Objective To identify and delineate the developmental trajectories of depressive symptoms in the middle-aged and elderly population in China,and to explore the risk factors for depressive symptom trajectories in China's middle-aged and elderly population.Methods According to our inclusion and exclusion criteria,7 600 participants were subjected based on the data from the China Health and Aged Care Tracking Survey(CHARLS)published by Peking University.The data from 5 waves of the survey from 2011 to 2023 were collected and analyzed with latent growth curve model(LGCM),latent class growth model(LGCM)to identify the developmental trajectories of depressive symptoms in the participants.Multicategorical logistic regression analyses were conducted to analyze whether gender,marital status,educational level,urban/rural residence,annual income,self-rated health status,and childhood bullying experience were risk factors for different trajectories of depressive symptoms.Results Two developmental trajectories of depressive symptoms were identified and classified in this study,that is,low-level stable(n=5 545,72.96%)and high-level ascending(n=2 055,27.04%).With the low-level stable group as a reference,multicategorical logistic regression analysis revealed that female(OR=1.373,95CI%:1.191～1.584,P<0.001),residence of rural area(OR=1.634,95CI%:1.410～1.895,P<0.001),and poor self-rated health status(OR=2.059,95%CI:1.890～2.243,P<0.001),and experience of childhood bullying(OR=1.76,95%CI:1.489～2.080,P<0.001)were associated with an increased risk of high-level ascending trajectory of depression.Conclusion There are 2 different trajectories of depressive mood in Chinese middle-aged and elderly population.And poor self-rated health status,history of childhood bullying,being female,and residence of rural area are risk factors for a high-level ascending trajectory of depressive symptoms.

Objective To investigate the characteristic changes in motor function and psychological factors among Parkinson's disease(PD)patients with different phenotypic patterns of freezing of gait(FOG),and to explore the trends in phenotypic heterogeneity of these features.Methods A cross-sectional study was conducted on 17 PD patients without FOG(PD-NFOG)and 25 PD patients with FOG(PD-FOG)[including 13 cases of trembling-in-place(TP)and 12 cases of shuffling-with-small-steps(SS)].Another 28 demographically matched(age,gender,education level and others)healthy individuals were recruited from community and served as healthy controls(HC).Motor function was assessed using quantitative gait analysis and clinical scales,including the unified Parkinson's disease rating scale part Ⅲ(UPDRS-Ⅲ)and H&Y staging.Psychological evaluations were carried out with Hospital Anxiety and Depression Scale(HADS-A/HADS-D),Generalized Anxiety Disorder-7(GAD-7),Patient Health Questionnaire-9(PHQ-9),Snaith-Hamilton Pleasure Scale(SHAPS),Reading the Mind in the Eyes Test(RMET),Montreal Cognitive Assessment(MoCA),and digital symbol substitution test(DSST).Results ① There were significant differences between the PD-FOG and PD-NFOG groups in terms of motor parameters(stride width,length,height and cadence)and cognitive function(MoCA)score(P<0.05).The largest effect sizes were found for cognitive function scores of RMET[η2=0.716(95%CI:0.611～0.761),P<0.05],DSST[η2=0.667(95%CI:0.553～0.744),P<0.05],and MoCA[η2=0.597(95%CI:0.425～0.750),P<0.05],all of which were classified as medium effect sizes.② Associative characteristics of motor and psychological factors in the PD-FOG group:H&Y stage was positively correlated with HADS-A[r=0.470(95%CI:0.080～0.735),P=0.018]and HADS-D[r=0.560(95%CI:0.199～0.787),P=0.004],while the total score of UPDRS-Ⅲ was negatively correlated with DSST[r=-0.574(95%CI:-0.794～-0.219),P=0.003].③Subgroup analysis revealed significant differences(P<0.05)between the TP and SS patterns in motor parameters(stride length and cadence).Moderate effect sizes were observed for HADS-A[δ=0.752(95%CI:-0.070～1.558),P=0.072],SHAPS[δ=0.512(95%CI:-0.291～1.305),P=0.132]and HADS-D[δ=0.481(95%CI:-0.321～1.273),P=0.253],with mean increase by 39.0%,8.3%,and 24.5%,respectively,in the TP subgroups when compared to the SS subgroups.Conclusion PD-FOG patients exhibit characteristic changes in motor function and psychological factors.Cognitive impairment in PD patients may serve as a characteristic marker for FOG progression.Additionally,psychological features in PD-FOG patients with different motor phenotypes show trends of phenotypic heterogeneity.

This article summarizes Professor Shang Lili's experience in diagnosing and treating recurrent respiratory tract infections(RRTIs)in children based on the theory of"internal deficiency and external injury".Professor Shang believes that children are in the stage of growth and development,with delicate organs and insufficient vital energy,which is called"internal deficiency";external pathogens repeatedly invade the human body,resulting in clinical manifestations of both cold and heat,ultimately damaging the body's qi,blood,essence,and spirit,known as"external injury"."Internal deficiency and external injury"leads to repeated infections of pathogens in children and causes physical and mental distress,affecting their growth and development.The theory of"internal deficien-cy and external injury"emphasizes the influence of internal and external factors on RRTIs in children,reflecting the evolution of patho-genesis and guiding clinical staging treatment.During the acute infection period,the treatment of wind heat syndrome is based on the Xin Liang and Qing San methods,while the treatment of wind cold syndrome is based on the Xin Wen and Kai Bi methods.For the mixed deficiency and excess syndrome,various methods such as attacking,supplementing,harmonizing,and supporting should be used,and treatment should be based on syndrome differentiation,with adjustments made according to the symptoms;during the inter-mittent period of infection,Professor Shang aims to assist the righteous qi,taking into account the upper,middle,and lower Jiao,and adopting treatment principles such as nourishing the lungs,spleen,and kidneys.Professor Shang's experience provides useful ideas and methods for the treatment of RRTIs in children.