[Objective]To summarize Professor GAO Xiufei's clinical experience of using Amorphophalli Rhizoma to prevent recurrence and metastasis of breast cancer,and to relieve obesity and dyslipidemia in patients with breast cancer.[Methods]By learning from the outpatient clinic and collating the medical records,Professor GAO's clinical experience of using Amorphophalli Rhizoma on breast cancer patients with obesity and dyslipidemia was analyzed,accompanied with a medical case demonstration.[Results]Medication-food homologous Amorphophalli Rhizoma(Konjac)has the effect of dissipating phlegm,dissipating accumulation and relieving pain to dissipate the accumulation of cancer poison,Qi and blood stasis,so as to prevent breast cancer recurrence and metastasis,also reduce weight and lipids.GU's surgery believes that the accumulation of phlegm and blood stasis and toxin is the basic pathogenesis of the recurrence and metastasis of breast cancer.Professor GAO believes that the pathogenesis of obesity is mainly spleen dysfunction,phlegm and blood stasis obstruction,which is the same as breast cancer.Inheriting GU's surgical diagnosis and treatment experience,Professor GAO uses Amorphophalli Rhizoma to treat the recurrence of cancer toxin by supplementing Qi,invigorating the spleen and strengthening the body,and innovates the combination of Amorphophalli Rhizoma and invigorating spleen and Qi drugs to treat the patients with spleen deficiency,phlegm dampness and obesity of breast cancer,so as to achieve the same treatment of different diseases.The attached medical case was the deficiency of Qi and Yin after mastocarcinoma surgery,which was treated by nourishing Qi and Yin,detoxifying and dispersing knots,insisted on taking medicine,and finally achieved good results.[Conclusion]Professor GAO is adept at using Amorphophalli Rhizoma to treat breast cancer and relieve obesity and dyslipidemia in breast cancer patients.Professor GAO has inheriting and innovative ideas,and her clinical experience is worth learning and promoting.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

[Objective]To summarize Professor GAO Xiufei's clinical experience of using Amorphophalli Rhizoma to prevent recurrence and metastasis of breast cancer,and to relieve obesity and dyslipidemia in patients with breast cancer.[Methods]By learning from the outpatient clinic and collating the medical records,Professor GAO's clinical experience of using Amorphophalli Rhizoma on breast cancer patients with obesity and dyslipidemia was analyzed,accompanied with a medical case demonstration.[Results]Medication-food homologous Amorphophalli Rhizoma(Konjac)has the effect of dissipating phlegm,dissipating accumulation and relieving pain to dissipate the accumulation of cancer poison,Qi and blood stasis,so as to prevent breast cancer recurrence and metastasis,also reduce weight and lipids.GU's surgery believes that the accumulation of phlegm and blood stasis and toxin is the basic pathogenesis of the recurrence and metastasis of breast cancer.Professor GAO believes that the pathogenesis of obesity is mainly spleen dysfunction,phlegm and blood stasis obstruction,which is the same as breast cancer.Inheriting GU's surgical diagnosis and treatment experience,Professor GAO uses Amorphophalli Rhizoma to treat the recurrence of cancer toxin by supplementing Qi,invigorating the spleen and strengthening the body,and innovates the combination of Amorphophalli Rhizoma and invigorating spleen and Qi drugs to treat the patients with spleen deficiency,phlegm dampness and obesity of breast cancer,so as to achieve the same treatment of different diseases.The attached medical case was the deficiency of Qi and Yin after mastocarcinoma surgery,which was treated by nourishing Qi and Yin,detoxifying and dispersing knots,insisted on taking medicine,and finally achieved good results.[Conclusion]Professor GAO is adept at using Amorphophalli Rhizoma to treat breast cancer and relieve obesity and dyslipidemia in breast cancer patients.Professor GAO has inheriting and innovative ideas,and her clinical experience is worth learning and promoting.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

With the aging population in China,health issues among the elderly are becoming increasingly prominent,leading to a rapidly growing demand for health interventions for the elderly.Exergames are one of the important emerging methods in the field of health interventions for the elderly,widely used and yielding positive results.While research on exergames is well-established abroad,it is still in its infancy in China,lacking reports on the types,interaction forms,intervention content,application status,and effectiveness of exergames.Exergames are suitable for widespread use among the elderly in China,and there is a need to accelerate the development and application of exergames in the field of health interventions for the elderly in China.

One of the important causes of developmental epileptic encephalopathy (DEE) is the mutation of ion channel genes, including the mutation of the CACNA1E gene. CACNA1E-related DEE cases were first reported in 2018.The mutation types include new missense mutations, nonsense mutations and frameshift mutations, but the correlation between mutation sites and types with the phenotype of DEE is not clear.This review aims to summarize the reported CACNA1E-related DEE cases, and explore the correlation between the clinical phenotype of CACNA1E-related DEE and gene mutation sites and mutation types.Meanwhile, possible pathogenesis of CACNA1E-related DEE and the progress of drug intervention were reviewed to provide references for the diagnosis and precise treatment of DEE.

OBJECTIVE From the perspective o f China ’s h ealth service system ，to ev aluate the cost-effectiveness of sintilimab combined with chemotherapy in the first-line treatment of advanced or recurrent non-small cell lung cancer （NSCLC），so as to provide reference for the selection of clinical medication plan and medical and health decision-making. METHODS Based on the ORIENT-11 study data ，a partitioned survival model was established ，and the model period was 21 days to simulate the death of 99％ of the patients. Using quality-adjusted life years （QALY）as an output indicator ，the cost-effectiveness of sintilimab combined with chemotherapy （trial group ）versus chemotherapy alone （control group ）in the first-line treatment of advanced or recurrent NSCLC was evaluated. Cost and utility were discounted using 5％ discount rate ；sensitivity analysis and scenario analysis were used to verify the robustness of the underlying analysis results. RESULTS Under the premise that 3 times of the per capita gross domestic product （GDP）of China in 2020 was used as the threshold of willingness-to-pay （WTP），the patients in the trial group obtained more utility （0.482 QALY）and also spent nearly twice as much as the control group. The incremental cost-effectiveness ratio（ICER）was 334 974.41 yuan/QALY. Univariate sensitivity analysis showed that progression-free survival status utility value ， pemetrexed price ，utility discount rate ，cost discount rate and sintilimab price had a greater impact on ICER. The results of probability sensitivity analysis showed that when the WTP threshold was 3 times of China ’s per capita GDP in 2020，the probability of the trial group ’s plan being cost-effective was 6.5％. The results of the scenario analysis verified the robustness of the underlying analysis results. CONCLUSIONS On the premise of taking 3 times of China ’s per capita GDP in 2020 as the WTP threshold ， sintilimab combined with chemotherapy is not cost-effective for first-line treatment of advanced or recurrent NSCLC compared with chemotherapy alone.

Objective:To investigate the role of down-regulating serine racemase (SRR) in alleviating the β-amyloid peptide (Aβ) induced neurotoxicity and synaptic damage and possible mechanism in PC12 cells.Methods:(1) PC12 cells cultured in vitro were divided into 0, 20, 40 and 80 μmol/L Aβ 25-35 treatment groups; they were treated with 0, 20, 40 and 80 μmol/L Aβ 25-35 for 24 h, respectively; cell counting kit (CCK)-8 was used to detect the survival rate of cells in each group, and Western blotting was used to detect the SRR protein expression. PC12 cells were treated with 40 μmol/L Aβ 25-35 for 0, 12, 24 and 48 h, respectively; cell survival and SRR protein expression were detected by CCK-8 and Western blotting, respectively. (2) PC12 cells were divided into control group, nonsense sequence group, SRR small interfering RNA (siRNA) group 1, SRR siRNA group 2, and SRR siRNA group 3; cells in the later three groups were transfected with SRR nonsense sequence or different SRR siRNA sequences, respectively; 48 h after that, Western blotting was used to detect the SRR protein expression of cells in each group, and SRR siRNA with best effect was selected for subsequent experiments. (3) PC12 cells were divided into control group, AD group, AD+nonsense sequence group, and AD+SRR siRNA group; cells in the latter two groups were transfected with nonsense sequence or SRR siRNA for 48 h, respectively; cells in the latter three groups were added 40 μmol/L Aβ 25-35, and cells in the control group were added same amount of solvent; 24 h after treatment, the SRR protein expression was detected by Western blotting, cell survival was detected by CCK-8, cell apoptosis was detected by Hoechst 33258 fluorescent staining, Caspase 3 activity was detected by enzyme linked immunosorbent assay, and the expressions of activated Caspase 3, N-methyl- D aspartate (NMDA) receptor-associated proteins and postsynaptic dense protein 95 (PSD95) were detected by Western blotting. Results:(1) The survival rate of cells in 0, 20, 40 and 80 μmol/L Aβ 25-35 treatment groups was successively decreased and the SRR protein expression was successively increased, with significant differences ( P<0.05); PC12 cells treated with 40 μmol/L Aβ 25-35 for 0, 12, 24 and 48 h had successively decreased survival rate and successively increased SRR protein expression, with significant differences ( P<0.05). (2) The SRR protein expressions in the SRR siRNA group 1, SRR siRNA group 2 and SRR siRNA3 group 3 were significantly decreased as compared with those in the control group and nonsense sequence group ( P<0.05), and the decrease in the SRR siRNA group 2 was the most obvious. (3) As compared with the control group, the cells in the AD group had significantly increased SRR protein expression and apoptosis rate, statistically decreased cell survival rate, significantly increased Caspase 3 activity and activated Caspase 3 protein expression, significantly increased protein expressions of NMDA receptor 2A (NMDAR2A) and NMDA receptor 2B(NMDAR2B), and statistically decreased PSD95 protein expression ( P<0.05); as compared with cells in the AD group, cells in the AD+SRR siRNA group had significantly decreased SRR protein expression and apoptosis rate, statistically increased cell survival rate, significantly decreased Caspase 3 activity and activated Caspase 3 protein expression, significantly decreased NMDAR2A protein expression, and statistically increased PSD95 protein expression ( P<0.05). Conclusion:Down-regulation of SRR expression can reduce the NMDAR2A protein expression, alleviate the over-activation of NMDA receptor, reduce the cell apoptosis, improve cell survival rate, protect nerve cells, increase PSD95 protein expression, and alleviate synaptic damage in PC12 cells.

Objective: To observe the incidence of unreasonable use of high beam at nighttime among motor vehicle drivers, so as to provide the evidence for the prevention and control of road traffic injury. Methods: Four roads into city and five urban roads were selected in Yongkang of Zhejiang Province. An automatic recording system was used to collect the unreasonable use of high beam among motor vehicle drivers on the selected roads from 19:00 to 5:00 on Monday, Wednesday, Friday and Sunday during a week in July 2020. The regression tree model was used to analyze the relationship of the unreasonable use of high beam with road, time and traffic flow. Results: A total of 89 989 motor vehicles were observed, and 2 419 motor vehicle drivers had unreasonable use of high beam, with an incidence rate of 2.69%. The incidence rate of the unreasonable use of high beam was 3.14% in the roads into city, which was higher than 2.30% in the urban roads ( P<0.05 ). The incidence rates of the unreasonable use of high beam in the roads into city and in the urban roads were 5.15% and 2.90% on Wednesday, which were higher than those on Monday ( 2.89% and 2.34% ), Friday ( 2.90% and 1.92% ) and Sunday (2.06% and 2.12%). The highest incidence rate of the unreasonable use of high beam in the roads into city was 6.07% between 4:00 and 5:00, and in the urban roads was 4.50% between 2:00 and 3:00. The results of regression tree classification analysis showed that the highest incidence rate was 8.13% on the roads into city in the east, west and south directions, and on the urban roads in the east and north directions with less than 317 vehicles per hour on Wednesday. Conclusion It is more likely for motor vehicle drivers to use high beams unreasonably at nighttime on the roads into city with less traffic flow.

Objective To construct the standard nursing path index for perioperative enhanced recovery of patients after thoracoscopic lobectomy, and to provide theoretical basis for providing high quality nursing services for patients after thoracoscopic lobectomy. Methods Based on evidence-based medicine, systematic literature review and expert group meetings were organized to form the first draft of standard nursing pathway index for perioperative enhanced recovery of thoracoscopic lobectomy. Through Delphi method, 55 thoracic surgery medical and nursing experts were consulted for two rounds, and the structure and entries of the first draft were revised. Finally, a set of perioperative enhanced recovery standard nursing path index was formed. Results The recovery rate of the two rounds of expert consultation questionnaire were both 100%. The authoritative coefficients of experts in the two rounds were 0.855 and 0.874, and the coordination coefficients Kendall's W were 0.35 and 0.44, respectively. The standard nursing path index of perioperative enhanced recovery after thoracoscopic lobectomy included 4 dimensions (preoperative baseline assessment, preoperative preparation, intraoperative nursing intervention, postoperative nursing intervention), 25 items. Conclusions In this study, experts' enthusiasm and authority are high, opinions are well coordinated, the results are reliable, and the indexes can better meet the actual needs of patients, which can provide a basis for the next step to carry out perioperative enhanced recovery nursing practice for patients undergoing thoracoscopic lobectomy.