Objective: To investigate the detection rate and influencing factors of dementia among community-dwelling elderly in Jiaxing City, Zhejiang Provinc, so as to provide the evidence for developing early screening strategies and intervention measures for dementia in the elderly. Methods: From September to December 2024, residents aged ≥65 years from 8 villages (neighborhood committees) in Jiaxing City were selected as study participants using convenience sampling. Data on demographic characteristics, family history of dementia, lifestyle factors, and chronic medical conditions were collected through questionnaire surveys. Depressive symptoms were assessed using the Patient Health Questionnaire-9, and dementia was evaluated using the Brief Community Dementia Screening Scale. Multivariable logistic regression models were used to analyze the influencing factors of dementia among community-dwelling elderly. Results: A total of 7 242 older adults were included, including 3 585 males (49.50%) and 3 657 females (50.50%). A total of 638 participants (8.81%) had a family history of dementia, 2 941 (40.61%) had chronic diseases, 1 011 (13.96%) had comorbidity of chronic diseases, and 377 (5.21%) presented with depressive symptoms. Dementia was identified in 510 participants, with a detection rate of 7.04%. Multivariable logistic regression analysis showed that the elderly with rural household registration (OR=2.225, 95%CI: 1.649-3.084), primary school education or below (illiteracy, OR=3.114, 95%CI: 1.695-5.719; primary school, OR=2.209, 95%CI: 1.217-4.012), family history of dementia (OR=2.180, 95%CI: 1.677-2.833), comorbidity of chronic diseases (OR=1.478, 95%CI: 1.133-1.928) and depressive symptoms (OR=9.894, 95%CI: 7.790-12.566) had a higher risk of dementia. Conclusions The detection rate of dementia among community-dwelling older adults in Jiaxing City was 7.04%. Dementia was mainly affected by household registration, educational level, family history of dementia, chronic disease status and depressive symptoms.

OBJECTIVES: To investigate the protective effects and underlying mechanisms of Gynostemma pentaphyllum (GP)ethanol extract on motor dysfunction in a mouse model of Parkinson's disease (PD). METHODS: Eighty C57BL/6 male mice were randomly divided into five groups: control group, model group, levodopa group (positive control group), low-dose GP group, and high-dose GP group, with 16 mice per group. The PD model was induced by injection of 6-hydroxydopamine into the substantia nigra pars reticulata of the mice. Two weeks after 6-hydroxydopamine, positive control group received intraperitoneal injection of levodopa 10 mg·kg^－1·d^－1, while low-dose GP and high-dose GP groups received GP extract 100 or 200 mg·kg^－1·d^－1 orally for three weeks. After a 3-week-treatment, the effects of GP on motor dysfunction in 6-hydroxydopamine-induced PD were assessed using open field and CatWalk gait tests, while the effects on muscle strength were evaluated by forelimb grip strength. Immunofluorescence staining was used to detect the number of tyrosine hydroxylase (TH) positive neurons. The levels of dopamine and serotonin in the midbrain were determined by enzyme-linked immunosorbent assay. In addition, Western blotting was performed to detect the expression of mitogen-activated protein kinase (MAPK) family proteins such as p-extracellular signal-regulated kinase (ERK)1/2, p-p38 and p-c-Jun N-terminal kinase (JNK)1/2, and mitochondrial apoptosis pathway proteins such as B-cell lymphoma (Bcl)-2, Bcl-2 associated X protein (Bax), and cleaved-cysteine aspartic acid specific protease (caspase)-3. RESULTS: Behavioral experiments showed that GP significantly improved the spontaneous activity and motor coordination of PD mice (P<0.05). The forelimb grip strength was also increased by GP treatment (P<0.05), compared to the PD model group. In addition, compared with the model group, the number of TH-positive neurons in substantia nigra pars reticulata region, the levels of dopamine and serotonin in midbrain and the expression of p-ERK1/2 were significantly increased by GP treatment (all P<0.05), whereas the expression of p-p38 and p-JNK1/2, the ratio of Bax/Bcl-2 and cleaved-caspase-3/caspase-3 were significantly decreased (all P<0.05). CONCLUSIONS The results indicate that GP might increase dopamine and serotonin levels in the midbrain and promote the survival of dopaminergic neurons in substantia nigra pars reticulata by regulating the expression of phosphorylation of MAPK family proteins and the expression of mitochondrial apoptosis-related proteins, thereby ameliorating motor deficits in PD mice.
Animals ; Mice ; Male ; Gynostemma/chemistry* ; Mice, Inbred C57BL ; Apoptosis/drug effects* ; Plant Extracts/therapeutic use* ; Parkinson Disease/metabolism* ; Disease Models, Animal ; Neurons/pathology*

Objective: To investigate the subjective well-being and its influencing factors among grassroots civil servants in Jiaxing City, Zhejiang Province, so as to provide the basis for enhancing their subjective well-being. Methods: Grassroots civil servants were selected from five counties (cities, districts) in Jiaxing City using a convenient sampling method from November to December 2021. Demographic information were collected through questionnaire surveys. Psychological capital, social support, and subjective well-being were assessed using the Positive Psychological Capital Questionnaire, Social Support Rating Scale and General Well-being Scale, respectively. Factors affecting subjective well-being were analyzed by using a multiple linear regression model. Results: A total of 5 689 participants were surveyed, including 3 696 males (64.97%) and 1 993 females (35.03%). There were 968 participants aged 18 to <31 years (17.02%), 2 202 participants aged 31 to <41 years (38.71%), 1 483 participants aged 41 to <51 years (26.07%) and 1 036 participants aged 51 to 60 years (18.21%). Among them, 4 485 participants had a bachelor's degree (78.84%), and 4 870 participants were married (85.60%). The median score of subjective well-being among grassroots civil servants was 87.00 (interquartile range, 30.00) points. Multiple linear regression analysis showed that age (31 to <41 years, β'=-0.087; 41 to <51 years, β'=-0.098; 51 to 60 years, β'=-0.044), educational level (college degree, β'=-0.093; bachelor's degree, β'=-0.130; master's degree or above, β'=-0.085), psychological capital (β'=0.710) and social support (β'=0.161) were factors affecting subjective well-being among grassroots civil servants. Conclusion Grassroots civil servants who aged 18 to <31 years, have high school education or below and score high in psychological capital and social support may have higher levels of subjective well-being.

Objective:To analyze the clinical features and magnetic resonance imaging of non-malignant patients assigned to Prostate Imaging Reporting And Data System (PI-RADS) 5 score.Methods:We performed a retrospective review of 289 patients who underwent magnetic resonance ultrasound targeted combined system biopsy with PI-RADS 5 lesions in the First Affiliated Hospital of Nanjing Medical University between May 2019 and July 2021. The median age 72 (66, 77)years, median body mass index 24.4(22.3, 27.1)kg/m 2, median prostate volume (PV) 37.39(29.39, 48.86) ml, median PSA 22.24(10.91, 62.69) ng/ml, and median PSAD 0.53(0.30, 1.52)ng/ml 2 were recorded. According to the biopsy pathological results, all patients were divided into benign lesion group and prostate cancer group. PSA, PSAD, PV, and apparent diffusion coefficient (ADC) values were compared, and magnetic resonance imaging and clinical characteristics of patients with biopsy benign lesions were analyzed. Results:There were 11 cases (3.8%) with benign lesion and 278 cases (96.2%) with prostate cancer. The characters of 11 negative biopsy cases were displayed as follows: median age 69(66, 79)years, median body mass index 22.0(21.0, 25.5)kg/m 2, median PV 62.90(38.48, 71.96)ml, median PSA 5.55(2.99, 20.52)ng/ml, median PSAD 0.16(0.07, 0.24) ng/ml 2, median ADC 714.47(701.91, 801.26)×10 -6 mm 2/s, abnormal digital rectal and amination in 5 cases, smoking in 7 cases, and alcohol consumption in 4 cases. The median PV [62.90(38.48, 71.96) vs. 37.21(29.22, 47.82)ml, P<0.01], the PSA value [5.55(2.99, 20.52) vs. 23.53(11.14, 65.98)ng/ml, P<0.01], and the PSAD value [0.16(0.07, 0.24) vs. 0.58(0.31, 1.57)ng/ml 2, P<0.01] were significantly different between benign condition group and prostate carcinoma group. Benign condition group included 5 chronic prostatitis, 2 acute prostatitis (1 with focal adenocarcinoma), 2 granulomatous inflammation, and 2 tuberculous granulomatous inflammation. In 7 benign cases, PSA was less than 10 ng/ml, combined with frequent urination, urgency of urination and incontinence were founded. In 8 benign cases, the area of lesion was more than 50% of the total prostate area in the axial position and the imaging of magnetic resonance were diffused, with regular shape and uniform signal. The imaging of symmetrical distribution was in 6 cases. Conclusions:The benign condition with PI-RADS 5 lesions included chronic prostatitis, acute prostatitis, granulomatous inflammation and tuberculous granulomatous inflammation, among which prostatitis was the most common cause. The PSA value were less than 10 ng/ml in most benign cases, with symptoms such as frequent urination, urgency of urination and incontinence. The imaging of magnetic resonance were diffused, symmetrically distributed, with regular shape and uniform signal.

Epidemiological and animal studies indicate that pre-existing diabetes increases the risk of Parkinson's disease(PD).However,the mechanisms underlying this association remain unclear.In the present study,we found that high glucose(HG)levels in the cerebrospinal fluid(CSF)of diabetic rats might enhance the effect of a subthreshold dose of the neurotoxin 6-hydroxydopamine(6-OHDA)on the development of motor disorders,and the damage to the nigrostriatal dopaminergic neuronal pathway.In vitro,HG promoted the 6-OHDA-induced apoptosis in PC12 cells differentiated to neurons with nerve growth factor(NGF)(NGF-PC12).Metabolomics showed that HG promoted hyperglycolysis in neurons and impaired tricarboxylic acid cycle(TCA cycle)activity,which was closely related to abnormal mito-chondrial fusion,thus resulting in mitochondrial loss.Interestingly,HG-induced upregulation of pyruvate kinase M2(PKM2)combined with 6-OHDA exposure not only mediated glycolysis but also promoted abnormal mitochondrial fusion by upregulating the expression of MFN2 in NGF-PC12 cells.In addition,we found that PKM2 knockdown rescued the abnormal mitochondrial fusion and cell apoptosis induced by HG+6-OHDA.Furthermore,we found that shikonin(SK),an inhibitor of PKM2,restored the mito-chondrial number,promoted TCA cycle activity,reversed hyperglycolysis,enhanced the tolerance of cultured neurons to 6-OHDA,and reduced the risk of PD in diabetic rats.Overall,our results indicate that diabetes promotes hyperglycolysis and abnormal mitochondrial fusion in neurons through the upre-gulation of PKM2,leading to an increase in the vulnerability of dopaminergic neurons to 6-OHDA.Thus,the inhibition of PKM2 and restoration of mitochondrial metabolic homeostasis/pathways may prevent the occurrence and development of diabetic PD.

OBJECTIVE Parkinson's disease(PD)is a progressive neurodegenerative disease clinically char-acterized by dyskinesia,tremor,rigidity,abnormal gait,whereas 90%of patients with PD suffer from defects of the sense of smell before the appearance of the motor dysfunctions.However,the mechanism of olfactory disor-der is still not clear.METHODS We utilized olfaction based delayed paired association task in head-fixed mice.We focused on functional role of neural circuit using opto-genetic techniques.In addition,we viewed the synaptic transmission by slice physiological recording and count-ed the cell number of targeted circuits.RESULTS AND CONCLUSION In our experiments,olfactory working memory impairments were found in the PD mice,and the working memory impairment appeared before motor dys-functions.Furthermore,we also investigated the functional role of neural circuit for olfactory working memory in PD mice.Meanwhile,the excitatory post synaptic currents were decreased as a result of presynaptic release proba-bility suppression in PD mice.However cell loss wasn't found in working memory related circuit recently.These will provide a new idea of clinic diagnosis for PD.

Objective: To investigate the level of mental health literacy among residents in Jiaxing City, Zhejiang Province, so as to provide insights into implementation of mental health education and improvements of the quality of mental health services. Methods: A total of 2 248 permanent residents at ages of 18 years and older were sampled using a multi-stage stratified random sampling method from 3 streets (townships) in Jiaxing City. Residents' demographics were collected using self-designed questionnaires, and the mental health literacy was investigated using the Mental Health Literacy Questionnaire. Factors affecting the achievement of the target of mental health literacy were identified among residents using a multivariable logistic regression model. Results: A total of 2 248 questionnaires were allocated and 2 172 valid questionnaires were recovered, with an effective recovery rate of 96.62%. The respondents included 1 075 men (49.49%) and 1 097 women (50.51%). There were 623 respondents that met the target of the mental health literacy (28.68%). Multivariable logistic regression analysis showed a higher possibility of achieving the target of mental health literacy levels among women than among men (OR=1.282, 95%CI: 1.047-1.570), among unmarried residents (OR=1.685, 95%CI: 1.018-2.788) than among married residents, among residents with educational levels of junior high school (OR=1.689, 95%CI: 1.168-2.441), high school/vocational high school/technical secondary school (OR=2.420, 95%CI: 1.601-3.658) and college or above (OR=3.543, 95%CI: 2.252-5.574) than among residents with an educational level of primary and below, among students (OR=2.572, 95%CI: 1.013-6.527), medical personnel (OR=3.330, 95%CI: 2.029-5.467), teachers (OR=2.909, 95%CI: 1.202-7.040), freelance/self-employed staff (OR=1.519, 95%CI: 1.100-2.098) and other professional technical personnel (OR=1.529, 95%CI: 1.012-2.310) than among workers. Conclusions The proportion of mental health literacy levels meeting the target is high among residents in Jiaxing City, and gender, educational level, occupation and marital status are factors affecting mental health literacy levels.

Objective: To investigate the prevalence of Internet addiction among primary and middle school students in Jiaxing City, so as to provide insights into the development of interventions for Internet addiction among primary and middle school students. Methods: A total of 1 701 students were sampled from two primary schools, two junior high schools, two senior high schools and two vocational high schools in Jiaxing City during the period between September and October, 2021, using the stratified cluster sampling method. The Internet addiction status was evaluated using the Internet Addiction Test, and the depression status was tested using the Patient Health Questionnaire-9 (PHQ-9), while the anxiety was assessed with the Generalized Anxiety Disorder Scale (GAD-7). Results: The participants included 783 men (46.03%) and 918 women (53.97%), and 873 rural students (51.32%) and 828 urban students (48.68%). The overall detection of Internet addiction was 6.53% among the participants, and the prevalence of moderate and severe Internet addiction was 5.88% and 0.65%, respectively. A higher prevalence of Internet addiction was detected in rural students (χ2=4.695, P<0.05), junior high school students (χ2=65.337, P<0.05), students with a poor relationship with family members (χ2=39.231, P<0.05), teachers (χ2=28.799, P<0.05) and classmates (χ2=36.341, P<0.05). The prevalence of depressive and anxiety symptoms was 23.81% and 21.52%, respectively, and the prevalence rates of depressive and anxiety symptoms were both higher among primary and middle school students with Internet addiction (68.47% and 56.76%) than among those without Internet addiction (χ2=130.556 and 87.327, both P<0.05). Conclusion The prevalence of Internet addiction is high among primary and middle school students living in rural areas and with poor interpersonal relationships in Jiaxing City. Students with Internet addiction are more likely to develop depressive and anxiety symptoms.

Objective:To explore the efficacy of single-plane bi-parameter magnetic resonance imaging (bpMRI) in the diagnosis of prostate cancer.Methods:The clinical data of 343 patients who underwent transperineal template prostate magnetic resonance-transrectal ultrasound (MRI-TRUS) cognitive fusion biopsy at the First Affiliated Hospital of Nanjing Medical University from January 2020 to July 2021 were retrospectively analyzed, with median age of [65.0(59.0, 72.0)] years, median body mass index (BMI) of [24.1(22.2, 25.6)]kg/m 2, median prostate volume (PV) of [41.7(29.1, 53.3)]ml, median PSA[6.9 (5.5, 8.4) ng/ml], median PSAD of[0.17(0.12, 0.22) ng/ml 2], and abnormal rate of digital rectal examination (DRE) [6.4%(22/343)]. All patients underwent initial biopsy and bi-parameter magnetic resonance imaging (bpMRI) examination before biopsy, and the images were interpreted using prostate image reporting and data system version 2.1 (PI-RADS v2.1). The detection rates of prostate cancer and clinically significant prostate cancer (csPCa) were compared between single-plane bpMRI and bpMRI. When PI-RADS≥3 score, MRI results were positive; when PI-RADS ≤2 score, MRI results were negative. Results:In the single-plane bpMRI group, 121 MRI results were negative and 222 were positive. Positive patients included 95 with PI-RADS 3 score, 94 with PI-RADS 4 score, and 33 with PI-RADS 5 score. In bpMRI group, 141 MRI results were negative and 202 were positive. Among the positive patients, 67 patients with PI-RADS 3 score, 102 patients with PI-RADS 4 score, and 33 patients with PI-RADS 5 score. The detection rates of single-plane bpMRI and bpMRI for prostate cancer were 22.3% (27/121) and 15.6% (22/141) in MRI negative cases[22.3% (27/121) and 15.6% (22/141), P=0.17], and PI-RADS scores with 3 points [35.8% (34/95) vs. 44.8% (30/67), P=0.25], 4 points [89.4% (84/94)vs. 90.2% (92/102), P=0.85] and 5 points [90.9% (30/33) vs. 93.9% (31/33), P=1.00] showed no significant difference in stratification. The detection rate of csPCa in the single-plane bpMRI group and bpMRI group was significantly different in the MRI negative cases [7.4% (9/121) and 2.1% (3/141), P=0.04]. PI-RADS scores with 3 points [22.1% (21/95) vs. 29.9% (20/67), P=0.27], 4 points [80.9% (76/94) vs. 79.4% (81/102), P=0.80] and 5 points [84.9% (28/33) vs. 90.9% (30/33), P=0.71] showed no significant difference in stratification. Conclusions:For those suspected of prostate cancer patients with PSA 4-10 ng/ml and PI-RADS score ≥3, single-plane bpMRI or bpMRI examination has the same efficacy in term of the detection rate of prostate cancer and csPCa.

ObjectiveTo explore the relationship between schizotypal personality traits and creativity in college students and the mediating role of cognitive flexibility. MethodsSchizotypal Personality Questionnaire （SPQ）， Cognitive Flexibility Inventory （CFI） and Williams Creative Aptitude Test （WCAT） were used to assess 471 college students. Thereafter， Spearman correlation analysis was used to explore the relationship among the variables and the Bootstrap methodology was used to estimate the mediating role of cognitive flexibility. ResultsThe total SPQ， positive and disorganized schizotypal traits scores， and CFI score were all positively correlated with WCAT score （r=0.241~0.313， P<0.01）. The total SPQ， positive and disorganized schizotypal traits scores were also positively correlated with CFI score （r=0.111~0.128， P<0.05）. Cognitive flexibility mediated the relationship between positive schizotypal traits and creativity ［indirect effect=0.052 （95% CI： 0.016~0.112， P<0.01）， accounting for 11.93% of the total effect］. Cognitive flexibility mediated the relationship between disorganized schizotypal traits and creativity ［indirect effect=0.075 （95% CI： 0.020~0.161， P<0.01）， accounting for 11.50% of the total effect］. ConclusionSchizotypal personality has a direct impact on the creativity of medical students and also cause an indirect impact on their creativity through the mediating role of cognitive flexibility.