KI3),and their control points were generally consistent,with characteristic infrared spectral wavelengths located at 11.25 μm.Prior to menstruation,the total intensity of infrared radiation at the right Taixi(KI3)was significantly lower than that at the control point(P<0.05),and that at the left Taichong(LR3)was significantly lower than that at the control point(P<0.01).During and after menstruation,the total infrared radiation intensity at both Taixi(KI3)was significantly lower than that of the control point(P<0.05).The wavelength points exhibiting significant differences in the infrared radiation intensity between points and control points were concentrated at the primary peak of 7.50-14.25 μm and the secondary peak of 15.00-17.25 μm. Conclusion:During different menstrual phases,the infrared radiation spectra of Taichong(LR3)and Taixi(KI3)exhibited distinct point specificity,mainly evident in the infrared radiation intensity and wavelength.

Objective:To compare the prognostic values of different classification by using transpulmonary pressure gradient (TPG), diastolic pressure gradient (DPG) and pulmonary vascular resistance (PVR) in patients with pulmonary hypertension due to left heart disease (PH-LHD), and investigated hemodynamic and clinical factors associated with mortality in patients with PH-LHD.Methods:This was a single-center prospective cohort study. In-hospital patients diagnosed with PH-LHD via right heart catheterization at the Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, from September 2013 to December 2019 were enrolled. Patients were divided according to TPG (cutoff value 12 mmHg; 1 mmHg=0.133 kPa), DPG (cutoff value 7 mmHg), PVR (cutoff value 3 Wood Units), and the combination of TPG and PVR. Baseline characteristic was recorded. All patients were followed up until the occurrence of endpoint event, defined as all-cause death that occurred during the follow-up period, or until April 18, 2022. Receiver operating characteristic curves were used to compare the predictive value of 3 classification methods for all-cause death in PH-LHD patients. The optimal cutoff values were calculated using Jorden index. Survival analysis was performed using Kaplan-Meier analysis, and log-rank test was used to compare the predictive efficacy of classification methods based on optimal cutoff values or guidance-recommended thresholds for the survival of PH-LHD patients. Variables showing statistical significance in the univariate analysis were incorporated into multivariate Cox regression model to analyze the independent risk factors for all-cause mortality.Results:A total of 243 patients were enrolled, aged (54.9±12.7) years old, including 169 (69.5%) males. During a median follow-up of 57 months, there were 101 (41.6%) deaths occurred. Grouping results were as follows: (1) TPG: TPG≤12 mmHg group 115 patients, TPG>12 mmHg group 128 patients; (2) DPG: DPG<7 mmHg group 193 patients, DPG≥7 mmHg group 50 patients; (3) PVR: PVR≤3 Wood Units group 108 patients, PVR>3 Wood Units group 135 patients; (4) TPG and PVR: TPG≤12 mmHg and PVR≤3 Wood Units group 89 patients, TPG>12 mmHg and PVR>3 Wood Units group 109 patients. PVR ( AUC=0. 698,95% CI:0.631-0.766) had better predictive value for all-cause mortality than TPG ( AUC=0.596, 95% CI: 0.523-0.669) and DPG ( AUC=0.526, 95% CI: 0.452-0.601) (all P<0.05). The optimal cutoff values for TPG, DPG, and PVR were13.9 mmHg, 2.8 mmHg, and 3.8 Wood Units, respectively. Kaplan-Meier analysis based on the optimal cutoff values or guidance-recommended thresholds showed that PVR and TPG were the predictors of survival ( P<0.05), while DPG did not showed significance ( P>0.05). Multivariate Cox regression analysis showed that age, PVR and log 2N-terminal pro-B-type natriuretic peptide were independent risk factors for all-cause mortality in PH-LHD patients (all P<0.05). Conclusion:Classification according to PVR was most valuable in predicting all-cause death in PH-LHD patients, while TPG showed moderate predictive ability and DPG had no predictive value.

The standardization of classification methods of Traditional Chinese Medicine(TCM) ancient books can provide a clear and reliable reference for all kinds of TCM ancient books collection units, which can also promote the sharing and utilization of TCM ancient books. We studied and investigated the classification methods of TCM ancient books in past dynasties. The standard on classification of TCM ancient books was formulated by compared with the classification table of Zhongguo Zhongyi Guji Zongmu, and referred to the classification table of Zhonghua Guji Zongmu. This standard specified three-level categories and classification principles of TCM ancient books, and mainly composed of basic categories, three-level category table, classification principles and examples, and instructions for use.