Objective Observational studies have shown an association between Parkinson disease （PD） and mental illness， but further studies are needed to explore the causal relationship between them. This study aims to investigate such causal relationship using the method of two-sample Mendelian randomization （MR）. Methods Related data were extracted from GWAS， and summary statistics associated with PD， depression， sleep disorders， and anxiety phenotype-variants were obtained. Single nucleotide polymorphisms （SNPs） for PD were selected as instrumental variables， and MR-PRESSO was used to exclude outliers. Inverse variance weighting was used as the main method to assess causal effect estimates， and MR Egger， weighted median， simple mode， and weighted mode were used to verify the robustness of the findings. A sensitivity analysis was used to validate the reliability of the results， including the Cochran Q test， the MR-Egger intercept test， funnel plots， and the leave-one-out method. Results A total of 21 SNPs associated with PD were identified. The MR analysis showed that PD had a causal relationship with depression （OR=0.974，95%CI 0.934‒1.015， P=0.210）， sleep disorders （OR=1.056， 95%CI 0.970-1.149， P=0.211）， and anxiety （OR=0.998， 95%CI 0.996‒1.001， P=0.118）， with no statistical significance. Different MR analyses and sensitivity analyses showed that PD did not directly contribute to the development of mental illness. Conclusion There is no direct causal relationship between PD and depression/sleep disorders/anxiety. In clinical practice， healthcare professionals should pay attention to the mental health of patients with PD. Randomized controlled studies should be conducted in the future to further validate the results of this study.
Depression ; Anxiety

Objective To investigate the effect of tetrandrine tablets on inflammatory cytokines and acute phase response following the first-dose of zoledronic acid in postmenopausal osteoporosis patients. Methods 80 postmenopausal osteoporosis patients receiving the first-dose of zoledronic acid admitted in the Affliated Xuzhou Municipal Hospital of Xuzhou Medical University from June, 2022 to December, 2024 were selected as study objects, and the patients were randomly divided into control group （40 cases, prophylactic treatment with acetaminophen tablets） and study group （40 cases, prophylactic treatment with tetrandrine tablets and acetaminophen tablets）. The high-sensitivity C-reactive protein （hs-CRP）, interleukin-1β （IL-1β）, IL-6, tumor necrosis factor-α （TNF-α） and the occurrence of acute phase reactions （fever, muscle and joint pain, gastrointestinal discomfort） between two groups were compared. Results The levels of serum hs-CRP, IL-1β, IL-6, and TNF-α in both groups significantly increased on day 1 and day 3 after infusion of zoledronic acid （all P values <0.05）. The levels of serum hs-CRP, IL-6, and TNF-α in the control group were higher than those in the study group on day 1 and 3 after infusion of zoledronic acid, with statistical significance （all P values <0.05）. In terms of acute phase reactions, the incidence of fever, muscle and joint pain in the control group after infusion of zoledronic acid were higher than those in the study group, with statistical significance （P<0.05）. No statistically significant difference in the incidence of gastrointestinal discomfort between the two groups （P>0.05）. Conclusion Tetrandrine tablets could reduce the expression levels of hs-CRP, IL-1β, IL-6, and TNF-α following the first-dose of zoledronic acid in postmenopausal osteoporosis patients, reduce the incidence of acute phase reactions, and alleviate adverse reactions.

Objective: To analyze the characteristics and key risk factors of abnormal blood disposal throughout the 2024-2025 blood collection and supply process based on nationwide multi-site monitoring data, develop a comprehensive prevention and control strategy across the entire chain, reduce preventable blood waste, and ensure clinical blood safety. Methods: According to the Guidelines for Haemovigilance (T/CSBT 001-2026), we extracted 74 cases of abnormal blood disposal events reported by the China Blood Transfusion Association′s Blood Safety Monitoring System from January 1 2024, to December 31 2025, and conducted descriptive statistical analysis on the distribution of events, types of deviations, root causes, and classifications of disposal manifestations. Results: A total of 664 adverse events related to blood collection and supply were reported over two years, with 74 cases involving discarded abnormal blood units, accounting for 11.1% of the total. Among these, blood component preparation (40.5%) and blood collection (37.8%) remained traditional high-risk stages. The proportion of blood waste occurring during storage, distribution, and transportation increased from 7.7% in 2024 to 34.3% in 2025. Deviations from standard operating procedures (SOP) by personnel were the primary cause, accounting for 74.3% of cases. Discarded blood units were categorized into four types: compromised closed blood bag systems (40 cases), mainly due to inadequate heat sealing, physical damage, or dropped bags; blood out of the cold chain (12 cases), primarily resulting from blood being left at work sites; imbalanced proportion of preservation solution (10 cases), mostly caused by blood collection volumes exceeding the standard capacity of blood bags; and other causes (12 cases). Conclusion: Human operational errors are the core cause of abnormal blood waste. The collection and preparation stages have long been at high-risk, and the risks in the storage and transportation stages have been increasing year by year. We should focus on standardizing personnel management, improving specialized operation norms such as heat sealing, transportation, and storage, establishing a full-process intelligent cold chain monitoring and multi-node visual verification mechanism, and systematically reducing the occurrence rate of abnormal blood waste through a closed-loop quality intervention system, thereby improving the utilization efficiency of voluntary blood donation resources.

As a key treatment method for end-stage liver diseases, long-term efficacy of liver transplantation is limited by rejection and serious complications such as liver and kidney toxicity, infection risks and tumor recurrence caused by immunosuppressive drugs. In recent years, nanotechnology, with its targeted delivery capabilities and spatio-temporal controlled release characteristics, has demonstrated great potential in precisely regulating immune responses. This article systematically reviews the multi-level application strategies and mechanisms of nanomedicine in the immunoreprogramming of liver transplantation, covering innate immunoreprogramming (phenotypic transformation of Kupffer cells or macrophages, inhibition of inflammasomes and mitochondrial repair), adaptive immune remodeling (targeted regulation of dendritic cells, gene silencing vectors and reprogramming of T cell functions), and elaborates on the strategies for coordinated regulation of the microenvironment. The article also focuses on the targeted application of liver sinusoidal endothelial cells. In response to clinical translation bottlenecks, innovative solutions such as the design of degradable polymer carriers, the construction of intelligent response systems and the optimization of large-scale production pathways are proposed, providing theoretical support and practical directions for achieving the paradigm shift from "global immunosuppression" to "precise immune tolerance".

" Mutual recognition and sharing of medical examination and test results in Zhejiang Province" (MRZJ) holds significant value in rationally utilizing healthcare resources, reducing patient costs, streamlining treatment procedures, and enhancing patient satisfaction. This study reviewed the development of medical test result mutual recognition in China and summarized the implementation of MRZJ at Zhejiang Provincial People′s Hospital. Since its launched in October 2021, the hospital had achieved interoperability through enhanced organizational leadership, standardized coding, process optimization, capacity building, quality control reinforcement, and public awareness campaigns. By March 2024, MRZJ covered all outpatient departments of the pilot hospital, with 936 items recognized daily, improving healthcare efficiency and generating notable social and economic benefits. These outcomes provided references for advancing nationwide medical test mutual recognition. Future efforts should focused on strengthening standardized training, refining performance evaluation mechanisms, developing MRZJ early warning functions, and safeguarding patients′ informed consent and choice rights.

Objective To conduct a scoping review of the application of gamification programs in exercise rehabilitation for knee osteoarthritis,examining the application carriers,game content,outcome indicators,measurement tools,and application effects of gamification programs,to provide references for future practice and related research in this field.Methods The search was conducted in PubMed,Web of Science,Cochrane Library,Scopus,CIN AHL,China National Knowledge Infrastructure,CNKI,and Wanfang Data from their inception to December 28,2024.The included studies were summarized and analyzed.Results A total of 28 studies were included in the review.The game carriers encompassed virtual reality technology,sensor devices,and mobile applications.The game content covered interactive motion games,aerobic exercises,and goal-motivated games.Outcome indicators included functional performance,physical activity,pain,psychological and health status,and user experience.Gamification programs were found to effectively enhance user engagement,improve physical function,reduce negative emotions,and improve quality of life.However,there remains controversy regarding their efficacy in pain relief.Conclusion Gamification programs have shown positive effects in exercise rehabilitation for knee osteoarthritis.Future efforts should focus on developing gamification programs that are culturally appropriate for China,creating"digital therapeutics",continuously updating systems,conducting economic evaluations,and ensuring digital equity to enhance patients'rehabilitation experiences and improve health outcomes.

Objective:To investigate the efficacy of pelvic floor neuromuscular stimulation combined with progesterone in the treatment of pelvic floor function recovery after hysterectomy.Methods:This study used a randomized controlled design, involving 108 patients with pelvic floor dysfunction who underwent hysterectomy at Shaanxi Provincial People's Hospital between January 2021 and December 2023. These patients were randomly assigned to either a control group or an observation group, with 54 patients in each group, using a random number table for allocation. Both groups received basic pelvic floor muscle training. The control group was treated solely with progesterone vaginal soft capsules, while the observation group also received neuromuscular stimulation through pelvic rehabilitation equipment. Before and after treatment, changes in muscle strength (measured by electromyography values of type I and type II muscle fibers), quality of life (assessed using the Pelvic Floor Dysfunction Index Questionnaire-7 and the Pelvic Floor Distress Inventory-Short Form 20), pelvic relaxation indicators (levels of laminin, relaxin, and transforming growth factor beta-3), and Pelvic Organ Prolapse Quantification staging were compared between the two groups. Additionally, stress urinary incontinence, lumbosacral pain, sexual satisfaction, vaginal prolapse conditions, and overall efficacy post-treatment were compared between the two groups.Results:After treatment, electromyography values for type I and type II muscle fibers in the observation group were (4.71 ± 0.61) μA and (5.63 ± 0.79) μA, respectively, which were significantly higher than those in the control group [(3.51 ± 0.53) μA, (4.53 ± 0.50) μA, t = -10.91, -8.65, both P < 0.001]. The scores for the Pelvic Floor Dysfunction Index Questionnaire-7 and Pelvic Floor Distress Inventory-Short Form 20 in the observation group were (4.56 ± 0.64) and (4.56 ± 0.64), respectively, both of which were significantly lower than those in the control group [(5.36 ± 0.70), (5.36 ± 0.70), t = 6.20, 26.74, both P < 0.001]. The levels of laminin, relaxin, and transforming growth factor beta-3 in the observation group were (27.28 ± 3.00) μg/L, (53.32 ± 6.40) μg/L, and (28.25 ± 3.67) mg/L, respectively, all of which were significantly lower than those in the control group [(32.14 ± 3.54) μg/L, (59.22 ± 6.51) μg/L, (36.25 ± 3.99) mg/L, t = 7.70, 4.75, 10.84, all P < 0.001]. The proportion of patients in the observation group with a POP-Q stage of 0 was 90.74% (49/54), which was significantly higher than that in the control group [68.52% (37/54), χ2=8.22, P < 0.05]. The proportion in the observation group with a stage of 1 was 7.41% (4/54), which was significantly lower than that in the control group [25.93% (14/54), χ2 = 6.67, P < 0.05]. The incidence rates of stress urinary incontinence, lumbosacral pain, sexual dissatisfaction, and vaginal prolapse in the observation group were all significantly lower than those in the control group ( χ2 = 4.41, 4.36, 4.70, 4.41, all P < 0.05). The overall effective rate in the observation group was 92.59% (50/54), which was significantly higher than that in the control group [74.07% (40/54), χ2 = 6.67, P < 0.05]. Conclusions:Pelvic floor neuromuscular stimulation combined with progesterone vaginal soft capsules can improve muscle strength in patients with pelvic floor dysfunction after hysterectomy, enhance life satisfaction, relieve pelvic relaxation, and promote comprehensive recovery of pelvic function.

Objective:To find out about the sentiment about the current physical training among Air Force pilots (cadets), propose methods for optimizing their programs of physical training, and to enhance the effectiveness of training in order to improve flight adaptability.Methods:A total of 1 135 pilots (cadets) were randomly selected as the subjects and divided into 3 groups according to types of aircraft and types of personnel: group A (pilots of fighters, bombers and advanced trainers), group B (pilots of fighter bombers, transporters, helicopters, special aircraft and junior trainers), and group C (flying cadets). A questionnaire survey was conducted to collect data on current physical training among pilots and flying cadets.Results:A total of 1 135 questionnaires were distributed, with 1 086 valid responses collected, yielding an effective response rate of 95.68%. Of the 1 086 participating pilots (cadets), 209 were in Group A, 499 in Group B, and 378 in Group C.There was statistically significant difference in the frequency and duration of weekly physical training between the 3 groups ( χ2=82.23, 61.56, both P<0.001). The proportion of participants engaging in >3 h weekly physical training sessions was significantly higher in group C (71.7%) than in group A (38.8%) and group B (44.9%). Significant differences were observed in weekly training durations between group C and group A (all P<0.05), as well as between group C and group B in the training durations of <3 h and 5-7 h (all P<0.05). The percentage of subjects who trained for 5-7 h per week was the highest in group C (41.5%). In groups A and B, pilots mostly trained for 3-<5 h per week (51.7% and 39.9%, respectively). The survey on the willingness to adjust training programs revealed statistically significant differences between the 3 groups in their willingness to engage in muscle strength training, coordination training, specific ability training, and adjustment of intensities of core training ( H=46.23, 16.12, 22.03, 60.68, all P<0.001). No significant difference was observed in their willingness to have aerobic training programs adjusted ( P>0.05). Group C was significantly different from groups A and B in their preference for adjustment in training programs related to muscle strength, coordination, specific abilities, and in core training programs (all P<0.01). Group C was mostly in favor of "increasing" muscle strength, coordination, and core training while opting for "no change" in aerobic training and specific ability training. Groups A and B preferred "no change". Regarding their willingness to have training intensities revised, statistically significant differences were observed between the 3 groups ( H=15.58, 19.08, 8.17, 58.01, P<0.001, <0.001, =0.017, <0.001), but no significant difference was found in their preference for adjustment of aerobic training intensities ( P>0.05). Group C showed much more preference for intensity adjustment related to muscle strength, coordination, specific abilities, and core training programs than groups A and B (all P<0.05 or 0.01). All the 3 groups predominantly favored "no change" in training intensities. Conclusions:Pilots of different aircraft types generally meet the requirements of the current physical training programs. However, the frequency of physical training for pilots (cadets) requires more rigorous supervision. Flying cadets can adaptively engage in targeted training programs. Pilots of fighters, fighter bombers and advanced trainers should care about the intensity of aerobic training while giving more weight to load resistance physical training. Pilots of other types of aircraft should devote more effort to core training programs.

BACKGROUND:There are few studies on the effect of different patellar morphologies on the outcome after unicompartmental knee arthroplasty.OBJECTIVE:To investigate the effect of different patellar morphologies on functional recovery and patellofemoral joint alignment after unicompartmental knee arthroplasty based on patellar Wiberg classification.METHODS:A retrospective study was conducted in 186 patients with medial knee osteoarthritis who underwent unicompartmental knee arthroplasty at Affiliated Hospital of Xuzhou Medical University between January 2022 and March 2023.Patients were categorized into group A(type Ⅰ,n=43),group B(typeⅡ,n=104),and group C(type Ⅲ,n=39)according to the Wiberg classification.The Hospital for Specia Surgery knee score,Feller score,and incidence of anterior knee pain,as well as radiologic data(patellar index,patellar tilt angle,and lateral patellofemoral angle)were compared among the three groups.RESULTS AND CONCLUSION:(1)There was no significant difference in the Feller patellar score and Hospital for Specia Surgery score at the final postoperative follow-up in patients with Wiberg type Ⅰ,type Ⅱ,and type Ⅲ patellae(P＞0.05).(2)Although there was no significant difference in the incidence of anterior knee pain among the three groups at the final follow-up,patients with type Ⅲ patellae were significantly more likely to have experienced anterior knee pain early in the postoperative period.(3)Different patellar morphologies can improve patellar position to some extent after unicompartmental knee arthroplasty,but type Ⅲ had greater patellar tilt than types Ⅰ and Ⅱ,both preoperatively and postoperatively.(4)This finding highlights the need for tailored morphological adjustments to the Wiberg Ⅲ patella during unicompartmental knee arthroplasty to improve surgical outcomes.

Objective: To investigate the nutritional status and influencing factors among Tibetan and Mongolian children and adolescents aged 7-18 years in high-altitude regions, so as to provide evidence for early prevention and control of malnutrition in this population. Methods: From May to June 2022, a cluster sampling method was employed to recruit 1 019 Tibetan and Mongolian children and adolescents aged 7-18 years from two primary and secondary schools in Golmud City. Physical examinations, dietary frequency questionnaires, and physical activity assessments were conducted. Nutritional status was classified as obesity, combined overweight/obesity, underweight, or central obesity according to national standards including Screening for Overweight and Obesity among School-age Children and Adolescents, Screening Standard for Malnutrition of School-age Children and Adolescents, Blue Book on Obesity Prevention and Control in China. Chi-square tests, t-test and Logistic regression analyses were performed to identify factors associated with different nutritional statuses. Results: The detection rates of obesity, combined overweight/obesity, underweight, and central obesity were 8.0%, 18.1%, 5.2%, and 19.7%, respectively. The height of children and adolescents across all age groups was generally lower than the national standard values. Tibetan participants exhibited significantly lower height-for-age Z-scores (HAZ)(9-10, 13-17 years, Z =2.01, 2.78, 4.16, 3.38, 4.12, 3.63, 3.00) and BMI-for-age Z-scores (BAZ) compared to Mongolian participants ( Z =-2.95, -2.47, -2.31, -2.89, -2.14, -2.17)( P < 0.05 ). Multivariate Logistic regression revealed that Mongolian children and adolescents had higher risks of obesity ( OR =2.20) and combined overweight/obesity ( OR = 2.18 ) ( P <0.05). Additionally, insufficient moderate-to-vigorous physical activity (MVPA) was associated with an increased risk of central obesity ( OR =1.48, P <0.05), compared with children and adolescents who meet the standard of MVPA. Conclusions The rates of overweight and obesity among Tibetan and Mongolian children and adolescents in Golmud City are higher, influenced by multiple factors. Nutrition interventions and physical activity strategies tailored to ethnic characteristics should be implemented, with emphasis on promoting MVPA to improve nutritional outcomes in this population.