Abstract:As a critical factor affecting cognitive function and mental health in the elderly,mental fatigue has become a focal point in geriatric health research.This study systematically examines the adverse effects of mental fatigue on the physical and mental health of the elderly,and comprehensively sorts out the mechanisms by which exercise interventions alleviate mental fatigue.It specifically analyzes the differences in effectiveness of various exercise types,intensities,and volumes in improving mental fatigue,along with their potential physiological mechanisms.The findings suggest that exer‐cise interventions can effectively alleviate mental fatigue in the elderly through multiple pathways,including improving brain structure and function,regulating autonomic nervous system balance,and promoting neurotransmitter secretion.This review holds that future research should further explore the combined effects of diverse exercise interventions and de‐velop personalized exercise prescriptions,providing scientific evidence for establishing precision-based mental fatigue in‐tervention strategies for the elderly.

Abstract:Objective To explore the application effect of feedback-based health education model in respiratory function training for elderly patients with pulmonary tuberculosis.Methods A total of 80 elderly patients with pulmo‐nary tuberculosis treated at the Third People's Hospital of Yangzhou from June 2024 to November 2024 were selected as the research subjects.The patients were randomly divided into a control group and an observation group,with 40 cases in each group,using a random number table method.The control group patients were treated with conventional health educa‐tion,while the observation group patients were treated with a feedback-based health education model in addition to the con‐ventional approach.On the day before or the day of discharge,the accuracy of respiratory function training was compared between the two groups.Additionally,respiratory function training compliance,quality of life,and lung function were compared between the two groups before and three months after the intervention.Results After intervention,the accura‐cy and compliance of respiratory function training in the observation group were better than those in the control group(all P<0.05);the scores and total scores of each dimension(clinical symptoms,activity ability,disease impact)of the St.George's Respiratory Questionnaire(SGRQ)for evaluating quality of life in the observation group were lower than those of the control group(all P<0.05);the forced vital capacity(FVC),forced expiratory volume at the end of one second(FEV1),and FEV1/FVC ratio in the observation group were higher than those in the control group(all P<0.05).Conclu-sion The application of feedback-based health education model in respiratory function training of elderly patients with pulmonary tuberculosis can improve their mastery of respiratory function training methods and compliance,thereby improv‐ing their quality of life and lung function.

Abstract:Objective To conduct a scoping review of medication literacy interventions in patients with chronic dis‐eases.Methods Based on the framework of the Joanna Briggs Institute(JBI)scoping guidelines in Australia,CNKI,Wanfang,VIP,CBM,PubMed,Web of Science,The Cochrane Library and Scopus were systematically searched for rele‐vant studies on medication literacy intervention in patients with chronic diseases.The search period was from the establish‐ment of the database to April 1,2025.The literature was screened according to the inclusion and exclusion criteria,and relevant data were extracted for organization and analysis.Results A total of 18 articles were included.The core inter‐vention strategies of medication literacy included education and training interventions,digital health interventions,tool-as‐sisted interventions,individualized management and psychosocial support.Intervention forms included individual,group and combination models.The frequency of intervention was mostly once or twice a week,with the duration concentrated be‐tween 3 and 12 weeks.The outcome indicators encompassed three aspects:medication management ability,medication be‐havior,and health outcome indicators.Conclusions The medication literacy interventions for patients with chronic dis‐eases demonstrate multidimensional and personalized characteristics.Technology-enhanced interventions can improve ac‐cessibility,interactivity,and sustainability.The short-term effect is significant,but the long-term effect needs to be fur‐ther verified.Future efforts should focus on establishing standardized assessment systems,expanding the scope of target populations,and conducting long-term prospective follow-up studies to develop localized medication literacy intervention programs,so as to promote the clinical transformation and application of intervention strategies.

Abstract:Objective To conduct a systematic review on the incidence of frailty and its influencing factors in elder-ly patients with hip fracture,and to provide evidence for early identification of frailty high risk group and implementation of individualized intervention measures.Methods Observational studies related to frailty in elderly patients with hip frac-ture were retrieved from databases including CNKI,Wanfang,VIP,CBM,Pubmed,Embase,Web of Science,and The Cocrone Library via computer-based search.The search was restricted to the period from the databases'establishment up to February 28,2025.Literature screening and quality evaluation were performed by two investigators.Meta analysis was performed by Stata 17.0 software.Results A total of 25 studies were included.The results of meta-analysis showed that the incidence of frailty in elderly patients with hip fracture was 34%.BMI and hemoglobin were protective factors for frailty in elderly patients with hip fracture;age,gender,CCI,never exercised,osteoporosis,history of falls in the past year,de-pression,cognitive impairment,multiple underlying disease,polypharmacy,creatinine,prolonged bed rest after opera-tion,anemia,malnutrition,living alone,and lack of family care were the risk factors of frailty in elderly patients with hip fracture(all P<0.05).Conclusion The incidence of frailty is relatively high in elderly patients with hip fracture,which is influenced by physical factors,disease-related factors,and other factors.

Abstract:Stroke is a disease with high incidence and disability rates,which seriously endangers human life and health.Five-element music therapy has unique advantages in the rehabilitation treatment of stroke.It can improve pa-tients'mood,enhance limb motor ability,promote language rehabilitation,alleviate cognitive impairment,and improve sleep quality.This article reviews the concept of five-element music therapy,the theoretical basis for treating stroke,the mechanism of action in stroke treatment,and its application status in stroke patients.The purpose is to promote its applica-tion in clinical practice,give play to its distinctive advantages,and improve clinical efficacy.

Abstract:Objective To comprehensively and multi-levelly explore the influencing factors of frailty among Chinese elderly based on health ecology model,providing a theoretical basis for developing interventions to improve frailty in the el-derly.Methods A total of 5 935 adults aged 65 and above from the 2017-2018 China Longitudinal Healthy Longevity Survey(CLHLS)were included.Using frailty status as the dependent variable and factors across the five levels of health ecology model as independent variables,logistic regression models were constructed to identify influencing factors of frail-ty.Results The explanatory power of the model increased with the inclusion of variables from more levels,with the most significant improvements observed after adding interpersonal network and psychosocial-behavioral factors.The regression results showed that at the psychological-behavioral level,drinking(OR=0.632,95%CI:0.484-0.825),smoking(OR=0.674,95%CI:0.519-0.876),physical exercise(OR=0.440,95%CI:0.361-0.535),vegetable consumption(OR=0.640,95%CI:0.504-0.813);in the social network layer of family community,rural residence(OR=0.814,95%CI:0.685-0.967),living alone(OR=0.370,95%CI:0.292-0.468),being married(OR=0.492,95%CI:0.402-0.603),occasionally socialize with friends(OR=0.297,95%CI:0.235-0.376),frequently socialize with friends(OR=0.196,95%CI:0.162-0.236);at the living and working environment level,primary education(OR=0.752,95%CI:0.616-0.916),sufficient income(OR=0.676,95%CI:0.527-0.867);at the economic policy environment level,and high an-nual precipitation of the economic policy environment layer(OR=0.805,95%CI:0.650-0.998)were protective factors against frailty in the elderly(all P<0.05).In the personal trait level,75-84 years old(OR=3.352,95%CI:2.345-4.791),≥85 years old(OR=13.045,95%CI:9.192-18.511);at the psychological-behavioral level,depression(OR=1.516,95%CI:1.281-1.795),anxiety(OR=1.500,95%CI:1.170-1.922),and high per capita GDP of the economic policy environment layer(OR=1.337,95%CI:1.132-1.579)were risk factors against frailty in the elderly(all P<0.05).Conclusions The health ecology model offers a comprehensive framework for analyzing frailty influencing factors.Psy-chosocial-behavioral factors and interpersonal networks should be prioritized when designing frailty management and inter-vention strategies for the elderly.

Abstract:Patients with heart failure are often comorbid with frailty symptoms.Early assessment of frailty status in these patients can effectively improve their prognosis.However,traditional frailty assessment tools have issues such as strong subjectivity and insufficient specificity for heart failure patients.As an important branch of artificial intelligence,machine learning has demonstrated clinical value in the precise assessment of frailty in heart failure patients.This study re-views the current application status of machine learning in this field,specifically including the construction of frailty assess-ment indices,prediction of frailty assessment scale scores,evaluation of different frailty phenotypes,and identification of frailty by combining wearable devices and voice biomarkers.It also discusses the challenges in its application,aiming to provide a reference for promoting multimodal data fusion and establishing a precise and intelligent assessment system for patients comorbid with heart failure and frailty in the future.

Abstract:This study reviews previous research on the current status,influencing factors,and psychological effects of short video use among the elderly.It is found that short video use can positively influence the mental health of the elderly by enhancing social engagement,providing positive emotional experiences,and enriching cognitive stimulation.However,excessive or passive use of short videos may have detrimental effects on their mental health.Future research should consid-er the heterogeneity of short video use among the elderly,adopt longitudinal designs and objective measurement approach-es,to explore the internal mechanisms underlying the impact of short video use on mental health,with the aim of promot-ing healthy aging in this population.

Abstract:Objective To investigate the dyadic coping of elderly patients with type 2 diabetes mellitus(T2DM)complicated by mild cognitive impairment(MCI)and their spouses,and to analyze the relationship between the dyadic cop-ing and the occurrence of hypoglycemic events.Methods A total of 249 elderly patient-spouse dyads with T2DM and MCI under follow-upmanagement were recruited using a cross-sectional study design from the Department of Endocrinolo-gy,Jiangsu Province Official Hospital(November 2023 to June 2024).The General Information Questionnaire,Montreal Cognitive Assessment,Dyadic Coping Inventory,and Family Caregiver Task Inventory were administered.Structural equa-tion modeling was used to analyze the relationship between dyadic coping of patients and their spouses and the occurrence of hypoglycemic events in patients with T2DM and MCI.Results The dyadic coping scores of elderly patients with T2DM and MCI and their spouses were 105.64±23.31 and 105.94±18.43 respectively,both at a low level.Hypoglycemic events occurred in 80 patients out of 249 patients(32.13%).Point-biserial correlation showed that positive dyadic coping in patients and their spouses was negatively correlated with the occurrence of hypoglycemic events(r=-0.70 and-0.64,respectively,P<0.001);negative dyadic coping of patients and their spouses was positively correlated with the occurrence of hypoglycemic events in patients(r=0.40 and 0.33,respectively,P<0.001).The general path relationship model showed that positive dyadic coping in patients and their spouses was negatively correlated with the occurrence of hypoglyce-mic events(β=-0.47 and-0.42,respectively,P<0.001);negative dyadic coping in patients and their spouses was posi-tively correlated with the occurrence of hypoglycemic events(β=0.33 and 0.21,respectively,P<0.001).Conclu-sions Dyadic coping has a significant impact on hypoglycemic events in elderly patients with T2DM and MCI.Positive dyadic coping may help patients improve glycemic control and reduce the occurrence of hypoglycemic events.

Abstract:Objective To systematically review the prevalence and influencing factors of cognitive frailty in elderly patients with ischemic stroke in China.Methods Embase,PubMed,Web of Science,EBSCO,CNKI,Wanfang,VIP,and CBM were searched to collect studies on the prevalence and factors affecting cognitive frailty in elderly patients with ischemic stroke in China.The retrieval period was from the establishment of the database to March 10,2025.The Ameri-can Healthcare Quality and Research Organization(AHRQ)and Newcastle Ottawa Scale(NOS)were used to evaluate the quality of the included literature,and Stata 18.0 software was used for meta-analysis.Results A total of 4 794 elderly patients with ischemic stroke in China and 1 284 patients with cognitive frailty were included in 15 medium to high-quality literature.Meta-analysis showed that the prevalence of cognitive frailty in elderly patients with ischemic stroke in China was 26.6%(95%CI:0.240-0.292),and the influencing factors included age(OR=2.828,95%CI:2.110-3.792),sleep status(OR=2.219,95%CI:1.730-2.846),malnutrition(OR=2.724,95%CI:2.035-3.648),multimorbidity(OR=1.620,95%CI:1.253-2.049),blood pressure(OR=1.829,95%CI:1.272-2.631),depression(OR=2.861,95%CI:1.770-4.624),exercise(OR=0.239,95%CI:0.125-0.456),and self-care ability(OR=0.280,95%CI:0.097-0.805)with all P<0.05.Conclusions The prevalence of cognitive frailty is high in elderly patients with ischemic stroke in China,and insufficient attention is paid to the pre-frailty stage.Advanced age,sleep disorders,malnutrition,multimorbidity,poor blood pressure control and depression are the major risk factors for cognitive frailty,while regular ex-ercise and good self-care ability have protective effects.

Abstract:This paper reviews the mechanism of action,application status,clinical efficacy and implementation difficulties of cognitive interventions,motor interventions,and their synergistic interventions inpatients with vascular cognitive impairment.It focuses on comparing the characteristics and limitations of different intervention modes,aiming to provide a reference for the formulation of evidence-based and individualized rehabilitation programs.

Abstract:Unresectable hepatocellular carcinoma(u-HCC)is a global challenge in cancer treatment,and its patho-genesis is mainly associated with chronic hepatitis B,chronic hepatitis C,and non-alcoholic fatty liver disease and other diseases.Traditional single-discipline diagnosis and treatment often fail to comprehensively access tumor burden,liver function reserve,and the overall condition of patients,resulting in limited therapeutic effects.The multidisciplinary team(MDT)model integrates resources from multiple departments,including surgery,medical oncology,interventional radiolo-gy,radiology,pathology and hepatology,to promote personalized full process management.Existing evidence has showed that MDT could significantly prolong the median overall survival of patients,improve the conversion resection rate,and re-duce treatment-related adverse events.It also has clear benefits for high-risk subgroups such as portal vein thrombosis,Child-Pugh grade B,and elderly patients.MDT is not only a leading diagnostic and treatment model widely respected in the modern international medical field,but also provides a reference for the diagnosis and treatment of complex tumors.However,the clinical popularization of MDT still faces challenges such as uneven resource distribution,lack of standards,and insufficient policy support.In the future,efforts should be made to build a precise decision-making system based on multi-omics and artificial intelligence,establish a full-cycle management pathway,and promote regional and international practices under a unified framework.

Abstract:Diabetes mellitus poses a major global public health challenge.Traditional diabetes nursing models are lim-ited by delayed risk assessment,homogeneous interventions,and high resource consumption,failing to meet the demands for individualized precision nursing.Artificial intelligence(AI)technology,leveraging its strengths in integrating multi-source heterogeneous data and providing real-time decision support,presents significant opportunities for precision diabe-tes nursing.This study summarizes the core technical framework of AI,its applicability in precision diabetes nursing,and its key applications in risk assessment,intervention practices,and process optimization.It also analyzes challenges faced by AI,including technical barriers,clinical practice adaptability,and ethical and legal risks.Future directions are out-lined,emphasizing the need for technological integration,optimization of training systems,and establishment of ethical guidelines to promote further development.The aim is to provide a reference for the deeper application of AI technology in precision diabetes nursing.

Abstract:Objective To analyze the health-related quality of life(HRQoL)and its influencing factors among elderly res-idents in East China.Methods Using data from the China Health and Retirement Longitudinal Study(CHARLS)2020 sur-vey,3 016 middle-aged and elderly residents aged≥60 years with complete variables from six provinces and one municipality in East China were selected as study subjects.The EuroQol five-dimension three-level(EQ-5D-3L)scale was employed to assess HRQoL,while Mann-Whitney or Kruskal-Wallis tests and Tobit regression models were used to analyze influencing factors.Re-sults The health utility value of elderly residents in East China was 0.861(IQR:0.782,0.964).The pain/discomfort dimen-sion showed a relatively high proportion of"some problems"(1 050 cases,34.81%),while the anxiety/depression dimension had the highest proportion of"severe problems"(1 349 cases,44.73%).Tobit regression analysis revealed that residing in Zhe-jiang Province,male gender,urban or suburban residence,participation in the New Rural Cooperative Medical Scheme,inter-net usage,and alcohol consumption>1 time/month were protective factors for HRQoL(all P<0.05).Conversely,residence in Anhui or Jiangxi Province,age≥75 years,annual household income<10 000 yuan,and insufficient nighttime sleep duration were risk factors(all P<0.05).Conclusions The overall HRQoL among elderly residents in East China is moderate and exhib-its significant disparities,with marginal effect gap between Zhejiang and Anhui Provinces.Cross-provincial medical compensa-tion,targeted poverty alleviation,and age-friendly technology promotion should be implemented to improve elderly HRQoL.

Abstract:The sporadic inclusion body myositis(sIBM)has unique characteristics in terms of age of onset and muscle group involvement,but its early clinical manifestations lack specificity,making diagnosis challenging.Moreover,clinical-ly significant cardiac involvement is relatively rare.This article provided a detailed account of the diagnosis and treatment process of a 78-year-old male patient with sIBM and myocardial injury.The patient presented with symptoms such as fa-tigue and poor appetite.Laboratory tests revealed significantly elevated levels of cardiac enzymes and high-sensitivity tropo-nin T.Further examinations,including electrocardiogram,coronary angiography,echocardiography,and cardiac magnet-ic resonance imaging were performed to rule out acute coronary syndrome,myocarditis and other conditions.Subsequent-ly,further examinations including myositis autoantibody testing,electromyography,magnetic resonance imaging of lower limb muscle,and muscle biopsy were completed,ultimately confirmed the diagnosis of sIBM.After hormonal therapy,the patient's symptoms and related indicators improved compared with the baseline.

Abstract:Objective To explore the latent profiles of elderly disability and analyze the influencing factors of differ-ent latent profile classifications.Methods Convenience sampling was used to select 244 elderly individuals from 5 elder-ly care institutions in Hunan Province as research subjects.A general information questionnaire and the World Health Or-ganization Disability Assessment Schedule 2.0(WHODAS 2.0)were utilized to survey the elderly participants,while manual muscle testing method was conducted to assess their muscle strength.Latent profiles of disability among elderly were identified using latent profile analysis.Variables that showed significance in univariate analyses were then included in multivariate analysis.Additionally,decision tree model and random forest models were constructed to explore the pre-dictors of different latent profile classes and to rank their relative importance.Results The disability score of the elderly was 96.20±25.29,which could be categorized into four latent profiles:the extremely severe disability group with low activ-ity and high cognition(31.6%),the severe disability group with low activity and high self-care ability(23.8%),the mod-erate disability group with low activity(30.7%),and the mild disability group with balanced function(13.9%).The in-fluencing factors of different latent profiles of disability in the elderly included muscle strength,marital status,cardiovas-cular diseases,and surgical history.Results from the decision tree model and random forest model indicated that muscle strength has the highest importance in influencing the classification of disability status.Conclusions The disability among the elderly exhibits group heterogeneity,with muscle strength,marital status,cardiovascular diseases,and surgi-cal history as influencing factors.Healthcare providers should implement personalized interventions for the elderly based on different latent profiles and influencing factors to improve their disability status.

Abstract:Objective To explore the real experience of self-management of patients with chronic multimorbidity,so as to provide a basis for medical staff to formulate scientific and effective intervention strategies.Methods Based on the theoretical guidance of the Capability,Opportunity,Motivation-behavior Model(COM-B model),phenomenological re-search method was used to select 14 patients with chronic multimorbidity in Union Hospital,Tongji Medical College,Hua-zhong University of Science and Technology by purposive sampling method,and Semi-structured in-depth interviews were conducted.NVivo12 Plus software and Colaizzi's seven-step analysis method were used to code and refine the interview da-ta.Results The self-management experience of patients with chronic multimorbidity could be summarized into 3 core themes(self-ability,diversity of support channels and internal and external motivation)and 9 sub-themes.Conclusion Med-ical staff should improve health literacy,integrate multi-level support resources and enhance patients'initiative,so as to promote the continuous improvement of their self-management ability.

Abstract:Objective To systematically evaluate frailty risk prediction models for stroke patients and provide a sci-entific screening tool for healthcare workers.Methods CNKI,Wanfang,VIP,CBM,PubMed,Embase,Web of Sci-ence,and The Cochrane Library databases were systematically searched for studies on frailty risk prediction models for stroke patients,with the search period from database establishment to April 2025.Two researchers independently screened literature and extracted data.The PROBAST tool was used for assessment of bias risk and applicability.RevMan 5.4 software was applied for Meta-analysis of predictors with a frequency>2 times,and MedCalc software was used to eval-uate the performance of the included prediction models.Results A total of 13 studies were included.The AUC of the prediction models ranged from 0.629 to 0.94,and the pooled AUC by MedCalc was 0.857(95%CI:0.796-0.917),in-dicating moderate predictive performance.Meta-analysis results showed that age,depression,falls,dysphagia,diabetes,malnutrition,National Institutes of Health Stroke Scale(NIHSS)score,comorbidity,living alone,activities of daily living(ADL),and physical exercise were significant predictors of frailty in stroke patients(all P<0.05).Conclusions Frail-ty risk prediction models for stroke patients have certain value,but they carry a high risk of bias and their performance needs further improvement.Future studies should adopt machine learning technology and conduct large-sample,multi-cen-ter,prospective research.Healthcare workers should scientifically and reasonably apply the prediction models according to patients'individual differences to improve model accuracy.

Abstract:Objective To conduct a scoping review of the risk prediction models for frailty in Chinese patients with diabetes.Methods PubMed,Embase,Web of Science,EBSCO,The Cochrane Library,CNKI,Wanfang,VIP,and CBM were systematically searched to collect Chinese and English literature on the risk prediction models for frailty in Chi-nese patients with diabetes.The retrieval period was from the establishment of the database to February 22,2025.Two re-searchers independently screened and extracted information from the literature,and the quality of the included literature was evaluated using the prediction model bias risk assessment tool.Results A total of 17 studies and 26 diabetes frailty risk prediction models were included,and the incidence of frailty in Chinese diabetic patients was 10.9%-51.2%.The modeling methods included logistic regression and machine learning algorithms.All models reported the AUC(0.768-0.975),and 15 studies calibrated the models.The risk of bias of the included literature was high,mainly in the research subjects and analysis fields,and the overall applicability was good.Age,depression and glycated hemoglobin level were the important predictors of frailty in Chinese patients with diabetes.Conclusions The included models have good predic-tive performance,but the risk of bias is high.Future research should focus on developing or validating risk prediction mod-els with low risk of bias and high applicability.

Abstract:Myasthenia gravis is an acquired autoimmune disorder of neuromuscular junction transmission.In tradition-al Chinese medicine(TCM),it falls within the category of"Wei Syndrome".This paper reviews the application of data-mining techniques in elucidating the etiology and pathogenesis,symptom-pattern correlations,therapeutic regularities,and outcome prognoses of myasthenia gravis.The advantages of data mining in TCM diagnosis and treatment are fully dis-cussed to provide references for clinical management of myasthenia gravis.