his cross-sectional study employed convenience sampling to enroll 1 994 community-dwelling older adults (aged ≥65 years) undergoing health examinations at a Guangzhou community hospital between January and December 2024, aiming to investigate associations between blood lipid profiles and cognitive impairment. Cognitive function was assessed using the AD8 scale, with demographic characteristics (age, sex, education, occupation), health status (hypertension, diabetes mellitus), and lifestyle factors (smoking/alcohol use) collected via questionnaires. Fasting blood samples quantified triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Propensity score matching (PSM) balanced baseline characteristics between lipid-level groups. Pre-PSM analyses revealed significant intergroup differences: TG groups differed in sex, BMI, alcohol use, hypertension, and self-rated health ( P<0.05); TC groups in sex, age, occupation, diabetes, and hypertension; LDL-C groups in sex, age, occupation, diabetes, hypertension, and daily living ability; HDL-C groups in sex, age, education, occupation, BMI, smoking, diabetes, and hypertension. Post-PSM adjustment eliminated baseline differences ( P>0.05). Multivariable logistic regression adjusted for demographic, clinical, and lifestyle factors demonstrated that elevated TG levels conferred a 48% reduced risk of cognitive dysfunction [ OR (95% CI): 0.52 (0.29-0.94)], whereas TC, LDL-C, and HDL-C showed no significant associations (all P>0.05). These findings suggest an inverse association between higher triglyceride levels and cognitive dysfunction risk in older adults, highlighting TG′s potential protective role in cognitive health.

BACKGROUND:The pathogenesis of moyamoya disease is unclear,and there is a lack of early diagnostic methods and effective medical treatments.OBJECTIVE:To identify biomarkers of moyamoya disease through machine learning,and analyze the therapeutic mechanism of Bu Huang Si Wu Tang in moyamoya disease.METHODS:Moyamoya disease gene dataset from gene expression omnibus database was retrieved.R language was used to screen differentially expressed genes and perform enrichment analysis on differentially expressed genes.Moyamoya disease biomarkers were screened using least absolute shrinkage and selection operator and support vector machine-recursive feature elimination machine learning algorithms.A diagnostic model was constructed by establishing a column chart,and its clinical utility and diagnostic value were evaluated and further validated through detecting clinical serum markers of patients with moyamoya disease.In vitro experiments were performed to observe the effect of Bu Huang Si Wu Tang on umbilical vein endothelial cells under oxygen glucose deprivation,and the main components of Bu Huang Si Wu Tang were selected for molecular docking and molecular dynamics simulation with the screened targets to explore its potential mechanism.RESULTS AND CONCLUSION:This study identified 76 differentially expressed genes,mainly enriched in immune and metabolic related pathways.Two potential biomarkers,complement factor D(CFD)and DKFZp434L192,were obtained through machine learning.The calibration curve,decision curve analysis,and clinical impact curve showed that the column chart had good predictive ability.qRT-PCR analysis showed that CFD and DKFZp434L192 expression levels were significantly upregulated in patients with moyamoya disease(P<0.001).In vitro experiments showed that Bu Huang Si Wu Tang significantly enhanced the activity and migration ability(P<0.01)of umbilical vein endothelial cells under oxygen glucose deprivation.Molecular docking results showed that all four active ingredients of Bu Huang Si Wu Tang could bind to the target site,and the dynamic simulation results further verified its binding stability.To conclude,CFD and DKFZp434L192 exhibit good diagnostic efficacy for moyamoya disease and can serve as potential diagnostic biomarkers and therapeutic targets for moyamoya disease.Bu Huang Si Wu Tang has a certain protective effect on vascular endothelial cells under ischemic conditions,which may be related to CFD.

his cross-sectional study employed convenience sampling to enroll 1 994 community-dwelling older adults (aged ≥65 years) undergoing health examinations at a Guangzhou community hospital between January and December 2024, aiming to investigate associations between blood lipid profiles and cognitive impairment. Cognitive function was assessed using the AD8 scale, with demographic characteristics (age, sex, education, occupation), health status (hypertension, diabetes mellitus), and lifestyle factors (smoking/alcohol use) collected via questionnaires. Fasting blood samples quantified triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Propensity score matching (PSM) balanced baseline characteristics between lipid-level groups. Pre-PSM analyses revealed significant intergroup differences: TG groups differed in sex, BMI, alcohol use, hypertension, and self-rated health ( P<0.05); TC groups in sex, age, occupation, diabetes, and hypertension; LDL-C groups in sex, age, occupation, diabetes, hypertension, and daily living ability; HDL-C groups in sex, age, education, occupation, BMI, smoking, diabetes, and hypertension. Post-PSM adjustment eliminated baseline differences ( P>0.05). Multivariable logistic regression adjusted for demographic, clinical, and lifestyle factors demonstrated that elevated TG levels conferred a 48% reduced risk of cognitive dysfunction [ OR (95% CI): 0.52 (0.29-0.94)], whereas TC, LDL-C, and HDL-C showed no significant associations (all P>0.05). These findings suggest an inverse association between higher triglyceride levels and cognitive dysfunction risk in older adults, highlighting TG′s potential protective role in cognitive health.

BACKGROUND:The pathogenesis of moyamoya disease is unclear,and there is a lack of early diagnostic methods and effective medical treatments.OBJECTIVE:To identify biomarkers of moyamoya disease through machine learning,and analyze the therapeutic mechanism of Bu Huang Si Wu Tang in moyamoya disease.METHODS:Moyamoya disease gene dataset from gene expression omnibus database was retrieved.R language was used to screen differentially expressed genes and perform enrichment analysis on differentially expressed genes.Moyamoya disease biomarkers were screened using least absolute shrinkage and selection operator and support vector machine-recursive feature elimination machine learning algorithms.A diagnostic model was constructed by establishing a column chart,and its clinical utility and diagnostic value were evaluated and further validated through detecting clinical serum markers of patients with moyamoya disease.In vitro experiments were performed to observe the effect of Bu Huang Si Wu Tang on umbilical vein endothelial cells under oxygen glucose deprivation,and the main components of Bu Huang Si Wu Tang were selected for molecular docking and molecular dynamics simulation with the screened targets to explore its potential mechanism.RESULTS AND CONCLUSION:This study identified 76 differentially expressed genes,mainly enriched in immune and metabolic related pathways.Two potential biomarkers,complement factor D(CFD)and DKFZp434L192,were obtained through machine learning.The calibration curve,decision curve analysis,and clinical impact curve showed that the column chart had good predictive ability.qRT-PCR analysis showed that CFD and DKFZp434L192 expression levels were significantly upregulated in patients with moyamoya disease(P<0.001).In vitro experiments showed that Bu Huang Si Wu Tang significantly enhanced the activity and migration ability(P<0.01)of umbilical vein endothelial cells under oxygen glucose deprivation.Molecular docking results showed that all four active ingredients of Bu Huang Si Wu Tang could bind to the target site,and the dynamic simulation results further verified its binding stability.To conclude,CFD and DKFZp434L192 exhibit good diagnostic efficacy for moyamoya disease and can serve as potential diagnostic biomarkers and therapeutic targets for moyamoya disease.Bu Huang Si Wu Tang has a certain protective effect on vascular endothelial cells under ischemic conditions,which may be related to CFD.

Objective The present study aimed to establish a bone mineral density (BMD) reference database in China and to investigate the prevalence of osteoporosis in Chinese adults aged 50 years and older using dual energy X-ray absorptiometry (DXA). Method A total of 75321 examineers over 25 years old who underwent health checkups in 7 health check centers between 2008 and 2018 were included. All centers used a GE Lunar-DXA system to measure BMD of the lumbar spine (L1-L4), femoral neck, and total femur. The same European Spine Phantom (ESP) was used for scanning 10 times at every center, a regression equation was generated, and BMD data were cross-calibrated in each center. Peak BMD and standard deviation (SD) were identified according to 5-year age groups, and T scores were calculated based on the peak BMD and SD. Osteoporosis was defined according to the World Health Organization criteria. The prevalence of osteoporosis was standardized based on 2010 national census data for the Chinese population. Result The mean BMD values decreased with age, were highest in North China, followed by Northeast China, East China, and Southwest China, respectively, and increased with body mass index. Males aged 20-30 years and females aged 35-40 years had peak BMD values. Peak BMD values of the lumbar spine, femoral neck, and total femur were 1.09 g/cm2, 0.97 g/cm2, and 0.97 g/cm2 in males, and 1.11 g/cm2, 0.84 g/cm2, and 0.88 g/cm2 in females, respectively. Among all scanned sites, the prevalence of osteoporosis was highest in the femoral neck in males (4.58％) and in the lumbar spine in females (23.38％). The age-standardized prevalence of osteoporosis at any site was 6.46％ in males and 29.13％ in females aged 50 years and older. Based on the 2010 national census data, 10879115 males and 49286542 females currently have osteoporosis. Conclusion Mean BMD values varied according to geographic region, body mass index, age group, and sex in Chinese adults. The age-standardized prevalence of osteoporosis was 6.46％ in males and 29.13％ in females aged 50 years and older.

Objective To determine the relationship between brain injury and cerebral glucose metabolism in rat model of cardiac arrest. Methods Asphyxia-induced cardiac arrest model was established. Forty-two male Wistar rats were randomly assigned to sham or experimental groups. Rats in the CA4,CA6 and CA8 group were treated with cardiopulmonary resuscitation(CPR) 4 min, 6 min and 8 min after cardiac arrest, respectively. The maximum standardized uptake value (SUVmax) of glucose was detected by PET, and neural defi cit score (NDS) were evaluated at 24 h and 72 h after ROSC. The numbers of injured neurons and apoptotic cells and the protein level of hexokinase I (HXK I) were measured at 72 h after ROSC. Results SUVmax, NDS and the level of HXK I were all decreased after ROSC, and interestingly, this declination of these markers was correlated with the prolongation of the duration of CA, the longer duration of CA the more declination of these biomarkers. Accordingly, the number of injured neurons and apoptotic cells increased were correlated with duration of CA, and thus CA8 group had greater numbers of those cells than CA6 group and CA4 group (P<0.05),and CA6 group had greater numbers of those cells than CA4 group(P<0.05). In addition, the SUVmaxwas positively correlated with NDS(P<0.05), and negatively correlated with the numbers of injured neurons and apoptotic index(P<0.05). Conclusions The degree of brain injury is associated with cerebral glucose metabolism, and PET may become a novel method to assess the severity of brain damage after CA.

Objective To evaluate the feasibility and clinical outcomes of second sacral alar-iliac (S2AI) technique utilized in patients with tuberculosis of Lumbosacral spine.Methods 24 cases (15 male,9 female,aged 36-73 years old,average 47.1 years) of tuberculosis of Lumbosacral spine were collected for surgery using spinal and pelvic fixation system (S2AI or IS) between January 2014 and May 2016.Lumbosacral pain and restricted movement were noticed in all cases,of which 9 cases with radiating pain of lower limb and 7 cases with intermittent claudication,2 cases with saddle anesthesia.Formal anti-tuberculosis medicine treatment was given for at least 2-3 weeks before operation.All patients with lumbosacropelvic fixation were compared by recording with ESR/CRP,preoperatively,postoperatively and the last following-up.The clinical effect oswestry disability index (ODI) score,visual analogue scale (VAS),ambulatory status,SF-36 scale and related complications of 2 groups were also compared.Results The average follow-up period was average 23.4 months in the two groups.The results show that operative time,blood loss,drainage time,hospitalization days and fusion time were not statistically significant;the recording of ESR,CRP,ODI,VAS scores and ambulatory status scores between S2AI and IS groups showed no significantly different,preoperatively,postoperatively and the last following-up.Comparisons within each group were improved at postoperatively and the last following-up related to preoperatively;The difference of the SF-36 scales in each group was statistically significant between preoperatively and the last following-up;There was no statistically difference in recurrence,sinus,pseudarthrosis between two groups,but The S2AI technique was associated with lower rates of symptomatic screw prominence compared to the IS technique.Conclusion Application of S2AI screw technique in the treatment of lumbosacral tuberculosis can achieve solid fixation and satisfactory clinical effect,and reduce the complications of traditional IS screws,which is an alternative method of posterior structure reconstruction of lumbosacral tuberculosis.

Objective To evaluate the clinical effects of the Masquelet technique combined with antibiotic calcium sulfate pellets in treating infected bone defects.Methods From February 2014 to February 2016,9 patients with infected bone defects were treated in our department,including 7 males and 2 females,with an average age of 37.0 years (range,24-56 years).6 cases were infected because of open fractures,3 infected after internal fixation operation.All defects were located in the lower limb diaphysis and metaphysis (3 cases in femur,6 cases in tibia).The length of the bone defects were 4-12 cm after debridement,all defects filled with PMMA loaded with Vancomycin,and fixed with exterual fixators.After 6-10 weeks,the bone cement spacers were taken out and the antibiotic calcium sulfate pellets were implanted into the membrane.A certain amount of autogenous cancellous bone granules would be mixed into the calcium sulfate pellets if the defect was larger than 6-8 cm.5 cases remained fixed with external fixators,3 cases replaced for plates,1 case replaced for plaster external fixator.Regular X-ray follow-ups were taken and complications recorded as well.Evaluate the healing of bone defect and functional recovery of adjacent joints by Samantha X score system,visual analogue scale (VAS) and Paley method,respectively.Results The 9 cases were followed up for a mean duration of 9.3 months (range,6-15 months).All bone defects healed after a mean time of 14 weeks (range,10-24 weeks).The wound poor healing occurred in only 1 case in the first stage of surgery,and cured by dressing changes.No complications of the recurrence of infection and implant failure.At the last follow-up,the average Samantha X score was 4.9,the VAS score was 0 to 3 (average 1.5) for patients standing on crutches and all the bone defect healing graded excellent evaluated by Paley method,the functional recovery of the adjacent joints graded:excellent in 6 cases,good in 2 cases,and fair in 1 case (the excellent and good rate was 89％).Conclusion Masquelet technique combined with antibiotic calcium sulfate particles is effective in the treatment of infected bone defects.

AIM: To investigate the effect of cobalt chloride (CoCl2) on the apoptosis of neural stem cells (NSCs) and the expression of microRNA-26a (miR-26a) in vitro, and to explore the mechanisms of NSC apoptosis in-duced by CoCl 2 .METHODS:NSCs were exposed to CoCl 2 at different doses (200~600μmol/L) for 24 h.The cell via-bility and apoptosis were measured by CCK-8 assay and TUNEL method.The expression of miR-26a-3p, miR-26a-5p, GSK-3β, caspase-3, Bcl-2 and Bax was examined by real-time PCR.The protein levels of Bcl-2 and Bax were detected by Western blotting .RESULTS: The cell viability was inhibited and the apoptosis of NSCs was increased significantly by CoCl2 in a dose-dependent manner (P<0.05).CoCl2 at concentration of 400μmol/L for 24 h was used to induce apopto-sis and the expression of miR-26a was down-regulated compared with control (P<0.05).Exposure to CoCl2 at concentra-tion of 400μmol/L up-regulated the expression of GSK-3β, caspase-3 and Bax , down-regulated the expression of Bcl-2 and Bcl-2/Bax (P<0.05).CONCLUSION:CoCl2 at concentration of 400μmol/L induces the apoptosis of NSCs obviously . CoCl2 may induce the NSC apoptosis by mitochondrial apoptotic pathway .Declining miR-26a may be related to NSC apopto-sis.

Objective To investigate the clinical outcomes of the surgical management for spinal tuberculosis with paraplegia retrospectively.Methods From March 2008 to April 2012,we retrospectively analyzed 78 patients with spinal tuberculosis combined with paraplegia.Among them,45 patients were male and 33 were female.The average age was 39.5(13 to 71) years.69 patients had focus-active paraplegia.41 patients had received chemotherapy before admissed to our hospital.They also received further standard chemotherapy for an average period of 2.3 (0 to 4) weeks after the admission.22 patients with complex complications (6 patients with active pulmonary tuberculosis,5 with tuberculous meningitis,7 with drug hepatitis,3 with kidney failure and 1 with unstable angina) received preoperative treatment for an average period of 4.5(3 to 8) weeks after the admission.6patients were managed with chemotherapy only.All 9 patients who had focus-healed paraplegia received surgical treatment after the admission immediately.Results All the patients were followed up clinically and radiologically for an average period of 31.4 (12 to 48) months.There was no recurrence of patients.At the final follow-up,all the patients had achieved rigid bony fusion.Both the VAS score and the Cobb angle had satisfactory improvement postoperatively and at the final follow-up.The neurological status began to improve 1-21 days after the operation.From 3 months postoperatively to the final follow-up,65 patients achieved complete recovery,7 partial recovery and 6 no recovery.The clinical outcomes for focus-active paraplegia were similar,while focushealed paraplegia had slower recovery and worse outcomes.Conclusion Patients with focus-active paraplegia combined with mild destruction and relative favourable neurological status could be treated conservatively.For patients with severe bony destruction and neurologic deficits (Frankel A-C,or combined with kyphosis),surgical treatment as early as possible is crucial to improve the neurologic status.If patients had contraindications,operation could be performed after the complications had been cured.However,the neurologic status improvement in focus-healed paraplegia is worse than focus-active paraplegia,suggesting that the reconstruction of spinal stability is important for initial treatment of spinal tuberculosis and children.