Table of Content

20 March 2026, Volume 40 Issue 3 Previous Issue    Next Issue

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Advances in drug targets for chronic pain Alina Zhawatibai, DAN Chuancai, WANG Shu, WU Zhengyi, WANG Kun, ZHU Weifan, LIN Qingqing, LIU Huanbing 2026, 40 (3):  217-223.  doi: 10.3969/j.issn.1003-9198.2026.03.001 Abstract ( 88 )   PDF (1165KB) ( 147 )   Save Chronic pain is a globally prevalent and difficult-to-cure disease. Current treatment approaches, such as opioids and nonsteroidal anti-inflammatory drugs, are unable to meet the needs of clinical practice due to their adverse reactions and limited efficacy. This review comprehensively introduces the current research on drug targets for chronic pain. For traditional targets such as opioid receptors, the focus is now on developing biased agonists and optimizing personalized medication regimens, while cyclooxygenase targets are shifting towards balance regulation and using combination therapy. Emerging targets such as ion channels, inflammatory mediators, and neurotransmitter receptors is opening up new pathways for highly specific analgesia. However, it remains challenging to practical treatment. In addition, cutting-edge targets such as epigenetic regulation and gut microbiota, when combined with artificial intelligence technology, are driving the advancement of precision medicine for chronic pain. Finally, this paper points out that the current research still confronts challenges such as species differences and individual variations. Future research directions will focus on multi-omics integration and the development of multi-target drug, which may lead to the creation of safer, more effective, and highly personalized analgesic strategies and therapies. References | Related Articles | Metrics

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Research progress on molecular mechanism and drug target of fraity syndrome LIU Yukun, LEI Jiawei, ZHU Chunming, ZHANG Yuqiang, WANG Jiahe 2026, 40 (3):  224-228.  doi: 10.3969/j.issn.1003-9198.2026.03.002 Abstract ( 63 )   PDF (1125KB) ( 123 )   Save With the acceleration of population aging, frailty as a multifactorial medical syndrome has become an important research hotspot in geriatrics and chronic disease management. The features of fraitly are loss of strength, endurance and physiological function, which can significantly increase vulnerability, functional dependence and mortality risk. The biological mechanisms driving its occurrence and progression have not been fully elucidated, which to some extent limits the development of relevant risk assessment tools and intervention strategies. In recent years, the rapid progress of multi-omics technologies and physiological/biochemical research methods has provided new research pathways for systematically elucidating the molecular basis of frailty. This article systematically reviews the latest research progress on the core molecular mechanisms driving frailty and drug targets, providing a reference for future translational studies on frailty mechanisms and precision interventions. References | Related Articles | Metrics

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Research progress on drug targets for the treatment of sarcopenia in the elderly SUN Kexin, LEI Jiawei, ZHANG Guilei, YANG Zhenrong, WANG Jiahe 2026, 40 (3):  229-233.  doi: 10.3969/j.issn.1003-9198.2026.03.003 Abstract ( 80 )   PDF (1020KB) ( 135 )   Save Sarcopenia is a prevalent progressive skeletal muscle disease associated with aging population, which characterized by reduced muscle mass, decreased strength, and impaired physical function, significantly increasing the risk of falls, disability, and mortality in the elderly. The pathogenesis of sarcopenia is complex and involves multiple pathophysiological processes such as mitochondrial dysfunction, chronic inflammation, protein homeostasis imbalance, and neuromuscular junction degeneration. Currently, there are no approved specific therapeutic agents in clinical practice, and the treatment primarily relies on resistance training combined with nutritional support. However, due to the compliance and individual variability of patients, the efficacy is often difficult to ensure with certainty. This article provides a systematic review of the major pathological mechanisms and current therapeutic approaches for sarcopenia, with a focus on cutting-edge treatment targets of research value, including modulation of iron metabolism to promote skeletal muscle regeneration, targeted inhibition of the myostatin (Myostatin/ActRⅡB) signaling pathway, application of selective androgen receptor modulators (SARMs), and other molecular intervention strategies. This article aims to provide theoretical basis and scientific reference for the development of precise and effective therapeutic drugs and comprehensive intervention strategies for sarcopenia by reviewing the latest research progress. References | Related Articles | Metrics

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Research advances in drug targets for visual impairment in the elderly LI Minglin, LI Minfeng, ZENG Sanlong, LIANG Qingjing, LIU Jiye, LUO Jianwen 2026, 40 (3):  234-240.  doi: 10.3969/j.issn.1003-9198.2026.03.004 Abstract ( 68 )   PDF (1141KB) ( 136 )   Save The global disease burden of visual impairment in the elderly is substantial, encompassing various types such as age-related cataract, age-related macular degeneration, glaucoma, diabetic retinopathy, xerophthalmia, refractive errors, and retinal vein occlusion. Current clinical treatment options face limitations including gradual drug resistance, difficulty in reversing damage, poor medication adherence, and limited therapeutic choices. Ongoing research into drug targets has become key to breaking through these therapeutic bottlenecks. This article systematically reviews the core pathological mechanisms of the aforementioned common visual impairments, summarizes recent advances in related drug target research, and finally proposes that future efforts should focus on multi-target synergistic treatment strategies, develop novel drug delivery technologies, and combine gene editing techniques to develop new therapies for visual impairment in the elderly. References | Related Articles | Metrics

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Mechanism of macrophage senescence-driven atherosclerosis based on single-cell multi-omics analysis CHEN Xuguan, XIA Yudong, WANG Yingying, XU Yunfan, WU Jun 2026, 40 (3):  241-246.  doi: 10.3969/j.issn.1003-9198.2026.03.005 Abstract ( 68 )   PDF (3097KB) ( 121 )   Save Objective To investigate the role of macrophage senescence in atherosclerosis(AS) and identify the key genes. Methods The data were obtained from the Gene Expression Omnibus (GEO) database. Cell clusters were analyzed using Seurat, aging scores were calculated via the UCell method, co-expression networks were constructed through high-dimensional weighted gene co-expression network analysis (hdWGCNA), differential expression was analyzed with limma, core genes were screened using Lasso regression and random forest algorithms, gene significance was assessed by Shapley additive explanations(SHAP), and immune infiltration was evaluated by CIBERSORT. Results The senescence score of macrophages in the AS core plaques (AC group) was higher than that in the patient-matched proximal adjacent portions (PA group) of carotid artery tissue (P<0.001). hdWGCNA identified 11 functional modules, and Macrophages_NEW6 showed the strongest correlation with senescence scores. Four core genes (MAF、FILIP1L、PEBP1、SPRED1) were screened out, and the random forest model had high predictive efficacy (AUC=0.889). SHAP analysis revealed MAF as the most important gene in terms of feature importance. M2/M0 macrophages were the predominant infiltrating cells in atherosclerotic plaque tissues and showed a significant correlation with the core genes. Conclusions Macrophages regulate AS development through four genes, which has potential value for clinical application. References | Related Articles | Metrics

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LncRNA MEG3 targets miR-21 to mediate TLR4/NF-κB pathway and alleviate myocardial ischemia-reperfusion injury in mice XING Zhi, Shajidan Abudureyimu, Palida Abulaiti, WANG Yu, LYU Maolin, GAO Ying 2026, 40 (3):  247-253.  doi: 10.3969/j.issn.1003-9198.2026.03.006 Abstract ( 53 )   PDF (4669KB) ( 163 )   Save Objective To observe the effect of long non-coding ribonucleic acid human maternal expressed gene 3 (LncRNA MEG3) targeting microribonuclease-21 (miR-21) mediating Toll like receptor 4 (TLR4) and nuclear factor-κB (NF-κB) pathway on myocardial ischemia-reperfusion injury (MIRI) in mice. Methods A total of 54 BAB/c mice were randomly divided into LncRNA MEG3 upregulation group, LncRNA MEG3 downregulation group, miR-21 upregulation group, miR-21 downregulation group, both upregulation group, both downregulation group, empty load group, model group, and sham surgery group, with 6 mice in each group. Except for the sham group, MIRI models were established for all mice. After 24 hours of modeling, mice in each group were euthanized. Abdominal aortic blood was collected and enzyme-linked immunosorbent assay was used to detect the levels of myocardial injury markers [cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB), brain natriuretic peptide (BNP), and myoglobin (Mb)] and inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-8]. Morphological changes in myocardial tissue were observed using hematoxylin eosin (HE) staining. The expressions of TLR4 and NF-κB p65 genes and the expressions of TLR4, NF-κB p65 protein in cytoplasm and nucleus in myocardial tissues were detected. The dual luciferase gene reporter experiment and RNA pull-down experiment were used to validate the targeted regulation of miR-21 by LncRNA MEG3. Results Myocardial injury markers, inflammatory factor levels among different groups showed LncRNA MEG3 downregulation group>miR-21 upregulation group>both downregulation group>model group/empty vector group>both upregulation group>miR-21 downregulation group>LncRNA MEG3 upregulation group>sham group (P<0.05). TLR4 gene and protein in myocardial tissues, NF-κB p65 gene and nuclear NF-κB p65 protein expression showed LncRNA MEG3 downregulation group>miR-21 upregulation group>both downregulation group>model group>both upregulation group>miR-21 downregulation group>LncRNA MEG3 upregulation group>sham surgery group/empty load group (P<0.05), and the trend of cytoplasmic NF-κB p65 protein expression was positively opposite (P<0.05). There were no changes in the morphology of myocardial tissue in the sham surgery group, and the changes in the model group/empty load group, both downregulation group, miR-21 upregulation group, and LncRNA MEG3 downregulation group gradually became increasingly severe, while the changes in the both upregulation group, miR-21 downregulation group, and LncRNA MEG3 upregulation group gradually decreased. The dual luciferase gene reporter experiment and RNA pull-down experiment revealed that LncRNA MEG3 could negatively feedback and target miR-21 regulation. Conclusions Upregulation of LncRNA MEG3 expression can inhibit miR-21, downregulate TLR4/NF-κB pathway, alleviate MIRI and inflammatory response in mice, and also antagonize myocardial injury caused by miR-21 upregulation. References | Related Articles | Metrics

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Insulin nasal drops for the prevention of delirium after surgery in elderly patients: a meta-analysis XIAO Lingyi, XIAO Guojin, LIAO Shunqi, HOU Suying, LIU Lixin, XIA Lin 2026, 40 (3):  254-260.  doi: 10.3969/j.issn.1003-9198.2026.03.007 Abstract ( 64 )   PDF (2315KB) ( 137 )   Save Objective To systematically evaluate the effectiveness, safety, and optimal dose of intranasal insulin in preventing postoperative delium (POD) in the elderly patients. Methods Systematic searches were conducted in the China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, China Biology Medicine disc (CBM), PubMed, Embase, Cochrane Library, and Web of Science databases using the search formula: Keywords+Free words, “Insulin, postoperative delirium, POD”, from the establishment of each database to June 2025. Meta-analysis was completed using RevMan 5.4 software. Results A total of 8 randomized controlled trials (RCT) involving 901 elderly participants were included, with 527 in the experimental group (receiving intranasal insulin) and 374 in the control group (receiving saline nasal drops). Compared with the control group, the incidence rate of POD was significantly lower in the experimental group (RR=0.30, 95%CI: 0.23－0.40, P＜0.001), but there was no statistically significant difference in the incidence rate of POD between the 20 U and 40 U intranasal insulin subgroups (P＞0.05). Compared with the control group, the experimental group had lower levels of postoperative IL-6 (SMD=-2.44, 95%CI: -3.75－-1.12, P＜0.001) and CRP (SMD=-2.83, 95% CI: -4.82－-1.28, P=0.005). There were no significant differences in the incidence rates of adverse reactions between 20 U intranasal insulin subgroup and control group, but one study reported that the 40 U intranasal insulin subgroup experienced increased hypoglycemic events, greater glycemic variability and higher nasal irritation score compared to 20, 30 U intranasal insulin subgroups or control group. Conclusions 20 U intranasal insulin can reduce the incidence of POD, inhibit the elevation of postoperative IL-6 and CRP levels, and does not increase the incidence of adverse reactions in the elderly patients. References | Related Articles | Metrics

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Construction and validation of an in-hospital hypothermia risk prediction model for elderly patients with severe trauma in Emergency Department XU Jiaping, HE Chao, LIN Xiaofeng, ZHANG Lixia, ZHU Zixian, KONG Li 2026, 40 (3):  261-266.  doi: 10.3969/j.issn.1003-9198.2026.03.008 Abstract ( 72 )   PDF (2026KB) ( 117 )   Save Objective To investigate the incidence and risk factors of in-hospital hypothermia in the elderly patients with severe trauma at Emergency Department, and to develop and validate a prediction model. Methods A retrospective analysis was conducted on 524 elderly patients with severe trauma admitted to Emergency Department of the Second Affiliated Hospital of Naval Medical University from September 2020 to September 2024. Patients were randomly divided into a modeling cohort and a validation cohort at a ratio of 7∶3. According to the occurrence of hypothermia, each cohort was further stratified into a hypothermia group and a non-hypothermia group. After univariate analysis of candidate variables, multivariate logistic regression was performed to identify independent risk factors. A nomogram-based prediction model for in-hospital hypothermia in the elderly patients with severe trauma was constructed accordingly. The model’s discrimination, calibration, and clinical applicability were evaluated by the receiver operating characteristic(ROC) curve, calibration curve, and decision curve analysis (DCA), respectively. Results Of the 367 patients in the modeling cohort, 65 developed hypothermia, with an incidence rate of 17.71% (65/367). Multivariate logistic regression identified core body temperature (CBT) on arrival, injury severity score (ISS), hemoglobin (Hb), fibrinogen (FIB), and lactate (Lac) were independent risk factors for in-hospital hypothermia (P<0.05). The area under the ROC curve (AUC) of the prediction model was 0.874(95%CI:0.782-0.945)in the modeling cohort and 0.863(95%CI: 0.721-0.914) in the validation cohort, which indicated good discrimination. Calibration curves showed close agreement between the predicted probabilities and actual occurrence of hypothermia in both datasets, demonstrating good calibration. DCA indicated substantial net benefit, supporting favorable clinical utility. Conclusions CBT, ISS, Hb, FIB, and Lac are independent risk factors for in-hospital hypothermia in the elderly patients with severe trauma at Emergency Department. The prediction model constructed based on these factors shows high discrimination and good clinical application value. References | Related Articles | Metrics

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Analysis of oral frailty prevalence and its influencing factors in hospitalized elderly patients with comorbidities ZHAO Xia, WANG Dongxu, LAI Xiaoxing, HUO Xiaopeng 2026, 40 (3):  267-271.  doi: 10.3969/j.issn.1003-9198.2026.03.009 Abstract ( 86 )   PDF (1043KB) ( 134 )   Save Objective To analyze the oral frailty prevalence and its influencing factors in hospitalized elderly patients with comorbidities. Methods A total of 253 elderly patients with comorbidities who were hospitalized in Department of Geriatric of five hospitals from October 2023 to January 2024 were enrolled in this study. Self-administered questionnaires were used to collect demographic data and perform comprehensive geriatric assessments. Oral frailty and oral health status were assessed by Oral Frailty Index-8(OFI-8) and Oral Health Assessment Tool (OHAT) respectively. Multivariate logistic regression analysis were used to analyze the influencing factors for oral frailty in elderly patients with comorbidities. Results A total of 253 cases were enrolled, and 74.7% (189/253) presented with oral frailty. Compared with non-oral frailty group,oral frailty group had older average age,lower number of remaining teeth, higher OHAT score, higher prevalence of using dentures, frailty, malnutrition, cognitively impaired, dependence in daily living (P<0.05). Multivariate logistic regression analysis showed denture use (OR=6.396, 95% CI:2.827-14.467, P<0.001), high OHAT score (OR=1.632, 95% CI:1.329-2.005, P<0.001), and frailty (OR=3.255, 95% CI:1.271-8.335, P=0.014) were risk factors for oral frailty in elderly patients with comorbidities. Conclusions Older patients with multiple comorbidities have a high incidence of oral frailty, which is associated with denture use, high OHAT scores, and frailty status. Precise clinical interventions should be enhanced to slow the progression of oral frailty. References | Related Articles | Metrics

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A randomized controlled study on Otago exercise program improving frailty status and physical function in elderly inpatients with frailty or pre-frailty FAN Tingyong, HUANG Zhaojing, PENG Chunlan, LIU Hong, WANG Yao, LIU Xin 2026, 40 (3):  272-277.  doi: 10.3969/j.issn.1003-9198.2026.03.010 Abstract ( 60 )   PDF (1066KB) ( 106 )   Save Objective To explore the effects of 12-week Otago exercise program (OEP) on frailty degree, fall risk, balance ability, gait function, lower limb function, and body composition in the elderly inpatients with frailty or pre-frailty. Methods A total of 110 elderly patients with frailty and pre-frailty who were hospitalized in West China Hospital of Sichuan University were enrolled in the study. They were randomly divided into an observation group and a control group, with 55 cases in each group. The control group received routine nursing care and health education; the observation group underwent 12 weeks of OEP in addition to routine nursing care. The scores of FRAIL scale, fall risk score, Tinetti score, Simple Physical Performance Bureau (SPPB) score and body composition index were observed and compared between the two groups before and after 12 weeks of intervention. Results After 12 weeks of intervention, the scores of FRAIL scale and fall risk and the fat content of the body in the observation group were significantly lower than those in the control group (P<0.05); The Tinetti score, SPPB score, and skeletal muscle mass in the observation group were higher than those in the control group (P<0.05). Conclusions OEP can effectively improve the frailty status of elderly patients with frailty or pre-frailty, reduce the risk of falls, and enhance balance ability and muscle mass, which is an effective comprehensive strategy for optimizing the management of frail elderly inpatients. References | Related Articles | Metrics

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Correlation between peripheral blood phosphate level and poor prognosis risk in elderly patients with acute infections ZHANG Liyan, FENG Xuefei, CHEN Lin, ZHAO Yonghua 2026, 40 (3):  278-282.  doi: 10.3969/j.issn.1003-9198.2026.03.011 Abstract ( 52 )   PDF (1106KB) ( 103 )   Save Objective To explore the correlation between peripheral blood phosphate level and poor prognosis risk in the elderly patients with acute infections. Methods A retrospective study was conducted on 246 elderly patients with acute infections admitted to ICU of Langfang People’s Hospital from January 2019 to December 2023, with a hospitalization duration exceeding 72 hours. Based on mortality outcomes during hospitalization, the patients were divided into a survival group and a mortality group. Peripheral blood phosphate level and clinical data were collected within 24 hours of admission. Multivariate logistic regression analysis was performed to identify risk factors for poor prognosis in elderly patients with acute infections. Patients were further stratified into low-, normal-, and high-level peripheral blood phosphate groups based on admission 24-hour phosphate level. Kaplan-Meier survival curve analysis was used to evaluate the relationship between peripheral blood phosphate level and in-hospital mortality, while a multivariate Cox regression model was employed to assess the prognostic value of peripheral blood phosphate level. Results Multivariate logistic regression analysis showed that Sequential Organ Failure Assessment (SOFA) score (OR=2.343), alanine aminotransferase (OR=1.079), procalcitonin (OR=8.668), ICU stay (OR=5.390), number of antibiotics types (OR=6.131) and peripheral blood phosphate level (OR=12.314) were risk factors for poor prognosis in elderly patients with acute infections. There was a statistically significant difference in the in-hospital mortality rate among the low-level group (n=41), normal-level group (n=77) and high-level group (n=128) (P<0.01). The in-hospital mortality rate was significantly higher in the high-level group (49 cases, 38.28%) compared to the normal-level group (12 cases, 15.58%) (P<0.01), but no statistically significant difference was observed when compared with the low-level group (11 cases, 26.83%) (P>0.05). Cox regression analysis revealed that elevated peripheral blood phosphate level was independently associated with increased in-hospital mortality after adjustment for confounding factors (P<0.05). Conclusions Peripheral blood phosphate level within 24 hours after admission shows great significance for evaluation of poor prognosis risk in the elderly patients with acute infections. References | Related Articles | Metrics

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Changes of intestinal flora in elderly patients with chronic kidney disease and their relationship with serum LRG1, SOCS-3, TXNIP LI Jianjun, YAN Junhui, SUN Yingchun, LIU Yushuo, YANG Zaibo, LU Fan 2026, 40 (3):  283-287.  doi: 10.3969/j.issn.1003-9198.2026.03.012 Abstract ( 71 )   PDF (1055KB) ( 104 )   Save Objective To analyze the changes of the levels of Bacteroides, Bifidobacterium, Lactobacillus, Akkermansia and Enterococcus in the intestinal flora of elderly patients with chronic kidney disease (CKD), and their correlations with the serum levels of rich leucine alpha-2 glycoprotein 1 (LRG1), suppressor of cytokine signaling 3 (SOCS-3), and thioredoxin-interacting protein (TXNIP). Methods A total of 200 elderly patients admitted to Qinhuangdao Hospital of Peking University Third Hospital from January 2022 to June 2024 were enrolled as the CKD group. Meantime, 85 volunteers who underwent health check-up were selected as the control group. The screening medium was used to detect the levels of Bacteroides, Bifidobacterium, Lactobacillus, Akkermansia, and Enterococcus. Enzyme-Linked Immuno Sorbent Assay kits were used to detect the serum levels of LRG1, SOCS-3, and TXNIP. Pearson correlation analysis was used to analyze the relationships between the intestinal flora and serum LRG1, SOCS-3 and TXNIP. The multiple logistic regression model was used to analyze the influencing factors for CKD in the elderly. Results Compared with the control group, the CKD group had higher levels of urinary protein, cystatin C, blood creatinine, blood urea nitrogen, LRG1, and TXNIP, and lower levels of hemoglobin, estimated glomerular filtration rate (eGFR) and SOCS-3 (P<0.01). In elderly CKD patients, the serum levels of LRG1 and TXNIP were negatively correlated with the levels of Bacteroides, Bifidobacterium, Lactobacillus, and Akkermannella, and positively correlated with the level of Enterococcus (all P<0.01); SOCS-3 level was positively correlated with the levels of Bacteroides, Bifidobacterium, Lactobacillus, and Akkermannella, and negatively correlated with the level of Enterococcus (all P<0.01). Multivariate logistic regression analysis revealed that cystatin C, eGFR, Bacteroides, Bifidobacterium, Lactobacillus, Akkermannella, Enterococcus, LRG1, SOCS-3, and TXNIP were significant risk factors for CKD occurrence in older adults (P<0.05). Conclusions The levels of Bacteroides, Bifidobacterium, Lactobacillus, Akkermannella, Enterococcus, as well as LRRG1, SOCS-3, and TXNIP are abnormally expressed in elderly patients with CKD. These serum indicators show correlations with gut microbiota and are all influencing factors of the occurrence of CKD. References | Related Articles | Metrics

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Application of ultrasound-guided popliteal artery and knee joint posterior capsule space nerve block combined with adductor canal block in elderly patients undergoing unilateral total knee arthroplasty YIN Chunwei, XU Jun, DONG Peilong, QU Fangfang 2026, 40 (3):  288-293.  doi: 10.3969/j.issn.1003-9198.2026.03.013 Abstract ( 82 )   PDF (1069KB) ( 117 )   Save Objective To evaluate the application effect of ultrasound-guided infiltration between the popliteal artery and capsule of the posterior knee (IPACK) combined with adductor canal block (ACB) in the elderly patients undergoing unilateral total knee arthroplasty (TKA). Methods A total of 118 elderly patients who underwent unilateral TKA from May 2023 to May 2025 were selected as the research subjects. They were randomly divided into the observation group and the control group using a random number table method, with 59 cases in each group. The control group received ultrasound-guided proximal ACB, while the observation group received IPACK on the basis of the control group. The anesthesia time, number of postoperative analgesic pump presses, sufentanil dosage, and time to get out of bed were recorded. The visual analog scale (VAS) scores were evaluated 3, 12, 24, and 48 h after surgery. Serum levels of inflammatory factors, oxidative stress indicators, knee joint range of motion (ROM), and quadriceps muscle strength before surgery and 48 h after surgery were compared between the two groups. The occurrence of adverse reactions was also observed. Results Compared with the control group, the time to get out of bed in the observation group was shorter. The number of postoperative analgesic pump presses, sufentanil dosage, VAS score, levels of inflammatory factors and oxidative stress indicators were significantly lower, while the knee joint ROM and quadriceps muscle strength were significantly higher in the observation group compared with those in the control group (all P＜0.05). There was no statistically significant difference in the incidence rate postoperative adverse reactions between the two groups (11.9% vs 8.5%, P＞0.05). Conclusions Ultrasound-guided IPACK combined with ACB can provide better analgesic effect, milder inflammatory and oxidative stress responses, and better knee joint function recovery compared with single proximal ACB in the elderly patients undergoing unilateral TKA, without increasing adverse reactions. References | Related Articles | Metrics

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Clinical utility of artificial intelligence in elderly patients with chronic obstructive pulmonary disease complicated by lung cancer WANG Ting, WANG Fei, WEN Hongxia 2026, 40 (3):  294-298.  doi: 10.3969/j.issn.1003-9198.2026.03.014 Abstract ( 52 )   PDF (1022KB) ( 105 )   Save This article reviews and summarizes the application scenarios and practical value of artificial intelligence (AI) in the screening, early diagnosis, auxiliary pathological diagnosis and histological classification, assessment of disease severity, and prognosis evaluation of elderly patients with chronic obstructive pulmonary disease (COPD) complicated by lung cancer. It indicates that AI, by integrating imaging techniques, machine learning and other technologies, can break through the limitations of traditional diagnosis and treatment, and significantly enhance the diagnostic accuracy. However, in current clinical applications, AI is confronted with issues including privacy concerns, ethical issues, and data standardization. In the future, it is necessary to further optimize databases and improve relevant standard systems to standardize and promote the application of AI in the diagnosis and treatment of elderly patients with COPD complicated by lung cancer. References | Related Articles | Metrics

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Advances of transfer RNA-derived fragments in age-related diseases DE Xiaomeng 2026, 40 (3):  299-303.  doi: 10.3969/j.issn.1003-9198.2026.03.015 Abstract ( 55 )   PDF (1027KB) ( 108 )   Save Transfer RNA-derived fragments (tRFs), generated through specific nuclease cleavage of transfer RNAs (tRNAs), represent a class of non-coding RNAs characterized by high evolutionary conservation, structural stability, and functional diversity. Their aberrant expression has been implicated in various pathological conditions, exhibiting regulatory mechanisms that are more intricate than those of microRNAs (miRNAs), which function through multiple pathways such as miRNA-like effect, translation regulating, and interactions with RNA-binding proteins. With the global trend of population aging, dysregulated expression of tRFs in aging-related pathologies, including neoplasms, neurodegenerative disorders, and metabolic syndromes, has garnered significant scientific attention. Furthermore, the remarkable stability of tRFs in bodily fluids makes them promising candidates for non-invasive biomarkers. This review summarizes the classification of tRFs and discusses their diagnostic and therapeutic potential in age-associated diseases, aiming to provide novel perspectives for advancing research in this emerging field. References | Related Articles | Metrics

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Gut microbiota-immune axis: a new perspective on the pathogenesis and therapeutic interventions for postmenopausal osteoporosis LIU Yue, XUE Qing, LIU Zekun, LIU Bing, QI Hao 2026, 40 (3):  304-308.  doi: 10.3969/j.issn.1003-9198.2026.03.016 Abstract ( 54 )   PDF (1034KB) ( 120 )   Save Postmenopausal osteoporosis (PMO) is a common skeletal disorder among postmenopausal women, significantly impacting their quality of life. Research indicates that the gut microbiota (GM) -immune axis influences the progression of PMO through multiple pathways, and in-depth studies in this area are expected to bring new breakthroughs in the prevention and treatment of osteoporosis. This paper systematically reviews the role of the GM-immune axis in PMO, with a focus on its molecular mechanisms, therapeutic potential, associated controversies, and prospects. Through a comprehensive analysis of relevant literature, we propose that the core direction for future research lies in the precise regulation of the GM-immune axis, such as designing specific probiotics, prebiotics, or drugs to target and modulate the composition and function of GM, thereby providing novel strategies for the treatment of osteoporosis and related diseases. Furthermore, combining GM modulation with traditional anti-osteoporosis medications is expected to enhance therapeutic efficacy and reduce adverse drug reactions. References | Related Articles | Metrics

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Search progress on the role and mechanism of enolase-1 in hematological malignancies DONG Jiahui, XU Jiaxuan, ZHOU Jiale, CHEN Bing 2026, 40 (3):  309-314.  doi: 10.3969/j.issn.1003-9198.2026.03.017 Abstract ( 55 )   PDF (1044KB) ( 127 )   Save Enolase-1 (ENO1) is a key metabolic enzyme in the glycolytic pathway, catalyzing the conversion of 2-phosphoglycerate (2-PGA) to phosphoenolpyruvate (PEP). It also possesses multiple functions, including plasminogen receptor and RNA-binding protein. In recent years, numerous studies have demonstrated that ENO1 is universally overexpressed in various solid tumors and hematologic malignancies, suggesting its biological and clinical significance in tumor development. Given the pivotal role of ENO1 in tumor metabolic reprogramming and malignant tumor progression, further investigation into its functions and mechanisms may provide a basis for identifying novel prognostic markers and therapeutic targets. This article will focus on reviewing the research progress, mechanisms of action, and molecular pathways of ENO1 in hematologic malignancies such as acute myeloid leukemia (AML), non-Hodgkin lymphoma (NHL), and multiple myeloma (MM), and introduce the potential application prospects of specific enolase inhibitors (ENOblock) in antitumor therapy. References | Related Articles | Metrics

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Research progress on the effects of sleep architecture disruption on Alzheimer’s disease XU Zhicong, DONG Jingde 2026, 40 (3):  315-319.  doi: 10.3969/j.issn.1003-9198.2026.03.018 Abstract ( 53 )   PDF (1034KB) ( 119 )   Save AD is a common neurodegenerative disease, characterized by progressive cognitive decline and gradually worsening neuropsychiatric symptoms. Studies have found that sleep structure disorder is one of the important risk factors of Alzheimer’s disease, which is closely related to the pathological formation of β-amyloid and tau proteins in the brain as well as the structural and functional changes of related brain regions. Meanwhile, sleep structure disorder can worsen cognitive dysfunction and play an important role in the progression of AD. Therefore, sleep intervention has the potential to serve as a future strategy for the early prevention and treatment of AD. References | Related Articles | Metrics

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Correlations between the peak systolic velocity variability of superior mesenteric artery and Gastrointestinal Dysfunction Score in elderly septic patients KAN Xiaohua, YU Chunxuan, XU Huaijin, YE Ziyu, QI Ping 2026, 40 (3):  320-324.  doi: 10.3969/j.issn.1003-9198.2026.03.019 Abstract ( 55 )   PDF (1056KB) ( 115 )   Save Objective To analyze the correlation between the peak systolic velocity (PSV) variability of superior mesenteric artery (SMA) and Gastrointestinal Dysfunction Score (GIDS) in the elderly septic patients, and to explore the predictive value of SMV-PSV variability on prognosis of the patients. Methods Sixty-six elderly septic patients admitted to Department of Critical Care Medicine, Nanjing First Hospital from October 2022 to March 2025 were enrolled in this study. The SMA-PSV values on the 1st, 2nd, 3rd day at Intensive Care Unit (ICU) were collected to calculate SMA-PSV variability. Baseline clinical data and GIDS on the 3rd and 7th day at ICU were also collected. The occurrence of feeding intolerance (FI) during enteral nutrition was recorded. The mortality rate of 28-day, ICU-free days, mechanical ventilation (MV)-free days, and continuous renal replacement therapy (CRRT)-free days were also documented. Results Patients were divided into two groups based on the median SMA-PSV variability, with 33 cases in each group. There were no statistically significant differences between the two groups in age, sex, body mass index, Acute Physiology and Chronic Health Evaluation score, Sequential Organ Failure Assessment score, SMV-PSV values from the 1st day to the 3rd day, CRRT-free days, and 28-day mortality (P>0.05). There were significant differences in GIDS on the 3rd and 7th day, ICU-free days, MV-free days, and the incidence rate of FI between the two groups (P<0.05 or P<0.01). Spearman correlation analysis showed that SMA-PSV variability was negatively correlated with GIDS on the 3rd and 7th day (r=-0.408, -0.425, all P<0.01), and positively correlated with ICU-free days and MV-free days (r=0.280, 0.267, P<0.05). Receiver operating characteristic (ROC) curve analysis indicated that the areas under the curve of SMA-PSV variability for predicting FI and 28-day mortality were 0.807 (P<0.01) and 0.731 (P<0.05), respectively. Conclusions SMA-PSV variability is associated with GIDS on the 3rd and 7th day at ICU, and could be a valuable predictor for prognosis in the elderly septic patients. References | Related Articles | Metrics