Objective:To investigate the possible mechanism of treadmill exercise(TR)in improving cognitive function of rats with chronic unpredictable mild stress(CUMS)by detecting pathological changes and the expression of sigma-1 receptor(SIR),endoplasmic reticulum stress-related proteins in hippocampus.Methods:30 SD rats were ran-domly allocated into control group(n=10),CUMS group(n=10)and CUMS exercise group(CUMS+TR,n=10).Subsequently,depressive model was established in rats of CUMS group and CUMS+TR group,meanwhile,CUMS+TR group rats were subjected to 4 weeks of moderate intensity treadmill exercise(20 m/min).After the CUMS and tread-mill exercise,the eight-arm radial maze test(RAM)was carried out to evaluate the learning-memory functions.Subse-quently,the pathological changes of neurons in the hippocampus of rats were measured by HE staining,the protein expression of the GRP78,IRE1,XBP1,CHOP,caspase-3 and SIR in the hippocampus were measured by Western blot.Results:Compared with the control group,the time of finishing the eight-arm radial maze prolonged and the num-ber of total memory errors increased(P＜0.05)in the RAM of the CUMS group rats.The morphology and structure of neurons in the hippocampus of CUMS group rats showed obvious pathological changes,the protein expression levels of GRP78,IRE1,XBP1,CHOP and caspase-3 significantly increased and SIR protein expression decreased(P＜0.05)in hippocampus in the CUMS group compared with the control group rats.4-week treadmill exercise significantly im-prove the learning and memory ability and pathological changes of neurons in hippocampus of CUMS+TR group rats.Compared with CUMS group rats,the protein expression levels of GRP78,IRE1,XBP1,CHOP and caspase-3 signifi-cantly decreased,the SIR expression in hippocampus significantly increased in the CUMS+TR group rats(P＜0.05).Conclusion:Treadmill exercise can improve cognitive impairment in CUMS rats,and its mechanism may be related to the up-regulation of SIR expression and the inhibition of ERS-mediated apoptosis pathway in hippocampus.

Objective To explore the clinical efficacy and safety of salbutamol sulfate combined with reduced glutathione in treating acute exacerbation of chronic obstructive pulmonary disease(COPD)in the elderly.Methods A total of 103 elderly patients with acute exacerbation of COPD who were admitted to the Qingpu Branch of Zhongshan Hospital,Fudan University from January 2020 to June 2022 were randomly assigned to three groups.Control group 1(34 cases)received nebulized normal saline treatment.Control group 2(34 cases)received conventional treatment(e.g.,oxygen therapy,anti-infection,expectorant therapy,etc.)plus reduced glutathione.Treatment group(35 cases)received additional salbutamol sulfate on the basis of the control group 2.The treatment course was 12 days.Lung function,inflammatory factors,COPD assessment test,(CAT)score,BODE index,cardiopulmonary oxygenation function,6-minute walk test(6MWT)distance,modified medical research council dyspnea scale(mMRC)score,St.George's respiratory questionnaire(SGRQ)score,acute exacerbation frequency within 2 years,and adverse reactions were recorded.Results After treatment,the forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),and FEV1/FVC ratio in the treatment group were significantly higher than those in the control groups,while procalcitonin(PCT)and C-reactive protein(CRP)levels in the treatment group were significantly lower than those in the control groups(P<0.05).The treatment group exhibited lower CAT scores and BODE indices,higher maximal oxygen uptake(VO2max),metabolic equivalent of task at peak exercise(METspk),and respiratory frequency at peak exercise(RFEspk),longer 6MWT distances,and lower mMRC and SGRQ scores as compared with the control groups(P<0.05).The frequency of acute exacerbation in the treatment group was lower than that in the control groups at 6 months,1 year,and 2 years after treatment(P<0.05).No significant differences in adverse reactions were observed among the three groups(P>0.05).Conclusion The combination of salbutamol sulfate and reduced glutathione can significantly improve lung function,reduce inflammation,enhance quality of life,decrease acute exacerbation frequency,and demonstrate good safety in elderly patients with acute exacerbation of COPD.

Objective:To systematically evaluate the efficacy and safety of nirsevimab in preventing respiratory syncytial virus (RSV) infection in infants.Methods:Randomized controlled trials (RCTs) of nirsevimab in the prevention of RSV infection in newborns and infants (≤ 2 years old) were collected by searching relevant databases at home and abroad (up to February 12, 2025). Subjects in the trial group received a single dose injection of nirsevimab, while those in the control group received placebo or no interventions, with an observation period of ≥150 days. The efficacy outcome indicators included the incidence of acute lower respiratory tract infections (LRTI), RSV-associated hospital visits, RSV-associated hospitalization, and severe RSV infection events. The safety outcome indicators were the occurrence of adverse events (AEs) after injection of nirsevimab. Quality of methodology was evaluated using bias risk assessment tool of Cochrane collaboration networks. Meta-analysis was performed using RevMan 5.4 software. The effect sizes were relative risk ( RR) and its 95% confidence interval ( CI). Results:A total of 4 RCTs and 11 051 subjects were entered in the analysis, including 6 032 subjects in the trial group and 5 019 in the control group. The results of meta-analysis showed that compared with the control group, the incidences of acute LRTI [4.94% (298/6 032) vs. 5.70% (286/5 019), RR=0.57, 95% CI: 0.41-0.81], RSV-associated hospital visits [1.85% (37/1 995) vs. 7.11% (71/998), RR=0.26, 95% CI: 0.18-0.38], RSV-associated hospitalization [0.31% (19/6 032) vs. 1.75% (88/5 019), RR=0.17, 95% CI: 0.07-0.43], and severe RSV infection events [0.10% (5/5 038) vs. 1.52% (69/4 523), RR=0.07, 95% CI: 0.03-0.17] in the trial group were significantly lower, and the differences were statistically significant (all P<0.001). The differences in incidences of AEs, grade ≥3 AEs, AEs of great concern, and death events in the 2 groups during the observation period were not significant (all P>0.05), and no nirsevimab-related death events occurred. Conclusion:Nirsevimab is effective in preventing RSV infection in infants and has a good safety profile.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective:To analyze the occurrence of metabolic dysfunction-associated fatty liver disease (MAFLD) and related inflammatory indicators in obstructive sleep apnea hypopnea syndrome (OSAHS) and explore the risk factors of MAFLD.Methods:A cross-sectional study. From January 2022 to October 2024,172 patients with sleep disorders were enrolled in the First Affiliated Hospital of Soochow University,including 38 patients with non-OSAHS,53 patients with mild OSAHS,37 patients with moderate OSAHS,and 44 patients with severe OSAHS. The occurrence of MAFLD was comprehensively judged from three aspects: metabolic dysfunction-associated fatty liver (MAFL),elevated liver enzymes,and liver fibrosis. The situation of MAFLD and the level of related inflammatory markers were compared among the four groups. Binary logistic regression was used to analyze the risk factors for MAFLD in OSAHS.Results:There were significant differences in the prevalence of MAFL,the percentage of elevated liver enzymes,and interleukin-6 and tumor necrosis factor-alpha levels among the four groups ( P<0.05). The differences of fibrosis-4 index and C-reactive protein among the four groups were not statistically significant ( P>0.05). Binary logistic regression showed that BMI,triglycerides,longest time of sleep apnea and tumor necrosis factor-alpha were the risk factors for MAFL ( P<0.05). BMI,glucose,and apnea-hypopnea index were the risk factors for elevated liver enzymes ( P<0.05). Conclusions:OSAHS is strongly associated with MAFLD,and the involvement of OSAHS in the occurrence and development of MAFLD may be related to obesity,lipid metabolism disorders,insulin resistance,inflammatory responses,and intermittent hypoxia.

Objective:To investigate the possible mechanism of treadmill exercise(TR)in improving cognitive function of rats with chronic unpredictable mild stress(CUMS)by detecting pathological changes and the expression of sigma-1 receptor(SIR),endoplasmic reticulum stress-related proteins in hippocampus.Methods:30 SD rats were ran-domly allocated into control group(n=10),CUMS group(n=10)and CUMS exercise group(CUMS+TR,n=10).Subsequently,depressive model was established in rats of CUMS group and CUMS+TR group,meanwhile,CUMS+TR group rats were subjected to 4 weeks of moderate intensity treadmill exercise(20 m/min).After the CUMS and tread-mill exercise,the eight-arm radial maze test(RAM)was carried out to evaluate the learning-memory functions.Subse-quently,the pathological changes of neurons in the hippocampus of rats were measured by HE staining,the protein expression of the GRP78,IRE1,XBP1,CHOP,caspase-3 and SIR in the hippocampus were measured by Western blot.Results:Compared with the control group,the time of finishing the eight-arm radial maze prolonged and the num-ber of total memory errors increased(P＜0.05)in the RAM of the CUMS group rats.The morphology and structure of neurons in the hippocampus of CUMS group rats showed obvious pathological changes,the protein expression levels of GRP78,IRE1,XBP1,CHOP and caspase-3 significantly increased and SIR protein expression decreased(P＜0.05)in hippocampus in the CUMS group compared with the control group rats.4-week treadmill exercise significantly im-prove the learning and memory ability and pathological changes of neurons in hippocampus of CUMS+TR group rats.Compared with CUMS group rats,the protein expression levels of GRP78,IRE1,XBP1,CHOP and caspase-3 signifi-cantly decreased,the SIR expression in hippocampus significantly increased in the CUMS+TR group rats(P＜0.05).Conclusion:Treadmill exercise can improve cognitive impairment in CUMS rats,and its mechanism may be related to the up-regulation of SIR expression and the inhibition of ERS-mediated apoptosis pathway in hippocampus.

Objective:To systematically evaluate the efficacy and safety of nirsevimab in preventing respiratory syncytial virus (RSV) infection in infants.Methods:Randomized controlled trials (RCTs) of nirsevimab in the prevention of RSV infection in newborns and infants (≤ 2 years old) were collected by searching relevant databases at home and abroad (up to February 12, 2025). Subjects in the trial group received a single dose injection of nirsevimab, while those in the control group received placebo or no interventions, with an observation period of ≥150 days. The efficacy outcome indicators included the incidence of acute lower respiratory tract infections (LRTI), RSV-associated hospital visits, RSV-associated hospitalization, and severe RSV infection events. The safety outcome indicators were the occurrence of adverse events (AEs) after injection of nirsevimab. Quality of methodology was evaluated using bias risk assessment tool of Cochrane collaboration networks. Meta-analysis was performed using RevMan 5.4 software. The effect sizes were relative risk ( RR) and its 95% confidence interval ( CI). Results:A total of 4 RCTs and 11 051 subjects were entered in the analysis, including 6 032 subjects in the trial group and 5 019 in the control group. The results of meta-analysis showed that compared with the control group, the incidences of acute LRTI [4.94% (298/6 032) vs. 5.70% (286/5 019), RR=0.57, 95% CI: 0.41-0.81], RSV-associated hospital visits [1.85% (37/1 995) vs. 7.11% (71/998), RR=0.26, 95% CI: 0.18-0.38], RSV-associated hospitalization [0.31% (19/6 032) vs. 1.75% (88/5 019), RR=0.17, 95% CI: 0.07-0.43], and severe RSV infection events [0.10% (5/5 038) vs. 1.52% (69/4 523), RR=0.07, 95% CI: 0.03-0.17] in the trial group were significantly lower, and the differences were statistically significant (all P<0.001). The differences in incidences of AEs, grade ≥3 AEs, AEs of great concern, and death events in the 2 groups during the observation period were not significant (all P>0.05), and no nirsevimab-related death events occurred. Conclusion:Nirsevimab is effective in preventing RSV infection in infants and has a good safety profile.

Objective:To analyze the occurrence of metabolic dysfunction-associated fatty liver disease (MAFLD) and related inflammatory indicators in obstructive sleep apnea hypopnea syndrome (OSAHS) and explore the risk factors of MAFLD.Methods:A cross-sectional study. From January 2022 to October 2024,172 patients with sleep disorders were enrolled in the First Affiliated Hospital of Soochow University,including 38 patients with non-OSAHS,53 patients with mild OSAHS,37 patients with moderate OSAHS,and 44 patients with severe OSAHS. The occurrence of MAFLD was comprehensively judged from three aspects: metabolic dysfunction-associated fatty liver (MAFL),elevated liver enzymes,and liver fibrosis. The situation of MAFLD and the level of related inflammatory markers were compared among the four groups. Binary logistic regression was used to analyze the risk factors for MAFLD in OSAHS.Results:There were significant differences in the prevalence of MAFL,the percentage of elevated liver enzymes,and interleukin-6 and tumor necrosis factor-alpha levels among the four groups ( P<0.05). The differences of fibrosis-4 index and C-reactive protein among the four groups were not statistically significant ( P>0.05). Binary logistic regression showed that BMI,triglycerides,longest time of sleep apnea and tumor necrosis factor-alpha were the risk factors for MAFL ( P<0.05). BMI,glucose,and apnea-hypopnea index were the risk factors for elevated liver enzymes ( P<0.05). Conclusions:OSAHS is strongly associated with MAFLD,and the involvement of OSAHS in the occurrence and development of MAFLD may be related to obesity,lipid metabolism disorders,insulin resistance,inflammatory responses,and intermittent hypoxia.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective: To predict the risk of cognitive decline among elderly patients with type 2 diabetes mellitus (T2DM), so as to provide insights into the early identification of cognitive decline in elderly patients with T2DM. Methods: The elderly patients with T2DM hospitalized in the Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University were selected as subjects. General information was collected by a questionnaire survey, including demographics and nutritional status, and cognitive decline was assessed using the frailty Phenotype Scale, the Montreal Cognitive Assessment and the Clinical Dementia Rating. Multivariable logistic regression model was used to analyze the influencing factors of cognitive decline among elderly patients with T2DM. A nomogram was established, and was verified with Bootstrap resampling method and receiver operation characteristic curve. Results: A total of 270 questionnaires were sent out and 262 valid questionnaires were collected, with an effective rate of 97.04%. There were 137 males (52.29%), 146 patients at ages of 60 to 69 years (55.73%), 179 married patients (68.32%), and 85 patients with cognitive decline (32.44%). Multivariable logistic regression analysis identified gender (female, OR=3.118), age (70 to 79 years, OR=3.218; 80 years and older, OR=3.058), educational level (high school or technical secondary school, OR=0.335; junior college, OR=0.130; college and above, OR=0.300), regular exercise (OR=0.083), memory (decreased, OR=29.723), nutritional status (risk of malnutrition, OR=16.307; malnutrition, OR=39.469), activity of daily living (decreased, OR=6.804) and depressive symptoms (OR=8.609) as factors affecting cognitive decline among elderly patients with T2DM (all P<0.05). The nomogram based on the above factors fit well and indicated strong predictive ability. Conclusion Gender, age, educational level, regular exercise, memory, nutritional status, activity of daily living and depressive symptoms can effectively predict the risk of cognitive decline among elderly patients with T2DM.