Objective: To analyze the association between dietary diversity and cognitive function among the elderly using group-based trajectory model, so as to provide the basis for formulating dietary intervention strategies to prevent cognitive impairment. Methods: Based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) project, demographic information, lifestyle behaviors, psychological well-being, and activities of daily living of elderly individuals aged ≥65 years from 2008 to 2018 were collected. Dietary diversity was assessed using a food frequency questionnaire, with a score of <7 points defined as low dietary diversity. Cognitive function was evaluated using the Chinese version of the Mini-Mental State Examination (MMSE). A group-based trajectory model was established based on cognitive function scores from 2008 to 2018 to analyze the trajectories of cognitive function change. The association between dietary diversity and cognitive function was analyzed using a multinomial logistic regression model. Results: A total of 1 613 individuals were collected, with a median age was 72.00 (interquartile range, 10.00) years. There were 810 males (50.22%) and 803 females (49.78%). The group-based trajectory model analysis categorized the participants into three groups: the low-level normal group, the high-level normal group, and the slow-then-rapid decline group, comprising 796 (49.35%), 585 (36.27%), and 232 (14.38%) individuals, respectively. Among these groups, the numbers of individuals with low dietary diversity were 497 (62.44%), 311 (53.16%), and 166 (71.55%), respectively, with a statistically significant difference (P<0.05). Multinomial logistic regression analysis showed that after adjusting for demographic information, lifestyle behaviors, psychological well-being, and activities of daily living, compared with the high-level normal group, low dietary diversity was statistically associated with cognitive function in the slow-then-rapid decline group (OR=1.622, 95%CI: 1.103-2.384). Conclusion Low dietary diversity may increase the risk of cognitive impairment among the elderly.

OBJECTIVE: To explore the association between blood glucose trajectories within 7 days of intensive care unit (ICU) admission and mortality in patients with sepsis-associated acute respiratory distress syndrome (ARDS). METHODS: Based on the MIMIC-IV database, sepsis-associated ARDS patients with daily blood glucose monitoring data within 7 days of ICU admission were selected. Blood glucose trajectories were analyzed using group-based trajectory modeling (GBTM), and the optimal number of groups was determined based on the minimum Akaike information criterion (AIC), Bayesian information criterion (BIC), average posterior probability (AvePP), odds of correct classification (OCC), and proportion of group membership (Prop). Baseline characteristics including demographics, comorbidities, severity scores, vital signs, laboratory indicators within the first 24 hours of ICU admission, and treatments were collected. Kaplan-Meier survival curves were used to compare 28-day and 1-year survival across trajectory groups. Multivariate Logistic regression was performed to evaluate the associations between glucose trajectory groups and in-hospital mortality, ICU mortality. The incidence of hypoglycemia within 7 days in the ICU was analyzed among different groups. RESULTS: A total of 3 869 patients with sepsis-associated ARDS were included, with a median age of 63.52 (52.13, 73.54) years; 59.6% (2 304/3 869) were male. Based on glucose levels within 7 days, patients were categorized into three groups: persistent hyperglycemia group (glucose maintained at 10.6-13.1 mmol/L, n = 894), moderate glucose group (7.8-8.9 mmol/L, n = 1 452), and low-normal glucose group (6.1-7.0 mmol/L, n = 1 523). There were statistically significant differences in 28-day mortality and 1-year mortality among low-normal glucose group, moderate glucose group, and persistent hyperglycemia group [28-day mortality: 11.42% (174/1 523), 19.83% (288/1 452), 25.50% (228/894), χ ² = 82.545, P < 0.001; 1-year mortality: 23.31% (355/1 523), 33.75% (490/1 452), 39.49% (353/894), χ ² = 77.376, P < 0.001]. Kaplan-Meier analysis showed that higher glucose trajectories were associated with significantly lower 28-day and 1-year cumulative survival rates (Log-rank test: χ ² were 83.221 and 85.022, both P < 0.001). There were statistically significant differences in in-hospital mortality and ICU mortality among the low-normal glucose group, moderate glucose group, and persistent hyperglycemia group [in-hospital mortality: 9.65% (147/1 523), 19.70% (286/1 452), 24.50% (219/894), χ ² = 102.020, P < 0.001; ICU mortality: 7.22% (110/1 523), 16.05% (233/1 452), 20.13% (180/894), χ ² = 93.050, P < 0.001]. Logistic regression confirmed that, using the persistent hyperglycemia group as the reference, the low-normal glucose group had significantly lower risks of in-hospital mortality and ICU mortality after multiple factor adjustment. Although the moderate glucose group showed a trend toward lower mortality, the differences were not statistically significant. Using the moderate glucose group as a reference, the low-normal glucose group had 43.1% lower in-hospital mortality [odds ratio (OR) = 0.569, 95% confidence interval (95%CI) was 0.445-0.726, P < 0.001] and 42.0% lower ICU mortality (OR = 0.580, 95%CI was 0.439-0.762, P < 0.001). There was no statistically significant difference in the incidence of hypoglycemia within 7 days of ICU admission among low-normal glucose group, moderate glucose group, and persistent hyperglycemia group [2.82% (43/1 523), 2.69% (39/1 452), 3.02% (27/894), χ ² = 0.226, P = 0.893]. CONCLUSIONS Blood glucose trajectories during ICU stay are closely associated with prognosis in patients with sepsis-associated ARDS. Persistent hyperglycemia (10.6-13.1 mmol/L) is linked to significantly higher short- and long-term mortality.
Humans ; Respiratory Distress Syndrome/etiology* ; Sepsis/blood* ; Intensive Care Units ; Male ; Female ; Middle Aged ; Blood Glucose/metabolism* ; Hospital Mortality ; Aged

Objective To investigate the association between nonalcoholic fatty liver disease(NAFLD)and osteoporosis in elderly patients.Methods A total of 824 patients,aged≥60 years,who were hospitalized in Department of Gerontology,Peking University People's Hospital,from June 2016 to April 2023 were enrolled,with 398 patients in the osteoporosis group and 426 in the non-osteoporosis group.Related data were collected from all subjects,including general information,blood biochemical parameters,liver ultrasound,and bone mineral density measured by dual-energy X-ray examination.The independent-samples t test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups;the chi-square test was used for comparison of categorical variables;a binary Logistic regression analysis was used to investigate the independent risk factors for osteoporosis.Results Compared with the non-osteoporosis group,the osteoporosis group had a significantly higher age,a significantly higher proportion of female patients or patients with diabetes,and a significantly lower body mass index(all P<0.05).The osteoporosis group had a significantly higher proportion of patients with NAFLD than the non-osteoporosis group(36.2%vs 24.6%,χ2=12.878,P<0.001).Compared with the non-osteoporosis group,the osteoporosis group had significantly lower levels of hemoglobin,uric acid,and albumin and significantly higher levels of total cholesterol,low-density lipoprotein cholesterol(LDL-C),bone-specific alkaline phosphatase,and tartrate-resistant acid phosphatase(all P<0.05).The binary Logistic regression analysis showed that old age(odd ratio[OR]=1.040,95%confidence interval[CI]:1.015-1.066,P=0.002),female sex(OR=4.089,95%CI:2.607-6.411,P<0.001),NAFLD(OR=1.697,95%CI:1.076-2.678,P=0.023),diabetes(OR=1.509,95%CI:1.008-2.260,P=0.046),and LDL-C(OR=1.431,95%CI:1.010-2.029,P=0.044)were independent risk factors for osteoporosis in elderly patients.Considering the impact of diabetes on the research findings,a subgroup analysis was performed for the patients without diabetes,and the results showed that NAFLD(OR=1.573,95%CI:1.015-2.439,P=0.043)was an independent risk factor for osteoporosis in the elderly patients without diabetes.Conclusion NAFLD,old age,and female sex are independent risk factors for osteoporosis in elderly patients.

Background::Previous studies have reported associations of specific maternal and paternal lifestyle factors with offspring’s cognitive development during early childhood. This study aimed to investigate the prospective associations between overall parental lifestyle and offspring’s cognitive performance during adolescence and young adulthood in China.Methods::We included 2531 adolescents aged 10-15 years at baseline in 2010 from the China Family Panel Studies. A healthy parental lifestyle score (ranged 0-5) was constructed based on the following five modifiable lifestyle factors: Smoking, drinking, exercise, sleep, and diet. Generalized estimating equation models were used to examine the association between baseline parental healthy lifestyle scores and offspring’s fluid and crystallized intelligence in subsequent years (2012, 2014, 2016, and 2018).Results::Offspring in the top tertile of parental healthy lifestyle scores performed better in overall fluid intelligence (multivariable-adjusted β = 0.53, 95% confidence interval [CI]: 0.29-0.77) and overall crystallized intelligence (multivariable-adjusted β = 0.35, 95% CI: 0.16-0.54) than those in the bottom tertile of parental healthy lifestyle scores. The results were similar after further adjustment for the offspring’s healthy lifestyle scores and persisted across the subgroups of parental socioeconomic status. Additionally, maternal and paternal healthy lifestyle scores were independently associated with better offspring’s cognitive performance, with significant contribution observed for paternal never-smoking, weekly exercise, and diversified diet. When both parents and offspring adhered to a healthier lifestyle, we observed the highest level of the offspring’s overall crystallized intelligence. Conclusions::Our study indicates that parental adherence to a healthier lifestyle is associated with significantly better offspring’s cognitive performance during adolescence and early adulthood, regardless of socioeconomic status. These findings highlight the potential cognitive benefits of promoting healthy lifestyles among parents of adolescents.

Dental pulp stem cells(DPSCs)are a type of mesenchymal stem cells with broad application potential.Due to their multipotent differentiation capabilities and ease of access,DPSCs have become a focus of research in the field of ophthalmology.In recent years,DPSCs have shown the potential clinical applications in the treatment of corneal epithelial injuries and retinal degenerative diseases.DPSCs can promote the corneal epithelial regeneration and reconstruction by differentiating into the corneal epithelial cells and inhibiting the M1 macrophages.Additionally,DPSCs can differentiate into the retinal photoreceptor-like cells and retinal ganglion-like cells,replace original retinal neurons,secrete neurotrophic factors to mediate injury repair,promote retinal regeneration,and improve the original function of the retina.This article systematically reviews the relevant domestic and international literatures in recent years,discussing the biological characteristics of DPSCs and the research progress in their applieation in the treatment of corneal and retinal diseases,with the aim of providing insights and strategies for the study of DPSCs in translational medicine and ophthalmic-related diseases.

Objective:To establish a UPLC method for the simultaneous determination of paeoniflorin,naringin,hesperidin,neohesperidin,costunolide and dehydrocostuslactone to improve the quality standard of Shangke Dieda Tablets.Methods:An Agilent Poroshell 120 C18 column(100 mm × 4.6 mm;2.7 μm)was used with a mobile phase of acetonitrile and 0.1％phosphate solution with binary gradient system at a flow rate of 1.0 mL·min-1.The detection wavelength was 230 nm and the column temperature was 30 ℃.Results:Paeoniflorin,naringin,hesperidin,neohesperidin,cosinolide and dehydrocosinolide showed a good linear relationship between injection concentration and peak area(r＞0.999).The linear ranges of six components were 0.854 2-256.272 μg·mL-1(r=0.999 9),1.057 5-317.247 μg·mL-1(r=0.999 9),and 0.989 5-269.850 μg·mL-1(r=0.999 9),1.055 6-316.689 μg·mL-1(r=0.999 9),0.905 1-271.527 μg·mL-1(r=0.999 8),and 1.064 7-319.395 μg·mL-1(r=0.999 9),respectively.The average recoveries of six components were 99.4％(RSD=1.2％),104.0％(RSD=1.2％),101.6％(RSD=1.0％),102.9％(RSD=0.4％),97.0％(RSD=1.9％),and 104.2％(RSD=1.0％),respectively.A total of 74 batches of samples were collected from 10 manufacturers.The contents of paeoniflorin,naringin,hesperidin,neohesperidin,coxinolactone,and dehydro-cosinolactone were 0.250 8-0.653 2,0.042 2-0.930 9,0.590 9-3.978 0,0.021 2-0.592 6,0.002 4-0.156 7,0.009 2-0.231 3 mg per tablet,respectively.Conclusion:The validated results showed that the method can be used to control the quality of Shangke Dieda Tablets.

Objective To investigate the effects of ethanol extract of Akebia trifoliate(Thunb.)Koidz(EEATK)on the proliferation and apoptosis of human hepatocellular carcinoma Hep3B and Huh-7 cells and to explore its underlying mechanism.Methods Human Hep3B cells and Huh-7 cells were cultured in vitro and separated into control group,Sorafenib group(5 μmol/L),and EEATK groups(0.10 mg/mL,0.15 mg/mL,0.20 mg/mL,0.3 mg/mL)and given the corresponding drug interventions.A CCK-8 assay was used to measure the impact of the different interventions on the proliferation of Hep3B cells and Huh-7 cells to screen the optimal action-inducing concentrations for subsequent experiments.EdU staining assay and colony formation assay were used to explore the effect of EEATK on proliferation,and Annexin V-FITC/PI double-staining assay was applied for apoptotic rate analysis.Transcriptome sequencing(RNA-seq)technology was used to analyze differentially expressed genes(DEGs)related to cell proliferation and apoptosis in the control group and EEATK(0.15 mg/mL)groups of Hep3B cells.DEGs were analyzed for function with Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment.The Comparative Toxicogenomics Database(CTD)was used to validate the expression of key proteins related to cell proliferation and apoptosis,and the findings were verified by qRT-PCR.Results Compared with the control group,different concentration of EEATK significantly inhibited the activity of Hep3B and Huh-7 cells(P＜0.01).Hep3B cells were treated with 0.15 mg/mL EEATK,the EdU-positive cell rate and clone formation rate significantly decreased(all P＜0.01).At the same time,the apoptotic rate of the EEATK group significantly increased(P＜0.01).Transcriptome sequencing of Hep3B cells showed that EEATK induced significant changes in the expression of 1577 genes(P＜0.01),of which 942 were up-regulated and 635 were down-regulated compared with the control group.GO functional enrichment analysis revealed that the DEGs were mainly enriched for cholesterol synthesis,inflammation,and extracellular matrix.KEGG pathway analysis showed that EEATK plays an anti-tumor role,mainly through the TFG-β and NF-κB signaling pathways.CTD and qRT-PCR analysis showed that EEATK significantly down-regulated the expression of apoptosis-related genes such as BIRC5 and CDK1(P＜0.01)and significantly upregulated the expression of CDKN1A and EGLN3(P＜0.01).At the same time,EEATK caused the significant downregulation of cell-proliferation-related genes such as FAM83D and MKI-67(P＜0.01),and significantly upregulated the expression of MYC and FOXC1(P＜0.01).Conclusions EEATK can inhibit cell proliferation and induce apoptosis in a manner that may be related to the regulation of TGF-β and NF-κB signal pathway-related gene expression.

Objective To investigate the relationship between the changes in vasopressin(VP)level and disease severity and prognosis in patients with septic shock(SS).Methods A total of 96 patients with SS in the hospital from December 2021 to December 2022 were selected as the study group,and 95 healthy volun-teers in the hospital during the same period were selected as the control group.The plasma VP levels of the two groups were compared,and their correlation with multiple organ dysfunction syndrome(MODS)score,a-cute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,serum C-reactive protein(CRP),and procalcitonin(PCT)levels were analyzed.The study group received shock treatment,and was divided into a good prognosis group and a poor prognosis group based on the prognosis after 28 days of hospitalization.The clinical data of the two groups were compared.Multivariate Logistic regression analysis was used to analyze the factors affecting poor prognosis.A new prediction scheme and a conventional prediction scheme were con-structed,and the predictive efficacy of different prediction schemes was evaluated using area under the curve(AUC),net reclassification index and comprehensive discrimination improvement index.Results Compared with the control group,the plasma VP level in the study group was significantly decreased,and MODS score,APACHE Ⅱ score,the levels of serum CRP and PCT were significantly increased,with statistical significance(P＜0.05).Pearson correlation analysis showed that plasma VP level was negatively correlated with MODS score,APACHE Ⅱ score,serum CRP and PCT level(r=-0.426,-0.519,-0.483,-0.395,P＜0.05).The proportion of diabetes mellitus,acute respiratory distress syndrome(ARDS),acute kidney injury(AKI),MODS score,APACHE Ⅱ score,serum CRP and PCT levels in the poor prognosis group were higher than those in the good prognosis group,while the plasma VP level was lower than that in the good prognosis group,with statistical significance(P＜0.05).Logistic regression analysis showed that concurrent ARDS,concurrent AKI,plasma VP,MODS score,APACHE Ⅱ score,serum CRP and PCT were all influential factors for poor prognosis of SS patients(P＜0.05).The AUC of plasma VP predicting poor prognosis of SS patients was 0.752,and the AUC of the new prediction scheme predicting poor prognosis of SS patients was greater than that of the conventional prediction scheme predicting poor prognosis of SS patients(P＜0.05).Conclu-sion Plasma VP level decrease in SS patients and closely relate to the severity of the condition.Based on the results of Logistic regression analysis,the new predictive model is established,which has certain predictive value for poor prognosis.

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.

AIM: To investigate the efficacy of vitrectomy combined with intravitreal injection of dexamethasone sustained-release agent for the treatment of idiopathic macular membrane(IMEM).METHODS: A retrospective analysis was conducted on 72 patients(72 eyes)diagnosed with IMEM at Xi'an People's Hospital from January 2019 to January 2023. They were divided into Group A and Group B according to different treatment method. Group A, consisting of 36 eyes, underwent vitrectomy, epiretinal membrane(ERM)removal surgery, and dexamethasone intraocular injection treatment; group B(36 eyes)only received vitrectomy and ERM removal surgery. Follow up for 12 mo, the best corrected visual acuity(BCVA), intraocular pressure, central macular thickness(CMT), and changes in macular retinal structure before and at 1, 3, 6, and 12 mo after surgery were compared.RESULTS: There were significant differences in BCVA between the two groups at 1, 3, and 6 mo postoperatively(all P<0.05), with group A showing a more significant improvement in visual acuity; there was no significant difference in BCVA between the two groups at 12 mo after surgery(P=0.056). There were significant differences in CMT between the two groups at 1, 3, and 6 mo postoperatively(all P<0.05), with a more significant decrease in CMT of the group A compared with the group B; there was no significant difference in CMT between the two groups at 12 mo after surgery(P=0.165). The comparison of intraocular pressure before and after surgery were all statistically significant(Ftime=2.763, Ptime<0.05; Fintergroup=26.800, Pintergroup<0.05; Finteraction=5.091, Pinteraction<0.05). Group A showed significant structural changes in the macula and retina after surgery.CONCLUSION: Vitreous surgery combined with single intravitreal injection of slow-release dexamethasone in patients with late stage IMEM can rapidly improve macular morphology and help restore visual function within 6 mo after surgery.