Objective:To develop a health management model tailored for the elderly population in rural areas and to evaluate its effectiveness.Methods:This before-and-after controlled intervention study was conducted from January 2024 to June 2024 in rural areas of Jiaocheng County, Shanxi Province. A multi-stage stratified random sampling method was used to include 5 000 permanent residents aged ≥65 years. A baseline health survey was first conducted to collect multidimensional data, including demographic characteristics, chronic disease information, cognitive and psychological scales, sleep quality, and health service utilization. Using the comprehensive health index as the outcome variable, seven machine learning models, including LightGBM, were constructed to identify key factors influencing health status and explore intervention pathways. Subsequently, under the framework of a "five-level linkage+shared database, " comprehensive interventions such as health communication, integrated medical and elderly care, and dynamic follow-ups were implemented. Differences in major health indicators were compared before and after the 6-month intervention.Results:At baseline, the prevalence rates of hypertension, diabetes, and coronary heart disease were 58.2%, 24.8%, and 16.1%, respectively. The rate of cognitive impairment was 36.9%, and the positive rates for depression and anxiety were 27.3% and 17.4%, respectively. Machine learning analysis showed that the Naive Bayes model had the best predictive performance (area under the curve=0.966), with key influencing factors including number of follow-ups, number of health lectures, and medical check-up frequency. After six months of intervention, systolic blood pressure decreased from (142.95±15.84) to (138.37±17.20) mmHg (1 mmHg=0.133 kPa), fasting glucose from (6.43±1.26) to (6.09±1.40) mmol/L, and MMSE scores increased from (25.04±3.28) to (25.71±3.29) points. The positive rates of anxiety and depression declined from 17.4% to 12.8% and 27.3% to 20.6%, respectively. Follow-up compliance improved from 76.5% to 80.5%, and health record completeness from 69.8% to 75.8% (all P<0.001). Conclusions:The integrated health management model based on the"five-level linkage+shared database,"incorporating health education and the integration of medical and elderly care, effectively improves chronic disease control and enhances cognitive and psychological health among older adults in rural areas of Shanxi Province. This model also strengthens service adherence and management efficiency.

Bone grafting is a primary method for treating bone defects. Among various graft materials, xenogeneic bone substitutes are widely used in clinical practice due to their abundant sources, convenient processing and storage, and avoidance of secondary surgeries. With the advancement of domestic production and the limitations of imported products, an increasing number of bone filling or grafting substitute materials isentering clinical trials. Relevant experts have drafted this consensus to enhance the management of medical device clinical trials, protect the rights of participants, and ensure the scientific and effective execution of trials. It summarizes clinical experience in aspects, such as design principles, participant inclusion/exclusion criteria, observation periods, efficacy evaluation metrics, safety assessment indicators, and quality control, to provide guidance for professionals in the field.
Humans ; Bone Substitutes/therapeutic use* ; Randomized Controlled Trials as Topic/methods* ; Consensus ; Bone Transplantation ; Research Design

Aim To verify the mechanism of action of Carthami Flos-Lycopodii Herba in treating KOA carti-lage inflammation based on network pharmacology and in vitro and in vivo experiments.Methods The effec-tive ingredients of Carthami Flos-Lycopodii Herba were screened through the database,the core targets of"drug disease"were analyzed,and pathway enrichment analy-sis and molecular docking verification were conducted.Experimental verification:Primary chondrocytes were extracted from mice and divided into the control group,IL-1β group,treatment group,and treatment+TLR4 agonist group.CCK-8 method was used to screen the optimal intervention concentration of Carthami Flos-Ly-copodii Herba.ELISA was used to detect the content of inflammatory factors in chondrocytes.Western blot was employed to detect the protein expression related to cellular pathways.Subsequently,a KOA mouse model was constructed using the DMM method.After admin-istration,the knee joint injury of mice was evaluated u-sing safranin O-green staining.ELISA was used to de-tect the levels of inflammatory factors in serum.West-ern blot was employed to detect collagen Ⅱ,MMP13,Aggrecan,and apoptosis related protein expression in cartilage tissue.TUNEL staining was used to detect the apoptosis rate of cells.Results A total of 26 active ingredients of Carthami Flos-Lycopodii Herba were screened,as well as 123 potential targets for treating KOA.The enrichment analysis results indicated that it mainly involved mechanisms such as Toll like receptors and cell apoptosis.The experimental results showed that Carthami Flos-Lycopodii Herba alleviated the in-flammatory response of chondrocytes and affected the expression of pathway related proteins.Compared with KOA mice,safflower stretched muscle grass could im-prove cartilage damage and reduce the concentration of serum inflammatory factors,regulate the expression of collagen Ⅱ,MMP13,Aggrecan,and apoptosis related proteins in cartilage tissue,and reduce the fluorescence intensity of TUNEL staining in the tissue.Conclusions Carthami Flos-Lycopodii Herba can improve KOA cartilage inflammation,and its mechanism may be relat-ed to the TLR4/MyD88/NF-κB signaling pathway.

Aim To investigate the therapeutic effects of cinnamaldehyde on synovial lesions in mice with knee osteoarthritis(KOA)and its regulatory mecha-nism in the phagocytic function of synovial macropha-ges.Methods In the animal experiments,mouse ser-um and synovial tissue were extracted.HE staining was used to evaluate the inflammatory cell infiltration in the synovial tissue.ELISA was employed to detect the lev-els of inflammatory factors such as interleukins in the serum.Western blot was used to detect the expression of Ras homolog family member A(RhoA),Rho-associ-ated protein kinase 1(ROCK1),myosin light chain(MLC),and p-MLC proteins in the synovial tissue.RT-qPCR was utilized to detect the expression of in-flammatory factors and pathway-related mRNA in the synovial tissue.TUNEL staining was used to detect ap-optosis in the synovial tissue.In the cellular experi-ments,after the intervention,RAW267.4 cells were subjected to Western blot and RT-qPCR for the detec-tion of the aforementioned indicators,and confocal mi-croscopy was used to assess phagocytic function.Re-sults After cinnamaldehyde intervention,the synovial inflammatory infiltration was significantly reduced,the protein and mRNA expression of the RhoA/ROCK1/MLC signaling pathway was markedly downregulated,the fluorescence intensity of TUNEL staining signifi-cantly decreased,and the phagocytic function of macro-phages was enhanced.Conclusion Cinnamaldehyde can inhibit RhoA/Rock1/MLC signaling pathway,en-hance macrophage burial,improve synovial inflamma-tion,and delay the progression of KO A mice.

Aim To investigate the therapeutic effects of cinnamaldehyde on synovial lesions in mice with knee osteoarthritis(KOA)and its regulatory mecha-nism in the phagocytic function of synovial macropha-ges.Methods In the animal experiments,mouse ser-um and synovial tissue were extracted.HE staining was used to evaluate the inflammatory cell infiltration in the synovial tissue.ELISA was employed to detect the lev-els of inflammatory factors such as interleukins in the serum.Western blot was used to detect the expression of Ras homolog family member A(RhoA),Rho-associ-ated protein kinase 1(ROCK1),myosin light chain(MLC),and p-MLC proteins in the synovial tissue.RT-qPCR was utilized to detect the expression of in-flammatory factors and pathway-related mRNA in the synovial tissue.TUNEL staining was used to detect ap-optosis in the synovial tissue.In the cellular experi-ments,after the intervention,RAW267.4 cells were subjected to Western blot and RT-qPCR for the detec-tion of the aforementioned indicators,and confocal mi-croscopy was used to assess phagocytic function.Re-sults After cinnamaldehyde intervention,the synovial inflammatory infiltration was significantly reduced,the protein and mRNA expression of the RhoA/ROCK1/MLC signaling pathway was markedly downregulated,the fluorescence intensity of TUNEL staining signifi-cantly decreased,and the phagocytic function of macro-phages was enhanced.Conclusion Cinnamaldehyde can inhibit RhoA/Rock1/MLC signaling pathway,en-hance macrophage burial,improve synovial inflamma-tion,and delay the progression of KO A mice.

Aim To verify the mechanism of action of Carthami Flos-Lycopodii Herba in treating KOA carti-lage inflammation based on network pharmacology and in vitro and in vivo experiments.Methods The effec-tive ingredients of Carthami Flos-Lycopodii Herba were screened through the database,the core targets of"drug disease"were analyzed,and pathway enrichment analy-sis and molecular docking verification were conducted.Experimental verification:Primary chondrocytes were extracted from mice and divided into the control group,IL-1β group,treatment group,and treatment+TLR4 agonist group.CCK-8 method was used to screen the optimal intervention concentration of Carthami Flos-Ly-copodii Herba.ELISA was used to detect the content of inflammatory factors in chondrocytes.Western blot was employed to detect the protein expression related to cellular pathways.Subsequently,a KOA mouse model was constructed using the DMM method.After admin-istration,the knee joint injury of mice was evaluated u-sing safranin O-green staining.ELISA was used to de-tect the levels of inflammatory factors in serum.West-ern blot was employed to detect collagen Ⅱ,MMP13,Aggrecan,and apoptosis related protein expression in cartilage tissue.TUNEL staining was used to detect the apoptosis rate of cells.Results A total of 26 active ingredients of Carthami Flos-Lycopodii Herba were screened,as well as 123 potential targets for treating KOA.The enrichment analysis results indicated that it mainly involved mechanisms such as Toll like receptors and cell apoptosis.The experimental results showed that Carthami Flos-Lycopodii Herba alleviated the in-flammatory response of chondrocytes and affected the expression of pathway related proteins.Compared with KOA mice,safflower stretched muscle grass could im-prove cartilage damage and reduce the concentration of serum inflammatory factors,regulate the expression of collagen Ⅱ,MMP13,Aggrecan,and apoptosis related proteins in cartilage tissue,and reduce the fluorescence intensity of TUNEL staining in the tissue.Conclusions Carthami Flos-Lycopodii Herba can improve KOA cartilage inflammation,and its mechanism may be relat-ed to the TLR4/MyD88/NF-κB signaling pathway.

Objective:To develop a health management model tailored for the elderly population in rural areas and to evaluate its effectiveness.Methods:This before-and-after controlled intervention study was conducted from January 2024 to June 2024 in rural areas of Jiaocheng County, Shanxi Province. A multi-stage stratified random sampling method was used to include 5 000 permanent residents aged ≥65 years. A baseline health survey was first conducted to collect multidimensional data, including demographic characteristics, chronic disease information, cognitive and psychological scales, sleep quality, and health service utilization. Using the comprehensive health index as the outcome variable, seven machine learning models, including LightGBM, were constructed to identify key factors influencing health status and explore intervention pathways. Subsequently, under the framework of a "five-level linkage+shared database, " comprehensive interventions such as health communication, integrated medical and elderly care, and dynamic follow-ups were implemented. Differences in major health indicators were compared before and after the 6-month intervention.Results:At baseline, the prevalence rates of hypertension, diabetes, and coronary heart disease were 58.2%, 24.8%, and 16.1%, respectively. The rate of cognitive impairment was 36.9%, and the positive rates for depression and anxiety were 27.3% and 17.4%, respectively. Machine learning analysis showed that the Naive Bayes model had the best predictive performance (area under the curve=0.966), with key influencing factors including number of follow-ups, number of health lectures, and medical check-up frequency. After six months of intervention, systolic blood pressure decreased from (142.95±15.84) to (138.37±17.20) mmHg (1 mmHg=0.133 kPa), fasting glucose from (6.43±1.26) to (6.09±1.40) mmol/L, and MMSE scores increased from (25.04±3.28) to (25.71±3.29) points. The positive rates of anxiety and depression declined from 17.4% to 12.8% and 27.3% to 20.6%, respectively. Follow-up compliance improved from 76.5% to 80.5%, and health record completeness from 69.8% to 75.8% (all P<0.001). Conclusions:The integrated health management model based on the"five-level linkage+shared database,"incorporating health education and the integration of medical and elderly care, effectively improves chronic disease control and enhances cognitive and psychological health among older adults in rural areas of Shanxi Province. This model also strengthens service adherence and management efficiency.

Objective To establish ecological suitability zone of Forsythia suspensa(Thunb.)Vahl in Shanxi Province;To study the quality regionalization of Forsythia suspensa(Thunb.)Vahl from different producing areas in Shanxi Province;To provide reference for reasonable planting and wild tending of Forsythia suspensa(Thunb.)Vahl.Methods Maximum entropy(MaxEnt)model and ArcGIS software were used to study the ecological suitability of Forsythia suspensa(Thunb.)Vahl in Shanxi Province;By screening the main environmental factors and combining them with the content of forsythoside and forsythoside A in Forsythia suspensa(Thunb.)Vahl of different regions,a quality zoning of Forsythia suspensa Thunb.Vahl medicinal materials in Shanxi Province based on forsythoside,forsythoside A and environmental factors was constructed.Results The ecological suitable areas of Forsythia suspensa Thunb.Vahl in Shanxi Province were mainly distributed in the southern part of Shanxi Province,mainly in Linfen,Yuncheng,Changzhi,and Jincheng.The general contents of forsythoside and forsythoside A in the Forsythia suspensa(Thunb.)Vahl medicinal material were gradually reduced from southern part to northern part of Shanxi Province.The comprehensive quality was high in southern part of Shanxi Province,mainly in Linfen,Changzhi,Yuncheng and Jincheng.Conclusion The results of this study are consistent with the actual survey.The southern part of Shanxi province is a suitable planting area for high quality Forsythia suspensa(Thunb.)Vahl,which provides a reference for the standardized planting and wild tending of Forsythia suspensa(Thunb.)Vahl.

Objective To investigate the length of hospital stay,hospitalization expense and mortality attributable to the occurrence of carbapenem-resistant Enterobacterales(CRE)infection in patients in intensive care unit(ICU).Methods Patients admitted to the ICU in a tertiary first-class hospital from 2017 to 2022 were selected for the study.According to whether CRE infection occurred,patients were divided into infected group and non-infected group.Propensity score matching method was used to conduct a 1∶1 match between the infected group and non-infected group.Length of hospital stay,hospitalization expense and mortality of patients after matching were analyzed sta-tistically.A generalized linear model was established to recalculate the odds ratio(OR)of length of hospital stay,hospitalization expense and mortality of patients after matching.Results After propensity score matching,length of hospital stay of patients in the infected group extended by 10.56 days(P＜0.001),hospitalization expense in-creased by 36 021.02 Yuan(P＜0.001),and mortality increased by 6.70％(P=0.035).The results of the gene-ralized linear model indicated that OR for length of hospital stay,hospitalization expense,and mortality were 1.187(95％CI:1.013-1.393),1.134(95％CI:0.975-1.318),and 1.130(95％CI:1.049-1.218)respectively for CRE infected patients,compared with non-infected patients,except for hospitalization expense,length of hospital stay and mortality between two groups were statistically significant(both P＜0.05).Conclusion CRE infection in ICU patients will increase the length of hospital stay,economic burden,and mortality of patients.Measures should be taken to prevent and control CRE infection.

Objective:To analyze the effect of recombinant human thrombopoietin(rhTPO)on platelet(PLT)reconstitution after autologous peripheral blood stem cell transplantation(APBSCT)in patients with multiple myeloma(MM).Methods:The clinical data of 147 MM patients who were diagnosed in the First Affiliated Hospital of Soochow University and received APBSCT as the first-line therapy were retrospectively analyzed.According to whether rhTPO was used during APBSCT,the patients were divided into rhTPO group(80 cases)and control group(67 cases).The time of PLT engraftment,blood product infusion requirements,the proportion of patients with PLT recovery to ≥ 50 × 109/L and ≥ 100 × 109/L at+14 days and+100 days after transplantation,and adverse reactions including the incidence of bleeding were compared between the two groups.Results:There were no significant differences between the two groups in sex,age,M protein type,PLT count at the initial diagnosis,median duration of induction therapy before APBSCT,and number of CD34+cells reinfused(all P＞0.05).The median time of PLT engraftment in the rhTPO group was 10(6-14)days,which was shorter than 11(8-23)days in the control group(P＜0.001).The median PLT transfusion requirement in the rhTPO group during APBSCT was 15(0-50)U,which was less than 20(0-80)U in the control group(P=0.001).At+14 days after transplantation,the proportions of patients with PLT 2 50 × 109/L in the rhTPO group and the control group were 66.3％and 52.2％,while the proportions of patients with PLT ≥ 100 × 109/L were 23.8％and 11.9％,respectively,with no significant differences(all P＞0.05).At+100 days after transplantation,the proportion of patients with PLT ≥ 50 × 109/L in rhTPO group and control group was 96.3％and 89.6％,respectively(P＞0.05),but the proportion of patients with PLT ≥ 100 × 109/L in rhTPO group was higher than that in control group(75.0％vs 55.2％,P=0.012).There was no difference in the overall incidence of bleeding events in different locations during period of low PLT level of patients between the two groups.In rhTPO group,the rhTPO administration was well tolerated,and the incidences of abnormal liver and kidney function and infection were similar to those in the control group.Conclusion:When MM patients undergo first-line APBSCT,subcutaneous injection of rhTPO can shorten the time of platelet engraftment,reduce the transfusion volume of blood products,and be well tolerated,moreover,more patients have achieve a high level of PLT recovery after transplantation,which is very important for ensuring the safety of APBSCT and maintenance therapy.