Table of Content

05 August 2026, Volume 29 Issue 22

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Editorial

The Current Situation and Challenges of Building a Standards System for High-quality Development of Health Care Empowered by Generative Artificial Intelligence

CHEN Kaiyuan, WANG Hongchuan, GE Yi, SUN Nailing, CHEN Cheng, WANG Tianran, ZENG Huatang, LEI Suwen, LIANG Wannian

2026, 29(22):  3073-3078.  DOI: 10.12114/j.issn.1007-9572.2026.0010

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Generative artificial intelligence (AI), especially the new generation of generative AI technologies represented by Large Language Models (LLMs), is profoundly transforming and reshaping the development path toward high-quality development in the field of health care. Generative AI technologies have rapidly expanded from technical-level applications in health care: such as clinical auxiliary diagnosis and treatment, disease prevention and control, and health management-to exert an impact on the institutional design and governance tools of this sector, thus posing new challenges. As an important foundational institutional guarantee for ensuring the quality and safety of medical and health services and the equity of basic public health services, the standard system in the health care field is confronted with an urgent demand for digital and intelligent transformation. Against the backdrop of the rapid iteration of medical and health technologies, the continuous evolution of service models, and the increasingly diversified health needs, it is imperative to directly address the current status and challenges in constructing a standard system empowered by generative AI to advance the high-quality development of health care. Building on a systematic review of recent research on the application of generative AI in health and wellness, this paper focuses on its enabling role in the development of health and wellness standards. It systematically examines potential application pathways across key stages: including standard formulation, implementation, evaluation, and dynamic updating: and further discusses major challenges related to technical reliability, ethical governance, legal liability, data quality, and organizational capacity. The study concludes that, guided by the principles of human-centered design and risk controllability, the deliberate integration of generative artificial intelligence into the health and wellness standards framework holds significant promise for advancing the modernization of health governance and promoting health equity in China.

Guidelines Interpretation

Interpretation of BMJ Clinical Practice Guideline: SGLT-2 Inhibitors for Adults with Chronic Kidney Disease

QU Furong, ZHAO Lijun, ZENG Xiaoxi, LI Jing, LI Sheyu

2026, 29(22):  3079-3085.  DOI: 10.12114/j.issn.1007-9572.2026.0006

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The clinical practice guideline on the use of sodium-glucose cotransporter 2 (SGLT-2) inhibitors in adult patients with chronic kidney disease (CKD), published in the BMJ in October 2024, stratifies patients with CKD into four risk tiers-low, moderate, high, and very high-based on estimated glomerular filtration rate (eGFR) and proteinuria levels to assess their risk of complications and disease progression. The guideline provides a quantitative evaluation of the benefits and risks of SGLT-2 inhibitors across different risk tiers and proposes a tiered recommendation strategy. For instance, for adult patients with CKD who have a low or moderate risk of disease progression and complications, the use of SGLT-2 inhibitors can be considered (weak recommendation); whereas for those with a high or very high risk, the use of SGLT-2 inhibitors is recommended (strong recommendation). This approach supports individualized decision-making for patients and assists general practitioners in the rational and standardized use of SGLT-2 inhibitors across diverse clinical settings. Additionally, the guideline's rapid-access web version offers highly visualized evidence and recommendation presentation tools, facilitating quick reference for general practitioners and supporting the implementation of shared decision-making between clinicians and patients.

Interpretation of the ACLM Clinical Practice Guideline: Lifestyle Interventions for the Treatment and Remission of Type 2 Diabetes and Prediabetes in Adults

LI Ge, ZHOU Yingsheng, TIAN Xiangyang, GAO Ying

2026, 29(22):  3086-3093.  DOI: 10.12114/j.issn.1007-9572.2025.0562

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Lifestyle interventions can effectively lower blood glucose levels, promote weight control, improve quality of life, and reduce cardiovascular risk, and constitute a fundamental strategy for the prevention and management of diabetes and other chronic non-communicable diseases. In this context, the American College of Lifestyle Medicine released the Clinical Practice Guideline on Lifestyle Interventions for the Treatment and Remission of Type 2 Diabetes and Prediabetes in Adults, representing the first multidisciplinary clinical practice guideline to position lifestyle intervention as the core therapeutic strategy. Based on available evidence from randomized controlled trials, systematic reviews, and observational studies, the guideline systematically integrates key lifestyle domains, including dietary optimization, promotion of physical activity, sleep management, stress reduction, avoidance of unhealthy substance use, and social support, and establishes a comprehensive management framework encompassing assessment, intervention, follow-up, and dynamic adjustment. The guideline emphasizes patient-centered care and multidisciplinary collaboration, highlights the potential for achieving diabetes remission in selected individuals through intensive lifestyle intervention, and provides principle-based recommendations on medication adjustment and long-term safety monitoring. In addition, practical assessment tools, intervention prescription templates, and follow-up strategies are provided to enhance clinical feasibility. This article interprets the core recommendations of the guideline, focusing on its evidence base, clinical implications, and implementation considerations, with the aim of informing the standardized application of lifestyle interventions in the management of prediabetes and type 2 diabetes in adults.

Methodology Series in Chinese General Practice Medicine (Ⅰ)

A Five-stage Approach for Primary Care Practitioners to Refine High-quality Research Questions with Artificial Intelligence Assistance

WANG Yang, ZOU Chuan, GUO Mengruo, HE Liuhua, LU Xuhang, GUI Xianzhong, XU Zhijie, LIN Kai, JIN Hua, YAO Mi, YANG Hui, YU Dehua

2026, 29(22):  3094-3102.  DOI: 10.12114/j.issn.1007-9572.2025.0579

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Formulating high-quality research questions is one of the most fundamental challenges facing general practice professionals in China. Although they are deeply embedded in frontline practice and accumulate rich experiential knowledge, many still lack systematic methodological training and sustained research support. To address this gap, this methodological study developed and preliminarily validated a five-step human-AI collaborative approach based on AI chatbots. The approach translates classic methodological theories—such as the JBI PCC framework, implementation science, On Contradiction, and On Practice—into a set of standardized prompts, and combines them with stepwise human input to support five core tasks: practice observation and value assessment, information extraction and evidence-based conceptualization, literature searching and knowledge synthesis, construction of a preliminary research question, and method selection with feasibility assessment. This study provides a practical and accessible toolkit for Chinese general practice professionals, especially those with limited research training, to refine practice-based research questions in a structured manner. By lowering the threshold for moving from practical confusion to research initiation, this approach may help frontline practitioners overcome the common "zero-to-one" difficulty in starting research. More broadly, it offers a feasible methodological pathway for strengthening the generation of locally grounded evidence and promoting a practice-theory cycle in China's primary health care system.

General Practice Education

Retention of Rural Order-oriented Medical Graduates in Primary Care: an Eight-year Follow-up Study Based on Four Institutions

ZHENG Huixian, TANG Haoqing, LI Mingyue, TIAN Yiran, HAN Leyang, LONG Ren, LIU Xiaoyun

2026, 29(22):  3103-3109.  DOI: 10.12114/j.issn.1007-9572.2024.0718

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Background

The training of rural order-oriented medical students is an important initiative to alleviate the shortage of medical human resources in rural areas. As of October 2023, three batches of order-oriented medical graduates have completed their required service obligations. However, there is still a lack of systematic research and definitive conclusions regarding their career development and whether they will continue to serve in rural areas after fulfilling their service commitments.

Objective

Based on eight years of panel data from a cohort of rural order-oriented medical students, this study aims to analyze their early career development characteristics and identify key factors influencing their retention in primary healthcare institutions. The findings are intended to provide policy recommendations for the training and management of order-oriented medical graduates in China.

Methods

Since 2010, a dynamic follow-up cohort has been established, involving order-oriented medical graduates from Qinghai University, Guangxi Medical University, Jiujiang University, and Gannan Medical University. This study utilized data from 2 041 graduates from the 2015-2019 cohorts, collected through annual online surveys conducted over eight years. The surveys tracked their career development, including professional title promotion, administrative role acquisition, average monthly income, and the proportion of performance-based pay. Descriptive analysis was used to summarize the characteristics of career development, while Logistic regression models were employed to explore factors influencing retention in primary healthcare institutions after the contractual period.

Results

Among the 2 041 order-oriented medical graduates included, 1 068 (52.3%) were male and 973 (47.7%) were female. By the eighth year after graduation, 92.0% (69/75) of graduates had obtained the title of attending physician, and 24.0% (18/75) held administrative positions. The median monthly income was 5 214.0 yuan, with median performance-based pay accounting for 42.5% of the total. As of December 2023, with 232 graduates remaining in their positions after contract completion, resulting in a 37.5% retention rate in primary healthcare settings. Among the 386 graduates who left primary healthcare settings, 136 (35.2%) transitioned to hospitals above the county level, representing the largest proportion, followed by 107 (27.7%) moving to county-level hospitals, and 29.0 (7.5%) pursuing graduate studies. Multivariate Logistic regression analysis revealed that contract placement in home county/city (OR=2.74, 95%CI=1.57-4.78, P=0.001) and holding administrative positions (OR=2.02, 95%CI=1.14-3.59, P=0.016) were significant facilitators of retention in primary healthcare settings post-contract completion among order-oriented medical graduates. Conversely, passing the national medical licensing exam within two years of graduation (OR=0.37, 95%CI=0.15-0.94, P=0.036) emerged as a barrier to retention.

Conclusion

Order-oriented medical graduates show rapid career progression, with over half choosing to remain in county-level or lower primary healthcare institutions after fulfilling their contracts. This strengthens human resource capacity and improves care quality in primary healthcare settings. Notably, order-oriented medical graduates who obtained physician qualification within two years post-graduation exhibited significantly higher occupational mobility in primary healthcare settings.

Preliminary Construction of the Index System of Continuing Medical Education for Rural Order-oriented General Practitioners

YUAN Chengju, XIAO Xue, FAN Tengyang, LIU Shifang, HUANG Nian, ZHANG Nian, YU Changyin

2026, 29(22):  3110-3115.  DOI: 10.12114/j.issn.1007-9572.2024.0516

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Background

To establish the index system of continuing medical education for rural order-oriented general practitioners is the key to cultivating "useful and developed" grassroots general practitioners.

Objective

To explore the construction of a set of scientific and systematic continuing education index system that meets the needs of rural order-oriented general practitioners, and to provide a basis for conducting continuing medical education for rural order-oriented general practitioners.

Methods

From January to March 2024, based on literature review and preliminary interview and questionnaire data collected from targeted general practitioners in Guizhou Province, a preliminary candidate indicator system was drafted by the project team. A two-round Delphi expert consultation method (12 experts, 5-point Likert scale, screening criteria: mean importance > 3.5 and coefficient of variation < 0.25) was used to screen and refine the indicators. Descriptive statistics were performed using SPSS 22.0, and the Analytic Hierarchy Process (AHP) was used to determine the weights of indicators at each level.

Results

The response rates for both rounds of the consultation questionnaire were 91.67%. The expert authority coefficients for the two rounds were 0.950 and 0.923 (both > 0.700), indicating a high degree of expert authority. The coefficients of variation for each indicator ranged from 0 to 0.21, and Kendall's W coefficients of concordance were 0.167 (χ²=69.922, P<0.001) and 0.217 (χ²=95.322, P<0.001) respectively, showing a continuous improvement in the consistency of expert opinions. After adding, deleting, merging, and splitting indicators through two rounds of consultation, the final constructed indicator system included 4 primary indicators (basic medical services, public health services, professional qualities, career development), 12 secondary indicators, and 41 tertiary indicators. The weights of each primary indicator ranged from 0.131 0 to 0.390 4, with basic medical services having the highest weight (0.390 4). The weights of all secondary and tertiary indicators passed the consistency test.

Conclusion

The index system of continuing medical education constructed in this study is relatively scientific and systematic, which can provide theoretical basis for the continuing medical education of rural order-oriented general practitioners.

General Practice/Community Health Services · Community Health Workforce Management

Research on the Driving Factors and Enhancement Path of Job Performance of Community Health Service Personnel Based on Fuzzy Set Qualitative Comparative Analysis

LIU Di, LI Kun, HU Bingjie, SHI Lei

2026, 29(22):  3116-3122.  DOI: 10.12114/j.issn.1007-9572.2024.0689

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Background

Building a strong and healthy nation through grassroots public health services has been established as a fundamental national strategy in China. Enhancing the job performance of community health service personnel is therefore of critical importance.

Objective

This study aimed to analyze the driving factors and improvement pathways for the job performance of community health service personnel, providing insights for strengthening the capacity of primary health services.

Methods

A questionnaire survey was conducted from July to September 2023 using purposive sampling. Participants included 4 000 community health service personnel from northern (Heilongjiang Province), central (Hubei Province), western (Gansu Province), and southern (Guangdong Province) China. The questionnaire comprised the following sections: a General Information Questionnaire, Job Motivation Measurement Scale, Job Content Questionnaire, the Minnesota Satisfaction Questionnaire, the Social Support Rating Scale, the WHO-5 Well-being Index, and Job Performance Measurement Scale. Data were analyzed using fuzzy-set qualitative comparative analysis (fsQCA) .

Results

A total of 3 854 valid questionnaires were collected, with an effective response rate of 98.2%. The fsQCA results indicated that no single factor constituted a necessary condition for high job performance. Five distinct causal configurations were found to enhance job performance, with an overall solution consistency of 0.933 5 (exceeding the 0.800 0 threshold), indicating strong explanatory power for the model. Work climate motivation, work environment motivation, and job support motivation emerged as core conditions across solutions. Compensation and benefits motivation, job satisfaction, and social support played important roles in specific pathways. Job content motivation, career development motivation, and occupational stress acted as peripheral conditions in certain configurations.

Conclusion

The three motivational factors of work environment motivation, work climate motivation and job support motivation are the core influencing factors to enhance the job performance of community health service workers. Job performance should be improved by optimising and improving the working environment, creating a good working atmosphere and strengthening the job support system.

Latent Profile Analysis and Influencing Factors of Job Performance among Community Health Service Personnel

LIU Di, HUANG Wanyao, LI Li, SHI Lei

2026, 29(22):  3123-3130.  DOI: 10.12114/j.issn.1007-9572.2024.0700

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Background

At present, community health service personnel in China are facing many practical problems, which seriously affect their work enthusiasm and motivation. At the same time, the research on the relationship between work motivation and work performance of community health service personnel is still in its infancy, and there is no systematic research.

Objective

To identify potential subgroups of job performance among community health service personnel using a person-centered approach and to examine the predictive effect of work motivation on different job performance subgroups.

Methods

This study was conducted from July to September 2023, surveying 50 randomly selected community health centers or service stations in Heilongjiang, Hubei, Gansu, and Guangdong provinces. Within each community service center or station, 20 staff members were randomly selected to complete work motivation and work performance scales. A total of 4 000 staff members were surveyed, with 3 925 questionnaires returned and 3 854 valid questionnaires, resulting in an effective response rate of 98.2%. Latent profile analysis was used to determine the latent classification of community health service personnel's work performance. Multivariate linear regression analysis was employed to assess the relationship between different work performance subcategories and work motivation, while controlling for demographic variables such as gender and age.

Results

The latent profile analysis (LPA) identified three distinct classes of job performance among community health service personnel, namely low, moderate, and high job performance groups, accounting for 14.71%, 46.16%, and 39.13% of the sample, respectively. The three-class model demonstrated good classification quality, with average posterior probabilities ranging from 93.8% to 96.6% across classes. Significant differences were observed among the three performance classes in task performance, contextual (relational) performance, and learning performance scores (all P<0.001). The low-, moderate-, and high-performance groups also differed significantly with respect to age, marital status, educational attainment, years of work experience, professional title, employment status, and average monthly income (all P<0.001). Multiple linear regression analyses indicated that, after controlling for relevant demographic characteristics, work motivation was a significant positive predictor of job performance in the low-, moderate-, and high-performance groups (β=0.264, 0.207, and 0.340, respectively; all P<0.001).

Conclusion

The work motivation of community health service personnel is effectively improved through corresponding incentive measures, which will directly promote the improvement and improvement of their work performance.

Development of a Work Motivation Scale for Community Health Service Providers

LIU Di, LI Chenglu, YU Dandan, SHI Lei

2026, 29(22):  3131-3137.  DOI: 10.12114/j.issn.1007-9572.2024.0690

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Background

The assessment of work motivation among community health service providers is crucial for improving service quality. However, there is still a lack of tools to evaluate their work motivation, and a corresponding scale urgently needs to be developed.

Objective

To develop an assessment tool for the work motivation of community health service providers in order to boost their enthusiasm and proactivity at work.

Methods

Based on grounded theory, an interview outline was constructed using a literature review. From February to July 2022, in-depth interviews were conducted with personnel from community health service centers (n=40) in Heilongjiang, Hubei, Gansu, and Guangdong provinces, selected through theoretical sampling. Grounded theory was used to extract concepts and categories to form an initial scale, which, after expert review, resulted in 42 items. From August to December 2022, questionnaires were distributed online in two phases, yielding two independent samples for exploratory factor analysis (n=314) and confirmatory factor analysis (n=327). SPSS 25.0 and AMOS 17.0 were used for reliability and validity testing, assessing the scale's internal consistency, structural validity, and model fit.

Results

A total of 800 questionnaires were distributed, and 641 valid responses were collected, with an overall effective response rate of 80.1%. The final work motivation scale for community health service providers consisted of six dimensions, including compensation and benefits, job content, work climate, working environment, career development, and work support, with a total of 29 items. The Cronbach's α coefficient for the total scale was 0.966, and the Cronbach's α coefficients for the six dimensions were 0.864, 0.878, 0.937, 0.934, 0.940, and 0.902, respectively.

Conclusion

The work motivation scale for community health service providers developed in this study demonstrates good reliability and validity in measuring their work motivation. It provides a measurement tool for in-depth investigation of work motivation among community health service providers and offers a reference for organizations to assess and improve employee incentive strategies.

Article

A Prospective Cohort Study on Relationship between Lipid Accumulation Product and Incidence of Metabolic Syndrome in Adults

ZHANG Ji, LI Ling, ZHOU Jie, WU Yanli, JI Wei, LIU Tao

2026, 29(22):  3138-3145.  DOI: 10.12114/j.issn.1007-9572.2025.0442

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Background

Metabolic Syndrome (MetS) exerts a significant adverse impact on human health, while the Lipid Accumulation Product (LAP) is capable of reflecting the degree of visceral fat accumulation in the human body. Previous studies investigating the relationship between LAP and MetS have mostly been cross-sectional studies, with a lack of evidence from cohort studies. Additionally, the predictive ability of LAP varies across different studies, and its value in predicting the future incidence of MetS requires further exploration.

Objective

To analyze the relationship between long-term exposure to the LAP and the risk of developing MetS, and to explore the predictive performance of this index for MetS, thereby providing evidence for the early prevention of MetS.

Methods

This study utilized data from the Guizhou Natural Population Cohort Study. The cohort was established between November 2010 and December 2012, and a follow-up survey was conducted on the baseline participants from April 2016 to October 2020. Participants were divided into 4 groups (Q1 to Q4) based on their baseline LAP levels: Q1 (LAP<8.52, n=1 003), Q2 (8.52≤LAP<15.44, n=1 001), Q3 (15.44≤LAP<27.85, n=1 006), and Q4 (LAP≥ 27.85, n=1 003). Cox proportional hazards models were used to analyze the relationship between LAP and MetS in the total population and in subgroups stratified by sex. Hazard ratios (HR) and their corresponding 95% confidence intervals (95%CI) were calculated. Restricted cubic splines were applied to evaluate the dose-response relationship between LAP and the incidence of MetS. Additionally, time-dependent receiver operating characteristic (ROC) curves for LAP in predicting MetS were plotted to assess the predictive performance of this index.

Results

A total of 4 013 study subjects were enrolled, including 1 803 males (44.93%) and 2 210 females (55.07%). The baseline mean age was (43.7±14.6) years, with a mean BMI of (22.45±2.84) kg/m². The median follow-up duration was 6.54 years, during which 889 cases of MetS were observed. The MetS incidence rates in the overall population, males, and females were 31.62 per 1 000 person-years, 33.36 per 1 000 person-years, and 30.19 per 1 000 person-years, respectively. Cox proportional hazards regression analysis showed that after adjusting for relevant confounding factors, the risk of MetS increased with the elevation of the LAP (P _{for trend}<0.05). In the total population, compared with the Q1 group, the adjusted hazard ratios (aHRs) or MetS risk were gradually elevated in the Q2 (aHR=1.26, 95%CI=1.02-1.57), Q3 (aHR=1.35, 95%CI=1.08-1.68), and Q4 (aHR=1.55, 95%CI=1.24-1.94) (P<0.05). In the male, compared with the Q1 group, the Q2 (aHR=1.45, 95%CI=1.09-1.93), Q3 (aHR=1.52, 95%CI=1.12-2.05), Q4 (aHR=1.56, 95%CI=1.13-2.10) all exhibited an increased risk of MetS (P<0.05). In the female, however, a significant increase in MetS risk was only observed in the Q4 (aHR=1.44, 95%CI=1.03-2.01) relative to the Q1 group (P<0.05). Result s from restricted cubic splines indicated a linear dose-response relationship between LAP and MetS risk in the total population (P_overall<0.05, P_nonlinear=0.069) and the male subgroup (P_overall<0.05, P_nonlinear=0.255), while a non-linear dose-response relationship was observed in the female subgroup (P_overall<0.05, P_nonlinear=0.038). The results of time-dependent ROC curves showed that for the prediction of MetS after 7, 8, and 9 years of LAP exposure, the AUC values in the total population were 0.56, 0.56, and 0.57, respectively, in males, the AUC values were 0.55, 0.55, and 0.59, respectively, and in females, the AUC values were 0.57, 0.58, and 0.57, respectively.

Conclusion

Elevated LAP levels increase the risk of MetS in the general population and across different sex groups. However, its predictive efficacy for future MetS development is limited, making it an suboptimal prognostic marker. Thus, more indicators with higher predictive value should be explored.

Analysis of the Correlation between Different Surrogate Indicators of Insulin Resistance and the Occurrence of MACEs after PCI in Patients with Metabolic Dysfunction-associated Steatotic Liver Disease and Coronary Heart Disease

SUN Qinyu, YANG Tianxiao, DENG Yifan, FANG Zhen, JI Jun, HE Shenghu, ZHANG Jing

2026, 29(22):  3146-3153.  DOI: 10.12114/j.issn.1007-9572.2025.0503

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Background

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a steatotic liver disorder closely linked to metabolic dysregulation. Insulin resistance (IR) plays a key role in its pathophysiology and is considered a significant component of cardiometabolic risk.

Objective

To investigate the association between different surrogate indicators of IR and the occurrence of major adverse cardiovascular events (MACEs) after percutaneous coronary intervention (PCI) in patients with MASLD and coronary heart disease (CHD), and to identify simple predictive indicators suitable for this population.

Methods

A total of 958 patients diagnosed with MASLD and CHD who underwent PCI at Northern Jiangsu People's Hospital from January 1, 2019 to October 31, 2023, were retrospectively enrolled. Baseline data were collected, cardiac function was assessed by echocardiography, and liver status was evaluated by ultrasound. IR surrogate indicators were calculated based on laboratory results. Patients were followed up to collect the occurrence of postoperative MACEs. Cox proportional hazards regression models were used to explore prognostic factors. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive efficacy of IR surrogate indicators. Kaplan-Meier survival curves were drawn to compare cumulative survival rates, with Log-rank tests for group comparisons. Restricted cubic spline (RCS) curves were used to explore the nonlinear trends between IR indicators and prognosis.

Results

Based on follow-up results, patients were divided into the non-MACEs group (n=768) and the MACEs group (n=190). Significant differences were observed between the two groups in white blood cell count, neutrophil count, monocyte count, fasting plasma glucose (FPG), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A, apolipoprotein B, albumin, aspartate aminotransferase, TyHGB, TyG, TG/HDL-C, and METS-IR (P<0.05). Cox regression analysis showed that elevated TyG (HR=1.820, 95%CI=1.223-2.707) and METS-IR (HR=7.309, 95%CI=3.770-14.170) were risk factors for postoperative MACEs (P<0.05). Group analysis indicated that TyG Q2-Q4, TG/HDL-C Q4, TyHGB Q3-Q4, and METS-IR Q3-Q4 were risk factors for MACEs (P<0.05). Kaplan-Meier curves showed significant differences in MACEs risk across quartiles of TyG (χ²=17.428), TG/HDL-C (χ²=41.682), TyHGB (χ²=47.345), and METS-IR (χ²=104.233) (P<0.05). RCS curves indicated a nonlinear correlation of TG/HDL-C, TyHGB, and METS-IR with MACEs (P_nonlinear<0.001), while TyG showed a linear correlation (P_nonlinear=0.643). ROC analysis showed the AUC for TyHGB, TyG, TG/HDL-C, and METS-IR were 0.653(95%CI=0.611-0.696), 0.599(95%CI=0.553-0.644), 0.652(95%CI=0.608-0.695), and 0.741, respectively.

Conclusion

TyHGB, TyG, TG/HDL-C, and METS-IR are positively associated with the occurrence of MACEs after PCI in patients with MASLD and CHD and can serve as potential epidemiological predictive indicators, with METS-IR demonstrating the best predictive performance.

Analysis of Clinical Characteristics and Prognostic Risk Factors in Patients with Pulmonary Mucormycosis Complicated with Diabetes Mellitus

WANG Xinliang, ZOU Nannan, CHEN Nana, WANG Xin

2026, 29(22):  3154-3161.  DOI: 10.12114/j.issn.1007-9572.2025.0410

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Background

Pulmonary mucormycosis (PM) is a highly invasive fungal infection, which is characterized by rapid progress and high mortality. Diabetes mellitus (DM) is a major predisposing factor, especially under the condition of poorly control. It is difficult to diagnose the disease early because of the lack of specificity in clinical manifestations and imaging features. This is easy to delay diagnosis and treatment, leading to poor prognosis. However, data on the clinical characteristics and prognostic factors of PM in patients with DM remain scarce.

Objective

To investigate the clinical characteristics of PM in patients with DM and to identify the independent risk factors for 28-day mortality.

Methods

This retrospective study included 51 hospitalized patients who were proven or probable PM diagnosed according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria at Jinan Central Hospital between May 2015 and May 2025. Patients were divided into two groups: a PM with DM group (PM+DM, n=24) and a PM without DM group (PM+NDM, n=27). Clinical characteristics, laboratory findings, imaging features, and treatment regimens of the two groups were compared. Univariate and multivariable Cox regression analyses were performed to identify independent risk factors for 28-day mortality in the PM with DM group.

Results

No significant differences were observed between the PM+DM and PM+NDM groups in baseline characteristics, clinical features, or treatment regimens (P>0.05). Compared with the PM+NDM group, the PM+DM group had significantly higher levels of high-sensitivity C-reactive protein, and arterial partial pressure of carbon dioxide, HbA_1c, fasting blood glucose, and serum galactomannan (GM) test results (P<0.05), but significantly lower albumin levels and thrombin time (P<0.05). There was no significant differences were found in the other laboratory parameters (P>0.05). In terms of imaging findings, the proportions of patients with involvement of three or more lung lobes and pulmonary cavitary lesions were significantly higher in the PM+DM group than that in the PM+NDM group (P<0.05). However, no significant between-group differences were found in reversed halo sign, pulmonary nodules, or other imaging manifestations (P>0.05). Multi-variable analysis identified HbA_1c and serum creatinine levels as independent predictors of 28-day mortality in the PM+DM group (P<0.05).

Conclusion

Patients with pulmonary mucormycosis complicated by diabetes mellitus are characterized by a heightened inflammatory response, hypoalbuminemia, poor glycemic control, pulmonary cavitary lesions, and multi-lobar involvement. HbA_1c and serum creatinine levels may serve as important predictors of 28-day mortality.

Predictive Value of Red Blood Cell Transfusion Frequency for Adverse Outcomes in Very and Extremely Low Birth Weight Infants: a Retrospective Cohort Study

FANG Xiaohong, XU Chun, HUANG Dali, XU Liping

2026, 29(22):  3162-3167.  DOI: 10.12114/j.issn.1007-9572.2025.0461

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Background

Very/extremely low birth weight infants (VLBWI/ELBWI) have a common need for red blood cell transfusion (RBCT) within 28 days after birth. The current controversy centers on the selection of the transfusion threshold strategy, with a lack of in-depth discussion on the frequency of red blood cell transfusion and the correction for disease severity.

Objective

This study aimed to explore the relationship between the frequency of blood transfusion within 28 days after birth for very low birth weight infants (VLBWI) and adverse outcomes (severe complications and in-hospital death).

Methods

A retrospective analysis was conducted on the data of 408 very low birth weight infants and extremely low birth weight infants admitted to the Neonatal Intensive Care Unit of Zhangzhou Hospital Affiliated to Fujian Medical University from 2018 to 2020.Based on the results of RBCT, 408 infants were divided into the blood transfusion group (303 cases) and the no-blood-transfusion group (105 cases). Compare the clinical characteristics and adverse outcomes of the two groups of children [at least one of the following complications must occur, including retinopathy of prematurity (ROP)>stage 2, moderate to severe bronchopulmonary dysplasia (BPD), and in-hospital death]. Spearman rank correlation analysis was used to explore the relationships between gestational age at birth (GA), birth weight (BW), and complications (delivery room intubation, mechanical ventilation for more than 5 days, confirmed sepsis, grade 3-4 periventricular-intraventricular hemorrhage) and the number of blood transfusions. Multivariate Logistic regression analysis was used to assess the associations between GA, BW, comorbidities and the number of blood transfusions and the occurrence of adverse outcomes in VLBWI and extremely low birth weight infants (ELBWI).

Results

Among the 408 infants, 256 were male (62.7%) and 152 were female (59.3%). The average gestational age was (29.8±2.1) weeks and the average birth weight was (1 205±248) grams. Among them, 303 cases (74.3%) of the infants underwent RBCT within 28 days after birth. There were statistically significant differences (P<0.05) between the transfusion group and the non-transfusion group in terms of GA, BW, 5-minute Apgar score, small for gestational age (SGA), delivery room intubation, mechanical ventilation >5 days, confirmed sepsis, grade 3-4 periventricular-intraventricular hemorrhage, ROP >stage 2, moderate to severe BPD, and in-hospital death. The results of the correlation analysis showed that GA and BW were negatively correlated with the number of blood transfusions (r_s=-0.544, P<0.001; r_s=-0.541, P<0.001), while complications were positively correlated with the number of blood transfusions (r_s=0.385, P<0.001). The results of the multivariate Logistic regression analysis showed that GA≥30 weeks (OR=0.482, 95%CI=0.281-0.827, P=0.008) and BW≥1 250 g (OR=0.447, 95%CI=0.261-0.765, P=0.003) were protective factors for adverse outcomes in VLBWI/ELBWI, while having complications (OR=1.868, 95%CI=1.138-3.066, P=0.013) and the number of blood transfusions ≥3 times (OR=3.275, 95%CI=1.707-6.275, P<0.001) were risk factors for adverse outcomes in VLBWI/ELBWI.

Conclusion

Receiving RBCT within 28 days after birth is relatively common in VLBWI/ELBWI cases (74.3%), and factors such as GA<30 weeks, BW<1 250 g, presence of complications, and ≥3 blood transfusions may be independent risk factors for severe complications and in-hospital mortality. It is suggested that ≥3 blood transfusions within 28 days be used as a high-risk warning sign for VLBWI/ELBWI, and for infants with ≥3 blood transfusions, intensified monitoring of complications should be carried out to improve prognosis.

Efficacy Evaluation of Manual Therapy for Cervical Spondylotic Radiculopathy Using Semg Frequency Domain and Nonlinear Analysis

LI Jing, ZHENG Jiacheng, LI Hongtao, ZHU Liguo, FENG Minshan

2026, 29(22):  3168-3174.  DOI: 10.12114/j.issn.1007-9572.2026.0013

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Background

Manual therapy is a standard conservative treatment for cervical spondylotic radiculopathy (CSR); however, clinical electrophysiological evidence regarding its efficacy in improving neuromuscular function in CSR patients remains insufficient.

Objective

This study aimed to elucidate the electrophysiological effects of cervical rotation-traction manipulation and tendon-regulating manipulation on the affected muscles of CSR patients using frequency-domain and nonlinear analysis of surface electromyography (sEMG).

Methods

Sixty patients with CSR admitted to Wangjing Hospital, China Academy of Chinese Medical Sciences, from April 2024 to April 2025 were enrolled and randomly assigned to either the cervical rotation-traction manipulation group or the tendon-regulating manipulation group (n=30 each). Electrophysiological characteristics-frequency-domain indices [median frequency (MDF), mean power frequency (MNF)] and nonlinear index [sample entropy (SampEn)]-of the affected wrist flexors, wrist extensors, biceps brachii, triceps brachii, and deltoid muscles were measured at pre-treatment (T0), mid-treatment (T1), and post-treatment (T2). Independent samples t-tests and analysis of variance (ANOVA) were employed to evaluate the treatment effects.

Results

At T1 and T2, the MDF of the biceps and triceps brachii in the cervical rotation-traction manipulation group were significantly higher than those in the tendon-regulating manipulation group (P<0.05). At T1, the MNF of the biceps and triceps brachii in the cervical rotation-traction manipulation group were higher than those in the tendon-regulating manipulation group (P<0.05); at T2, only the MNF of the biceps brachii was higher in the cervical rotation-traction manipulation group (P<0.05). At T1, the SampEn values of the biceps and triceps brachii in the cervical rotation-traction manipulation group were significantly higher than those in the tendon-regulating manipulation group (P<0.05). Within the cervical rotation-traction manipulation group, MDF, MNF, and SampEn showed statistically significant differences among muscles at all time points (T0-T2) (P<0.05), with effect sizes (η²) ranging from 0.308-0.413 for MDF and MNF, and 0.090-0.107 for SampEn. In the tendon-regulating manipulation group, significant differences among muscles were observed for MDF and MNF at all time points (P<0.001, η²=0.108-0.164), whereas no significant differences were found for SampEn (P>0.05, η²=0.036-0.051).

Conclusion

The electrophysiological regulation effect of cervical rotation-traction manipulation on the affected muscles of CSR patients is superior to that of tendon-regulating manipulation, particularly in improving the frequency-domain and nonlinear indices of key muscle groups (biceps and triceps brachii), providing an objective basis for clinical selection of manual therapies.

Research on the Central Mechanism of Chronic Idiopathic Tinnitus Based on rs-fMRI

LI Baijie, ZHANG Xueting, FU Yuanbo, LIU Huilin, CHEN Peng, NI Yutong, ZENG Yuhan

2026, 29(22):  3175-3181.  DOI: 10.12114/j.issn.1007-9572.2023.0523

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Background

Due to the complexity of its etiology and mechanisms, idiopathic tinnitus still lacks effective treatments. As the condition persists, it significantly impairs patients' quality of life. In recent years, with the rapid development of resting-state functional magnetic resonance imaging (rs-fMRI), this technique has been widely applied to investigate the pathological mechanisms of chronic idiopathic tinnitus. A growing body of research suggests that chronic idiopathic tinnitus involves plastic changes across multiple central brain regions.

Objective

This study aims to analyze and summarize the research progress over the past decade on the central mechanisms of chronic idiopathic tinnitus using rs-fMRI, clarify the mechanisms of central neural remodeling, and lay a solid foundation for constructing a central model of chronic idiopathic tinnitus.

Methods

Retrieval of studies related to the central mechanism of idiopathic tinnitus and rs-fMRI included in China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP Journal Resource Integration Service Platform (VIP), and PubMed from January 1, 2013 to January 1, 2023, eight studies were included to explore alterations in functional activity in brain regions, while another seven studies investigated changes in functional connectivity within brain networks.

Results

Compared with healthy subjects, patients with chronic idiopathic tinnitus exhibited an excitatory-inhibitory imbalance in the auditory cortex, along with aberrant coupling with limbic system regions such as the amygdala, hippocampus, and frontal-striatal circuit. In terms of brain networks, abnormal functional connectivity was observed in the auditory-visual network, default mode network, executive control network, salience network, attention network, and subcortical-cerebellar network.

Conclusion

This review summarizes current rs-fMRI research on the central mechanisms of chronic idiopathic tinnitus and suggests that the condition may result from neural remodeling involving the auditory pathway, limbic system, and multiple functional brain networks.

Exploring the Existential Emptiness and Coping Behaviors in Young People from New Media Suicide Notes: Content Analysis Assisted by Artificial Intelligence

HUNG Tan, LIU Yuan, LIU Simin, WU Jianwei, HU Xiaoxia

2026, 29(22):  3182-3191.  DOI: 10.12114/j.issn.1007-9572.2024.0214

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Background

Emptiness has become a serious public health problem and is closely linked to suicidal behavior. Existential emptiness may be an emerging mental health challenge faced by contemporary young people due to social factors such as involution.

Objective

To explore the psychological state of young people's existential emptiness and their coping behaviors in new media suicide notes by using artificial intelligence-assisted content analysis.

Methods

By data mining suicide notes reported in new media (WeChat, Weibo, and Xiaohongshu) from January, 2013 to December, 2023, 31 suicide notes from young individuals aged≤24 were included. The analysis of the collected texts of suicide notes was conducted using the DiVoMiner® text big data mining and analysis platform. A method of machine-assisted manual coding is employed to construct the category system, and the reliability among coders is evaluated using the Holsti formula, with the Holsti coefficient serving as the reliability of the category system. Semantic network analysis and correlation analysis were used to conduct an in-depth analysis of the vocabulary and themes of the contents of the suicide notes.

Results

This study identified 35 secondary categories through keyword coding, further refined into 5 primary categories, with intercoder reliability ranging from Holsti's coefficient 0.85 to 0.93, and a composite reliability of 0.90 for the category system. The semantic network analysis revealed complex structural relationships among the text contents. The results showed that keywords such as "father" "mother" "hope" "life" and "world" ppeared with high frequency and occupied central positions in the network. Correlation analysis showed a significant positive correlation between psychological distress and a lack of sense of meaning in life (r_s=0.540), a lack of identity and sense of belonging (r_s=0.420), and negative coping behaviors (r_s=0.505). Additionally, a lack of meaning in life was positively correlated with important social relationship breakdowns (r_s=0.384) and negative coping behaviors (r_s=0.531) (P<0.05).

Conclusion

The main manifestations of existential emptiness in the context of youth suicide include deep disturbances about the meaning of life, complex emotions such as despair generated in the process of pursuing the meaning of life, contradictory feelings about the meaning of life and intimate relationships, and a strong desire for social connection. Young people often adopt negative methods such as self-disguise, alienation from others, self-harm, and suicide. The findings underscore the critical need for targeted, empathetic suicide prevention strategies that address the core psychosocial dilemmas and unmet needs of suicidal youth, including early identification of existential emptiness, strengthening social connections especially those with fathers, and facilitating meaning-making.

Investigation of Utilization Behaviors and Influential Factors in the Integration of Medical and Preventive Care for Diabetic Patients in Shandong Province

FAN Wenyu, FENG Xia, ZHANG Shilong, MA Xingli, ZHANG Xindan, ZHAO Yang, WANG Haipeng

2026, 29(22):  3192-3198.  DOI: 10.12114/j.issn.1007-9572.2024.0352

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Background

With the development of the economy and society, the prevalence of diabetes has been increasing year by year. Diabetic patients require not only treatment services but also comprehensive and continuous integration of medical and preventive care. However, due to the fragmentation of "medical-preventive" services, there are certain deficiencies in the utilization of integration of medical and preventive care for diabetic patients. Therefore, improving the utilization of these services is crucial.

Objective

To understand the current status and influencing factors of the utilization of integration of medical and preventive care among diabetic patients in Shandong Province, and to provide references for further improving related policies and practices.

Methods

In August 2023, a multi-stage stratified cluster random sampling method was employed. Based on geographical location and economic development, Yantai City, Weifang City, and Liaocheng City were selected from the eastern, central, and western regions of Shandong Province, respectively. From each city, one county/county-level city was chosen as a sample area. Within each county/city, four townships were randomly selected. From each township, two villages were randomly chosen. In each village, 25 diabetic patients included in the basic public health service management were randomly selected for a questionnaire survey. A self-designed questionnaire was used to investigate the personal characteristics of diabetic patients and their utilization behavior of integrated medical and preventive care services. Multivariate Logistic regression analysis was used to explore the factors influencing diabetic patients' utilization behavior of integrated medical and preventive care services.

Results

A total of 602 patients were surveyed, and 600 valid questionnaires were collected, with a validity rate of 99.67%. The good utilization rate of integration of medical and preventive care among diabetic patients was 54.5% (327/600). There were statistically significant differences in the utilization of these services among patients with different education levels, living conditions, awareness of integration of medical and preventive care, health beliefs, family doctor contracting status, presence of other chronic diseases, and self-rated health status (P<0.05). Multivariate Logistic regression analysis showed that patients with junior high school education (OR=1.896), good awareness of integration of medical and preventive care (OR=5.818), good health beliefs (OR=2.701), and those who had contracted a family doctor (OR=2.106) had better utilization behavior integration of medical and preventive care (P<0.05) .

Conclusion

At present, there is still significant room for improvement in the utilization of integration of medical and preventive care among diabetic patients in Shandong Province. Efforts should be made to further improve these services, improving the quality of family doctor services, and increase the publicity of integration of medical and preventive care and related policies.

The Sensitivity and Specificity Analysis of the WHO Integrated Care for Older People Screening Tool for Intrinsic Capacity Decline

LI Xiaxia, PAN Yiming, LIU Pan, SONG Yu, LI Bixi, ZHANG Yaxin, ZHANG Wanshu, LI Jing, MA Lina

2026, 29(22):  3199-3205.  DOI: 10.12114/j.issn.1007-9572.2024.0227

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Background

Intrinsic capacity (IC) is the sum of an individual's physical and mental capacities. IC decline is highly prevalent and associated with a variety of adverse outcomes in older adults. Early identification and intervention of IC decline is important for the health of older individuals. The World Health Organization (WHO) recommends screening for IC decline with the Integrated Care for Older People (ICOPE) Screening Tool. The Chinese version of the WHO ICOPE Screening Tool has a good level of reliability and validity.

Objective

To investigate the sensitivity and specificity of the Chinese version of the WHO ICOPE Screening Tool for IC decline, and its association with physical function decline, frailty, social frailty, and sarcopenia.

Methods

From December 2019 to December 2023, older adults from the Geriatric Medicine Department of Xuanwu Hospital, Capital Medical University, were selected using convenience sampling. The Chinese version of the WHO ICOPE Screening Tool and IC assessment were respectively used to screen and assess the IC. As well as to assess physical function, frailty, social frailty, and sarcopenia. Paired Chi-square test and receiver operating characteristic (ROC) curves were used to analysis the sensitivity and specificity of WHO ICOPE Screening Tool.

Results

This study included a total of 769 older adults aged 60 to 97 years, with a mean age of (71.0±8.2) years.The Chinese version of the WHO ICOPE Screening Tool has a sensitivity of 95.96%, a specificity of 51.80%, an accuracy of 80.34% for the diagnosis of IC decline, and the ROC curve showed the AUC for diagnosis was 0.739 (95% confidence interval 0.699-0.779, P<0.001). A statistically significant differences (P<0.05) were observed in the prevalence of intrinsic capacity decline and the number of domains for intrinsic capacity decline among older adults with varying physical functions, sarcopenia screening results, frailty and social frailty when assessed using the Chinese version of the WHO ICOPE Screening Tool.

Conclusion

the Chinese version of the WHO ICOPE Screening Tool has high sensitivity and accuracy, and can be used as a Screening Tool for early identification of high-risk older adults to initiate comprehensive assessment and intervention.

Barriers and Facilitators to Implementation of Screening for High-risk Populations of Breast Cancer in Communities: an Interview Study with Women, Organizers and Providers

ZHOU Mingyao, ZHANG Liuliu, HAN Renqiang, LU Ningning, WANG Dan, CHENG Fang

2026, 29(22):  3206-3213.  DOI: 10.12114/j.issn.1007-9572.2025.0355

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Background

Currently, the incidence of breast cancer remains high. The "Cancer Screening Program in Urban China" program, initiated by the National Health Commission, aims to promote early diagnosis and treatment among high-risk populations. However, survey results indicate that the current status of screening among high-risk women is still suboptimal.

Objective

To explore the barriers and facilitators of screening implementation among the high-risk population for breast cancer, and to provide a basis for formulating targeted implementation strategies.

Methods

From September to November 2024, six community health service centers and the sole designated screening hospital in Nanjing, Jiangsu Province, were selected as study sites using convenience sampling. Semi-structured interviews were conducted with medical staff involved in screening work and high-risk women for breast cancer, following the principle of maximum variation sampling. Researchers constructed interview outlines based on the five dimensions and 48 constructs of the Consolidated Framework for Implementation Research (CFIR). And the interview data were analyzed using the content analysis method combined with the top-down approach.

Results

A total of 16 high-risk women for breast cancer, 12 medical personnel from community health service centers, and 10 medical personnel from the designated screening hospital were interviewed. At the screening provider level, barriers included long waiting times for examination and report issuance, limited capacity in interpreting risk assessment results, insufficient information transmission to screening demanders, and unmet human resource and time needs of providers. Facilitators included smooth internal collaboration and adequate reflective work. At the screening recipient level, barriers included digital exclusion, limited information accessibility, insufficient capacity, and weak motivation. Facilitators included perceived risk and benefits, and adequate social support.

Conclusion

There are multi-level barriers and facilitators in screening implementation for high-risk populations of breast cancer. Future efforts should focus on developing targeted implementation strategies to promote the smooth conduct of breast cancer screening, while also providing insights for the overall advancement of the "Cancer Screening Program in Urban China" program.

Article·Drug Use Guide

Construction of a Scientific Popularization Framework for Antibacterial Drugs for Children Discharged from Hospital

MA Linling, WANG Qiqiong, NI Xiaofeng, SHI Yuqing, WEN Yan, PAN Xiangcheng

2026, 29(22):  3214-3219.  DOI: 10.12114/j.issn.1007-9572.2025.0160

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Background

The problem of irrational use of antibacterial drugs by the parents of children after leaving the hospital was particularly prominent. Providing correct guidance and popular science education on the use of antibacterial drugs and to children and their parents was an important measure to improve parents' awareness of antibacterial drugs and the level of their rational use. However, there is currently no standardized scientific popularization framework for the production of resources on antibacterial drugs for children.

Objective

Formulate a scientific popularization framework for antibacterial drugs for children discharged from hospital, providing a reference for the standardized production of pediatric antibacterial scientific popularization resources and guiding parents to use antibacterial drugs reasonably after discharge.

Methods

A systematic scoping review of the pediatric antibacterial scientific popularization upon discharge was conducted through literature research, and the content of the literature was integrated by thematic synthesis from December 2024 to February 2025. Based on the results of the review, a preliminary framework was developed and transformed into a questionnaire. Clinical experts engaged in pediatric infections, pediatric scientific popularization, and pediatric medication education were selected. In March 2025, Delphi expert consultation was completed through the questionnaire was distributed and collected via the online platform "Wenjuanxing". Items were considered to have reached consensus if the mean importance score was ≥4 and the coefficient of variation (CV) was ≤25%. The Delphi expert consultation was used to ultimately determine the indicators and construct a framework for pediatric antibacterial scientific popularization upon discharge.

Results

A total of 7 886 articles were initially retrieved, and 55 articles were finally included after screening. Thematic synthesis summarized 19 descriptive themes (secondary indicators) and 4 analytical themes (primary indicators). A total of 35 questionnaires were distributed, and 21 were collected. The 21 experts rated the importance of 19 secondary indicators and 4 primary indicators, with all scores ranging from 4 to 5 and CV ≤ 25%. The intraclass correlation coefficient (ICC) was 0.52 (95%CI=0.18-0.76, P=0.003), indicating a moderate level of agreement among experts and that consensus was reached. Based on the expert consultation results of the initial indicators, a framework for pediatric antibacterial scientific popularization upon discharge was finally established, including 4 primary indicators (basic knowledge, medication methods, adverse reactions, and behavioral habits) and 19 secondary indicators (definitions of antibiotics, classification of antibiotics, concept differentiation, disease awareness, etc.) .

Conclusion

The framework for pediatric antibacterial scientific popularization upon discharge constructed in this study has high scientific validity and reliability. It can provide an important reference for formulating scientific popularization materials on pediatric antibacterial drugs upon discharge, and guiding parents to use antibacterial drugs reasonably.

Analysis of the Current Situation and Influencing Factors of Medication Adherence among the Elderly in Shandong Province under an Active Health Management Model

CHEN Yingying, ZHU Gaopei, XUE Fuzhong

2026, 29(22):  3220-3225.  DOI: 10.12114/j.issn.1007-9572.2024.0134

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Background

The elderly often suffer from a variety of chronic diseases and require multiple drug treatments. However, many patients struggle to sustain or standardize their medication due to various factors, leading to poor disease control and unsatisfactory medical outcomes. Therefore, understanding the current status and influencing factors of medication adherence among the elderly is crucial for improving and enhancing their adherence. Shandong Province, one of the most populous provinces in China, is at the forefront of the country in terms of aging. The overall medication compliance among the elderly in Shandong is poor, characterized by frequent changes in medication timing, missed doses, or incorrect dosages. As a result, medication adherence among the elderly in Shandong has become a key factor affecting treatment efficacy and quality of life.

Objective

This study aims to explore the medication adherence among elderly individuals in Shandong Province under the active health management model, and to analyze the factors influencing their medication adherence, thereby providing an effective reference for the management of medication behavior in this population.

Methods

A total of 5 447 elderly individuals aged 65 and above were selected from 100 basic community units in Shandong Province using a multi-stage random sampling method. The survey content included basic sociodemographic information, health-related knowledge, health-related attitudes, health-related behaviors, medication adherence, and quality of life. Multivariate Logistic regression analysis was employed to explore the factors influencing medication adherence in this population.

Results

Among the 5 447 elderly individuals included in the study, the score on the Morisky scale was (6.33±1.31). Of these, 4 480 (82.25%) had good medication adherence, while 967 (17.75%) had poor adherence. Logistic regression analysis revealed that gender (OR=0.86, 95%CI=0.74-0.99, P=0.038), marital status (OR=0.90, 95%CI=0.82-0.98, P=0.017), health-related attitudes (OR=0.78, 95%CI=0.68-0.90, P<0.001), willingness to change behavior (OR=0.51, 95%CI=0.41-0.65, P<0.001), and quality of life (OR=0.66, 95%CI=0.57-0.77, P<0.001) were significant factors influencing medication adherence among the elderly.

Conclusion

The medication adherence of the elderly in Shandong Province is generally good. However, factors such as health-related attitudes, willingness to change behavior, and quality of life significantly impact adherence. Therefore, these factors should be prioritized in the development of intervention strategies to improve medication adherence among the elderly.

Application Status of Traditional Computational Methods and Machine Learning in Cancer Drug Repositioning

CAO Yixin, LI Yongzhi, WEI Lingxi, ZHOU Yan, GAO Fei, YU Qi

2026, 29(22):  3226-3232.  DOI: 10.12114/j.issn.1007-9572.2024.0568

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The escalating global cancer burden has spurred extensive research and development efforts towards effective anti-cancer agents. Nevertheless, the exorbitant cost of developing novel drugs poses a significant challenge. This paper describes a cost-effective strategy, drug repositioning, which reuses approved drugs for novel medical indications, potentially resolving this predicament. This paper presents a comprehensive review of computational strategies for cancer drug repositioning, with an emphasis on machine learning. In recent years, the integration of bioinformatics technology and multi-omics data has significantly propelled the progress of cancer drug repurposing. In particular, machine learning and deep learning have contributed significantly to the remarkable advancements in cancer drug repositioning. This review summarizes the current application status of traditional computational methods and machine learning in this domain, and the analysis shows that machine learning holds great promise in facilitating cancer drug repositioning, both independently and in combination with other bioinformatics-based approaches. This paper can provide a valuable reference for the further integration of computational strategies and cancer drug research and development.