Objective: To investigate the association between nighttime sleep duration, physical activity and disability among the elderly, so as to provide the basis for reduce the risk of disability and promote healthy aging. Methods: Based on the 2020 database of China Health and Retirement Longitudinal Study (CHARLS), demographic information, lifestyle behaviors, chronic diseases and nighttime sleep duration were collected from people aged 60 years and older. Physical activity level was evaluated using the International Physical Activity Questionnaire-Short. Disability status was measured using the basic Activities of Daily Living (ADL) scale. Association between nighttime sleep duration, physical activity and disability among the elderly were analyzed using multivariable logistic regression model. Results: Totally 11 126 elderly participants were enrolled, with 5 423 males (48.74%) and 5 703 females (51.26%). The mean age was (69.92±7.08) years. Among them, 6 838 individuals (61.46%) had a nighttime sleep duration of <7 hours, and 2 247 individuals (20.20%) had a physical activity level of <600 MET-min/week. A total of 3 213 individuals were identified as having disability, with a detection rate of 28.88%. Multivariable logistic regression analysis showed that, after adjusting for age, gender, marital status, education level, residence, smoking, alcohol consumption, and multimorbidity of chronic diseases, compared with a nighttime sleep duration of 7-8 hours, those with <7 hours (OR=1.535, 95%CI: 1.386-1.700) and >8 hours (OR=1.186, 95%CI: 1.003-1.402) had an increased risk of disability by 53.5% and 18.6%, respectively. Compared with a physical activity level of ≥600 MET-min/week, those with <600 MET-min/week (OR=2.106, 95%CI: 1.901-2.335) had an increased risk of disability by 110.6%. Compared with those who had a nighttime sleep duration of 7-8 hours and a physical activity level of ≥600 MET-min/week, the elderly with a nighttime sleep duration of <7 hours and a physical activity level of <600 MET-min/week (OR=3.299, 95%CI: 2.831-3.843), a nighttime sleep duration of >8 hours and a physical activity level of <600 MET-min/week (OR=2.566, 95%CI: 1.954-3.369), a nighttime sleep duration of 7-8 hours and a physical activity level of <600 MET-min/week (OR=1.911, 95%CI: 1.564-2.334), and a nighttime sleep duration of <7 hours and a physical activity level of ≥600 MET-min/week (OR=1.503, 95%CI: 1.334-1.692) had an increased risk of disability by 229.9%, 156.6%, 91.1%, and 50.3%, respectively. Conclusion Short or long nighttime sleep duration and low physical activity levels can increase the risk of disability in the elderly.

Objective:To analyze the association between osteoporosis and the risk for Alzheimer's disease (AD).Methods:A total of 471 922 study subjects were selected from the UK Biobank database, including 12 818 osteoporosis cases and 459 104 controls. Cox proportional hazard regression model and competing risk model were used to evaluate the association between osteoporosis and AD after adjusting confounding factors. Furthermore, a Mendelian randomization (MR) study was conducted by using the data of two published genome-wide association studies, and 1 050 highly relevant single nucleotide polymorphisms were identified from the bone mineral density data as instrumental variables. The association between bone mineral density and the risk for AD was evaluated by using inverse variance weighted method, MR-Egger regression, and weighted median estimator method. Additionally, sensitivity analyses were performed.Results:After adjusting for confounders, no significant association between osteoporosis and an increased risk for AD was found in the cohort study (Cox proportional hazard regression model analysis: HR=1.10, 95% CI: 0.78-1.56, P=0.588). The MR analysis revealed no association between bone mineral density and the risk for AD (inverse-variance weighted: OR=1.03, 95% CI: 0.98-1.09, P=0.252), and the results remained robust in multiple sensitivity analyses. Conclusion:The study result does not support the association between osteoporosis and risk for AD.

Objective:The Fuxing Program was established in Zhuhai as an action plan to micro-eliminate hepatitis C in response to the World Health Organization's goal of eliminating hepatitis C by 2030. Therefore, the effectiveness of this program in terms of hepatitis C screening, treatment, follow-up, and other aspects is evaluated here.Methods:The "Fuxing Project" was established in May 2021 under the supervision of the Zhuhai Medical Quality Control Center for Infectious Diseases. A bridge was formed among the governmental entities, hospitals at all levels, and the community to train hepatitis C prevention and control strategies. Hepatitis C screening, publicity, and educational awareness were conducted in-and out-of-hospital. The responsibility for the diagnosis, treatment, and follow-up of a patient with hepatitis C was assigned to the staff. The screening and treatment rates of hepatitis C in hospitals before and after the initiation of the project were compared and analyzed using the χ2 test or Fisher's exact test. The hepatitis C virus (HCV) infection and treatment status were investigated and analyzed among the general population, high-risk populations such as human immunodeficiency virus (HIV) infection, drug addicts, and the population residing in supervised sites within Zhuhai communities, rural areas, schools, or factories. Results:Anti-HCV positivity rate (0.82% vs. 0.43%, P<0.001), HCV RNA detection rate (98.1% vs. 59.5%, P<0.001), HCV RNA detection positivity rate (52.56% vs. 29.76%, P<0.001), HCV RNA positivity rate (0.4% vs. 0.13%, P<0.001), and hepatitis C treatment rate (76.76% vs. 31.97%, P<0.001) were significantly higher among the inpatient population after the Fuxing Program initiation than before. The HCV RNA detection rate (58.52% vs. 6.93%, P<0.001) and HCV RNA detection positivity rate (77.72% vs. 29.41%, P<0.001) in Zhuhai were significantly higher after the Fuxing Program initiation than before. Anti-HCV positivity rate (0.46% vs. 1.28%, P=0.009) and HCV RNA (0.32% vs. 0.99%, P=0.03) were significantly lower in the Zhuhai general population of urban communities than those of the general population in rural areas. The HCV infection rate was more than three times higher in rural populations than in urban populations. Anti-HCV positivity rate, HCV RNA positivity rate, HCV RNA detection positivity rate, and hepatitis C treatment rates were 2.64% (31/1 175), 3.40% (69/2 022) and 94.4% (34/36), 2.64% (31/1 175), 2.72% (55/2 022), 50.00% (18/36), and 100% (31/31), 79.71% (55/69) and 52.94% (18/34), and 100% (31/31), 0 (0/55) and 55.55% (10/18) among the HIV infection, supervised population under supervised sites, and methadone maintenance treatment clinic population, respectively. Anti-HCV positivity rate (4.15% vs. 0.72%, P<0.001) and HCV RNA (3.22% vs. 0.53%, P<0.001) were significantly higher in the high-risk group than those in the general population, while the treatment rate of hepatitis C in the high-risk group (39.42% vs. 82.35%, P<0.01) was significantly lower than that of the general population. Conclusion:The establishment of the hospital grid linkage mechanism and the management model of hepatitis C follow-up by specialists, with the infectious diseases medical quality control center as the supervisory body, have improved the screening rate, the HCV RNA detection rate, and the treatment rate in the hospital, thereby providing a reference for exploring a management model to eliminate the nationwide threat of hepatitis C.

Objective To establish the fingerprints and predict the quality markers of Sanqi Shenfeng oral liquid based on fingerprint and network pharmacology.Methods The fingerprints of 12 batches of Sanqi Shenfeng oral liquid were established by using HPLC,and their peaks were identified and assigned.The candidate components were selected by multiple statistical analysis methods such as similarity evaluation,hierarchical cluster analysis,principal component analysis and orthogonal partial least squares discrimination analysis(OPLS-DA).The"component-target-pathway"network diagram was constructed by network pharmacology,and the quality markers of Sanqi Shenfeng oral liquid were predicted.Results The 13 common peaks were identified from the established fingerprint.Compared with the reference material,eight common peaks were identified as 3(tetrahydroxystilbene glucoside),5(sodium benzoate),6(lobetyolin),7(notoginsenoside Ri),9(ginsenoside Rgi),10(ginsenoside Re),12(10-hydroxy-2-decenoic acid),13(ginsenoside Rb1).The similarity of 12 batches of Sanqi Shenfeng oral liquid samples was higher than 0.997,and 12 batches of samples were grouped into two categories.OPLS-DA analysis showed that peaks 2,3,4,7,9,10,11,12 were the main signature components affecting the quality of Sanqi Shenfeng oral liquid.Network pharmacology predicted that lobetyolin,notoginsenoside R1,ginsenoside Rg1,ginsenoside Rb1,ginsenoside Re and 10-hydroxy-2-decenoic acid were potential Q-markers of Sanqi Shenfeng oral liquid.The traditional functions are performed through STAT3/AKT1-Drp1,HIF-1 and PI3K-AKT signaling pathway.Conclusion The established fingerprint has good reproducibility,stability and feasibility.The six components have great influence on the quality of Sanqi Shenfeng oral liquid,which are transferable and traceable,and are closely related to the efficacy.They can be used as potential quality markers to provide a scientific basis for the quality control and evaluation of Sanqi Shenfeng oral liquid.

Objective:To analyze the association between osteoporosis and the risk for Alzheimer's disease (AD).Methods:A total of 471 922 study subjects were selected from the UK Biobank database, including 12 818 osteoporosis cases and 459 104 controls. Cox proportional hazard regression model and competing risk model were used to evaluate the association between osteoporosis and AD after adjusting confounding factors. Furthermore, a Mendelian randomization (MR) study was conducted by using the data of two published genome-wide association studies, and 1 050 highly relevant single nucleotide polymorphisms were identified from the bone mineral density data as instrumental variables. The association between bone mineral density and the risk for AD was evaluated by using inverse variance weighted method, MR-Egger regression, and weighted median estimator method. Additionally, sensitivity analyses were performed.Results:After adjusting for confounders, no significant association between osteoporosis and an increased risk for AD was found in the cohort study (Cox proportional hazard regression model analysis: HR=1.10, 95% CI: 0.78-1.56, P=0.588). The MR analysis revealed no association between bone mineral density and the risk for AD (inverse-variance weighted: OR=1.03, 95% CI: 0.98-1.09, P=0.252), and the results remained robust in multiple sensitivity analyses. Conclusion:The study result does not support the association between osteoporosis and risk for AD.

Objective To establish the fingerprints and predict the quality markers of Sanqi Shenfeng oral liquid based on fingerprint and network pharmacology.Methods The fingerprints of 12 batches of Sanqi Shenfeng oral liquid were established by using HPLC,and their peaks were identified and assigned.The candidate components were selected by multiple statistical analysis methods such as similarity evaluation,hierarchical cluster analysis,principal component analysis and orthogonal partial least squares discrimination analysis(OPLS-DA).The"component-target-pathway"network diagram was constructed by network pharmacology,and the quality markers of Sanqi Shenfeng oral liquid were predicted.Results The 13 common peaks were identified from the established fingerprint.Compared with the reference material,eight common peaks were identified as 3(tetrahydroxystilbene glucoside),5(sodium benzoate),6(lobetyolin),7(notoginsenoside Ri),9(ginsenoside Rgi),10(ginsenoside Re),12(10-hydroxy-2-decenoic acid),13(ginsenoside Rb1).The similarity of 12 batches of Sanqi Shenfeng oral liquid samples was higher than 0.997,and 12 batches of samples were grouped into two categories.OPLS-DA analysis showed that peaks 2,3,4,7,9,10,11,12 were the main signature components affecting the quality of Sanqi Shenfeng oral liquid.Network pharmacology predicted that lobetyolin,notoginsenoside R1,ginsenoside Rg1,ginsenoside Rb1,ginsenoside Re and 10-hydroxy-2-decenoic acid were potential Q-markers of Sanqi Shenfeng oral liquid.The traditional functions are performed through STAT3/AKT1-Drp1,HIF-1 and PI3K-AKT signaling pathway.Conclusion The established fingerprint has good reproducibility,stability and feasibility.The six components have great influence on the quality of Sanqi Shenfeng oral liquid,which are transferable and traceable,and are closely related to the efficacy.They can be used as potential quality markers to provide a scientific basis for the quality control and evaluation of Sanqi Shenfeng oral liquid.

Objective:The Fuxing Program was established in Zhuhai as an action plan to micro-eliminate hepatitis C in response to the World Health Organization's goal of eliminating hepatitis C by 2030. Therefore, the effectiveness of this program in terms of hepatitis C screening, treatment, follow-up, and other aspects is evaluated here.Methods:The "Fuxing Project" was established in May 2021 under the supervision of the Zhuhai Medical Quality Control Center for Infectious Diseases. A bridge was formed among the governmental entities, hospitals at all levels, and the community to train hepatitis C prevention and control strategies. Hepatitis C screening, publicity, and educational awareness were conducted in-and out-of-hospital. The responsibility for the diagnosis, treatment, and follow-up of a patient with hepatitis C was assigned to the staff. The screening and treatment rates of hepatitis C in hospitals before and after the initiation of the project were compared and analyzed using the χ2 test or Fisher's exact test. The hepatitis C virus (HCV) infection and treatment status were investigated and analyzed among the general population, high-risk populations such as human immunodeficiency virus (HIV) infection, drug addicts, and the population residing in supervised sites within Zhuhai communities, rural areas, schools, or factories. Results:Anti-HCV positivity rate (0.82% vs. 0.43%, P<0.001), HCV RNA detection rate (98.1% vs. 59.5%, P<0.001), HCV RNA detection positivity rate (52.56% vs. 29.76%, P<0.001), HCV RNA positivity rate (0.4% vs. 0.13%, P<0.001), and hepatitis C treatment rate (76.76% vs. 31.97%, P<0.001) were significantly higher among the inpatient population after the Fuxing Program initiation than before. The HCV RNA detection rate (58.52% vs. 6.93%, P<0.001) and HCV RNA detection positivity rate (77.72% vs. 29.41%, P<0.001) in Zhuhai were significantly higher after the Fuxing Program initiation than before. Anti-HCV positivity rate (0.46% vs. 1.28%, P=0.009) and HCV RNA (0.32% vs. 0.99%, P=0.03) were significantly lower in the Zhuhai general population of urban communities than those of the general population in rural areas. The HCV infection rate was more than three times higher in rural populations than in urban populations. Anti-HCV positivity rate, HCV RNA positivity rate, HCV RNA detection positivity rate, and hepatitis C treatment rates were 2.64% (31/1 175), 3.40% (69/2 022) and 94.4% (34/36), 2.64% (31/1 175), 2.72% (55/2 022), 50.00% (18/36), and 100% (31/31), 79.71% (55/69) and 52.94% (18/34), and 100% (31/31), 0 (0/55) and 55.55% (10/18) among the HIV infection, supervised population under supervised sites, and methadone maintenance treatment clinic population, respectively. Anti-HCV positivity rate (4.15% vs. 0.72%, P<0.001) and HCV RNA (3.22% vs. 0.53%, P<0.001) were significantly higher in the high-risk group than those in the general population, while the treatment rate of hepatitis C in the high-risk group (39.42% vs. 82.35%, P<0.01) was significantly lower than that of the general population. Conclusion:The establishment of the hospital grid linkage mechanism and the management model of hepatitis C follow-up by specialists, with the infectious diseases medical quality control center as the supervisory body, have improved the screening rate, the HCV RNA detection rate, and the treatment rate in the hospital, thereby providing a reference for exploring a management model to eliminate the nationwide threat of hepatitis C.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

Pulmonary hypertension(PH)is the pulmonary vascular remodeling caused by endothe-lial dysfunction and other factors,which leads to the increase of pulmonary artery pressure and finally right heart failure and patient death.Medications can significantly improve the symptoms of patients with pulmonary hypertension,but drugs can't cure vascular remodeling and right heart failure once for all,so it is urgent to find new treatments.Endothelial cells can obtain mesenchymal phenotypes after hypoxia stimulation,that is,endothelial-to-mesenchymal transition(EndMT).Increasing studies have shown that EndMT plays an important role in pulmonary vascular remodeling of PH.In this review,three signaling pathways related to induction of endothelial-to-mesenchymal transition under hypoxic conditions and research progress in related drugs are elaborated:① Transforming growth factor-β/bone morphogenetic protein(TGF-β/BMP)signaling pathway.The TGF-β/BMP pathway is mediated by Smad,and hypoxia regulates the expressions of EndMT-related genes by inhibiting or inducing the phosphorylation level of Smad in the downstream medium.② Notch signaling pathway.Hypoxia can enhance Jagged/Notch signaling pathway and promote the EndMT process.③Wnt/β-catenin signaling pathway.Hypoxia increases the expression of β-catenin,activates the Wnt signaling pathway,and regulates the expressions of EndMT regulatory genes.The significance of hypoxia-induced EndMT as an impor-tant pathogenic factor in PH is clarified in order to provide new ideas for the improvement of pulmonary vascular remodeling and recommend new effective strategies for the prevention and treatment of PH.