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.

BACKGROUND:At present,there are shortcomings and risks in the surgical revision of vertebral bodies that failed to be fixed in clinical practice.To avoid the risks of conventional revision surgery,the cortical bone trajectory technique is used to perform revision surgery on vertebral bodies that failed to be fixed.However,the mechanical properties of cortical bone trajectory technique screws in revision surgery are not clear. OBJECTIVE:The mechanical properties of cortical bone trajectory in lumbar revision surgery were analyzed by the finite element method to provide a theoretical basis for the clinical application of cortical bone trajectory in revision surgery. METHODS:CT scan data of the osteoporotic vertebral body were obtained and the L4 vertebral body model was established.The initial cortical bone trajectory placement and traditional pedicle screw in the L4 vertebral body model were completed,respectively,and their mechanical data were taken as the baseline standard for later evaluation of revision surgical performance.The traditional pedicle screw was removed and the screw path was retained.The cortical bone trajectory screw was used for secondary screw placement on the vertebral body to achieve lumbar refixation.The axial pull-out force,stability,and lumbar motion range of the revised screw were analyzed by the finite element method. RESULTS AND CONCLUSION:(1)The screw axial pull-out force of the cortical bone trajectory revision group was 25.6%higher than that of the traditional pedicle initial group.(2)In the lower,left,and right working conditions,the load-displacement ratio of screws in the cortical bone trajectory revision group increased by 18.5%,41.3%,and 35.0%,respectively,compared with the traditional pedicle initial group.The load-displacement ratio of screws in the cortical bone trajectory revision group was slightly higher than that in the traditional pedicle initial group under the above condition,but there was no statistically significant difference(P>0.05).(3)In anterior and posterior flexion conditions,lumbar motion range in the cortical bone trajectory revision group was increased by 45.5%and 36.1%compared with the traditional pedicle initial group,but there was no statistically significant difference in left bend,right bend,and axial rotation conditions(P>0.05).(4)There were no statistically significant differences in screw axial pull-out force,screw load-displacement ratio,and lumbar motion range between the cortical bone trajectory revision group and cortical bone trajectory initial group(P>0.05).(5)The mechanical data exhibited that although the revised nail track bone was damaged or lost to a certain extent,the mechanical properties of the cortical bone trajectory revision group were still better than those of the traditional pedicle initial group to a certain extent.Moreover,there was no significant difference in the mechanical properties between the cortical bone trajectory revision group and the cortical bone trajectory initial group.It provides a reference for revision surgery of lumbar internal fixation with cortical bone trajectory technique in patients with failed traditional pedicle fixation.

BACKGROUND:Autophagy may be involved in the pathological process of steroid-induced necrosis of the femoral head(SINFH).Some studies have confirmed that circular RNAs(circRNAs)have a regulatory mechanism in SINFH;however,whether circCDR1as affects autophagy in SINFH has not been investigated. OBJECTIVE:To explore the level of autophagy and the regulatory mechanism of circCDR1as in SINFH. METHODS:Gene expression profiles of SINFH and control rats were extracted from the GSE26316 dataset and differential expression analysis was performed.Subsequently,the biological functions of differentially expressed genes were analyzed.Then,the target miRNAs of circCDR1as and the target genes of target miRNAs were predicted.Further,the target genes were compared with the differentially expressed genes to construct the regulatory network of circCDR1as.In addition,femoral head samples from patients with SINFH and healthy control individuals were collected.Bone marrow mesenchymal stem cells were also applied for cellular experiments and randomly divided into bone marrow mesenchymal stem cell group,model group(methylprednisolone-treated),model+si-NC group,and model+si-CDR1as group.RT-qPCR was used to detect the expression of circCDR1as and target genes in cells and tissue samples.Western blot was used to examine the expression of autophagy proteins.The luciferase reporter gene vectors,pmirGLO-CDR1as(WT),pmirGLO-RAF1(WT),pmirGLO-CDR1as(MUT),and pmirGLO-RAF1(MUT),were constructed and transfected into the cells.miR-7-5p mimic and mimic NC groups were established.The target-regulatory relationship of the circCDR1as network was detected. RESULTS AND CONCLUSION:A total of 1 283 differentially expressed genes were identified between the SINFH and control groups,which were mainly involved in apoptotic and autophagic signaling pathways.Prediction analysis revealed that circCDR1as targeted 6 miRNAs,which in turn regulated 305 target genes.Among these target genes,31 showed differential expression in SINFH.Among the differentially expressed target genes,RAF1,involved in autophagy,was selected as a key gene,leading to the construction of the circCDR1as/miR-7-5p/RAF1 regulatory network.Compared with the control group,circCDR1as,RAF1,and autophagy levels were upregulated in patients with SINFH and in hormone-induced bone marrow mesenchymal stem cells(P<0.05),while miR-7-5p expression was downregulated(P<0.05).Knockdown of circCDR1as significantly decreased cellular autophagy levels(P<0.05).Dual-luciferase reporter assays confirmed the targeting relationships between circCDR1as and miR-7-5p,as well as between miR-7-5p and RAF1.To conclude,the CircCDR1as/miR-7-5p/RAF1 may potentially promote SINFH through autophagy.Targeting circCDR1as is a potential strategy for partial autophagic repair in the treatment of SINFH.

【Objective】 To observe the effects of early postnatal immune activation (EPIA) on social behaviors of male and female mice, and to explore the possible role of the functional state of astrocytes and microglia in this process. 【Methods】 Using lipopolysaccharide (LPS) induced EPIA mice as study subjects, mice were divided into the male-control, male-model, female-control, and female-model groups, each containing 10 mice (n=10). Behavioral tests were performed at 25 - 32 days of age, and the social behavior ability of mice was evaluated by open field test, three-chamber sociability test, and marble burying test. The expression levels of GFAP, IBA-1, TLR4, and NFκB p65 in the cortex and hippocampus were detected by Western blot (n=3). 【Results】 In behavioral tests, social index significantly decreased in LPS treatment group (F=14.907, P<0.05). The interaction effect between treatment and sex was significant in the residence time (F=5.260, P<0.05) and the number of buried marbles (F=7.788, P<0.05). LPS treatment decreased the retention time of the central region in male mice (F=4.261, P<0.05), and increased the number of buried marbles in males (F=20.645, P<0.05). Western blot results showed that LPS treatment increased the expression of GFAP protein in the hippocampus (F=50.443, P<0.05) and cortex (F=30.116, P<0.05), as well as the expression of IBA-1 protein (F=21.844. P<0.05) and TLR4 protein (F=6.215, P<0.05) in the cortex. The results of NFκB p65 showed a significant interaction between treatment and sex in the cortex (F=6.558, P<0.05), and LPS increased the expression of NFκB p65 protein in the cortex in female mice (F=16.317, P<0.05). 【Conclusions】 EPIA is sufficient to induce sex-specific autism spectrum disorder (ASD)-like behavior and enhance astroglial and microglial reactivity in mice. ASD-like behavior induced by EPIA may be related to the TLR4/NFκB signaling pathway in the cortex.

Objective A novel variable-diameter cortical threaded screw used in a modified cortical bone trajectory(MCBT)was designed to verify its mechanical properties using the MCBT technique.Methods According to MCBT technology,the screw pitch was fixed at 2 mm,the total length was 45 mm,the diameter of the thick rod was 5.5 mm,the diameter of the thin rod was 4.0-4.5 mm,and the length of variable-diameter position connecting the thick rod and the thin rod was 2 mm.The parameters were set based on three aspects:variable-diameter position,thread depth,and thread type.Three-factor and three-level L9 tests were conducted and screw models were established.The torsion and the bending and pull-out force of the designed screws were calculated based on the finite element method,the results were analyzed using range analysis,and then the screw models were determined.The three-dimensional(3D)model of L4 vertebral body in osteoporosis specimens was established and screws were placed according to the MCBT technique.The pull-out force of the novel variable-diameter cortical threaded screw was compared with that of a conventional non-variable-diameter cortical threaded screw.Results Range analysis showed that screw No.6(variable-diameter position:24 mm from the screw head,thread depth:0.7 mm,45° symmetrical thread)was the optimal screw.The anti-pull-out force of the No.6 variable-diameter cortical threaded screw was 13.1%higher than that of the 4.5 mm conventional non-variable-diameter cortical threaded screw,and no statistical difference in anti-pull-out force was found between the No.6 variable-diameter cortical threaded screw and the 5.5 mm conventional non-variable-diameter cortical threaded screw.Conclusions The variable-diameter position has the smallest influence on pull-out force of the screw,the thread type has the largest influence on pull-out force,and the thread depth has the largest influence on torsion and bending.Compared with that of the conventional non-variable-diameter cortical threaded screw,the variable-diameter cortical threaded screw had a smaller front end,which prevented splitting at the entrance point of the screw.The screw has a large diameter at rear end,thereby showing improved pull-out performance.The results provide a new theoretical basis for the clinical application of MCBT technology.

Objective To analyze the latest research hotspots and development trends of hyperuricemia and cardiovascular diseases in the past 20 years by using CiteSpace software and VOSviewer software.Methods The Web of Science database was searched from January 2005 to July 2024 for the literature on hyperuricemia and cardiovascular diseases,and the keywords,authors,institutions,and countries were analyzed by CiteSpace software and VOSviewer software,and the network cooperation map was constructed.Results A total of 2344 articles written by 5844 authors from 75 countries and 1713 institutions were analyzed.The journal Nutrition Metabolism and Cardiovascular Diseases had published the most papers in this field,with a total of 36 articles.Scholar Johnson has published 19 papers in this field,ranking first.A total of 2678 keywords were included,and the keywords that identified the research frontier and continued through 2024 were"asymptomatic hyperuricemia""xanthine oxidoreductase""adults".Conclusion The literature published in the field of hyperuricemia and cardiovascular disease correlation from 2005 to 2024,are comprehensively summarize,and sort out the development trends and research hotspots in this field in the past 20 years,through bibliometrics and visual analysis,which is expected to provide a reference direction for researchers in this field for subsequent research.

Aim To investigate the feasibility and mechanism of rhynchophylline in the treatment of in-rhynchophylline flammatory bowel disease (IBD) based on network pharmacology combined with in vivo and in vitro experiments. Methods The target of rhynchophylline-IBD intersection was obtained from the database, and GO and KEGG enrichment analysis were performed. The binding of key target proteins was screened by molecular docking. In vivo the IBD model of mice was induced by sodium dextran sulfate (DSS). After seven days of rhynchophylline intervention, the signs of mice in each group were observed and DAI scores were recorded. The levels of interleukin-1β (3 (IL-1 β), my-eloperoxidase (MPO) and other inflammatory factors in colon tissue of mice were detected by ELISA. The intestinal permeability of each group was detected. In vitro experiments were conducted to establish the inflammatory model of Caco2 cells induced by DSS, and to clarify the regulatory effect of leptosinine on key targets. Results A total of 70 rhynchophylline-IBD intersection targets were screened, and enrichment analysis showed that they were related to the inflammatory prooess, PI3K-Akt and Hippo signaling pathway s. Molecular docking results showed that was most stable in binding with JAK2 and JAK1. In vivo experiment results showed that compared with model group, body weight, colon length and weight of rhynchophylline group significantly increased (P < 0. 05). DAI score, IL-1β, MPO and other inflammatory factors in colon tissue and intestinal permeability significantly decreased (P < 0. 01). In vitro experiment results showed that compared with model group, rhynchophylline group significantly promoted the proliferation of Caco2 cells (P < 0. 05). The levels of IL-6 and NO were significantly reduced (P < 0. 05). Western blot results showed that rhynchophylline could decrease the expressions of JAK2 and JAK1 (P < 0. 05). Conclusion Rhynchophylline may play a role in the treatment of IBD by inhibiting the expression of JAK2 and JAK1 proteins and reducing inflammatory response in body.

Objective To analyze the risk factors for recurrence of primary spontaneous pneumothorax and to establish a prediction model.Methods The clinical data of 803 patients clearly diagnosed with primary spontaneous pneumothorax in the First Affiliated Hospital of Xinjiang Medical University from January 2010 to January 2021 were retrospectively analyzed,and 70％of the patients were randomly included in the modeling group(562 patients)and 30％in the validation group(241 patients).Risk factors for recurrence were analyzed by univariate and multivariate Cox regression using R 4.2.1 software,and a Nomogram prediction model was developed.Receiver operating characteristic curves were plotted,and the area under the curve(AUC)was calculated to assess model discrimination,and calibration curves were plotted to assess model calibration.Results The overall recurrence rate was 22.67％(182/803).Multivariate Cox regression analysis showed that age,smoking index,dystrophic severity score and treatment regimens were independent risk factors for recurrence of primary spontaneous pneumothorax,and the AUC of the Nomogram prediction model was 71.7％(95％CI 64.1-79.2),with high predictive efficiency.Conclusion This recurrence prediction model of primary spontaneous pneumothorax can assist clinicians to accurately assess the risk of recurrence in individual patients.

Objective To predict the potential mechanism of Punicalagin in the treatment of Inflammatory bowel disease by network pharmacology.Methods The intersection genes of Punicalagin and IBD were obtained from the database,and PPI,GO and KEGG pathways were enriched and analyzed.Punicalagin and the target were verified by molecular docking.C57BL/6J mice were drunk dextran sulfate sodium to establish inflammatory enteritis model,and were given Punicalagin for 7 d of intervention.During the administration,signs of mice in each group were observed,daily disease activity index was calculated;Intestinal permeability test after administration;The colon tissue was stained with hematoxylin eosin to observe the pathological changes and calculate the histological damage score;Detection of tumor necrosis factor(TNF-α),Interleukin-10(IL-10),myeloperoxidase(MPO),chemokine 1(CXCL1)and other cytokines in colon tissue of mice by ELISA.Detection of TNF-α,IL-6,MPO and CXCL1 level in mouse serum by ELISA.CCK8 method was used to determine the effect of Punicalagin on the proliferation activity of caco-2 cells.The levels of cytokines released by caco-2 cells induced by lipopolysaccharide(LPS)were detected by ELISA.Results 14 common targets of Punicalagin and IBD were obtained,including tumor necrosis factor(TNF),arachidonic acid-5-lipoxygenase(ALOX5)and vascular endothelial growth factor A(VEGFA).KEGG enrichment analysis predicted that the treatment of IBD by Punicalagin mainly acted on arachidonic acid signaling pathway,age-rage signaling pathway,VEGR signaling pathway and Ras signaling pathway.Molecular docking showed that Punicalagin had good docking activity with TNF receptor.Compared with the model group,the decreasing range of body mass in Punicalagin group abated(P<0.01);the disease activity index of Punicalagin group decreased significantly(P<0.01);The congestion and edema of colonic mucosa were significantly reduced,and the histological injury score was significantly reduced(P<0.01);The level of TNF-α,IL-1β,MPO,CXCL1,IL-6,IL-18,IFN-γ in colon tissue was significantly decreased(P<0.01);20-300 μmol·L-1 Punicalagin promoted caco-2 cell proliferation and inhibited TNF-α secretion induced by LPS,up-regulation of IL-10 levels.Conclusion Punicalagin inhibits the secretion of TNF-α and other proinflammatory factors,up-regulation of the level of anti-inflammatory factor IL-10,and improvement of colonic inflammatory response in IBD mice.