Objective To investigate the reciprocal relationships between trajectories of depressive symptoms(DS)and cognitive function(CF)and to provide a basis for formulating comprehensive management for depression and cognitive impairment among older adults.Methods Group－based dual trajectory modelling was performed to identify dual trajectories of DS and CF usinglongitudinal data from the Chinese Health and Retirement Longitudinal Study.Results 3076 older adults were included in the analysis.Four trajectories of DS(DS1~DS4)were determined:constantly low(30.7%),mild increasing lightly(46.7%),moderately decreasing(19.0%),and constantly high(3.6%);four trajectories of CF(CF1~CF4):persistently high(8.3%),suboptimal slowly decline(51.8%),middle rapidly decline(33.8%)and low rapidly decline(6.1%).Compared with DS 1,the elderly in DS 2~4 were more likely to experience CF 3 and CF 4.Using CF 1 as a reference,the elderly in CF 2~4 were more likely to follow DS 2~4.Conclusion GBMDT captures the degree of overlap and dynamic developmental associations between developmental trajectories for DS and CF among Chinese elderly.

It is well established that blood pressure plays a critical role in the onset of stroke. In recent years, the trajectory of blood pressure has emerged as a novel focus in stroke research, as it is associated with stroke incidence, recurrence, outcomes, and prognosis. Accurately identifying various blood pressure trajectories and exploring their developmental patterns are of significant importance for implementing targeted interventions aimed at reducing the burden of stroke. Consequently, this article reviews the progress of research related to the concept, indicators, and research models of blood pressure trajectories, as well as the mechanisms underlying blood pressure variation and the relationship between blood pressure trajectories and stroke, in order to provide new insights for the prevention and control of stroke.

Objective To investigate the reciprocal relationships between trajectories of depressive symptoms(DS)and cognitive function(CF)and to provide a basis for formulating comprehensive management for depression and cognitive impairment among older adults.Methods Group－based dual trajectory modelling was performed to identify dual trajectories of DS and CF usinglongitudinal data from the Chinese Health and Retirement Longitudinal Study.Results 3076 older adults were included in the analysis.Four trajectories of DS(DS1~DS4)were determined:constantly low(30.7%),mild increasing lightly(46.7%),moderately decreasing(19.0%),and constantly high(3.6%);four trajectories of CF(CF1~CF4):persistently high(8.3%),suboptimal slowly decline(51.8%),middle rapidly decline(33.8%)and low rapidly decline(6.1%).Compared with DS 1,the elderly in DS 2~4 were more likely to experience CF 3 and CF 4.Using CF 1 as a reference,the elderly in CF 2~4 were more likely to follow DS 2~4.Conclusion GBMDT captures the degree of overlap and dynamic developmental associations between developmental trajectories for DS and CF among Chinese elderly.

It is well established that blood pressure plays a critical role in the onset of stroke. In recent years, the trajectory of blood pressure has emerged as a novel focus in stroke research, as it is associated with stroke incidence, recurrence, outcomes, and prognosis. Accurately identifying various blood pressure trajectories and exploring their developmental patterns are of significant importance for implementing targeted interventions aimed at reducing the burden of stroke. Consequently, this article reviews the progress of research related to the concept, indicators, and research models of blood pressure trajectories, as well as the mechanisms underlying blood pressure variation and the relationship between blood pressure trajectories and stroke, in order to provide new insights for the prevention and control of stroke.

ObjectiveTo explore the mechanism of Astragali Radix-Aconiti Lateralis Radix Praeparata in the treatment of heart failure and substance basis based on ultra-performance liquid chromatography-quadrupole-time of flight-mass spectrometer （UPLC-Q-TOF-MS） and network pharmacology. MethodThe chemical components of Astragali Radix-Aconiti Lateralis Radix Praeparata solution was analyzed by UPLC-Q-TOF-MS， and the active components and targets were screened out by the PubChem database. The targets related to heart failure disease were retrieved from Comparative Toxicogenomics Database（CTD）， Online Mendelian Inheritance in Man （OMIM）， and GeneCard databases， and the common targets were obtained by Venn analysis. The target protein-protein interactions （PPI） were analyzed using the STRING database. Gene ontology （GO） functional enrichment analysis and Kyoto encyclopedia of genes and genomes （KEGG） pathway enrichment analysis were performed using the Metascape database， and molecular docking verification of key targets and active components was performed using SYBYL-X 2.1.1. Experimental validation of key targets was carried out using the rat model of heart failure. ResultThere were 202 chemical components identified in Astragali Radix-Aconiti Lateralis Radix Praeparata solution， of which 64 active components were predicted to act on 183 targets for the treatment of heart failure. The important active components were caffeic acid， L-arginine， biochanin A， adenine， nicotinic acid， trans-ferulic acid， p-coumaric acid， riboflavin， calycosin， etc. The main targets were interleukin （IL）-6， cysteine aspartic acid specific protease （Caspase）-3， vascular endothelial growth factor A （VEGFA）， protein kinase B1 （Akt1）， tumor necrosis factor （TNF）， IL-1B， matrix metallopeptidase （MMP）-9， etc. The main signaling pathways involved hypoxia-inducible factor （HIF）-1 signaling pathway， TNF signaling pathway， phosphatidylinositol 3-kinase （PI3K）/Akt signaling pathway， Toll-like receptor signaling pathway， mitogen-activated protein kinase （MAPK） signaling pathway， forkhead box O （FoxO） signaling pathway， etc. The molecular docking results showed that the active components in Astragali Radix-Aconiti Lateralis Radix Praeparata solution had a good binding ability with HIF-1α， VEGFA， Akt1， Caspase-3， and IL-6， which were the key proteins in the HIF-1 signaling pathway. Animal experiments showed that Astragali Radix-Aconiti Lateralis Radix Praeparata solution significantly improved the hemodynamic indexes， reduced the serum atrial natriuretic peptide （ANP）， brain natriuretic peptide （BNP）， and IL-6 levels， improved the myocardial histopathological changes， protected the mitochondrial morphology of cardiomyocytes， down-regulated the expression of HIF-1α， VEGFA and phosphorylation（p）-Akt， and reduced the activation of Caspase-3 in the myocardial tissue of rats with heart failure. ConclusionAstragali Radix-Aconiti Lateralis Radix Praeparata treats heart failure in a multi-component， multi-target， and multi-pathway manner. The experimental validation indicates that it treats heart failure by improving myocardial histopathological changes and regulating HIF-1 signaling pathway， which provides references for the subsequent pharmacodynamic substance research.

objective:To understand and quantify the main influencing factors related to disability free life expectancy (DFLE) among Chinese elderly.Methods:Using publicly available data from the Chinese Longitudinal Healthy Longevity Survey (2011-2018), we fitted multi-states Markov model and microsimulation to estimate DFLE at age 65, life expectancy (LE) at age 65 and proportion of DFLE to LE (DFLE/LE) at age 65. We calculated 95% CI by Bootstrap. Result:DFLE of the Chinese elderly aged 65 was 14.27 (95% CI: 13.85-14.74) years, higher in female than male and higher in elderly with higher economic status. DFLE/LE at age 65 was 86.33% (95% CI: 85.52%-87.18%), higher in male than female and rural than urban. The risk factors of DFLE include not undergoing physical examination, inadequate fruit/vegetable intake, smoking, and feeling stress, leading to 0.74, 0.41, 0.62, 0.12 years of DFLE lost for male, and 0.82, 0.42, 0.19, 0.20 years of DFLE lost for female, respectively. Eliminating these risk factors can improve DFLE at age 65 by 1.73 years for male and 1.45 years for female. Conclusions:Policies targeting male elderly and the elderly with lower economic status, and measures promoting physical examination and adequate fruit/vegetable intake, relieving stress and banning smoking can substantially improve DFLE of Chinese elderly.

Objective To explore how much impact that the educational level may exert on the Montreal Cognitive Assessment Scale (MoCA) for screening mild cognitive impairment (MCI) among the old people.Methods 3 230 participants aged 60+ years in 6 districts of Xiamen were selected using multi-stage stratified randomized sampling.One-way ANOVA and Scheffe were performed using SPSS 23.0 to compare the MoCA scores among different educational level groups.Binary logistic regression was used to analyze differential item functioning (DIF).If the P＜0.000 3 125 (Bonferroni correction),the corresponding item is considered to have DIF.Results The educational level of the elderly in Xiamen is generally lower,with 39.63％(1 133/2 858) illiterate and 28.04％(801/2 858) educated only at primary school,respectively.MoCA scores of elderly with different educational backgrounds were quite different with statistical significance(x2=413.73,P＜0.01),but Scheffe showed that there was no significant difference in MoCA scores between high school educated and undergraduate.Age,gender and MoCA scores of the elderly were significantly correlated (P＜0.01).The items that had DIF included:trail making test,copy cube,numbers of clock,hands of clock,abstraction 1 and 2,and word 1,2,3,and 5 of delayed recall,adding up to 11 items.The items of trail making test and copy cube only have DIF in the people above junior high school education level,while the 2 items of abstraction dimension only show DIF in the people above senior high school education level.Conclusion Most items of MoCA scale are suitable for screening people with all educational levels except when applying trail making test,copy cube and the 2 items of abstract dimension.

Objective To explore how much impact that the educational level may exert on the Montreal Cognitive Assessment Scale (MoCA) for screening mild cognitive impairment (MCI) among the old people.Methods 3 230 participants aged 60+ years in 6 districts of Xiamen were selected using multi-stage stratified randomized sampling.One-way ANOVA and Scheffe were performed using SPSS 23.0 to compare the MoCA scores among different educational level groups.Binary logistic regression was used to analyze differential item functioning (DIF).If the P＜0.000 3 125 (Bonferroni correction),the corresponding item is considered to have DIF.Results The educational level of the elderly in Xiamen is generally lower,with 39.63％(1 133/2 858) illiterate and 28.04％(801/2 858) educated only at primary school,respectively.MoCA scores of elderly with different educational backgrounds were quite different with statistical significance(x2=413.73,P＜0.01),but Scheffe showed that there was no significant difference in MoCA scores between high school educated and undergraduate.Age,gender and MoCA scores of the elderly were significantly correlated (P＜0.01).The items that had DIF included:trail making test,copy cube,numbers of clock,hands of clock,abstraction 1 and 2,and word 1,2,3,and 5 of delayed recall,adding up to 11 items.The items of trail making test and copy cube only have DIF in the people above junior high school education level,while the 2 items of abstraction dimension only show DIF in the people above senior high school education level.Conclusion Most items of MoCA scale are suitable for screening people with all educational levels except when applying trail making test,copy cube and the 2 items of abstract dimension.

Objective: To survey the mothers' acceptance of the HPV vaccination for their adolescent girls in Xiamen and to explore the influencing factors. Methods: Mothers of adolescent girls were selected by multistage cluster random sampling. Data of demography of the mothers and girls, the knowledge and attitude of cervical cancer and HPV vaccine of the mothers were collected. The influencing factors of mothers' attitudes were analyzed with univariate and multivariate logistic regression. Results: A total of 2 307 mothers were selected. The average age of mothers was (38.0±4.7) years. 13.1% (300) of the mothers had a family history of malignant tumor. The mothers' acceptance for vaccinating girls was 61.9% (1 428). The awareness rates of HPV and HPV vaccine were 42.5% (980) and 21.4% (493), respectively. Mothers who had family history of cancer (OR=1.36, 95%CI:1.02-1.82) showed a greater willingness to vaccinate their girls than the mothers who had not. Mothers who had knowledge of HPV (OR=1.32, 95%CI:1.08-1.62) and HPV (OR=2.03, 95%CI:1.56-2.66) vaccines showed a greater willingness to vaccinate their girls than the mothers who had not. Conclusion The mothers' acceptance to vaccinate adolescent girls against cervical cancer needs to be raised, especially for the mothers who had not family history of cancer, no-knowledge of HPV and HPV vaccines.

Objective To examine the prevalence,disease spectrum of non-communicable chronic diseases and its risk factors among the elderly residents in Xiamen.Methods The elderly residents aged 60 or over in Xiamen were selected by stratified randomly sampling to analyze the spectrum of chronic disease.The data were analyzed by x2 test,trend x2 test and unconditional logistic regression.Results A total of 14292 elderly were investigated.The prevalence of chronic diseases was 63.3 ％.With the age increasing,the prevalence was also increased,the female residents had a higher prevalence compared with male,and the city was higher than the rural area(P ＜0.001).While suffering from two or more chronic diseases accounted for 31.9 ％.The top 5 of the most prevalent chronic diseases were osteoarthritis (30.5 ％),hypertension (30.1％),diabetes mellitus (9.7 ％),heart disease (7.9 ％),and gastrointestinal disease (7.6％).Sex,age,residence,marital status,loneliness,self-rated health are the influencing factors of the elderly in Xiamen.Conclusion More attention should be paid to the impact of osteoarthritis,hypertension,diabetes,heart disease and gastrointestinal gallbladder disease on the health of the elderly,especially osteoarthritis,and targeted to multiple chronic diseases comprehensive prevention and control and management.