Objective:To investigate the mediating effects of medical inquiry ability and attitudes toward aging on the relationship between socioeconomic status and mental health among the elderly.Methods:Utilizing data from the 2021 China General Social Survey(CGSS), a sample of 957 individuals aged 60 years and older was selected for analysis.The influence of each variable was assessed through regression analysis, and the mediating effects were evaluated using the Bootstrap method.Results:The study samples ranged in age from 60 to 95 years, including 479 females and 478 males.Socioeconomic status significantly positively influenced mental health( β=0.208, P<0.001).Additionally, socioeconomic status had a notable positive effect on medical inquiry ability( β=0.244, P<0.001)and attitudes toward aging( β=0.163, P<0.001)among the elderly population.Furthermore, medical inquiry ability positively affected both attitudes toward aging( β=0.158, P<0.001)and mental health( β=0.139, P<0.001).The attitude toward aging also had a significant positive impact on mental health( β=0.216, P<0.001).Notably, both medical inquiry ability and attitudes toward aging served as significant mediators between socioeconomic status and mental health in the elderly, with a total indirect effect value of 0.091(95% CI: 0.063-0.123).The chain mediating effect of medical inquiry ability and pension mentality was also significant, with an effect size of 0.010(95% CI: 0.005-0.017). Conclusions:Enhancing the socioeconomic status of older adults can foster their medical inquiry ability, positively influence their attitudes toward aging, and ultimately contribute to the promotion of their mental health.

Objective:This study aims to investigate the impact of socioeconomic status on cognitive function in older adults, while analyzing the mediating role of health-related social determinants.The findings will provide a foundation for the implementation of an active aging strategy.Methods:Utilizing data from the China Health and Retirement Longitudinal Study(CHARLS)2020, this study employed multiple linear regression analysis to investigate the relationship between socioeconomic status and cognitive function among older adults.A multiple mediation model was applied to evaluate the mediating effects of health-related social determinants on the association between socioeconomic status and cognitive function, with these mediation effects assessed using the Bootstrap method.Results:The results of the multiple linear regression analysis indicated that socioeconomic status significantly positively influences cognitive function in older adults.Factors such as younger age, male gender, Han ethnicity, and urban residence were associated with higher cognitive scores.The mediation analysis demonstrated that, of the total effect of socioeconomic status on cognitive function, health status accounted for 1.564%, individual lifestyle for 14.820%, social support networks for 2.719%, living conditions for 1.632%, and other social structural factors for 1.496%.In the multiple mediation model, a total of 17.945% of the effect of socioeconomic status on cognitive function in older adults was jointly mediated by health-related social determinants.Conclusions:Socioeconomic status is a critical determinant of cognitive impairment among older adults in China.To address this issue, comprehensive interventions should be implemented to promote the equitable distribution of economic and social resources, reduce socioeconomic disparities, and mitigate health inequalities, thereby enhancing the overall cognitive function of disadvantaged groups.Preventive measures and strategies aimed at improving health status, encouraging healthy lifestyle choices, strengthening social support networks, enhancing living conditions, and optimizing social structural factors could serve as essential intervention points to improve the cognitive function of older adults with lower socioeconomic status.

Objective:To investigate the mediating effects of medical inquiry ability and attitudes toward aging on the relationship between socioeconomic status and mental health among the elderly.Methods:Utilizing data from the 2021 China General Social Survey(CGSS), a sample of 957 individuals aged 60 years and older was selected for analysis.The influence of each variable was assessed through regression analysis, and the mediating effects were evaluated using the Bootstrap method.Results:The study samples ranged in age from 60 to 95 years, including 479 females and 478 males.Socioeconomic status significantly positively influenced mental health( β=0.208, P<0.001).Additionally, socioeconomic status had a notable positive effect on medical inquiry ability( β=0.244, P<0.001)and attitudes toward aging( β=0.163, P<0.001)among the elderly population.Furthermore, medical inquiry ability positively affected both attitudes toward aging( β=0.158, P<0.001)and mental health( β=0.139, P<0.001).The attitude toward aging also had a significant positive impact on mental health( β=0.216, P<0.001).Notably, both medical inquiry ability and attitudes toward aging served as significant mediators between socioeconomic status and mental health in the elderly, with a total indirect effect value of 0.091(95% CI: 0.063-0.123).The chain mediating effect of medical inquiry ability and pension mentality was also significant, with an effect size of 0.010(95% CI: 0.005-0.017). Conclusions:Enhancing the socioeconomic status of older adults can foster their medical inquiry ability, positively influence their attitudes toward aging, and ultimately contribute to the promotion of their mental health.

Objective:This study aims to investigate the impact of socioeconomic status on cognitive function in older adults, while analyzing the mediating role of health-related social determinants.The findings will provide a foundation for the implementation of an active aging strategy.Methods:Utilizing data from the China Health and Retirement Longitudinal Study(CHARLS)2020, this study employed multiple linear regression analysis to investigate the relationship between socioeconomic status and cognitive function among older adults.A multiple mediation model was applied to evaluate the mediating effects of health-related social determinants on the association between socioeconomic status and cognitive function, with these mediation effects assessed using the Bootstrap method.Results:The results of the multiple linear regression analysis indicated that socioeconomic status significantly positively influences cognitive function in older adults.Factors such as younger age, male gender, Han ethnicity, and urban residence were associated with higher cognitive scores.The mediation analysis demonstrated that, of the total effect of socioeconomic status on cognitive function, health status accounted for 1.564%, individual lifestyle for 14.820%, social support networks for 2.719%, living conditions for 1.632%, and other social structural factors for 1.496%.In the multiple mediation model, a total of 17.945% of the effect of socioeconomic status on cognitive function in older adults was jointly mediated by health-related social determinants.Conclusions:Socioeconomic status is a critical determinant of cognitive impairment among older adults in China.To address this issue, comprehensive interventions should be implemented to promote the equitable distribution of economic and social resources, reduce socioeconomic disparities, and mitigate health inequalities, thereby enhancing the overall cognitive function of disadvantaged groups.Preventive measures and strategies aimed at improving health status, encouraging healthy lifestyle choices, strengthening social support networks, enhancing living conditions, and optimizing social structural factors could serve as essential intervention points to improve the cognitive function of older adults with lower socioeconomic status.

Objective:To analyze the disparity in the prevalence of chronic comorbidities between the urban and rural elderly populations, providing scientific evidence to tailor health management strategies and policies.Methods:Data from 9, 252 participants aged 60 years and older, drawn from the 2020 China Health and Retirement Longitudinal Study(CHARLS, 2020), were analyzed.The urban-rural disparity in chronic comorbidities prevalence and the associated factors were examined using logistic regression analysis and Fairlie decomposition.Results:Of the 9, 252 participants, the rate of chronic comorbidities was 66.10%, with a higher prevalence observed in the urban population compared to the rural population(68.52% vs.64.86%, =12.421, P<0.001).Logistic regression analysis indicated that among the urban population, chronic comorbidities were less prevalent in participants who reported more than 6 hours of sleep, were employed, and assessed their health as good.Conversely, a higher prevalence was noted in individuals aged 65 and older.In the rural population, the rate of chronic comorbidities was lower in participants who reported more than 6 hours of sleep, were employed, had annual incomes exceeding RMB 10, 000, assessed their health as good, and reported higher life satisfaction.Utilizing the Fairlie decomposition method, it was found that the differences in the prevalence of chronic comorbidities between urban and rural elderly populations were primarily attributable to employment status and sleep duration( P<0.05), with contribution rates of 69.22% and 6.92%, respectively. Conclusions:In the context of global aging, this study examined the factors influencing the prevalence of comorbidity among elderly populations in urban and rural settings.The findings demonstrate that enhancing sleep quality, promoting employment opportunities, fostering community engagement, and encouraging family interaction may contribute to reducing the health disparities between urban and rural areas, thereby supporting healthy aging.

Objective:To analyze the disparity in the prevalence of chronic comorbidities between the urban and rural elderly populations, providing scientific evidence to tailor health management strategies and policies.Methods:Data from 9, 252 participants aged 60 years and older, drawn from the 2020 China Health and Retirement Longitudinal Study(CHARLS, 2020), were analyzed.The urban-rural disparity in chronic comorbidities prevalence and the associated factors were examined using logistic regression analysis and Fairlie decomposition.Results:Of the 9, 252 participants, the rate of chronic comorbidities was 66.10%, with a higher prevalence observed in the urban population compared to the rural population(68.52% vs.64.86%, =12.421, P<0.001).Logistic regression analysis indicated that among the urban population, chronic comorbidities were less prevalent in participants who reported more than 6 hours of sleep, were employed, and assessed their health as good.Conversely, a higher prevalence was noted in individuals aged 65 and older.In the rural population, the rate of chronic comorbidities was lower in participants who reported more than 6 hours of sleep, were employed, had annual incomes exceeding RMB 10, 000, assessed their health as good, and reported higher life satisfaction.Utilizing the Fairlie decomposition method, it was found that the differences in the prevalence of chronic comorbidities between urban and rural elderly populations were primarily attributable to employment status and sleep duration( P<0.05), with contribution rates of 69.22% and 6.92%, respectively. Conclusions:In the context of global aging, this study examined the factors influencing the prevalence of comorbidity among elderly populations in urban and rural settings.The findings demonstrate that enhancing sleep quality, promoting employment opportunities, fostering community engagement, and encouraging family interaction may contribute to reducing the health disparities between urban and rural areas, thereby supporting healthy aging.

Objective:Through a typical case of corticobasal degeneration (CBD) with primary progressive aphasia (PPA) to analyze the clinical characteristics of CBD and the special manifestations of aphasia with that disease.Methods:Retrospective analysis was performed on a patient with PPA based CBD who was admitted to the First Affiliated Hospital, Sun Yat-sen University in July 2020 to summarize the clinical features and diagnostic thinking of CBD.Results:The patient was a 59-year-old male, manifested rapidly progressive dysfunction of language and memory function. The aphasia was mainly featured as slow speech, reduced content and grammatical errors, and diagnosed as PPA, non-fluent grammatical variation. The imaging results showed the atrophy of the left frontal lobe, parietal lobe, basal ganglia and thalamus, coupled with the reduction in 18F-fluorodeoxyglucose radioactive uptake. The patient was finally diagnosed as possible CBD. Conclusions:PPA as the initial manifestation of CBD is very rare in clinical practice. The high non-specificity of clinical features and the lack of typical motor symptoms result in the difficulty of correct diagnosis of CBD. Timely functional imaging in nuclear medicine and reliable biomarkers help to facilitate early diagnosis of atypical CBD.

Objective:To investigate the predictive value of myoglobin (Mb) for the prognosis of sepsis related chronic critical illness (CCI).Methods:Retrospective study was conducted on septic patients with the length of ICU stay equal or greater than 14 days, and sepsis-related organ failure assessment (SOFA) score equal or greater than 2 on the 14th day in ICU in the First Department of Critical Care Medicine at the First Affiliated Hospital of Sun Yat-sen University from January 2017 to March 2020. Patients′ clinical and laboratory data were collected on the 1st and 14th day in ICU. The survival on day 28 in ICU was recorded. According to the myoglobin levels on day 1 and day 14, all subjects were divided into myoglobin elevation group and decline group. Kaplan-Meier survival curve was used to compare the cumulative survival rate at day 28. Cox regression analysis was used to analyze the independent risk factors of mortality. Receiver operating characteristic (ROC) curve was used to analyze the prognostic value of myoglobin.Results:A total of 131 patients with sepsis related CCI were recruited, including 58 patients in the elevation group and 73 in the decline group. The Mb level in elevation group on day 1 was significantly lower than that in decline group [172.40(59.99, 430.53) μg/L vs. 413.60(184.40, 1 328.50) μg/L, Z=3.749, P=0.000], and the Mb level on day 14 was the opposite change in two groups [483.65(230.38, 1 471.75)μg/L in elevation group vs. 132.20(76.86, 274.35)μg/L in decline group, Z=5.595, P=0.000]. Kaplan-Meier survival curve analysis showed that the 28-day cumulative survival rate of the elevation group was significantly lower than that of decline group (χ2=7.051, P=0.008). Cox ratio regression analysis suggested that elevated myoglobin was an independent risk factor for 28-day mortality in septic patients with CCI ( OR=2.534, 95% CI 1.212-5.295, P=0.013). ROC curve analysis suggested that the sensitivity of myoglobin elevation in predicting mortality related to CCI within 28 days was 64.5%, and the specificity was 32.0% with area under the curve(AUC) 0.661(95% CI 0.550-0.773, P=0.007) and Jorden Index was 0.325. Conclusion:Elevated myoglobin, an independent risk factor for mortality within 28 days in ICU, can predict the prognosis of sepsis related chronic critical illness.

Objective:To investigate the role and significance of heme oxygenase-1 (HO-1) in regulating macrophage polarization on seawater-drowning-induced acute lung injury (ALI) in mice.Methods:Raw 264.7 cells were divided into four groups. The control group was not stimulated with artificial seawater (SW), while the SW 8 h group, SW 24 h group, and SW 72 h group stimulated with artificial seawater for 8 h, 24 h, and 72 h, respectively. The morphological changes of cells were observed, the apoptosis, the contents of inducible nitric oxide synthase (iNOS), and HO-1 protein were detected. Hmox1 flox/ floxCre+ /- and Hmox1 -/- (HO-1 M-KO) mice with conditional knockout of HO-1 gene in alveolar macrophages were produced and randomly divided into HO-1 flox/flox Control group, HO-1 flox/flox SW 24 h group, HO-1 M-KO Control group, and HO-1 M-KO SW 24 h Group, with 6 mice in each group. The mouse model of seawater-drowning-induced ALI was established by placing mice in a hollow container and then immersing them in 6 cm deep and (25±2)℃ artificial seawater for 28 s. Samples were taken 24 hours after seawater drowning to carry out alveolar lavage, and then the total cell counts and protein concentrations in bronchoalveolar lavage fluid (BALF), and the pathological changes and the iNOS protein content in lung tissues were observed. Results:Abnormally shaped Raw 264.7 cells increased while the total number of Raw 264.7 cells decreased after seawater stimulation. The apoptosis rates of the control group, SW 8 h group, SW 24 h group, and SW 72 h group were increased to (5.99±0.23)%, (16.71±1.16)%, (41.80±2.50)%, and (77.84±1.59)%, respectively, with statistically significant differences ( P<0.01). The contents of HO-1 protein in the control group, SW 8 h group, SW 24 h group, and SW 72 h group were (1.07±0.06), (1.42±0.01), (2.77±0.22), and (0.99±0.10), respectively, and the contents of HO-1 protein of both SW 8 h group and SW 24 h group increased significantly ( P<0.05). The contents of iNOS protein in the cells of the control group, SW 8 h group, SW 24 h group, and SW 72 h group were (0.94±0.10), (3.44±0.32), (1.52±0.09), and (2.26±0.11), respectively, and the contents of iNOS protein of SW 8 h group, SW 24 h group, and SW 72 h group increased significantly ( P<0.05); compared with the SW 8 h group, the HO-1 protein content increased significantly, while the iNOS protein content decreased in the SW 24 h group significantly ( P<0.01). Lung tissue injury in HO-1 M-KO mice was significantly aggravated after drowning. The cavity of pulmonary alveoli collapsed and shrunk, intra-alveolar hemorrhage occurred, alveolar septum thickened, and inflammatory cell infiltration aggravated. The cell number and protein concentration in BALF significantly increased ( P<0.01), and the iNOS content in lung tissue significantly increased( P<0.01). Conclusion:HO-1 can alleviate the seawater-drowning-induced ALI in mice by inhibiting the M1 macrophage polarization.