Objective To investigate the prevalence of cognitive frailty and its associated factors among middle-aged and elderly patients with chronic obstructive pulmonary disease (COPD) in Gusu District, Suzhou City, to provide a basis for intervention measures. Methods COPD patients managed at Pingjiang New Town Community Health Service Center in Gusu District from January to December 2024 were selected. Data were collected using the Fried Frailty Phenotype, Mini-Mental State Examination, and a general information questionnaire. Chi-square tests, one-way analysis of variance, and multivariate Logistic regression were used for data analysis. Results A total of 1 388 patients were included, with 916 males (65.99%) and 472 females (34.01%). Cognitive frailty was observed in 554 cases (prevalence: 39.91%). Univariate analysis showed significant differences in gender, education, visual impairment, hearing impairment, sleep disorders, and disease duration between the cognitive frailty and non-cognitive frailty groups (all P<0.05). Multivariate Logistic regression indicated that education was negatively associated with cognitive frailty (illiteracy OR=6.969, P<0.001; primary school OR=1.499, P=0.005), while visual impairment (OR=2.347, P<0.001), hearing impairment (OR=1.705, P<0.001), sleep disorders (OR=2.488, P<0.001), and disease duration (≤5 years OR=0.329, P<0.001; 6-10 years OR=0.487, P<0.001) were positively associated with cognitive frailty. Conclusion The prevalence of cognitive frailty among middle-aged and elderly COPD patients in Gusu District, Suzhou City, is high (39.91%). Epositively associated with cognitive frailtyducation, sensory impairments, sleep disorders, and disease duration are associated factors. Clinical attention to high-risk groups and implementation of early screening and targeted interventions are recommended.

Objective:To evaluate the efficacy and safety of upadacitinib in the real-world treatment of difficult-to-treat Crohn's disease (DTT-CD) .Methods:This multicenter, retrospective cohort study included patients diagnosed with DTT-CD according to the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) criteria, and treated at eight Chinese inflammatory bowel disease centers between January 2023 and March 2025. Clinical outcomes were assessed after 12 weeks of induction therapy with upadacitinib (45 mg qd), including clinical remission rate, clinical response rate, and incidence of adverse events.Results:Among 151 enrolled DTT-CD patients, the clinical remission rate was 47.0%, and the clinical response rate was 90.7% after 12 weeks of treatment. Adverse events occurred in 42 cases (27.8%) .Conclusion:Upadacitinib demonstrated favorable efficacy in inducing clinical remission in DTT-CD patients, with a good safety profile at the induction dose (45 mg qd) .

Objective:To evaluate the efficacy and safety of upadacitinib in the real-world treatment of difficult-to-treat Crohn's disease (DTT-CD) .Methods:This multicenter, retrospective cohort study included patients diagnosed with DTT-CD according to the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) criteria, and treated at eight Chinese inflammatory bowel disease centers between January 2023 and March 2025. Clinical outcomes were assessed after 12 weeks of induction therapy with upadacitinib (45 mg qd), including clinical remission rate, clinical response rate, and incidence of adverse events.Results:Among 151 enrolled DTT-CD patients, the clinical remission rate was 47.0%, and the clinical response rate was 90.7% after 12 weeks of treatment. Adverse events occurred in 42 cases (27.8%) .Conclusion:Upadacitinib demonstrated favorable efficacy in inducing clinical remission in DTT-CD patients, with a good safety profile at the induction dose (45 mg qd) .

Objective:To investigate the influence of age on the fresh cycle live birth rate in patients with poor ovarian response in different controlled ovarian hyperstimulation groups.Methods:The clinical data of 3 342 patients in The First Affiliated Hospital of Zhengzhou University from February 2014 to November 2018 were retrospectively collected, including early-follicular phase long-acting gonadotropin-releasing hormone (GnRH) agonist long protocol group (1 375 cases), mid-luteal phase short-acting GnRH agonist long protocol group (1 161 cases) and GnRH antagonist protocol group (806 cases); each group was divided into 4 subgroups according to age: ≤30 years, 31－35 years, 36－40 years and >40 years, the pregnancy outcomes in each age subgroup were analyzed under different controlled ovarian hyperstimulation protocols.Results:In early-follicular phase long-acting GnRH agonist long protocol group, the final live birth rates of each age subgroup were 39.4% (228/579), 36.1% (135/374), 16.6% (48/290) and 3.0% (4/132); in mid-luteal phase short-acting GnRH agonist long protocol group, live birth rates of each age subgroup were 32.1% (99/308), 20.8% (55/264), 13.0% (45/346) and 7.0% (17/243); in GnRH antagonist protocol group, live birth rates of each age subgroup were 22.8% (26/114), 16.3% (25/153), 11.2% (31/278), and 3.8% (10/261); the live birth rate of each group decreased significantly with the increase of age (all P<0.01). When the age≤35 years old, the fresh cycle live birth rate of the early-follicular phase long-acting GnRH agonist long protocol group was significantly better than those of the other two groups (all P<0.01). The multivariate logistic regression analysis of age and live birth rate of the three controlled ovarian hyperstimulation groups showed age was the independent influence factor ( OR=0.898, 95% CI: 0.873-0.916, P<0.01; OR=0.926, 95% CI: 0.890-0.996, P<0.01; OR=0.901, 95% CI: 0.863-0.960, P<0.01). Conclusions:Age is an independent influencing factor for the prediction of fresh cycle live birth rate in low ovarian response patients. No matter which controlled ovarian hyperstimulation protocol is adopted, the final live birth rate decreases significantly with the increase of women′s age. In addition, the early-follicular phase long-acting GnRH agonist long protocol has the highest fresh cycle live birth rate among all controlled ovarian hyperstimulation groups.

Objective To explore the effects of aqueous extracts of Codonopsis Radix onD-galactose induced aging model mice; To discuss the anti-aging molecular mechanism of Codonopsis Radix.Methods Subcutaneous injection ofD-galactose solution was used to establish aging models. 100 Kunming mice were divided into normal control group, model group and low-, medium-, high-dose of Codonopsis Radix interventional groups randomly, 20 mice in each group. Low-, medium-, high-dose of Codonopsis Radix interventional groups were given relevant dosage for gavage, while normal control group and model group were given the same volume of NS by gavage for 42 d. After treatment for 42 days, the BUN and CREA in mouse serum were examined; the AffymetrixmiRNA 4.0 microarray was employed to identify the differentially expressed microRNA (miRNA) related with these processes; the bioinformatic tools were also used to further analyze the cluster of miRNA microarrys and the pathways which the target genes of miRNA were involved in.Results Compared with normal control group, the levels of BUN and CREA in mouse serum increased in model group (P<0.05); compared with model group, the levels of BUN and CREA in Low-, medium-, high-dose of Codonopsis Radix interventional groups decreased, in which high-dose of Codonopsis Radix could most significantly inhibit the level of BUN (P<0.05); the cluster analysis showed the miRNA expression profilings of high dose of Codonopsis Radix interventional group and normal control group were brought together, while the profiling of model group was clearly divided with the other groups. In model group vers normal control group, 36 differentiated expressed miRNA showed, which predicated in 10 main biological functions. In high-dose of Codonopsis Radix interventional group vers model group, 34 differentiated expressed miRNAs in high-dose of Codonopsis Radix interventional group showed, and the analytical results of biological functions of target genes were the same as those of model group vers normal control group.Conclusion In the anti-aging process, Codonopsis Radix can not only influence the miRNA expression profiling, but also influence its functional environment.

Objective:To evaluate the precision of digital impressions taken under simulated clinical impression taking conditions with TRIOS and to compare with the precision of extraoral digitalizations . Methods:Six #14 -#17 epoxy resin dentitions with extracted #16 tooth preparations embedded were made.For each artificial dentition , ( 1 ) a silicone rubber impression was taken with individual tray , poured with type IV plaster ,and digitalized with 3Shape D700 model scanner for 10 times;(2) fastened to a dental simulator , 10 digital impressions for each were taken with 3Shape TRIOS intraoral scanner .To assess the precision , best-fit algorithm and 3 D comparison were conducted between repeated scan models pairwise by Geomagic Qualify 12.0, exported as averaged errors (AE) and color-coded diagrams.Non-parametric analysis was performed to compare the precisions of digital impressions and model images .The color-coded diagrams were used to show the deviations distributions .Results:The mean of AE for digital impressions was 7.058 281 μm, which was greater than that of 4.092 363 μm for the model images (P<0.05).However, the means and medians of AE for digital impressions were no more than 10 μm, which meant that the consistency between the digital impressions was good .The deviations distribution was uniform in the model images ,while nonuniform in the digital impressions with greater deviations lay mainly around the shoulders and interproximal surfaces .Conclusion:Digital impressions with TRIOS are of good precision and up to the clinical standard .Shoulders and interproximal surfaces scanning are more difficult.

Objective To investigate the effects of acupuncture at acupoints at different time points on the occurrence of postoperative nausea and vomiting ( PONV ) in patients undergoing radical rectal cancer operation.Methods One hundred and thirty ASA Ⅰ - Ⅲ patients,aged 40-59 yr,with body mass index of 20-25 kg/m2,scheduled for elective radical rectal cancer operation,were randomly divided into 5 groups ( n =25 each):control group ( group Ⅰ ),treatment with the conventional drug group (group Ⅱ ),preoperative acupuncture group ( group Ⅲ ),acupuncture during operation group (group Ⅳ ),and postoperative acupuncture group (group Ⅴ ).Granisetron 3 mg was injected intravenously before the end of the operation in group Ⅱ.Acupuncture was performed at 30 min before induction of anesthesia,at skin incision and at the end of operation in groups Ⅲ,Ⅳ and Ⅴ respectively.Bilateral Neiguan ( PC6 ),Hegu ( LI4 ),Zhigou ( SJ6 ),and Quchi ( LI11 ) acupoints were selected in groups Ⅲ,Ⅳ and Ⅴ.Acupuncture stimulation lasted for 30 min.Blood samples were collected from the peripheral vein after admission to the operating room (T0),at 1 h after skin incision (T1),at the end of operation (T2 ),and at 24 h after operation (T3) to determine the plasma gastrin concentration.The occurrence of PONV was recorded within 2 h after operation,during 2-6 h,6-12 h and 12-24 h after operation,and within 24 h after operation.Results Compared with group Ⅰ,the incidence of PONV within 2 and 24 h after operation,and the plasma gastrin concentration at T3 were significantly decreased in groups Ⅱ and Ⅲ ( P ＜ 0.05),and no significant change was found in the indexes mentioned above in groups Ⅳ and Ⅴ (P ＞ 0.05).Compared with group Ⅱ,the plasma gastrin concentration at T3 was significantly decreased in group Ⅲ,the incidence of PONV within 2 and 24 h after operation was significantly increased in groups Ⅳ and Ⅴ ( P ＜ 0.05).Compared with group Ⅲ,the incidence of PONV within 2 and 24 h after operation,and the plasma gastrin concentration at T3 were significantly increased in groups Ⅳ and Ⅴ ( P ＜ 0.05 ).Conclusion Preoperatvie acupuncture at acupoints can decrease the occurrence of PONV in patients undergoing radical rectal cancer operation,the efficacy is similar to that of the conventional drugs,and the decreased concentration of the plasma gastrin after operation is involved in the mechanism.

Objective To investigate whether pregnant rats exposure to ketamine cause offspring changes in space cognitive abilities and exploration abilities.Methods 3-month Sprague-Dawley female rats ( n =24)were randomly divided into four groups:group N (control group),group K1 (small doses of ketamine group),group K2 ( clinical anesthesia dose of ketamine group),group K3 ( large doses of ketamine group).3-month Sprague-Dawley male rats ( n =4) and female rats were mated at the same cage by the proportion of 2∶ 1.Pregnant mice were treated at tenth day:group N were treated saline with equal-volume to ketamine vein injection; group K1,group K2,group K3 administered vein injection 3,8,20mg/kg of ketamine.Then the 20-day offspring rats'learning and memory were assessed used Open Field Test ( record the time of the offspring in the central case through the number of grid within 2 min ) and Hole Board Test ( Counting the times of offspring stretch into the hole in 5 min) at postnatal days 20.Results In the Open Field Test,the retention time in central check of group N,group K2 and group K3 were (2.45 ± 1.23)s,(6.42 ±2.50)s,(6.41 ±2.19)s.Compared with group N,the retention time in central check of group K2 and group K3 were significantly higher (F=13.42,P＜0.01 ),and group K1 were not significant different ( t =1.33,P＞0.01 ),and the locomotion of group K1,group K2,group K3 were significantly reduced( ( 15.33 ± 6.81 ),( 13.75 ± 5.93 ),( 16.92 ± 6.54 ),F =4.24,P ＜ 0.05 ).In the Hole Board Test,the times of offspring stretch into the hole were not significant different comparing with the control group(F=2.17,P ＞ 0.05 ).Conclusion The dose of ketamine that equivalented clinical anesthesia can affect offspring rats' space cognitive abilities; but the exploring cognitive ability were not significantly influenced.