Objective: To examine the association between frailty and cognitive function in middle-aged and elderly populations using group-based trajectory model (GBTM), so as to provide insights into the prevention and intervention strategies for cognitive impairment in this population. Methods: From 2011 to 2018, data of demographic information and lifestyle behavior for individuals aged ≥45 years were collected from the China Health and Retirement Longitudinal Study. Frailty status was assessed using the frailty index, and cognitive function was evaluated using the Chinese version of the Mini-Mental State Examination. GBTM was applied to establish frailty trajectories based on the frailty index from 2011 to 2018 to analyze the trajectory of frailty changes. The association between frailty and cognitive function was analyzed using multiple linear regression model. Results: A total of 4 809 participants were included, with a mean age of (56.63±7.73) years. There were 2 621 males (54.50%) and 2 188 females (45.50%). The 2018 survey identified 574 individuals (11.94%) with cognitive function decline. GBTM identified four distinct frailty trajectories including the normal and stable group (69.27%), recovering frail group (9.32%), progressing pre-frail group (16.20%) and persistently frail group (5.22%). The mean cognitive funtion scores for these groups were (17.24±4.83) (16.38±5.53) (15.74±5.20) (15.02±5.11) points, respectively. The differences in cognitive funtion scores across groups were statistically significant (P<0.05). Multiple linear regression analysis showed, after adjusting for confounding factors such as gender, age, nighttime sleep duration, and smoking, compared with the normal and stable group, the cognitive function decline risk was higher in the frailty recovery group (β=-0.581), the pre-frail progression group (β=-0.583), and the persistently frail group (β=-0.662) compared with the non-frail stable group (all P<0.05). Conclusions There are four groups of changes in frailty among the middle-aged and elderly populations. Compared with the normal and stable group, the groups experiencing progression, persistence, and recovery of frailty exhibit a more pronounced risk of cognitive funtion decline.

Objective: To analyze the association between altitudes and nutritional status of children and adolescents, and to explore the moderating effects of dietary behaviors and physical activity, so as to provide a scientific basis for developing lifestyle interventions tailored to local conditions. Methods: From September to November 2023, physical examinations and questionnaire surveys were conducted among children and adolescents aged 7-17 in two autonomous regions, Inner Mongolia and Xizang, with a final sample of 156 511 participants by the stratified cluster random sampling method. Height and weight were measured to calculate body mass index (BMI). Sociodemographic characteristics, dietary behaviors, and physical activity were collected via questionnaires, while the altitude of each participant s school was obtained using Amap. Logistic regression was performed to examine the relationship between altitudes and nutritional status. Interaction terms and stratified analyses were applied to assess the moderating effects of dietary behaviors and physical activity. Restricted cubic spline (RCS) were used for visualization. Results: In 2023, the prevalence of wasting and overweight/obesity among children and adolescents in Xizang were 9.7% and 9.0%, respectively, compared to 2.9% and 22.0% in Inner Mongolia. Logistic regression analysis results showed that for every 1 km increase in altitude, the risk of wasting increased, while the risk of overweight/obesity decreased ( OR =1.43, 0.19, both P <0.05). The results of the stratified analysis showed that compared to those living at altitudes <1 km, children and adolescents with healthy diets showed no significant association between altitudes (1-<2 and 2-<3 km) and wasting ( OR =1.22, 0.75, both P >0.05), whereas significant associations were observed at 3-<4 and ≥4 km altitudes ( OR =2.25, 2.89, both P <0.05). In contrast, unhealthy dietary groups showed statistically significant associations across altitudes ( OR =1.18-4.04, all P <0.05), consistent with RCS results. No moderating effects were observed for physical activity on the altitude wasting association or for dietary behaviors and physical activity combined on the altitude overweight/obesity association ( P interaction =0.63, 0.10, 0.53). Conclusion Healthy dietary behaviors play a critical role in improving the nutritional status of children and adolescents and reducing regional disparities, providing a scientific foundation for public health policy formulation and implementation.

Objective To explore the interaction mechanisms among different dimensions of online learning competence in undergraduates,providing scientific evidence for optimizing software design and online education strategies.Methods A cross-sectional study was conducted with 347 undergraduates from Kunming Medical University via an online questionnaire in October 2024.Reliability testing and exploratory factor analysis were performed using SPSS 26.0,while structural equation modeling was constructed with Amos 24.0.Results Driving force directly and positively influenced regulatory force(β=0.778,P<0.001)and reciprocal force(β=0.302,P=0.003),but had no significant direct effect on adaptive force(β=0.131,P=0.182).Regulatory force and reciprocal force both exerted direct positive effects on adaptive force(β=0.262,P=0.022;β=0.410,P<0.001).The indirect effect of driving force on adaptive force accounted for 78.1%of the total effect(P=0.007),with regulatory force showing a significant mediating role(β=0.178,P=0.023),while reciprocal force alone did not(β=0.108,P=0.060).A chain mediating effect(driving force→regulatory force→reciprocal force→adaptive force)was confirmed(β=0.124,P=0.004).Conclusion Driving force serves as the core of online learning competence,and adaptive capacity is enhanced through regulatory and reciprocal forces.To promote knowledge internalization and adaptability,it is required to optimize feedback mechanisms and deepen interactive designs in online learning platforms.

Objective To analyze the morphology of the pterygoid hamulus and its relationship with adjacent tissues on CBCT ima-ges,establish reference data of the anatomical structure of the pterygoid hamulus in the adult population,in order to provide a basis for clinical assisted diagnosis and treatment of pterygoid hamulus syndrome and obstructive sleep apnea hypopnea syndrome.Methods A total of 151 patients with CBCT images who met the inclusion criteria were collected from August 2020 to December 2023 in the Depart-ment of Stomatology at the Second Traditional Chinese Medicine Hospital of Jiangsu Province.The CBCT images were reconstructed u-sing the maximum intensity projection(MIP)and volume rendering(VR)modes of cone-beam CT.The morphology,length,width,vertical height,abduction angle,mucosal thickness,distance from the pterygoid hamulus to the midline of the palate,and distance from the pterygoid hamulus to the greater palatine foramen were observed and statistically analyzed in 302 bilateral cases.The differ-ences in the morphology of the pterygoid hamulus and its adjacent tissues were analyzed in different places,genders and age groups.Results The apex of the pterygoid hamulus faced inward on 6 sides and outward on 296 sides.The apex of the pterygoid hamulus was sharp on 46 sides and blunt on 256 sides.The pterygoid hamulus showed no statistically significant differences in various parameters be-tween the left and right sides,except for the width.In males,the length,width,height,distance from the pterygoid hamulus to the mid-palatal suture,and mucosal thickness on the surface of the hamulus were all greater than those in females,demonstrating statisti-cally significant differences.Females also exhibited a larger outward angle of the pterygoid hamulus than males,which was statistically significant.Moreover,with the increase of age,the length and height of the pterygoid hamulus initially increased and then decreased,exhibiting statistically significant differences.Conclusion CBCT has the advantages of low radiation dosage,convenient operation,clear imaging,stable measurement data,and clear images in the examination of pterygoid hamulus.It helps in the diagnosis and treat-ment of pterygoid hamulus-related diseases in a clinical setting.

Objective:To investigate the clinical characteristics and treatment analysis of unicentric retroperitoneal Castleman's dis-ease (CD) and to improve its levels of diagnosis and treatment. Methods:The clinical data of 18 patients with unicentric retroperitone-al CD were retrospectively reviewed from January 2002 to December 2016. We analyzed the demographic characteristics, clinical fea-tures, histological diagnosis, treatment, and prognostic characteristics of these patients. Results:The patients comprised 4 males and 14 females with a median age of 44.1 years old (ranging from 24 years old to 70 years old). The tumor was located in the kidney in one case, while it was located in the adrenal region in eight cases. In the other cases, the tumor was in the retroperitoneal region. Seven patients had a clinical atypical abdominal pain, and one patient had moderate anemia. All patients underwent surgical resection. The mean operation time was 153.3 min with a range of 60 min to 260 min. The mean blood loss was 447.2 mL (ranging from 10 mL to 3000 mL). Two cases had blood transfusion after operation, and one had urinary fistula complication. CD was confirmed by histopathol-ogy. Hyaline vascular type of CD was observed in 16 cases, and mixed type of CD was observed in 2 cases. The median follow-up was 25 months. One patient had tumor recurrence after 2 years of operation and died. Other patients remained alive without recurrence. Conclusion:Unicentric retroperitoneal CD is a rare disease that is often misdiagnosed because of the absence of specific clinical mani-festations. The final diagnosis depends on the results of a pathologic examination. Complete surgical resection offers a favorable result for unicentric retroperitoneal CD.

Objective To explore the effects of chlorhexidine aeetate and trielosan on inhibition of microorganism adhesion on soft denture-lining materials. Methods Silicone rubber soft denture- lining material and resin soft denture-lining material were soaked in 0. 2% chlorhexidine acetate and 0. 1% trielosan for 5 minutes. Then the colony numbers of three different microorganisms (streptococcus mutans, actinomyces viscosus, candida albicans) adhering to soft denture-lining materials were counted. Results The colony numbers of candida albicans were (121.0±7. 0) × 105 cfu/ml in resin soft denture-lining material and (208. 8±8. 6) × 105cfu/ml in silicone rubber soft denture-lining material (P<0. 05). But there were no differences in colony numbers of streptococcus mutans and actinomyces viseosus. After soaked in chlorhexidine acetate and triclosan, the colony numbers of streptococcus mutans were significantly reduced to (87.1±4. 3)× 105cfu/ml, (61.6± 7.9) × 105cfu/ml, (42.1±8.2) × 105cfu/ml and (21.3±4.3)× 105cfu/ml, and the colony numbers of candida albicans were significantly reduced to (11.6±3.6) × 105cfu/ml, (11.1±3. 7) × 105cfu/ml, (41.6±3.0) × 105cfu/ml and (44. 6±4.1)× 105cfu/ml(all P<0. 01). However, chlorhexidine acetate and triclosan had no effects on actinomyces viscosus. There were no significant differences in the action effects between the two detergents (P>0. 05). Conclusions Chlorhexidine acetate and trielosan can effectively inhibit the adhesion of microorganism on denture-lining materials, which are useful in clinic.