1.The World Health Organization Integrated Care for Older People (ICOPE) Framework and the Association with Frailty in Older Adults
Wan-Yun CHOU ; Kun-Pei LIN ; Chiung-Jung WEN ; Ding-Cheng (Derrick) CHAN ; Su-I HOU
Annals of Geriatric Medicine and Research 2026;30(1):41-50
Background:
The World Health Organization published the 2019 Integrated Care for Older People (ICOPE) framework to guide, assess, and promote the intrinsic capacity (IC) of older adults, referring to their physical and mental health. This study aims to investigate the relationship between IC and frailty among older adults.
Methods:
This cross-sectional study was conducted in a medical center in Taiwan in 2021. Two hundred ten patients over 65 admitted to the geriatric ward were invited to participate. The questionnaire included an IC measure, Fried Frailty Scale, and demographic items. The IC measure was ascertained using the six domains of ICOPE (cognition, mobility, nutrition, visual, hearing, and depressive symptoms). The Fried Frailty Scale was used to categorize participants as robust (Fried Frailty Scale=0), prefrail (Fried Frailty Scale=1-2), or frail (Fried Frailty Scale ≥3). Multinomial logistic regression was used to analyze the association between individual ICOPE domains and frailty stages, while adjusting for confounders.
Results:
Among the participants, 39.0% were prefrail, and 28.6% were frail. Limited mobility and depressive symptoms were significantly associated with prefrail (adjusted odds ratio [aOR]=4.44, 95% confidence interval [CI] 1.82–10.82; aOR=8.41, 95% CI 1.75–40.37) and frail (aOR=11.57, 95% CI 3.63–36.93; aOR=13.77, 95% CI 2.62–72.49) individuals, respectively. Malnutrition (aOR=4.01, 95% CI 1.18–13.62) and hearing loss (aOR=4.37, 95% CI 1.09–19.66) were significantly associated with frail older adults.
Conclusion
Limited mobility and depressive symptoms occurring at the prefrail stage could be used as assessment items for early detection of prefrail.
2.Eccentric Cycling Improves Cardiopulmonary Fitness, Respiratory Function, and Quality of Life in Chronic Kidney Disease: A Randomized Controlled Trial
Yu-Ting HUANG ; Hsin-Yeh LEE ; Hui-Ching CHENG ; Hsin-Lun YANG ; Ching-Hsia HUNG ; Chien-Chou SU ; Yu-Tzu CHANG ; Chien-Yao SUN ; Kun-Ling TSAI
Annals of Rehabilitation Medicine 2026;50(2):105-116
Objective:
To compare the effects of eccentric cycling (ECC), concentric cycling (CON), and standard care (CTL) on cardiopulmonary capacity, respiratory health, and quality of life (QoL) in patients with chronic kidney disease (CKD).
Methods:
Thirty-one CKD patients were divided into the CTL, CON, and ECC groups. The CON and ECC groups participated in 8-week, 24-session cycling programs. Outcomes were assessed through cardiopulmonary exercise tests, respiratory function tests, and the 36-Item Short Form Survey Instrument questionnaire.
Results:
The ECC group achieved significant improvements in maximal oxygen uptake, while the CTL group showed a decline. For oxygen uptake efficiency slope, significant changes were observed only in the ECC group, with a group-by-time interaction effect compared to CTL. Furthermore, the ECC group demonstrated the most significant increase in diaphragm movement and a significant increase in diaphragm thickness, with comparisons indicating that ECC outperformed both CTL and CON. Regarding QoL, the ECC group exhibited significantly greater improvements in Physical Component Summary and Mental Component Summary, with statistically significant differences compared with the CTL and CON groups.
Conclusion
ECC is a low-effort, high-benefit exercise modality that significantly enhances cardiopulmonary fitness, respiratory function, and QoL in patients with CKD.
3.Molecular and Phenotypic Characterization of Fluid-Derived Patient-Derived Cell and Organoid Models in Advanced Gastric Cancer
Ye Jin MOON ; Woo Sun KWON ; Chan Hee PARK ; Jinsoo JANG ; Juin PARK ; Byeong Gyu YOON ; Han Byeol MUN ; Namju KIM ; Choong-kun LEE ; Hei Cheul JEUNG ; Su-Jin SHIN ; Tae Soo KIM ; Sun Young RHA
Journal of Gastric Cancer 2026;26(2):260-278
Purpose:
Patient-derived cells (PDCs) and patient-derived organoids (PDOs) are complementary preclinical models widely used in translational cancer research. However, their molecular and functional differences have not been systematically characterized. This study established and analyzed paired PDC and PDO models derived from the same gastric cancer ascites to delineate platform-dependent molecular and functional profiles.
Materials and Methods:
Malignant ascites or pleural fluid obtained from 6 patients with advanced gastric cancer were used to establish paired PDC and PDO models. All pairs underwent comprehensive multi-omics profiling, integrating genomic, transcriptomic, and proteomic data. Phenotypic characterization included morphological, histological, proliferative, and cell cycle analyses. Drug sensitivity assays were performed using 4 chemotherapeutic agents commonly used to treat gastric cancer.
Results:
The 6 paired PDC and PDO models exhibited distinct morphological characteristics.Whole-genome analyses demonstrated high concordance among primary tumors, PDCs, and PDOs, confirming tumor representation across platforms. Multi-omics profiling identified platform-dependent molecular signatures; PDOs were enriched for extracellular matrix remodeling and stemness, whereas PDCs displayed proliferation- and immune-related signatures. Clinically relevant biomarkers, including HER2 and MET alterations, were concordant with primary tumors. Notably, drug responses differed between platforms and patients, indicating platform-dependent and patient-specific chemosensitivity.
Conclusions
Paired PDC and PDO models derived from the same patients preserved core patient-specific tumor characteristics while exhibiting distinct molecular and functional profiles. These findings underscore the culture platform as a critical determinant of experimental outcomes and therapeutic responses. Therefore, careful selection of an appropriate preclinical model is essential to accurately address biological questions and optimize precision oncology strategies.
4.Challenges and management strategies of obesity in the clinical practive of liver transplantation
Tianfei GAO ; Xiaoqin LIU ; Kun YANG ; Yi SU ; Zengxi LUO ; Yingpeng ZHAO
Organ Transplantation 2026;17(4):659-665
Obesity has become one of the important factors affecting the entire management process of liver transplantation. Its impact is not only reflected in the increased risk of liver steatosis and ischemia-reperfusion injury in the donor, but also involves the increased technical difficulty during the perioperative period for the recipient, the increase in postoperative metabolic complications and poorer long-term prognosis. This article, based on recent relevant studies, reviews aspects such as the utilization of obese donors, the characteristics of adult and pediatric recipients, pre-transplant risk assessment and weight loss intervention, and post-transplant weight and metabolic management. Current evidence suggests that simply judging transplantation risks based on body mass index has limitations. Analysis of body composition, assessment of cardiovascular function and identification of sarcopenic obesity are more clinically valuable. For obese liver transplant recipients, in a multidisciplinary collaboration framework, emphasis should be placed on individualized screening, perioperative optimization and long-term follow-up management to improve the outcomes of the graft and the recipient.
5.Occupational health literacy among key populations in the tertiary industry in Lu'an City
LIU Lei ; CHENG Tingting ; QIAN Chunsheng ; HUANG Rui ; LI Ting ; TANG Kun ; WEI Dong ; SU Yiwen ; LI Haowei ; LI Pengfei
Journal of Preventive Medicine 2025;37(11):1179-1183
Objective:
To analyze the occupational health literacy (OHL) level and its influencing factors among key populations in the tertiary industry in Lu'an City, Anhui Province, so as to provide a basis for developing targeted health interventions and improving regional occupational health policies.
Methods:
A stratified cluster random sampling method was employed to select five categories of key populations from the tertiary industry in Lu'an City as study subjects from August to September 2024. Data on gender, age, education level, and OHL were collected through the National OHL Monitoring Questionnaire for Key Populations. The OHL levels were analyzed, and influencing factors of OHL levels among key populations were analyzed using a multivariable logistic regression model.
Results:
A total of 1 243 individuals were surveyed, comprising 700 (56.32%) males and 543 (43.68%) females. The median age was 42.00 (interquartile range, 17.00) years. There were 609 individuals with OHL, and the OHL level was 48.99%. The OHL levels in fundamental knowledge of occupational health protection, healthy work styles and behaviors, knowledge of occupational health laws, and basic skills for occupational health protection were 84.71%, 60.34%, 43.93%, and 37.09%, respectively. Multivariable logistic regression analysis showed that educational level (primary school and below, OR=0.149, 95%CI: 0.064-0.344; junior high school, OR=0.340, 95%CI: 0.184-0.629; high school, OR=0.408, 95%CI: 0.230-0.723), average monthly personal income (3 000-<5 000 yuan, OR=1.655, 95%CI: 1.092-2.508; 5 000-<7 000 yuan, OR=2.195, 95%CI: 1.302-3.699; ≥7 000 yuan, OR=2.062, 95%CI: 1.016-4.183), employer nature (private enterprises, OR=2.992, 95%CI: 1.569-5.443), and industry category (education, OR=3.423, 95%CI: 1.407-8.327; courier / food delivery services, OR=0.459, 95%CI: 0.268-0.787; healthcare, OR=7.539, 95%CI: 3.255-17.461) were statistically associated with the OHL level among key population.
Conclusion
The OHL level among key population in the tertiary industry of Lu'an City can be further enhanced, with educational level, average monthly personal income, employer nature, and industry category identified as the primary influencing factors.
6.Diagnosis and treatment of 281 elderly patients with pulmonary ground-glass opacity: A retrospective study in a single center
Lei SU ; Yi ZHANG ; Yan GAO ; Bing WEI ; Tengteng WANG ; Yuanbo LI ; Kun QIAN ; Peilong ZHANG ; Leiming WANG ; Xiuqin WEI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(01):94-99
Objective To explore the diagnosis and treatment strategies for elderly patients with ground-glass opacity (GGO). Methods The imaging features and postoperative pathological findings of the elderly patients with pulmonary GGO receiving surgery in our hospital from 2017 to 2019 were retrospectively analyzed. The patients were divided into an elderly patient group and a non-elderly patient group based on their age. Results Finally 575 patients were included in the study. There were 281 elderly patients, including 83 males and 198 females, with an average age of (67.0±5.3) years. There were 294 non-elderly patients, including 88 males and 206 females, with an average age of (49.1±7.3) years. Compared with the non-elderly patients, elderly GGO patients showed the following distinct clinical features: long observation time for lesions (P=0.001), high proportion of rough edges of GGO (P<0.001), significant pleural signs (P<0.001) and bronchial signs (P<0.001), and high proportion of type Ⅱ-Ⅳ GGO (P<0.001), lobectomy type (P=0.013), and invasive lesions reported in postoperative pathology (P<0.001). There was no statistical difference in the average hospital stay between the two groups (P=0.106). Multivariate logistic regression analysis showed that GGO diameter and GGO type were the main factors affecting the operation. Observation time, GGO diameter, GGO type and pleural signs were the main influencing factors for postoperative pathological infiltrative lesions. The cut-off value of GGO diameter in predicting infiltrating lesions was 10.5 mm in the elderly patients group. Conclusion The size and type of GGO are important factors in predicting invasive lesions and selecting surgical methods. Elderly patients with radiographic manifestations of type Ⅱ-Ⅳ GGO lesions with a diameter greater than 10.5 mm should be closely followed up.
7.Textual Research on Historical Evolution and Key Information of Classical Famous Formula of Da Qinjiaotang
Na LI ; Jianying BAI ; Fuping LI ; Xiufen ZHANG ; Di LU ; Yishuo BAI ; Cuixiang WANG ; Kun SU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):201-211
Da Qinjiaotang is the 54th formula of the 100 formulas in the Catalogue of Ancient Classical Formulas (the first batch) ,and it originated from the Collection of Writings on the Mechanism of Disease, Suitability of Qi, and Safeguarding of Life Discussed in Plain Questions. Da Qinjiaotang is composed of Gentiana macrophylla, Glycyrrhizae Radix et Rhizoma, Ligusticum chuanxiong, Angelica sinensis, Paeonia lactiflora, Asari Radix et Rhizoma, Notopterygium incisum, Saposhnikoviae Radix, Scutellariae Radix, Gypsum, Angelica dahurica, Atractylodis Macrocephalae Rhizoma, Rehmanniae Radix, Rehmanniae Radix Praeparata, Poria, and Angelicae Pubescentis Radix. It is a classical formula for treating strokes. Da Qinjiaotang is widely used in modern clinical practices for treating ischemic stroke, peripheral facial paralysis, cervical spondylosis, rheumatic arthritis, neurodermatitis, and other multisystem diseases. Therefore, following the Principles of Textual Research on the Key Information of Ancient Classical Famous Formulas, the authors collected the ancient Chinese medical literature of Da Qinjiaotang by the method of bibliometrics and screened out 177 valid data, involving 100 ancient books of traditional Chinese medicine. Based on the historical evolution, composition, dosage, method of preparation, and preparation of the original medicinal materials of Da Qinjiaotang, a systematic study was carried out. It was found that among the 175 records of the main diseases and syndromes, stroke (144) was the most, accounting for 82.29% of the total diseases and syndromes. Later generations mostly followed the practice of LIU Wansu in using Da Qinjiaotang to treat stroke caused by "weak blood and inability to nourish tendon", featuring "hands and feet cannot move, stiff tongue hinders speaking", as well as other symptoms, such as slant of the mouth, hemiplegia, numbness of the limbs, paroxysmal pain, and acerbic syncope. The treatment scope was expanded, covering tendon dryness, clonic convulsion, spasm syndrome, and arthralgia syndrome. At the same time, it was found that there was a controversy between "internal wind" and "external wind" in the treatment of stroke by Da Qinjiaotang. LIU Wansu thought that stroke was caused by internal factors, created the theory of "hot stroke", and used Da Qinjiaotang to treat "internal wind". Many doctors in later generations focused on treating the "external wind" of "internal deficiency and evil". There were 76 valid data on the composition of drugs, 59 of which had doses for each drug. It was suggested to use the modern conversion dosage of the original formula, with 41.30 g per dose. The drug should be boiled in 600 mL water until 300 mL, decocted once, and taken in a warm state after removing the dregs anytime. Through the analysis and study of the ancient books about Da Qinjiaotang, the paper clarified its historical evolution and confirmed its key information, so as to provide the ancient literature evidence for the research and development of the classical famous formula Daqinjiaotan and its better clinical application.
8.Textual Research on Historical Evolution and Key Information of Classical Famous Formula of Da Qinjiaotang
Na LI ; Jianying BAI ; Fuping LI ; Xiufen ZHANG ; Di LU ; Yishuo BAI ; Cuixiang WANG ; Kun SU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):201-211
Da Qinjiaotang is the 54th formula of the 100 formulas in the Catalogue of Ancient Classical Formulas (the first batch) ,and it originated from the Collection of Writings on the Mechanism of Disease, Suitability of Qi, and Safeguarding of Life Discussed in Plain Questions. Da Qinjiaotang is composed of Gentiana macrophylla, Glycyrrhizae Radix et Rhizoma, Ligusticum chuanxiong, Angelica sinensis, Paeonia lactiflora, Asari Radix et Rhizoma, Notopterygium incisum, Saposhnikoviae Radix, Scutellariae Radix, Gypsum, Angelica dahurica, Atractylodis Macrocephalae Rhizoma, Rehmanniae Radix, Rehmanniae Radix Praeparata, Poria, and Angelicae Pubescentis Radix. It is a classical formula for treating strokes. Da Qinjiaotang is widely used in modern clinical practices for treating ischemic stroke, peripheral facial paralysis, cervical spondylosis, rheumatic arthritis, neurodermatitis, and other multisystem diseases. Therefore, following the Principles of Textual Research on the Key Information of Ancient Classical Famous Formulas, the authors collected the ancient Chinese medical literature of Da Qinjiaotang by the method of bibliometrics and screened out 177 valid data, involving 100 ancient books of traditional Chinese medicine. Based on the historical evolution, composition, dosage, method of preparation, and preparation of the original medicinal materials of Da Qinjiaotang, a systematic study was carried out. It was found that among the 175 records of the main diseases and syndromes, stroke (144) was the most, accounting for 82.29% of the total diseases and syndromes. Later generations mostly followed the practice of LIU Wansu in using Da Qinjiaotang to treat stroke caused by "weak blood and inability to nourish tendon", featuring "hands and feet cannot move, stiff tongue hinders speaking", as well as other symptoms, such as slant of the mouth, hemiplegia, numbness of the limbs, paroxysmal pain, and acerbic syncope. The treatment scope was expanded, covering tendon dryness, clonic convulsion, spasm syndrome, and arthralgia syndrome. At the same time, it was found that there was a controversy between "internal wind" and "external wind" in the treatment of stroke by Da Qinjiaotang. LIU Wansu thought that stroke was caused by internal factors, created the theory of "hot stroke", and used Da Qinjiaotang to treat "internal wind". Many doctors in later generations focused on treating the "external wind" of "internal deficiency and evil". There were 76 valid data on the composition of drugs, 59 of which had doses for each drug. It was suggested to use the modern conversion dosage of the original formula, with 41.30 g per dose. The drug should be boiled in 600 mL water until 300 mL, decocted once, and taken in a warm state after removing the dregs anytime. Through the analysis and study of the ancient books about Da Qinjiaotang, the paper clarified its historical evolution and confirmed its key information, so as to provide the ancient literature evidence for the research and development of the classical famous formula Daqinjiaotan and its better clinical application.
9.Study on the Pathological Mechanism-Syndrome-Treatment Patterns of Approved Chinese Patent Medicines Targeting Collateral Disorders
Pengli SU ; Peng XU ; Yanhong WANG ; Yaqi ZU ; Run YUAN ; Kun LI ; Yufeng ZHAO
Journal of Traditional Chinese Medicine 2025;66(16):1711-1718
ObjectiveTo explore the pathological mechanism-syndrome-treatment patterns of approved Chinese patent medicines (CPMs) that treat collateral disorders, providing a reference for the principle of "treating different diseases with the same therapy" in collateral pathology. MethodsCPMs that apply treatment strategies based on collateral disorders were identified from the Pharmacodia database by extracting information from the "efficacy" or "indications" sections of drug package inserts. A database was established to extract the names and compositions of the CPMs, as well as their indications, related traditional Chinese medicine (TCM) symptoms, disease locations (affected areas), and pathological factors. Frequency statistics were performed. Using the Apriori algorithm, an association rule analysis was conducted on CPMs and disease-location combinations related to the top three most frequent pathological factor combinations. Core formulas for these combinations were identified and analyzed through drug network analysis and MCODE module clustering. ResultsA total of 660 CPMs targeting collateral disorders were retrieved, involving 299 indications, 323 TCM symptoms, 21 disease locations, 19 pathological factors, and 124 pathological factor combinations. The most frequent pathological factor combinations were blood stasis (involved in 109 CPMs, 16.52%), exogenous wind (外风) -cold-dampness (involved in 43 CPMs, 6.52%), and qi deficiency-blood stasis (involved in 42 CPMs, 6.36%). Analysis of the core formulas for these combinations revealed common ingredients such as Honghua (Carthami Flos), Chuanxiong (Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), and Dilong (Pheretima). ConclusionCollateral disorders involve a wide range of pathogenesis and represent a fundamental mechanism in the onset and development of various diseases, characterized by obstruction and stagnation. The primary therapeutic principle is unblocking of the collaterals. Blood stasis obstructing the collaterals is the core pathological basis, and the strategy of activating blood circulation and resolving stasis to unblock the collaterals should be central to the treatment. The core medication pattern involves combining blood-activating and stasis-resolving herbs with insect-derived medicinals that unblock collaterals. Exogenous wind is often the initiating patholo-gical factor in colla-teral disorders, and the appropriate addition of wind-dispelling herbs can enrich the treatment strategies for such conditions.
10.Pain Lateralization in Cluster Headache and Associated Clinical Factors
Soohyun CHO ; Mi Ji LEE ; Min Kyung CHU ; Jeong Wook PARK ; Heui-Soo MOON ; Pil-Wook CHUNG ; Jong-Hee SOHN ; Byung-Su KIM ; Daeyoung KIM ; Kyungmi OH ; Byung-Kun KIM ; Soo-Jin CHO
Journal of Clinical Neurology 2025;21(3):220-229
Background:
and Purpose The pain lateralization in cluster headache (CH) may be related to the asymmetry in the functions of the brain hemispheres. The right-sided dominance of pain in CH has been found inconsistently across studies, and so we aimed to characterize this and identify the factors influencing pain lateralization during current and previous bouts.
Methods:
This study enrolled 227 patients from the Korean Cluster Headache Registry between October 2018 and December 2020. We evaluated the side of pain during current and previous bouts, demographic features, and clinical characteristics, including handedness. Multivariable logistic regression analyses were performed to identify factors associated with the side of pain.
Results:
The 227 patients with CH included 131 (57.7%) with right-sided pain and 86 (37.9%) with left-sided pain during the current bout (p<0.001). The 189 patients with previous bouts of CH included 86.8% who consistently reported the same side of pain throughout multiple bouts (side-locked pain), with a higher prevalence of pain on the right than the left side (55.0% vs. 31.7%, p<0.001). Multivariable analyses revealed that higher age at diagnosis (odds ratio [OR]=1.045, p=0.031) and shorter CH attacks (OR=0.992, p=0.017) were associated with left-side-locked pain. However, handedness was not associated with the lateralization of leftside-locked pain.
Conclusions
This study has confirmed the predominance of right-sided pain throughout multiple CH bouts. We found that higher age at diagnosis and shorter CH attacks were associated with left-side-locked pain, suggesting that certain clinical factors are associated with the pain laterality. However, the underlying mechanisms linking these factors to lateralized pain remain unclear and therefore require further investigation.


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