Objective:To investigate the status quo of cognitive frailty in elderly patients with heart failure and analyze its influencing factors, so as to provide evidence for healthcare professionals to formulate effective intervention strategies.Methods:A total of 330 elderly patients with heart failure admitted to the First Affiliated Hospital of the University of South China and the Second Affiliated Hospital of the University of South China from October 2023 to January 2024 were selected as the study objects by convenience sampling method. General data questionnaire, Frailty Phenotype, Montreal Cognitive Assessment, Clinical Dementia Rating Scale, Geriatric Depression Scale-15 and Short Form Mini Nutritional Assessment were used for a sectional investigation. Random forest algorithm was used to rank the importance of variables and binary logistic regression was combined to explore the influencing factors of elderly patients with heart failure.Results:According to the evaluation criteria of cognitive frailty, 330 elderly patients with heart failure were divided into cognitive frailty group (124 cases) and non-cognitive frailty group (206 cases). The incidence of cognitive frailty was 37.6% (124/330). Among which, the median age of the cognitive frailty group was 73 years old, with 63 males and 61 females. The median age of the non-cognitive frailty group was 71 years old, with 117 males and 89 females. The random forest results showed that the top 7 variables in importance ranking were weekly intellectual activity, frequency of physical exercise, age, educational levels, depression status, cardiac function grade and risk of malnutrition. Binary logistic regression analysis showed that weekly intellectual activity ( OR=0.076, 95% CI 0.027-0.216), requency of physical exercise ( OR=0.184, 95% CI 0.079-0.430), age ( OR=1.173, 95% CI 1.077-1.277), educational levels ( OR=0.283, 95% CI 0.143-0.559), depression status ( OR=4.440, 95% CI 1.451-13.585), cardiac function grade ( OR=3.030, 95% CI 1.673-5.489) and risk of malnutrition ( OR=3.833, 95% CI 1.530-9.602) were the main influencing factors (all P<0.05). Conclusions:The incidence of cognitive frailty in elderly patients with heart failure is high. Healthcare professionals ought to focus on the screening and assessing of cognitive frailty in elderly patients with heart failure, and formulate effective intervention strategies by considering the above influencing factors to mitigate the occurrence of cognitive frailty.

Objective:To investigate the status quo of cognitive frailty in elderly patients with heart failure and analyze its influencing factors, so as to provide evidence for healthcare professionals to formulate effective intervention strategies.Methods:A total of 330 elderly patients with heart failure admitted to the First Affiliated Hospital of the University of South China and the Second Affiliated Hospital of the University of South China from October 2023 to January 2024 were selected as the study objects by convenience sampling method. General data questionnaire, Frailty Phenotype, Montreal Cognitive Assessment, Clinical Dementia Rating Scale, Geriatric Depression Scale-15 and Short Form Mini Nutritional Assessment were used for a sectional investigation. Random forest algorithm was used to rank the importance of variables and binary logistic regression was combined to explore the influencing factors of elderly patients with heart failure.Results:According to the evaluation criteria of cognitive frailty, 330 elderly patients with heart failure were divided into cognitive frailty group (124 cases) and non-cognitive frailty group (206 cases). The incidence of cognitive frailty was 37.6% (124/330). Among which, the median age of the cognitive frailty group was 73 years old, with 63 males and 61 females. The median age of the non-cognitive frailty group was 71 years old, with 117 males and 89 females. The random forest results showed that the top 7 variables in importance ranking were weekly intellectual activity, frequency of physical exercise, age, educational levels, depression status, cardiac function grade and risk of malnutrition. Binary logistic regression analysis showed that weekly intellectual activity ( OR=0.076, 95% CI 0.027-0.216), requency of physical exercise ( OR=0.184, 95% CI 0.079-0.430), age ( OR=1.173, 95% CI 1.077-1.277), educational levels ( OR=0.283, 95% CI 0.143-0.559), depression status ( OR=4.440, 95% CI 1.451-13.585), cardiac function grade ( OR=3.030, 95% CI 1.673-5.489) and risk of malnutrition ( OR=3.833, 95% CI 1.530-9.602) were the main influencing factors (all P<0.05). Conclusions:The incidence of cognitive frailty in elderly patients with heart failure is high. Healthcare professionals ought to focus on the screening and assessing of cognitive frailty in elderly patients with heart failure, and formulate effective intervention strategies by considering the above influencing factors to mitigate the occurrence of cognitive frailty.

Thyroid cancer (TC) is the most common endocrine malignancy. Although most patients have a favorable prognosis following standardized treatment,a subset experiences rapid disease progression and poor outcomes. Recent studies have identified N6-methyladenosine (m6A) methylation as the most prevalent RNA modification,which regulates RNA transcription,maturation,degradation,and stability,playing a role throughout the tumorigenesis process. Consequently,m6A methylation has been extensively studied in tumor treatment and prevention. Changes in m6A levels can lead to abnormal activation or inhibition of oncogenes or tumor suppressor genes in TC,thereby contributing to its initiation and progression. This review summarizes the concept of m6A methylation,the components and functions of its regulatory factors,its role in the development and progression of TC,and its implications for treatment and prognosis.

Thyroid cancer (TC) is the most common endocrine malignancy. Although most patients have a favorable prognosis following standardized treatment,a subset experiences rapid disease progression and poor outcomes. Recent studies have identified N6-methyladenosine (m6A) methylation as the most prevalent RNA modification,which regulates RNA transcription,maturation,degradation,and stability,playing a role throughout the tumorigenesis process. Consequently,m6A methylation has been extensively studied in tumor treatment and prevention. Changes in m6A levels can lead to abnormal activation or inhibition of oncogenes or tumor suppressor genes in TC,thereby contributing to its initiation and progression. This review summarizes the concept of m6A methylation,the components and functions of its regulatory factors,its role in the development and progression of TC,and its implications for treatment and prognosis.

Objective:To compare the dosimetric difference between intensity-modulated photon radiaotherapy (IMRT) planning and intensity-modulated proton radiotherapy (IMPT) planning for glioma.Methods:The clinical data of 15 glioma patients who underwent IMRT in ion medical center of the First Affiliated Hospital of USTC from November 2020 to April 2022 were retrospectively analyzed. IMRT planning and IMPT planning were designed for the image of each patient in the therapy planning system. Main dosimetric parameters were compared including plan target volume (PTV), coverage index (CI), dose homogeneity index (HI), and maximal dose (D max) and mean dose (D mean) of organs at risk between both plans. Results:There were no significant differences between IMRT planning and IMPT planning in terms of D max and D mean of PTV1 and PTV2, CI and HI (all P > 0.05). Compared with IMRT planning, brainstem D mean [6.92 GyE (0.09 GyE, 12.58 GyE) vs. 24.41 GyE (2.59 GyE, 34.18 GyE)], left optic nerve D max [0.78 GyE (0.04 GyE, 25.18 GyE) vs. 20.42 GyE (6.38 GyE, 37.17 GyE)], left optic nerve D mean [0.10 GyE (0.01 GyE, 11.63 GyE) vs. 9.74 GyE (2.99 GyE, 20.87 GyE)], right optic nerve D mean [1.57 GyE (0.13 GyE, 14.90 GyE) vs. 14.08 GyE (2.66 GyE, 23.67 GyE)], left len D max [0 GyE (0 GyE, 2.91 GyE) vs. 4.84 GyE (1.42 GyE, 5.48 GyE)], left len D mean [0 GyE (0 GyE, 1.73 GyE) vs. 3.84 GyE (1.25 GyE, 4.30 GyE)], right len D max [0.25 GyE (0.04 GyE, 4.55 GyE) vs. 4.28 GyE (1.58 GyE, 5.84 GyE)], right len D mean [0.16 GyE (0.01 GyE, 1.95 GyE) vs. 3.73 GyE (1.04 GyE, 4.86 GyE)], pituitary D max [6.97 GyE (0.18 GyE, 39.70 GyE) vs. 36.60 GyE (2.74 GyE, 45.19 GyE)], pituitary D mean [1.36 GyE (0.06 GyE, 13.85 GyE) vs. 24.74 GyE (2.42 GyE, 32.80 GyE)], hippocampus D max [5.10 GyE (0.24 GyE, 26.52 GyE) vs. 35.83 GyE (5.03 GyE, 46.11 GyE)], hippocampus D mean [0.36 GyE (0.04 GyE, 25.65 GyE) vs. 18.79 GyE (2.37 GyE, 28.10 GyE)] in IMPT planning were lower, and the differences were statistically significant (all P < 0.05). There were no statistical differences in brainstem D max [51.98 GyE (0.66 GyE, 53.43 GyE) vs. 53.29 GyE (3.87 GyE, 53.48 GyE)], right optic nerve D max [9.60 GyE (0.01 GyE, 43.32 GyE) vs. 25.37 GyE (3.45 GyE, 41.25 GyE)] of both plans (all P > 0.05). Conclusion:In the radiotherapy for glioma, IMRT and IMPT can meet the dose demand in clinic. Furthermore, IMPT planning can protect organs at risk and reduce radiation dose in hippocampus, brainstem, optic nerve, lens and pituitary.

OBJECTIVE：To provide reference for improving the level of pediatric pharmacoeconomic research in China. METHODS： Using “Pediatric”“Pharmacoeconomics”“Cost-effectiveness”“Cost-utility”“Cost-benefit”“Minimum cost ” as keywords，pediatric pharmacoeconomic research literatures published during Jan. 2009 to Dec. 2018 were retrieved from CNKI ， Wanfang，VIP and CBMdisc. The Pediatric Quality Appraisal Questionnaire was used to evaluate the quality of the literatures. The problems of these literatures were analyzed to put forward the suggestions. RESULTS & CONCLUSIONS ：Totally 140 literatures were eventually included. The number of published literatures was increasing and the distrubtion of journals was scattered. The first auther was mainly from medical institutions. Included literatures mainly involved respiratory disease and drug treatment ，etc. Among them ，15 literatures indicated the research angle ；research time limit of 109 literatures was equal to or less than one year ；6 literatures carried out sensitivity analysis. Most of them adopted cost-effectiveness analysis and decision analysis model. The results of quality evaluation showed that the economic evaluation ，camparators，target population ，outcomes，analysis and conclusions domains had high scores （0.62 to 1.00 score），time horizon and discounting domains had middle scroes （0.49 and 0.53 score respectively），but perspective ，costs and resource use ，incremental analysis ，sensitivity analysis and conflict of intrest domains had low scores （0.10 to 0.31 score）. The main problems of pediatric pharmacoeconomic literatures in China focused on selection of research perspective ，measurement of costs and clinical outcomes ，and selection of analytical methods. The quality of pediatric pharmacoeconomic evaluations in China need to improve. It is suggested to supplement the content of pediatric pharmacoeconomics in China Guidelines for Pharmacoeconomic Evaluations . It is also suggested for pediatric pharmacoeconomic evaluations to clarify the perspective ，standardize the cost identification ，reasonably select health outcome indicators and correctly apply analysis method in order to improve the quality.

OBJECTIVE： To explore the current situation of service ability and pharmaceutical service construction of primary healthcare institutions in Jiangsu province. METHODS： Questionnaire survey was conducted among primary healthcare institutions of 13 prefecture level cities in Jiangsu province， involving basic service information （such as serving mode， medical departments）， resource allocation （such as hardware， human resource） and pharmaceutical care construction （such as the leaders of the drug procurement， pharmaceutical departments allocation， mediation safety management）. The current situation of service ability and pharmaceutical service construction was evaluated in primary healthcare institutions of Jiangsu province. RESULTS： A total of 579 primary healthcare institutions in Jiangsu province were investigated and 579 questionnaires were collected （some items in the questionnaires were not answered）. Outpatient service （543/555，97.8％） was the main mode of service provided by primary healthcare institutions in Jiangsu province， followed by emergency call （321/555，57.8％） and hospitalization （292/555，52.6％）； the frequently established department in primary healthcare institutions was the medical department for all （452/568，79.6％）， preventive healthcare department（401/568，70.6％）， internal medicine department （365/568，64.3％）； 16.1％ （93/533）of the primary healthcare institutions had no beds； 36.4％ （211/579）of the institutions had no chief physician； 20.9％ （111/532）of the primary healthcare institutions medicine procurement were managed by pharmacists； 42.5％ （212/499）of the institutions had no pharmaceutical departments； physicians were responsible for patients' medication safety in 43.9％ （236/537） of the primary healthcare institutions and pharmacists were responsible for patients' medication safety in only 16.2％ （87/537）of the institutions. CONCLUSIONS： Primary healthcare institutions in Jiangsu province have made some achievements in service capability building. Human resources， equipment and facilities， pharmaceutical care construction and other aspects still need to be improved.

Objective To investigate the effect of ketamine on the mitochondrial function of rat neurons subjected to anoxia. Methods Primarily cultured rat hippocampal neurons were seeded in culture dishes (35 mm in diameter) at the density of 5×105-1×106 cells∕ml, and divided into 3 groups (n=11 each) using a random number table: control group, anoxia group and ketamine group. The neurons were exposed to 90% N2 plus 10% CO2 50 ml∕min for 5 min in anoxia group. In ketamine group, ketamine was added to the culture medium with the final concentration of 20 μmol∕L at 1 h before anoxia, and then the neurons were exposed to 90% N2 plus 10% CO2 50 ml∕min for 5 min. After the end of treatment in each group, the dead neurons were detected using trypan blue staining, the ATP content was determined by ATP bioluminescence assay, and mitochondrial membrane potential was measured by rhodamine 123 staining. Results Compared with control group, the mortality rate of hippocampal neurons was significantly in?creased, and the ATP content and mitochondrial membrane potential were significantly decreased in anoxia group and ketamine group ( P<0.05) . Compared with anoxia group, the mortality rate of hippocampal neu?rons was significantly decreased, and the ATP content and mitochondrial membrane potential were signifi?cantly increased in ketamine group (P<0.05). Conclusion The mechanism by which ketamine amelio?rates anoxia?induced damage to rat neurons is related to improved mitochondrial function.

Objective To evaluate the clinical efficacy of sodium tanshinone IIA sulfonate(STS)in the treatment of ad-vanced schistosomiasis. Methods Fifty cases with advanced schistosomiasis admitted to the Touzao Township Hospital of Dong-tai City during the period from November 2012 to November 2013 were treated with STS for 10 days,and the internal diameter of the portal vein,levels of ALT,AST,γ-GT,PIIIP,CIV,HA and LN were measured and compared before and after the adminis-tration of STS. Results The mean levels of all serological parameters except HA were within the normal range before STS treat-ment,while the highest positive rate was detected inγ-GT(26.0%)and HA(54.0%). Following the STS treatment,the mean lev-els of all parameters and the positive rates reduced,with the greatest reduction observed inγ-GT(36.7%)and HA(37.8%);how-ever,the mean HA level was still higher than the normal range. The mean internal diameter of the portal vein reduced from(10.5± 1.7)mm before the STS treatment to(9.8±1.3)mm after the STS administration,with a significant diffrtence(P<0.05). Conclu-sion STS appears effective in the treatment of advanced schistosomiasis.

Objective To observe the incidence rate of anaemia and analyze the nutritional situation in the elderly population.Methods From April to August 2010,a total of 2052 elderly persons from out-department of Tianjin First Center Hospital were divided into four age groups:65-69years group (n=528),70-74 years group (n=593),75-79 years group (n=423) and 80 years and over group (n= 508).The body mass index (BMI),haemoglobin (Hb),mean corpuscular volume (MCV),triglyceride (TG),creatinine (Cr),serum albumin (ALB) and ferritin (Fer) were tested and evaluated using K-W test.Results (1) Anaemia was found in 90 subjects (4.4 %),4.0% in men and 6.l% in women,9.5% in 80 years and over group.The subjects with Hb level less than 90g/L were all 80 years and over.(2)There were significant differences among the groups in BMI,TG,Cr,ALB,Hb,MCV and Fer levels (all P＜0.01).There were significant differences among four groups in Hb and ALB levels (P＜0.01 ),and partially differences in TG, Cr and MCV levels (P＜0.05).(3)The Hb level was significantly correlated with TG, ALB, Fer and MCV levels (r=0.115,0.211, 0.114 and 0.089, all P＜0.01 ) from Pearson analysis.Conclusions Anemia incidence in elderly population is increased along with aging and is higher in women than in men, especially higher in 80 years and over group.Nutritional situation gets worse with aging.