Table of Content

15 September 2026, Volume 29 Issue 26

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Guidelines·Consensus

Expert Consensus on Whole-period Systematic Rehabilitation Management for Critically Ill Patients

Chinese Association of Rehabilitation Medicine, Critical Care Rehabilitation Specialty Committee, DENG Luoyi, HUANG Huai, WU Shuang

2026, 29(26):  3713-3725.  DOI: 10.12114/j.issn.1007-9572.2026.0118

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Critical care rehabilitation constitutes an essential strategy to optimize the clinical outcomes of critically ill patients. The high prevalence of post-intensive care syndrome (PICS) highlights the urgent demand for developing an integrated, standardized full-cycle rehabilitation management framework. In China, clinical delivery of critical care rehabilitation is still in its initial rollout phase, constrained by limited clinical recognition, low uptake of early rehabilitation interventions, marked regional imbalance, inconsistent practice standards, immature interdisciplinary coordination systems, and fragmented long-term rehabilitative follow-up. Developed under the leadership of the Chinese Association of Rehabilitation Medicine, Critical Care Rehabilitation Specialty Committee, this consensus drew on a thorough literature search of Chinese and English evidence covering all available records up to November 30, 2025. Evidence grading and the formulation of clinical recommendations were performed using the Delphi technique and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. This consensus articulated the core connotations of full-cycle critical care rehabilitation, and established a three-stage interdisciplinary care team framework with unified operational protocols that covered ICU, dedicated critical rehabilitation wards, and community- or home-based rehabilitation. It specified standardized competency criteria for rehabilitation practitioners, built a robust quality assurance system, and elaborated phase-specific rehabilitation protocols. Additionally, it optimized the continuum of rehabilitative care after hospital discharge and offered guidance on setting up specialized critical care follow-up clinics. The present consensus was intended to formalize a structured full-cycle management pathway for critical care rehabilitation and standardize interdisciplinary collaborative workflows. Implementation of this systematic rehabilitation model was expected to lower patients' long-term disability burden and elevated their overall quality of life, delivered unified operational benchmarks for frontline clinical practice, and outlined multi-faceted developmental directions for the advancement of critical care rehabilitation in the future.

Guidelines Interpretation

Interpretation of the 2024 British and Irish Hypertension Society Position Statement: Investigation and Management of Hypertension in Young People

YANG Rui, LIAO Xiaoyang, HUANG Chuanying, YANG Ziyu, SHEN Can, JIA Yu, LIU Lidi, YANG Rong

2026, 29(26):  3726-3732.  DOI: 10.12114/j.issn.1007-9572.2025.0457

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The prevalence of hypertension among young people is increasing year by year, but the awareness rate, treatment rate and control rate remain low. Moreover, young patients with hypertension face longer disease exposure time and higher potential cardiovascular risks. Comprehensive investigation and early precise management of this group are crucial for reducing the burden of cardiovascular-related diseases. However, both domestic and international research and guidelines have not paid sufficient attention to this group. For this reason, this article has organized relevant experts to interpret the latest 2024 Position Statement of the British and Irish Hypertension Society: Investigation and Management of Hypertension in Young People, based on the Expert Consensus on the Management of Hypertension in the Young and Middle-aged Chinese Poulation in 2020, aiming to provide practical methods for the investigation and management of hypertension in young people for Chinese clinicians.

Special Topic: Clinical Features in General Practice

Analysis of Disease Characteristics of Outpatients in the Department of General Practice at a Tertiary General Hospital in Beijing

ZHAO Yawen, WANG Jieping, DU Xueping, WU Wei, YAN Wei, ZHOU Xiaoxia, GUAN Yajie, LI Qian, LI Haodong

2026, 29(26):  3733-3738.  DOI: 10.12114/j.issn.1007-9572.2025.0463

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Background

Under the "Healthy China 2030" strategy and the ongoing refinement of hierarchical medical systems, general practice departments in tertiary hospitals play an increasingly vital role in integrated healthcare delivery. However, their functional scope remains incompletely defined. Existing research has predominantly focused on inpatient services, with limited attention given to outpatient care in general practice departments of comprehensive hospitals, and a notable lack of stratified analysis of disease patterns across different demographic groups.

Objective

This study aimed to characterize the disease profile of patients attending the general practice outpatient clinic of a tertiary hospital in Beijing, and to explore the clinical and systemic role of such clinics within the integrated healthcare system.

Methods

A retrospective cross-sectional analysis was conducted on data from patients visiting the Department of General Practice, Fuxing Hospital of Capital Medical University in 2024. Demographic information, visit details, referral sources, and diagnoses were collected and analyzed.

Results

A total of 20 212 outpatient visits were enrolled, including 8 204 male visits (40.59%) and 12 008 female visits (59.41%). The age ranged from 14 to 105 years, with a mean age of (64.1±18.8) years, and 12 245 visits (60.58%) were from patients aged 60 years and above. Among them, 3 168 visits (15.67%) were referred from primary medical and health care institutions, 4 685 visits (23.18%) were initial visits, and 12 359 visits (61.15%) were follow-up visits. The top three diagnoses were hyperlipidemia (5 366 visits, 26.55%), hypertension (5 323 visits, 26.34%), and respiratory tract infection (3 827 visits, 18.93%). The top three unspecified symptoms were constipation (1 265 visits, 6.26%), cough (1 053 visits, 5.21%), and sore throat (720 visits, 3.56%). The system distribution of diagnoses was concentrated, with the top three being circulatory system diseases (13 342 visits, 21.05%), endocrine, nutritional and metabolic diseases (11 066 visits, 17.46%), and respiratory system diseases (7 704 visits, 12.15%). A single disease was diagnosed in 5 757 visits (28.48%), and six or more diseases were diagnosed in 2 997 visits (14.83%).

Conclusion

General practice outpatient clinics in tertiary hospitals manage a wide spectrum of health issues, including common acute illnesses, chronic diseases, undiagnosed symptoms, and multimorbidity. Their case mix aligns with national residency training standards and supports the hierarchical medical system by serving as a crucial interface between primary care and specialized services. These clinics also provide a robust platform for clinical education and research, thereby contributing to the advancement of general practice as a discipline.

Analysis of Disease Characteristics of Inpatients in the Department of General Practice at a Tertiary General Hospital in Beijing

ZHAO Zezhou, WANG Jieping, DU Xueping, YAN Wei, WU Wei, LI Qian, ZHAO Yawen, LI Haodong

2026, 29(26):  3739-3744.  DOI: 10.12114/j.issn.1007-9572.2026.0001

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Background

On August 27, 2018, the National Health Commission Office issued the "Notice on Issuing the Guiding Standards for the Establishment of General Practice Departments in Standardized Resident Training Bases (General Hospitals) (Trial) ", which stipulated that all general hospitals undertaking standardized resident training should independently establish a General Practice Department. Against this backdrop, the role and functional positioning of the General Practice Department become particularly important.

Objective

To explore the role and functional positioning of the General Practice Department in tertiary general hospitals by analyzing the disease characteristics of inpatients in the General Practice Department of a tertiary general hospital in Beijing.

Methods

Inpatients treated in the Department of General Practice, Fuxing Hospital of Capital Medical University, between 2021 and 2022 were selected as the study subjects. Basic patient demographics and clinical information were collected and retrospectively analysed, including gender, age, marital status, occupation, admission route, number of visits, admission diagnosis, discharge diagnosis, consultation details and clinical outcomes, and the prevalence of comorbidities was calculated.

Results

A total of 1 441 patient visits were surveyed, comprising 702 male patients (48.70%) and 739 female patients (51.20%); ages ranged from 17 to 102 years, with a mean age of (79.5±13.6) years; 519 (36.01%) patient visits were for patients who had been hospitalised two or more times; 890 (61.76%) patient visits were for outpatients admitted to hospital, 489 (33.93%) were for emergency admissions, and 62 (4.30%) were referred from primary care facilities; 1 343 (93.20%) patients were discharged on medical advice. The top three admission diagnoses were pulmonary infection (197 cases, 13.67%), dizziness (167 cases, 11.59%) and cerebral infarction (150 cases, 10.41%); the top three primary diagnoses at discharge were pulmonary infection (343 cases, 23.80%), cerebral infarction (258 cases, 17.90%) and urinary tract infection (65 cases, 4.51%). The most common pattern of two chronic diseases was hypertension and hyperlipidaemia [806 cases (55.93%)], whilst the most common pattern of three chronic diseases was hyperlipidaemia, hypertension and cerebral infarction [584 cases (40.53%)]. Among the 1 441 patients, admission diagnoses covered 40 conditions within the general practice training curriculum, totalling 550 diagnoses; consultation diagnoses covered 63 conditions, totalling 1 137 diagnoses; and discharge diagnoses covered 83 conditions, totalling 12 328 diagnoses. Among admission diagnoses, conditions in internal medicine, surgery and rehabilitation medicine had a high coverage rate (>60%); among consultation diagnoses, conditions in surgery, infectious diseases, psychiatry and rehabilitation medicine achieved 100% coverage; and among discharge diagnoses, conditions in internal medicine, surgery, infectious diseases, psychiatry and rehabilitation medicine achieved 100% coverage.

Conclusion

In the daily clinical practice of general practice departments at tertiary general hospitals, chronic diseases, geriatric comorbidities and undiagnosed conditions predominate. These departments play a vital role in the comprehensive management of common diseases, provide an excellent teaching platform for the standardised training of general practitioners, establish a fast-track mechanism for collaboration between primary care and tertiary hospitals, and lay a solid foundation and provide safeguards for advancing clinical research in general practice.

A Comparative Study of the Regional Characteristics of General Medically Unspecified Disease Patients in Northern and Southern China Based on Multi-center Real-world Data

HE Guoshu, REN Jingjing, ZHU Jiahong, MA Fanghui, SUN Wenping, LIU Lei, YIN Ankang, TANG Wenjuan

2026, 29(26):  3745-3751.  DOI: 10.12114/j.issn.1007-9572.2025.0188

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Background

Medically unspecified disease (MUD) refers to health conditions at any stage where a definitive diagnosis cannot be made based on clinical manifestations and examination results. In recent years, the prevalence of MUD has increased in various regions due to the aging population and the rising burden of chronic diseases. However, there is a lack of systematic studies on how regional differences influence the clinical manifestations, physical and mental health, and multimorbidity in MUD patients.

Objective

This study aims to compare the clinical characteristics, physical and mental health, and multimorbidity of MUD patients in northern and southern China, and to analyze the potential impact of regional differences on the health of MUD patients, in order to provide evidence for personalized treatment strategies.

Methods

This is a nationwide, multi-center, real-world study collecting clinical data of MUD patients from 14 research centers in China between July 1, 2022, and June 30, 2023. The patients were divided into northern and southern groups based on the Qinling-Huaihe Line. We compared patients' basic clinical data, lifestyle factors, psychological health assessments (PHQ-15, GAD-7, PHQ-9), quality of life (SF-36), fatigue (PFS), and multimorbidity status.

Results

A total of 1 414 patients were included in this study, comprising 444 (31.4%) from the northern region and 970 (68.6%) from the southern region. The average age of patients in the northern region was significantly younger than that in the southern region (P=0.002). Northern patients had significantly higher BMI, smoking, and alcohol consumption rates compared to those in the south (P<0.001). In terms of the clinical manifestations of MUD, edema had an incidence of 39.9% (177/444) in the northern region, followed by fatigue at 30.6% (136/444), weight loss at 20.9% (93/444), chest pain at 1.6% (7/444), and dizziness at 0.9% (4/444). In the southern region, fatigue was most common at 41.1% (399/970), followed by edema at 22.4% (218/970), weight loss at 14.0% (136/970), dizziness at 8.6% (84/970), and chest tightness at 2.5% (25/970). The distribution of MUD categories differed significantly between the two regions (P<0.001). Southern patients had generally higher scores in physical and mental health assessments (PHQ-15, SF-36, PFS). Northern patients exhibited more severe anxiety (GAD-7) and depression (PHQ-9) symptoms (P<0.001). In terms of multimorbidity, the proportion of 51-60 years patients in the northern region with ≥3 comorbid conditions was significantly higher than in the southern region (P<0.05).

Conclusion

Significant regional differences exist in the clinical manifestations, physical and mental health, and multimorbidity of MUD patients between northern and southern China. To more effectively manage MUD patients, particularly in addressing the challenges of multimorbidity and uncertain health issues, individualized treatment strategies should be developed based on regional differences, with an emphasis on multidisciplinary interventions and comprehensive health assessments.

Article

Correlation of Upper Limb Somatosensory Function and Attention, and Memory in Stroke Patients with Different Sides of Hemiplegia

LIN Yansheng, ZHANG Shuyang, LIN Jiaying, ZHU Jie, ZHOU Yuxin, LIN Jiali, JIA Jie

2026, 29(26):  3752-3759.  DOI: 10.12114/j.issn.1007-9572.2025.0327

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Background

Upper limb somatosensory dysfunction and cognitive impairment are common clinical issues after stroke. As critical domains of cognitive function, attention and memory may potentially influence the recovery of upper limb somatosensory function after stroke. However, there remains a lack of research evidence to explore this relationship separately based on the side of hemiplegia.

Objective

To explore the relationship between upper limb somatosensory function and attention, as well as memory, in stroke patients with different hemiplegic sides.

Methods

This multicenter, cross-sectional study enrolled stroke patients in post-acute phase admitted to 26 hospitals across different regions of China from January to December 2024. All study subjects were divided into left-sided and right-sided hemiplegia groups depending on the paralysis side after stroke. General information of patients was collected, and the sensory function subscale of the Fugl-Meyer Assessment for upper extremity (FMA-S-UE) was applied to assess the somatosensory function of the upper extremities. The Montreal Cognitive Assessment (MoCA) was applied to evaluate the attention and memory. The Modified Barthel Index (MBI) was applied to assess the patients' level in activities of daily living (ADL). The Hospital Anxiety and Depression Scale (HADS) was applied to assess the patients' level of anxiety and depression. We compared the differences in general information and rehabilitation assessment indicators between the left and right hemiplegia groups. Additionally, we investigated the correlation of upper limb somatosensory function with attention, memory, activities of daily living, and psychosocial indicators.

Results

A total of 304 patients were enrolled in this study, including 169 patients in the left-sided hemiplegia group and 135 patients in the right-sided hemiplegia group. The MoCA-Attention and MoCA-Memory scores were higher in the left-sided hemiplegia group than in the right-sided hemiplegia group, while the HADS-A and HADS-D scores were lower in the left-sided hemiplegia group than in the right-sided hemiplegia group (P<0.05). The FMA-S-UE, FMA-S-UE light touch, and FMA-S-UE proprioception scores in both groups were positively correlated with the MoCA-attention score (left hemiplegia group: r_s=0.380, 0.356, 0.374; right hemiplegia group: r_s=0.229, 0.233, 0.218, P<0.05). In the left hemiplegic group, the FMA-S-UE total score and subscale scores showed positive correlations with the MoCA-memory scores (r_s=0.186, 0.175, 0.183, P<0.05). Positive correlations were observed between the total and subscale scores of the FMA-S-UE and MBI scores in both patient groups (left hemiplegia group: r_s=0.332, 0.288, 0.324; right hemiplegia group: r_s=0.222, 0.181, 0.234, P<0.05). In the right hemiplegia group, the FMA-S-UE total and proprioception scores showed negative correlations with the HADS-A scores (r_s=-0.182 and -0.187, P<0.05). Meanwhile, the FMA-S-UE total score and subscale scores demonstrated negative correlations with the HADS-D scores (r_s=-0.213, -0.202, -0.210, P<0.05).

Conclusion

The attention, memory, and mental psychological functions of patients with left-sided hemiplegia are superior to those with right-sided hemiplegia. Furthermore, upper limb somatosensory function in patients with left-sided hemiplegia is highly correlated with attention function and activities of daily living. The side of hemiplegia may influence the correlation between upper limb somatosensory function and memory, as well as mental and psychological functions. It provides a scientific basis for the practice of hand-brain perceptual rehabilitation after stroke.

Study on the Predictive Value of a Multi-parameter Model Based on Lymphocyte Count for the Prognosis of Patients with Acute Exacerbation of Interstitial Lung Disease Complicated with Pulmonary Infection

YAN Yi, JIANG Yu, CHEN Bi, ZHANG Cantang, WANG Jing

2026, 29(26):  3760-3766.  DOI: 10.12114/j.issn.1007-9572.2025.0105

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Background

Patients with interstitial lung disease (ILD) are prone to acute exacerbation (AE-ILD), with infection being a significant trigger. AE-ILD patients exhibit high mortality rates and poor prognoses, yet domestic research on this population remains limited.

Objective

To investigate the clinical predictive value of dynamic changes in peripheral blood lymphocyte count (LYM) for 28-day prognosis in AE-ILD patients with pulmonary infection and to establish a corresponding prognostic prediction model.

Methods

A retrospective cohort study included AE-ILD patients with pulmonary infection hospitalized in the Department of Respiratory and Critical Care Medicine at the Affiliated Hospital of Xuzhou Medical University from January 2022 to June 2024. Patients were stratified into survival (n=37) and non-survival (n=65) groups based on 28-day outcomes. Data collected included demographics (sex, age, diagnosis, ILD subtype, comorbidities), disease severity scores (APACHEⅡ, SOFA), and laboratory parameters: white blood cell count (WBC), neutrophil count (NEU), lymphocyte count on days 1, 3, and 5 (d1 LYM, d3 LYM, d5 LYM), hemoglobin (Hb), platelet count (PLT), procalcitonin (PCT), C-reactive protein (CRP), albumin (ALB), total bilirubin (Tbil), lactate dehydrogenase (LDH), Serum creatinine (Scr), activated partial thromboplastin time (APTT), partial pressure of oxygen (PaO₂), partial pressure of carbon dioxide (PaCO₂), fraction of inspired oxygen (FiO₂), PaO₂/FiO₂ ratio (P/F), and lactate (Lac). Intergroup differences were analyzed, and statistically significant variables were identified. Receiver operating characteristic (ROC) curves evaluated prognostic predictive capacity. Univariate and multivariate Cox proportional hazards regression analyses were conducted using R software. Scores were assigned to each indicator based on the hazard ratio (HR). A nomogram prediction model was constructed. After calculating the total score of each indicator, risk stratification was established. The ROC curve of the prediction model was drawn to evaluate its predictive value. The survival curves of 28-day prognosis of patients with different risk stratifications were plotted using R software, and the 28-day survival rates of patients in different groups were compared.

Results

The non-survival group exhibited higher APACHEⅡ scores, SOFA scores, PCT, CRP, and LDH than survival group, but lower d3 LYM, d5 LYM, ALB, and P/F than survival group (P<0.05). The results of the ROC curve showed that the AUCs of d3 LYM, d5 LYM, APACHEⅡ score, and SOFA score in predicting the 28-day prognosis of AE-ILD patients with pulmonary infectionwere 0.723, 0.764, 0.733, and 0.704, respectively. Multivariate Cox regression identified P/F (HR=2.01, 95%CI=1.08-3.75), PCT (HR=2.14, 95%CI=1.02-4.49), Hb (HR=2.34, 95%CI=1.22-4.48), d5 LYM (HR=2.40, 95%CI=1.01-5.70) as independent predictors of 28-day mortality (P<0.05). The nomogram model was constructed based on d5 LYM, P/F, PCT and Hb. The AUC value of this model for predicting 28-day mortality in AE-ILD patients with pulmonary infection was 0.853 (95%CI=0.781-0.925), with the optimal cut-off value being 2. The sensitivity and specificity were 88.24% and 82.35%, respectively. According to the results of the optimal risk stratification, 0-2 was classified as the low-risk group (n=39), and 3-6 was classified as the high-risk group (n=63). There were significant differences on the 28-day survival rates between the two groups of patients (χ²=51.00, P<0.001).

Conclusion

Lymphopenia is associated with increased 28-day mortality in AE-ILD patients with pulmonary infection. The nomogram model incorporating d5 LYM, P/F, PCT, and Hb provides a clinically practical tool for risk stratification and prognostic assessment.

Analysis of the Efficacy and Safety of Gemcitabine plus S-1 Regimen versus S-1 Combined with Oxaliplatin and Irinotecan Regimen as Adjuvant Chemotherapy for Pancreatic Ductal Adenocarcinoma

CHEN Jingjing, BAI Xinyuan, SHA Huizi, SUN Yi, NI Jiayao, TONG Fan, ZOU Lu, MENG Fanyan, DU Juan

2026, 29(26):  3767-3773.  DOI: 10.12114/j.issn.1007-9572.2025.0407

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Background

The mFOLFIRINOX regimen(oxaliplatin, irinotecan, leucovorin and 5-fluorouracil) and GX regimen (gemcitabine combined with capecitabine) are standard adjuvant chemotherapies for resected pancreatic ductal adenocarcinoma(PDAC), but mFOLFIRINOX exhibits significant toxicities. SOXIRI regimen(S-1 combined with oxaliplatin and irinotecan) and GS regimen(gemcitabine plus S-1) are used as modified on the basis of mFOLFIRINOX and GX regimen. The comparison of GS and SOXIRI has not been reported.

Objective

To compare the efficacy and safety of adjuvant GS with SOXIRI for PDAC retrospectively.

Methods

This study analyzed 41 patients with PDAC who underwent postoperative adjuvant chemotherapy at the Oncology Center of Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, from March 2018 to June 2023(21 in the GS group and 20 in the SOXIRI group). The enrolled patients were followed up via review of electronic medical records and telephone calls. The follow-up period continued until August 31, 2024. The primary endpoint was disease-free survival (DFS). Secondary endpoints included the 2-year overall survival (OS) rate and adverse events (AEs). Survival curves were plotted using the Kaplan-Meier method and compared with the Log-rank test. Univariate and multivariate Cox proportional hazards models were used to identify factors associated with DFS and OS.

Results

The median disease-free survival (mDFS) was 18.65 months in the GS group and 13.03 months in the SOXIRI group, with the 2-year overall survival (OS) rates being 84.7% and 66.0%, respectively. No statistically significant differences were observed in mDFS and 2-year OS rates between the two groups (χ²=0.646, P=0.421; χ²=3.269, P=0.071). Multivariate Cox proportional hazards regression analysis revealed that postoperative CA19-9 level (HR=3.66, 95%CI=1.26-10.64) and surgical margin status (HR=2.64, 95%CI=1.05-6.61) were independent influence factors for DFS (P<0.05), whereas advanced age (HR=3.42, 95%CI=1.13-10.36) and TNM stage (HR=5.68, 95%CI=1.40-22.97) were independent influnce factors for OS (P<0.05). Subgroup analysis showed no statistically significant difference in therapeutic efficacy between the GS and SOXIRI regimens (P>0.05). The incidences of overall diarrhea (χ²=7.796, P=0.005) and peripheral neurotoxicity (χ²=7.552, P=0.006) were significantly higher in the SOXIRI group than in the GS group.

Conclusion

For postoperative adjuvant therapy in PDAC, the GS demonstrated noninferiority to the SOXIRI regimen in efficacy and better safety with lower diarrhea/peripheral nerve toxicity incidence.

Study on the Relationship between Relevant Indicators in Postmenopausal Women with Subclinical Hypothyroidism and Bone Mineral Density

FENG Shaohui, ZHU Lingyan, SONG Kexin, ZHU Yan, WU Yanling, WU Wenjing, ZHANG Dandan, RAN Limei

2026, 29(26):  3774-3780.  DOI: 10.12114/j.issn.1007-9572.2025.0406

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Background

Previous studies have demonstrated an inverse association between subclinical hypothyroidism and osteoporosis (OP) risk in postmenopausal women. However, the precise effects of subclinical hypothyroidism on bone mineral density and its specific sites of action remain inconclusive.

Objective

To study the relationship between thyroid function indicators and bone mineral density at different sites in premenopausal and postmenopausal patients with subclinical hypothyroidism, and to explore predictive factors for osteoporosis.

Methods

A study was conducted on 591 women aged 40-60 years with subclinical hypothyroidism who underwent physical examinations at the Health Management Center of Guizhou Medical University Affiliated Hospital between 2023 and 2024. Participants were categorized by menopausal status into premenopausal women (n=189) and postmenopausal women (n=402). Serum levels of free triiodothyronine (FT₃), free thyroxine (FT₄), thyroid-stimulating hormone (TSH), aspartate aminotransferase (AST), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Bone mineral density (BMD) was measured at the lumbar spine, femoral neck and total hip in both groups. Pearson correlation analysis and multiple linear regression analysis were employed to investigate the correlation between thyroid indicators and bone density at various sites. Receiver operating characteristic (ROC) curves were plotted to explore the predictive value of FT₃ for osteoporosis in postmenopausal women.

Results

Pearson correlation analysis revealed that FT₃, FT₄, AST and age were negatively correlated with lumbar spine bone mineral density (P<0.05); age, FT₄, AST, TC and LDL-C were negatively correlated with femoral neck bone mineral density (P<0.05); age, FT₄ and HDL-C were negatively correlated with total hip bone mineral density (P<0.05); height, body weight and BMI were positively correlated with lumbar spine, femoral neck and total hip bone mineral density (P<0.05). Multivariate linear regression analysis revealed that FT₃ (β=-0.120, P<0.05), body weight (β=0.267, P<0.05), and age (β=-0.401, P<0.05) were significant predictors of lumbar spine bone density in female examinees overall; FT₃ (β=-0.161, P<0.05), body weight (β=0.201, P<0.05), and age (β=-0.235, P<0.05) were factors influencing lumbar spine bone density in postmenopausal women; FT₃ was not associated with femoral neck or total hip bone mineral density in premenopausal women, postmenopausal women, or the overall female cohort (P>0.05); FT₄ was not associated with bone mineral density at any site in premenopausal women, postmenopausal women, or the overall female cohort (P>0.05). ROC curve analysis revealed that FT₃ predicted lumbar osteoporosis in postmenopausal women with an area under the curve (AUC) of 0.609 (95%CI=0.523-0.696), sensitivity of 69.2%, specificity of 51.0%, and optimal cutoff value of 4.605 pmol/L.

Conclusion

FT₃ is a significant factor influencing lumbar spine bone mineral density in postmenopausal women with subclinical hypothyroidism, with subclinical hypothyroidism. A level of 4.605 pmol/L represents the optimal cutoff value for FT₃ in predicting lumbar osteoporosis in this population, providing a reference indicator for preliminary screening of lumbar OP risk.

Association Study between Chinese Visceral Adiposity Index and Risk of All-cause and Cause-specific Mortality in the Elderly

ZHAO Yuanyuan, LIU Pulin, DAI Juan, ZHANG Gang, ZHANG Wei, ZHANG Xiaoxia, DENG Qing, YAN Yaqiong

2026, 29(26):  3781-3787.  DOI: 10.12114/j.issn.1007-9572.2025.0367

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Background

Visceral fat accumulation is closely associated with health outcomes in the elderly. As an indicator specific to the Chinese population, the Chinese Visceral Adiposity Index (CVAI) has not been fully validated in large cohort studies regarding its association with mortality risk in the elderly.

Objective

To investigate the relationship between CVAI and risk of all-cause and cause-specific mortality among the elderly population in Wuhan.

Methods

Data were obtained from the 2014 Wuhan Basic Public Health Service Elderly Health Examination Program. From May 2014 to February 2015, a total of 332 389 elderly people aged 65 years and older participated in the program under the principle of informed consent and voluntary participation. After excluding data with logical errors, 330 474 subjects were included in the analysis. Baseline information was collected, including demographic characteristics, lifestyle, medical history, physical examination and laboratory test results. Using the ID number as the unique identifier, physical examination data were linked to the China CDC Cause of Death Registration Database for survival follow-up. The endpoint was death or December 31, 2019. Missing data were handled by multiple imputation. Log-Logistic accelerated failure time models and stratified analyses were performed to explore the associations of CVAI with all-cause and cause-specific mortality. Sensitivity analysis was conducted to test the robustness of the results.

Results

The mean baseline age of the 330 474 elderly participants was (71.6±5.8) years, including 152 551 males (46.16%) and 177 923 females (53.84%). The mean follow up duration was (5.0±1.0) years, and 46 007 deaths were documented by the end of follow up. Participants were divided into four groups according to quartiles of baseline CVAI: Q1 (<78.11, n=82 169), Q2 (78.11-108.44, n=82 169), Q3 (108.45-140.74, n=82 168), and Q4 (>140.74, n=82 169). Results from Log-Logistic accelerated failure time models showed that, compared with the Q1 (CVAI<78.11), the Q2 (78.11-108.44, TR=1.06, 95%CI=1.04-1.09), Q3 (108.45-140.74, TR=1.13, 95%CI=1.10-1.15) and Q4 (>140.74, TR=1.14, 95%CI=1.11-1.17) groups had longer survival time for all cause mortality. In cause specific mortality analysis, CVAI also showed protective effects on survival time: a consistent protective effect was observed for cancer mortality (P<0.05); for cardiovascular and cerebrovascular disease mortality, significant protective effects were found in the Q3 and Q4 groups (P<0.05). Restricted cubic spline analysis revealed a significant inverted U shaped relationship between CVAI and all cause mortality (P overall<0.001), with the optimal survival time observed at CVAI ranging from 110.3 to 195.0. Stratified analyses indicated that the protective effect of CVAI was most prominent in participants aged 65-69 years and females. After excluding individuals with less than 1 year of follow up and refitting the model, the positive association between higher CVAI and longer survival time remained significant (P<0.05).

Conclusion

Among people aged 65 years and older in Wuhan, higher CVAI is associated with a lower risk of all cause mortality. The optimal survival time is achieved when CVAI ranges from 110.3 to 195.0. CVAI can be used as a reference indicator for predicting mortality risk in the elderly.

Nrp1 Negatively Regulates PI3K/AKT Pathway to Inhibit the Activation of Lung Fibroblasts and Its Role in Mouse Pulmonary Fibrosis

CHENG Guocang, JIA Yuanyuan, ZHAO Tingting, QI Ruixin, NIAN Miaomiao, CHEN Juan

2026, 29(26):  3788-3797.  DOI: 10.12114/j.issn.1007-9572.2025.0204

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Background

Idiopathic pulmonary fibrosis (IPF) has a complex pathogenesis, limited treatment options and a poor prognosis. Therefore, it is crucial to identify the safe and effective therapeutic targets.

Objective

To investigate the regulatory effect of Nrp1 on the activation of mouse pulmonary fibroblasts (MPFs) through PI3K/AKT signaling pathway and the therapeutic effect and safety of recombinant Nrp1 protein on pulmonary fibrosis (PF) in mice.

Methods

GSE150910, GSE218997, GSE173523, GSE47460, and GSE32537 were downloaded from the GEO database to analyze the expression of Nrp1 in lung tissues of PF mouse models and IPF patients, as well as the correlation between Nrp1 expression and pulmonary function parameters in IPF patients. A total of 45 IPF patients diagnosed in the Department of Respiratory and Critical Care Medicine and 29 healthy controls who underwent physical examinations in the health management center in General Hospital of Ningxia Medical University from 2022 to 2024 were selected. Cell-free RNA (cfRNA) sequencing was used to analyze the expression levels of Nrp1 in the plasma of IPF patients and healthy controls and its diagnostic efficacy. MPFs were divided into the control group, TGF-β1 group, Nrp1 overexpression group and TGF-β1+Nrp1 overexpression group. TGF-β1 was used to induce the activation of MPFs, and the effects of Nrp1 overexpression on the PI3K/AKT pathway and the expression of α-SMA, Vim and Fn were detected. Thirty male C57BL/6J mice were randomly divided into the control group, BLM group and BLM+Nrp1 group, with 10 mice in each group. After establishing the mouse PF model, the BLM+Nrp1 group was intraperitoneally injected with 100 μg·kg^-1·d^-1 of recombinant Nrp1 protein for 20 consecutive days. HE and Masson staining were used to observe the pathological changes of mouse lung tissues, and liver and kidney function indicators were evaluated. Western blotting and immunohistochemistry were used to detect the expression of α-SMA, Vim and Fn in lung tissues. ELISA was used to measure the levels of Nrp1 in plasma and BALF.

Results

Compared with normal lung tissues, The expression of Nrp1 was decreased in the lung tissues of PF mouse and IPF patients (P<0.05), and the expression of Nrp1 was positively correlated with FEV₁%pred, FVC%pred and DLCO%pred. The mRNA expression of Nrp1 in plasma of IPF patients was significantly lower than that of healthy controls (P<0.05), and the area under the receiver operating characteristic curve of plasma Nrp1 for diagnosing IPF was 0.754 (95%CI=0.634-0.874). Compared with the TGF-β1 group, the ratios of p-PI3K/PI3K and p-AKT/AKT in the TGF-β1+Nrp1 overexpression group were decreased, and the expression of α-SMA, Vim and Fn was decreased (P<0.05). After intraperitoneal injection of recombinant Nrp1 protein, the pathological features of PF in mice were improved. There were no statistically significant differences in the levels of ALT, AST, ALP, BUN and CREA in plasma among the control group, BLM group and BLM+Nrp1 group (P>0.05). Compared with the BLM group, the expression of α-SMA and Fn in the lung tissues of the BLM + Nrp1 group was decreased, and the levels of Nrp1 in plasma and BALF were increased (P<0.05).

Conclusion

The expression of Nrp1 is decreased in the lung tissues, plasma and BALF of IPF patients. Nrp1 inhibits the activation of mouse pulmonary fibroblasts by negatively regulating the PI3K/AKT signaling pathway. Intraperitoneal injection of recombinant Nrp1 protein can alleviate pulmonary fibrosis in mice and exhibits systemic safety.

Shaoyao Gancao Decoction Combined with Electroacupuncture Improves Synaptic Plasticity in Poststroke Spastic Rats

SHANG Ying, WANG Fei, HUANG Yaqi, MA Xiaoning, ZHANG Shengfu, XU Nenggui, GUO Bin

2026, 29(26):  3798-3804.  DOI: 10.12114/j.issn.1007-9572.2024.0582

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Background

Currently, acupuncture combined with Traditional Chinese Medicine (TCM) herbs show excellent outcomes in treating poststroke spasticity, but the mechanism remains unclear.

Objective

To observe the effect of Shaoyao Gancao Decoction combined with electroacupuncture on the motor function and synaptic plasticity in the M1 cortex of rats with poststroke spasticity.

Methods

From November 2022 to June 2023, 72 healthy male Sprague-Dawley (SD) rats with 7 weeks old were included. Finally, 60 rats were randomly divided into the blank group, model group, electroacupuncture group, baclofen group, TCM group, and electroacupuncture combined with TCM group, with 10 rats in each group. The intervention began from the first day after modeling and lasted for 6 days. Electroacupuncture was applied to the "Quchi" and "Yanglingquan" acupoints on the affected side, with a dense wave at the frequency of 100 Hz for 30 minutes daily. Daily gavage of Shaoyao Gancao Decoction at a dose of 4.2 g/kg, and 5.25 mg/kg baclofen were given in the corresponding groups. The acupuncture group received electroacupuncture combined with oral administration of Chinese herbal medicine, using the same method and dosage as above, once daily. Catwalk gait analysis was tested before modeling and on the 1st, 3rd and 6th day after modeling. The samples were taken on day 6, and nerve cells injury in the M1 cortex was tested by Nissl stain. The mRNA and protein expression levels of brain-derived neurotrophic factor (BDNF), γ-aminobutyric acid (GABA), and neurotrophin-3 (NT3) in M1 cortex were detected by RT-qPCR and Western blotting. Synaptic plasticity was scanned by transmission electron microscopy (TEM).

Results

Catwalk gait analysis showed a significantly higher average footprint intensity on day 3 in the model group than the blank group (P<0.05). The percentage of four-feet stance on day 6 was significantly higher in the electroacupuncture combined with TCM group than the blank group (P<0.05). Nissl staining showed similar neuronal damage between the electroacupuncture combined with TCM group and the blank group. RT-qPCR results showed a significantly higher mRNA level of BDNF and lower mRNA level of GABA in the electroacupuncture combined with TCM group than the blank group (P<0.05). Western blotting results showed significantly lower protein levels of GABA, NT3 and BDNF in the model group, electroacupuncture group and baclofen group than the blank group (P<0.05). Their relative protein levels were significantly higher in the TCM group and electroacupuncture combined with TCM group than the model group (P<0.001). TEM revealed relatively complete synaptic morphology, great number of vesicles, clear boundaries of the front and rear membranes, and long contact boundary, presenting a similar morphology to the blank group.

Conclusion

Electroacupuncture combined with Shaoyao Gancao Decoction group is effective in treating poststroke spasticity in rats by improving synaptic plasticity.

Article·Proactive Health

Study on the Correlation between Chinese Healthy Dietary Pattern and Sarcopenia in Colorectal Cancer Patients

LI Xuebo, LIU Xuan, LI Shuxing

2026, 29(26):  3805-3815.  DOI: 10.12114/j.issn.1007-9572.2025.0300

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Background

Sarcopenia significantly influences the treatment outcomes and prognosis of colorectal cancer patients, and dietary patterns show a notable correlation with sarcopenia. Elucidating the characteristics of Chinese healthy dietary patterns and their association with sarcopenia is crucial for developing targeted nutritional interventions based on traditional Chinese dietary practices.

Objective

To explore the correlation between Chinese healthy dietary pattern and sarcopenia in colorectal cancer patients, utilizing the Chinese Healthy Eating Index (CHEI).

Methods

From July 2024 to May 2025, a total of 326 colorectal cancer patients from Tangshan People's Hospital, North China University of Science and Technology Affiliated Hospital, and Kailuan General Hospital were enrolled as study subjects. The CHEI and various diagnostic indicators of sarcopenia were collected. Binary Logistic regression analysis was employed to examine the associations between the total CHEI score and its dietary components with low muscle mass, impaired physical function and sarcopenia in colorectal cancer patients.

Results

Among the 326 patients, 195 (59.82%) were male and 131 (40.18%) were female, with an average age of (64.0±8.8) years. Among them, there were 49 cases (15.03%) with reduced muscle mass, and the CHEI score was 50 (40, 55). Muscle strength was reduced in 220 cases (67.48%), and the CHEI score was 55 (45, 60). Physical function declined in 217 cases (66.56%), with CHEI scores of 55 (45, 60). There were 46 patients (14.11%) with sarcopenia, with a CHEI score of 478 (40, 55). Binary Logistic regression analysis results indicated that CHEI scores were negatively associated with the risk of low muscle mass (OR=0.934, 95%CI=0.891-0.979, P=0.004), impaired physical function (OR=0.968, 95%CI=0.942-0.995, P=0.020), and sarcopenia (OR=0.931, 95%CI=0.889-0.975, P=0.003). Analysis of the correlation between various dietary components and low muscle mass, impaired physical function, and sarcopenia revealed that scores for fruits (OR=0.880, 95%CI=0.786-0.985, P=0.026), legumes (OR=0.480, 95%CI=0.290-0.794, P=0.004), poultry intake (OR=0.799, 95%CI=0.644-0.991, P=0.041), and sodium (OR=0.897, 95%CI=0.805-1.000, P=0.049) were negatively correlated with the risk of low muscle mass. Scores for whole grains (OR=0.839, 95%CI=0.714-0.986, P=0.033) and seafood (OR=0.848, 95%CI=0.730-0.985, P=0.031) were negatively correlated with the risk of impaired physical function, while red meat (OR=1.256, 95%CI=1.048-1.506, P=0.014) was positively correlated with the risk of impaired physical function. Grains (OR=1.608, 95%CI=1.115-2.317, P=0.011) showed a significant positive correlation with the risk of sarcopenia. Scores for fruits (OR=0.886, 95%CI=0.788-0.996, P=0.043), legumes (OR=0.409, 95%CI=0.238-0.703, P=0.001), and poultry (OR=0.731, 95%CI=0.584-0.916, P=0.007) were negatively correlated with the risk of sarcopenia.

Conclusion

The CHEI is negatively associated with the risk of low muscle mass, impaired physical function, and sarcopenia in colorectal cancer patients. Adequate intake of fruits, legumes, poultry, whole grains, and seafood, moderate red meat consumption, and controlled intake of sodium and grains may help lower the risk of sarcopenia in colorectal cancer patients.

Effects of Interval and Continuous Training on Cognitive Function in Healthy Adults: a Systematic Review and Three-level Meta-analysis

ZHUANG Mingnan, YAN Henghao, XIAO Ningkun, YIN Mingyue, FAN Zhiwei, LIU Chaohui, ZOU Xintong, ZHOU Yuehua, BI Zhiyuan, DENG Hengzhi, WU Bitai, SONG Zhiquan, SHI Donglin

2026, 29(26):  3816-3828.  DOI: 10.12114/j.issn.1007-9572.2025.0385

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Background

With global population aging, cognitive decline has become a major public-health challenge. Moderate-intensity continuous training (MICT) has been shown to improve cognition but is time-consuming, whereas high-intensity interval training (HIIT) is considered a time-efficient alternative with comparable promise. Prior meta-analyses have largely relied on traditional two-level models and have not adequately addressed the dependence among multiple cognition outcomes within studies; a three-level meta-analytic approach is therefore warranted to obtain more robust effect estimates and inferences.

Objective

To investigate the effects of HIIT and MICT on cognitive function in healthy individuals, as well as the moderating factors, in order to establish precise prescription guidelines for these two training modalities in enhancing cognitive function.

Methods

Following PRISMA guidelines, we searched PubMed, Web of Science, Cochrane Library, Scopus, and Embase from inception to August 2025 for randomized controlled trials examining the effects of HIIT and MICT on cognitive function in healthy populations. Meta-analysis was conducted in R 4.4.3 using random-effects models for primary pooling. Subgroup analyses, meta-regression, and sensitivity analyses were performed to probe sources of heterogeneity and identify determinants of intervention efficacy.

Results

A total of 19 randomized controlled trials involving 2 277 participants were included. Compared with the control group, HIIT significantly improved executive function (Hedges'g=0.36, 95%CI=0.10-0.61, P=0.01) and memory function (Hedges'g=0.61, 95%CI=0.12-1.09, P<0.01) in healthy individuals, but had no significant effect on information processing (Hedges'g=0.69, 95%CI=-0.65 to 2.03, P=0.25) or attention (Hedges'g=0.36, 95%CI=-0.20 to 0.92, P=0.15). Regression analysis revealed that older participants showed greater improvement in memory function (β=0.02, P<0.01), and the greatest memory enhancement was observed in participants with a BMI of 27.66 kg/m2 (β=2.05, P<0.01). The duration of rest intervals was negatively associated with improvements in executive function (β=-0.01, P=0.04), indicating better outcomes with shorter rest periods; among these, a 150-second rest interval demonstrated the most significant effect (β=2.39, P<0.01). Single training duration was positively correlated with improvements in executive function (β=0.10, P=0.03); specifically, a 6-minute training session showed the most pronounced benefit (β=2.31, P<0.01).

Conclusion

HIIT significantly improves executive and memory functions in healthy individuals, offering health benefits similar to those of MICT and serving as a time-efficient alternative for cognitive enhancement. Greater cognitive improvements were observed in older adults and those with moderate-to-high BMI through HIIT. Based on previous research findings, this study suggests that an optimal training prescription may include approximately 150 seconds of intermittent exercise per session, each session lasting about 6 minutes, and consistent intervention over 6 to 12 weeks.

Revealing the Relationship between Lifestyle and Sub-health Based on Machine Learning: a Cross-sectional Study in Guangdong Province

LIU Yang, FENG Xiaojie, CHEN Jieyu, LUO Ren, ZHAO Xiaoshan, BI Jianlu

2026, 29(26):  3829-3837.  DOI: 10.12114/j.issn.1007-9572.2025.0290

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Background

Sub-health status, as a subclinical and reversible stage between health and chronic disease, has received widespread attention. Previous studies have indicated that various lifestyle factors significantly influence the dynamic changes of sub-health.

Objective

This study aims to explore the association between diverse lifestyle factors and sub-health status using machine learning methods. In addition, it seeks to develop a predictive model for sub-health to enable early identification, diagnosis, and intervention in sub-health populations.

Methods

This study was a cross-sectional survey conducted from September 2017 to January 2024. A multistage cluster sampling method was employed to randomly select survey sites and units in stages from seven representative cities in Guangdong Province, with a total of 20 375 participants ultimately included. Data were collected on-site during routine health examinations by uniformly trained investigators using standardized questionnaires, including the Sub-health Assessment Scale and the Health-promoting Lifestyle ProfileⅡ (HPLP-Ⅱ). For statistical analysis, SPSS 25.0 and Python 3.9 were used for data processing and analysis. Feature selection was first performed using recursive feature elimination, and sub-health prediction models were then developed based on Logistic regression, support vector machine, k-nearest neighbors, and XGBoost. Subsequently, five-fold cross-validation and data balancing techniques were employed to evaluate and optimize model performance, aiming to identify associated factors and predict sub-health status.

Results

A total of 20 375 participants were included. Among them, 2 586 (12.7%) participants were classified as healthy, and 17 789 (87.3%) were classified as having sub-health status. In the sub-health group, there were 8 581 (48.2%) males and 9 208 (51.8%) females. Univariate analysis showed that there were statistically significant differences between the healthy and sub-health groups in sex, age, educational level, marital status, BMI, alcohol consumption, and the scores of all 52 HPLP-Ⅱ items (P<0.05), whereas no statistically significant difference was observed in smoking status (P>0.05). Feature selection results indicated that BMI and sleep quality were the key factors most closely associated with sub-health status. The model constructed based on the XGBoost algorithm demonstrated good performance, with an accuracy of 0.860 and an F1 score of 0.672. SHAP analysis further confirmed that these variables had high contributions to the model and played an important role in predicting sub-health status.

Conclusion

This study indicates that BMI and sleep quality are key factors associated with suboptimal health status, providing a scientific basis for the prevention and management of chronic diseases. Against the backdrop of rapid advances in predictive, preventive, and personalized medicine, early prediction and precise intervention for suboptimal health may facilitate disease state reversal and ultimately improve population health outcomes.

Article·Epidemiological Study

Analysis of Mortality Trends of Cervical, Endometrial, and Ovarian Cancers among Women in China from 2004 to 2021

WANG Yanyan, DONG Xiaoxue, KONG Jinchen, CHEN Yutong, ZHAI Yujie, JIANG Shuai

2026, 29(26):  3838-3843.  DOI: 10.12114/j.issn.1007-9572.2025.0460

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Background

Cervical cancer, endometrial cancer, and ovarian cancer are common malignant tumors of the female reproductive system. Long-term trends in mortality rates and disparities across urban and rural areas, regions, and age groups remain unclear. Analyzing and revealing their epidemiological trends in different populations provides critical evidence for optimizing prevention and control strategies.

Objective

To analyze trends in mortality rates for cervical, endometrial, and ovarian cancers among Chinese women from 2004 to 2021, examining differences by urban/rural location, region, and age group to inform optimized prevention and control strategies.

Methods

Total deaths from cervical, endometrial, and ovarian cancers were extracted from the Chinese Cause of Death Surveillance Dataset within the Chinese Center for Disease Control and Prevention Information System from 2004 to 2021. Mortality rates were calculated for each cancer type, stratified by urban/rural residence, region (eastern, western, central), and age group. Joinpoint regression models were used to calculate annual percentage change (APC), average annual percentage change (AAPC) and age-adjusted death rate (AADR), and to analyze temporal trends of AADR.

Results

Cervical cancer AADR increased significantly in both urban (APC=21.89%, P<0.05) and rural (APC=28.02%, P<0.05) areas from 2012 to 2015. Starting in 2015, urban areas showed a significant decline (APC=-3.42%, P<0.05). Urban endometrial cancer AADR showed a declining trend from 2013 to 2016 (APC=-14.12%, P<0.05). The AADR for endometrial cancer among urban populations shifted to an upward trend in 2016 (APC=7.10%, P<0.05), while the rural population AADR shifted upward in 2015 (APC=4.23%, P<0.05). The AADR for ovarian cancer in urban populations showed an increasing trend from 2004 to 2021 (APC=1.52%, P<0.05); the AADR in rural populations showed an increasing trend from 2011 to 2017 (APC=11.14%, P<0.05). Cervical cancer AADR showed an upward trend in the eastern region (APC=25.15%, P<0.05) and western region (APC=35.09%, P<0.05) from 2012 to 2015, while the central region exhibited an upward trend from 2012 to 2016 (APC=15.26%, P<0.05). The AADR for endometrial cancer in the eastern region showed a decreasing trend from 2012 to 2015 (APC=-14.69%, P<0.05); while AADR in the western region (APC=-22.47%, P<0.05) and central region (APC=-23.87%, P<0.05) showed a declining trend from 2013 to 2016, followed by an increasing trend from 2016 to 2021 (APC=9.60%, 10.12%, P<0.05). The AADR for ovarian cancer in the eastern region showed an increasing trend from 2004 to 2021 (APC=4.34%, P<0.05). The AADR for malignant tumors of the reproductive system in the 15 to <30 years group showed a decreasing trend from 2004 to 2021 (APC=-1.88%, P<0.05); the AADR for reproductive system malignancies in the 30 to <45 years group showed decreasing trends from 2004 to 2016 and from 2016 to 2021 (APC=-1.31%, -7.34%, P<0.05); the AADR for reproductive system malignancies among individuals aged 45 to <60 years showed a declining trend from 2004 to 2013 (APC=-1.86%, P<0.05); the AADR for reproductive system malignancies among individuals aged≥75 years showed a declining trend from 2004 to 2014 (APC=-2.99%, P<0.05). Semi-logarithmic trend lines revealed a significant shift in the ranking of female reproductive system cancer mortality trends: from "endometrial cancer>cervical cancer>ovarian cancer" during 2004-2013 to "cervical cancer > ovarian cancer > endometrial cancer" during 2015-2021.

Conclusion

During 2015-2021, the burden of malignant neoplasms of the female reproductive system changed. Cervical cancer replaced endometrial cancer as the leading cause of death from female reproductive system malignancies in China. Significant urban-rural and regional heterogeneity existed across the three cancer types: urban cervical cancer mortality declined in recent years while rural areas lagged in improvement; endometrial cancer mortality rebounded in central-western regions, urban and rural areas; ovarian cancer mortality showed an upward trend across all populations.

Spatiotemporal Patterns and Determinants of Dengue in China during 2004-2023

WANG Jiaxuan, WANG Zhaoxian, HUANG Xiaofen, ZHAO Jinkui, LABA Sangzhu

2026, 29(26):  3844-3850.  DOI: 10.12114/j.issn.1007-9572.2026.0017

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Background

Dengue is the fastest-rising mosquito-borne disease in China, with its prevalence rapidly expanding northward in recent years.

Objective

To analyze the disease burden, spatiotemporal patterns, and determinants of Dengue in China from 2004 to 2023.

Methods

Data from the Global Burden of Disease Study 2024, Chinese Public Health Science Data Center, China Health Statistics Yearbook (2022), National Statistics, and weather databases were utilized. Estimated annual percentage change (EAPC) for incidence and mortality were calculated. Spatiotemporal distribution and trends were described. After addressing multicollinearity and spatial autocorrelation, a geographically and temporally weighted regression (GTWR) model was employed to analyze provincial regional heterogeneity by incorporating influencing factors from four dimensions—economy, transportation, healthcare, and natural environment from 2018 to 2020.

Results

From 2004 to 2023, the age-standardized incidence rate (EAPC=5.51%) increased, while age-standardized mortality (EAPC=-5.16%) declined. Dengue fever incidence in most provinces and cities of China showed an increasing trend from 2004 to 2020, with the peak occurring in September. The GTWR model demonstrated strong explanatory power (R²=0.739, Adjusted R²=0.719, AIC=340.492). Based on the spatiotemporal distribution of fitted coefficients, per capita disposable income and passenger turnover showed negative correlations with dengue incidence across provinces. International tourist arrivals and average temperature exhibited positive nationwide correlations. Health personnel per 1 000 population correlated positively only in eastern developed provinces. Average precipitation correlated positively north of the Qinling-Huaihe Line but negatively south of it.

Conclusion

The incidence of dengue fever in most provinces and cities of our country has been on the rise from 2004 to 2020, with the peak incidence in September. The per capita disposable income of all residents, the turnover of tourists, the number of international tourists received, the number of health technicians per thousand people, the average temperature and the average precipitation all have significant influences on the incidence of dengue fever in China. However, there is a strong regional heterogeneity. Therefore, targeted prevention and control measures should be formulated according to the specific conditions of each place.

Review & Perspectives

Research Progress on Lactate in Non-small Cell Lung Carcinoma

JIANG Yuetong, YANG Zhixiong

2026, 29(26):  3851-3855.  DOI: 10.12114/j.issn.1007-9572.2024.0536

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Lactate, a primary product of the reduction of pyruvate catalyzed by lactate dehydrogenase, plays multiple roles in the occurrence and progression of non-small cell lung carcinoma (NSCLC). This article systematically summarizes the biosynthesis and transport mechanisms of lactate, explores the interaction between lactate and the metabolic processes and immunological microenvironment of tumors, then provides a comprehensive analysis of how lactate affects the drug resistance and prognosis of NSCLC. It also summarizes the research findings on lactate metabolism as a new therapeutic target for NSCLC. In summary, lactylation modification can participate in the regulation of various biological processes such as metabolism, proliferation, invasion, and immune evasion of tumor cells by affecting gene expression and protein function. Lactate-related genes can serve as important markers for assessing the progression of NSCLC, providing a basis for disease progression prediction, treatment effect evaluation and the development of personalized treatment plans.

Research Progress Neuroprotective Mechanism of Baicalin against Cerebral Ischemia-reperfusion Injury

QIN Wenxiu, KONG Qingjie, WEI Gang, SUN Huiying, WANG Qi, XU Junfeng

2026, 29(26):  3856-3864.  DOI: 10.12114/j.issn.1007-9572.2024.0665

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Cerebral ischemia-reperfusion injury refers to the process of restoring cerebral blood flow supply after the interruption of cerebral blood flow in brain tissues due to a variety of biological processes such as energy metabolism disorders, oxidative stress, free radical damage, inflammatory response, blood-brain barrier disruption, apoptosis and necrosis, which lead to ischemic brain tissue re-injury. Cerebral ischemia-reperfusion injury not only aggravates nerve cell damage or even death, impedes the recovery of patients' neurological function, but also seriously affects the quality of patients' survival. Therefore, effective prevention and treatment protocols for cerebral ischemia-reperfusion injury have become the focus of current research in the cerebrovascular field. Baicalin is a flavonoid compound extracted from the Traditional Chinese Medicine Scutellaria baicalensis, and increasing evidence suggests that baicalin may be effective in preventing cerebral ischemia/reperfusion injury through a variety of pharmacological mechanisms including. This paper summarizes the neuroprotective effects of baicalein in in vivo and in vitro experimental models of cerebral ischemia/reperfusion injury, and describe the specific neuroprotective mechanisms and pharmacological mechanisms of baicalein in preventing and treating cerebral ischemia/reperfusion injury in a multi-targeted, multi-pathway manner, such as attenuating inflammation, anti-oxidative stress, regulating mitochondrial homeostasis, inhibiting apoptosis and pyroptosis, protecting the blood-brain barrier, maintaining the structure and function of astrocytes, and attenuating neurocellular toxicity.

Research Methodology & Tools

Development Reliability Validity Test of Traditional Chinese Medicine Health Behaviors Scale

YUAN Yue, WANG Sixue, YUAN Xiangqing, ZHOU Chunyi, XIONG Lisha, ZHANG Ailin, FANG Xuelian, WANG Yuncui

2026, 29(26):  3865-3872.  DOI: 10.12114/j.issn.1007-9572.2025.0323

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Background

Traditional Chinese Medicine (TCM) health behaviors play an important role in maintaining and promoting public health. Scientifically assessing the level of TCM health behaviors has practical significance for health management and intervention. However, there is currently a lack of standardized localized assessment tools for TCM health behaviors in China.

Objective

To develop a TCM Health Behavior Scale and examine its reliability and validity.

Methods

Guided by the conceptual framework of TCM health behaviors, the initial scale was developed through literature review, semi-structured interviews, and group discussions. A test version was formed after expert consultation and a pilot survey. From October to December 2024, 590 community residents aged 18-80 from Sichuan, Hubei, and Hunan provinces were selected by convenience sampling. A total of 641 questionnaires were distributed, with 590 valid responses (92.04% effective rate). Item analysis and reliability-validity tests were conducted.

Results

An initial scale of 9 dimensions and 41 items was constructed based on literature review and qualitative interviews. After expert revision, both rounds of consultation achieved 100% response rates, with suggestion rates of 95% and 74%, respectively. Expert authority coefficients were 0.889 and 0.903, and Kendall's W values were 0.168 and 0.073 (P<0.05). A test version with 9 dimensions and 40 items was finalized through expert feedback and panel discussions. After psychometric testing, the final scale comprised 8 dimensions and 34 items. Exploratory factor analysis extracted 8 common factors with a cumulative variance contribution of 70.944%, item loadings ranged from 0.548 to 0.899. Confirmatory factor analysis indicated good model fit: χ²/df=1.713, RMSEA=0.049, GFI=0.860, CFI=0.945, NFI=0.879, TLI=0.937, IFI=0.946. All item factor loadings exceeded 0.5, CR values were > 0.7, AVE ranged 0.478-0.682, and inter-dimension correlation coefficients ranged 0.007-0.583, indicating acceptable convergent and discriminant validity. S-CVI was 0.935, and I-CVI ranged 0.890-1.000. The overall Cronbach's α was 0.918, and split-half reliability was 0.962, demonstrating good reliability.

Conclusion

The TCM Health Behavior Scale demonstrates good reliability and validity, and can serve as a localized tool for health managers to assess the TCM health behavior levels of Chinese residents.