Objective:Mild cognitive impairment(MCI)is characterized by its heterogeneity in pathology, clinical outcomes, and the degree of cognitive impairment.This study aims to identify distinct subtypes of MCI and examine their associated risk of progression to Alzheimer's disease(AD).Methods:Four cognitive domains—memory, language, attention/executive function, and visuospatial ability—were evaluated using seven neuropsychological tests.K-means cluster analysis was employed to categorize MCI into distinct subtypes.Kaplan-Meier survival analysis and Cox regression were utilized to estimate the median survival time and the risk of progression to AD for each subtype, with cognitively normal(CN)individuals at baseline serving as the control group.Only participants with a minimum of two follow-up visits were included in this analysis.Results:A total of 1, 020 subjects with baseline MCI were included in the study, with an age range of 60 to 90 years and a mean age of 73.6 years.Among these subjects, 40.5% were female, and the mean length of education was 16.0 years.The MCI subtypes were classified based on their characteristics as follows: amnestic(n=485), mixed(n=147), and derived normal(n=388).The mixed subtype performed poorly across all neuropsychological tests, particularly demonstrating significantly worse results than the other two subtypes in attention/executive ability and visuospatial functioning.The amnestic subtype primarily exhibited deficits in the memory cognition dimension, while the derived normal subtype scored poorly on the delayed recall aspect of memory cognition.For the survival analysis, a total of 1, 427 subjects were included, with a mean follow-up duration of 50 months.The proportions of subjects who progressed to AD during follow-up were 48.8% for amnestic MCI, 60.0% for mixed MCI, 16.0% for derived normal MCI, and 6.4% for CN individuals at baseline.The mean time to conversion to AD was 29.1 months for amnestic MCI, 19.6 months for mixed MCI, 53.6 months for derived normal MCI, and 85.9 months for CN subjects.There were statistically significant differences in survival time among the subtypes( P<0.001), with the mixed subtype exhibiting the shortest median survival time and the highest risk of progression to AD( HR=20.0, 95% CI: 13.0-30.8).In contrast, the derived normal subtype had the longest survival time and the lowest risk of progression to AD( HR=2.7, 95% CI: 1.7-4.1). Conclusions:MCI subtypes exhibit significant heterogeneity regarding cognitive impairment, progression risk, and time to AD.Individuals with mixed MCI demonstrate the shortest progression time and the highest risk of transitioning to AD.Consequently, early prevention and intervention strategies for AD should prioritize this particular subgroup.

Objective:Mild cognitive impairment(MCI)is characterized by its heterogeneity in pathology, clinical outcomes, and the degree of cognitive impairment.This study aims to identify distinct subtypes of MCI and examine their associated risk of progression to Alzheimer's disease(AD).Methods:Four cognitive domains—memory, language, attention/executive function, and visuospatial ability—were evaluated using seven neuropsychological tests.K-means cluster analysis was employed to categorize MCI into distinct subtypes.Kaplan-Meier survival analysis and Cox regression were utilized to estimate the median survival time and the risk of progression to AD for each subtype, with cognitively normal(CN)individuals at baseline serving as the control group.Only participants with a minimum of two follow-up visits were included in this analysis.Results:A total of 1, 020 subjects with baseline MCI were included in the study, with an age range of 60 to 90 years and a mean age of 73.6 years.Among these subjects, 40.5% were female, and the mean length of education was 16.0 years.The MCI subtypes were classified based on their characteristics as follows: amnestic(n=485), mixed(n=147), and derived normal(n=388).The mixed subtype performed poorly across all neuropsychological tests, particularly demonstrating significantly worse results than the other two subtypes in attention/executive ability and visuospatial functioning.The amnestic subtype primarily exhibited deficits in the memory cognition dimension, while the derived normal subtype scored poorly on the delayed recall aspect of memory cognition.For the survival analysis, a total of 1, 427 subjects were included, with a mean follow-up duration of 50 months.The proportions of subjects who progressed to AD during follow-up were 48.8% for amnestic MCI, 60.0% for mixed MCI, 16.0% for derived normal MCI, and 6.4% for CN individuals at baseline.The mean time to conversion to AD was 29.1 months for amnestic MCI, 19.6 months for mixed MCI, 53.6 months for derived normal MCI, and 85.9 months for CN subjects.There were statistically significant differences in survival time among the subtypes( P<0.001), with the mixed subtype exhibiting the shortest median survival time and the highest risk of progression to AD( HR=20.0, 95% CI: 13.0-30.8).In contrast, the derived normal subtype had the longest survival time and the lowest risk of progression to AD( HR=2.7, 95% CI: 1.7-4.1). Conclusions:MCI subtypes exhibit significant heterogeneity regarding cognitive impairment, progression risk, and time to AD.Individuals with mixed MCI demonstrate the shortest progression time and the highest risk of transitioning to AD.Consequently, early prevention and intervention strategies for AD should prioritize this particular subgroup.

Mild cognitive impairment(MCI)is a prodromal phase of dementia with heterogeneity in etiology, clinical presentation, disease progression, outcome, and prognosis.The number of studies on MCI subtypes is increasing each year.This article discussed the subtypes of MCI from the perspectives of phenotypic characteristics, etiology, progression, outcome, and data-driven approaches, and further summarizes the epidemiological characteristics, influencing factors, and risk of progression to dementia of each subtype.Despite the increasing number of studies on MCI subtyping, research remains limited on the correlation between MCI subtypes from different perspectives, indicating a need for further investigation in order to achieve more accurate and effective diagnosis and treatment of MCI and obtain evidence for dementia prevention.

Objective: To analyze the trend change of the drowning mortality among children and adolescents in Chongqing, 2012-2021, and to provide suggestion for drowning prevention and control. Methods: Drowning death cases (ICD-10:W65.0-W74.9) among children and adolescents in Chongqing from 2012 to 2021 were derived from Chongqing death registration system. The difference of the drowning mortality between male and female, urban and rural area were compared by Chi square test. The trend change of the drowning mortality between 2012 and 2021 was analyzed by annual percent change( APC ). Results: The mortality and ASMR of drowning among children and adolescents decreased from 9.57/10 5, 9.42/10 5 in 2012 to 2.80/10 5, 2.83/10 5 in 2021 significantly( t=10.93, 10.52, P <0.01). And its APC were -13.15% and 13.06% respectively. The drowning mortality in male was higher than that in female( P <0.05). The drowning mortality in rural area was higher than that in urban area( P <0.05). The mortality of drowning among children aged between 0 and 4 years old, 5 and 9 years old, 10 and 14 years old decreased by 15.30 %,17.80% and 11.40%( APC =-15.30%, -17.80%, -11.40%, t=11.11, 9.22, 5.62, P <0.05). The proportion of drowning in natural water field among children and adolescents accounted for about 80%. Conclusion The mortality of drowning among children and adolescents in Chongqing decreases rapidly. Vulnerable population of drowning includes boys, rural children and adolescents, and children age of 0-14 years old. Comprehensive prevention for drowning should be carried out continuously.

Objective: To understand and compare the differences in help-seeking behavior among junior high school students and senior high school students and their association with non-suicidal self-injury to provide a basis for the prevention and control of non-suicidal self-injury among middle school students. Methods: Three middle schools in Nanchang were selected,and the survey were conducted among 4 434 students through the General Situation Questionnaire, the Ottawa Self-injury Judgment Entry, and the Middle School Students Help Seeking Behavior Questionnaire, and SPSS 22.0 was used for statistical analysis. Results: The NSSI detection rate among middle school students was 33.3% , and junior high school students detection rate(36.0%) were higher than high school students(29.6%) (χ 2=19.41，P<0.01). Differences in willingness to ask for help, asking for help from family and teachers, and talking face-to-face for help were statistically significant (all P<0.01) among NSSI participants and non-NSSI participants, for both junior high school and high school students. Females (OR=1.45), class cadres (OR=1.26), urban household registration (OR=1.45), frequent scolding by elders (OR=1.98) and a high academic burden (OR=1.39) all possible increased the risk of NSSI in junior high school students, while assistance to family members (OR=0.95) or teachers (OR=0.95) possible reduced the risk of NSSI in junior high school students. Females (OR=1.50), class cadres (OR=1.34), only children (OR=1.45), fathers with college education and above (compared to junior high school and below) (OR=1.56), frequent scolding by elders (OR=2.08), frequent corporal punishment from elders (OR=4.12) and high academic burden (OR=1.38) possibly increased the risk of NSSI among high school students, while willingness to ask for help (OR=0.82), asking for help from family (OR=0.95) and teachers (OR=0.96) possible reduced the risk of NSSI among high school students. Conclusion There are some differences in help-seeking behavior between junior and high school students, and school and parents should actively focus on middle school students help-seeking behavior and encourage them to seek help.