Objective: To examine the mediating effect of frailty on social isolation and cognitive function among the elderly. Methods: Demographic information, smoking, alcohol consumption and cognitive function of the elderly at ages of 60 years and older were collected from the China Health and Retirement Longitudinal Study 2020. Social isolation and frailty were evaluated using social isolation index and frailty index, respectively. The mediating effect of frailty on social isolation and cognitive function was analyzed using the Process program, and the significance of the mediating role was tested using the Bootstrap test. Results: A total of 2 822 individuals were enrolled, including 1 483 males (52.55%) and 1 339 females (47.45%). There were 2 497 (88.48%) and 325 (11.52%) individuals at ages of 60-<75 years and ≥75 years, respectively. The median cognitive function score was 14 (interquartile range, 16) points. There were 432 cases with social isolation (15.31%), with a median social isolation index of 10 (interquartile range, 5) points. The median frailty index was 0.11 (interquartile range, 0.15). There were 1 111 individuals without frailty, accounting for 39.37%; 1 214 individuals with pre-frailty, accounting for 43.02%; and 497 individuals with frailty, accounting for 17.61%. Mediating effect analysis showed that social isolation affected cognitive function directly and negatively with the effect value of -0.773 (95%CI: -0.899 to -0.647), and also affected cognitive function by frailty indirectly and negatively with the effect value of -0.147 (95%CI: -0.188 to -0.110), with the mediating effect contributed 15.98% of the total effect. Conclusion Frailty can directly or indirectly affect cognitive function among elderly through social isolation.

BACKGROUND: Generalized pustular psoriasis (GPP), a rare and recurrent autoinflammatory disease, imposes a substantial burden on patients and society. Awareness of GPP in China remains limited. METHODS: This cross-sectional survey, conducted between September 2021 and May 2023 across 14 hospitals in China, included GPP patients of all ages and disease phases. Data collected encompassed demographics, clinical characteristics, economic impact, disease severity, quality of life, and treatment-related complications. Risk factors for GPP recurrence were analyzed. RESULTS: Among 127 patients (female/male ratio = 1.35:1), the mean age of disease onset was 25 years (1st quartile [Q1]-3rd quartile [Q3]: 11-44 years); 29.2% had experienced GPP for more than 10 years. Recurrence occurred in 75.6% of patients, and nearly half reported no identifiable triggers. Younger age at disease onset ( P  = 0.021) and transitioning to plaque psoriasis ( P  = 0.022) were associated with higher recurrence rates. The median diagnostic delay was 8 months (Q1-Q3: 2-41 months), and 32.3% of patients reported misdiagnoses. Comorbidities were present in 53.5% of patients, whereas 51.1% experienced systemic complications during treatment. Depression and anxiety affected 84.5% and 95.6% of patients, respectively. During GPP flares, the median Dermatology Life Quality Index score was 19.0 (Q1-Q3: 13.0-23.5). This score showed significant differences between patients with and without systemic symptoms; it demonstrated correlations with both depression and anxiety scores. Treatment costs caused financial hardship in 55.9% of patients, underscoring the burden associated with GPP. CONCLUSIONS The substantial disease and economic burdens among Chinese GPP patients warrant increased attention. Patients with early onset disease and those transitioning to plaque psoriasis require targeted interventions to mitigate the high recurrence risk.
Humans ; Male ; Female ; Psoriasis/pathology* ; Adult ; Cross-Sectional Studies ; Adolescent ; Child ; Young Adult ; Quality of Life ; Middle Aged ; China/epidemiology* ; Recurrence ; Risk Factors ; Surveys and Questionnaires ; East Asian People

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective To investigate the effect of compassion focused therapy on cognitive function and sense of shame in stroke patients with hemiplegia.Methods A total of 100 stroke patients with hemiplegia admitted in our hospital were included as the research objects.The patients were randomly divided into a control group admitted from December 2020 to December 2021 and an observation group admitted from January 2022 to January 2023,with 50 patients per group.The patients in the control group received cognitive behavioural therapy,while those in the observation group received compassion focused therapy as well as cognitive behavioural therapy.The sense of shame,cognitive function,self-criticism and social anxiety in the two groups were observed and compared before and at the end of the intervention.Results The score of the sense of shame in the observation group was significantly lower than that in the control group(P<0.001).The cognitive function score in the observation group was lower than that in the control group at the end of intervention(P<0.05).and the score of the sense of shame scale in the observation group was lower than that in the control group at the end of the intervention(all P<0.05).Conclusion Compassion focused therapy can significantly reduce the self-criticism and sense of shame in the stroke patients with hemiplegia,and promote the recovery of the cognitive function.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.