Rheumatoid arthritis （RA） is a chronic autoimmune disease characterized by persistent synovial inflammation and progressive joint destruction. Recent studies have shown that lactate metabolic reprogramming plays a key role in the pathological process of RA， and the accumulation of lactate in the synovial microenvironment triggers a cascade of immune regulatory effects. These metabolic changes create a self-sustaining cycle of inflammation and tissue damage， leading to progressively worsening disease. Therefore， lactate metabolism has been identified as a therapeutic target. Therapeutic strategies targeting lactate metabolism， such as LDHA inhibitors， targeting PKM2， MCT inhibitors， GPR81 antagonists， lactylation modification regulators， and nanosponges， have shown great potential in restoring immune balance and protecting joint integrity. This review summarizes the mechanisms of lactate metabolism in RA and its therapeutic applications， providing a theoretical basis for the development of novel metabolic intervention therapies.

Objective To investigate the potential risk factors for mild cognitive impairment (MCI) in the elderly population in the community, and to provide a basis for the primary prevention of MCI. Methods A cross-sectional study of elderly population in communities of Shanghai, China was conducted. A total of 368 subjects including both males and females, aged 65-80 years old, were selected to complete the mini-mental state examination (MMSE), basic information questionnaires, and physical examinations. Logistic regression analysis was used to analyze the potential risk factors of MCI. Results Of the 368 subjects participating in the study, 53 were found to have MCI and the prevalence rate was 14.4%. Univariate analysis found that older age, low education, no folic acid supplementation, stroke, osteoporosis and hyperlipidemia were risk factors of MCI. Multiple logistic regression analysis showed that advanced age [OR=1.146 (95%CI: 1.052-1.249)] and osteoporosis [OR=2.371 (95%CI: 1.042-5.396)] were the independent risk factors for MCI, while higher education [OR=0.073 (95%CI: 0.011-0.478)] was a protective factor. Age influenced all the aspects of MMSE scores (all P values <0.05). In addition, the analysis of the results suggested that subjects with regular folic acid supplementation got higher MMSE scores, especially in the aspect of language and praxis (P=0.002). On the contrary, patients with osteoporosis had lower attention and computing power scores (P=0.022). Conclusion The prevalence of MCI increased with age. Low education and osteoporosis may be the independent risk factors for MCI in the elderly population. Although no association was observed between folic acid supplementation and MCI, folic acid supplementation could improve the performance of language and praxis.