Objective:To investigate the efficacy of the intelligent version of the Montreal Cognitive Assessment Scale(MoCA)in identifying mild cognitive impairment(MCI)in elderly inpatients.Methods:Seventy-five patients diagnosed with mild cognitive impairment(MCI group)from the Neurology and Geriatrics Departments of a tertiary hospital in Changsha City, along with 195 patients with normal cognitive function(normal control group), were selected between July 2020 and December 2022.Both groups underwent evaluations using the intelligent version of the Montreal Cognitive Assessment(MoCA)and the Mini Mental State Examination(MMSE), and the results were analyzed.Results:The MCI group showed significantly lower total MoCA scores and MMSE scores[(19.73±2.42) vs.(24.8±2.33)]compared to the normal control group[(24.47±2.02) vs.(26.50±1.65)], with a statistically significant difference( P<0.01).The optimal cut-off score for the MoCA was found to be 23.5 points in diagnosing MCI, showing higher sensitivity, specificity, and kappa value(96.0%, 82.1%, and 0.690)compared to the MMSE scale(90.0%, 62.6%, and 0.428). Conclusions:The intelligent MoCA has a high screening accuracy for identifying MCI in this population, demonstrating superior sensitivity and specificity compared to the MMSE.

Traditional Chinese medicines (TCMs) possess a rich historical background, unique theoretical framework, remarkable therapeutic efficacy, and abundant resources. However, the modernization and internationalization of TCMs have faced significant obstacles due to their diverse ingredients and unknown mechanisms. To gain deeper insights into the phytochemicals and ensure the quality control of TCMs, there is an urgent need to enhance analytical techniques. Currently, two-dimensional (2D) chromatography, which incorporates two independent separation mechanisms, demonstrates superior separation capabilities compared to the traditional one-dimensional (1D) separation system when analyzing TCMs samples. Over the past decade, new techniques have been continuously developed to gain actionable insights from complex samples. This review presents the recent advancements in the application of multidimensional chromatography for the quality evaluation of TCMs, encompassing 2D-gas chromatography (GC), 2D-liquid chromatography (LC), as well as emerging three-dimensional (3D)-GC, 3D-LC, and their associated data-processing approaches. These studies highlight the promising potential of multidimensional chromatographic separation for future phytochemical analysis. Nevertheless, the increased separation capability has resulted in higher-order data sets and greater demands for data-processing tools. Considering that multidimensional chromatography is still a relatively nascent research field, further hardware enhancements and the implementation of chemometric methods are necessary to foster its robust development.

Objective To retrospectively analyze the research on the integrated medical and elderly care in China in re-cent ten years,and explore the research hotspots and future research trend of the integrated medical and elderly care.Methods Using the method of literature research,the journal articles with the theme of combination of medical care and nursing,integration of medical care and nursing or medical care and nursing service from 2013 to 2023 were searched in CNKI.The sources were lim-ited to Peking University Core,CSSCI,CSCD and AMI,and the selected articles were analyzed by CiteSpace.Results This ar-ticle takes 896 literatures as research objects,we found that the number of articles reached a peak in 2018,the higher number of articles issued by the institutions are medicine-related institutions.The high-frequency keywords are the integrated medical and elderly care,elderly services,senior citizens,elderly care institutions and elderly care model.The strongest emergent word de-tected is health care integration.Conclusion In the past ten years,domestic research on the integration of medical care and eld-erly care has shown diversification and innovation.Policy tools,pension insurance,community and rural pension,quality evalua-tion index system,influencing factors were the research focus of scholars.Future research needs to focus on the application of quantitative methods,empirical and practical analysis.

OBJECTIVES: Acute ischemic stroke (AIS) is one of the main causes of disability in middle-aged and elderly people, and early activity plays an important role in functional recovery. This study aims to understand the factors that affect the implementation of early activity in patients with AIS and to provide reference for promoting early activity implementation and developing intervention strategies for AIS patients. METHODS: Using purposive sampling, 19 AIS patients and their caregivers who visited at Stroke Center in the Third Xiangya Hospital of Central South University and the Third Hospital of Changsha from June to December 2021, as well as 19 medical staff, hospital administrators, or community workers providing medical health services to stroke patients, were selected as interviewes. A semi-structured interview was conducted based on the social ecological theory model, and the Colaizzi seven-step method was used to analyze the interview data. RESULTS: According to qualitative interview results, the factors affecting early activity in AIS patients were summarized into 4 themes and 12 sub-themes: medical staff factors (insufficient knowledge and skills, insufficient knowledge of early activity, unclear division of responsibilities), patient factors (severity of the disease, lack of knowledge, psychological pressure, fear of falling), social environmental factors (lack of social support, shortage of human resources and rehabilitation equipment, insufficient medical insurance support), and evidence and norms (the evidence for early activity needs improvement, lack of standardized early activity procedures). CONCLUSIONS Early activity in AIS patients is impacted by factors at multiple levels, including medical staff, patients, social environment, and evidence and norms. Developing comprehensive intervention strategies to address these factors can promote early activity implementation in AIS patients.
Aged ; Middle Aged ; Humans ; Ischemic Stroke ; Accidental Falls ; Fear ; Social Environment ; Stroke

Objective:To explore the correlation between lean nonalcoholic fatty liver disease (NAFLD) and metabolic indicators in a young and middle-aged population undergoing physical examination.Methods:It was a cross-sectional study. A total of 8 250 individuals who underwent routine physical examinations at the Health Medical Center of the Second Affiliated Hospital of Chongqing Medical University from January to December 2021 and met the inclusion and exclusion criteria were selected as the research subbjects. The general examination, fasting blood glucose, blood lipids, liver function, renal function, and fasting color ultrasound examination results were analyzed retrospectively to assess the correlation between lean NAFLD and major metabolic indicators using independent sample t-test, chi-square test, and multivariable logistic regression. Results:The prevalence of lean NAFLD was higher in men than in women (50.7% vs. 49.3%, χ2=97.261, P<0.001). After stratifying the age of onset of lean NAFLD, the peak age of onset was found to be between 45 and 59 years, with the prevalence gradually increasing with age. When stratified by body mass index (BMI), the peak incidence of lean NAFLD was observed in individuals with a BMI of ≥20 and <23 kg/m 2, with the prevalence showing a significant upward trend as BMI increased. The systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low-density lipoprotein, fasting blood glucose, alanine aminotransferase, aspartate aminotransferase, γ-glutamyltransferase, and serum uric acid in lean NAFLD groupwere all significantly higher than those in lean non-NAFLD group (all P<0.01), and the level of high density lipoprotein was significantly lower than that of lean non-NAFLD group ( t=23.755, P<0.001). The logistic analysis showed that systolic blood pressure ( OR=1.258, 95% CI: 1.081-1.465), diastolic blood pressure ( OR=1.282, 95% CI: 1.056-1.557), total cholesterol ( OR=1.712, 95% CI: 1.525-1.923), triglyceride ( OR=4.115, 95% CI: 3.621-4.676), alanine aminotransferase ( OR=1.467, 95% CI: 1.104-1.950), γ-glutamyltransferase ( OR=1.482, 95% CI: 1.242-1.769), fasting blood glucose ( OR=2.479, 95% CI: 2.092-2.939) and serum uric acid ( OR=1.390, 95% CI: 1.236-1.563) were independent metabolic risk factors for lean NAFLD (all P<0.05). Conclusions:The levels of various metabolic markers in young and middle-aged patients with lean NAFLD increase, and the risk of lean NAFLD increases. Metabolic markers are helpful to screen people at risk of lean NAFLD.

Objective:To understand the current situation of early mobilization in elder patients with acute ischemic stroke, and to analyze the influencing factors of early mobilization in patients with different degrees of neurological deficits, aiming to provide evidence for promoting early mobilization in patients with stroke and for formulating intervention strategies.Methods:Patients with acute ischemic stroke admitted to the stroke centers of two class A tertiary hospitals in Hunan Province between January and December 2021 were enrolled.The degree of neurological impairment, activities of daily living and muscle strength were evaluated within 24 hours after admission, and patients' performance of early mobilization was recorded.Based on whether patients performed out-of-bed activities such as sitting at the bedside, standing or walking, transferring from bed to chair within 48 hours after admission, they were divided into an early ambulation group and a non-early ambulation group.Univariate analysis and Logistic regression analysis were then used to examine the influencing factors of early ambulation in patients with mild to moderate neurological deficits.Results:Among 257 patients with acute ischemic stroke, 60.7%(156 cases)conducted early mobilization.The rate of early mobilization for patients with moderate neurological deficits was only 12.9%(12/193), significantly lower than that for patients with mild neurological deficits(87.8%, 144/164)( χ2=139.571, P<0.001).Univariate analysis showed that there were significantly differences in the level of activities of daily living, stroke history, strength of the upper and lower limbs of the affected side between the early and non-early ambulation groups with moderate neurological impairment(all P<0.05), and there were significant differences in the level of activities of daily living between the early ambulation group and the non-early ambulation group in patients with mild neurological impairment( χ2=11.907, P<0.001).Logistic regression analysis showed that requiring assistance in daily life( OR=4.189, 95% CI: 1.724-10.668, P=0.002), muscle strength of the affected lower extremity ≤ grade 3( OR=9.605, 95% CI: 2.627-35.113, P=0.001)and moderate neurological deficits( OR=8.585, 95% CI: 3.216-22.913, P<0.001)were the risk factors of early mobilization in stroke patients. Conclusions:The rate of stroke patients with moderate neurological impairment performing early mobilization is low within 48 hours after admission.Activities of daily living ability, limb muscle strength and degrees of neurological deficits are influencing factors of early mobilization in stroke patients.

Colorectal cancer is one of the common malignant tumors with high morbidity， and changes in lifestyle， dietary structure and environment in China in recent decades have been associated with an increase in the incidence of colorectal cancer. A large number of studies have shown that traditional Chinese medicine（TCM） can be used as a complementary and alternative treatment for colorectal cancer after conventional western medicine treatment. TCM physicians have accumulated a lot of clinical experience in the treatment of patients with stage Ⅰ-Ⅲ colorectal cancer， and have proved that TCM has unique efficacy， but there is still a lack of relevant clinical practice guidelines to standardize and guide the diagnosis and treatment of TCM. Based on this， according to the guideline development process of the World Health Organization Handbook for Guideline Development and the Clinical Evidence Grading Criteria on TCM Based on Evidence Body， under the framework of relevant laws， regulations and technical guidance documents， combined with the evidence of relevant domestic and foreign clinical research in recent years for evidence grading and opinion recommendation， and then the Guidelines for TCM Intervention After Conventional Western Medicine Treatment for Stage Ⅰ-Ⅲ Colorectal Cancer were developed by expert consensus. This guideline introduces the etiology， pathogenesis， syndrome differentiation and treatment of TCM intervention for colorectal cancer， which can provide guiding opinions for TCM clinicians and clinicians of integrated traditional Chinese and western medicine engaged in the prevention and treatment of colorectal cancer.

Pulmonary hypertension (PH) is a life-threatening disease characterized by pulmonary vascular remodeling, in which hyperproliferation of pulmonary artery smooth muscle cells (PASMCs) plays an important role. The cysteine 674 (C674) in the sarcoplasmic/endoplasmic reticulum Ca²⁺ ATPase 2 (SERCA2) is the critical redox regulatory cysteine to regulate SERCA2 activity. Heterozygous SERCA2 C674S knock-in mice (SKI), where one copy of C674 was substituted by serine to represent partial C674 oxidative inactivation, developed significant pulmonary vascular remodeling resembling human PH, and their right ventricular systolic pressure modestly increased with age. In PASMCs, substitution of C674 activated inositol requiring enzyme 1 alpha (IRE1α) and spliced X-box binding protein 1 (XBP1s) pathway, accelerated cell cycle and cell proliferation, which reversed by IRE1α/XBP1s pathway inhibitor 4μ8C. In addition, suppressing the IRE1α/XBP1s pathway prevented pulmonary vascular remodeling caused by substitution of C674. Similar to SERCA2a, SERCA2b is also important to restrict the proliferation of PASMCs. Our study articulates the causal effect of C674 oxidative inactivation on the development of pulmonary vascular remodeling and PH, emphasizing the importance of C674 in restricting PASMC proliferation to maintain pulmonary vascular homeostasis. Moreover, the IRE1α/XBP1s pathway and SERCA2 might be potential targets for PH therapy.

Spinal cord injury (SCI) is a disabling and destructive central nervous system injury that has not yet been successfully treated at this stage. Three-dimensional (3D) bioprinting has become a promising method to produce more biologically complex microstructures, which fabricate living neural constructs with anatomically accurate complex geometries and spatial distributions of neural stem cells, and this is critical in the treatment of SCI. With the development of 3D printing technology and the deepening of research, neural tissue engineering research using different printing methods, bio-inks, and cells to repair SCI has achieved certain results. Although satisfactory results have not yet been achieved, they have provided novel ideas for the clinical treatment of SCI. Considering the potential impact of 3D bioprinting technology on neural studies, this review focuses on 3D bioprinting methods widely used in SCI neural tissue engineering, and the latest technological applications of bioprinting of nerve tissues for the repair of SCI are discussed. In addition to introducing the recent progress, this work also describes the existing limitations and highlights emerging possibilities and future prospects in this field.