ObjectiveTo identify key factors influencing cognitive function in the elderly, including traditional Chinese medicine (TCM) constitutional classification, and to rank their relative importance.MethodsWe used cross-sectional data from seven geographical regions across mainland China. The Changsha version of the Montreal Cognitive Assessment was used to assess cognitive function. A “least absolute shrinkage and selection operator” (LASSO) model, multivariate linear regression analysis, and random forest (RF) model were used. Subgroup analyses were performed to examine the correlation between key TCM constitution types and cognitive function in different population subgroups.ResultsA total of 24 803 individuals aged 60 and above were included in the study. We selected 18 influential factors using the LASSO model. Higher education, being married, and having insurance were positively correlated with cognitive function in the elderly (all P .05). In contrast, poor sleep, vision impairment, hearing impairment, basic activities of daily living disability, instrumental activities of daily living disability, depression, hypertension, coronary heart disease, diabetes, stroke, yang-deficiency constitution (YADC), yin-deficiency constitution (YIDC), qi deficiency constitution (QDC), and blood stasis constitution (BSC) were negatively correlated with cognitive function (all P .05). YIDC and BSC affected all dimensions of cognitive function (all P .05). YADC mainly affected attention, language, abstraction (verbal analogies), memory, and orientation to time and place dimensions (P .001). QDC mainly affected language and abstraction (verbal analogies) dimensions (P .05). The negative correlations between BSC, YADC, YIDC, and QDC scores and cognitive function revealed statistically significant differences across most subgroups. The RF model identified education, BSC, and poor sleep quality as the three most influential factors in our study.ConclusionBSC, YADC, YIDC, and QDC were associated with cognitive decline in the elderly. Our findings provide new perspectives and significant references for interventions for early-stage cognitive disorders.

Fangcang shelter hospitals are modular, rapidly deployable facilities that play a vital role in pandemic response by providing centralized isolation and basic medical care for large patient populations. Artificial intelligence (AI) has the potential to transform Fangcang shelter hospitals into intelligent, responsive systems that are capable of significantly improving emergency preparedness, operational efficiency, and patient outcomes. Key application areas include site selection and design optimization, clinical decision support, AI-assisted clinical documentation and patient engagement, intelligent robotics, and operational management. However, realizing AI's full potential requires overcoming several challenges, including limited data accessibility, privacy and governance concerns, inadequate algorithmic adaptability in dynamic emergency settings, insufficient transparency and accountability in AI-driven decisions, fragmented system architectures due to proprietary formats, high costs disproportionate to the temporary nature of Fangcang shelter hospitals, and hardware reliability in austere environments. Addressing these challenges demands standardized data-sharing frameworks, development of explainable and robust AI algorithms, clear ethical and legal oversight, interoperable modular system designs, and active collaboration among multidisciplinary stakeholders.
Artificial Intelligence ; Humans ; Emergency Shelter ; China ; Hospitals ; COVID-19

Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

OBJECTIVES: To investigate the effect of age-friendly social and family care environment on the long-term care (LTC) services for the disabled elderly people. METHODS: A questionnaire-based survey was conducted among disabled elderly people in three cities of Zhejiang province from June to August 2022, involving 311 subjects from Ningbo city (LTC service insurance pilot site, insured group) and 542 subjects from Hangzhou and Quzhou cities (uninsured group). The service provisions, including ensuring daily activities, preventive healthcare, and satisfying spiritual comfort, were compared among the groups. The family friendly care environment was evaluated with the Family Function Scale and assistance of daily activities, financial support and emotional comfort. The social friendly care environment was measured with the revised WHO recommended age-friendly city environmental framework, including accessibility guarantee environment, information dissemination environment, social participant environment, and life security environment. After controlling for covariates such as sociodemographic, elderly care status, and health risk characteristics, the impact of environment on the effectiveness of service provision of LTC insurance was explored by multiple logistic regression analysis. The mediating and moderating effects were tested to explore the role of age-friendly care environment. A fixed effects model was used to test the service provision effects of LTC insurance policy. RESULTS: Disabled elderly with LTC insurance had a higher proportion of their preventive health care and spiritual comfort needs met. Additionally, a multifactorial analysis found a significant positive association between LTC insurance and meeting the spiritual comfort needs. Compared with insured group (Ningbo city), disabled elderly people in Hangzhou urban area (OR=0.45, 95%CI:0.27-0.74, P<0.01) and Quzhou rural area (OR=0.21, 95%CI:0.12-0.37, P<0.01) were more likely to feel unsatisfied with spiritual comfort. The results of mediation analysis showed that the scores of accessibility guarantee environment (OR=1.22, 95%CI:1.02-1.45, P<0.05), information dissemination environment (OR=1.19, 95%CI:1.02-1.39, P<0.05), and social participation environment (OR=1.40, 95%CI:1.17-1.67, P<0.01) in a socially friendly care environment were positively correlated with the satisfaction rate of mental comfort services. The results of the moderation effect analysis indicated that a socially friendly care environment (OR=1.46, 95%CI:1.16-1.84, P<0.01) could compensate for the difference in effectiveness between insured (Ningbo) and uninsured (Hangzhou and Quzhou) areas of LTC insurance. A fixed effect model confirmed the policy chain of LTC insurance policy-social friendly care environment-mental health service satisfaction. CONCLUSIONS The implementation of LTC insurance has improved service accessibility, making disabled elderly people feel "seen and valued", and generating psychological and spiritual satisfaction. Accelerating the establishment and improvement of the LTC insurance system requires systematic design, especially emphasizing the supportive role of a socially friendly care environment, and promoting it in urban and rural areas according to the local conditions.
Humans ; Aged ; Persons with Disabilities ; Surveys and Questionnaires ; Long-Term Care ; Female ; Male ; China ; Social Environment ; Middle Aged ; Aged, 80 and over

Alzheimer's disease (AD) is characterized by cognitive and functional deterioration, with pathological features such as amyloid-beta (Aβ) aggregates in the extracellular spaces of parenchymal neurons and intracellular neurofibrillary tangles formed by the hyperphosphorylation of tau protein. Despite a thorough investigation, current treatments targeting the reduction of Aβ production, promotion of its clearance, and inhibition of tau protein phosphorylation and aggregation have not met clinical expectations, posing a substantial obstacle in the development of drugs for AD. Recently, artificial intelligence (AI), computational biology (CB), and systems biology (SB) have emerged as promising methodologies in AD research. Their capacity to analyze extensive and varied datasets facilitates the identification of intricate patterns, thereby enriching our comprehension of AD pathology. This paper provides a comprehensive examination of the utilization of AI, CB, and SB in the diagnosis of AD, including the use of imaging omics for early detection, drug discovery methods such as lecanemab, and complementary therapies like phototherapy. This review offers novel perspectives and potential avenues for further research in the realm of translational AD studies.

Objective:To develop a training content framework for hospice volunteers based on the competency model.Methods:This was a qualitative study. A draft of the training content framwork for hospice volunteers was first formed according to results of literature review and qualitative interviews based on the competency model. From December 2023 to March 2024, two rounds of Delphi consultation with 16 experts were conducted to develop the final version of the system, and the weights of each indicator were determined with analytic hierarchy process.Results:Among the 14 consulting experts who completed two rounds of consultation, including 10 females, all held intermediate or above professional titles, and their working years ranged from 10 to 34 years, covering fields of hospice care, nursing management, clinical nursing and nursing education. In two rounds of consultation the expert positive coefficient was 14/16 and 14/14, the expert authority coefficient was 0.882 and 0.893, and the Kendall coordination coefficient of all indicators was 0.109 and 0.161 ( P<0.01), the coefficient of variation was 0-0.31 and 0-0.19, respectively. The final version of the system consisted of 3 first-level indicators, 7 second-level indicators, 20 third-level indicators, and 55 specific training contents. The three first-level indicators were knowledge, skill, role and value, and the weight coefficients were 0.335, 0.313 and 0.352, respectively. Each judgment matrix was consistent. Conclusions:A training content system for hospice care volunteers has been developed in this study, which may be used for medical institutions and organizations to train hospice care volunteers.

Objective Evaluate the effects of different solvent extracts from Jujing Pills on improving retinal damage in kidney Yang deficiency aging mice and explore the underlying mechanism.Methods A composite modeling method of subcutaneous injection of D-galactose and hind limb injection of hydrocortisone was used to establish a kidney Yang deficiency type aging mouse model,and various solvent extract of Jujing Pills were given for intervention treatment.The improvement effect of different solvent extracts of Jujing Pills on aging mice with kidney Yang deficiency was evaluated by observing physical signs,measuring serum oxidative stress marker levels,and cyclic nucleotide levels.Optical coherence tomography(OCT)was used to detect the condition of the mouse retina,HE staining was used to detect the degree of retinal cell damage,TUNEL staining was used to detect retinal cell apoptosis,assay kit was used to detect oxidative stress factor expression,enzyme-linked immunosorbent assay was used to detect the expression of ciliary neurotrophic factor(CNTF),brain-derived neurotrophic factor(BDNF),and nerve growth factor(NGF)in the mouse eyeball,and Western blotting(WB)was used to quantitatively analyze the expression levels of apoptosis and neurotrophic pathway related proteins in the mouse retina tissue.Results Compared with the control group,the model group mice showed slow weight gain,reduced activity,decreased expression of antioxidant factors such as superoxide dismutase(SOD)and glutathione(GSH)in serum(P<0.01),and decreased cAMP/cGMP ratio(P<0.01).Different solvent extracts of Jujing Pills significantly increased the expression of antioxidant factors such as SOD and GSH(P<0.05),reduced the production of oxidative product malondialdehyde(MDA)(P<0.01),and increased the cAMP/cGMP ratio(P<0.01);Significantly increased the retinal thickness of model mice(P<0.01),improved retinal damage and inhibited retinal cell apoptosis(P<0.01),and significantly downregulated the ratio expression levels of Cleaved Caspase-3 and Caspase-3(P<0.01);The expression of CNTF,BDNF,and NGF was upregulated by water extracted medicinal residue alcohol extract,water extracted alcohol sediment,and total extract(P<0.01).The phosphorylation levels of CREB and ERK in the eyeball were significantly upregulated by water extracted medicinal residue alcohol extract and total extract(P<0.05).Conclusion Different solvent extracts of Jujing Pills can exert different pharmacological effects on improving retinal damage in aging mice with kidney yang deficiency model.Its mechanism of action is related to improving retinal apoptosis caused by oxidative stress and increasing the expression of nutritional factors.

Objective:To develop a training content framework for hospice volunteers based on the competency model.Methods:This was a qualitative study. A draft of the training content framwork for hospice volunteers was first formed according to results of literature review and qualitative interviews based on the competency model. From December 2023 to March 2024, two rounds of Delphi consultation with 16 experts were conducted to develop the final version of the system, and the weights of each indicator were determined with analytic hierarchy process.Results:Among the 14 consulting experts who completed two rounds of consultation, including 10 females, all held intermediate or above professional titles, and their working years ranged from 10 to 34 years, covering fields of hospice care, nursing management, clinical nursing and nursing education. In two rounds of consultation the expert positive coefficient was 14/16 and 14/14, the expert authority coefficient was 0.882 and 0.893, and the Kendall coordination coefficient of all indicators was 0.109 and 0.161 ( P<0.01), the coefficient of variation was 0-0.31 and 0-0.19, respectively. The final version of the system consisted of 3 first-level indicators, 7 second-level indicators, 20 third-level indicators, and 55 specific training contents. The three first-level indicators were knowledge, skill, role and value, and the weight coefficients were 0.335, 0.313 and 0.352, respectively. Each judgment matrix was consistent. Conclusions:A training content system for hospice care volunteers has been developed in this study, which may be used for medical institutions and organizations to train hospice care volunteers.

Objective Evaluate the effects of different solvent extracts from Jujing Pills on improving retinal damage in kidney Yang deficiency aging mice and explore the underlying mechanism.Methods A composite modeling method of subcutaneous injection of D-galactose and hind limb injection of hydrocortisone was used to establish a kidney Yang deficiency type aging mouse model,and various solvent extract of Jujing Pills were given for intervention treatment.The improvement effect of different solvent extracts of Jujing Pills on aging mice with kidney Yang deficiency was evaluated by observing physical signs,measuring serum oxidative stress marker levels,and cyclic nucleotide levels.Optical coherence tomography(OCT)was used to detect the condition of the mouse retina,HE staining was used to detect the degree of retinal cell damage,TUNEL staining was used to detect retinal cell apoptosis,assay kit was used to detect oxidative stress factor expression,enzyme-linked immunosorbent assay was used to detect the expression of ciliary neurotrophic factor(CNTF),brain-derived neurotrophic factor(BDNF),and nerve growth factor(NGF)in the mouse eyeball,and Western blotting(WB)was used to quantitatively analyze the expression levels of apoptosis and neurotrophic pathway related proteins in the mouse retina tissue.Results Compared with the control group,the model group mice showed slow weight gain,reduced activity,decreased expression of antioxidant factors such as superoxide dismutase(SOD)and glutathione(GSH)in serum(P<0.01),and decreased cAMP/cGMP ratio(P<0.01).Different solvent extracts of Jujing Pills significantly increased the expression of antioxidant factors such as SOD and GSH(P<0.05),reduced the production of oxidative product malondialdehyde(MDA)(P<0.01),and increased the cAMP/cGMP ratio(P<0.01);Significantly increased the retinal thickness of model mice(P<0.01),improved retinal damage and inhibited retinal cell apoptosis(P<0.01),and significantly downregulated the ratio expression levels of Cleaved Caspase-3 and Caspase-3(P<0.01);The expression of CNTF,BDNF,and NGF was upregulated by water extracted medicinal residue alcohol extract,water extracted alcohol sediment,and total extract(P<0.01).The phosphorylation levels of CREB and ERK in the eyeball were significantly upregulated by water extracted medicinal residue alcohol extract and total extract(P<0.05).Conclusion Different solvent extracts of Jujing Pills can exert different pharmacological effects on improving retinal damage in aging mice with kidney yang deficiency model.Its mechanism of action is related to improving retinal apoptosis caused by oxidative stress and increasing the expression of nutritional factors.

OBJECTIVE To optimize the deproteinization process of Isatidis Radix polysaccharides and further explore its immu-nomodulatory activity,and to provide a scientific basis for the development and utilization of it.METHODS The optimum conditions of enzymatic deproteinization were optimized by a single factor combined with the Box-Behnken response surface method.The chemical composition and structural characteristics of deproteinized Isatidis Radix polysaccharides were analyzed by UV-visible spectrum,Fourier transform-infrared spectroscopy,high-performance gel permeation chromatography,high-performance liquid chromatography and scan-ning electron microscopy.The effects of deproteinized Isatidis Radix Polysaccharide on neutrophils,macrophages,IL-1β and IL-6 in zebrafish were investigated by using a zebrafish immunocompromised model.RESULTS The optimal enzymatic deproteinization process was as follows:trypsin 500 U·mL-1,pH 8.0,enzymatic hydrolysis time 5 h,enzymatic hydrolysis temperature 37℃.The deproteinization rate was(86.39±0.07)%,and the comprehensive score was(91.15±0.37)%.Ultraviolet,infrared spectroscopy scanning and scanning electron microscopy showed that the protein contained in the crude polysaccharide could be removed by enzymat-ic method.The relative molecular weight of the polysaccharides were between 5.82 and 60.26 kDa.The monosaccharide mole compo-sition was mannose ∶ rhamnose ∶ galacturonic acid ∶ glucose ∶ galactose ∶ arabinose=2.17 ∶ 0.96 ∶ 2.90 ∶ 83.25 ∶ 4.88 ∶ 5.84.The results of immune activity evaluation showed that when the concentration of deproteinized Radix Isatidis polysaccharides was 50～300 μg·mL-1,it could significantly increase the density of zebrafish immune cells,increase the number of macrophages,and reduce the content of IL-1β and IL-6 in immunocompromised zebrafish,thus exerting immunomodulatory effects.CONCLUAION The enzy-matic method can effectively remove the proteins contained in the crude polysaccharides of Isatidis Radix,and the deproteinized Isatidis Radix polysaccharides have certain immunomodulatory effects.