OBJECTIVE:To examine the differences in cognitive processing between patients with mild cognitive impairment(MCI)of different Traditional Chinese Medicine(TCM)syndrome types to provide evidence supporting the TCM typing of MCI. METHODS:Participants were screened using a battery of scales for spleen and kidney deficiency(SKD)/liver Qi stagnation(LQS)-type MCI or those without syndrome or normal control(NC).Following sex,age,and educational matching,behavioral and electroencephalographic data were recorded using the verbal N-back experimental paradigm.The data were then analyzed and compared with respect to the reaction time and correctness of the participants in each group,as well as the amplitude and latency of the event-related potential(ERP)components of P2,N2,and P3. RESULTS:There were no statistically significant differences in the accuracy or reaction times of the behavioral data of the groups.Regarding ERP data,the SKD group had a shorter P2 latency than the LQS and NC groups,while the latter two groups did not differ statistically.The SKD group had a shorter N2 latency than the NC group,while the SKD group did not differ from the LQS group.The SKD and LQS groups had a shorter P3 latency than the NC group. CONCLUSION:Our study offers objective evidence of the distinction between the types of TCM syndrome.Different types of TCM syndromes produce different disease mechanisms,resulting in brain damage with different presentations of cognitive impairment and cognitive processing characteristics.

OBJECTIVE:Evidence of an association between a change in body size and the risk of all-cause mortality is limited among older populations. We explored the association of a change in body size over three years with the risk of all-cause mortality in an older Chinese population. METHODS:A total of 5134 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were recruited. Cox proportional-hazards models were used to assess the association of changes in body mass index (BMI) and body fat percentage (BF%) with risk of all-cause mortality, using hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS:Of the 5134 participants (median age, 81 years; 2716 women [52.90%]), 1494 deaths were observed over a median of 4.08 years of follow-up. Compared with participants with stable body size (change within 5%), those with more than a 10% decrease in BMI or BF% had 36% and 46% higher risks, respectively, of all-cause mortality (HR = 1.36, 95% CI: 1.17-1.59; and HR = 1.46, 95% CI: 1.25-1.72); also, those with more than a 10% increase in BMI or BF% had 22% and 17% higher risks of all-cause mortality (HR = 1.22, 95% CI: 1.05-1.41; and HR = 1.17, 95% CI: 1.02-1.35). CONCLUSIONS:This prospective cohort study of older adults suggests that a dramatic change in body size was positively associated with a higher risk of all-cause mortality. More attention should be paid to the effects of a dramatic change in body size, particularly a dramatic decrease in body size, among the Chinese population.

Objectives: Evidence on the association between garden work and risk of incident dementia in the older Chinese population is limited. This study aimed to explore the association between the frequency of garden work and risk of incident dementia in an older population in China. Study design: This was a national cohort study. Methods: This study analysed data from 8676 participants (median age: 86 years) from the Chinese Longitudinal Healthy Longevity Survey. Cox proportional hazard models were used to assess the association between the frequency of garden work and risk of incident dementia using hazard ratios (HRs) and 95% confidence intervals (CIs). Multiplicative and additive interaction effects were calculated between the frequency of garden work and age, sex or residence on incident dementia; subgroup analyses of the association were also conducted by age, sex and residence. In addition, sensitivity analyses were performed to assess the robustness of the results. Results: During 4.31 years (median) of follow-up, 633 participants developed dementia. Compared with participants who did not engage in garden work, the adjusted risk of incident dementia for those who regularly or almost daily engaged in garden work decreased by 28% (HR = 0.72, 95% CI: 0.57-0.93). An additive interaction effect between frequency of garden work and age on incident dementia was observed, with subgroup analyses demonstrating similar statistically significant associations among participants aged >= 85 years, women and city or town residents. Sensitivity analyses were consistent with the primary analysis in the present study. Conclusions: Frequent engagement in garden work may be associated with a reduced risk of dementia and may be an effective measure to prevent incident dementia in the older population in China. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Evidence on the association of dynamic change in frailty index (FI) with risk of all-cause mortality in the older Chinese population is limited. This study aimed to explore the association of 3-year change in FI with risk of all-cause mortality in an older Chinese population. We analyzed the data of 4969 participants from the Chinese Longitudinal Healthy Longevity Survey. The primary outcome was all-cause mortality, which was a binary variable and defined as completed data and censored data. Cox proportional-hazard models were used to assess the association of 3-year change in FI with risk of all-cause mortality by using hazard ratios (HRs) and 95

2020年以来新型冠状病毒肺炎的防治中,中医药作为主力军发挥了重要的积极作用.在疫情抗击中,防治并重,中医"治未病"思想的"未病先防""既病防变""病后防复"3个阶段的认识在此次新发传染病防治中均有充分体现.文章总结了此次疫情中在疾病未发生阶段运用中医病因学说、中医发病理论、中医体质学说未病先防;在疾病阶段根据病邪发病特点、性质和所损害的脏腑、疾病传变规律而既病防变;在疾病后期阶段或者临床治愈后运用中医综合方法多方面进行病后防复.文章为建立融入中医药"治未病"思想的传染病公共卫生防控体系提供基础研究资料.

疫情步入常态化防控阶段,加强人才队伍建设是提高我国公共卫生预防疾病能力的关键.中医药在此次抗疫过程中,发挥出巨大作用,其对轻症患者疗效显著,极大地改善了重症患者的病情,成为此次疫情防控中的一大亮点.此文通过分析我国预防医学教育现状,回顾中医药抗疫历史及在疫情防控过程中的巨大贡献,结合我国中医药院校开办预防医学专业的特色及优势,探讨中医药院校预防医学专业在发展过程中存在的不足,提出符合中医药院校特色的预防医学人才培养建议.

目的 比较不同年龄被试的失匹配负波(MMN)和P3a脑电成分,探讨脑老化对认知注意加工的影响.方法 按照性别1:2匹配,选择郑州市某社区认知功能正常的青年(青年组)和中老年被试(中老年组),采用听觉三刺激oddball范式记录被试脑电数据,比较两组被试脑电注意加工成分MMN和P3a的差异.结果 两组MMN波幅及潜伏期均无统计学差异(P>0.05).与青年组相比,中老年组P3a波幅明显减小(P<0.05),青年组波幅显著大于中老年组(P<0.05);且中老年组P3a潜伏期延长显著长于青年组(P<0.05).结论 随着年龄的增加,认知加工晚期的注意朝向加工出现损伤,最终导致认知功能逐渐下降.

Background: Existing evidence on the association of dynamic change in sleep duration with risk of allcause mortality in Chinese older population is limited. We aimed to explore the association of 3-year change in sleep duration with risk of all-cause mortality in a Chinese older population. Materials and methods: A total of 5772 Chinese older participants (median age 82 years) were enrolled in the current study. Cox proportional-hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of 3-year change in sleep duration with risk of all-cause mortality. Subgroup analyses of the association between 3-year change in sleep duration and risk of all-cause mortality were conducted by age, sex and residence. Results: During a median of 4.08 years of follow-up, death developed in 1762 participants. Compared with -1 to <1 h/day change in sleep duration, the adjusted risk of all-cause mortality with < -3 h/day change in sleep duration may increase 26% (HR = 1.26, 95% CI: 1.05-1.52); the risk of all-cause mortality with 3-year change from short to long sleep duration, or long to short sleep duration versus stable normal sleep duration status was increased about 28% and 52%, respectively (HR = 1.28, 95% CI: 1.00-1.64 and HR = 1.52, 95% CI: 1.21-1.92). Subgroup analyses demonstrated that similar significant associations were observed among participants with 65 to <85 years, men and living in city and town. Conclusions: Dynamic sleep duration change was significantly associated with risk of all-cause mortality. The current study suggests that sleep duration may be a non-invasive indicator for interventions aiming to reduction risk of all-cause mortality in Chinese older population. (c) 2023 Elsevier B.V. All rights reserved.

当前医学教育发展对高素质医学科研人才基本素质提出的新要求,让培养研究生创新意识与创新能力成为迫切需要.为此,此研究在对往年研究生医学统计学的教学经验和教训进行系统梳理的基础上,结合当前各种教育改革新模式,构建以"科研创新能力培养"为导向的研究生医学统计学课程体系,对研究生科研创新能力的培养具有非常重要的意义.

自疫情进入常态化管理,恢复线下教学之后,如何使线上线下混合式教学真正能够提高教学效果,增加学生的主观能动性成为教学改革的热点问题.此研究以中医药院校医学统计学为例,对BOPPPS模型在后疫情时代混合式教学中的运用进行探讨,证明基于课堂派等网络辅助教学平台的BOPPPS模型的确能够激发学生的主观能动性,有效达成教学目标.

目的:分析中医思维方式的基本特征并探讨其研究现状.方法:检索中医思维方式相关文献,整理后进行频次、年份相关的统计分析,并对其聚类和归类.结果:整理归纳出23种中医思维方式,频率排前三位的中医思维方式分别为象思维、整体思维、辨证思维,用聚类分析法将思维方式聚类为七类,同时参照定义和内涵将中医思维方式按照不同的分类依据归为七类.结论:①象思维、整体思维和辨证思维在中医思维方式中频次最高,其出现的年份也相对较早,在中医学习和临床中认可度和应用度都较高;②聚类分析结果反映出思维方式之间的一定关联性,每一类都有其不同的特点;③明确分类依据形成七大类思维方式分类,为以后的研究提供新的参考.

面对当前医学教育发展对高素质医学科研人才基本素质提出的新要求,迫切需要培养医学生科学的统计思维和解决实际医学科研问题的能力,如何对其学习成效进行评测成为教学研究新的思考方向.教学评测环节应从课程目标设置就开始考虑.为此我们在系统总结《医学统计学》教学经验和教训的基础上,结合医学教育实际,开展了"以成果为导向"的《医学统计学》课程体系以及多元化评测系统的构建与探索,旨在提高本科生的科研创新能力.

目的 分析1990年与2019年中国10～24岁青少年人群HIV/AIDS疾病负担在性别中的变化,为制定针对该年龄层人群的有效干预措施提供信息.方法 使用全球疾病负担(Global Burden of Disease,GBD)2019数据库资料,按性别和年龄提取1990-2019年中国10～24岁青少年人群因HIV/AIDS的死亡数和死亡率、伤残调整寿命年(DALY)、DALY率、过早死亡损失寿命年(YLL)、YLL率、伤残损失寿命年(YLD)、YLD率等指标来分析该群体HIV/AIDS疾病负担在性别中的变化幅度.结果 2019年,中国10～24岁青少年人群因HIV/AIDS的死亡数和死亡率、DALY、DALY率、YLL、YLL率、YLD 与 YLD 率分别为 847 人、0.37/10 万、62 621 人年、27.51/10 万、58 036 人年、25.49/10 万、4 584 人年与 2.01/10 万,相比 1990 年增幅分别为 401.18％,691.49％,370.48％,648.26％,409.53％,710.33％,138.87％与 279.25％.2019 年中国 10～14,15～19岁与20～24岁男性因HIV/AIDS的死亡数和死亡率、DALY与DALY率均高于女性,与1990年相比,增幅均高于女性;10～14岁人群疾病负担增幅高于20～24岁.1990-2019年,随着年龄和年份的增加,青少年死亡率和DALY率的性别差距增大.结论 与1990年相比,2019年中国10～24岁青少年人群HIV/AIDS感染风险持续增加,低龄HIV感染者增幅明显,性别差异日益明显.

课程思政是当前高校思想政治工作的新理念新模式,强调"立德树人",注重知识传授与社会主义核心价值观的融合,是当前教学改革中高度关注的理论和实践问题.文章从"大思政"理念下的"课程思政"改革的新要求、课程定位、课程思政的必要性、课程思政的原则、课程思政的途径等方面探索医学统计学课程思政教学改革,为新时期医学统计学教学改革提供了新思路.

目的 分析2005-2020年河南省南阳市乙型肝炎(乙肝)的流行病学特征,调整和完善乙肝防控策略.方法 收集2005-2020年南阳市乙肝疫情数据,运用描述性流行病学方法对乙肝的流行病学特征进行分析,计算不同时期、区域以及职业人群的乙肝报告病例流行病学指标;采用随机整群抽样的方法,对南阳市0～79岁常住人口进行抽样调查,采用酶联免疫吸附试验检测乙肝表面抗体水平;采用x2检验和直线回归分析对相应指标进行统计分析.结果 2005-2020年南阳市乙肝累计报告153 361例,年均报告发病率为100.46/10万,总体呈下降趋势,其中,未分类乙肝报告病例构成比逐渐减少,慢性乙肝构成比逐渐增加.发病以15～45岁人群为主,男女性别比为1.23∶1,发病最多的职业为农民,占总病例数的77.19％.结论 青壮年乙肝现状不能忽视,在儿童乙肝免疫策略基础上,南阳市应将工作重点转向成年人群的慢性乙肝防控,加速病毒性肝炎的消除进程.

目的:通过临床提取食管癌病位、病性证素分析其证素特点及组合规律.方法:通过拟定证候调查表,采集173例食管癌患者信息对其病位病性证素进行频数分析,并对高频证素进行聚类分析、因子分析,以获得证素组合规律.结果:提取出病位证素12个,病性证素17个,其中高频病位证素分别为胃、肝、肺、肾、脾,高频病性证素分别为气滞、痰、阳虚、阴虚、湿、气虚、血虚、血瘀、寒,证素组合规律呈现肝胃气滞阴虚、肺蕴痰浊、气血肾阳亏虚、脾胃血瘀寒湿4种证型.结论:本研究结果与传统的食管癌4种证型有明显不同,突出了病位和病性结合的特点,补充了肺与本病发生有密切关系的认识,无"热"这一病性证素呈现出阴虚和气滞并存等复杂病机.

目的 比较中国居民1990年与2019年抑郁症疾病负担,为抑郁症的预防控制提供参考依据.方法 收集全球疾病负担(GBD)2019中中国居民1990年和2019年的抑郁症发病数和伤残调整寿命年(DALYs),比较1990年与2019年中国居民抑郁症的变化情况.结果 中国居民2019年抑郁症的发病数和DALY分别为41 005 280例和7 561 985人年,较1990年的31 303 436例和5 486 751人年增加了 31.0％和37.8％;抑郁症的标化发病率和标化DALYs率由1990年的2 647.72/10万和470.65/10万下降至2019年的2 301.41/10万和416.95/10万.与1990年相比,男性居民2019年抑郁症的发病数和DALYs增加了 37.0％和41.9％,均高于女性居民的27.8％和35.5％;标化发病率和标化DALYs率降低了 7.8％和7.6％,均低于女性的16.5％和14.2％.2019年10～49岁男性、女性和总人群抑郁症DALYs率均低于1990年,≥50岁男性、女性和总人群抑郁症DALYs率均高于1990年.1990年和2019年重度抑郁症DALYs分别为4 006 829人年和5 087 997人年,分别占抑郁症总疾病负担的73.0％和67.3％,是中国居民抑郁症疾病负担最为严重的病种;2019年中国居民重度抑郁症和心境恶劣DALYs率分别较1990年增加了 5.7％和39.1％,心境恶劣疾病负担增加明显.结论 中国女性居民仍占抑郁症疾病负担的主导地位,但男性和中老年居民抑郁症疾病负担有所增加,心境恶劣的疾病负担亦增加明显,应予以重视.

[目的]基于网络药理学筛选出六味地黄汤主要活性化学物质,探讨六味地黄汤治疗痴呆的作用机制.[方法]根据TCMSP数据库找出六味地黄汤的主要活性成分和活性成分的主要作用靶点,从Uniprot数据库中获得药物的靶标的Uniprot ID;运用GeneCards数据库中检索出与痴呆疾病有关的靶点,通过STRING数据库将得到的六味地黄汤有效成分靶点与痴呆靶点相关的交集靶点;根据WebGestalt数据库对靶点进行GO分类富集分析,通过KOBAS 3.0对六味地黄汤治疗痴呆疾病的交集靶点进行KEGG通路的富集分析.[结果]运用TCMSP数据库分析得到六味地黄汤中的活性成分主要有地黄多糖、β谷甾醇、茯苓多糖、泽泻醇等,活性成分的相关靶点有PTGS2、CAT、AKT1、TGFB1、NOS3、CCL2等,它们主要通过雌激素信号通路、血清素能突触、神经活性配体-受体相互作用、胆碱能突触和胰岛素信号通路等,参与炎症反应、抗氧化应激、胰岛素抵抗、认知功能减退及DNA的复制与转录等过程.[结论]六味地黄汤治疗痴呆具有多成分、多途径和多靶点的特点,为临床的研究和应用及进一步探索其药效的作用机制奠定了一定的基础.

目的 探讨项目分层教学法在医学统计学教学中的应用,为高质量完成医学统计学教学提供参考依据.方法 随机抽取我校2017级针灸推拿专升本专业两个班的学生作为研究对象,开展教学试验对比研究,试验组采用项目分层教学法,对照组采用传统教学法.结果 试验组的平均作业成绩、期末测试成绩和总成绩均高于对照组;学生对项目分层教学法的满意度高于传统教学组.结论 项目分层教学法可用于我校医学统计学的教学.

Purpose The aim of this meta-analysis is to evaluate the changes in nutritional indicators in individuals with obesity before and after SG. Materials and Methods A systematic retrieval of the available literature was performed using PubMed, Embase, Web of Science, and Chinese National Knowledge Infrastructure databases. The following indicators were evaluated: serum 25-hydroxyvitamin D [25(OH)D], calcium, phosphorus, iron, vitamin B12, folate, magnesium, and zinc from pre-operation to post-operation. Results A total of 38 studies met inclusion criteria. A significant increase was observed in serum 25(OH)D (SMD = 0.70, 95%CI 0.38 to 1.02, P < 0.001), phosphorus (SMD = 0.40, 95%CI 0.14 to 0.67, P = 0.003), iron (SMD = 0.50, 95%CI 0.38 to 0.62, P < 0.001), and folate (SMD = 0.37, 95%CI 0.09 to 0.65, P = 0.01) after SG. Nevertheless, the increasing trend of serum phosphorus ( P = 0.143) and folate ( P = 0.774) disappeared in the unprescribed subgroup. A significant decrease in serum zinc (SMD = − 0.41, 95%CI − 0.81 to − 0.01, P = 0.044) was found after SG. No significant changes in serum calcium (SMD = 0.08, 95%CI − 0.09 to 0.25, P = 0.372), vitamin B12 (SMD = 0.10, 95%CI − 0.13 to 0.33, P = 0.398), and magnesium (SMD = 0.24, 95%CI − 0.10 to 0.58, P = 0.169) were observed. However, a significant decrease in serum calcium ( P = 0.042) and vitamin B12 ( P = 0.037) was found in the unprescribed subgroup. Conclusions Serum 25(OH)D, phosphorus, iron, and folate levels improved after a careful monitoring and due to a rigorous supplementation. The optimal dose of calcium, magnesium, and zinc supplementation has yet to be established; therefore, a broader supplementation of trace elements and minerals has to be suggested. Graphical abstract