Objective To construct and validate a risk prediction model for malnutrition in non-di-alysis patients with stages 3 to 5 chronic kidney disease(CKD)based on Logistic regression(LR)and XGBoost algorithms,and to compare the predictive performance between the two models.Methods A total of 506 CKD patients were enrolled as study subjects.According to chronological order,they were divided into training set(n=404)and test set(n=102)at the ratio of 8 to 2.The training set was divided into case group and control group based on whether they were malnourished,with 202 cases in each group.The LR and XGBoost models were established,and the model efficacy was evaluated through the area under the receiver operating characteristic(ROC)curve(AUC),sensitivity,speci-ficity,GiViTI calibration curve band and clinical decision curve.Results The LR model identified age ≥60 years,disease of stage 5,reduced appetite,hypoalbuminemia,low prealbumin,low mid-arm muscle circumference and high perceived stress as independent risk factors for malnutrition among non-dialysis CKD patients,while physical activity was identified as a protective factor(P＜0.05).In the XGBoost model,the top five influential variables were serum albumin,appetite,physical activity,prealbumin and mid-arm muscle circumference.The AUC of the LR and XGBoost models in the train-ing set were 0.930 and 0.947 respectively,and those in the test set were 0.925 and 0.933.The pre-dictive ability of the latter was slightly higher(P＞0.05).The GiViTI calibration curve bands all showed good calibration capability.Conclusion The XGBoost model combined with shapley additive explanation performs better in identifying malnourished patients and guiding precise care.

Objective:To systematically retrieve and summarize the best available evidence on aerobic exercise combined with resistance training in stroke patients.Methods:Using a structured computer-assisted search strategy based on the "6S" model, literature was retrieved top-down from clinical decision support systems, guideline databases, professional society websites, evidence-based databases, and comprehensive databases. The search included literature related to aerobic and resistance training in stroke patients, including clinical decision tools, guidelines, recommended practices, evidence summaries, systematic reviews, expert consensus documents, and randomized controlled trials (RCT) . The search was performed from the inception of each database to February 28, 2025. Two researchers independently screened the literature, assessed quality, and extracted and synthesized the evidence.Results:A total of 21 publications were included: nine guidelines, three systematic reviews, one expert consensus, and eight RCTs. A total of 32 best evidence statements were summarized across 12 dimensions: timing of training initiation, training methods, training modes, intensity formulation strategies, training dosage, rest intervals, progression principles, progression strategies, training effects, individualized modifications, safety, and adherence management.Conclusions:This study systematically identified and summarized best-practice evidence for aerobic and resistance training in stroke patients. The findings provide strong evidence-based support for developing tailored and effective exercise interventions in stroke rehabilitation.

Objective:To develop the Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus to provide community healthcare workers with an assessment tool to measure proactive health behaviors in a multidimensional manner.Methods:Guided by the information-motivation-behavioral skills theory, a test version of the Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus was developed through literature research, semi-structured interviews, Delphi expert consultation, and pre-survey. Convenience sampling was used to select 696 cases of type 2 diabetes mellitus high-risk people in the community of Lubei District, Tangshan City, from February to June 2024 for the item analysis, reliability and validity test. A total of 696 questionnaires were distributed and 664 valid questionnaires were recovered, with a valid recovery rate of 95.40%.Results:The Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus included four dimensions, including prevention knowledge, prevention motivation, prevention skills, and prevention behaviors, with a total of 38 items. Exploratory factor analysis extracted four common factors, with a cumulative variance contribution rate of 64.203%. Confirmatory factor analysis showed good model fit. The total Cronbach's α coefficient for the scale was 0.940, the half fold reliability coefficient was 0.964, and the test-retest reliability coefficient was 0.859.Conclusions:The Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus has good reliability and validity, which can be used to evaluate the proactive health behaviors in population at high-risk of type 2 diabetes mellitus.

Objective:To systematically retrieve and summarize the best available evidence on aerobic exercise combined with resistance training in stroke patients.Methods:Using a structured computer-assisted search strategy based on the "6S" model, literature was retrieved top-down from clinical decision support systems, guideline databases, professional society websites, evidence-based databases, and comprehensive databases. The search included literature related to aerobic and resistance training in stroke patients, including clinical decision tools, guidelines, recommended practices, evidence summaries, systematic reviews, expert consensus documents, and randomized controlled trials (RCT) . The search was performed from the inception of each database to February 28, 2025. Two researchers independently screened the literature, assessed quality, and extracted and synthesized the evidence.Results:A total of 21 publications were included: nine guidelines, three systematic reviews, one expert consensus, and eight RCTs. A total of 32 best evidence statements were summarized across 12 dimensions: timing of training initiation, training methods, training modes, intensity formulation strategies, training dosage, rest intervals, progression principles, progression strategies, training effects, individualized modifications, safety, and adherence management.Conclusions:This study systematically identified and summarized best-practice evidence for aerobic and resistance training in stroke patients. The findings provide strong evidence-based support for developing tailored and effective exercise interventions in stroke rehabilitation.

Objective:To develop the Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus to provide community healthcare workers with an assessment tool to measure proactive health behaviors in a multidimensional manner.Methods:Guided by the information-motivation-behavioral skills theory, a test version of the Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus was developed through literature research, semi-structured interviews, Delphi expert consultation, and pre-survey. Convenience sampling was used to select 696 cases of type 2 diabetes mellitus high-risk people in the community of Lubei District, Tangshan City, from February to June 2024 for the item analysis, reliability and validity test. A total of 696 questionnaires were distributed and 664 valid questionnaires were recovered, with a valid recovery rate of 95.40%.Results:The Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus included four dimensions, including prevention knowledge, prevention motivation, prevention skills, and prevention behaviors, with a total of 38 items. Exploratory factor analysis extracted four common factors, with a cumulative variance contribution rate of 64.203%. Confirmatory factor analysis showed good model fit. The total Cronbach's α coefficient for the scale was 0.940, the half fold reliability coefficient was 0.964, and the test-retest reliability coefficient was 0.859.Conclusions:The Proactive Health Behavior Scale for Population at High Risk of Type 2 Diabetes Mellitus has good reliability and validity, which can be used to evaluate the proactive health behaviors in population at high-risk of type 2 diabetes mellitus.

Objective:To explore the effect and correlation of long non-coding RNA (lncRNA) IDI2-AS1/microRNA-33b-5p (miR-33b-5p)/nuclear receptor-associated protein NR4A2 competitive endogenous RNA (ceRNA) regulatory network on acute myocardial infarction (AMI), and to verify whether IDI2-AS1 regulates NR4A2 through miR-33b-5p to affect the occurrence and development of myocardial infarction.Methods:The miRNA and mRNA expression chips related to myocardial infarction were obtained from gene expression omnibus (GEO), and the differential expression was analyzed. The upstream regulatory mechanism of NR4A2 was predicted using TargetScan database. Thirty-two male C57/BL6 mice were divided into Sham group, AMI model group, miR-33b-5p mimic group [miR-33b-5p mimic lentivirus (5×10 7 TU) was injected locally into the heart tissue during ligation] and miR-33b-5p inhibitor group [miR-33b-5p inhibitor lentivirus (5×10 7 TU) was injected locally into the heart tissue during ligation] according to random number table method, with 8 mice per group. Left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were asseessed by echocardiography, left ventricular fractional shortening (LVFS) and left ventricular ejection fraction (LVEF) were calculated. After the last weighing, the anesthetized mice were sacrificed and the heart tissues were taken. Masson staining of the heart tissues was observed under light microscope, myocardial collagen volume fraction (CVF) and infarct size were calculated. Cardiomyocytes of SPF grade SD rats were collected. They were divided into normal control group (control group), ischemia-hypoxia model group, miR-33b-5p mimic transfection group (miR-33b-5p mimic transfection group before ischemia and hypoxia treatment) and miR-33b-5p inhibitor transfection group (miR-33b-5p inhibitor transfection group before ischemia and hypoxia treatment). The activity of caspase-3/7 in cardiomyocytes was measured. The levels of interleukins (IL-1β, IL-6) and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA). The levels of malondialdehyde (MDA), superoxide dismutase (SOD), creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB) and lactate dehydrogenase (LDH) were detected by colorimetry. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression of apoptosis-related proteins Bax and Bcl-2, cytochrome C (Cyt C) and IDI2-AS1/miR-33b-5p/NR4A2 regulatory axis genes. Results:The myocardial infarction microarray analysis showed that NR4A2 expression was significantly up-regulated in myocardial infarction, with predicted upstream regulatory mechanisms indicating its possible influence through the IDI2-AS1/miR-33b-5p/NR4A2 regulatory axis. Echocardiographic detection showed that compared with AMI model group and miR-33b-5p inhibitor group, LVEF and LVFS in the heart tissue of mice in miR-33b-5p mimic group were significantly increased, while the levels of LVEDD, LVESD, CK, CK-MB and LDH were significantly decreased, with statistical significance. Light microscope showed myocardial fibrosis and myocardial infarction in AMI model group and miR-33b-5p inhibitor group. In the miR-33b-5p mimic group, the degree of myocardial fibrosis was decreased and the myocardial infarction size was significantly reduced. Compared with AMI model group and miR-33b-5p inhibitor group, the levels of MDA, IL-1β, IL-6, TNF-α and the expressions of Bax and Cyt C in the heart tissue of mice in miR-33b-5p mimic group were significantly decreased, while the levels of SOD and Bcl-2 expression were significantly increased, and the differences were statistically significant. The expressions of IDI2-AS1 and NR4A2 in the heart tissue of mice in miR-33b-5p mimic group were significantly lower than those in AMI model group and miR-33b-5p inhibitor group [IDI2-AS1 (2 -ΔΔCt): 1.96±0.08 vs. 2.73±0.08, 3.10±0.05, NR4A2 (2 -ΔΔCt): 2.36±0.07 vs. 3.16±0.08, 3.80±0.08, all P < 0.01]. The expression of miR-33b-5p was significantly higher than that of AMI model group and miR-33b-5p inhibitor group (2 -ΔΔCt: 0.88±0.07 vs. 0.57±0.07, 0.23±0.01, both P < 0.01). The cell experiment results showed that the caspase-3/7 activity of rat neonatal cardiomyocytes in the miR-33b-5p mimic transfection group was significantly lower than that in the ischemia-hypoxia model group and the miR-33b-5p inhibitor transfection group, suggesting that miR-33b-5p can significantly reduce the apoptosis level of the ischemia-hypoxia model. The levels of peroxidation and inflammation indexes, important genes of apoptosis pathway and the expression of IDI2-AS1/miR-33b-5p/NR4A2 regulatory axis of rat neonatal cardiomyocytes in all groups were consistent with the above. Conclusion:IDI2-AS1 can regulate NR4A2 through miR-33b-5p, thus affecting the occurrence and development of AMI.

Objective:To explore the effect of variable priority cognitive-motor dual-task training in aged cognitive frailty patients with type 2 diabetes mellitus.Methods:From September 2022 to September 2023, a total of 108 aged cognitive frailty patients with type 2 diabetes mellitus were selected in the Department of Endocrinology of North China University of Science and Technology Affiliated Hospital as research subjects.The subjects were divided into three groups in the order of admission, with 36 people in each group.Three groups of patients were intervened for 8 weeks using variable priority cognitive-motor dual-task training (VP group), exercise combined cognitive intervention with sequential task (ST group), and endocrinology routine treatment and nursing (control group), respectively.The scores of mini-mental state examination(MMSE), frailty phenotype(FP) and Berg balance scale(BBS) were compared among the three groups before and after the intervention.Repeated measurement variance analysis was used to compare scale results by SPSS 22.0.Results:(1)The MMSE score of patients before and after intervention had significant interaction effect between time and groups ( F=69.929, P<0.05).The MMSE scores of the VP group and ST group after 8 weeks of intervention were higher than those before intervention and after 4 weeks of intervention, and the MMSE scores of the two groups after 4 weeks of intervention were also higher than those before intervention (all P<0.05).After 4 weeks and 8 weeks of intervention, the MMSE score of the VP group was higher than that of the ST group and the control group, and the MMSE score of the ST group was higher than that of the control group after 8 weeks of intervention(all P<0.05).(2)The FP score of patients before and after intervention had a significant interaction effect between time and groups ( F=46.425, P<0.05).The FP score of the VP group at 8 weeks of intervention (2.64±0.59) was lower than that after 4 weeks of intervention (3.28±0.51) and before intervention (3.56±0.61), and the FP score after 4 weeks of intervention was lower than before intervention (all P<0.05).The FP score of the ST group after 8 weeks of intervention (3.44±0.56) was lower than before the intervention (3.59±0.56) ( P<0.05); After 4 weeks of intervention, the FP score of the VP group was lower than that of the control group (3.36±0.54) ( P<0.05).After 8 weeks of intervention, the FP score of the VP group was lower than that of the ST group and the control group (3.39±0.55) (both P<0.05).(3)The FP score of patients before and after intervention had a significant interaction effect between time and groups ( F=135.791, P<0.05).The BBS scores of the VP group and ST group after 8 weeks of intervention were higher than those before and after 4 weeks of intervention, and the BBS scores after 4 weeks of intervention were also higher than those before intervention (all P<0.05).After 4 weeks of intervention, the BBS score of the VP group was higher than that of the control group ( P<0.05).After 8 weeks of intervention, the BBS score of the VP group was higher than that of the ST group and the control group, and the BBS score of the ST group was also higher than that of the control group (all P<0.05). Conclusion:The variable priority cognitive-motor dual-task training can improve the cognitive function, physical frailty and balance function in aged cognitive frailty patients with type 2 diabetes mellitus, and the intervention effect is better than that of exercise combined cognitive intervention with sequential task and endocrinology routine treatment and nursing.

Five universities with health policy and management ranked top level worldwide, including Harvard University, John Hopkins University, Stanford University, University of North Carolina at Chapel Hill and National University of Singapore were selected in our study. From above universities, we found that the curriculum of PHD students was focused on research concentration, methodology courses, and numerous elective courses. Hence, in China, the curriculum of PHD students should be improved with emphasis on course studying, management courses and highlighting curriculum content according to research area to enhance the quality of doctoral education.

Objective:To explore the clinical effect of Bobath manipulation combined with traditional Chinese medicine fumigation and intradermal acupuncture on shoulder hand syndrome(SHS) after stroke.Methods:From April 2017 to August 2019, 80 patients with SHS after stroke admitted to the People's Hospital of Deqing County were selected, and they were divided into control group and observation group according to the random digital table method, with 40 cases in each group.The control group was treated by Bobath therapy, and the observation group was treated by Bobath therapy combined with acupuncture(intradermal acupuncture) and traditional Chinese medicine fumigation.After 8 weeks of treatment, the ROM scale, FMA scale, BI scale and VAS scores were used to evaluate the improvement in the mobility of the shoulder and wrist joints, motor function of the upper limbs, quality of life and pain, and the clinical efficacy of the two groups was compared.Results:Compared with before treatment, the ROM scale score of all dimensions of shoulder and wrist mobility, FMA scale score and BI scale score of all patients after treatment increased significantly, and the VAS score decreased significantly, the differences were statistically significant(all P<0.05). Compared with the control group after treatment, the improvement of the indicators mentioned above of the observation group were better[shoulder joint flexion ROM score: (154.83±25.63)points vs.(133.82±22.03)points; shoulder joint abduction ROM score: (152.36±25.68)points vs.(133.35±19.96 )points; shoulder joint external rotation ROM score: (75.87±14.69)points vs.(60.82±16.57 )points; wrist joint palm flexion ROM score: (73.94±14.37)points vs.(57.37±9.47)points; wrist joint back extension ROM score: (60.83±7.61)points vs.(42.27±6.37 )points; FMA scale score: (45.74±6.82)points vs.(34.19±4.07)points; BI scale score: (70.36±12.09)points vs.(58.70±12.53)points; VAS score: (1.05±0.49)points vs.(3.37±1.14)points, t=3.703, 3.715, 3.257, 5.576, 7.964, 3.037, 8.746, 3.153, all P<0.05]. The total effective rate of the observation group was significantly higher than that of the control group[97.5%(39/40) vs.62.5%(25/40), χ 2=15.313, P<0.05)]. Conclusion:The combination of Bobath therapy with traditional Chinese medicine fumigation and intradermal acupuncture can improve the pain degree, joint mobility disorder, upper limb motor function and quality of life of SHS patients, the efficacy is better than single Bobath therapy.The clinical effect is accurate, and it is worthy of further promotion and application.

Based on participatory idea, we constructed a novelty model of participatory health edu-cation, which was based on participatory research as the module, participatory role-playing as the core mod-ule, participatory review as enhanced module (abbreviation to as "3-PR"). We applied it to pre-selected health officer health promotion activities, and randomized controlled trials were designed. The results showed that "3-PR" model of participatory health education might be more effective in promoting health literacy than conventional health education methods. "3-PR" health education model has the advantages of participation, practicality, fun and flexibility, integration and education, which has certain reference signifi-cance for exploring health education methods and improving the health of the whole people.