Objective: To develop a prediction model for mild cognitive impairment (MCI) risk among the elderly, so as to provide a tool for MCI early screening. Methods : From July 2022 to September 2024, a multi-stage stratified random cluster sampling method was used to recruit permanent residents aged ≥65 years from the Xinjiang Uygur Autonomous Region as study participants. Data on sociodemographic characteristics, nutritional status, body composition indices, bone mineral density, and handgrip strength were collected through questionnaires and physical examinations. Sarcopenia was defined based on appendicular skeletal muscle index and handgrip strength. MCI was assessed using the Mini-Mental State Examination, with adjustments for educational level. Participants were randomly divided into a training set and a validation set in a 7∶3 ratio. LASSO regression and multivariable logistic regression models were employed to screen for predictors and construct an MCI risk prediction model. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve and decision curve analysis (DCA). Results: A total of 1 641 participants were surveyed, including 755 males (46.01%) and 886 females (53.99%). The majority of participants were aged 65-<75 years, comprising 1 154 individuals (70.32%). MCI was detected in 517 participants, corresponding to a detection rate of 31.51%. Resultsfrom LASSO regression and multivariate logistic regression analysis showed that residence (rural, OR = 2.323, 95% CI: 1.682-3.210), age (75-<85 years, OR = 1.405, 95% CI: 1.019-1.937; ≥85 years, OR = 3.655, 95% CI: 1.696-7.875), educational level (primary school, OR = 0.341, 95% CI: 0.247-0.472; junior high school, OR = 0.255, 95% CI: 0.160-0.408; high school, OR = 0.286, 95% CI: 0.154-0.531; bachelor's degree or above, OR = 0.120, 95% CI: 0.041-0.351), history of alcohol consumption (yes, OR = 3.216, 95% CI: 2.164-4.779), risk of malnutrition (yes, OR = 1.464, 95% CI: 1.064-2.014), sarcopenia (yes, OR = 3.197, 95% CI: 2.332-4.385), and waist-to-hip ratio (abnormal, OR = 1.540, 95% CI: 1.159-2.048) were identified as predictive factors for MCI among the elderly. In the training set, the area under the ROC curve, sensitivity, and specificity were 0.788, 0.719, and 0.712, respectively. In the validation set, the corresponding values were 0.784, 0.913, and 0.542, respectively. DCA demonstrated that the model provided a higher clinical net benefit for predicting MCI risk when the risk threshold probability ranged from 0.124 to 0.764. Conclusion The prediction model developed in this study demonstrates good discriminative ability and clinical utility, indicating its substantial value for predicting the MCI risk among the elderly.

BackgroundDepression has become a public health concern that affects the physical and mental health of college students. acute stress response is a risk factor of depression. Exploring the relationship and mechanism between acute stress response and depression is of great significance for preventing and intervening depression in college students. ObjectiveTo examine the relationship between acute stress response and depression among college students， and to analyze the mediating role of rumination and the moderated effect of perceived social support， so as to provide references for the prevention and intervention of depression in college student . MethodsFrom March to April 2020， a cluster sampling method was employed to select 1 355 college students from three universities in Hubei， Jiangxi and Guangxi Zhuang Autonomous Region. Participants were assessed with Acute Stress Disorder Scale （ASDS）， Ruminative Responses Scale （RRS）， Brief form of Perceived Social Support Questionnaire （F-SozU） and Patients' Health Questionnaire Depression Scale-9 item （PHQ-9）. Pearson correlation analysis was adopted to examine the correlation between the scores of each scale. The mediating role of rumination between acute stress response and depression and the moderated role of perceived social support were examined respectively by using Model 4 and Model 14 in Macro Program Process 3.3. ResultsA total of 1 303 valid questionnaires were collected， yielding a valid response rate of 96.16%. The results of Pearson correlation analysis showed that ASDS score was positively correlated with RRS score and PHQ-9 score （r=0.649， 0.528， P<0.01） among college students. The mediation analysis results demonstrated that rumination played a partial mediating role between acute stress response and depression， with the mediating effect value of 0.273 （95% CI：0.222~0.328）， accounting for 68.59% of the total effect. Perceived social support played a moderated role in the latter path of the mediation model （rumination → depression） （β=-0.004， 95% CI： -0.017~-0.004， P<0.01）. ConclusionRumination played a partial mediating role between acute stress response and depression in college students， and perceptive social support played a moderated role between rumination and depression. ［Funded by Scientific Research Fund Project of Education Department of Yunnan Province （number， 2025J0437）］

To summarize the nursing experience of a patient with acute injection botulism complicated with respiratory failure.The key nursing points include early standard use of botulinum antitoxin therapy to improve the signs of myasthenia;to strengthen respiratory support and airway management,to carry out respiratory training,and to promote the recovery of respiratory function;swallowing function training and dynamic evaluation were carried out to promote the recovery of swallowing function;narrative nursing was carried out to relieve patient's negative emotions.After 17 days of treatment and nursing care,the patient was removed from the tracheal tube on the 7th day,transferred to the general ward on the 14th day,and discharged successfully on the 17th day with a good prognosis.A telephone follow-up was conducted 4 months after discharge,and the patient recovered well.

To summarize the nursing experience of a patient with acute injection botulism complicated with respiratory failure.The key nursing points include early standard use of botulinum antitoxin therapy to improve the signs of myasthenia;to strengthen respiratory support and airway management,to carry out respiratory training,and to promote the recovery of respiratory function;swallowing function training and dynamic evaluation were carried out to promote the recovery of swallowing function;narrative nursing was carried out to relieve patient's negative emotions.After 17 days of treatment and nursing care,the patient was removed from the tracheal tube on the 7th day,transferred to the general ward on the 14th day,and discharged successfully on the 17th day with a good prognosis.A telephone follow-up was conducted 4 months after discharge,and the patient recovered well.

ObjectiveTo investigate the mechanism of Ershiwuwei Guijiu pill in preventing and treating postmenopausal osteoporosis （PMOP） by activating the phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR） signaling pathway and inhibiting excessive autophagy. MethodFemale SD rats were ovariectomized and randomly divided into the sham operation group （Sham）， the operation group （OVX）， the Ershiwuwei Guijiu pill （GJ） group， and the raloxifene hydrochloride （RLX） group， with 10 rats in each group. Enzyme-linked immunosorbent assay （ELISA） and colorimetric methods were used to detect the levels of estrogen， bone metabolism markers in serum， and total superoxide dismutase （T-SOD）， malondialdehyde （MDA）， and glutathione peroxidase （GSH-Px） in tibial tissue. Flow cytometry was used to detect reactive oxygen species （ROS） levels in bone marrow mesenchymal stem cells. Masson staining was used to observe pathological changes in the proximal tibia， and micro-computed tomography （Micro-CT） was used to observe changes in tibial microstructural parameters. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were used to detect the expression of autophagy-related proteins Beclin1， microtubule-associated protein 1A/1B-light chain 3 （LC3）， autophagy-related 5 （Atg5）， as well as PI3K， Akt， and mTOR in tibial tissue. ResultCompared with the Sham group， the OVX group showed a significant decrease in serum levels of estradiol （E₂） and calcium ion （Ca²⁺）， and T-SOD， GSH-Px， PI3K， Akt， and mTOR mRNA levels in bone tissue （P<0.05， P<0.01）， significantly reduced bone mineral density （BMD）， bone surface/bone volume （BS/BV）， trabecular thickness （Tb.Th）， trabecular number （Tb.N）， and trabecular connectivity （Con） in the tibia （P<0.05， P<0.01）， thinner epiphyseal growth plate， and the bone marrow cavity filled with fat vacuoles. Moreover， the levels of phosphorus （P）， MDA， ROS， and mRNA and protein expression of Beclin1， LC3， and Atg5， as well as trabecular separation （Tb.Sp） were significantly elevated （P<0.05， P<0.01）. Compared with the OVX group， the GJ and RLX groups showed significant increases in serum E₂ and Ca²⁺， and bone tissue levels of SOD， GSH-Px， and the mRNA levels of PI3K， Akt， and mTOR （P<0.05， P<0.01）， significantly increased BMD， BS/BV， Tb.Th， Tb.N， and Con in the tibia， thickened epiphyseal growth plate， and significantly reduced fat vacuoles in the bone marrow cavity （P<0.05， P<0.01）. Additionally， the levels of P， MDA， ROS， Beclin1， LC3， Atg5 mRNA and proteins， and Tb.Sp were significantly decreased （P<0.05， P<0.01）. The ratios of p-PI3K/PI3K， p-Akt/Akt， and p-mTOR/mTOR， which were significantly reduced in the OVX group （P<0.01）， were significantly increased in the GJ and RLX groups （P<0.01）. ConclusionThe Ershiwuwei Guijiu pill reduces oxidative stress and inhibits autophagy， thereby preventing and treating postmenopausal osteoporosis. Its mechanism may be related to the activation of the PI3K/Akt/mTOR signaling pathway， which inhibits autophagy.

Objective To investigate the effects of PRPF19 knockdown on the proliferation, migration, and invasion of pancreatic cancer cells. Methods The expression of PRPF19 in pancreatic cancer and normal tissues was analyzed using the GEPIA database. The protein and mRNA expression levels of PRPF19 in pancreatic cancer cells were detected by Western blot and qRT-PCR. Small interfering RNA (siRNA) was used to silence the expression of PRPF19 in pancreatic cancer cells, and the knockdown efficiency was verified by Western blot and qRT-PCR. CCK-8, colony forming, and Transwell assay were used to detect the effects of knockdown of PRPF19 on the proliferation, colony forming, migration, and invasion of pancreatic cancer cells. Results GEPIA analysis showed that PRPF19 was highly expressed in pancreatic cancer tissues compared with normal pancreatic tissues. In comparison with normal pancreatic cells, PRPF19 was highly expressed in various pancreatic cancer cell lines such as MIA PaCa-2 and PANC-1 (P < 0.05). In comparison with the control group, PRPF19 knockdown significantly reduced the proliferation rate, colony forming, cell migration, and invasion of pancreatic cancer cells (P < 0.05). Conclusion PRPF19 knockdown inhibits the proliferation, migration, and invasion of pancreatic cancer cells. PRPF19 may play an important role as an oncogene of pancreatic cancer.

Objective:To explore the mediating effect of social support and exercise self-efficacy on the intrinsic capacity of community-dwelling older adults and healthy aging, so to provide a basis for improving the healthy aging of community-dwelling older adults.Methods:From January to July 2022, cluster random sampling was used to select 1 303 community-dwelling older adults from Urumqi City as the research subject. The survey was conducted using the General Information Questionnaire, Healthy Aging Instrument, Intrinsic Capacity Questionnaire, Social Support Rating Scale, and Exercise Self Efficacy Scale for Aged People in Community. The conceptual model was used to explore the relationship among social support, exercise self-efficacy, intrinsic capacity, and healthy aging in community-dwelling older adults. A total of 1 303 questionnaires were distributed, and 1 042 valid questionnaires were collected, with an effective response rate of 80%.Results:Among 1 042 community-dwelling older adults, the scores of the Intrinsic Capacity Questionnaire, Healthy Aging Instrument, Social Support Rating Scale, and Exercise Self Efficacy Scale for Aged People in Community were [1.00 (0, 2.00) ] , [146.00 (133.75, 155.00) ] , [41.00 (36.00, 46.00) ] and [51.00 (39.00, 61.00) ] , respectively. The intrinsic capacity of community-dwelling older adults was negatively correlated with social support, exercise self-efficacy, and healthy aging ( r=-0.112, -0.121, -0.120, P<0.01) , and social support and exercise self-efficacy were positively correlated with healthy aging (r=0.129, 0.113, P<0.01) . Bootstrap mediating effect test showed that the mediating effect of social support and exercise self-efficacy between the intrinsic capacity of community-dwelling older adults and healthy aging was established, with a mediating effect value of -0.477, accounting for 24.75% of the total effect. The path effect value of intrinsic capacity→ social support→ healthy aging was -0.262, accounting for 54.93% of the mediating effect value. The path effect value of intrinsic capacity → exercise self-efficacy→ healthy aging was -0.214, accounting for 44.86% of the mediating effect value. Conclusions:In the community elderly population, social support and exercise self-efficacy can play a mediating role between intrinsic capacity and healthy aging. Community health care providers should pay attention to the internal capacity of the older adults, improve social support and exercise self-efficacy, and thus promote the realization of healthy aging of the older adults.

The incidence of metabolic rheumatism gout has been increasing with a trend of more younger patients and atypical symptoms. Typical gout is easy to be diagnosed, but it is difficult for atypical cases. Finding uric acid crystal in articular fluid by polarizing light microscope is a gold standard of diagnosis, but it is an invasive diagnostic method and difficult to be widely used. The patients need further imaging examination for assistance of diagnosis and guide of follow-up treatment. This article reviews the research progress of different imaging methods used for diagnosis of gouty arthritis.

Objective To investigate one -step overall treatment to improve the condition of diabetic foot ulcers based on transluminal technology.Methods The patients with diabetic foot ulcers were treated with percutaneous transluminal angioplasty(PTA)to open blood flow,intensively control patients'blood glucose,application of sensitive antibiotics,erode debridement and dressing change according to wound bed preparation(WBP)and moist wound heal, vacuum aspiration was applied in large wound.Results Eighty -two patients(eighty -five lower limbs)underwent PTA,the successful rate was 100.0%.Of 116 ulcers,106 cases were effective (91.4%),10 cases were invalid (8.6%).Their ankle -brachial index (ABI)increased from preoperatively (0.41 ±0.12)to postoperatively (0.75 ± 0.09).Transcutaneous oxygen pressure(TcPaO2 )increased from preoperatively (14.6 ±4.8)mmHg to postopera-tively (51.6 ±8.9)mmHg.Conclusion One -step treatment regarding multi disciplinary team on endocrine section can improve the treatment of diabetic foot and lower the amputation rate.

Objective To analyze the urodynamic data of the patients with benign prostatic hyperplasia(BPH)and provide evidence for the therapy.Methods 452 patients with BPH were selected.The mean age was(65.6 ±5.65)years(51 to 89 years).All patients had intact history documents which included the results of cystoscopy,urodynamics,doppler,DRE and PSA.Results 15 cases were not diagnosed with BOO.430 cases were diagnosed with BOO,among them,65 cases of bladder detrusor muscle weakness,bladder detrusor instability(detrusor,DI,instability)in 365 cases,3 cases were normal,and the other 4 cases had detrusor atony.In 445 patients the mean maximum urinary flow rate(8.32±3.15)ml/s,the average residual urine volume(87.68±79.46)ml,the average maximum flow rate when the detrusor pressure(62.32±7.54)cm H2O,maximum urethral closure pressure was(86.43±18.35)cmH2O,among which 19 cases were not suitable for surgery.At the end of the 426 patients underwent surgical treatment,postoperative follow-up of 3 to 18 months,the International Prostate Symptom Score(IPSS)from 0 to 5,the quality of life index(QOL)score of 0 to 1,Qmax 11 to 21 ml /s,residual urine(45.6±36.2)ml.There were significant differences between the preoperative and postoperative indexes(P<0.05).Conclusion Urodynamic tests can avoid the blindness in the surgery treatment of BPH.