Abstract:Objective To explore the characteristics of lipid metabolism and gut microbiota in elderly patients with bacterial pneumonia and their correlation with inflammatory response. Methods A total of 138 elderly patients with bacterial pneumonia admitted to Beijing Shijitan Hospital affiliated to Capital Medical University from May 2021 to December 2023 were selected as the observation group, and 50 healthy volunteers matched in age and gender with observation group were recruited as the control group. Lipid metabolism indicators [total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB)] and serum inflammatory factors [C-reactive protein (CRP) and procalcitonin (PCT)] were measured in both groups. The abundance and diversity of gut microbiota in fecal samples were analyzed using 16S rDNA gene sequencing. Bifidobacterium, Lactobacillus, Escherichia coli and Enterococcus in the fecal samples were quantitatively analyzed using 16S rDNA real-time fluorescence quantitative polymerase chain reaction (PCR). SPSS 26.0 was used for data analysis, and t test or Chi-square test was performed for between-group comparison according to the data type. Pearson correlation analysis was conducted to analyze the correlation between serum inflammatory factors and lipid metabolism indicators or gut microbiota quantification in the observation group. Results The levels of TG, HDL-C, and ApoA1 in the observation group were lower, while serum CRP and PCT levels were higher than those in the control group; the abundance-based coverage estimator (Ace) index, Chao index, and Shannon index of gut microbiota were lower than those in the control group, while Simpson index was higher than that in the control group; the quantitative values of Bifidobacterium and Lactobacillus were lower, while the quantitative values of Escherichia coli and Enterococcus were higher than those in the control group (P<0.05). Pearson correlation analysis indicated that CRP levels in the observation group was negatively correlated with TG, HDL-C, ApoA1, Bifidobacterium quantitative values, and Lactobacillus quantitative values (r=-0.411, -0.326, -0.331, -0.443, -0.362; P<0.05), and was positively correlated with Escherichia coli quantitative values (r=0.221, P<0.05), and that PCT levels were negatively correlated with TG, HDL-C, ApoA1 and Bifidobacterium quantitative values (r=-0.379, -0.279, -0.329, -0.261; P<0.05). Conclusion Elderly patients with bacterial pneumonia exhibit disorders lipid metabolism and gut microbiota, and levels of TG, HDL-C and ApoA1 and quantitative values of Bifidobacterium, Lactobacillus and Escherichia coli are correlated with inflammatory response indicators.

Abstract:Objective To analyze the relationship of cancer adaptation with social support and personality characteristics in elderly patients with breast cancer. Methods A questionnaire survey was conducted on 150 elderly patients with breast cancer admitted to our hospital from February 2021 to April 2024. The questionnaire included demographic data questionnaire, psychosocial adaptation questionnaire for breast cancer patients, social support rating scale (SSRS), and Chinese big five personality inventory-brief version (CBF-PI-B). Finally, 139 valid questionnaires were collected. The scores of cancer adaptation, SSRS and CBF-PI-B were analyzed in 139 elderly patients with breast cancer. SPSS statistics 25.0 was used to process and analyze the data. Depending on data type, intergroup comparisons were conducted using t test, one-way ANOVA, orχ² test. Pearson correlation coefficient was used to evaluate the correlation between cancer adaptation and social support as well as personality characteristics in the patients. Multivariate linear regression analysis was adopted to assess the influencing factors for cancer adaptation in these elderly patients. Results In the 139 elderly patients, the total scores of cancer adaptation and SSRS were (122.48±7.93) and (44.25±5.27) points, respectively, and the highest score of agreeableness in CBF-PI-B was (37.89±3.04) points, and the lowest score of openness was (22.03±3.36) points. Statistical difference was observed in the total score of cancer adaptation in the patients of different age and with different per capita monthly household income (P<0.05). Pearson correlation coefficient analysis indicated that the total score of cancer adaptation was positively correlated with the scores of subjective support, objective support, support utilization dimensions and total score in SSRS (r=0.521,0.398,0.455,0.519; all P<0.001), and was negatively correlated with neuroticism score of CBF-PI-B (r=-0.369; P<0.001). Multivariate linear regression analysis revealed that age, per capita monthly household income, total SSRS score and scores of subjective support, objective support and support utilization dimensions, and neuroticism score of CBF-PI-B were all influencing factors for cancer adaptation level in elderly patients with breast cancer (β=-0.138,0.163,0.151,0.115,0.124,0.117, -0.211; P<0.05). ConclusionOlder age, lower per capita monthly household income, lower social support, and high neuroticism can increase the risk of poor cancer adaptation in elderly breast cancer patients.

Abstract:Objective To explore the characteristics of elderly patients with antibiotic-associated diarrhea (AAD) secondary to pneumonia and analyze the efficacy of nutritional sequential therapy. Methods A total of 132 elderly patients with AAD secondary to pneumonia admitted in our hospital from May 2022 to December 2023 were enrolled as AAD group, and another 132 pneumonia patients without secondary AAD were included and served as non-AAD group. Clinical characteristics of secondary AAD and its influencing factors were analyzed. The patients in the AAD group were randomly divided into observation subgroup (66 cases) and control subgroup (66 cases). The control subgroup received routine intervention, while the observation subgroup was given nutritional sequential therapy on the basis of routine intervention. The diarrhea stopping time and levels of peripheral blood T lymphocyte subsets before and after treatment were compared between the two subgroups. SPSS statistics 22.0 was used for data analysis. Depending on data type, t test or Chi-square test was performed for comparison. Multivariate logistic regression analysis was employed to identify the related factors affecting secondary AAD in elderly patients with pneumonia. Results The diarrhea symptom of the AAD group appeared 3-17 (7.72±2.21) d after the application of antibiotics. The AAD group had significantly larger proportions of age ≥80 years, severe pneumonia, invasive procedures, use of antibiotics ≥3 types, time of antibiotics ≥7 d, and fasting than the non-AAD group (P<0.05). The diarrhea stopping time was obviously shorter in the observation subgroup than the control subgroup (P<0.05). After treatment, the percentages of cluster of differentiation (CD)3+ and CD4⁺ cells were notably risen while that of CD8⁺ cells was reduced in both subgroups, and the percentages of former cells were higher and that of the latter cells was lower in the observation subgroup than the control subgroup (P<0.05). Multivariate logistic regression analysis showed that age ≥80 years (OR=2.643,95%CI 1.486-4.703), severe pneumonia (OR=2.147,95%CI 1.238-3.724), invasive procedure (OR=1.931,95%CI 1.056-3.531), time of antibiotic use ≥7 d (OR=2.210,95%CI 1.269-3.848) and fasting (OR=1.804,95%CI 1.034-3.148) were independent risk factors for secondary AAD occurrence (P<0.05). Conclusion Age ≥80 years, severe pneumonia, invasive procedure, time of antibiotic use ≥7 d and fasting are high risk factors for secondary AAD. Nutritional sequential therapy can improve the immune function and promote the recovery in the patients.

Abstract:Objective To assess the risk of atrial fibrillation (AF) recurrence at 12-36 months after high-power short-duration (HPSD) radiofrequency ablation post-procedure in elderly patients with AF and to investigate its safety and predictors for recurrence. Methods A retrospective analysis was conducted of the clinical data of 139 elderly AF patients who underwent catheter ablation at the 983rd Hospital of the Joint Logistics Support Force from January 2020 to December 2022. According to the ablation strategy, they were divided into HPSD group (n=72) and low-power long-duration (LPLD) group (n=67). Baseline data, preoperative echocardiographic parameters, and procedural data were collected. The patients were followed up for 12-36 months postoperatively. SPSS 21.0 was used for statistical analysis. Data comparison between two groups was performed using t test, Mann-Whitney U test orχ² test depending on data type. Logistic regression was used to identify independent risk factors for postoperative AF recurrence. Kaplan-Meier analysis was employed to assess the long-term AF-free survival rates in the HPSD and LPLD groups. Results The HPSD group showed significantly shorter ablation times for bilateral pulmonary veins isolation than the LPLD group [right:(14.97±3.70) vs (18.00±3.56) min; left:(13.54±5.59) vs (16.30±4.37) min; both P<0.05]. Logistic regression analysis identified persistent AF (OR=5.50,95%CI 1.994-15.171), heart failure (OR=7.92,95%CI 2.484-25.257), left atrial diameter (OR=1.111,95%CI 1.028-1.202), and left ventricular diameter (OR=1.105 per mm, 95%CI 1.030-1.186) as independent risk factors for recurrence (all P<0.05). No statistically significant difference in cumulative recurrence rates was observed between the HPSD and LPLD groups at 12-36 months [ 33.3% (24/72) vs 37.3% (25/67), P=0.634]. Conclusion HPSD ablation improves procedural efficiency without increasing mid-to-long-term recurrence risk. Persistent AF, heart failure, and cardiac structural remodeling (left atrial/ventricular enlargement) are key predictors of recurrence in elderly AF patients.

Abstract:Objective To investigate the clinical characteristics of elderly patients with congestive heart failure (CHF) complicated with hyperuricemia (HUA) and to analyze the value of uric acid-lowering therapy in improving the prognosis of HUA patients. Methods A total of 316 elderly CHF patients admitted to the Second Affiliated Hospital of Xi′an Jiaotong University from July 2020 to May 2023 were enrolled as the study subjects. According to the serum uric acid (SUA) levels at admission, they were divided into HUA group and non-HVA (NHUA) group. The clinical data were compared between two groups, and the clinical characteristics of elderly CHF patients with HUA were analyzed. The in-hospital mortality was recorded. The factors affecting the in-hospital mortality in elderly CHF patients were analyzed by the Cox proportional hazards regression model. The patients in the HUA group were randomized into HUA-trial group and HUA-control group. The trial group received uric acid-lowering allopurinol in addition to routine medication. After one year of follow-up, the intervention effects were compared. SPSS 27.0 was used for statistical analysis. Data comparison between two groups was performed using t test or χ²test depending on data type. Results Among the 316 CHF patients, 180 (56.96%) were diagnosed with HUA . The HUA group had higher levels of SUA, plasma N-terminal pro-brain natriuretic peptide (NT-proBNP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), white blood cell count (WBC), and proportion of patients with New York Heart Association (NYHA) functional class Ⅲ-Ⅳ than the NHUC group, but lower left ventricular ejection fraction (LVEF), with statistically significant differences (P<0.05). Among 316 elderly CHF patients, 23 (7.28%) died in hospital. Multivariate Cox proportional hazards regression analysis indicated that age ≥ 80 years (HR=1.399, 95%CI 1.093-1.791), NT-proBNT level (HR=1.067, 95%CI 1.022-1.114), and diuretic dose within 24 h of admission (HR=1.123, 95%CI 1.040-1.212) were risk factor for in-hospital death, and systolic blood pressure (SBP) at admission (HR=0.911, 95%CI 0.846-0.982) was a protective factor (P<0.05). After one year of follow-up, levels of serum creatinine, SUA, NT-proBNP, IL-6, TNF-α, WBC, and left ventricular end-diastolic diameter in the HUA-trial group were lower than those in the HUA-control group, while the LVEF was higher than that in the HUA-control group, with statistically significant differences (P<0.05). The incidence of composite endpoint events after one year of follow-up was 39.02% (32/82) in the HUA-experimental group, lower than 59.76% (49/82) in the HUA-control group (χ²=7.050; P=0.008). Conclusion The SUA level at admission is not associated with in-hospital mortality in elderly CHF patients, but uric acid-lowering therapy can reduce the incidence of composite endpoint events one year after discharge.

Abstract:Objective To explore the surgical timing in elderly patients with aneurysmal subarachnoid hemorrhage (aSAH) of different Hunt-Hess grades. Methods The clinical data of 150 elderly aSAH patients admitted to Ningde Municipal Hospital of Ningde Normal University from January 2020 to December 2024 were retrospectively analyzed. According to the surgical timing, patients were divided into a group undergoing surgery within 24 h of onset (24 h group; n=66) and a group undergoing surgery within 24-72 h of onset (24-72 h group; n=84). The effects of surgical timing on perioperative indicators, postoperative complications, and prognosis at 6 months after surgery were analyzed in patients with different Hunt-Hess grades. SPSS 22.0 was used for data analysis, and independent-samples t test or Chi-square test was performed for comparison between groups according to the data type. Results There were 89 patients with Hunt-Hess grade Ⅰ-Ⅱ, including 40 who underwent surgery within 24 h and 49 who underwent surgery within 24-72 h. There were 61 patients with Hunt-Hess grade Ⅲ-Ⅳ, including 26 who underwent surgery within 24 h and 35 who underwent surgery within 24-72 h. Among patients with the same Hunt-Hess grade, there were no statistically significant differences in operation time, intraoperative blood loss, or embolization success rate between patients with different surgical timings (P>0.05). Among patients with the same Hunt-Hess grade, the 24 h group had shorter postoperative hospital stay, lower overall complication rate, higher rate of favorable prognosis at 6 months postoperatively than the 24-72 h group, all the differences being statistically significant (all P<0.05). Conclusion Elderly aSAH patients with Hunt-Hess grade Ⅰ-Ⅱ and grade Ⅲ-Ⅳ can benefit from ultra-early surgery (surgery within 24 h of onset). Early surgery can help reduce postoperative complications, shorten postoperative hospital stay, and improve prognosis at 6 months after surgery.

Abstract:Objective To explore the clinical characteristics, prognosis and risk factors of elderly male patients with primary hepatic carcinoma (PHC) of different genders. Methods A total of 311 elderly PHC patients admitted in our hospital from January 2020 to June 2021 were enrolled and served as PHC group, and 240 non-cancer volunteers of the same age who taking health checkup in our hospital during the same period were subjected and assigned into control group. Thus, all these participants were divided into male PHC group (n=271) and male control group (n=200), female PHC group (n=40) and female control group (n=40). The clinical data were compared between male PHC group and male control group, and between female PHC group and female control group. SPSS 24.0 was used for data processing, and Chi-square test was performed depending on data type. Multivariate logistic regression model was employed to identify the risk factors affecting the pathogenesis of male and female PHC, and survival curves were drawn to compare the 3-year survival status of PHC patients of different genders. Results Multivariate logistic regression analysis suggested that body mass index (BMI) ≥24.0 kg/m² (OR=1.732, 95%CI 1.123-2.670), family history of liver cancer (OR=2.568, 95%CI 1.393-4.733), liver cirrhosis (OR=5.228, 95%CI2.606-10.486), hepatitis B virus (HBV) infection (OR=5.714, 95%CI 2.514-12.991), diabetes mellitus (OR=1.992, 95%CI 1.083-3.664) and alcohol consumption >30 g/d (OR=2.492,95%CI 1.105-5.620) were risk factors of male PHC (P<0.05). Family history of liver cancer (OR=1.582, 95%CI 1.177-2.128), liver cirrhosis (OR=3.487, 95%CI 1.441-8.440), HBV infection (OR=4.100, 95%CI 2.425-6.933), and introversion (OR=1.818, 95%CI 1.321-2.503) were risk factors for female PHC (P<0.05).There were no statistical differences between male and female PHC patients in terms of clinicopathological characteristics and treatment methods (P>0.05). Until the end of follow-up to June 2024, the 3-year median survival time of male PHC patients was 32.73 months (95%CI 31.85-33.61) and that of female PHC patients was 32.53 months (95%CI 30.22-34.84). There was no statistical difference in the survival curve of PHC patients between different genders ( Log Rankχ²=0.130, P=0.718). Conclusion Family history of liver cancer, liver cirrhosis and HBV infection are common risk factors of PHC in both genders. In addition, the risk factors of male PHC include obesity, diabetes mellitus and alcohol consumption ≥30 g/d, and the risk factors of female PHC include introversion. It is suggested that targeted preventive measures should be taken for patients of different genders to prevent the occurrence of liver cancer.

Abstract:Objective To explore the vascular recanalization rate and safety of tirofiban combined with mechanical thrombectomy in elderly patients with acute cerebral infarction due to anterior circulation large artery occlusion (AC-LAO), and analyze the related factors affecting the short-term prognosis of patients. Methods A total of 120 elderly eligible patients admitted to our hospital from December 2022 to March 2024 were enrolled, and according to whether tirofiban was used or not, they were divided into tirofiban group (tirofiban+mechanical thrombectomy, n=67) and control group (mechanical thrombectomy, n=53). The vascular recanalization rate, symptomatic intracranial hemorrhage, treatment safety and neurological function after treatment were compared between the two groups. In 90 d after follow-up, modified Rankin scale (mRS) was applied to assess the prognosis of patients (mRS score ≤2 points as good prognosis). Data analysis was performed by using SPSS statistics 26.0, and t test or Chi-square test was performed depending on data type. Binary logistic regression model was used to analyze the related factors affecting the prognosis. Results The tirofiban group had significantly higher vascular recanalization rate [85.07%(57/67) vs 67.92%(36/53)], larger proportion of mRS score ≤2 points (good prognosis status) at 90 d after surgery [80.60% (54/67)vs 58.49%(31/53)], and lower National Institutes of Health stroke scale (NIHSS) score at 7 d after treatment when compared with the control group (P<0.05). There were no statistical differences between the two groups in incidence of symptomatic intracranial hemorrhage, re-occlusion occurrence and mortality rate during hospitalization (P>0.05). Taking the prognostic status at 90 d after surgery as a dependent variable, binary logistic regression analysis indicated that concurrent type 2 diabetes mellitus (OR=2.109, 95%CI 1.442-3.084) and baseline NIHSS score (OR=2.408, 95%CI 1.713-3.387) were risk factors for poor prognosis, and collateral circulation grade 3-4 (OR=0.359, 95%CI 0.159-0.810), combination of tirofiban (OR=0.482, 95%CI 0.296-0.786) and vascular recanalization (OR=4.100, 95%CI 2.069-8.126) were protective factors for poor prognosis (P<0.05). Conclusion Mechanical thrombectomy combined with tirofiban can effectively enhance the vascular recanalization rate and improve the neurological function and prognosis in the elderly patients with acute cerebral infarction due to AC-LAO, and it does not increase the risk of hemorrhage. Combination of tirofiban is a protective factor for poor postoperative short-term prognosis.

Abstract:Objective To investigate the relationship between lipid metabolism and cognitive function in elderly patients with Parkinson′s disease (PD) and anxiety. Methods A total of 90 elderly PD patients with concomitant anxiety admitted in our hospital from January 2021 to January 2024 were recruited and served as anxiety group, and another 70 age-matched PD patients without anxiety were enrolled and assigned into control group. The lipid levels and detection rate of cognitive impairment (CI) were compared between two groups. For the patients of the anxiety group, the detection rate of PD-CI was analyzed among those with different subtypes of lipid metabolism disorder. Binary logistic regression model was used to analyze the related factors affecting the occurrence of CI in elderly PD patients with anxiety. SPSS statistics 26.0 was used for statistical analysis. Data comparison between two groups was performed using t test or Chi-square test depending on data type. Results The anxiety group exhibited significantly higher detection rate of PD-CI, and increased levels of serum TC and TG than the control group (all P<0.05). For the patients from the anxiety group, the detection rate of PD-CI was higher in the hypercholesterolemia patients and mixed dyslipidemia patients than those with normal lipid metabolism (P<0.05). With whether PD-CI was detected in the anxiety patients as dependent variable, binary logistic regression analysis suggested that age of PD onset (OR=1.943,95%CI 1.373-2.748), H-Y grade (OR=3.114,95%CI 1.487-6.520), low or vague voice (OR=3.931,95%CI 2.357-6.557), rapid eye movement sleep behavior disorder (OR=2.008,95%CI 1.581-2.550), depression (OR=1.984,95%CI 1.408-2.795) and hypercholesterolemia (OR=2.210,95%CI 1.461-3.342) were risk factors affecting PD-CI (P<0.05). Conclusion PD patients with anxiety demonstrate higher incidence of CI, and more serious dyslipidemia. Concomitant hypercholesterolemia is an independent risk factor for CI in elderly PD patients with anxiety. In clinical practice, attention should be paid to lipid metabolism in PD patients, and life intervention and medication should be used to control hypercholesterolemia in order to reduce the risk of CI in later stage.

Abstract:Objective To evaluate the clinical characteristics of elderly inpatients with type 2 diabetes mellitus (T2DM) and to analyze the influencing factors of unplanned readmission. Methods A retrospective analysis was conducted of clinical data of 204 elderly T2DM patients who were hospitalized in Suzhou Jiulong Hospital of Shanghai Jiaotong University School of Medicine from October 2021 to August 2023. Clinical characteristics including disease duraiton and complications were recorded. The patients readmitted within six months after discharge were screened via hospital medical record information system as the readmission group (n=42), and those without readmission were included in the non-readmission group (n=162). SPSS 25.0 was used for data processing. According to the data type, t test or Chi-square test was used for comparison between groups. The influencing factors of unplanned readmission in elderly T2DM inpatients within six months were analyzed by multivariate logistic regression model. Results Among the 204 elderly T2DM inpatients, 56.86% (116/204) had a T2DM duration ≥ 10 years. Diabetic chronic complications were primarily peripheral neuropathy (82.35%, 168/204) and peripheral vascular disease (42.16%, 86/204). Most patients had two diabetic chronic complications (62.75%, 128/204), and comorbidities were mostly hypertension (61.76%, 126/204) and hyperlipidemia (23.53%,48/204). Statistically significant differences were observed between the readmission group and the non-readmission group in T2DM duration, number of diabetic chronic complications, geriatric nutritional risk index (GNRI), and cognitive frailty (P<0.05). Multi-variate logistic regression analysis identified T2DM duration ≥ 10 years (OR=2.421,95%CI 1.284-4.564; P<0.05), diabetic chronic complications ≥ 3 types (OR=3.124,95%CI 1.836-5.315; P<0.05), GNRI≤ 98 (OR=2.524,95%CI 1.368-4.660; P<0.05) and cognitive frailty (OR=3.010,95%CI 1.752-5.171; P<0.05) as risk factors for unplanned readmission in elderly T2DM inpatients within six months after discharge. Conclusion Long course of disease, two diabetic chronic complications, hypertension, and hyperlipidemia are more common in elderly T2DM inpatients. T2DM duration ≥10 years, diabetic chronic complications ≥ 3 types, malnutrition and cognitive frailty can increase the risk of unplanned readmission within six months after discharge.

Abstract:Objective To investigate the role of continuous far-infrared radiation therapy in maintaining the function of autogenous arteriovenous fistula (AVF) in elderly dialysis patients with diabetic nephropathy (DN) and its effect on fistula blood flow. Methods A total of 152 elderly DN dialysis patients using VF admitted to the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from January 2020 to December 2023 were selected as the study subjects. They were randomly divided into a radiation group and a control group, with 76 patients in each group. The control group received topical application of mucopolysaccharide polysulfate cream on the AVF skin 24 h after dialysis, while the radiation group received additional continuous far-infrared radiation. The incidence and time of occurrence of fistula complications were compared between the two groups. The actual dialysis blood flow was measured, and the peripheral venous blood was collected to detect the vascular endothelial function indicators [nitric oxide (NO), endothelin (ET)] and inflammatory indicators [C-reactive protein (CRP)] before and after intervention. SPSS statistics 26.0 was used for statistical analysis. Data comparison between two groups was performed using t test, χ²test or rank-sum test depending on data type. Results During intervention, no case of fistula failure caused by fistula embolism and stenosis occurred in either group. The incidence of complications such as subcutaneous ecchymosis, skin and subcutaneous induration, and decreased vascular elasticity in the radiation group were lower than that in the control group, and the time of occurrence of each complication was later than that in the control group. After intervention, the actual dialysis blood flow in the radiation group was higher than that in the control group , and the differences were statistically significant (P<0.05). After intervention, the serum NO level in the radiation group increased, while ET and CRP levels decreased as compared with before intervention in the radiation group (P<0.05). NO, ET and CRP in the control group did not change significantly before and after intervention (P>0.05). Furthermore, the NO level in the radiation group after intervention was higher, while the ET and CRP levels were lower than those in the control group , and the differences were statistically significant (P<0.05). Conclusion Combined continuous far-infrared radiation based on mucopolysaccharide polysulfate cream application can effectively reduce the risk of AVF puncture-related complications, delay the occurrence of complications, improve vascular endothelial function, reduce inflammatory response, and ensure adequate actual dialysis blood flow in elderly DN dialysis patients.

Abstract:Objective To investigate the effects and mechanisms of exosomes derived from adipose-derived mesenchymal stem cells (AMSCs-Exo) on rats with diabetic cognitive impairment (DCI) through the phosphatidyl inositol 3-kinase/protein kinase B/glycogen synthase kinase-3β(PI3K/Akt/GSK-3β) pathway. Methods Among the 24 male SD rats, 8 were fed with normal chow as the blank control (normal group); the remaining 16 were fed with high-sugar and high-fat chow to establish the model, and among them, 14 successfully modeled DCI rats were randomly divided into a model group (n=7,normal saline) and an intervention group (n=7,AMSCs-Exo). During the experiment, one rat in each group died. After 6 weeks of intervention, glucose metabolism related indicators, learning and memory abilities, and molecular expression of the molecules related to the PI3K/Akt/GSK-3β pathway in hippocampal tissue were detected in each group of rats. SPSS 29.0 and Graphpad Prism 8.0 was used for statistical analysis. The escape latency was compared using repeated measures ANOVA, while intergroup comparisons among multiple groups were conducted with one-way ANOVA, and intragroup pairwise comparisons were performed using Tukey test. Results The model group exhibited significantly increased random blood glucose level and HOMA-insulin resistance index (HOMA-IRI), declined learning and memory abilities (P<0.05), and dis-ordered neuronal arrangement in hippocampal tissues by HE staining when compared with the normal group. AMSCs-Exo intervention resulted in obvious decreases in the random blood glucose level and HOMA-IRI, improvements in learning and memory abilities (P<0.05), and better arrangement of hippocampal neuronal cells when compared with the conditions in the model group. Real-time quantitative polymerase chain reaction (RT-qPCR) showed that the mRNA levels of PI3K and Akt in the hippocampus tissues were notably lower in the model group than the normal group, and AMSCs-Exo intervention reversed the decreases (P<0.05). The results of Western blotting indicaterd that compared with the normal group, the model group showed significant decreases in p-PI3K/PI3K, p-Akt/Akt, and p-GSK-3β/GSK-3β ratios, and the intervention group showed increases in these above ratios (P<0.05). Conclusion AMSCs-Exo can regulate glucose metabolism, alleviate hippocampal tissue damage, and improve cognitive function in DCI rats, which may be related to the activation of the PI3K/Akt/GSK-3β pathway.

Abstract:Sedentary behavior is a confirmed independent risk factor that adversely affects both physical and mental health in older adults with coronary heart disease, and engages in a bidirectional relationship with deteriorating cardiometabolic function. In this article, we systematically review the current state, assessment tools, influencing factors, and interventions for sedentary behavior in this population, and provide a reference for developing personalized, comprehensive intervention program in clinical practice, aiming to improve patient prognosis and facilitate cardiac rehabilitation.

Abstract:Carotid atherosclerosis is a chronic inflammatory vascular disease characterized by lipid metabolism disorders, vascular endothelial dysfunction, and activation of immune-inflammatory responses. It represents a major cause of ischemic stroke, and its incidence has been increasing annually. In this article, we review and conduct a comprehensive analysis on the current literature on the epidemiology, risk factors, diagnostic methods, and stroke risk assessment of carotid atherosclerosis, and systematically summarize the prevention and control strategies for the disease, so as to provide a reference for the scientific decision-making of clinicians and public health managers.

Abstract:The primary language of Chinese scientific journals is Chinese. However, to enhance their academic influence, these journals also include a significant amount of English information. To date, there are no standardized documents or guidelines in China regarding the requirement for the amount of English information in Chinese scientific journals, leaving the decision largely to the discretion of individual journal editorial boards. So, what is the appropriate amount of English information for Chinese scientific journals? How should this balance be struck? We have conducted in-depth reflections on this issue. In this paper, we discuss the necessity of providing English information in Chinese scientific journals and the specific content of English information in various sections. Furthermore, we provide a detailed analysis from four perspectives:the advantages and disadvantages, guiding principles, tiered strategies, and specific suggestions for determining the appropriate amount of English information. We aim to offer references and insights for Chinese scientific journals in determining their specific English information.