Objective:This study examines the impact of integrated healthcare and elderly care policy pilots on paid work among older adults.Methods:Using CHARLS panel data(2013-2020),we employed a difference-in-differences(DID)model to assess the policy effects.Results:The results indicate a 10.3%average increase in paid work among older adults in pilot areas.Mechanism analysis reveals that health status mediated this effect,while social security exhibited a suppression effect.The policy significantly increased participation in agricultural work,non-agricultural employment,and self-employed farming but reduced participation in hired agricultural labor.Heterogeneity analysis shows stronger effects in rural and central-western regions.Conclusion and Suggestions:The integrated care policy effectively promotes older adults'paid work engagement.We recommend strengthening service systems,implementing phased benefit improvements with work incentives,expanding pilot coverage in rural and central-western regions,and fostering health-labor policy coordination.

Aim To investigate the effect of dihydro-myricetin(DMY)on Ang Ⅱ-induced cardiac hypertro-phy in mice and the underlying mechanisms.Methods Fifty mice were randomly divided into control group,Ang Ⅱ group,Ang Ⅱ+catopril 12.0 mg·kg-1·d-1 group,AngⅡ+DMY 100 mg·kg-1·d-1 group,and Ang Ⅱ+DMY 200 mg·kg-1·d-1 group,with 10 mice in each group.The control mice were given saline by gavage,the drug intervention group was given DMY,and the positive drug group was given captopril;the mice in all groups except the control group were in-jected subcutaneously with Ang Ⅱ 1.0mg·kg-1·d-1.After four weeks,heart weight/body weight(HW/BW)and left ventricular weight/body weight(LVW/BW)ratios were calculated.The mRNA ex-pression of the fetal genes atrial natriuretic factor(ANF),brain natriuretic peptide(BNP),β-myosin heavy chain(β-MHC),adenosine triphosphate 5β-subunit(ATP 5β)and uncoupling protein 2(UCP2)were monitored,and the morphological changes of car-diac tissue were observed.Secondly,the creatine ki-nase isoenzyme(CK-MB),lactate dehydrogenase(LDH),free fatty acids(FFA)and lactic acid in ser-um were investigated.Lastly,the expression of AMP-activated proteinkinase(AMPK),peroxisome prolifer-ator-activated receptor alpha(PPAR-α)and T-cell nu-clear factor cytoplasmic 4(NFATc4)protein expres-sion were also detected.The Ang Ⅱ-induced H9C2 cardiomyocyte hypertrophy model was established and treated with the AMPK inhibitor compound C.The mRNA of ANF,BNP,β-MHC and the protein expres-sion of AMPK/PPAR-α were analyzed.Results DMY intervention significantly reduced HW/BW and LVW/BW in mice,fetal genes ANF,BNP,β-MHC and UCP2 mRNA expression decreased,whereas ATP 5 β mRNA increased,and the degree of hypertrophy of cardiomyocytes was alleviated.In addition,the serum levels of CK-MB,LDH,FFA and lactic acid were re-duced in DMY treated groups.Finally,DMY upregu-lated the protein expression of P-AMPK,AMPK and PPAR-α,and downregulated protein expression of NFATc4.In the Ang Ⅱ-induced cardiomyocyte hyper-trophy model,DMY pretreatment reduced the mRNA expression of fetal genes(ANF,BNP,β-MHC).However,when AMPK was inhibited by compound C,the expression of these fetal genes rebounded,accom-panied by decreased protein levels of AMPK and PPAR-α.Conclusions DMY can improve Ang Ⅱ-in-duced myocardial hypertrophy in mice by ameliorating disorders of glycolipid metabolism and increasing ener-gy supply to cardiomyocytes,and its mechanism is re-lated to the activation of the AMPK/PPAR-α pathway and the inhibition of NFATc4 expression.

Ferroptosis is a programmed cell death depends on iron and lipid peroxidation,which has been recognized as the key pathogenic factor for the occurrence of various diseases in recent years,especially playing a significant role in neurodegenerative diseases.Ferroptosis triggers lipid peroxidation and oxidative stress in neuronal cells,leading to neuronal damage and death,thereby accelerating disease progression.Hydrogen sulfide,as an endogenous gaseous signaling molecule,exhibits multiple protective effects,including anti-inflammatory,antioxidant,and anti-ferroptosis properties.Hydrogen sulfide can effectively inhibit the occurrence of ferroptosis through various mechanisms,such as regulating iron metabolism,inhibiting lipid peroxidation,and enhancing the activity of antioxidant enzymes,thereby slowing down the progression of neurodegenerative diseases.This article reviews the related research progress on hydrogen sulfide and ferroptosis and ferroptosis-mediated neurodegenerative diseases,and analyzes the underlying mechanisms,aims to provide new insights and theoretical foundations for the treatment of neurodegenerative diseases.

Aim To investigate the effect of dihydro-myricetin(DMY)on Ang Ⅱ-induced cardiac hypertro-phy in mice and the underlying mechanisms.Methods Fifty mice were randomly divided into control group,Ang Ⅱ group,Ang Ⅱ+catopril 12.0 mg·kg-1·d-1 group,AngⅡ+DMY 100 mg·kg-1·d-1 group,and Ang Ⅱ+DMY 200 mg·kg-1·d-1 group,with 10 mice in each group.The control mice were given saline by gavage,the drug intervention group was given DMY,and the positive drug group was given captopril;the mice in all groups except the control group were in-jected subcutaneously with Ang Ⅱ 1.0mg·kg-1·d-1.After four weeks,heart weight/body weight(HW/BW)and left ventricular weight/body weight(LVW/BW)ratios were calculated.The mRNA ex-pression of the fetal genes atrial natriuretic factor(ANF),brain natriuretic peptide(BNP),β-myosin heavy chain(β-MHC),adenosine triphosphate 5β-subunit(ATP 5β)and uncoupling protein 2(UCP2)were monitored,and the morphological changes of car-diac tissue were observed.Secondly,the creatine ki-nase isoenzyme(CK-MB),lactate dehydrogenase(LDH),free fatty acids(FFA)and lactic acid in ser-um were investigated.Lastly,the expression of AMP-activated proteinkinase(AMPK),peroxisome prolifer-ator-activated receptor alpha(PPAR-α)and T-cell nu-clear factor cytoplasmic 4(NFATc4)protein expres-sion were also detected.The Ang Ⅱ-induced H9C2 cardiomyocyte hypertrophy model was established and treated with the AMPK inhibitor compound C.The mRNA of ANF,BNP,β-MHC and the protein expres-sion of AMPK/PPAR-α were analyzed.Results DMY intervention significantly reduced HW/BW and LVW/BW in mice,fetal genes ANF,BNP,β-MHC and UCP2 mRNA expression decreased,whereas ATP 5 β mRNA increased,and the degree of hypertrophy of cardiomyocytes was alleviated.In addition,the serum levels of CK-MB,LDH,FFA and lactic acid were re-duced in DMY treated groups.Finally,DMY upregu-lated the protein expression of P-AMPK,AMPK and PPAR-α,and downregulated protein expression of NFATc4.In the Ang Ⅱ-induced cardiomyocyte hyper-trophy model,DMY pretreatment reduced the mRNA expression of fetal genes(ANF,BNP,β-MHC).However,when AMPK was inhibited by compound C,the expression of these fetal genes rebounded,accom-panied by decreased protein levels of AMPK and PPAR-α.Conclusions DMY can improve Ang Ⅱ-in-duced myocardial hypertrophy in mice by ameliorating disorders of glycolipid metabolism and increasing ener-gy supply to cardiomyocytes,and its mechanism is re-lated to the activation of the AMPK/PPAR-α pathway and the inhibition of NFATc4 expression.

Non-alcoholic fatty liver disease(NAFLD)is an increasingly serious chronic liver disease worldwide,with complex pathogenesis and many challenges in diagnosis and treatment.In recent years,genome-wide studies have revealed the important roles of epigenetic modifications in the development of NAFLD,especially the involvement of imprinted genes.The parental origin effect of NAFLD suggests that imprinted genes play a key role in its pathogenesis.The Dlk1-Dio3 gene cluster,as one of the largest clusters of imprinted genes,has become a focus of research because of its central role in embryonic devel-opment and metabolic regulation.This review explores the structure and function of the Dlk1-Dio3 gene cluster and its potential role in NAFLD pathogenesis.This gene cluster plays a key role in the"second strike"of NAFLD through a complex regulatory network that affects biological processes such as lipid me-tabolism,glucose metabolism,inflammatory response and oxidative stress in the liver.Specifically,DLK1 acts as a negative regulator,inhibiting adipocyte differentiation and thus reducing hepatic lipid ac-cumulation,while DIO3 promotes adipocyte differentiation and increases hepatic lipid accumulation by regulating thyroid hormone conversion.In addition,the Dlk1-Dio3 gene cluster regulates lipid metabolism by modulating multiple microRNAs(e.g.miR-370,miR-122,etc.).miR-370 exacerbates lipid accu-mulation by inhibiting CPT1α;miR-122 up-regulates SREBP-1c and promotes fatty acid synthesis;and miR-379/410 clusters increase lipid scavenging capacity by decreasing lipid accumulation.Long non-coding RNA MEG3 also plays an important role in NAFLD.meg3 promotes fatty acid oxidation and re-duces lipid droplet accumulation by up-regulating SIRT6,and attenuates lipid synthesis by inhibiting the Wnt/mTOR signaling pathway through binding to miR-21.In terms of insulin resistance,DLK1 inhibits gluconeogenesis and promotes fatty acid oxidation by activating the PI3K/Akt/mTOR pathway,thereby reducing hepatic lipid burden.DIO3,on the other hand,affects insulin sensitivity by regulating thyroid hormones and promotes the development of NAFLD.Meanwhile,the Dlk1-Dio3 gene cluster also plays an important role in regulating oxidative stress and inflammatory responses,and DLK1 attenuates hepatic oxi-dative stress injury by inhibiting inflammatory factor expression and activating antioxidant signaling.Taken together,the Dlk1-Dio3 gene cluster plays a multidimensional role in the occurrence and develop-ment of NAFLD,providing potential biomarkers and therapeutic targets.

Ferroptosis is a programmed cell death depends on iron and lipid peroxidation,which has been recognized as the key pathogenic factor for the occurrence of various diseases in recent years,especially playing a significant role in neurodegenerative diseases.Ferroptosis triggers lipid peroxidation and oxidative stress in neuronal cells,leading to neuronal damage and death,thereby accelerating disease progression.Hydrogen sulfide,as an endogenous gaseous signaling molecule,exhibits multiple protective effects,including anti-inflammatory,antioxidant,and anti-ferroptosis properties.Hydrogen sulfide can effectively inhibit the occurrence of ferroptosis through various mechanisms,such as regulating iron metabolism,inhibiting lipid peroxidation,and enhancing the activity of antioxidant enzymes,thereby slowing down the progression of neurodegenerative diseases.This article reviews the related research progress on hydrogen sulfide and ferroptosis and ferroptosis-mediated neurodegenerative diseases,and analyzes the underlying mechanisms,aims to provide new insights and theoretical foundations for the treatment of neurodegenerative diseases.

Objective: This study aimed to explore the correlation between balance function and core muscle activation in patients with adolescent idiopathic scoliosis (AIS), compared to healthy individuals. Methods: A total of 24 AIS patients and 25 healthy controls were recruited. The limits of stability (LOS) test were conducted to assess balance function, while surface electromyography was used to measure the activity of core muscles, including the internal oblique, external oblique, and multifidus. Diaphragm thickness was measured using ultrasound during different postural tasks. Center of pressure (COP) displacement and trunk inclination distance were also recorded during the LOS test. Results: AIS patients showed significantly greater activation of superficial core muscles, such as the internal and external oblique muscles, compared to the control group (p < 0.05). Diaphragm activation was lower in AIS patients during balance tasks (p < 0.01). Although no significant difference was observed in COP displacement between the groups, trunk inclination was significantly greater in the AIS group during certain tasks (p < 0.05). Conclusion These findings suggest distinct postural control patterns in AIS patients, highlighting the importance of targeted interventions to improve balance and core muscle function in this population.

Objective: This study aimed to explore the correlation between balance function and core muscle activation in patients with adolescent idiopathic scoliosis (AIS), compared to healthy individuals. Methods: A total of 24 AIS patients and 25 healthy controls were recruited. The limits of stability (LOS) test were conducted to assess balance function, while surface electromyography was used to measure the activity of core muscles, including the internal oblique, external oblique, and multifidus. Diaphragm thickness was measured using ultrasound during different postural tasks. Center of pressure (COP) displacement and trunk inclination distance were also recorded during the LOS test. Results: AIS patients showed significantly greater activation of superficial core muscles, such as the internal and external oblique muscles, compared to the control group (p < 0.05). Diaphragm activation was lower in AIS patients during balance tasks (p < 0.01). Although no significant difference was observed in COP displacement between the groups, trunk inclination was significantly greater in the AIS group during certain tasks (p < 0.05). Conclusion These findings suggest distinct postural control patterns in AIS patients, highlighting the importance of targeted interventions to improve balance and core muscle function in this population.

Objective: This study aimed to explore the correlation between balance function and core muscle activation in patients with adolescent idiopathic scoliosis (AIS), compared to healthy individuals. Methods: A total of 24 AIS patients and 25 healthy controls were recruited. The limits of stability (LOS) test were conducted to assess balance function, while surface electromyography was used to measure the activity of core muscles, including the internal oblique, external oblique, and multifidus. Diaphragm thickness was measured using ultrasound during different postural tasks. Center of pressure (COP) displacement and trunk inclination distance were also recorded during the LOS test. Results: AIS patients showed significantly greater activation of superficial core muscles, such as the internal and external oblique muscles, compared to the control group (p < 0.05). Diaphragm activation was lower in AIS patients during balance tasks (p < 0.01). Although no significant difference was observed in COP displacement between the groups, trunk inclination was significantly greater in the AIS group during certain tasks (p < 0.05). Conclusion These findings suggest distinct postural control patterns in AIS patients, highlighting the importance of targeted interventions to improve balance and core muscle function in this population.

Objective:To investigate the differences in clinical outcomes of septic children with varying serum zinc levels,and to analyze the relationship between reduced serum zinc levels and organ dysfunction as well as 28-day mortality in septic children.Methods:This study conducted a retrospective analysis of clinical data from pediatric patients diagnosed with sepsis or septic shock in the Department of critical care medicine of the children's Hospital of Soochow University between January 2017 and December 2022.Clinical characteristics,organ dysfunction,and prognosis were compared between two groups:children with low serum zinc levels and those with normal zinc levels.Results:The serum zinc level of septic children within 24 hours of admission was 9.60(5.52,13.80)μmol/L,with 50.54%(94/186)of the children exhibiting low serum zinc levels(<10.07 μmol/L).Compared to the normal serum zinc group,the low serum zinc group had a significantly lower Pediatric Critical Illness Score(PCIS)[(78.71±9.35)vs.(85.12±8.51),P=0.005]and higher 28-day mortality(46.80%vs.14.13%,P<0.001).The low serum zinc group also had a higher proportion of invasive mechanical ventilation(64.89%vs.47.82%,P=0.019),renal replacement therapy(15.59%vs.3.26%,P=0.003),and use of vasoactive drugs(56.38%vs.30.43%,P<0.001).The rate of underlying conditions in the low serum zinc group was significantly higher than that in the normal serum zinc group(57.44%vs.36.95%,P=0.005).Additionally,the low serum zinc group had a higher incidence of disseminated intravascular coagulation(DIC),respiratory failure,acute kidney injury,shock,and multiple organ dysfunction syndrome(MODS)compared to the normal serum zinc group(P<0.05).Serum zinc levels had predictive value for 28-day mortality in septic children(AUC=0.813;95%CI:0.725～0.902;P<0.001).A serum zinc level of less than 6.950 μmol/L predicted the death of septic children with a sensitivity of 0.618 and a specificity of 0.902.Conclusion:Sepsis in children is commonly associated with low serum zinc levels,especially in those with underlying conditions such as hematologic and oncologic disorders.Sepsis patients hypozincemia with a higher incidence of DIC,respiratory failure,acute kidney injury,shock,and MODS.A serum zinc level below 6.95 μmol/L serves as a significant predictor of 28-day mortality in children with severe sepsis.