Background: The incidence of NAFLD is increasing. Preclinical evidences indicate that modulation of the gut microbiome could be a promising target in nonalcoholic fatty liver disease.Method: A systematic review and network meta-analysis was conducted to compare the effect of probiotics, synbiotics, prebiotics, fecal microbiota transplant, and antibiotics on the liver-enzyme, metabolic effects and liver-specific in patients with NAFLD. The randomized controlled trails (RCTs), limited to English language were searched from database such as Pubmed, Embase, Web of science and Cochrane Library from inception to November 2024. Review Manager 5.3 was used to to draw a Cochrane bias risk. Inconsistency test and publication-bias were assessed by Stata 14.0. Random effect model was used to assemble direct and indirect evidences. The effects of the intervention were presented as mean differences with 95% confidence interval.Results: A total of 1921 patients from 37 RCTs were eventually included in our study. 23 RCTs evaluated probiotics, 10 RCTs evaluated synbiotics, 4 RCTs evaluated prebiotics, 3 RCTs evaluated FMT and one RCT evaluated antibiotics. Probiotics and synbiotics were associated with a significantly reduction in alanine aminotransferase [ALT, (MD: −5.09; 95%CI: −9.79, −0.39), (MD: −7.38, 95CI%: −11.94, −2.82)] and liver stiffness measurement by elastograph [LSM, (MD: −0.37;95%CI: −0.49, −0.25), (MD: −1.00;95%CI: −1.59, −0.41)]. In addition to, synbiotics was superior to probiotics in reducing LSM. Synbiotics was associated with a significant reduction of Controlled Attenuation Parameter [CAP, (MD: −39.34; 95%CI: −74.73, −3.95)]. Both probiotics and synbiotics were associated with a significant reduction of aspartate transaminase [AST, (MD: −7.81; 95%CI: −15.49, −0.12), (MD: −13.32; 95%CI: −23, −3.64)]. Probiotics and Allogenic FMT was associated with a significant reduction of Homeostatic Model Assessment for Insulin Resistance [HOMA-IR, (MD: −0.7, 95%CI: −1.26, −0.15), (MD: −1.8, 95%CI: −3.53, − 0.07)]. Probiotics was associated with a significant reduction of body mass index [BMI, MD: −1.84, 95%CI: −3.35, −0.33].Conclusion: The supplement of synbiotics and probiotics maybe a promising way to improve liver-enzyme, LSM, and steatosis in patients with NAFLD. More randomized controlled trials are needed to determine the efficacy of FMT and antibiotics on NAFLD. And the incidence of adverse events of MTTs should be further explored.Systematic review registration: https://www.crd.york.ac.uk/prospero/, CRD42023450093.

Purpose: This study aimed to explore the core factors influencing participation in the “shared elderly care” model among urban Chinese seniors and propose targeted solutions to address the challenges of an aging society. Methods: A mixed-methods study was conducted. A questionnaire survey was conducted among 533 seniors in Zhengzhou. Data on demographic characteristics, health literacy, and environmental factors were analyzed using four machine learning algorithms: logistic regression, random forest, K-nearest neighbor, and support vector machine. Approximately 3 years later, qualitative validation was conducted through six focus group interviews. Themes were extracted using Colaizzi phenomenological analysis, and the predictions were validated. Results: Five hundred valid questionnaires were collected. The machine learning algorithm results showed that the random forest model had the best predictive performance (AUC = 0.652), revealing that e-health literacy and policy awareness were key drivers (jointly explaining 24.1% of the variance in participation intention), with age, environmental sensitivity, and social influence as significant cofactors. Qualitative analysis confirmed that technology usability and a sense of social belonging were core experiential elements of deep participation. Conclusion: Addressing the primary obstacles of digital literacy gaps and limited technological accessibility, we propose three countermeasures: increasing publicity and promotion of shared elderly care models; conducting community digital health literacy training; and increasing resource allocation to precisely match needs, thus providing an implementation path for building an inclusive shared elderly care ecosystem.

O-GlcNAc modification is a glycosylation modification that is commonly observed in nuclear and organelle proteins of cells. In recent years, several studies have shown that O-GlcNAc modification plays an important regulatory role in immune cells, which regulates their activity and function and inhibits inflammatory responses. It also enhances immune cells recognition and clearance of pathogens, and improves the host´s antibacterial immune response. Sepsis is a systemic inflammatory response to infection, whose development and progression are regulated by the immune system. therefore. In the present review, we will discuss the mechanism of O-GlcNAc modification in immune cells and its potential therapeutic value in sepsis, which will be expected to provide new insights and targets for the treatment of sepsis.

Older adults who have undergone percutaneous coronary intervention (PCI) face a heightened risk of major adverse cardiovascular and cerebrovascular events (MACCE). While physical activity is known to lower MACCE risk, improve long-term prognosis, and enhance quality of life, studies consistently report inadequate physical activity levels in this population. The relationships and potential mechanisms linking physical activity with its influencing factors remain incompletely understood, limiting the development of effective interventions. Therefore, this study aimed to identify key factors affecting physical activity and examine their underlying pathways in elderly post-PCI patients. A cross-sectional study was conducted in Zhengzhou, China, from December 2024 to May 2025. Four hundred and eighty elderly individuals aged over 60 years who had undergone PCI completed the International Physical Activity Questionnaire-Long Form, Coronary Heart Disease Patients’ Rehabilitation Exercise Questionnaire, Cardiac Rehabilitation Exercise Self-efficacy Scale, 7-item Generalized Anxiety Disorder Scale, Patient Health Questionnaire-9, and a socio-demographic data sheet. Data analysis was performed using SPSS 25.0 for descriptive statistics, Spearman correlation, and binary logistic regression. Mediation analysis was conducted via structural equation modeling (SEM) in MPLUS 8.3. 52.90% of participants did not meet the recommended physical activity guidelines. Physical activity self-efficacy significantly mediated the relationship between physical activity knowledge and physical activity (β = 0.730, P < 0.001). Although anxiety and depression symptoms were not directly associated with physical activity (P > 0.05), they exerted significant indirect negative effects through reduced physical activity self-efficacy(anxiety: β=-0.287, 95% confidence interval [-0.553,-0.118]; depression: β=-0.394, 95% confidence interval [-0.683,-0.204]). This study found that the prevalence of being physically inactive was high in elderly adults after PCI. The present study’s findings suggested that healthcare providers should try to enhance physical activity self-efficacy, knowledge, and positive emotions of elderly adults after PCI to improve their physical activity with a focus on physical activity self-efficacy. Registry: The Central China Cardiovascular Hospital in Fuwai, TRN: 2025 No. 29, Registration date: 12 March 2025. Registry: The First Affiliated Hospital of Henan University of Traditional Chinese Medicine’s Ethics Committee, TRN:2025HL-030-01, Registration date: 13 February 2025.

Background: Alzheimer’s disease patients often experience cognitive decline during disease progression, impacting their quality of life. Photostimulation therapy, as a non-invasive neuromodulation method, has been increasingly used in the adjunctive management of Alzheimer’s patients in recent years. Despite the increasing number of related studies, a systematic review and comprehensive evaluation are still lacking. Objective: This review systematically summarizes the current application of photostimulation therapy in Alzheimer’s disease patients, outlines its implementation characteristics, outcome indicators, intervention effects and mechanisms of action in cognitive function intervention, and identifies evidence gaps in current research. Methods: Relevant studies were systematically retrieved from PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, CBM, WanFang Database, and VIP Database from their inception to January 5, 2026. Data from the included literature were extracted and analyzed. Results: A total of 21 studies were included. Photostimulation therapy primarily includes light stimulation, 40 Hz rhythm-related light stimulation, photobiological modulation and their combined therapies, as well as transcatheter intracranial laser therapy. This therapy has potential value in improving cognitive function or delaying cognitive decline and may affect sleep/rhythm and behavioral symptoms. Its potential mechanisms involve neural oscillation modulation, circadian rhythm reconstruction, and improvement of synaptic plasticity. However, existing evidence exhibits significant heterogeneity in study design, sample size, intervention parameters, and outcome indicators. Conclusion: Photostimulation therapy has shown promising potential in cognitive function intervention for Alzheimer’s disease patients, but current evidence is still largely in the exploratory stage. Future research should focus on multi-center, large-sample, and standardized studies to determine the optimal parameter combinations for different stages and scenarios, and to optimize individualized intervention protocols to improve clinical efficacy. Plain Language Summary: Investigates the effectiveness and limitations of photostimulation therapy in improving cognitive function in Alzheimer’s disease patients and summarizes its mechanisms of action. The results show that photostimulation therapy shows promising potential in improving cognitive function in Alzheimer’s patients, and its mechanism of action involves multiple aspects. However, existing evidence exhibits heterogeneity in terms of study design and sample size, necessitating future multi-center, large-sample, and standardized studies. Infographic on photostimulation therapy for Alzheimer’s, covering introduction, literature screening and conclusions.

Background: Professional identity is an important indicator of career development and workforce stability among nursing undergraduates. However, the pathways through which positive psychological resources are associated with professional identity remain unclear. This study aimed to examine the mediating role of career resilience in the relationship between trait positive empathy and professional identity among nursing undergraduates. Methods: A cross-sectional survey was conducted among 617 nursing undergraduates from a university in Henan Province, China. Participants completed the Trait Positive Empathy Scale (TPES), Career Resilience Scale (CRS), and Professional Identity Questionnaire for Nursing Students (PIQN). Pearson correlation analysis was used to examine the relationships among the variables. The mediating role of career resilience was tested using PROCESS Model 4 with 5,000 bootstrap resamples. Results: The total scores of trait positive empathy, career resilience, and professional identity were 28.07 ± 4.59, 19.86 ± 3.30, and 60.72 ± 10.44, respectively. Trait positive empathy was positively correlated with career resilience ( r = 0.654, p < 0.001) and professional identity ( r = 0.486, p < 0.001). Career resilience was positively correlated with professional identity ( r = 0.557, p < 0.001). Mediation analysis indicated that career resilience partially explained the relationship between trait positive empathy and professional identity. More than half of this association was explained through career resilience, with the indirect association accounting for 56.23% of the total association. Conclusion: Trait positive empathy was directly associated with professional identity and indirectly associated with professional identity through career resilience among nursing undergraduates. These findings highlight the importance of cultivating positive psychological resources and career resilience to support professional identity development in nursing education.