Vascular cognitive impairment (VCI), caused by cerebrovascular dysfunction, severely impacts the quality of life in the elderly population, yet effective therapeutic approaches remain limited. Mitophagy, a selective mitochondrial quality-control mechanism, has emerged as a critical focus in neurological disease research. Accumulating evidence indicates that mitophagy modulates oxidative stress, neuroinflammation, and neuronal apoptosis. Key signaling pathways associated with mitophagy—including PINK1/Parkin, BNIP3/Nix, FUNDC1, PI3K/Akt/mTOR, and AMPK—have been identified as potential therapeutic targets for VCI. This review summarizes the mechanistic roles of mitophagy in VCI pathogenesis and explores emerging therapeutic strategies targeting these pathways, aiming to provide novel insights for clinical intervention and advance the development of effective treatments for VCI.

To investigate the correlation between vitamin D nutritional status and insulin resistance in pubertal adolescents.

BackgroundWith the rapid development of the networking technologies， internet addiction has increasingly become a serious mental health issue. Previous studies have revealed the link between childhood trauma and internet addiction， while the mediating role of perceived stress in this link is not yet clear. ObjectiveTo investigate the role of medical students' perceived stress in the relationship between childhood trauma and internet addiction， so as to provide references for the intervention of internet addiction. MethodsFrom February to March 2023， a random sampling technique was used to select 1 232 undergraduate students from the School of Clinical Medical Sciences of Southwest Medical University as research subjects. The Childhood Trauma Questionnaire-Short Form （CTQ-SF）， Perceived Stress Scale （PSS）， Internet Gaming Disorder Scale （IGDS）， and Bergen Social Media Addiction Scale （BSMAS） were used for assessment. Pearson's correlation coefficients were calculated. The mediation effect of perceived stress in the relationship between childhood trauma and internet addiction was tested using Model 4 in the SPSS Process 4.1， and Bootstrapping procedure involving 5 000 replicates was employed to confirm the statistical significance. ResultsA total of 1 016 （82.47%） valid completed questionnaires were gathered. The CTQ-SF scores of medical students were positively correlated with PSS scores， IGD scores， and BSMAS scores （r=0.583， 0.474， 0.465， P<0.01）. PSS scores were positively correlated with IGD scores and BSMAS scores （r=0.369， 0.479， P<0.01）. Childhood trauma in medical students was found to positively predict perceived stress （β=0.191， P<0.01）， social media addiction （β=0.160， P<0.01）， and internet gaming disorder （β=0.106， P<0.01）. Perceived stress played a significant mediating role in the relationship between childhood trauma and internet gaming disorder， indirect effect value was 0.018 （95% CI： 0.009~0.027）， accounting for 16.98%. Perceived stress also exhibited a significant mediating role in the relationship between childhood trauma and social media addiction， indirect effect value was 0.063 （95% CI： 0.048~0.079）， accounting for 39.38%. ConclusionChildhood trauma in medical students may affect internet gaming disorder and social media addiction through perceived stress. ［Funded by 2022 Annual Research Project of Sichuan Applied Psychology Research Center，（number，CSXL-22102）］

With the rapid advancement of artificial intelligence technology, chatbots have shown great potential in the healthcare sector. From personalized health advice to chronic disease management and psychological support, chatbots have demonstrated significant advantages in improving the efficiency and quality of healthcare services. As the scope of their applications expands, the relationship between technological complexity and practical application scenarios has become increasingly intertwined, necessitating a more comprehensive evaluation of both aspects. This paper, from the perspective of he althcare applications, systematically reviews the technological pathways and development of chatbots in the medical field, providing an in-depth analysis of their performance across various medical scenarios. It thoroughly examines the advantages and limitations of chatbots, aiming to offer theoretical support for future research and propose feasible recommendations for the broader adoption of chatbot technologies in healthcare.

Objective:Based on multi-subject coordination perspective,it aimed to define the stakeholders in the active health management model,analyze the functional positioning and interests of each party,and put forward relevant governance strategies,so as to provide the participating subjects with governance ideas for the subsequent exploration of the implementation path of active health.Methods:Stakeholders are identified,categorized and managed using Delphi expert consultation and Mitchell scoring method.Results:After two rounds of expert consultation,a total of 17 stakeholders were identified and categorized into three types:deterministic,anticipatory,and marginal stakeholders.In addition,taking into account the opinions from the expert interviews,the functional positioning and interests of each party were further identified,and corresponding management strategies were proposed.Conclusion:Active health management should adopt the strategy of"holistic coordination and categorization",adopting different governance strategies according to the priority of the demands of each type of stakeholder,and at the same time establishing a sound mechanism for sharing responsibilities and preventing conflicts of interest,so as to coordinate and balance the interests of all parties.

Objective Explore the impact of payment by DRG on rehabilitation cases,evaluate the effect of DRG policy reform for rehabilitation cases and make relevant recommendations.Methods Rehabilitation cases admitted to designated medical institutions in Sichuan Province in 2020-2021 were extracted,and regression analyses were per-formed after Propensity Score Matching using the Difference in Differences method to evaluate the impact of DRG payment on the inpatient costs and the hospitalization days of rehabilitation cases,then analyze the net effect of the policy.Results After the implementation of DRG payment,the total hospitalization cost,drug cost,treatment cost,and examination cost of rehabilitation cases decreased to different degrees,and only the bed cost increased,in which the total hospitalization cost decreased by 21.8％(P＜0.05),and the cost structure of the cases changed to a certain extent compared with that before the implementation of DRG payment.In addition,the number of hospi-talization days for rehabilitation cases has not been effectively reduced under the DRG policy,but rather increased by 13.4％(P＜0.05).Conclusion DRG payment can effectively reduce the financial burden of rehabilitation cases,but it does not optimize the operational efficiency of hospitals.Whether payment by DRG is applicable to rehabilita-tion cases is open to further discussion,the health insurance department and hospitals should be in close contact to actively explore new modes of health insurance payment for rehabilitation cases.

Objective:Based on multi-subject coordination perspective,it aimed to define the stakeholders in the active health management model,analyze the functional positioning and interests of each party,and put forward relevant governance strategies,so as to provide the participating subjects with governance ideas for the subsequent exploration of the implementation path of active health.Methods:Stakeholders are identified,categorized and managed using Delphi expert consultation and Mitchell scoring method.Results:After two rounds of expert consultation,a total of 17 stakeholders were identified and categorized into three types:deterministic,anticipatory,and marginal stakeholders.In addition,taking into account the opinions from the expert interviews,the functional positioning and interests of each party were further identified,and corresponding management strategies were proposed.Conclusion:Active health management should adopt the strategy of"holistic coordination and categorization",adopting different governance strategies according to the priority of the demands of each type of stakeholder,and at the same time establishing a sound mechanism for sharing responsibilities and preventing conflicts of interest,so as to coordinate and balance the interests of all parties.

Objective Explore the impact of payment by DRG on rehabilitation cases,evaluate the effect of DRG policy reform for rehabilitation cases and make relevant recommendations.Methods Rehabilitation cases admitted to designated medical institutions in Sichuan Province in 2020-2021 were extracted,and regression analyses were per-formed after Propensity Score Matching using the Difference in Differences method to evaluate the impact of DRG payment on the inpatient costs and the hospitalization days of rehabilitation cases,then analyze the net effect of the policy.Results After the implementation of DRG payment,the total hospitalization cost,drug cost,treatment cost,and examination cost of rehabilitation cases decreased to different degrees,and only the bed cost increased,in which the total hospitalization cost decreased by 21.8％(P＜0.05),and the cost structure of the cases changed to a certain extent compared with that before the implementation of DRG payment.In addition,the number of hospi-talization days for rehabilitation cases has not been effectively reduced under the DRG policy,but rather increased by 13.4％(P＜0.05).Conclusion DRG payment can effectively reduce the financial burden of rehabilitation cases,but it does not optimize the operational efficiency of hospitals.Whether payment by DRG is applicable to rehabilita-tion cases is open to further discussion,the health insurance department and hospitals should be in close contact to actively explore new modes of health insurance payment for rehabilitation cases.

Objective:Based on multi-subject coordination perspective,it aimed to define the stakeholders in the active health management model,analyze the functional positioning and interests of each party,and put forward relevant governance strategies,so as to provide the participating subjects with governance ideas for the subsequent exploration of the implementation path of active health.Methods:Stakeholders are identified,categorized and managed using Delphi expert consultation and Mitchell scoring method.Results:After two rounds of expert consultation,a total of 17 stakeholders were identified and categorized into three types:deterministic,anticipatory,and marginal stakeholders.In addition,taking into account the opinions from the expert interviews,the functional positioning and interests of each party were further identified,and corresponding management strategies were proposed.Conclusion:Active health management should adopt the strategy of"holistic coordination and categorization",adopting different governance strategies according to the priority of the demands of each type of stakeholder,and at the same time establishing a sound mechanism for sharing responsibilities and preventing conflicts of interest,so as to coordinate and balance the interests of all parties.

Objective Explore the impact of payment by DRG on rehabilitation cases,evaluate the effect of DRG policy reform for rehabilitation cases and make relevant recommendations.Methods Rehabilitation cases admitted to designated medical institutions in Sichuan Province in 2020-2021 were extracted,and regression analyses were per-formed after Propensity Score Matching using the Difference in Differences method to evaluate the impact of DRG payment on the inpatient costs and the hospitalization days of rehabilitation cases,then analyze the net effect of the policy.Results After the implementation of DRG payment,the total hospitalization cost,drug cost,treatment cost,and examination cost of rehabilitation cases decreased to different degrees,and only the bed cost increased,in which the total hospitalization cost decreased by 21.8％(P＜0.05),and the cost structure of the cases changed to a certain extent compared with that before the implementation of DRG payment.In addition,the number of hospi-talization days for rehabilitation cases has not been effectively reduced under the DRG policy,but rather increased by 13.4％(P＜0.05).Conclusion DRG payment can effectively reduce the financial burden of rehabilitation cases,but it does not optimize the operational efficiency of hospitals.Whether payment by DRG is applicable to rehabilita-tion cases is open to further discussion,the health insurance department and hospitals should be in close contact to actively explore new modes of health insurance payment for rehabilitation cases.