OBJECTIVE To systematically review medication-related risk factors for falls in older adults， to provide references for ensuring medication safety among older adults. METHODS A systematic search was conducted in PubMed， Embase， Web of Science， and CNKI for relevant literature published from database inception to November 1， 2025. Relevant studies on medication-related falls in older adults， both domestic and international， were included. Drug factors influencing falls in older adults were summarized and analyzed. RESULTS A total of 22 studies were included. Four major classes of fall-risk-increasing drugs were identified： psychotropic medications [12 studies， odds ratio （OR） range 1.500-5.790]， cardiovascular system drugs （5 studies， OR range 1.236-4.784）， analgesics （3 studies， OR range 1.500-4.490）， and hypoglycemic agents （3 studies， OR range 2.070-2.751）. Additionally， anticholinergic burden （1 study， OR was 2.610） and polypharmacy （7 studies， OR range 2.902-25.897 for the use of ≥4 medications） were identified as significant risk factors for falls. CONCLUSIONS Falls in older adults are significantly associated with psychotropic medications， cardiovascular system drugs， analgesics， and hypoglycemic agents， among which psychotropic medications pose the highest risk. Anticholinergic burden and polypharmacy are also important risk factors. In clinical practice， interventions should be implemented through deprescribing and risk monitoring to effectively reduce the risk of falls in older adults.

OBJECTIVE To analyze trends in the burden of disease associated with falls from 1990 to 2023， identify risk factors for falls， and provide a reference for the development of measures to reduce the burden of disease associated with falls and the formulation of public health policies. METHODS Based on the data of 2023 from the Global Burden of Disease （GBD） database， the changes in fall-related prevalence， mortality， disability-adjusted life years （DALYs） and incidence in China and globally from 1990 to 2023 were analyzed， and the stratified analyses by gender， age and socio-demographic index （SDI） were conducted. The risk factors related to falls in 2023 were systematically analyzed， and the impact of multimorbidity and polypharmacy on the occurrence of falls by combining relevant literature evidence was explored. RESULTS & CONCLUSIONS Globally， the percentage changes in age-standardized rates of fall-related prevalence， mortality， DALYs and incidence from 1990 to 2023 were －2.4% （95%UI： －4.8% to －0.3%）， －7.8% （95%UI： －20.5% to 10.9%）， －10.6% （95%UI： －16.5% to －4.3%）， and －4.6% （95%UI： －8.1% to －0.8%）， respectively. However， in some regions， the percentage changes in age-standardized rates for these indicators were greater than 0 （e.g.， prevalence， mortality and DALYs in Australasia， and incidence in Andean Latin America）. In China， the percentage changes in age-standardized rates of fall-related mortality and DALYs from 1990 to 2023 were －18.3% （95%UI： －56.7% to 32.3%） and 1.9% （95%UI： －10.1% to 12.4%）， while the percentage changes in age-standardized rates of prevalence and incidence were 25.9% （95%UI： 20.2% to 32.0%） and 35.7% （95%UI： 28.5% to 44.1%）， respectively. Globally， in regions with high and medium-to-high SDI levels， the percentage changes in age-standardized rates of fall-related prevalence and incidence showed an upward trend， while DALYs showed a downward trend； however， the trend in mortality was unclear. In regions with a middle SDI level， the percentage changes in age-standardized rates of fall-related prevalence and incidence both showed an upward trend， while the trends in mortality and DALYs were unclear. In regions with low-to-medium SDI level， the percentage changes in age-standardized rate of fall-related prevalence， DALYs and incidence all showed a downward trend， while the trend in mortality was unclear； in regions with low SDI level， the trends for all above indicators were unclear. Correlation analyses of the burden of fall-related diseases in China and globally indicated that the risk of fall-related diseases was higher among younger and middle-to-older adult male populations， while women were concentrated in older age groups. Meanwhile， as the SDI levels increase， the percentage change in age-standardized rate of DALYs for fall-related diseases showed a clear upward trend， and this trend was more pronounced in high-SDI regions. Tobacco use， alcohol consumption， low bone density， and occupational risks were risk factors for falls， with low bone density and occupational risks contributing significantly （exceeding 20% in some regions）； multimorbidity and polypharmacy could also significantly increase the risk of falls. It is recommended that clinical settings establish a list of fall-risk increasing drugs and a warning system， improve medication reviews， strengthen medication education and adherence management， foster multidisciplinary collaboration， and develop medication strategies for specific patient populations to reduce the incidence of falls and alleviate the burden of disease.

Kidney deficiency syndrome is a common clinical syndrome in traditional Chinese medicine （TCM）. With the progress of science and technology， clinical and animal experiments on kidney deficiency syndrome have made remarkable progress. Research on kidney deficiency and the nature of "kidney" involves a large number of physiological and pathological bases， which are closely related to physiological and pathological links in the human body， among which the neuroendocrine-immune network shares the closest relationship. However， there are still many challenges in modern research on kidney deficiency syndrome， such as expert consensus on clinical diagnostic criteria and evaluation indexes and optimization of animal experimental models. In the past decade， a large number of clinical and animal experiments have been reported in the literature on kidney deficiency syndrome， among which the literature focusing on the combination of disease and syndrome is predominant， and most of them focus on kidney Yang deficiency and kidney Yin deficiency， involving the exploration of many pathological mechanisms. Research on the mechanisms related to kidney deficiency syndrome encompasses multiple signaling pathways and various biochemical indicators， including the phosphatidylinositol 3-kinase/protein kinase B/nuclear factor-erythroid 2-relatedfactor-2（PI3K/Akt/Nrf2） signaling pathway， the Toll-like receptor 4/myeloid differentiation factor88/nuclear factor-κB（TLR4/MyD88/NF-κB） signaling pathway， the Janus kinase 2/signal transducer and activator of transcription 3（JAK2/STAT3） signaling pathway， Osteoprotectin/nuclear factor-κB receptor activator ligand/receptor activator of nuclear factor-κB （OPG/RANKL/RANK） signaling pathway. The biochemical indicators cover the cyclic adenosine monophosphate/cyclic guanosine monophosphate （cAMP/cGMP） ratio， Na⁺-K⁺-ATPase activity， Ca²⁺-Mg²⁺-ATPase activity， adrenocorticotropic hormone （ACTH）， polycorticosterone （CORT）， 17-OHCS， and other sex hormone indicators， providing crucial reference values for diagnosing kidney Yang deficiency or kidney Yin deficiency. The literature related to kidney deficiency syndrome over the past decade was collated and excavated， with a view to providing a reference for research on kidney deficiency syndrome.

Objective: To understand the nutritional literacy level and associated factors of primary and secondary school students in Beijing, so as to provide a scientific basis for improving student nutrition. Methods: From October 2022 to May 2023, a multi stage cluster random sampling method was employed to select a total of 14 568 primary, junior and senior high school students from 16 districts (ecluding the Economic Technological Development area) in Beijing. Through a survey questionnaire on nutritional literacy and dietary hehavior of school age children, basic information as well as data on nutritional literacy levels across four dimensions:nutrition related knowledge concepts, food selection, food preparation, and food intake dimensions were obtained. The Wilcoxon rank sum test, Kruskal-Wallis test, Spearman correlation analysis, Chi square test and binary Logistic regression were used for the analysis. Results: The median total score of nutritional literacy among primary and secondary school students in Beijing was 68.8. Approximately 26.0% of primary and secondary school students achieved nutritional literacy standards. The median scores and rates of meeting the standards for nutrition related knowledge concepts, food selection, food preparation and food intake dimensions were 23.0, 42.1%; 17.0, 27.4%; 6.5, 33.5%; 23.0, 33.3%, respectively. There were positive correlations between all pairs of the four dimensions ( r=0.33-0.49, P <0.05). The results of multiple Logistic regression analysis showed that primary school students, junior high school students, female students, suburban students, caregivers with a college education level and a bachelor s degree or above were the positive arrelation factors that promoted the achievement of nutritional literacy standards ( OR =2.21, 1.39, 1.18, 1.27, 1.42, 1.66, P <0.05). Conclusion The literacy level of primary and secondary school students in Beijing needs to be significantly improved. School stage, gender, region and caregiver s education level are associated factors.

Objective To explore the acupoint selection law for acupoint stimulation to improve gastrointestinal function after colorectal cancer surgery based on data mining technology.Methods Literature about acupoint stimulation to improve gastrointestinal function was retrieved from CNKI,VIP,Wanfang Data,SinoMed,PubMed,Web of Science and Cochrane Library from the establishment of databases to July 1,2023.Data extraction and analysis were performed using Excel 2021.Association rule analysis and clustering analysis were conducted using R language.Results Totally 197 articles were collected,with 242 combinations of acupoints involving 69 acupoints and the total use frequency of acupoints was 878 times.The top 3 acupoints used in frequency were Zusanli(ST36),Shangjuxu(ST37),and Neiguan(PC6).The top 3 involved meridians were the stomach meridian,Conception Vessel,and spleen meridian.The acupoints were mainly distributed in the lower limbs,and the most commonly used intervention method was needle punching.The association analysis discovered a combination of acupoints centered around Zusanli(ST36),which included Shangjuxu(ST37),Neiguan(PC6),and Sanyinjiao(SP6).Clustering analysis identified 4 effective cluster combinations.Conclusion Acupoint stimulation improves gastrointestinal function after colorectal cancer surgery.Multiple acupoint selection ideas are used,and the summarized acupoint selection and compatibility law in this study can provide reference for clinical research and application.

Objective To analyze the acupoint selection rule for cancer-related fatigue with acupoint stimulation using data mining techniques.Methods Clinical randomized controlled trial research literature about treatment for cancer-related fatigue with acupoint stimulation was retrieved from CNKI,Wanfang Data,VIP,SinoMed,PubMed,Web of Science and Embase from establishment of the databases to October 13,2023.The frequency anlysis,association rule analysis and clustering analysis on acupoints were performed using Excel 2021 and R 4.3.1.Results Totally 187 articles were included,with 214 combinations of acupoints involving 102 acupoints,with a total frequency of 1 044.The most frequently used acupoints were Zusanli(ST36),Qihai(CV6),and Guanyuan(CV4).The top three meridians used were the Conception Vessel,stomach meridian,and spleen meridian.The acupoints were mainly distributed in the lower limbs and thoracoabdominal,and the most commonly used specific acupoint was the crossing point.Moxibustion was the most commonly used intervention measure.Association rule analysis indicated that the core combination of acupoints in this study was Zusanli(ST36),Qihai(CV6),Guanyuan(CV4),and Sanyinjiao(SP6).Analysis of acupoint selection for cancer-related fatigue with different types of cancer demonstrated that acupoints with tonifying properties were most frequently chosen.Clustering analysis identified five effective combinations of acupoints.Conclusion The acupoint selection for treating cancer-related fatigue should focus on tonifying qi and nourishing blood,as well as supporting healthy qi to eliminate pathogenic factors.Special attention is given to the use of specific acupoints,and various acupoint combination methods are employed based on the differentiation of zang-fu organs and meridians to enhance clinical efficacy.

Objective To investigate the safety and feasibility of peripheral vascular intervention via the ipsilateral transulnar access(TUA)due to failure of transradial access(TRA)puncture.Methods The clinical data of 2546 peripheral vascular interventions via TRA,which were performed at authors'hospital between January 2019 and December 2021,were retrospectively analyzed.Among the 2546 interventions,TRA puncture failed in 37 procedures,and in 27 of these patients the ipsilateral TUA puncture had to be adopted.The puncture success rate,surgical success rate and puncture approach-related complications of TUA of the 27 patients receiving ipsilateral TUA puncture were analyzed.Results The success rate of ipsilateral TUA puncture after TRA puncture failed was 96.3％(26/27),and in one patient transfemoral access(TFA)puncture had to be substituted because of the ulnar artery spasm.The total success rate of interventional procedures was 96.3％(26/27).No serious complications occurred,and the incidence of minor complications was 19.2％(5/26).Conclusion Preliminary results indicate that for the experienced TRA operators,using ipsilateral TUA puncture due to failure of TRA puncture is a safe and feasible strategy choice.

Bacterial cellulose(BC)is a type of extracellular polymeric nanomaterial secreted by microorganisms over the course of their growth.It has gained significant attention in the field of bone tissue engineering due to its unique structure of three-dimensional fibrous network,excellent biocompatibility,biodegradability,and exceptional mechanical properties.Nevertheless,BC still has some weaknesses,including low osteogenic activity,a lack of antimicrobial properties,small pore size,issues with the degradation rate,and a mismatch in bone tissue regeneration,limiting its standalone use in the field of bone tissue engineering.Therefore,the modification of BC and the preparation of BC composite materials have become a recent research focus.Herein,we summarized the relationships between the production,modification,and bone repair applications of BC.We introduced the methods for the preparation and the modification of BC.Additionally,we elaborated on the new advances in the application of BC composite materials in the field of bone tissue engineering.We also highlighted the existing challenges and future prospects of BC composite materials.

Blood deficiency syndrome (BDS) refers to a pathological state with blood dysfunction and organ dystrophy in traditional Chinese medicine. Danggui Wuji granules (DWG) was developed from a formula containing Angelicae Sinensis Radix and Musculus et Os Galli Domestici. Herein, we investigated the mechanism of DWG in treating BDS by modulating gut microbiota. We found that DWG protected mice from BDS by elevating the levels of red blood cell count, hemoglobin, and hematocrit in peripheral blood and increasing the erythrocyte membrane Na⁺-K⁺-ATPase activity. Danggui Wuji granules changed the composition and metabolites of colonic flora. Notably, Lactobacillus, Muribaculaceae, and Alistipes were the main genera showing changes after DWG treatment. Our findings revealed that DWG presented a positive therapeutic effect on BDS in mice by regulating the gut microbiota and metabolites. The protective mechanism of DWG was associated with pathways such as metabolic pathways, biosynthesis of secondary metabolites, ABC transporters, ribosome, thyroid hormone synthesis, lysine degradation, galactose metabolism, tyrosine metabolism, etc.

ObjectiveTo reveal the targets and molecular mechanisms of the action of Qiangxin Decoction （强心汤） for the treatment of chronic heart failure based on the combination of network pharmacology and molecular docking. MethodsThe active ingredients of Qiangxin Decoction were retrieved from TCMSP database， and the targets of chronic heart failure were screened by searching GeneCards， OMIM， TTD， PharmGkb， and DrugBank databases， and the intersections were taken to obtain the intersecting targets of Qiangxin Decoction for the treatment of chronic heart failure. STRING platform was used to construct the protein-protein interaction network （PPI）， Cytoscape 3.8.0 software was used to calculate the network topology to screen the core targets， and R 4.2.3 was used to construct the “active ingredient-target” network by analyzing the GO enrichment analysis and KEGG pathway enrichment analysis. AutoDock 1.5.7 was used for molecular docking to predict the binding performance of active ingredients and core targets. ResultsSeventy-five intersecting targets were identified for the treatment of chronic heart failure with Qiangxin Decoction， among which the core targets were estrogen receptor 1 （ESR1， degree value=7）， nuclear receptor coactivator 1 （NCOA1， degree value=8）， glucocorticoid receptor （NR3C1， degree value=7）， and nuclear receptor coactivator 2 （NCOA2， degree value=7）. GO enrichment analysis showed that the top 3 items with the smallest P value in molecular function were G protein-coupled amine receptor activity， postsynaptic neurotransmitter receptor activity， and neurotransmitter receptor activity （P＜0.01）； the top 3 items with the smallest P value in biological process were adenylyl cyclase-activated adrenergic receptor signaling pathway， adrenergic receptor signaling pathway， and adenylyl cyclase-regulated G protein-coupled receptor signaling pathway （P＜0.01）； the top 3 items with the smallest P values in cellular composition were components of the postsynaptic membrane， synaptic membrane， and presynaptic membrane （P＜0.01）. KEGG enrichment analysis showed that the top 5 key signaling pathways were neuroactive ligand-receptor interactions， calcium signaling pathway， dopaminergic synapses， cocaine addiction， and cyclic guanosine monophosphate-protein kinase G （cGMP-PKG） signaling pathway. The molecular docking results showed that lignans and isoflavones had lower binding energies and more structural stability with the four core targets （ESR1， NCOA1， NR3C1， NCOA2）. ConclusionThe treatment of chronic heart failure by Qiangxin Decoction was associated with neuroactive ligand-receptor interactions， calcium signaling pathway， dopaminergic synapses， chemoattractant-receptor activation， cGMP-PKG signaling pathway， lipids and atherosclerosis， and cAMP signaling pathway， and lignans and isoflavones may be the core active compounds in its treatment of chronic heart failure.