Environmental DNA(eDNA)technology has revolutionized biodiversity monitoring with its non-invasive,sensitive,and cost-efficient approach.This paper systematically reviews eDNA advancements,examining its applications i...Environmental DNA(eDNA)technology has revolutionized biodiversity monitoring with its non-invasive,sensitive,and cost-efficient approach.This paper systematically reviews eDNA advancements,examining its applications in aquatic and terrestrial ecosystems and assessing China’s standardization progress.It delineates four developmental phases from single-species detection to high-throughput sequencing,and highlights China’s contribution to the development of technical standards.While significant progress has been made,challenges persist in quantitative accuracy,methodological consistency,and large-scale implementation.Future efforts should prioritize enhanced standardization,improved quantification techniques,broader applications,and international collaboration to drive innovation in eDNA technology.展开更多
Hepatocellular carcinoma presents with three distinct immune phenotypes,including immune-desert,immune-excluded,and immune-inflamed,indicating various treatment responses and prognostic outcomes.The clinical applicati...Hepatocellular carcinoma presents with three distinct immune phenotypes,including immune-desert,immune-excluded,and immune-inflamed,indicating various treatment responses and prognostic outcomes.The clinical application of multi-omics parameters is still restricted by the expensive and less accessible assays,although they accurately reflect immune status.A comprehensive evaluation framework based on“easy-to-obtain”multi-model clinical parameters is urgently required,incorporating clinical features to establish baseline patient profiles and disease staging;routine blood tests assessing systemic metabolic and functional status;immune cell subsets quantifying subcluster dynamics;imaging features delineating tumor morphology,spatial configuration,and perilesional anatomical relationships;immunohistochemical markers positioning qualitative and quantitative detection of tumor antigens from the cellular and molecular level.This integrated phenomic approach aims to improve prognostic stratification and clinical decision-making in hepatocellular carcinoma management conveniently and practically.展开更多
BACKGROUND Parkinson’s disease(PD)is a common neurodegenerative disorder in the elderly population.Non-motor symptoms such as anxiety and depression are often subtle,hindering early detection and intervention,yet the...BACKGROUND Parkinson’s disease(PD)is a common neurodegenerative disorder in the elderly population.Non-motor symptoms such as anxiety and depression are often subtle,hindering early detection and intervention,yet they markedly affect quality of life and clinical outcomes.AIM To investigate the prevalence of anxiety and depression in elderly PD patients,identify associated risk factors,and assess their relationship with fatigue severity.METHODS A cross-sectional analysis was conducted in 123 elderly PD patients treated at The Second Rehabilitation Hospital of Shanghai between January 2023 and December 2024.Demographic and clinical data were obtained using standardized questionnaires.Anxiety,depression,and fatigue were assessed using the Beck Anxiety Inventory(BAI),Geriatric Depression Scale(GDS),and Fatigue Scale-14(FS-14),respectively.Binary logistic regression identified risk factors for anxiety and depression,whereas Spearman’s correlation assessed associations with fatigue.RESULTS Anxiety and depression prevalence rates were 64.2%(mean BAI score:19.59±10.92)and 56.1%(mean GDS score:12.82±6.37),respectively.The mean FS-14 total score was 9.46±1.89,comprising physical(5.77±1.51)and mental(3.69±1.20)fatigue components.Significant positive correlations were observed between fatigue scores(total,physical,and mental)and both anxiety and depression(all P<0.05).Univariate analysis revealed statistically significant associations between anxiety/depression and monthly income,disease duration,and disease severity(all P<0.05).Multivariate logistic regression indicated higher anxiety risk in patients with lower monthly income,prolonged disease duration,advanced disease severity,or multimorbidity.Depression risk was elevated in patients with lower monthly income and severe disease,whereas longer disease duration unexpectedly served as a protective factor.CONCLUSION Elderly PD patients show high rates of anxiety and depression,both of which are significantly correlated with fatigue severity.These findings highlight the importance of psychological monitoring and targeted mental health interventions in PD management among the elderly.展开更多
BACKGROUND Edwardsiella tarda(E.tarda)belongs to the family Enterobacteriaceae and is generally seen to cause infections mainly in fish,but is also capable of infecting humans.Extraintestinal infections occur in patie...BACKGROUND Edwardsiella tarda(E.tarda)belongs to the family Enterobacteriaceae and is generally seen to cause infections mainly in fish,but is also capable of infecting humans.Extraintestinal infections occur in patients with certain risk factors,including immunocompromised status.We recently diagnosed a case of spontaneous bacterial peritonitis(SBP)due to E.tarda in an immuno-compromised dialysis patient.CASE SUMMARY Patient was a 55-year-old male,with a history of diabetic nephropathy being treated with hemodialysis three times a week.He was referred to our hospital due to an increased volume of ascites,and blood examination revealed increased inflammatory reaction.At our emergency department,he developed fever,disturbance of consciousness,abdominal distension,and abdomen-wide pain.In addition,a dialysis shunt was confirmed in his right forearm,and the shunt site showed no signs of inflammation.No wounds were confirmed on or in his body.A blood examination revealed increased values of white blood cells,C-reactive protein,and creatinine.Plain chest and abdominal computed tomography scanning revealed increased ascites volume.Abdominal paracentesis was performed and a Gram stain revealed Gramnegative bacillus.These findings prompted diagnosis of SBP.The patient was admitted and treated with cefmetazole,causing fever resolution and symptom improvements.Later,E.tarda was identified in ascites culture.The patient improved with decreased inflammatory response and was discharged on the 12th day of hospitalization.The antibiotic was terminated after 14 days of treatment.SBP in this case may have developed from chronic renal failure and diabetes mellitus.CONCLUSION We report the first known case of SBP due to E.tarda in an immuno-compromised dialysis patient.展开更多
Freshwater lakes globally are witnessing an escalation in the frequency and intensity of cyanobacterial harmful blooms.However,underlying factors influencing the succession or coexistence of cyanobacteria,especially f...Freshwater lakes globally are witnessing an escalation in the frequency and intensity of cyanobacterial harmful blooms.However,underlying factors influencing the succession or coexistence of cyanobacteria,especially filamentous ones,remain poorly understood.Lake Honghu,a Ramsar Wetland of International Importance with degrading aquatic ecological quality,served as a case study to elucidate the intricate relationship between environmental changes and cyanobacterial dynamics.Our analysis revealed a significant increase in the dominance of filamentous cyanobacteria,marked by high spatiotemporal variability in community structure.This dominance of filamentous diazotrophic cyanobacteria is attributed to a decrease in the ratio of dissolved inorganic nitrogen to total phosphorus and their capacity to utilize organic phosphorus in phosphorus-deficient conditions.Species-specific density variations were linked to diverse environmental factors,with total nitrogen or total phosphorus concentration remaining as a crucial factor influencing dominant cyanobacterial density fluctuations.The dominance of low-temperature-tolerant Aphanizomenon and Pseudanabaena was evident in spring and winter,whereas Dolichospermum and Cylindrospermopsis,which prefer higher temperatures,thrived in summer and autumn.Additionally,non-algal turbidity and heterogeneity can potentially alter the competitive outcome among filamentous cyanobacteria or foster coexistence under conditions of elevated temperatures and nutrient limitation.This study predicts that filamentous cyanobacteria may spread and persist in lakes spanning a wide trophic range.Current findings enhance our comprehen-sion of the dynamic responses exhibited by filamentous bloom-forming cyanobacteria in the face of environmental changes within shallow eutrophic lakes and provide valuable insights for lake managers involved in the remediation of degraded shallow lakes.展开更多
Hypersplenism is a common complication of cirrhosis that is associated with significant impairment to patients'life quality.Splenectomy is often employed in clinical settings as a treatment for hypersplenism.While...Hypersplenism is a common complication of cirrhosis that is associated with significant impairment to patients'life quality.Splenectomy is often employed in clinical settings as a treatment for hypersplenism.While splenectomy is carried out for the purposes of alleviating hypersplenism-related adverse outcomes like thrombocytopenia or anaemia,studies have suggested alterations in the immune status,hemodynamics,and intestinal microbiota of patients following splenectomy,which may potentially influence the onset and progression of hepatocellular carcinoma(HCC).Additionally,patients have been found to face new health risks post-splenectomy,including infections and thrombosis,which could adversely impact their overall health and potentially increase the risk of HCC.Despite these findings,there is currently no consensus on whether splenectomy affects the risk of postoperative HCC in cirrhotic patients.This review synthesizes the pertinent literature on the incidence of HCC following splenectomy,with an emphasis on current evidence related to its physiology,pathophysiology,and epidemiology.Concepts such as immune status,hemodynamics changes,and intestinal microbiota in post-splenectomy patients are explored,in hopes that it can inform more individualized treatment approaches for patients.展开更多
Assessing the threat status of species in response to global change is critical for biodiversity monitoring and conservation efforts.However,current frameworks,even the IUCN Red List,often neglect critical factors suc...Assessing the threat status of species in response to global change is critical for biodiversity monitoring and conservation efforts.However,current frameworks,even the IUCN Red List,often neglect critical factors such as genetic diversity and the impacts of climate and land-use changes,hindering effective conservation planning.To address these limitations,we developed an enhanced extinction risk assessment framework using Diploderma lizards as a model.This framework incorporates long-term field surveys,environmental data,and land-use information to predict distributional changes for 10 recently described Diploderma species on the Qinghai-Xizang Plateau,which hold ecological significance but remain underassessed in conservation assessment.By integrating the distribution data and genetically inferred effective population sizes(Ne),we conducted scenario analyses and used a rank-sum approach to calculate Risk ranking scores(RRS)for each species.This approach revealed significant discrepancies with the IUCN Red List assessments.Notably,D.yangi and D.qilin were identified as facing the highest extinction risk.Furthermore,D.vela,D.batangense,D.flaviceps,D.dymondi,D.yulongense,and D.laeviventre,currently classified as“Least Concern”,were found to warrant reclassification as“Vulnerable”due to considerable threat from projected range contractions.Exploring the relationship between morphology and RRS revealed that traits such as snout-vent length and relative tail length could serve as potential predictors of extinction risk,offering preliminary metrics for assessing species vulnerability when comprehensive data are unavailable.This study enhances the precision of extinction risk assessment frameworks and demonstrates their capacity to refine and update risk assessments,especially for lesser-known taxa.展开更多
This study investigates the mechanism of action of representative molecules of basalt fibers on the healing of water-soaked asphalt.Thermodynamic parameters,morphological characteristics,interfacial healing energy,and...This study investigates the mechanism of action of representative molecules of basalt fibers on the healing of water-soaked asphalt.Thermodynamic parameters,morphological characteristics,interfacial healing energy,and interfacial healing strength were analyzed using molecular dynamics and macroscopic tests under different time,temperature,and water conditions to evaluate the specific states and critical conditions involved in self-healing.The results indicate that basalt-fiber molecules can induce rearrangement and a combination of water-soaked asphalt at the healing interface.Hydroxyl groups with different bonding states increase the interfacial adsorption capacity of water-soaked asphalt.The interaction between basalt fiber molecules and water molecules leads to a"hoop"phenomenon,while aromatics-2 molecules exhibit a"ring band aggregation"phenomenon.The former reduces the miscibility of water and asphalt molecules,while the latter causes slow diffusion of the components.Furthermore,a micro-macro dual-scale comparison of interfacial healing strength was conducted at temperatures of 297.15 and 312.15 K to identify the strength transition point and critical temperature of 299.4 K during the self-healing process of basalt-fiber modified water-soaked asphalt.展开更多
High-mobility group box 1 was first discovered in the calf thymus as a DNA-binding nuclear protein and has been widely studied in diverse fields,including neurology and neuroscience.High-mobility group box 1 in the ex...High-mobility group box 1 was first discovered in the calf thymus as a DNA-binding nuclear protein and has been widely studied in diverse fields,including neurology and neuroscience.High-mobility group box 1 in the extracellular space functions as a pro-inflammatory damage-associated molecular pattern,which has been proven to play an important role in a wide variety of central nervous system disorders such as ischemic stroke,Alzheimer’s disease,frontotemporal dementia,Parkinson’s disease,multiple sclerosis,epilepsy,and traumatic brain injury.Several drugs that inhibit high-mobility group box 1 as a damage-associated molecular pattern,such as glycyrrhizin,ethyl pyruvate,and neutralizing anti-high-mobility group box 1 antibodies,are commonly used to target high-mobility group box 1 activity in central nervous system disorders.Although it is commonly known for its detrimental inflammatory effect,high-mobility group box 1 has also been shown to have beneficial pro-regenerative roles in central nervous system disorders.In this narrative review,we provide a brief summary of the history of high-mobility group box 1 research and its characterization as a damage-associated molecular pattern,its downstream receptors,and intracellular signaling pathways,how high-mobility group box 1 exerts the repair-favoring roles in general and in the central nervous system,and clues on how to differentiate the pro-regenerative from the pro-inflammatory role.Research targeting high-mobility group box 1 in the central nervous system may benefit from differentiating between the two functions rather than overall suppression of high-mobility group box 1.展开更多
In this editorial,I comment on the article by Zhang et al.To emphasize the importance of the topic,I discuss the relationship between the use of smart medical devices and mental health.Smart medical services have the ...In this editorial,I comment on the article by Zhang et al.To emphasize the importance of the topic,I discuss the relationship between the use of smart medical devices and mental health.Smart medical services have the potential to positively influence mental health by providing monitoring,insights,and inter-ventions.However,they also come with challenges that need to be addressed.Understanding the primary purpose for which individuals use these smart tech-nologies is essential to tailoring them to specific mental health needs and prefe-rences.展开更多
BACKGROUND Cytomegalovirus(CMV)infections can cause significant morbidity and mortality in immunocompromised individuals.CMV targets dysfunctional lymphocytes.Chronic rituximab(RTX)therapy can cause B-lymphocyte dysfu...BACKGROUND Cytomegalovirus(CMV)infections can cause significant morbidity and mortality in immunocompromised individuals.CMV targets dysfunctional lymphocytes.Chronic rituximab(RTX)therapy can cause B-lymphocyte dysfunction,increasing CMV risk.Rarely,CMV infections present with critical illness such as septic shock.CASE SUMMARY A 64-year-old African American woman presented with generalized weakness and non-bloody watery diarrhea of 4-6 weeks duration.She did not have nausea,vomiting or,abdominal pain.She had been on monthly RTX infusions for neuromyelitis optica.She was admitted for septic shock due to pancolitis.Blood investigations suggested pancytopenia and serology detected significantly elevated CMV DNA.Valganciclovir treatment led to disease resolution.CONCLUSION This case illustrates an extremely rare case of CMV colitis associated with RTX use presenting with septic shock.High suspicion for rare opportunistic infections is imperative in individuals with long-term RTX use.展开更多
The successful application of the Xixia Imperial Tombs for World Heritage Status has brought this civilization,sealed in the loess,to the global stage.The Xixia Imperial Tombs may become an important node connecting t...The successful application of the Xixia Imperial Tombs for World Heritage Status has brought this civilization,sealed in the loess,to the global stage.The Xixia Imperial Tombs may become an important node connecting the civilizations along the Silk Road.Their characteristic cultural integration serves as a unique window through which foreign tourists can understand Chinese civilization.展开更多
The Xixia Imperial Mausoleums stand as a tangible testament to ancient China’s ethnic harmony,architectural artistry,and burial practices.Now,its World Heritage status makes it poised to captivate broader global audi...The Xixia Imperial Mausoleums stand as a tangible testament to ancient China’s ethnic harmony,architectural artistry,and burial practices.Now,its World Heritage status makes it poised to captivate broader global audiences.展开更多
This study provides a comprehensive summary of the current development status of the potato industry in Liangshan Prefecture,and analyzes the primary factors that hinder the advancement of this industry,including a lo...This study provides a comprehensive summary of the current development status of the potato industry in Liangshan Prefecture,and analyzes the primary factors that hinder the advancement of this industry,including a low degree of scale,a limited popularization rate of high-quality seeds,insufficient mechanization,a low level of commercialization,inadequate technological support,minimal integration between the secondary and tertiary industries,and an ineffective mechanism for connecting and benefiting farmers.Furthermore,it presents a problem-oriented approach that is grounded in the current climatic,resource,water,and soil conditions of Liangshan Prefecture,and proposes several pathways to promote the high-quality development of the potato industry.The strategies include:expanding coverage and increasing production volume as foundational steps to ensure food security;enhancing quality and efficiency as key drivers to stimulate agricultural advancement through scientific and technological innovation;focusing on the integration of the three industries to achieve industrial revitalization;implementing risk management measures as a preventive strategy to ensure industrial stability;establishing incentive policies to foster production enthusiasm;and ultimately assisting farmers in increasing their income to achieve the overarching goal of improving the livelihoods of the population.展开更多
This paper investigates and analyzes the general situation of the tomato seed production industry in Lintong District,Xi'an City.Development strategies and suggestions are proposed to address existing problems.The...This paper investigates and analyzes the general situation of the tomato seed production industry in Lintong District,Xi'an City.Development strategies and suggestions are proposed to address existing problems.These include strengthening technological innovation and variety R&D,promoting industrial standardization and intelligent upgrading,enhancing brand building and market expansion,improving policy support and industrial chain coordination,strengthening intellectual property protection and talent cultivation,and expanding sales channels to promote industrial transformation and upgrading.展开更多
impacting quality of life.This study aimed to identify technological nursing interventions that promote self-care and improve the nutritional status of middle-aged and older adults undergoing hemodialysis.Methods:A sy...impacting quality of life.This study aimed to identify technological nursing interventions that promote self-care and improve the nutritional status of middle-aged and older adults undergoing hemodialysis.Methods:A systematic literature review was conducted in accordance with the Joanna Briggs Institute(JBI)and PRISMA guidelines.Searches were conducted in Medline,CINAHL,the Cochrane Library,Scopus,Web of Science,and grey literature,Studies published between 2018 and 2024,involving patients aged 40 years or more undergoing regular hemodialysis,and available in Portuguese,English,or Spanish,were included.JBI's critical appraisal tools were used to conduct a rigorous analysis and methodological quality assessment of the articles.Results:Out of a total of 738 articles,10 were included for analysis.Five key dimensions of technologydriven self-care interventions were established.1)Mobile applications and digital platforms with features like nutritional databases,food logging,and personalized feedback;2)E-learning and virtual education using social media and chat-based communication;3)Telenursing employing a hybrid follow-up model of face-to-face,telephone,and SMS contact;4)Educational strategies focused on nutritional status,utilizing methods such as teach-back and pictorial learning within a multidisciplinary team;and 5)Comprehensive assessment tools evaluating treatment adherence(hemodialysis,medication,diet,fluid)and laboratory markers.Significant improvements were reported across several outcomes:eight studies showed enhanced biochemical markers(e.g.,phosphorus,sodium,potassium,calcium,iron,albumin,urea,and hemoglobin)and nutritional status,three demonstrated increased selfefficacy,and two reported improved quality of life.Conclusion:Integrating technology and face-to-face education enhances nutritional status,highlighting the importance of comprehensive strategies to improve treatment adherence and prevent malnutrition in hemodialysis patients.展开更多
Purpureocillium lilacinum(formerly Paecilomyces lilacinus)is a hyaline hyphomycete with a ubiquitous distribution.In the last decade this fungus has been increasingly found as the causal agent of infections in humans ...Purpureocillium lilacinum(formerly Paecilomyces lilacinus)is a hyaline hyphomycete with a ubiquitous distribution.In the last decade this fungus has been increasingly found as the causal agent of infections in humans and other vertebrates.It is an emerging opportunistic pathogen and is increasingly reported,and can cause a wide spectrum of clinical manifestations,especially among immunocompromised patients or following surgical procedures.The pathogenic mechanisms are not yet fully understood.Ocular and cutaneous/subcutaneous infections are the most familiar clinical presentations,and these can also cause disseminated infections.Early and accurate species identification and suscept-ibility testing are vital.In general,surgical debridement combined with antifungal drug therapy,or the correction of predisposing factors,are usually required to obtain improvement.Infections present a therapeutic challenge,as they have intrinsic resistance to many antifungal agents,but voriconazole and posaconazole are good in vitro activity.The overall mortality was 22%and death was attributed to the infection in 46%of cases.Accurate diagnoses can be achieved through newer molecular biological techniques,and these can lead to appropriate management of infections due to this organism.Future studies should ideally aim to elucidate pathogenesis and determine more effective diagnoses and effective antifungal treatment.展开更多
Objective:Based on the CNKI database,this study analyzes the current research status and hotspots of the Timing it Right(TIR)Theory in China,providing insights and references for its further development in the field o...Objective:Based on the CNKI database,this study analyzes the current research status and hotspots of the Timing it Right(TIR)Theory in China,providing insights and references for its further development in the field of nursing.Methods:Using bibliometric methods and Citespace software,this study conducts a statistical and visual analysis of publications on TIR Theory from CNKI,focusing on annual publication volumes,author collaboration networks,high-frequency keywords,and emergent terms.Results:The study statistically analyzed the time distribution and research hotspots of 117 relevant papers.The annual publication volume shows a gradual upward trend,though the overall volume remains low.High-frequency keywords such as“family nursing,”“quality of life,”“acute myocardial infarction,”and“stroke”form the core research themes.Conclusion:Research on TIR Theory in China’s nursing field is still in the exploratory stage,and its attention and emphasis need to be enhanced.As it aligns with modern medical models,its application scope in nursing is expanding,promoting the high-quality,scientific,and diversified development of nursing services in China.展开更多
The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations ...The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations in this domain.Relevant articles on medication consultation were systematically collected,and bibliometric software such as CiteSpace 6.4R1 was employed to analyze author and institutional collaborations,keyword co-occurrence,clustering,and emerging trends.This approach helped elucidate key themes and hot topics in the field.A total of 1267 articles were included,with the peak number of publications recorded in 2011,followed by a steady decline in subsequent years.The most prolific author was Zhen Jiancun,contributing eight publications,while the First Affiliated Hospital of Sun Yat-sen University emerged as the leading institution with 11 publications.High-frequency identified keywords included medication consultation,rational drug use,pharmaceutical services,clinical pharmacists,and outpatient pharmacies.Cluster analysis revealed 12 significant themes,while emergent analysis highlighted that recent research hotspots centered on the Pareto chart,pregnancy,and traditional Chinese patent medicine.As a critical aspect of pharmaceutical services,the practice of medication consultation in China requires further advancement,with a particular need for enhanced collaboration among researchers and institutions.Moving forward,expanding the scope of medication consultation,improving the quality of related research,and fostering cross-regional collaboration among teams with diverse research focuses will be essential in deepening and broadening this field of study.展开更多
BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and...BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and dementia,can significantly affect the quality of life and independence of elderly individuals.Therefore,identifying risk factors for cognitive impairment in elderly hypertensive patients is crucial for developing effective interventions and improving health outcomes.Nutritional status is one of the potential factors that may influence cognitive function in elderly hypertensive patients.Malnutrition or inadequate nutrition can lead to various health problems,including weakened immune system,increased susceptibility to infections,and impaired physical and mental function.Furthermore,poor nutritional status has been linked to increased risk of cognitive decline and dementia in various populations.In this observational study,we aimed to investigate the nutritional status of elderly hypertensive patients and its relationship to the occurrence of cognitive impairment.By collecting baseline data on general information,body composition,and clinical indicators,we hope to identify risk factors for cognitive impairment in this patient population.The results of this study are expected to provide more scientific basis for the health management of elderly patients with hypertension,particularly in terms of maintaining good nutritional status and reducing the risk of cognitive impairment.AIM To explore the differences between clinical data and cognitive function of elderly hypertensive patients with different nutritional status,analyze the internal relationship between nutritional statuses and cognitive impairment,and build a nomogram model for predicting nutritional status in elderly hypertensive patients.METHODS The present study retrospectively analyzed 200 elderly patients admitted to our hospital for a hypertension during the period July 1,2024 to September 30,2024 as study subjects,and the 200 patients were divided into a modeling cohort(140 patients)and a validation cohort(60 patients)according to the ratio of 7:3.The modeling cohort were divided into a malnutrition group(26 cases),a malnutrition risk group(42 cases),and a normal nutritional status group(72 cases)according to the patients’Mini-Nutritional Assessment Scale(MNA)scores,and the modeling cohort was divided into a hypertension combined with cognitive impairment group(34 cases)and a hypertension cognitively normal group(106 cases)according to the Montreal Cognitive Assessment Scale(MoCA)scores,and the validation cohort was divided into a hypertension combined with cognitive impairment group(14 cases)and hypertension cognitively normal group(46 cases).The study outcome was the occurrence of cognitive impairment in elderly hypertensive patients.Univariate and multivariate logistic regression was used to explore the relationship between the general information of the elderly hypertensive patients and the influence indicators and the occurrence of cognitive impairment,the roadmap prediction model was established and validated,the patient work receiver operating characteristic curve was used to evaluate the predictive efficacy of the model,the calibration curve was used to assess the consistency between the predicted events and the actual events,and the decision curve analysis was used to evaluate the validity of the model.Pearson correlation analysis was used to explore the relationship between nutrition-related indicators and MoCA scores.RESULTS In this research,the modeling cohort comprised 140 cases,while the verification cohort consisted of 60 cases,with no notable discrepancy in the data between the two groups.In the modeling cohort,there were significant differences in body mass index(BMI),albumin(ALB),hemoglobin(Hb)and homocysteine levels among the malnourished group,the malnourished risk group and the normal nutritional status group.The results of univariate and multivariate analysis showed that BMI[odds ratio(OR)=0.830,P=0.014],ALB(OR=0.860,P=0.028),Hb(OR=0.939,P=0.035)and MNA score(OR=0.640,P=0.000)were independent protective factors for patients without cognitive impairment,and alkaline phosphatase(ALP)(OR=1.074,P=0.000)was an independent risk factor for patients with cognitive impairment.In this study,the prediction nomogram tailored for cognitive deterioration in elderly patients with hypertension demonstrated robust predictive power and a close correspondence between predicted and observed outcomes.This model offers significant potential as a means to forestall cognitive decline in hypertensive elderly patients.ALP was negatively correlated with MoCA score,while BMI,MNA score,Hb and ALB were positively correlated with MoCA score.CONCLUSION BMI,MNA score,Hb and ALB were independent protective factors for cognitive impairment in elderly hypertensive patients and were positively correlated with MoCA score.ALP was an independent risk factor for cognitive impairment in elderly hypertensive patients and was negatively correlated with the MoCA score.The column line graph model established in the study has a good predictive value.展开更多
基金supported by the National Natural Science Foundation of China(Grant No.32160172)the Key Science-Technology Project of Inner Mongolia(2023KYPT0010)+1 种基金the Natural Science Foundation of Inner Mongolia Autonomous Region of China(Grant No.2025QN03006)the 2023 Inner Mongolia Public Institution High-Level Talent Introduction Scientific Research Support Project.
文摘Environmental DNA(eDNA)technology has revolutionized biodiversity monitoring with its non-invasive,sensitive,and cost-efficient approach.This paper systematically reviews eDNA advancements,examining its applications in aquatic and terrestrial ecosystems and assessing China’s standardization progress.It delineates four developmental phases from single-species detection to high-throughput sequencing,and highlights China’s contribution to the development of technical standards.While significant progress has been made,challenges persist in quantitative accuracy,methodological consistency,and large-scale implementation.Future efforts should prioritize enhanced standardization,improved quantification techniques,broader applications,and international collaboration to drive innovation in eDNA technology.
文摘Hepatocellular carcinoma presents with three distinct immune phenotypes,including immune-desert,immune-excluded,and immune-inflamed,indicating various treatment responses and prognostic outcomes.The clinical application of multi-omics parameters is still restricted by the expensive and less accessible assays,although they accurately reflect immune status.A comprehensive evaluation framework based on“easy-to-obtain”multi-model clinical parameters is urgently required,incorporating clinical features to establish baseline patient profiles and disease staging;routine blood tests assessing systemic metabolic and functional status;immune cell subsets quantifying subcluster dynamics;imaging features delineating tumor morphology,spatial configuration,and perilesional anatomical relationships;immunohistochemical markers positioning qualitative and quantitative detection of tumor antigens from the cellular and molecular level.This integrated phenomic approach aims to improve prognostic stratification and clinical decision-making in hepatocellular carcinoma management conveniently and practically.
基金Supported by Foundation of Shanghai Baoshan Science and Technology Commission,No.2024-E-66Shanghai Nursing Association Scientific Research Project,No.2024MS-B02.
文摘BACKGROUND Parkinson’s disease(PD)is a common neurodegenerative disorder in the elderly population.Non-motor symptoms such as anxiety and depression are often subtle,hindering early detection and intervention,yet they markedly affect quality of life and clinical outcomes.AIM To investigate the prevalence of anxiety and depression in elderly PD patients,identify associated risk factors,and assess their relationship with fatigue severity.METHODS A cross-sectional analysis was conducted in 123 elderly PD patients treated at The Second Rehabilitation Hospital of Shanghai between January 2023 and December 2024.Demographic and clinical data were obtained using standardized questionnaires.Anxiety,depression,and fatigue were assessed using the Beck Anxiety Inventory(BAI),Geriatric Depression Scale(GDS),and Fatigue Scale-14(FS-14),respectively.Binary logistic regression identified risk factors for anxiety and depression,whereas Spearman’s correlation assessed associations with fatigue.RESULTS Anxiety and depression prevalence rates were 64.2%(mean BAI score:19.59±10.92)and 56.1%(mean GDS score:12.82±6.37),respectively.The mean FS-14 total score was 9.46±1.89,comprising physical(5.77±1.51)and mental(3.69±1.20)fatigue components.Significant positive correlations were observed between fatigue scores(total,physical,and mental)and both anxiety and depression(all P<0.05).Univariate analysis revealed statistically significant associations between anxiety/depression and monthly income,disease duration,and disease severity(all P<0.05).Multivariate logistic regression indicated higher anxiety risk in patients with lower monthly income,prolonged disease duration,advanced disease severity,or multimorbidity.Depression risk was elevated in patients with lower monthly income and severe disease,whereas longer disease duration unexpectedly served as a protective factor.CONCLUSION Elderly PD patients show high rates of anxiety and depression,both of which are significantly correlated with fatigue severity.These findings highlight the importance of psychological monitoring and targeted mental health interventions in PD management among the elderly.
文摘BACKGROUND Edwardsiella tarda(E.tarda)belongs to the family Enterobacteriaceae and is generally seen to cause infections mainly in fish,but is also capable of infecting humans.Extraintestinal infections occur in patients with certain risk factors,including immunocompromised status.We recently diagnosed a case of spontaneous bacterial peritonitis(SBP)due to E.tarda in an immuno-compromised dialysis patient.CASE SUMMARY Patient was a 55-year-old male,with a history of diabetic nephropathy being treated with hemodialysis three times a week.He was referred to our hospital due to an increased volume of ascites,and blood examination revealed increased inflammatory reaction.At our emergency department,he developed fever,disturbance of consciousness,abdominal distension,and abdomen-wide pain.In addition,a dialysis shunt was confirmed in his right forearm,and the shunt site showed no signs of inflammation.No wounds were confirmed on or in his body.A blood examination revealed increased values of white blood cells,C-reactive protein,and creatinine.Plain chest and abdominal computed tomography scanning revealed increased ascites volume.Abdominal paracentesis was performed and a Gram stain revealed Gramnegative bacillus.These findings prompted diagnosis of SBP.The patient was admitted and treated with cefmetazole,causing fever resolution and symptom improvements.Later,E.tarda was identified in ascites culture.The patient improved with decreased inflammatory response and was discharged on the 12th day of hospitalization.The antibiotic was terminated after 14 days of treatment.SBP in this case may have developed from chronic renal failure and diabetes mellitus.CONCLUSION We report the first known case of SBP due to E.tarda in an immuno-compromised dialysis patient.
基金supported by the National Key Research and Development Program of China(No.2018YFD0900701)the National Natural Science Foundation of China(No.42177246)+2 种基金Additional support was provided by Yunnan Province-Kunming City Major Science and Technology Project(No.202202AH210006)the convenience provided by workstation of academician Liu Yongding in Kunming(No.YSZJGZZ-2020018)The Natural Science Foundation of Hunan Province(No.2022JJ30691)also supported this research.
文摘Freshwater lakes globally are witnessing an escalation in the frequency and intensity of cyanobacterial harmful blooms.However,underlying factors influencing the succession or coexistence of cyanobacteria,especially filamentous ones,remain poorly understood.Lake Honghu,a Ramsar Wetland of International Importance with degrading aquatic ecological quality,served as a case study to elucidate the intricate relationship between environmental changes and cyanobacterial dynamics.Our analysis revealed a significant increase in the dominance of filamentous cyanobacteria,marked by high spatiotemporal variability in community structure.This dominance of filamentous diazotrophic cyanobacteria is attributed to a decrease in the ratio of dissolved inorganic nitrogen to total phosphorus and their capacity to utilize organic phosphorus in phosphorus-deficient conditions.Species-specific density variations were linked to diverse environmental factors,with total nitrogen or total phosphorus concentration remaining as a crucial factor influencing dominant cyanobacterial density fluctuations.The dominance of low-temperature-tolerant Aphanizomenon and Pseudanabaena was evident in spring and winter,whereas Dolichospermum and Cylindrospermopsis,which prefer higher temperatures,thrived in summer and autumn.Additionally,non-algal turbidity and heterogeneity can potentially alter the competitive outcome among filamentous cyanobacteria or foster coexistence under conditions of elevated temperatures and nutrient limitation.This study predicts that filamentous cyanobacteria may spread and persist in lakes spanning a wide trophic range.Current findings enhance our comprehen-sion of the dynamic responses exhibited by filamentous bloom-forming cyanobacteria in the face of environmental changes within shallow eutrophic lakes and provide valuable insights for lake managers involved in the remediation of degraded shallow lakes.
基金Supported by National Natural Science Foundation of China,No.82200686.
文摘Hypersplenism is a common complication of cirrhosis that is associated with significant impairment to patients'life quality.Splenectomy is often employed in clinical settings as a treatment for hypersplenism.While splenectomy is carried out for the purposes of alleviating hypersplenism-related adverse outcomes like thrombocytopenia or anaemia,studies have suggested alterations in the immune status,hemodynamics,and intestinal microbiota of patients following splenectomy,which may potentially influence the onset and progression of hepatocellular carcinoma(HCC).Additionally,patients have been found to face new health risks post-splenectomy,including infections and thrombosis,which could adversely impact their overall health and potentially increase the risk of HCC.Despite these findings,there is currently no consensus on whether splenectomy affects the risk of postoperative HCC in cirrhotic patients.This review synthesizes the pertinent literature on the incidence of HCC following splenectomy,with an emphasis on current evidence related to its physiology,pathophysiology,and epidemiology.Concepts such as immune status,hemodynamics changes,and intestinal microbiota in post-splenectomy patients are explored,in hopes that it can inform more individualized treatment approaches for patients.
基金supported by the Second Tibetan Plateau Scientific Expedition and Research Program (STEP,2019QZKK0402)Science and Technology Plan Project of Xizang Autonomous Region to Y.Q. (XZ202201ZY0030G)National Natural Science Foundation of China (32201424 to Z.Y.L.and 31872233 to Y.Q.)。
文摘Assessing the threat status of species in response to global change is critical for biodiversity monitoring and conservation efforts.However,current frameworks,even the IUCN Red List,often neglect critical factors such as genetic diversity and the impacts of climate and land-use changes,hindering effective conservation planning.To address these limitations,we developed an enhanced extinction risk assessment framework using Diploderma lizards as a model.This framework incorporates long-term field surveys,environmental data,and land-use information to predict distributional changes for 10 recently described Diploderma species on the Qinghai-Xizang Plateau,which hold ecological significance but remain underassessed in conservation assessment.By integrating the distribution data and genetically inferred effective population sizes(Ne),we conducted scenario analyses and used a rank-sum approach to calculate Risk ranking scores(RRS)for each species.This approach revealed significant discrepancies with the IUCN Red List assessments.Notably,D.yangi and D.qilin were identified as facing the highest extinction risk.Furthermore,D.vela,D.batangense,D.flaviceps,D.dymondi,D.yulongense,and D.laeviventre,currently classified as“Least Concern”,were found to warrant reclassification as“Vulnerable”due to considerable threat from projected range contractions.Exploring the relationship between morphology and RRS revealed that traits such as snout-vent length and relative tail length could serve as potential predictors of extinction risk,offering preliminary metrics for assessing species vulnerability when comprehensive data are unavailable.This study enhances the precision of extinction risk assessment frameworks and demonstrates their capacity to refine and update risk assessments,especially for lesser-known taxa.
文摘This study investigates the mechanism of action of representative molecules of basalt fibers on the healing of water-soaked asphalt.Thermodynamic parameters,morphological characteristics,interfacial healing energy,and interfacial healing strength were analyzed using molecular dynamics and macroscopic tests under different time,temperature,and water conditions to evaluate the specific states and critical conditions involved in self-healing.The results indicate that basalt-fiber molecules can induce rearrangement and a combination of water-soaked asphalt at the healing interface.Hydroxyl groups with different bonding states increase the interfacial adsorption capacity of water-soaked asphalt.The interaction between basalt fiber molecules and water molecules leads to a"hoop"phenomenon,while aromatics-2 molecules exhibit a"ring band aggregation"phenomenon.The former reduces the miscibility of water and asphalt molecules,while the latter causes slow diffusion of the components.Furthermore,a micro-macro dual-scale comparison of interfacial healing strength was conducted at temperatures of 297.15 and 312.15 K to identify the strength transition point and critical temperature of 299.4 K during the self-healing process of basalt-fiber modified water-soaked asphalt.
基金supported by a grant of the M.D.-Ph.D./Medical Scientist Training Program through the Korea Health Industry Development Institute(KHIDI)funded by the Ministry of Health&Welfare,Republic of Korea(to HK)+3 种基金supported by National Research Foundation of Korea(NRF)grants funded by the Korean government(MSITMinistry of Science and ICT)(NRF2019R1A5A2026045 and NRF-2021R1F1A1061819)a grant from the Korean Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI),funded by the Ministry of Health&Welfare,Republic of Korea(HR21C1003)New Faculty Research Fund of Ajou University School of Medicine(to JYC)。
文摘High-mobility group box 1 was first discovered in the calf thymus as a DNA-binding nuclear protein and has been widely studied in diverse fields,including neurology and neuroscience.High-mobility group box 1 in the extracellular space functions as a pro-inflammatory damage-associated molecular pattern,which has been proven to play an important role in a wide variety of central nervous system disorders such as ischemic stroke,Alzheimer’s disease,frontotemporal dementia,Parkinson’s disease,multiple sclerosis,epilepsy,and traumatic brain injury.Several drugs that inhibit high-mobility group box 1 as a damage-associated molecular pattern,such as glycyrrhizin,ethyl pyruvate,and neutralizing anti-high-mobility group box 1 antibodies,are commonly used to target high-mobility group box 1 activity in central nervous system disorders.Although it is commonly known for its detrimental inflammatory effect,high-mobility group box 1 has also been shown to have beneficial pro-regenerative roles in central nervous system disorders.In this narrative review,we provide a brief summary of the history of high-mobility group box 1 research and its characterization as a damage-associated molecular pattern,its downstream receptors,and intracellular signaling pathways,how high-mobility group box 1 exerts the repair-favoring roles in general and in the central nervous system,and clues on how to differentiate the pro-regenerative from the pro-inflammatory role.Research targeting high-mobility group box 1 in the central nervous system may benefit from differentiating between the two functions rather than overall suppression of high-mobility group box 1.
文摘In this editorial,I comment on the article by Zhang et al.To emphasize the importance of the topic,I discuss the relationship between the use of smart medical devices and mental health.Smart medical services have the potential to positively influence mental health by providing monitoring,insights,and inter-ventions.However,they also come with challenges that need to be addressed.Understanding the primary purpose for which individuals use these smart tech-nologies is essential to tailoring them to specific mental health needs and prefe-rences.
文摘BACKGROUND Cytomegalovirus(CMV)infections can cause significant morbidity and mortality in immunocompromised individuals.CMV targets dysfunctional lymphocytes.Chronic rituximab(RTX)therapy can cause B-lymphocyte dysfunction,increasing CMV risk.Rarely,CMV infections present with critical illness such as septic shock.CASE SUMMARY A 64-year-old African American woman presented with generalized weakness and non-bloody watery diarrhea of 4-6 weeks duration.She did not have nausea,vomiting or,abdominal pain.She had been on monthly RTX infusions for neuromyelitis optica.She was admitted for septic shock due to pancolitis.Blood investigations suggested pancytopenia and serology detected significantly elevated CMV DNA.Valganciclovir treatment led to disease resolution.CONCLUSION This case illustrates an extremely rare case of CMV colitis associated with RTX use presenting with septic shock.High suspicion for rare opportunistic infections is imperative in individuals with long-term RTX use.
文摘The successful application of the Xixia Imperial Tombs for World Heritage Status has brought this civilization,sealed in the loess,to the global stage.The Xixia Imperial Tombs may become an important node connecting the civilizations along the Silk Road.Their characteristic cultural integration serves as a unique window through which foreign tourists can understand Chinese civilization.
文摘The Xixia Imperial Mausoleums stand as a tangible testament to ancient China’s ethnic harmony,architectural artistry,and burial practices.Now,its World Heritage status makes it poised to captivate broader global audiences.
基金Supported by Special Fund for the Construction of China Agricultural Industry Research System(CARS-09-ES22).
文摘This study provides a comprehensive summary of the current development status of the potato industry in Liangshan Prefecture,and analyzes the primary factors that hinder the advancement of this industry,including a low degree of scale,a limited popularization rate of high-quality seeds,insufficient mechanization,a low level of commercialization,inadequate technological support,minimal integration between the secondary and tertiary industries,and an ineffective mechanism for connecting and benefiting farmers.Furthermore,it presents a problem-oriented approach that is grounded in the current climatic,resource,water,and soil conditions of Liangshan Prefecture,and proposes several pathways to promote the high-quality development of the potato industry.The strategies include:expanding coverage and increasing production volume as foundational steps to ensure food security;enhancing quality and efficiency as key drivers to stimulate agricultural advancement through scientific and technological innovation;focusing on the integration of the three industries to achieve industrial revitalization;implementing risk management measures as a preventive strategy to ensure industrial stability;establishing incentive policies to foster production enthusiasm;and ultimately assisting farmers in increasing their income to achieve the overarching goal of improving the livelihoods of the population.
基金Supported by Research Project on Food Detection Technology Innovation and Standard Integration 2024(YNXM-2024-FW-019).
文摘This paper investigates and analyzes the general situation of the tomato seed production industry in Lintong District,Xi'an City.Development strategies and suggestions are proposed to address existing problems.These include strengthening technological innovation and variety R&D,promoting industrial standardization and intelligent upgrading,enhancing brand building and market expansion,improving policy support and industrial chain coordination,strengthening intellectual property protection and talent cultivation,and expanding sales channels to promote industrial transformation and upgrading.
基金funded by national funds through the Foundation for Science and Technology,under the project UIDB/04923。
文摘impacting quality of life.This study aimed to identify technological nursing interventions that promote self-care and improve the nutritional status of middle-aged and older adults undergoing hemodialysis.Methods:A systematic literature review was conducted in accordance with the Joanna Briggs Institute(JBI)and PRISMA guidelines.Searches were conducted in Medline,CINAHL,the Cochrane Library,Scopus,Web of Science,and grey literature,Studies published between 2018 and 2024,involving patients aged 40 years or more undergoing regular hemodialysis,and available in Portuguese,English,or Spanish,were included.JBI's critical appraisal tools were used to conduct a rigorous analysis and methodological quality assessment of the articles.Results:Out of a total of 738 articles,10 were included for analysis.Five key dimensions of technologydriven self-care interventions were established.1)Mobile applications and digital platforms with features like nutritional databases,food logging,and personalized feedback;2)E-learning and virtual education using social media and chat-based communication;3)Telenursing employing a hybrid follow-up model of face-to-face,telephone,and SMS contact;4)Educational strategies focused on nutritional status,utilizing methods such as teach-back and pictorial learning within a multidisciplinary team;and 5)Comprehensive assessment tools evaluating treatment adherence(hemodialysis,medication,diet,fluid)and laboratory markers.Significant improvements were reported across several outcomes:eight studies showed enhanced biochemical markers(e.g.,phosphorus,sodium,potassium,calcium,iron,albumin,urea,and hemoglobin)and nutritional status,three demonstrated increased selfefficacy,and two reported improved quality of life.Conclusion:Integrating technology and face-to-face education enhances nutritional status,highlighting the importance of comprehensive strategies to improve treatment adherence and prevent malnutrition in hemodialysis patients.
基金Supported by The Japan Society for the Promotion of Science KAKENHI Grant,No.24K15491.
文摘Purpureocillium lilacinum(formerly Paecilomyces lilacinus)is a hyaline hyphomycete with a ubiquitous distribution.In the last decade this fungus has been increasingly found as the causal agent of infections in humans and other vertebrates.It is an emerging opportunistic pathogen and is increasingly reported,and can cause a wide spectrum of clinical manifestations,especially among immunocompromised patients or following surgical procedures.The pathogenic mechanisms are not yet fully understood.Ocular and cutaneous/subcutaneous infections are the most familiar clinical presentations,and these can also cause disseminated infections.Early and accurate species identification and suscept-ibility testing are vital.In general,surgical debridement combined with antifungal drug therapy,or the correction of predisposing factors,are usually required to obtain improvement.Infections present a therapeutic challenge,as they have intrinsic resistance to many antifungal agents,but voriconazole and posaconazole are good in vitro activity.The overall mortality was 22%and death was attributed to the infection in 46%of cases.Accurate diagnoses can be achieved through newer molecular biological techniques,and these can lead to appropriate management of infections due to this organism.Future studies should ideally aim to elucidate pathogenesis and determine more effective diagnoses and effective antifungal treatment.
文摘Objective:Based on the CNKI database,this study analyzes the current research status and hotspots of the Timing it Right(TIR)Theory in China,providing insights and references for its further development in the field of nursing.Methods:Using bibliometric methods and Citespace software,this study conducts a statistical and visual analysis of publications on TIR Theory from CNKI,focusing on annual publication volumes,author collaboration networks,high-frequency keywords,and emergent terms.Results:The study statistically analyzed the time distribution and research hotspots of 117 relevant papers.The annual publication volume shows a gradual upward trend,though the overall volume remains low.High-frequency keywords such as“family nursing,”“quality of life,”“acute myocardial infarction,”and“stroke”form the core research themes.Conclusion:Research on TIR Theory in China’s nursing field is still in the exploratory stage,and its attention and emphasis need to be enhanced.As it aligns with modern medical models,its application scope in nursing is expanding,promoting the high-quality,scientific,and diversified development of nursing services in China.
文摘The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations in this domain.Relevant articles on medication consultation were systematically collected,and bibliometric software such as CiteSpace 6.4R1 was employed to analyze author and institutional collaborations,keyword co-occurrence,clustering,and emerging trends.This approach helped elucidate key themes and hot topics in the field.A total of 1267 articles were included,with the peak number of publications recorded in 2011,followed by a steady decline in subsequent years.The most prolific author was Zhen Jiancun,contributing eight publications,while the First Affiliated Hospital of Sun Yat-sen University emerged as the leading institution with 11 publications.High-frequency identified keywords included medication consultation,rational drug use,pharmaceutical services,clinical pharmacists,and outpatient pharmacies.Cluster analysis revealed 12 significant themes,while emergent analysis highlighted that recent research hotspots centered on the Pareto chart,pregnancy,and traditional Chinese patent medicine.As a critical aspect of pharmaceutical services,the practice of medication consultation in China requires further advancement,with a particular need for enhanced collaboration among researchers and institutions.Moving forward,expanding the scope of medication consultation,improving the quality of related research,and fostering cross-regional collaboration among teams with diverse research focuses will be essential in deepening and broadening this field of study.
基金Supported by the Wuxi Science and Technology Plan Project Plan,No.BJ21008.
文摘BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and dementia,can significantly affect the quality of life and independence of elderly individuals.Therefore,identifying risk factors for cognitive impairment in elderly hypertensive patients is crucial for developing effective interventions and improving health outcomes.Nutritional status is one of the potential factors that may influence cognitive function in elderly hypertensive patients.Malnutrition or inadequate nutrition can lead to various health problems,including weakened immune system,increased susceptibility to infections,and impaired physical and mental function.Furthermore,poor nutritional status has been linked to increased risk of cognitive decline and dementia in various populations.In this observational study,we aimed to investigate the nutritional status of elderly hypertensive patients and its relationship to the occurrence of cognitive impairment.By collecting baseline data on general information,body composition,and clinical indicators,we hope to identify risk factors for cognitive impairment in this patient population.The results of this study are expected to provide more scientific basis for the health management of elderly patients with hypertension,particularly in terms of maintaining good nutritional status and reducing the risk of cognitive impairment.AIM To explore the differences between clinical data and cognitive function of elderly hypertensive patients with different nutritional status,analyze the internal relationship between nutritional statuses and cognitive impairment,and build a nomogram model for predicting nutritional status in elderly hypertensive patients.METHODS The present study retrospectively analyzed 200 elderly patients admitted to our hospital for a hypertension during the period July 1,2024 to September 30,2024 as study subjects,and the 200 patients were divided into a modeling cohort(140 patients)and a validation cohort(60 patients)according to the ratio of 7:3.The modeling cohort were divided into a malnutrition group(26 cases),a malnutrition risk group(42 cases),and a normal nutritional status group(72 cases)according to the patients’Mini-Nutritional Assessment Scale(MNA)scores,and the modeling cohort was divided into a hypertension combined with cognitive impairment group(34 cases)and a hypertension cognitively normal group(106 cases)according to the Montreal Cognitive Assessment Scale(MoCA)scores,and the validation cohort was divided into a hypertension combined with cognitive impairment group(14 cases)and hypertension cognitively normal group(46 cases).The study outcome was the occurrence of cognitive impairment in elderly hypertensive patients.Univariate and multivariate logistic regression was used to explore the relationship between the general information of the elderly hypertensive patients and the influence indicators and the occurrence of cognitive impairment,the roadmap prediction model was established and validated,the patient work receiver operating characteristic curve was used to evaluate the predictive efficacy of the model,the calibration curve was used to assess the consistency between the predicted events and the actual events,and the decision curve analysis was used to evaluate the validity of the model.Pearson correlation analysis was used to explore the relationship between nutrition-related indicators and MoCA scores.RESULTS In this research,the modeling cohort comprised 140 cases,while the verification cohort consisted of 60 cases,with no notable discrepancy in the data between the two groups.In the modeling cohort,there were significant differences in body mass index(BMI),albumin(ALB),hemoglobin(Hb)and homocysteine levels among the malnourished group,the malnourished risk group and the normal nutritional status group.The results of univariate and multivariate analysis showed that BMI[odds ratio(OR)=0.830,P=0.014],ALB(OR=0.860,P=0.028),Hb(OR=0.939,P=0.035)and MNA score(OR=0.640,P=0.000)were independent protective factors for patients without cognitive impairment,and alkaline phosphatase(ALP)(OR=1.074,P=0.000)was an independent risk factor for patients with cognitive impairment.In this study,the prediction nomogram tailored for cognitive deterioration in elderly patients with hypertension demonstrated robust predictive power and a close correspondence between predicted and observed outcomes.This model offers significant potential as a means to forestall cognitive decline in hypertensive elderly patients.ALP was negatively correlated with MoCA score,while BMI,MNA score,Hb and ALB were positively correlated with MoCA score.CONCLUSION BMI,MNA score,Hb and ALB were independent protective factors for cognitive impairment in elderly hypertensive patients and were positively correlated with MoCA score.ALP was an independent risk factor for cognitive impairment in elderly hypertensive patients and was negatively correlated with the MoCA score.The column line graph model established in the study has a good predictive value.
