Objective To investigate the relationship between biological aging and the rate of cognitive decline in middle-aged and elderly populations.Methods Longitudinal tracking data of cognitive function were obtained from the China Health and Retirement Longitudinal Study(CHARLS).We employed the Klemera and Doubal method(KDM)to estimate biological age(BA),and calculate the biological aging index(BAI)and biological aging type(BAT).A multivariate linear regression model was employed to analyze the relationships between baseline BAI,BAT,and cognitive function scores.Based on the baseline analysis,a mixed-effects model was used to examine the longitudinal associations between baseline BAI,BAT,and cognitive function during follow-up.Results A total of 5 897 participants were included in the study.BAI was found to be negatively associated with baseline cognitive function scores,with the partial regression coefficient(β)(95％CI)being-0.185(—0.231,—0.139)(P＜0.001).Compared with the lagged aging group,the premature aging group had lower cognitive function scores(β[95％CI]:—0.741[—0.966,—0.516]).For age and sex,for each additional year of baseline BAI,cognitive function scores declined by an average of 0.012(95％CI:—0.019,—0.005)points per year after adjusting for age and sex,and declined by 0.011(95％CI:—0.018,—0.004)points per year after adjusting for other covariates.Compared with participants with lagged aging,those with premature aging experienced,on average,an additional decline of 0.042(95％CI:—0.075,0.009)points per year in cognitive function scores after adjusting for age and sex alone,and by 0.039(95％CI:—0.072,—0.007)points per year after adjusting for other covariates.Conclusion Biological aging affects the rate of cognitive decline in middle-aged and elderly populations.A higher BAI is associated with a faster decline in cognitive function.Compared with those with lagged aging,individuals with premature aging exhibit a more rapid rate of cognitive decline.

Objective To explore the mediating role of activities of daily living (ADL) in pain and depressive symptoms in the elderly in China. Methods Utilizing the data from 2020 China Health and Retirement Longitudinal Study, 4403 Chinese elderly individuals aged ≥ 60 years old were selected as the research subjects. Depression Scale (CES-D 10) of the Center for Epidemiological Survey and ADL scale were used in the study. The PROCESS4.1 macro was used to test the mediating effect of daily living activities between pain and depressive symptoms, and the Bootstrap method was applied for verification of the mediating variables. Results A total of 2368 cases of depressive symptoms were detected in the elderly in China, with a detection rate of 53.78%. Pain was positively correlated with depressive symptoms (r=0.27, P<0.01), and activities of daily living were negatively correlated with pain and depressive symptoms (r=-0.27, -0.337, P<0.01). The results showed that the total effect value of pain on depressive symptoms was 0.33, the direct effect value was 0.24, and the mediating effect value of daily living activities was 0.09, accounting for 27.27%. Conclusion Pain and activities of daily living are important factors influencing depressive symptoms in the elderly, and activities of daily living play a partial mediating role in the relationship between pain and depressive symptoms in the elderly.

Objective To observe the value of intraoperative ultrasound(IOUS)for microsurgical resection of primary supratentorial glioblastoma.Methods Totally 130 cases of central nervous system WHO grade 4 primary supratentorial glioblastoma confirmed by postoperative pathology were retrospectively enrolled and divided into IOUS group and control group(each n=65)based on whether IOUS was used during operation.The general information,resection related indicators and postoperative complications were compared between groups,and the application value of IOUS was analyzed.Results In IOUS group,the tumor depth was greater,while the intraoperative bleeding,duration of hospitalization and operation-duration were all less than those in control group(all P＜0.05).Postoperative complications occurred in 28 cases of IOUS group and 29 cases of control group,and the incidence of subdural effusion in IOUS group was lower than that in control group(P＜0.05).Conclusion IOUS could effectively reduce intraoperative bleeding,duration of hospitalization,operation-duration and incidence of postoperative subdural effusion in microsurgical resection of primary supratentorial glioblastoma.

Objective To investigate the value of intraoperative ultrasound radiomics for predicting isocitrate dehydrogenase 1(IDH1)mutation of high-grade glioma.Methods Ninety-five patients with high-grade glioma(WHO grade Ⅲ and Ⅳ)who underwent craniotomy glioma resection and ultrasound assisted tumor localization during operation and then confirmed by pathology were retrospectively enrolled.The patients were divided into training set(n=66,including 24 IDH1 mutation type and 42 IDH1 wild type)and validation set(n=29,including 11 IDH1 mutation type and 18 IDH1 wild type)at the ratio of 7∶3.Based on intraoperative ultrasound,radiomics features were extracted,the best ones were screened,and a radiomics model was established for predicting IDH1 mutation of high-grade glioma using random forest algorithm.Receiver operating characteristic(ROC)curve was plotted,the area under the curve(AUC)was calculated to evaluate the predictive efficacy of the model,and decision curve analysis(DCA)was used to evaluate the clinical value of the model.Results A total of 851 radiomics features were extracted based on intraoperative ultrasound,and finally 5 best ones were screened out to construct a radiomics model.The AUC of the radiomics model for predicting IDH1 mutation of high-grade glioma in training and validation sets was 0.902 and 0.707,respectively,with no significant difference(P=0.097).DCA maps showed that the clinical net benefit of the radiomics model was high.Conclusion Intraoperative ultrasound radiomics could effectively predict IDH1 mutation of high-grade glioma.

Objective:To evaluate the clinical utility of left atrial strain parameters and left atrioventricular global longitudinal strain（LAVGLS）in detecting cardiovascular immune-related adverse events（CV-irAEs）among non-small cell lung cancer patients receiving immune checkpoint inhibitors（ICIs）.Methods:A total of 68 patients with non-small cell lung cancer were prospectively enrolled in Tianjin Medical University Cancer Institute and Hospital from October 2023 to October 2024. All patients were treated with ICIs for 6 cycles. Electrocardiogram，cardiac serological markers and echocardiography were examined before medication（T0 stage），4 cycles after medication（T1 stage）and 6 cycles after medication（T2 stage），respectively. According to the guidelines of the American Society of Clinical Oncology，all patients were divided into the CV-irAEs group（ n=14）and the No-CV-irAEs group（ n=54）. AFI software and 4D Auto LAQ software were used to calculate LVGLS，left atrial reservoir longitudinal strain（LASr），LAVGLS and a series of left atrial parameters. Cox proportional hazards regression model was applied to find the risk factors for the occurrence of CV-irAEs. ROC curve was applied to analyze the diagnostic efficiency of these parameters for CV-irAEs. Results:Fourteen patients（20.6%）developed CV-irAEs after T2 stage. After ICIs treatment，LVGLS，LASr and LAVGLS decreased in both groups，LVGLS，LASr and LAVGLS decreased more significantly in the CV-irAEs group than those in the No-CV-irAEs group（ P=0.038，0.047，0.005）. Left ventricular ejection fraction（LVEF）decreased in the CV-irAEs group at the same time（ P=0.003）. Cox multivariate analysis showed that ΔLAVGLS（the difference between stage T0 and stage T2）was a risk factor for CV-irAEs（ HR：1.395， P=0.019）. ROC curve analysis showed the area under the curve of LVGLS，LASr，LAVGLS，ΔLVGLS，ΔLASr，ΔLAVGLS，and LVEF at the T2 stage for diagnosis of CV-irAEs were 0.68，0.67，0.75，0.79，0.73，0.82，and 0.72，respectively. Conclusions:Decline of LAVGLS is a risk factor for CV-irAEs in patients with non-small cell lung cancer receiving ICIs and can be used for early detection of CV-irAEs. LASr has potential diagnostic value for CV-irAEs，but it is less valuable than LVGLS and LAVGLS.

Objective To observe the value of intraoperative ultrasound(IOUS)for microsurgical resection of primary supratentorial glioblastoma.Methods Totally 130 cases of central nervous system WHO grade 4 primary supratentorial glioblastoma confirmed by postoperative pathology were retrospectively enrolled and divided into IOUS group and control group(each n=65)based on whether IOUS was used during operation.The general information,resection related indicators and postoperative complications were compared between groups,and the application value of IOUS was analyzed.Results In IOUS group,the tumor depth was greater,while the intraoperative bleeding,duration of hospitalization and operation-duration were all less than those in control group(all P＜0.05).Postoperative complications occurred in 28 cases of IOUS group and 29 cases of control group,and the incidence of subdural effusion in IOUS group was lower than that in control group(P＜0.05).Conclusion IOUS could effectively reduce intraoperative bleeding,duration of hospitalization,operation-duration and incidence of postoperative subdural effusion in microsurgical resection of primary supratentorial glioblastoma.

Objective To investigate the value of intraoperative ultrasound radiomics for predicting isocitrate dehydrogenase 1(IDH1)mutation of high-grade glioma.Methods Ninety-five patients with high-grade glioma(WHO grade Ⅲ and Ⅳ)who underwent craniotomy glioma resection and ultrasound assisted tumor localization during operation and then confirmed by pathology were retrospectively enrolled.The patients were divided into training set(n=66,including 24 IDH1 mutation type and 42 IDH1 wild type)and validation set(n=29,including 11 IDH1 mutation type and 18 IDH1 wild type)at the ratio of 7∶3.Based on intraoperative ultrasound,radiomics features were extracted,the best ones were screened,and a radiomics model was established for predicting IDH1 mutation of high-grade glioma using random forest algorithm.Receiver operating characteristic(ROC)curve was plotted,the area under the curve(AUC)was calculated to evaluate the predictive efficacy of the model,and decision curve analysis(DCA)was used to evaluate the clinical value of the model.Results A total of 851 radiomics features were extracted based on intraoperative ultrasound,and finally 5 best ones were screened out to construct a radiomics model.The AUC of the radiomics model for predicting IDH1 mutation of high-grade glioma in training and validation sets was 0.902 and 0.707,respectively,with no significant difference(P=0.097).DCA maps showed that the clinical net benefit of the radiomics model was high.Conclusion Intraoperative ultrasound radiomics could effectively predict IDH1 mutation of high-grade glioma.

Objective:To evaluate the clinical utility of left atrial strain parameters and left atrioventricular global longitudinal strain（LAVGLS）in detecting cardiovascular immune-related adverse events（CV-irAEs）among non-small cell lung cancer patients receiving immune checkpoint inhibitors（ICIs）.Methods:A total of 68 patients with non-small cell lung cancer were prospectively enrolled in Tianjin Medical University Cancer Institute and Hospital from October 2023 to October 2024. All patients were treated with ICIs for 6 cycles. Electrocardiogram，cardiac serological markers and echocardiography were examined before medication（T0 stage），4 cycles after medication（T1 stage）and 6 cycles after medication（T2 stage），respectively. According to the guidelines of the American Society of Clinical Oncology，all patients were divided into the CV-irAEs group（ n=14）and the No-CV-irAEs group（ n=54）. AFI software and 4D Auto LAQ software were used to calculate LVGLS，left atrial reservoir longitudinal strain（LASr），LAVGLS and a series of left atrial parameters. Cox proportional hazards regression model was applied to find the risk factors for the occurrence of CV-irAEs. ROC curve was applied to analyze the diagnostic efficiency of these parameters for CV-irAEs. Results:Fourteen patients（20.6%）developed CV-irAEs after T2 stage. After ICIs treatment，LVGLS，LASr and LAVGLS decreased in both groups，LVGLS，LASr and LAVGLS decreased more significantly in the CV-irAEs group than those in the No-CV-irAEs group（ P=0.038，0.047，0.005）. Left ventricular ejection fraction（LVEF）decreased in the CV-irAEs group at the same time（ P=0.003）. Cox multivariate analysis showed that ΔLAVGLS（the difference between stage T0 and stage T2）was a risk factor for CV-irAEs（ HR：1.395， P=0.019）. ROC curve analysis showed the area under the curve of LVGLS，LASr，LAVGLS，ΔLVGLS，ΔLASr，ΔLAVGLS，and LVEF at the T2 stage for diagnosis of CV-irAEs were 0.68，0.67，0.75，0.79，0.73，0.82，and 0.72，respectively. Conclusions:Decline of LAVGLS is a risk factor for CV-irAEs in patients with non-small cell lung cancer receiving ICIs and can be used for early detection of CV-irAEs. LASr has potential diagnostic value for CV-irAEs，but it is less valuable than LVGLS and LAVGLS.

Caloric restriction (CR) is a well-established dietary intervention known to extend healthy lifespan and exert positive effects on aging-related diseases, including cardiovascular conditions. Sirtuins, a family of nicotinamide adenine dinucleotide (NAD +)-dependent histone deacetylases, have emerged as key regulators of cellular metabolism, stress responses, and the aging process, serving as energy status sensors in response to CR. However, the mechanism through which CR regulates Sirtuin function to ameliorate cardiovascular disease remains unclear. This review not only provided an overview of recent research investigating the interplay between Sirtuins and CR, specifically focusing on their potential implications for cardiovascular health, but also provided a comprehensive summary of the benefits of CR for the cardiovascular system mediated directly via Sirtuins. CR has also been shown to have considerable impact on specific metabolic organs, leading to the production of small molecules that enter systemic circulation and subsequently regulate Sirtuin activity within the cardiovascular system. The direct and indirect effects of CR offer a potential mechanism for Sirtuin modulation and subsequent cardiovascular protection. Understanding the interplay between CR and Sirtuins will provide new insights for the development of interventions to prevent and treat cardiovascular diseases.

Shift handover is a process of transferring power and responsibility between medical staff,and it is also a basic part of medical activities.Intensive care unit(ICU)is the core area for the treatment of critically ill patients,with complex patient conditions and fine and diverse treatment.If clinical information cannot be shared accurately and in time,it will lead to the delay of the patient's condition,diagnosis and treatment plan.At the same time,the omission of handover information and communication problems can easily lead to safety risks,prolonged hospital stay and increased number of readmissions.Therefore,as one of the important links in ICU diagnosis and treatment and nursing work,accurate,complete and effective handover can ensure the rapid and accurate transmission of patient information and promote the smooth development of diagnosis and treatment and nursing work.This paper reviews the application scope of ICU shift handover model,analyzes the main characteristics,application status and application effects of ICU shift model,and discusses the problems and shortcomings of the existing ICU shift model,in order to provide a reference for further optimizing the quality of ICU shift.PRISMA extension for scoping reviews(PRISMA-ScR)as methodological guidance,we conducted a systematic search across major databases including PubMed,Web of Science,Embase,Cumulative Index to Nursing and Allied Health Literature(CINAHL),and Chinese databases(Wanfang,CNKI,Chinese Medical Association,CBM)using both subject headings and free-text terms).The search time limit was from the establishment of the database to July 18,2024.The preliminary retrieved literature bibliographer was imported into Endnote 20.0 software,and the obtained literature was selected and screened by two researchers.A total of 14 articles were included,of which 10 were from China and 4 were from the United States,and all were published between 2012 and 2022.The analysis showed that the ICU shift mode mainly included improved shift mode,group system shift mode,anti-shift mode,checklist type shift sheet mode and electronic information ICU shift.The shift mode showed diversified characteristics,optimized staffing to a certain extent,standardized the specific content and process of shift,and improved the quality of shift.Significant advances have been made in information delivery and quality of care.However,domestic research is mostly focused on the improvement of the shift mode,which faces the shortcomings of increasing workload,coordination and communication challenges,and the scientification and standardization of tools.Electronic information technology makes up for the shortcomings of information omission in the traditional shift process through the advantages of automatic data collection and information collection,and shows positive results in the process of shift.Future research needs to further explore the basis of not increasing the load of ICU clinical medical staff,ensuring the efficiency of shift and normal work flow.Pay attention to the intelligent,standardized and personalized construction of ICU shift,improve the quality of diagnosis and treatment and nursing,and ensure the safety of patients.