Objective:To explore the relationships between physical activity and cognitive impairment in older adults aged ≥65 years in longevity areas in China.Methods:A total of 6 081 older adults aged ≥65 years from the Healthy Ageing and Biomarkers Cohort Study in China in 2021 were included in this study. Information about their demographic characteristics, lifestyles, and chronic disease histories were collected, the intensity of physical activity was evaluated by using Physical Activity Scale for the Elderly, and the cognitive function was evaluated by using Mini-Mental State Examination Scale (Chinese version). Multifactorial logistic regression model was used to analyze the associations between different levels and types of physical activity and cognitive impairment in older adults.Results:In the 6 081 older adults, 1 829 (30.1%) had cognitive impairment. After adjusting for confounders, older adults with T2 and T3 levels of physical activity had lower risks for cognitive impairment compared with those with T1 levels of physical activity, with ORs of 0.47 (95% CI: 0.40-0.55) and 0.22 (95% CI: 0.18-0.28). The results of different types of physical activities showed that the ORs in leisure activity T2 and T3 groups were 0.52 (95% CI: 0.44-0.63) and 0.49 (95% CI: 0.41-0.58), and the ORs in housework activity T2 and T3 groups were 0.36 (95% CI: 0.30-0.42) and 0.19 (95% CI: 0.16-0.24). There was no significant association between work-related activity and cognitive impairment. Conclusion:There is a negative association between the intensity level of physical activity and cognitive impairment, and active leisure and household activities might reduce the risk for cognitive impairment.

Objective To report the individualized rehabilitation protocol administered to a patient suffering from corpus callosum injury subsequent to cerebral infarction,manifesting clinically as alien hand syndrome,attention deficits,spatial neglect and gait apraxia;and to emphasize the application of functional near infrared spectroscopy(fNIRS)in the assessment of cerebral activation.Methods A 54-year-old male with corpus callosum damage following cerebral infarction was assessed by a comprehen-sive array of neuropsychological assessments,such as Mini-Mental State Examination,Montreal Cognitive As-sessment,Loewenstein Occupational Therapy Cognitive Assessment and Wisconsin Card Sorting Test,etc.Based on these assessments,a personalized rehabilitation program was devised,incorporating physical therapy,occupa-tional therapy,task-oriented training,mirror therapy,computer-assisted cognitive training,as well as Schulte's square attention training,bilateral limb coordination training and transcranial magnetic stimulation(TMS).fNIRS was used to evaluate changes in brain activation before and after rehabilitation.Results After more than a month of comprehensive rehabilitation,the patient experienced significant improvements in Alien hand syndrome,attention deficit and spatial neglect.Gait was normalized,and enhancements were ob-served in motor function,cognition and activity of daily living.fNIRS analysis revealed favorable alterations in cerebral activation patterns.Conclusion For the intricate symptoms associated with corpus callosum injury,a multidisciplinary rehabilitation ap-proach,particularly the incorporation of Schulte's square attention training,bilateral coordination exercises and TMS,alongside fNIRS for monitoring cerebral activation,showed significant rehabilitation effects.

Background: Bushen Zhuanggu Formula (BZF), derived from the classic Yougui Pills, has shown favorable clinical efficacy in treating advanced nontraumatic osteonecrosis of the femoral head (NONFH), particularly by promoting bone repair. However, its underlying mechanisms remain unclear. Objective: This study aimed to explore the mechanisms by which BZF promotes bone repair in advanced NONFH. Materials and methods: A total of 518 potential BZF targets were identified from the ETCM v2.0 database. Transcriptomic profiling of clinical cohorts revealed 485 differentially expressed genes in advanced NONFH patients compared to healthy controls. A drug target-disease gene interaction network was constructed to identify candidate BZF targets involved in NONFH pathogenesis. In vivo experiments were conducted to validate the effects of BZF in a rat model of advanced NONFH. Results: Network analysis identified key pathways associated with blood circulation obstruction, immune-inflammatory imbalance, and abnormal bone metabolism. Protein kinase C alpha (PKCA), Ras proto-oncogene (RAS), mitogen-activated protein kinase 3(ERK), ETS proto-oncogene 1 (ETS1), and receptor activator of nuclear factor-κB ligand (RANKL) formed a signaling axis implicated in NONFH pathogenesis. BZF treatment alleviated joint inflammation, preserved trabecular bone morphology, reduced bone loss, and promoted bone repair. Mechanistically, BZF significantly downregulated the expression of PKCA, RAS, ERK, ETS1, and RANKL, improved blood circulation, and inhibited osteoclast activation while promoting osteoblast activation. Conclusion: BZF may promote bone repair in advanced NONFH by enhancing blood circulation and modulating the PKC-RAS-ERK-ETS1-RANKL signaling axis, thereby reversing dysregulated bone metabolism.

Objective To investigate the clinical value of 18F-FDG PET/CT image in assisting CT-guided puncture of pancreatic tumor.Methods One hundred and thirteen patients with pancreatic tumors were selected and then divided into 18 F-FDG PET/CT image-assisted CT-guided group(abbreviation 18F-FDG PET/CT-assisted group)(n=54)and CT-guided group(n=59)according to the different guided puncture methods.The diagnostic efficacy and safety of the two guided puncture biopsy methods were analyzed and compared.Results All patients successfully completed the biopsy.The accuracy(the agreement rate between pathological diagnosis and final clinical diagnosis),sensitivity,and complication rate of the 18F-FDG PET/CT-assisted group were 96.30％(52/54),96.15％(50/52),and 3.70％(2/54);and those of the CT-guided group were 84.75％(50/59),83.64％(46/55),and 15.25％(9/59).Ultimately,it was found that the 18F-FDG PET/CT-assisted group performed better in terms of accuracy and complications than CT-guided group,and the differences were statistically significant(x2=4.280 9,P=0.038 5;x2=5.211 4,P=0.022 4).No serious complications such as hemorrhage,abdominal infection,pancreatic fistula,intestinal fistula and so on occurred in all patients.Conclusion 18F-FDG PET/CT image in assisting CT-guided pancreatic tumor puncture possesses more efficient,precise,and safe characteristics,which is the innovation and expansion of traditional CT image-guided puncture biopsy.However,there is still improvement room in terms of economy and feasibility.

Based on energy consumption data from 2019 to 2024 at a tertiary hospital in Guangzhou under China's"Dual Carbon"policy context,this study investigates the dynamic trends between air-conditioning energy use and associated factors u-sing Pearson correlation,multiple linear regression,and mutual information analysis.Results indicate that outpatient volume and outdoor temperature(both with Pearson correlation coefficients＞0.7)are the primary drivers,with medical activity intensity and seasonal climate fluctuations significantly influencing cooling energy demand.A hierarchical model validated at both hospital-wide and building levels demonstrated improved prediction accuracy for energy trends.The study further proposes a dynamic energy al-location strategy and an anomaly early-warning mechanism,providing data-driven solutions for intelligent energy management in hospitals and supporting energy-saving and emission-reduction goals.

Background:Bushen Zhuanggu Formula(BZF),derived from the classic Yougui Pills,has shown favorable clinical efficacy in treating advanced nontraumatic osteonecrosis of the femoral head(NONFH),particularly by promoting bone repair.However,its underlying mechanisms remain unclear.Objective:This study aimed to explore the mechanisms by which BZF promotes bone repair in advanced NONFH.Materials and methods:A total of 518 potential BZF targets were identified from the ETCM v2.0 database.Transcriptomic profiling of clinical cohorts revealed 485 differentially expressed genes in advanced NONFH patients compared to healthy controls.A drug target-disease gene interaction network was constructed to identify candidate BZF targets involved in NONFH pathogenesis.In vivo experiments were conducted to validate the effects of BZF in a rat model of advanced NONFH.Results:Network analysis identified key pathways associated with blood circulation obstruction,immune-inflammatory imbalance,and abnormal bone metabolism.Protein kinase C alpha(PKCA),Ras proto-oncogene(RAS),mitogen-activated protein kinase 3(ERK),ETS proto-oncogene 1(ETS1),and receptor activator of nuclear factor-κB ligand(RANKL)formed a signaling axis implicated in NONFH pathogenesis.BZF treatment alleviated joint inflammation,preserved trabecular bone morphology,reduced bone loss,and promoted bone repair.Mechanistically,BZF significantly downregulated the expression of PKCA,RAS,ERK,ETS1,and RANKL,improved blood circulation,and inhibited osteoclast activation while promoting osteoblast activation.Conclusion:BZF may promote bone repair in advanced NONFH by enhancing blood circulation and modulating the PKC-RAS-ERK-ETS1-RANKL signaling axis,thereby reversing dysregulated bone metabolism.

Objective To investigate the clinical value of 18F-FDG PET/CT image in assisting CT-guided puncture of pancreatic tumor.Methods One hundred and thirteen patients with pancreatic tumors were selected and then divided into 18 F-FDG PET/CT image-assisted CT-guided group(abbreviation 18F-FDG PET/CT-assisted group)(n=54)and CT-guided group(n=59)according to the different guided puncture methods.The diagnostic efficacy and safety of the two guided puncture biopsy methods were analyzed and compared.Results All patients successfully completed the biopsy.The accuracy(the agreement rate between pathological diagnosis and final clinical diagnosis),sensitivity,and complication rate of the 18F-FDG PET/CT-assisted group were 96.30％(52/54),96.15％(50/52),and 3.70％(2/54);and those of the CT-guided group were 84.75％(50/59),83.64％(46/55),and 15.25％(9/59).Ultimately,it was found that the 18F-FDG PET/CT-assisted group performed better in terms of accuracy and complications than CT-guided group,and the differences were statistically significant(x2=4.280 9,P=0.038 5;x2=5.211 4,P=0.022 4).No serious complications such as hemorrhage,abdominal infection,pancreatic fistula,intestinal fistula and so on occurred in all patients.Conclusion 18F-FDG PET/CT image in assisting CT-guided pancreatic tumor puncture possesses more efficient,precise,and safe characteristics,which is the innovation and expansion of traditional CT image-guided puncture biopsy.However,there is still improvement room in terms of economy and feasibility.

Objective:To explore medical students'cognition,current status,and demands regarding practical skills training in a medical college under the background of new medical science.Methods:A cross-sectional survey was conducted among medical undergraduates from Year 1 to Year 5 in a medical college.A self-designed scale was used to investigate the cognition,current status,and demands related to new medical education concepts.Pearson correlation analysis was used to analyze the relationship between satisfaction with practical teaching facilities and variables including understanding of new medical education,curriculum design,and proportion of practical teaching.Multiple linear regression was conducted to investigate the factors influencing satisfaction.Results:Among 1 253 participants,70.71%acquired new medical science information through online media,while 52.99%learned about it via school courses.Over 80%endorsed"whole-cycle health management"(preventive care before disease onset 91.94%,disease treatment 81.72%,and post-illness rehabilitation 82.60%).Experimental courses(85.16%),clinical skills training(66.88%),and social practice(66.24%)were primary practical forms,but the participation rates of research practice(40.78%)and innovation/entrepreneurship practice(34.72%)was comparatively lower.The satisfaction with practical teaching was positively correlated with adequacy of faculty guidance(r=0.707)and curriculum rationality(r=0.522)(P＜0.01).The multiple linear regression analysis showed that faculty guidance(β=0.436)and the proportion of practical teaching(β=0.319)were the key predictors of satisfaction.Conclusion:Medical students'cognition of practical skills training,curriculum optimization,and adequacy of faculty guidance significantly influence satisfaction with practical teaching,with faculty guidance and rationality of practical process playing key roles.

Objective To report the individualized rehabilitation protocol administered to a patient suffering from corpus callosum injury subsequent to cerebral infarction,manifesting clinically as alien hand syndrome,attention deficits,spatial neglect and gait apraxia;and to emphasize the application of functional near infrared spectroscopy(fNIRS)in the assessment of cerebral activation.Methods A 54-year-old male with corpus callosum damage following cerebral infarction was assessed by a comprehen-sive array of neuropsychological assessments,such as Mini-Mental State Examination,Montreal Cognitive As-sessment,Loewenstein Occupational Therapy Cognitive Assessment and Wisconsin Card Sorting Test,etc.Based on these assessments,a personalized rehabilitation program was devised,incorporating physical therapy,occupa-tional therapy,task-oriented training,mirror therapy,computer-assisted cognitive training,as well as Schulte's square attention training,bilateral limb coordination training and transcranial magnetic stimulation(TMS).fNIRS was used to evaluate changes in brain activation before and after rehabilitation.Results After more than a month of comprehensive rehabilitation,the patient experienced significant improvements in Alien hand syndrome,attention deficit and spatial neglect.Gait was normalized,and enhancements were ob-served in motor function,cognition and activity of daily living.fNIRS analysis revealed favorable alterations in cerebral activation patterns.Conclusion For the intricate symptoms associated with corpus callosum injury,a multidisciplinary rehabilitation ap-proach,particularly the incorporation of Schulte's square attention training,bilateral coordination exercises and TMS,alongside fNIRS for monitoring cerebral activation,showed significant rehabilitation effects.

Objective:To explore the relationships between physical activity and cognitive impairment in older adults aged ≥65 years in longevity areas in China.Methods:A total of 6 081 older adults aged ≥65 years from the Healthy Ageing and Biomarkers Cohort Study in China in 2021 were included in this study. Information about their demographic characteristics, lifestyles, and chronic disease histories were collected, the intensity of physical activity was evaluated by using Physical Activity Scale for the Elderly, and the cognitive function was evaluated by using Mini-Mental State Examination Scale (Chinese version). Multifactorial logistic regression model was used to analyze the associations between different levels and types of physical activity and cognitive impairment in older adults.Results:In the 6 081 older adults, 1 829 (30.1%) had cognitive impairment. After adjusting for confounders, older adults with T2 and T3 levels of physical activity had lower risks for cognitive impairment compared with those with T1 levels of physical activity, with ORs of 0.47 (95% CI: 0.40-0.55) and 0.22 (95% CI: 0.18-0.28). The results of different types of physical activities showed that the ORs in leisure activity T2 and T3 groups were 0.52 (95% CI: 0.44-0.63) and 0.49 (95% CI: 0.41-0.58), and the ORs in housework activity T2 and T3 groups were 0.36 (95% CI: 0.30-0.42) and 0.19 (95% CI: 0.16-0.24). There was no significant association between work-related activity and cognitive impairment. Conclusion:There is a negative association between the intensity level of physical activity and cognitive impairment, and active leisure and household activities might reduce the risk for cognitive impairment.