BackgroundBipolar disorder is a severe mental disorder characterized by alternating episodes of mania and depression. It has a high recurrence rate and a high rate of disability. Elderly patients often suffer from more severe cognitive impairment due to neurodegenerative changes. The clinical intervention for bipolar disorder mainly relies on drug treatment， but drugs have limited effects on improving cognitive function， and some drugs may even aggravate cognitive impairment. Aerobic exercise， as a non-drug intervention method， has shown positive effects in improving cognitive function in patients with mental disorders. However， there are still insufficient studies on elderly patients with bipolar disorder. ObjectiveTo explore the impact of aerobic exercise on the cognitive function of elderly patients with bipolar disorder， so as to provide references for the formulation of strategies to improve the cognitive function of this population. MethodsA randomized controlled trial was conducted. A total of 60 elderly patients who were hospitalized at the Third People's Hospital of Lanzhou from January 2024 to March 2025 and met the diagnostic criteria for bipolar disorder as defined in the International Classification of Diseases，tenth edition （ICD-10） were selected. They were divided into the study group and the control group， with 30 cases in each group， based on the random number table method. Both groups were given quetiapine fumarate tablets and magnesium valproate sustained-release tablets. The study group additionally received aerobic exercise （including slow walking， doing exercises， and running）， three times a week， for 30 minutes each time. At the baseline and at the end of the 3^rd， 6^th， 9^th， and 12^th week of the intervention， the Hamilton Depression Scale -24 item （HAMD-24）， the Young Manic Rating Scale （YMRS）， the Montreal Cognitive Assessment （MoCA）， and Wechsler Adult Intelligence Scale Revised in China （WMS-RC） were used for assessment. ResultsThe time effect of the HAMD-24 score was statistically significant （Wald χ²=124.564， P<0.01）. The time effect of the YMRS score was also statistically significant （Wald χ²=145.608， P<0.01）， and the interaction effect between time and group was statistically significant （Wald χ²=14.968， P<0.05）. At the 3^rd， 9^th， and 12^th week of the intervention， the YMRS score of the study group was lower than that of the control group in the same period， and the differences were statistically significant （P<0.05）. The time effect and group effect of the MoCA score were both statistically significant （F=99.347， 16.623， P<0.01）. The time effect， group effect， and interaction effect between time and group of the WMS-RC memory quotient were all statistically significant （F=64.678， 10.197， 12.472， P<0.01）. At the 6^th， 9^th， and 12^th weeks of the intervention， the MoCA score and WMS-RC memory quotient of the study group were higher than those of the control group， and the differences were statistically significant （P<0.05）. ConclusionAerobic exercise may help improve the manic symptoms and cognitive functions （especially memory ability） of elderly patients with bipolar disorder. ［Funded by Science and Technology Project of Gansu Province （number， 24JRRA775）； Science and Technology Project of Lanzhou City（number， 2022-5-155）］

BackgroundNon-suicidal self-injury （NSSI） behavior is highly prevalent during adolescence. Previous studies have mainly focused on the relationship between NSSI behavior and emotional regulation， pain perception， reward mechanisms， and impulsivity. However， the cognitive mechanisms underlying the occurrence and maintenance of NSSI behavior have not been sufficiently explored. Adolescence is a critical period for the development of cognitive control. However， it remains unclear whether adolescents with depressive disorder accompanied by NSSI behavior have abnormal cognitive control. ObjectiveTo reveal the potential deficits in cognitive control among adolescents with depressive disorder accompanied by NSSI behavior. MethodsThis study was a case-control study including 166 adolescent patients who visited the Third People's Hospital of Lanzhou from November 2024 to May 2025 and met the diagnostic criteria for depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. According to whether they had NSSI behavior or not， patients were divided into the NSSI group （n=86） and the non-NSSI group （n=80）. At the same time， healthy adolescents who passed mental health screenings in five public middle schools in the northwest region were selected as the control group （n=71）. All participants completed the color-word Stroop task， and the accuracy rates and reaction time in congruent and incongruent conditions of each group were recorded， and the interference effect based on accuracy rates and reaction time was calculated. ResultsIn terms of accuracy rate， the main effect of trial type was statistically significant （F=46.900， P<0.01， ηp²=0.160）， and the interaction effect between group and trial type was also statistically significant （F=3.390， P=0.035， ηp²=0.028）. In terms of reaction time， the main effect of trial type was statistically significant （F=72.020， P<0.01， ηp²=0.240）， and the interaction effect between group and trial type was also statistically significant （F=6.400， P=0.002， ηp²=0.050）. Simple effect analysis revealed that under both congruent and incongruent conditions， the reaction time of the NSSI group was longer than those of the non-NSSI group and the control group， and the reaction time of the non-NSSI group was also longer than that of the control group （P<0.01）. There were statistically significant differences in the interference effects among three groups based on reaction time （H=10.231， P=0.006）. The interference effect in the NSSI group was higher than that in the control group （Z=3.012， P_adj=0.008） and the non-NSSI group （Z=2.453， P_adj=0.043）. There was no statistically significant difference in the interference effect among the three groups based on accuracy rate （H=5.666， P=0.059）. ConclusionAdolescents with depressive disorder accompanied by NSSI behavior exhibit cognitive control deficits beyond depressive symptoms， particularly showing impaired conflict suppression ability. ［Funded by Lanzhou Municipal Health Industry Scientific Research Project （number，A2026019）］

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective: To analyze the features of unhealthy lifestyle patterns among primary and secondary school students in the nutrition improvement program for rural compulsory education students (NIPRCES) areas in China in 2021 and 2023, so as to provide data support for lifestyle promotion and healthy development among primary and secondary school students. Methods: Adopting a cluster random sampling method, data on primary and secondary students aged 7-15 years from nutrition and health surveillance of China NIPRCES in 2021 and 2023 were collected. The prevalence of unhealthy lifestyles among primary and secondary students such as physical inactivity, outdoor inactivity, excessive screen time, and sleep deprivation by gender, school section, urban/rural, and region were analyzed. The reporting rates of the above indicators among primary and secondary students were compared by Chi-square test. Results: In 2021 and 2023, the rates of moderate to vigorous physical inactivity among primary and secondary school students were 79.2% and 80.4%, the rates of outdoor inactivity were 42.8% and 49.3%, the rates of excessive video time were 2.6% and 2.9%, the rates of sleep deprivation were 32.9% and 22.6%, and the differences were statistically significant( χ 2=51.86,1 071.48,18.36,3 296.99, P <0.05). In 2023, the rate of outdoor inactivity for primary and secondary students increased by 6.5 percentage points compared with 2021, and the rate of sleep deprivation decreased by 10.3 percentage points compared with that in 2021. In 2021 and 2023, the reporting rates of moderate to vigorous physical inactivity, outdoor inactivity, and sleep deprivation among girls and junior high school students were higher than those among boys ( χ 2=174.41,180.11; 175.75, 85.46 ;92.22,151.35) and elementary school students ( χ 2=136.64,5.75; 40.55,4.71;162.80,3 291.61); the reporting rates of moderate to vigorous physical inactivity( χ 2=194.43,118.60) and sleep deprivation ( χ 2=969.66,983.72) among urban students were higher than those among rural students; the reporting rates of excessive video time for boys and junior high school students were higher than those for girls ( χ 2=103.62,84.85) and elementary school students ( χ 2=810.09,626.51)( P <0.05). From a regional distribution perspective, the reporting rates of moderato to vigorous physical inactivity, outdoor inactivity, and excessive video time among primary and seconday school students in the central and western regions were lower than those in the eastern region ( χ 2= 663.44,302.78; 356.97,82.10;50.89,81.83) ( P <0.05). Conclusions Unhealthy lifestyles remain prevalent among primary and secondary students in NIPRCES areas of China. These findings underscore the need to strengthen policy implementation for promoting healthy lifestyles among primary and secondary school students.

Objective: To understand the prevalence of elevated blood pressure and its association with dietary patterns in children and adolescents in China, providing evidence for developing dietary intervention of hypertension in children and adolescents. Methods: Data were derived from the China Children s Nutrition and Health System Survey and Application Project(2019-2021). A stratified cluster random sampling method was used to include 7 933 participants from 28 survey sites in seven major regions of Northeast, North, Northwest, East, Central, South and Southwest China. Multivariate Logistic regression models were used to analyze associations between demographic characteristics, nutritional status and elevated blood pressure. Exploratory factor analysis identified dietary patterns, which were divided into three quartile groups (T3, T2, T1) based on factor scores (compliance for dietary pattern) from high to low, and multivariate Logistic regression model assessed the correlation between elevated blood pressure and dietary patterns. Results: The prevalence of elevated blood pressure was 15.4% among Chinese children aged 7-17 years. Significant differences were observed across nutritional status (reference: underweight; normal weight: OR =1.57; overweight: OR = 2.61 ; obesity: OR =3.85), urban/rural residence (reference: rural; urban: OR =0.86), and paternal education (reference: junior high school and below; bachelor degree or above: OR =0.68) ( P <0.05). The detection rates of high blood pressure in T3 group children and adolescents with four dietary patterns (staple food, animal based food, snacks, vegetables and fruits) were 15.7%, 14.6%, 16.8%, and 15.8%, respectively. After adjusting for residence, paternal education, and nutritional status, the "snack dietary pattern" (mainly candy, sugar sweetened beverages, and processed snacks) showed positive associations with elevated blood pressure in T2 ( OR =1.21) and T3 ( OR =1.19) tertiles ( P <0.05). Conclusions The snack dietary pattern is a related factor for elevated blood pressure in children and adolescents. Restricting unhealthy snack intake may promote cardiovascular health.

Objective To analyze the burden and epidemic trends of gastric cancer in China from 1990 to 2021, and to provide a scientific basis for the formulation of effective prevention and control strategies. Methods　Data from the 2021 Global Burden of Disease (GBD) database were used to extract the number of the incidence, prevalence, and death cases, as well as the disability-adjusted life years (DALY) for gastric cancer in China from 1990 to 2021. The corresponding crude rates and age-standardized rates were calculated. The Joinpoint regression model was employed to analyze the trends in the burden of gastric cancer, and a comprehensive examination was conducted from multiple dimensions including age, gender, and time. Results From 1990 to 2021, the age-standardized incidence rate (ASIR) of gastric cancer in China decreased from 48.03 per 100,000 to 29.05 per 100,000, the age-standardized prevalence rate (ASPR) decreased from 67.17 per 100,000 to 57.23 per 100,000, the age-standardized mortality rate (ASMR) decreased from 46.05 per 100,000 to 21.51 per 100,000, and the age-standardized DALY rate (ASDR) decreased from 1181.61 per 100,000 to 501.26 per 100,000. The AAPCs of ASIR, ASPR, ASMR, and ASDR were -1.61%, -0.50%, -2.44%, and -2.75%, respectively. The incidence, prevalence, mortality and DALY rates showed a trend of increasing first and then decreasing with age. Although females had higher incidence, prevalence, mortality, and DALY numbers in the older age groups, males exhibited higher crude rates across all age groups. Conclusion　The overall disease burden of gastric cancer in China showed a downward trend from 1990 to 2021, and men and middle-aged and elderly people are the key populations for prevention and control efforts.

Ethanol (EtOH) is a common trigger for gastric mucosal diseases, and mitigating oxidative stress is essential for attenuating gastric mucosal damage. Capsaicin (CAP) has been identified as a potential agent to counteract oxidative damage in the gastric mucosa; however, its precise mechanism remains unclear. This study demonstrates that CAP alleviates EtOH-induced gastric mucosal injuries through two primary pathways: by suppressing the chemokine receptor 4 (CCR4)/Src/p47phox axis, thereby reducing oxidative stress, and by inhibiting the phosphorylation and nuclear translocation of nuclear factor-κB p65 (NF-κB) p65, resulting in diminished inflammatory responses. These findings elucidate the mechanistic pathways of CAP and provide a theoretical foundation for its potential therapeutic application in the treatment of gastric mucosal injuries.
Ethanol/toxicity* ; Animals ; Gastric Mucosa/metabolism* ; Signal Transduction/drug effects* ; Oxidative Stress/drug effects* ; Capsaicin/pharmacology* ; Male ; NADPH Oxidases/genetics* ; Mice ; Humans ; src-Family Kinases/genetics*

Chronic non-healing wounds significantly impair patient rehabilitation and remain a critical clinical challenge. Stem cell-derived exosomes, owing to their biocompatibility and physiological activity, have emerged as a promising therapeutic approach in regenerative medicine. Beyond their intrinsic wound-healing properties, exosomes are increasingly explored as carriers for small-molecule drugs to enhance synergistic treatment effects. Although microRNAs (miRNAs) exhibit potential in promoting cell proliferation and re-epithelialization, their clinical application is hindered by poor stability. In this study, we investigated the therapeutic effects of miR-132-3p-loaded human umbilical mesenchymal stem cell-derived exosomes (miR-132-3p@UMSC-EXOs) on human foreskin fibroblast-1 (HFF-1). Our findings demonstrated that miR-132-3p@UMSC-EXOs significantly enhanced proliferation and migration of HFF-1, while reducing intracellular reactive oxygen species (ROS) levels compared with unloaded exosomes. Furthermore, qRT-PCR and Western blotting analyses revealed that miR-132-3p@UMSC-EXOs modulated the expression of genes associated with extracellular matrix (ECM) remodeling and inflammation, suggesting their potential to upregulate collagen synthesis and improve ECM metabolism. These results highlight the therapeutic promise of miR-132-3p@UMSC-EXOs in accelerating wound healing.
Humans ; MicroRNAs/pharmacology* ; Exosomes/metabolism* ; Mesenchymal Stem Cells/cytology* ; Wound Healing ; Umbilical Cord/cytology* ; Cell Proliferation ; Fibroblasts/cytology* ; Skin/injuries* ; Cell Movement ; Reactive Oxygen Species/metabolism* ; Cells, Cultured

Obesity, as a chronic recurrent disease, has become a major public health challenge in China. To implement the requirements of the Healthy China Initiative (2019—2030), under domestic guidelines or consensus statements on overweight and obesity, and in alignment with the latest scientific advances globally, the Quality control protocol for adult overweight and obesity screening in health management (examination) institutions (2025 edition) was developed. This protocol was drafted by the Health Management Center of Shanghai Changzheng Hospital and formulated through multiple rounds of deliberation by experts in China’s health examination quality control field. The protocol establishes unified standards for screening facilities, personnel qualifications, and measurement or testing procedures. It defines specific screening items, outlines a standardized screening pathway, and sets requirements for the final medical review, ensuring the scientific validity, effectiveness, and safety of the screening process. The implementation of this protocol will enhance the consistency of weight management practices for adults across health examination institutions and strengthen the quality control of overweight and obesity screening programs.