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Return to work in young and middle-aged colorectal cancer survivors:Factors influencing self-efficacy,fear,resilience,and financial toxicity

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World Journal of Gastroenterology 2025年第1期31卷 79-92页

作者： Dan Hu Yue Li Hua Zhang Lian-Lian Wang Wen-Wen Liu Xin Yang ming-zhao Xiao Hao-Ling Zhang juan Li Department of Nursing The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Department of Nursing National Clinical Research Center for Child Health and DisordersMinistry of Education Key Laboratory of Child Development and DisordersChildren’s Hospital of Chongqing Medical UniversityChongqing 400014China Department of Gastrointestinal Surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Department of Biomedical Science Advanced Medical and Dental InstituteUniversity Sains MalaysiaPenang 13200Malaysia Academic Affairs Office The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China

BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social ***,these survivors encounter significant challenges during their RTW ***,scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC *** To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy(RTW-SE),fear of progression(FoP),eHealth literacy(eHL),family resilience(FR),and financial toxicity(FT)on their RTW *** A cross-sectional investigation was adopted in this *** September 2022 to February 2023,a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in *** investigation utilized a general information questionnaire alongside scales assessing RTW-SE,FoP,eHL,FR,and *** analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors,Cox regression modeling and Kaplan-Meier survival analysis were *** A total of 43.54%of the participants successfully returned to work,with an average RTW time of 100 *** regression univariate analysis revealed that RTW-SE,FoP,eHL,FR,and FT were significantly different between the non-RTW and RTW groups(P<0.05).Furthermore,Cox regression multivariate analysis identified per capita family monthly income,job type,RTW-SE,and FR as independent influencing factors for RTW(P<0.05).CONCLUSION The RTW rate requires further *** levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC *** professionals should focus on modifiable factors,such as RTW-SE and FR,to design targeted RTW support programs,thereby facilitating their timely reintegration into mainstream society.

关键词： Return to work Colorectal neoplasms Return-to-work self-efficacy Fear of progression Family resilience Financial toxicity

Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey

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Military Medical Research 2020年第4期7卷 418-429页

作者： Ying-Hui Jin Qiao Huang Yun-Yun Wang Xian-Tao Zeng Li-Sha Luo Zhen-Yu Pan Yu-Feng Yuan Zhi-Min Chen Zhen-Shun Cheng Xing Huang Na Wang Bing-Hui Li Hao Zi ming-juan zhao Lin-Lu Ma Tong Deng Ying Wang Xing-Huan Wang Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan University169 Donghu RoadWuchang DistrictWuhan 430071HubeiChina Department of Evidence-Based Medicine and Clinical Epidemiology The Second Clinical CollegeWuhan UniversityWuhan 430071HubeiChina Division of Medical Affairs Zhongnan Hospital of Wuhan UniversityWuhan 430071HubeiChina Department of Hepatopancreatobiliary Surgery Zhongnan Hospital of Wuhan UniversityWuhan 430071HubeiChina Division of Social and Medical Development Zhongnan Hospital of Wuhan UniversityWuhan 430071HubeiChina Department of Respiratory Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071HubeiChina School of Nursing and Health Henan UniversityKaifeng 475000HenanChina Institute of Evidence-Based Medicine and Knowledge Translation Henan UniversityKaifeng 475000HenanChina Department of Infectious Diseases Zhongnan Hospital of Wuhan UniversityWuhan 430071HubeiChina Leishenshan Hospital in Wuhan Wuhan 430200HubeiChina

Background:Many healthcare workers were infected by coronavirus disease 2019(COVID-19)early in the epidemic posing a big challenge for epidemic ***,this study aims to explore perceived infection routes,influencing factors,psychosocial changes,and management procedures for COVID-19 infected healthcare ***:This is a cross-sectional,single hospital-based *** recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29,*** participants completed a validated *** consent was obtained from all *** causes of infection,infection prevention,control knowledge and behaviour,psychological changes,symptoms and treatment were ***:Finally,103 professional staff with COVID-19 finished the questionnaire and was included(response rate:98.1%).Of them,87 cases(84.5%)thought they were infected in working environment in hospital,one(1.0%)thought their infection was due to the laboratory environment,and 5(4.9%)thought they were infected in daily life or community *** of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors ***-three(41.8%)thought their infection was related to protective equipment,utilization of common equipment(masks and gloves).The top three first symptoms displayed before diagnosis were fever(41.8%),lethargy(33.0%)and muscle aches(30.1%).After diagnosis,88.3%staff experienced psychological stress or emotional changes during their isolation period,only 11.7%had almost no emotional ***(Umifenovir;an anti-influza drug;69.2%)was the drug most commonly used to target infection in mild and moderate ***:The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected *** psychological intervention is necessa

关键词： COVID-19 SARS-CoV-2,2019-nCoV Healthcare worker Healthcare professional Infection transmission route Psychosocial status

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快速筛选优胜者的最优策略

数学的实践与认识 2001年第3期31卷 264-267页

作者：宋明娟刘照升黑龙江科技学院数学教研室

“快速遴选优胜者”一文 (简称文 [1 ])是刊登在《数学的实践与认识》96.4上的一份关于 MCM96B题的答卷 .它虽然给出了正确选出优胜者的方案 ,但它无法证明此方案是最优的 ,而且对于裁判数额等参数只给出了粗略的估计 .针对上述问题 ,... 详细信息

“快速遴选优胜者”一文 (简称文 [1 ])是刊登在《数学的实践与认识》96.4上的一份关于 MCM96B题的答卷 .它虽然给出了正确选出优胜者的方案 ,但它无法证明此方案是最优的 ,而且对于裁判数额等参数只给出了粗略的估计 .针对上述问题 ,本文对 MCM96B题又作了详尽的分析 ,通过论证给出了快速遴选优胜者的最优方案 ,而且给出了裁判数额与阅卷经费等参数的最优配置模型 .

关键词：标准分数评判单位数学建模竞赛最优策略最优配置模型

Salsolinol as an RNA m~6A methylation inducer mediates dopaminergic neuronal death by regulating YAP1 and autophagy

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Neural Regeneration Research 2025年第3期20卷 887-899页

作者： Jianan Wang Yuanyuan Ran Zihan Li Tianyuan zhao Fangfang Zhang juan Wang Zongjian Liu Xuechai Chen Beijing International Science and Technology Cooperation Base for Antiviral Drugs College of Chemistry and LifeBeijing University of TechnologyBeijingChina Department of Rehabilitation Beijing Rehabilitation HospitalCapital Medical UniversityBeijingChina

Salsolinol(1-methyl-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinoline,Sal)is a catechol isoquinoline that causes neurotoxicity and shares structural similarity with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine,an environmental toxin that causes Parkinson's ***,the mechanism by which Sal mediates dopaminergic neuronal death remains *** this study,we found that Sal significantly enhanced the global level of N~6-methyladenosine(m~6A)RNA methylation in PC12 cells,mainly by inducing the downregulation of the expression of m~6A demethylases fat mass and obesity-associated protein(FTO)and alk B homolog 5(ALKBH5).RNA sequencing analysis showed that Sal downregulated the Hippo signaling *** m~6A reader YTH domain-containing family protein 2(YTHDF2)promoted the degradation of m~6A-containing Yes-associated protein 1(YAP1)mRNA,which is a downstream key effector in the Hippo signaling ***,downregulation of YAP1 promoted autophagy,indicating that the mutual regulation between YAP1 and autophagy can lead to *** findings reveal the role of Sal on m~6A RNA methylation and suggest that Sal may act as an RNA methylation inducer mediating dopaminergic neuronal death through YAP1 and *** results provide greater insights into the neurotoxic effects of catechol isoquinolines compared with other studies and may be a reference for assessing the involvement of RNA methylation in the pathogenesis of Parkinson's disease.

关键词： ALKBH5 autophagy FTO Hippo pathway m~6A Parkinson's disease RNA methylation salsolinol YAP1 YTHDF2

Regulation and function of endoplasmic reticulum autophagy in neurodegenerative diseases

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Neural Regeneration Research 2025年第1期20卷 6-20页

作者： Xiu-Yun zhao De-En Xu ming-Lei Wu Ji-Chuan Liu Zi-Ling Shi Quan-Hong Ma Department of Neurology and Clinical Research Center of Neurological Disease the Second Affiliated Hospital of Soochow UniversitySuzhouJiangsu ProvinceChina Institute of Neuroscience&Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases Soochow UniversitySuzhouJiangsu ProvinceChina Department of Neurology Jiangnan University Medical CenterWuxiJiangsu ProvinceChina

The endoplasmic reticulum,a key cellular organelle,regulates a wide variety of cellular *** reticulum autophagy,one of the quality control systems of the endoplasmic reticulum,plays a pivotal role in maintaining endoplasmic reticulum homeostasis by controlling endoplasmic reticulum turnover,remodeling,and *** this review,we briefly describe the endoplasmic reticulum quality control system,and subsequently focus on the role of endoplasmic reticulum autophagy,emphasizing the spatial and temporal mechanisms underlying the regulation of endoplasmic reticulum autophagy according to cellular *** also summarize the evidence relating to how defective or abnormal endoplasmic reticulum autophagy contributes to the pathogenesis of neurodegenerative *** summary,this review highlights the mechanisms associated with the regulation of endoplasmic reticulum autophagy and how they influence the pathophysiology of degenerative nerve *** review would help researchers to understand the roles and regulatory mechanisms of endoplasmic reticulum-phagy in neurodegenerative disorders.

关键词： autophagy endoplasmic reticulum endoplasmic reticulum autophagy endoplasmic reticulum quality control system endoplasmic reticulum receptors endoplasmic reticulum-associated degradation neurodegeneration neurodegenerative disease selective autophagy unfolded protein response

Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline(updated version)

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Military Medical Research 2020年第3期7卷 249-282页

作者： Ying-Hui Jin Qing-Yuan Zhan Zhi-Yong Peng Xue-Qun Ren Xun-Tao Yin Lin Cai Yu-Feng Yuan Ji-Rong Yue Xiao-Chun Zhang Qi-Wen Yang Jianguang Ji Jian Xia Yi-Rong Li Fu-Xiang Zhou Ya-Dong Gao Zhui Yu Feng Xu ming-Li Tu Li-ming Tan Min Yang Fang Chen Xiao-Ju Zhang Mei Zeng Yu Zhu Xin-Can Liu Jian Yang Dong-Chi zhao Yu-Feng Ding Ning Hou Fu-Bing Wang Hao Chen Yong-Gang Zhang Wei Li Wen Chen Yue-Xian Shi Xiu-Zhi Yang Xue-Jun Wang Yan-Jun Zhong ming-juan zhao Bing-Hui Li Lin-Lu Ma Hao Zi Na Wang Yun-Yun Wang Shao-Fu Yu Lu-Yao Li Qiao Huang Hong Weng Xiang-Ying Ren Li-Sha Luo Man-Ru Fan Di Huang Hong-Yang Xue Lin-Xin Yu Jin-Ping Gao Tong Deng Xian-Tao Zeng Hong-Jun Li Zhen-Shun Cheng Xiao-Mei Yao Xing-Huan Wang Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China National Clinical Research Center for Respiratory Diseases China-Japan Friendship HospitalBeijing 100029China Department of Pulmonary and Critical Care Medicine China-Japan Friendship HospitalBeijing 10029China Leishenshan Hospital in Wuhan Wuhan 430200China Department of Critical Care Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Institutes of Evidence-based Medicine and Knowledge Translation Henan UniversityKaifeng 475000HenanChina Department of Medical Imaging Guizhou Provincial People’s HospitalGuiyang 550002China Departments of Orthopedics Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Hepatobiliary Surgery Zhongnan Hospital of Wuhan UniversityWuhan 430071China National Clinical Research Center for Geriatrics West China Hospital of Sichuan UniversityChengdu 610041China Department of Geriatrics West China Hospital of Sichuan UniversityChengdu 610041China Department of Radiology Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Clinical Laboratory Peking Union Medical College Hospital(PUMCH)Peking Union Medical CollegeChinese Academy of Medical Sciences(CAMS)Beijing 100730China Center for Primary Health Care Research Lund University and Region Skåne25002 MalmöSweden Emergency Center Zhongnan Hospital of Wuhan UniversityWuhan 403371China Department of Allergology Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Radiation and Medical Oncology Zhongnan Hospital of Wuhan UniversityWuhan 43071China Department of Critical Care Medicine Renmin Hospital of Wuhan UniversityWuhan 430060China Department of Emergency Medicine and Chest Pain Center Qilu Hospital of Shandong UniversityJinan 250002China Department of Respiratory and Critical Care Medicine Suizhou Central HospitalHubei University of MedicineSuizhou 441300HubeiChina Department of Clinic Pharmacy Second People’s Hospital of Huaihua Ci

The novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is the cause of a rapidly spreading illness,coronavirus disease 2019(COVID-19),affecting more than seventeen million people around the *** and treatment guidelines for clinicians caring for patients are *** the early stage,we have issued"A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infected pneumonia(standard version)";now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based *** formed a working group of clinical experts and *** steering group members proposed 29 questions that are relevant to the management of COVID-19 covering the following areas:chemoprophylaxis,diagnosis,treatments,and discharge *** searched the literature for direct evidence on the management of COVID-19,and assessed its certainty generated recommendations using the Grading of Recommendations,Assessment,Development and Evaluation(GRADE)*** were either strong or weak,or in the form of ungraded consensus-based ***,we issued 34 *** them,6 were strong recommendations for,14 were weak recommendations for,3 were weak recommendations against and 11 were ungraded consensus-based *** covered topics of chemoprophylaxis(including agents and Traditional Chinese Medicine(TCM)agents),diagnosis(including clinical manifestations,reverse transcription-polymerase chain reaction(RT-PCR),respiratory tract specimens,IgM and IgG antibody tests,chest computed tomography,chest X-ray,and CT features of asymptomatic infections),treatments(including lopinavirritonavir,umifenovir,favipiravir,interferon,remdesivir,combination of antiviral drugs,hydroxychloroquine/chloroquine,interleukin-6 inhibitors,interleukin-1 inhibitors,glucocorticoid,qingfei paidu decoction,lianhua qingwen granules/capsules,convalescent plasma,lung

关键词： COVID-19 SARS-CoV-2 Recommendation Chemoprophylaxis Diagnosis Treatment Discharge management Traditional Chinese medicine guideline

A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV) infected pneumonia(standard version)

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Military Medical Research 2020年第1期7卷 1-22页

作者： Ying-Hui Jin Lin Cai Zhen-Shun Cheng Hong Cheng Tong Deng Yi-Pin Fan Cheng Fang Di Huang Lu-Qi Huang Qiao Huang Yong Han Bo Hu Fen Hu Bing-Hui Li Yi-Rong Li Ke Liang Li-Kai Lin Li-Sha Luo Jing Ma Lin-Lu Ma Zhi-Yong Peng Yun-Bao Pan Zhen-Yu Pan Xue-Qun Ren Hui-Min Sun Ying Wang Yun-Yun Wang Hong Weng Chao-Jie Wei Dong-Fang Wu Jian Xia Yong Xiong Hai-Bo Xu Xiao-Mei Yao Yu-Feng Yuan Tai-Sheng Ye Xiao-Chun Zhang Ying-Wen Zhang Yin-Gao Zhang Hua-Min Zhang Yan zhao ming-juan zhao Hao Zi Xian-Tao Zeng Yong-Yan Wang Xing-Huan Wang 无 Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Institute of Hospital Management Wuhan UniversityWuhan 430071China Department of Respiratory Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Pharmacy Zhongnan Hospital of Wuhan UniversityWuhan 430071China Institute of Evidence-Based Medicine and Knowledge Translation Henan UniversityKaifeng 475000China China Academy of Chinese Medical Sciences Beijing 100700China China Center for Evidence Based Traditional Chinese Medicine(CCEBTCM) Beijing 100700China Department of Critical Care Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Clinical Laboratory Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Infectious Diseases Zhongnan Hospital of Wuhan UniversityWuhan 430071China Division of Medical Affairs Zhongnan Hospital of Wuhan UniversityWuhan 430071China Division of Nursing Affairs Zhongnan Hospital of Wuhan UniversityWuhan 430071China Office of Nosocomial Infection Control Zhongnan Hospital of Wuhan UniversityWuhan 430071China Emergency Center Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Radiology Zhongnan Hospital of Wuhan UniversityWuhan 430071China Department of Health Research Methods Evidenceand ImpactMcMaster UniversityHamiltonON L8S 4L8Canada Department of Traditional Chinese Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Global Health Institute Wuhan UniversityWuhan 430072China the Zhongnan Hospital of Wuhan University Novel Coronavirus Management and Research Team Evidence-Based Medicine Chapter of China International Exchange and Promotive Association for Medical and Health Care(CPAM)

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

关键词： 2019 novel coronavirus 2019-nCoV Respiratory disease Pneumonia Infectious diseases Rapid advice guideline Clinical practice guideline Evidence-based medicine

Laser direct writing of flexible multifunctional airflow sensors on the Kevlar fabric

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Nano Research 2025年第1期18卷 443-454页

作者： Wei Wang Zi-Qing Chen Yong-Qi Li Yu-Long Wang Mei-Chen Liu Yun-Bo Ruan Yang Zhang Shu-juan Liu Qiang zhao College of Electronic and Optical Engineering and College of Flexible Electronics(Future Technology) Nanjing University of Posts and TelecommunicationsNanjing 210023China State Key Laboratory of Organic Electronics and Information Displays and Jiangsu Key Laboratory for Biosensors Institute of Advanced Materials(IAM)Nanjing University of Posts and TelecommunicationsNanjing 210023China Zhe Jiang Topsun Logistic Control CO. LTD.Yuhuan 317600China Department of Rehabilitation Medicine School of Acupuncture-Moxibustion and Tuina and School of Health Preservation and RehabilitationNanjing University of Chinese MedicineNanjing 210023China

The growing interest in flexible devices has emerged as a global trend due to their advantages in flexibility,lightweight structure,and wearability,addressing the limitations of traditional *** wearable airflow sensors have been previously reported,the development of flexible fabric-based airflow sensors capable of functioning in environments with open flames—critical for fire rescue operations—has yet to be explored,largely due to the poor fire resistance of conventional *** this work,we first present a flexible,wearable,and multifunctional airflow sensor with excellent fire-resistant properties,fabricated through a simple direct laser writing *** sensor maintains airflow detection capabilities even in the presence of open ***,the fabrication of fabric-based sensors involves complex procedures such as carbon materials doping or vapor-phase deposition,leading to lengthy preparation cycles and high ***,fabric-based devices are inherently prone to *** address these challenges,we introduce twice-vertical laser-induced graphene(TVLIG)as a sensitive and reliable component for fire-resistant airflow *** resulting TVLIG/Kevlar fabric can be integrated into various garments,particularly protective suits,to form sensitive and fire-resistant airflow sensors capable of detecting airflow velocity and direction in both two-dimensional(2D)and three-dimensional(3D)spaces during fire ***,the TVLIG patterns can be expanded to multifunctional platforms,such as glucose detection for injured individuals,offering further applications in rescue *** functional expansion reduces the burden on rescue personnel and streamlines device *** its outstanding sensing capabilities,fire resistance,and expandability,the developed flexible airflow sensor shows great potential for various real-world rescue scenarios,promising advancements in wearable sensing technology for rescue enginee

关键词： flexible airflow sensor direct laser writing twice-vertical laser-induced graphene fire accident rescue Kevlar fabric

Mediating role of health literacy in the relationship between social isolation and psychological distress among pre-frail older adults

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World Journal of Psychiatry 2025年第1期15卷 137-144页

作者： juan Fang Li-Hui Li ming-Qian He Yue Ji Dong-Yan Lu Li-Bing Zhang Jin-Lan Yao School of Medicine Huzhou UniversityHuzhou 313000Zhejiang ProvinceChina

BACKGROUND Frailty has become a significant public health *** recent increase in the number of frail older adults has led to increased attention being paid to psycho-logical care services in *** social isolation of pre-frail older adults can impact their psychological *** To explore the mediating effect of health literacy between social isolation and psychological distress among communitydwelling older adults with *** This descriptive cross-sectional study was conducted with 254 pre-frail older individuals aged 60 years and *** isolation,health literacy,and psycholo-gical distress were comprehensively measured using the Lubben Social Network Scale-6,12-item Short-Form Health Literacy Questionnaire,and the Kessler Psy-chological Distress *** were evaluated using the SPSS 27.0 package program and the PROCESS macro *** statistical analyses,correlation analyses,and bootstrap mediation tests were used to assess associations between the *** The results showed that social isolation had an effect on health literacy among pre-frail older adults(β=0.240,P<0.001),social isolation impact on psycho-logical distress pre-frail older adults(β=-0.415,P<0.001);health literacy was identified effect on psychological distress among pre-frail older persons(β=-0.307,P<0.001).Health literacy partially mediated the relationship between social isolation and psychological distress among community-dwelling older adults with pre-frailty,with a mediation effect of-0.074,accounting for 17.83%of the total effect.

关键词： Frail Ageing Psychological distress Health literacy Social isolation