Objective To investigate the prevalence and related factors of sarcopenia among non–bedridden older adults in the community of Baoshan District using the China mini sarcopenia risk assessment 7 (C-MSRA-7) combined with Ishii scoring system. Methods The older individuals consulting at 20 community health stations in Baoshan District between April 2025 and June 2025 were enrolled. Data were collected using a general information questionnaire, a dietary and lifestyle habits survey, the C-MSRA-7, and the mini nutritional assessment-short form (MNA-SF). Handgrip strength and anthropometric measurements were also obtained. Individuals with both Ishii score and C-MSRA-7 results positive were classified into the sarcopenia risk group, while the remaining participants were assigned to the non–sarcopenia risk group. Differences in lifestyle habits, dietary patterns, and nutritional status between the two groups were compared. Results A total of 2 611 valid questionnaires were retrieved. Univariate analysis showed statistically significant differences in alcohol consumption, physical activity frequency, body mass index (BMI), nutritional status, activities of daily living, and regularity of three meals in sarcopenia risk group (n＝486) and non–sarcopenia risk group (n＝2 125, P<0.05). Logistic regression analysis showed that advanced age (75–84 years: OR＝2.55, 95%CI 2.03–3.21; ≥85 years: OR＝3.98, 95%CI 2.24–7.07), underweight status (OR＝2.19, 95%CI 1.50–3.19), weight loss＞2 kg (OR＝4.52, 95%CI 2.68–7.64) past 3 months, lack of regular physical activity (OR＝1.77, 95%CI 1.24–2.52) , and alcohol consumption (OR＝1.48, 95%CI 1.07–2.05) were independent risk factors for sarcopenia (P<0.05). Behaviors related to healthy diet, including daily milk consumption (OR＝0.40, 95%CI 0.30–0.52), regular three meals (OR＝0.56, 95%CI 0.41–0.78), and high-quality protein intake (OR＝0.70, 95%CI 0.52–0.94), were protective factors (P<0.05). Conclusions Sarcopenia among community–dwelling, non–bedridden older adults is closely associated with physical activity levels, dietary habits, and nutritional status. Early identification of individuals at risk, enhanced nutritional education, and timely implementation of nutritional interventions and exercise programs are recommended for this population.

Periodontitis leads to progressive destruction of periodontal supporting tissues, and conventional anti-infective therapies often fail to simultaneously achieve infection control and tissue regeneration. Due to the increasing threat of antibiotic resistance, the development of novel bioactive molecules with both anti-infective and pro-regenerative properties has become a focus of research. Antimicrobial peptides (AMPs), characterized by multi-target antimicrobial mechanisms and immunomodulatory functions, have attracted considerable attention in periodontal tissue regeneration. Current evidence indicates that AMPs not only inhibit periodontal pathogens and biofilm formation, but they also regulate macrophage polarization, suppress inflammatory cytokine release, and activate signaling pathways, such as Wnt/β-catenin and MAPK/ERK. These effects promote osteogenic differentiation of periodontal ligament stem cells and bone marrow mesenchymal stem cells, while enhancing angiogenesis through VEGF induction, thereby establishing a favorable immune microenvironment for periodontal regeneration. Despite these promising findings, the in vivo stability, dosage safety, and long-term mechanisms of AMPs remain to be fully elucidated. Future studies should focus on clarifying the molecular mechanisms by which AMPs regulate the periodontal immune microenvironment and angiogenesis-osteogenesis coupled regeneration. In addition, integrating structural optimization, advanced delivery systems, and artificial intelligence-assisted peptide discovery may accelerate the development and clinical translation of novel antimicrobial peptides.

Objective To investigate the changes in the density of Aedes albopictus across different regions and different breeding habitats in Baoshan District, Shanghai Municipality from 2018 to 2024, so as to inform evidence-based control strategies for mosquito-borne infectious diseases in Shanghai Municipality. Methods Ae. albopictus surveillance sites were deployed in 12 subdistricts (towns) of Baoshan District, Shanghai Municipality from 2018 to 2024, and the surveillance on the density of Ae. albopictus was performed in each surveillance site once weekly during the peak activity period of Aedes mosquitoes from May to October each year from 2018 to 2024. Mosquito ovitraps were deployed in various breeding habitats in each surveillance site according to geographical locations, including residential areas, schools, government institutions, hospitals, recycling stations, and construction sites, and regularly collected, and the mosquito ovitrap index (MOI) was calculated. The changes in the Ae. albopictus density were analyzed based on MOI across years, regions, and breeding habitats. Additionally, from May to October each year between 2018 and 2024, monthly risk assessments of Aedes albopictus density were conducted in every subdistrict (town) of Baoshan District, Shanghai. Results The annual mean MOI values of Ae. albopictus were 5.88 ± 2.29, 8.19 ± 4.46, 7.43 ± 3.40, 5.44 ± 2.52, 3.97 ± 2.72, 3.82 ± 1.57, and 2.56 ± 1.11 in Baoshan District from 2018 to 2024, respectively (F = 75.886, P < 0.05), and the MOI appeared a rise followed by a reduction each year and peaked during the period between June and August. There was a significant difference in the 7-year mean MOI of Ae. albopictus across the 12 subdistricts/towns (F = 26.558, P < 0.05), and there were 6 subdistricts/towns with a 7-year mean MOI of over 5, including Songnan Town (8.44 ± 4.68), Dachang Town (7.71 ± 5.28), Gucun Town (7.13 ± 3.57), Yuepu Town (5.74 ± 1.69), Gaojing Town (5.51 ± 3.44), and Wusong Subdistrict (5.41 ± 2.04). There was a significant difference in the MOI of Ae. albopictus across breeding habitats (F = 3.843, P < 0.05), with the highest MOI seen in recycling stations (9.86 ± 4.61), which was significantly higher than in other habitats (P < 0.05), and the lowest seen in construction sites (4.90 ± 2.95), which was significantly lower than in other habitats (P < 0.05). The proportion of frequency with Ae. albopictus density transmission risk decreased from 54.17% in 2018 to 11.11% in 2024 in all subdistricts (towns) of Baoshan District, and the frequency of outbreak risks peaked in 2019 (18 instances) and declined substantially in 2021 (6 instances), with no records of outbreak or transmission risk documented across the district in 2024. Conclusions There were substantial seasonal variations in the Ae. albopictus density in Baoshan District, Shanghai Municipality from 2018 to 2024. The Ae. albopictus density peaked during the period between June and August in Baoshan District each year from 2018 to 2024, with a relatively higher density in Songnan Town and Dachang Town, and in recycling stations. Precision control measures and intensified seasonal interventions are recommended in high-risk settings in Baoshan District to reduce the transmission risk of Aedes-borne infectious diseases.

Objective: To explore the interrelationships between mental vulnerability, cognitive emotion regulation strategies, and positive psychological capital in medical postgraduates, so as to provide precise intervention targets for mental health services in universities. Methods: From April to June 2025, a convenience sampling method was used to select 1 461 medical postgraduates from three colleges in Hubei Province. Participants were assessed using the Mental Vulnerability Questionnaire (MVQ), the Cognitive Emotion Regulation Questionnaire-Chinese Version (CERQ-C) and the Positive Psychological Capital Questionnaire (PPQ). The network analysis model was constructed using a Gaussian graphical model. Results: The network analysis revealed that the edge connection between somatic symptoms and mental symptoms was the strongest, followed by the connection between refocus on planning and positive reappraisal within cognitive emotion regulation, with edge weights of 0.69 and 0.59, respectively. Interpersonal problems within psychological vulnerability exhibited the highest expected influence( EI =1.27), serving as the core node of the network. Rumination within cognitive emotion regulation demonstrated the highest bridge expected influence( BEI =0.33), playing a critical connecting role among psychological vulnerability, cognitive emotion regulation, and positive psychological capital. Conclusion In the mental health network of medical postgraduates, mental vulnerability, cognitive emotion regulation, and positive psychological capital interact through their respective key dimensions, jointly affect overall mental health.

ObjectiveTo review the current application status， practical challenges， and ethical issues of artificial intelligence （AI） in the field of hospice care， and to conduct a critical evaluation， with a view to offering a reference for promoting the deep integration of AI into clinical hospice care practice in China. MethodsRelevant domestic and international literature was retrieved to comprehensively analyze the application scenarios of AI in hospice care， the practical barriers encountered， and the ethical controversies， and to explore clinical optimization pathways. ResultsAI is gradually transforming the traditional service model of hospice care， with its applications primarily focusing on patient monitoring， symptom management， predictive analytics， clinical decision support， and other aspects. However， its development faced significant practical constraints and complex ethical challenges. ConclusionWhile AI holds immense potential to enhance the quality of hospice care， its application must be grounded in a core ethical framework centered on dignity， empathy， and patient autonomy. Relevant international explorations have been relatively extensive， whereas domestic studies remain in their infancy. Future research urgently warrants an in-depth exploration of the ethical and practical challenges to find localized integration pathways suited to China’s national context.

ObjectiveTo investigate the value of albumin-bilirubin （ALBI） score combined with platelet count-to-spleen thickness ratio （PC/ST） in predicting rebleeding within one year after endoscopic variceal ligation in liver cirrhosis patients with esophagogastric variceal bleeding （EVB）， to evaluate the risk assessment ability of this model， and to provide a reference for clinical prevention of rebleeding. MethodsA retrospective analysis was performed on the clinical data of liver cirrhosis patients with EVB who were hospitalized in Gansu Provincial Hospital from January 1， 2020 to December 31， 2024. All patients achieved successful hemostasis after endoscopic variceal ligation， and according to whether rebleeding occurred within one year after surgery， they were divided into rebleeding group and non-rebleeding group. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The univariate and multivariate Cox regression analyses were used to identify independent influencing factors for rebleeding. A prediction model was constructed based on the factors identified， and a nomogram was plotted for model visualization. The receiver operating characteristic （ROC） curve was used to assess the discriminatory ability of the model， and the area under the ROC curve （AUC） was calculated； calibration curve was used to assess calibration； decision curve analysis was used to assess the net clinical benefit of the model. ResultsA total of 258 patients were enrolled， among whom 70 patients experienced rebleeding within one year， resulting in a rebleeding rate of 27.1%. The multivariate Cox regression analysis showed that ALBI score （hazard ratio ［HR］=4.679， 95% confidence interval ［CI］： 2.952 — 7.417， P<0.001） and PC/ST （HR=0.461， 95%CI： 0.318 — 0.668， P<0.001） were independent influencing factors for rebleeding in liver cirrhosis patients with EVB. The model constructed based on these two factors yielded an AUC of 0.766 （95%CI： 0.667 — 0.866）， 0.775 （95%CI： 0.699 — 0.851）， and 0.809 （95%CI： 0.752 — 0.866）， respectively， for predicting the risk of rebleeding at 6 weeks， 6 months， and 1 year. The calibration curve showed that the model systematically underestimated the probability of rebleeding at 6 weeks and 6 months， but its prediction for the probability of rebleeding at 1 year aligned well with the ideal curve. The decision curve analysis showed that the model provided a clear net clinical benefit for predicting rebleeding within 1 year. ConclusionThe model constructed based on ALBI score and PC/ST had good performance in predicting the risk of rebleeding within 1 year after endoscopic variceal ligation in liver cirrhosis patients with EVB.

Objective:To analyze the genetic characteristics of clinical manifestations in children with KBG syndrome due to microdeletions.Methods:A retrospective case summary was conducted. Four children diagnosed with KBG syndrome due to 16q24.3 microdeletion at Children′s Hospital of Zhengzhou University from July 2021 to April 2024 were enrolled.Their clinical manifestations, biochemical parameters, imaging data, whole-exome sequencing results, treatments and follow-up outcomes were reviewed.Results:The cohort included two males and two females (diagnosed at 81, 18, 26, and 56 months of age, respectively), from four unrelated families. All patients exhibited peculiar facial features (Cupid′s bowed-shaped lips, prominent ears, thick eyebrows), skeletal abnormalities (brachydactyly, abnormal ribs, short stature, etc.), ocular anomalies (astigmatism, strabismus, amblyopia, etc.), intrauterine growth restriction, and developmental retardation. Case 2, 3, 4 had cranial imaging abnormalities, including thin anterior pituitary lobes with pineal cyst, left ventricular cyst, and abnormal pituitary stalk or lateral ventricles with sinusitis, respectively. Two children had intellectual disability, two had congenital heart disease, and one had delayed bone age and hair abnormalities. Whole exome genomic sequencing confirmed 16q24.3 microdeletions encompassing ANKRD11 gene in all four cases. Two children treated with recombinant human growth hormone achieved height increments of 1.5 s and 0.4 s, respectively. Conclusions:Typical features of 16q24.3 microdeletion-induced KBG syndrome include peculiar facial features, macrodontia, skeletal anomalies, neurological abnormalities, and ocular defects. Genetic testing is essential for definitive diagnosis. The treatment of KBG syndrome requires early diagnosis and multidisciplinary collaboration to implement individualized treatment for multisystem symptoms.

Objective:To analyze the clinical features and diagnostic process of ring chromosome syndrome.Methods:Clinical data of 9 children with ring chromosome syndrome who were treated at the Children′s Medical Center of Peking University First Hospital from September 2009 to May 2025, were summarized and analyzed in a case series study. The data included clinical manifestations, types of epileptic seizures, genetic testing, treatment outcomes, and follow-up results, et al.Results:Among the 9 children with ring chromosome syndrome, there were 6 girls and 3 boys, including 4 children with ring chromosome 20 syndrome, 3 children with ring chromosome 14 syndrome, and 1 child each with ring chromosome 13 and 17 syndrome. All 9 children had de novo chromosomal variations. Among them, 3 children of ring chromosome 20 syndrome were mosaic, and the remaining 6 children were non-mosaic. All 9 children exhibited diverse clinical features, especially those with ring chromosome 20 syndrome, which presented with specific manifestations. The 4 children with ring chromosome 20 syndrome all had acute epileptic seizures as the initial symptom, with onset ages of 67, 39, 17, and 96 months, and all had focal seizures. One child with ring chromosome 20 syndrome had non-convulsive status epilepticus. Development of all 4 children with ring chromosome 20 syndrome was normal before seizure onset, but 3 children showed regression after onset. No physical deformities were observed in 4 children with ring chromosome 20 syndrome, and 2 children were misdiagnosed, 3 children underwent whole exome sequencing and copy number variation analysis in their families, with no abnormalities detected. All 4 children with ring chromosome 20 syndrome were diagnosed through chromosomal karyotype analysis, the intervals between onset and diagnosis were 2, 81, 19 and 13 months, respectively. Follow-up showed that epileptic seizures were not controlled in all 4 children with ring chromosome 20 syndrome. The other 5 children were characterized by developmental delay as the initial symptom, followed by epileptic seizures between 3 and 24 months of age. Developmental regression of the other 5 children did not occur after onset, 2 of them had microcephaly, and 3 had wide-set eyes. No misdiagnoses were reported in these 5 children, and the intervals between onset and diagnosis were 7, 3, 55, 3, and 106 months, respectively. Follow-up showed that epileptic seizures were controlled in these 5 children. Conclusions:Ring chromosome 20 syndrome typically manifest with epilepsy as the initial symptom and are refractory to drug treatment, their early development is entirely normal. Ring chromosome 13, 14, and 17 syndrome are characterized by developmental delay from an early age, followed by the onset of epileptic seizures, which are easily controlled. Conventional whole exome sequencing and copy number variation analysis in families rarely detect ring chromosome abnormalities. Early chromosomal karyotype analysis is essential for the diagnosis of ring chromosome syndrome.

Objective To compare the value of Logistic regression model and XGBoost model in predicting the risk of thrombosis in elderly patients with CHF complicated with LRTI.Methods A total of 138 elderly CHF patients with LRTI admitted to our department from April 2019 to April 2024 were prospectively enrolled,and divided into thrombus group(43 cases)and non-thrombus group(95 cases)according to whether thrombosis occurred.Clinical data of these pa-tients were collected,and two risk prediction models of thrombosis in these patients were con-structed based on logistic regression and XGBoost regression,respectively.The predictive value was compared between the two models.Results The thrombus group had higher neutrophil count,NLR,and CRP,D-D and vWF levels,and increased MA,estimated dissolution percentage,and percentage LY30,but K and R and lower coagulation index than the non-thrombus group(P＜0.01).NLR,CRP,D-D,vWF,LY30,K and R were influencing factors for thrombosis in the elderly CHF patients with LRTI(P＜0.05,P＜0.01).The AUC value of the multivariate logistic regression model and XGBoost model in predicting thrombosis in the patients was 0.915(95％CI:0.861-0.986)and 0.894(95％CI:0.841-0.971),respectively,with a sensitivity of 85.40％and 88.90％and a specificity of 96.50％and 82.30％,respectively.There was no statistical difference in AUC value between the two models(Z=0.573,P=0.678).Hosmer Lemeshow test showed the differences were not significant in the calibration curves of the multivariate logistic regression model and XGBoost model(x2=0.485,P=0.452;x2=0.669,P=0.335).Conclusion Multivari-ate logistic regression model and XGBoost model show equivalent efficacy in predicting thrombo-sis in CHF patients with LRTI.Abnormal levels of NLR,CRP,D-D,vWF,LY30,K,and R are im-portant factors affecting thrombosis in these elderly patients.

Objective To investigate the relationship between extracranial carotid artery tortuosity-related indicators and extracranial internal carotid artery aneurysm(ICAA)in elderly patients with suspected cerebrovascular disease.Methods A retrospective analysis was performed on 124 elderly patients with suspected cerebrovascular diseases undergoing head CT angiography(CTA)in our hospital from January 2021 to December 2023.According to the diagnostic results,they were divided into ICAA group(68 cases)and control group(56 cases).The extracranial carotid artery tortuosity-related indicators were compared between the two groups.Multivariate logistic regression analysis was used to identify the influencing factors for ICAA.ROC curve analysis was employed to analyze the diagnostic value of head CTA parameters for extracranial ICAA,and the area under curve(AUC)was calculated.Results There were no statistical differences in the pro-portions of extracranial internal carotid artery(EICA)without kinking,tortuosity,and coiling be-tween the two groups(P＞0.05).The ICAA group had significantly higher proportion of EICA(32.4％vs 14.3％,P＜0.05),and obviously greater common carotid artery kinking index,EICA kinking index,and internal carotid artery angle than the control group(P＜0.01).Multivariate lo-gistic regression analysis showed that kinking,common carotid artery kinking index,EICA kin-king index,and internal carotid artery angle were influencing factors for ICAA(P＜0.05,P＜0.01).ROC curve analysis indicated that in diagnosing ICAA,the sensitivity and the specificity was 70.59％and 82.14％,respectively,for common carotid artery kinking index,was 83.82％and 87.50％,respectively,for EICA kinking index,and was 80.88％and 83.93％,respectively,for in-ternal carotid artery angle.Conclusion The degree of EICA kinking is correlated with extracranial ICAA,and EICA kinking is more likely to cause ICAA.Head CTA parameters can reflect the morphological features of internal carotid artery kinking and had high adjuvant diagnostic value for diagnosing ICAA.