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.

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality, characterized by poor prognosis due to its high proliferative and invasive potential. Tumor metabolic reprogramming, particularly involving glucose metabolism, is essential for tumor survival. This study investigates the role of the Hippo pathway effector transcriptional co-activator with PDZ-binding motif (TAZ) in regulating gluconeogenesis and promoting tumorigenesis in HCC. Methods: TAZ expression in HCC was analyzed using The Cancer Genome Atlas data and validated in clinical samples and cell lines. TAZ was overexpressed or silenced in HCC cell lines to evaluate its effects on cell proliferation, apoptosis, migration, and invasion. The expression and prognostic relevance of the gluconeogenesis-related genes phosphoenolpyruvate carboxykinase 1 (PCK1) and glucose-6-phosphatase (G6PC) were examined, along with their correlation with TAZ expression. Tumor growth was assessed in nude mice. Interactions between TAZ and the glucocorticoid receptor (GR) were investigated using co-immunoprecipitation, immunofluorescence, and chromatin immunoprecipitation assays. Results: TAZ was significantly upregulated in HCC tissues and cell lines. TAZ overexpression enhanced proliferation, reduced apoptosis, and promoted migration and invasion. In contrast, PCK1 and G6PC were downregulated in HCC and showed a negative correlation with TAZ expression. Conclusion TAZ modulates gluconeogenesis and accelerates tumor growth, whereas its knockdown attenuates tumor progression. TAZ interacts with GR, suppressing its transcriptional activity on gluconeogenic gene promoters.

Mass spectrometry imaging （MSI） is an emerging molecular imaging technique that combines high spatial resolution and the ability to acquire molecular information. This technology can directly obtain spatial distribution maps of metabolites, proteins, lipids and other molecules in tumor tissues, reveal the abnormal molecular changes during the occurrence and development of liver cancer, and make up for the deficiency of information at the molecular level in traditional imaging （such as CT, MRI）. In liver cancer research, MSI has demonstrated unique advantages and application potential in early diagnosis and screening, precise classification, tumor heterogeneity analysis, and exploration of molecular mechanisms. The principle characteristics of MSI technology and its latest progress in the early diagnosis, classification and molecular mechanism research of liver cancer were reviewed, and the current challenges and future development directions were discussed, which aimed to provide a new perspective and theoretical basis for an in-depth understanding of the pathological mechanism of liver cancer and promoted its precise diagnosis and treatment.

Purpose To investigate the diagnostic value of 7T ultra-high field MRI in deep medullary venography.Materials and Methods This prospective controlled study enrolled 47 healthy subjects from the First Affiliated Hospital of Army Medical University from May to August 2022.All participants underwent susceptibility-weighted imaging scans on both 7T and 3T MRI systems on the same day.Subjective image quality was evaluated using a Likert 5-point scale,while deep medullary vein visualization was assessed via a visual quartile grading system.Objective metrics,including signal-to-noise ratio and contrast-to-noise ratio,were used to evaluate venous image quality.Results There were statistically significant differences in subjective Likert 5-point scores between the 7T and 3T MRI group[5(5,5)vs.4(3,4);Z=234.50,P<0.001].Deep medullary vein visual quartile scores also showed significant differences between 7T and 3T MRI[0(0,0)]vs.[1(1,2);Z=47.00,P<0.001].Signal-to-noise ratio in the 7T group(1.50±0.35)was lower than that in the 3T group(5.45±1.83),while contrast-to-noise ratio(7.64±1.70)was higher than that in the 3T group(5.44±2.11),with both differences being statistically significant(t=14.54,-5.68,P<0.001).Conclusion 7T ultra-high field MRI demonstrates superior image quality for deep medullary venography visualization compared to 3T MRI.

Objective To compare the efficacy and safety of perioperative chemotherapy regimens based on docetaxel administered in different cycles for locally advanced gastric cancer(LAGC)and gastroesophageal junction cancer(GEJC)through a network Meta-analysis.Methods PubMed,Embase,Cochrane Library,and Web of Science databases were electronically searched to collect randomized controlled trials(RCTs)evaluating docetaxel-based perioperative regimens for the treatment of LAGC and GEJC from inception to February 28,2025.Two researchers independently screened the literature,extracted relevant data,and assessed the risk of bias in the included studies.Subsequently,a network Meta-analysis was performed using R 4.5.0 software.Results A total of 10 RCTs involving 2,064 patients were included.The results of the network Meta-analysis showed that,compared with three cycles of epirubicin,cyclophosphamide,and fluorouracil(ECF regimen)and four cycles of platinum and fluorouracil(PF regimen),both three-cycle and four-cycle docetaxel,platinum,and fluorouracil(TPF regimen)significantly increased the complete tumor resection rate(R0 resection rate).Compared with surgery alone,the three-cycle TPF regimen significantly improved the R0 resection rate.Additionally,the four-cycle TPF regimen significantly improved 3-year and 5-year progression-free survival(PFS)compared with the two-cycle PF regimen,and significantly improved overall survival(OS)at 3 and 5 years compared with the three-cycle ECF regimen.Compared with surgery alone,the three-cycle TPF regimen also significantly increased the pathological complete response rate(pCR rate).Furthermore,compared with the two-cycle TPF and three-cycle ECF regimens,the four-cycle TPF and PF regimens were associated with a lower risk of surgical complications.Conversely,the two-cycle TPF and three-cycle ECF regimens significantly increased the risk of surgical complications compared with surgery alone.No statistically significant differences were observed in the incidence of grade 3 to 4 adverse events among the treatment regimens(P＞0.05).Based on the surface under the cumulative ranking curve(SUCRA)plot and pairwise comparisons,the three-cycle PF regimen appeared to be the most effective in achieving the highest R0 resection rate,the three-cycle TPF regimen appeared to be the most effective in achieving the highest pCR rate,while the four-cycle TPF regimen was associated with the best outcomes in terms of 3-year and 5-year PFS and OS.Conclusion The four-cycle TPF regimen may be associated with the optimal PFS and OS among perioperative chemotherapy regimens.No statistically significant differences were observed between the four-cycle TPF and the three-cycle PF in terms of R0 resection rate,between the four-cycle TPF and the three-cycle TPF in terms of pCR rate,or between the four-cycle TPF and the other seven regimens included in the study in terms of safety assessment.The four-cycle TPF regimen may represent the optimal perioperative chemotherapy regimen for patients with LAGC and GEJC.

Objective To explore the effect of playing moderate-intensity table tennis and badminton on myo-pia prevention among children between 7 and 9 years old,so as to provide related theoretical basis.Methods A total of 536 myopic children were initially screened from two schools in Guangzhou via questionnaires and in-terviews.Among them,36 children(7-9 years old)were selected and randomly divided into a control group,a table tennis group and a badminton group,each of 12.All groups underwent 1.5-hour training three times a week for six months,covering training on dynamic visual acuity,sports vision and attention training and the ex-ercise intensity was adjusted according the heart rate,rating of perceived exertion(RPE)and blood oxygen lev-els.Moreover,the equivalent spherical degree(SED),ocular biology,and accommodative parameters were mea-sured before and after the intervention.Results After intervention,the left eye SEDs of the control and badmin-ton groups were lower than before intervention(P<0.05).Moreover,the axial length(AL)in the left and right eyes and the axial length/corneal radius of curvature(AL/CR)of all 3 groups after intervention were significant-ly higher than before that(P<0.05).The table tennis group showed significant improvement in accommodative fa-cility(AF)in both eyes(P<0.05),while the badminton group demonstrated significant increases in AF of both eyes,amplitude of accommodation(AMP)in the right eye,but a significant decrease in the positive relative adjustment(PRA)(P<0.05).Moreover,after intervention,SE and AF of both eyes in the table tennis group was significantly higher,with lower AL and AL/CR ratios in the left eye compared to the control group(P<0.05).The badminton group exhibited greater AMP in the right eye and AF improvements in both eyes com-pared to the control and table tennis groups(P<0.05),but lower PRA(P<0.05).Moreover,the left-eye SE of the badminton group was higher than the control group(P<0.05),while the right-eye corneal curvature and the left-eye AL/CR were lower than the latter(P<0.05).Meanwhile,after the intervention,the left-eye AL and PRA of the badminton group were significantly lower than the table tennis group(P<0.05).Conclusion Pupils can effectively increase their reserve of eye adjustment,improve the adjustment function of the eye,and delay the development of myopia by playing table tennis and badminton with moderate intensity.Playing table tennis excels in delaying refractive power changes,while doing badminton significantly improves PRA,AMP,and AF.

OBJECTIVE To analyze the factors influencing patient satisfaction in the outpatient pharmacy of tertiary maternity and child specialist hospitals in Chongqing,and provide a reference for improving the pharmaceutical management capability of tertiary maternity and child specialist hospitals and enhancing patients'medical experience.METHODS Utilizing KANO model,a questionnaire was developed and data were analyzed.Key influencing factors were identified through the categorization of requirement attributes,Better values,Worse values,and two-dimensional matrix analysis.The impact of these categorized demand factors on overall satisfaction was further validated through Structural Equation Modeling (SEM).RESULTS Cronbach's α coefficient for the survey questionnaire was 0.855,exceeding the acceptable threshold of 0.7;Bartlett test for sphericality yielded a value of 5538.56 with P<0.01,indicating good reliability and validity of the survey results.Through the KANO model's factor selection process,the top four key factors influencing patient satisfaction in outpatient pharmacies were determined to be:medication pick-up time (r=0.45),pharmacist service attitude (r=0.45),rational medication consultation (r=0.41),self-service calling system (r=0.40),all of which were subsequently validated through SEM.CONCLUSIONS The four factors of medication pick-up time,self-service calling system,pharmacist service attitude,and rational medication consultation significantly influence patient satisfaction in the outpatient pharmacies of tertiary maternity and child hospitals in Chongqing.

Objective:To investigate the cognitive characteristics and related influencing factors in Parkinson′s disease (PD) patients with or without olfactory anosognosia (OA).Methods:A total of 113 PD patients who were treated at the Affiliated Hospital of Yangzhou University between March 2023 and April 2024 were selected. The PD Olfactory Dysfunction Auxiliary Diagnostic Card was used to assess olfactory function. Based on the olfactory identification scores and subjective awareness of olfactory dysfunction, patients were divided into the normosmic group, olfactory dysfunction group, and the later was further divided into olfactory dysfunction without OA (OA-) group, and olfactory dysfunction with OA (OA+) group. The results of the Unified Parkinson′s Disease Rating Scale-Ⅲ (UPDRS-Ⅲ) and Hoehn-Yahr (H-Y) staging assessments of the patients were collected. Non-motor symptoms such as cognitive function, anxiety, depression, sleep disturbances, and constipation were evaluated using relevant scales. Logistic regression analysis was used to explore the related factors affecting OA in PD patients with olfactory decline.Results:The Montreal Cognitive Assessment (MoCA) scores of the olfactory dysfunction group were lower than those of the normosmic group (20.30±4.47 vs 22.64±2.50, t=2.907, P=0.007). The Self-Rating Anxiety Scale scores (39.00±8.60 vs 43.86±10.63, t=2.444, P=0.016), visuospatial and executive function scores (2.35±1.32 vs 2.98±1.42, t=2.263, P=0.026), and orientation scores (4.88±1.14 vs 5.34±1.07, t=2.046, P=0.043) of the OA+ group were lower than those of the OA- group. Logistic regression analysis revealed that lower MoCA scores were an independent risk factor for PD combined with OA ( OR=0.853, 95% CI 0.743-0.980, P=0.024). Conclusions:PD patients with olfactory dysfunction exhibit more severe cognitive impairment. Among them, patients with OA show more significant impairments in visuospatial, executive function and orientation. Cognitive impairment may be an independent risk factor for PD combined with OA.

Objective To investigate the in vitro drug release behavior of hydroxyapatite-wedelolactone(Hap-Wed)and its effect on promoting osteogenic differentiation of bone marrow mesenchymal stem cells(BMSCs).Methods The in vitro release behavior of Hap-Wed fusion materials was detected by chromatographic technique.After the cells were passed continuously up to the third generation,they were divided into:① control group:complete medium;② Os group:osteogenic inducer(1mmol/L dexamethasone,10mmol/L vitamin C,1mol/L β-glycerol phosphate);③ Wed group:1μg/ml Web and osteogenic inducer were added to the complete medium;④ Hap-Web group:1 μg/ml Web,osteogenic inducer and Hap were added to the complete medium.Alkaline phosphates(ALP)activity assay,alizarin red S staining assay,real-time quantitative polymerase chain reaction(RT-qPCR)detection of osteocalcin,Osterix and Runx2 gene expression,analysis of Hap-Wed on BMSCs osteoblast differentiation.Results Hap-Wed fusion material released the drug slowly.Compared with control group,the number of ALP staining and the number of calcified nodules increased significantly in Hap-Wed experimental group.The Hap-Wed experimental group increased gene expression of osteocalcin,Osterix and Runx2.Conclusion Hap-Wed fusion material can slow and effective stimulation of osteoblast differentiation,which may provide a promising application prospect for the future development of the carrier material.

Objective:To construct service quality evaluation indicators for brain-heart health management outpatient clinics, providing a reference for the standardized, high-quality management and evaluation of brain-heart health management clinics.Methods:Based on Donabedian's "structure-process-outcome" three-dimensional quality evaluation theory, the initial evaluation indicators were drafted after reviewing relevant literature and conducting qualitative interviews. After two rounds of Delphi expert consultation, the final service quality evaluation indicators for brain-heart health management outpatient clinics were established.Results:The effective response rate for the questionnaires from both rounds of expert consultation was 100.00% (15/15). The experts' authority coefficients were 0.925 and 0.930, respectively, the variation coefficients of the indicators were 0 to 0.21 and 0 to 0.19, and the Kendall concordance coefficients were 0.231 and 0.219 ( P<0.01). The final service quality evaluation indicators for brain-heart health management outpatient clinics included three primary indicators, nine secondary indicators, and 23 tertiary indicators, with specific definitions for the tertiary indicators. Conclusions:The service quality evaluation indicators for brain-heart health management outpatient clinics constructed in this study are scientific and reliable. The indicators reflect the specialty of brain-heart health management and highlight the professional value of brain-heart health managers, providing a reference for the high-quality development of brain-heart health management.