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.

ObjectiveTo analyze the genomic characteristics of Streptococcus pyogenes (GAS) isolated from children with respiratory tract infections in a tertiary hospital in Jinshan District of Shanghai during 2013‒2024, to compare the changes in trend for genomic characteristics before and after 2000, and to provide scientific data for the prevention and control of GAS infections. MethodsGAS strains isolated from children with respiratory tract infections in this hospital were collected from 2013 to 2024. Antimicrobial susceptibility of the isolated strains to 12 antibiotics, including penicillin, cefotaxime, cefepime, linezolid, vancomycin, meropenem, chloramphenicol, ofloxacin, levofloxacin, erythromycin, clindamycin, and tetracycline, was determined using broth microdilution plate method. Besides, whole genome sequencing (WGS) was used to analyze multilocus sequence type (MLST), emm typing, carriage of superantigen genes, mobile genetic element (MGE), carriage of virulence gene, and genomic phylogenetic tree of the isolated strains. ResultsA total of 50 GAS strains were collected and identified from children with respiratory tract infections aged 4‒14 years old, and the resistance rates of those isolates to erythromycin, clindamycin, and tetracycline were 100.00%, 100.00%, and 86.00%, respectively. There were two emm types in the GAS isolates; the emm12 type accounted for 76.00% (38/50), corresponding to ST36 type, and the emm1 type accounted for 24.00% (12/50), corresponding to ST28, ST1274, and new-1 types. There was a statistically significant difference in the constitution of the MLST before and after 2020 (P=0.015). All the isolates carried the superantigen genes speC, speG, ssa, and smeZ. The predominant emm12 isolates belonged to the Clade Ⅱ, carrying the mobile elements ICE-emm12 (harboring erythromycin-resistance gene ermB and tetracycline-resistance gene tetM) and ΦHKU.vir (carrying virulence genes speC and ssa). The emm1 isolates carried the mobile elements ICE-HKU488 (harboring erythromycin-resistance gene ermB and tetracycline-resistance gene tetM) and ΦHKU488.vir (carrying virulence genes speC and ssa), and had close phylogenetical relationships with isolates from Hong Kong, China. No M1_UK new clone strains were found. The ST1274 isolates of emm1 were newly discovered in 2020‒2024, and belonged to a separate phylogenetic clade. ConclusionGAS strains isolated from children with respiratory tract infections in a tertiary hospital in Jinshan District of Shanghai exhibit a high resistance to erythromycin, clindamycin, and tetracycline. It is recommended that the clinical treatments change to use other antimicrobial drugs, such as penicillin, third-generation cephalosporins, and fluoroquinolones. During 2020‒2024, a new ST1274 clone strain is discovered in emm1 GAS isolates, without M1_UK new clone strains being found. It is essential to continuously concern locally prevalent GAS strains and perform early identification of MLST types to promptly monitor the internal changes of the bacterial population and potential prevalence of new clones.

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 explore the correlation between foot morphology and toe/metatarsophalangeal joint muscle strength. Methods Twenty-six male recreational runners were recruited. Foot length, truncated foot length, foot width, navicular height, dorsum height at 50% of the foot length, metatarsophalangeal joint strength, tensile force of the first and remaining four toes were measured by using digital caliper, metatarsophalangeal joint strength tester and dynameter, respectively. Partial correlations were used to analyze the correlation between foot morphology and foot muscle strength. ResultsWith adjusted age and body mass index (BMI), the foot width in standing position and truncated foot length in sitting and standing position were positively correlated to tensile force of the first toe; the foot length, foot width and truncated foot length were positively correlated to tensile force of the remaining four toes in both positions, and the arch height index in sitting position was negatively associated with tensile force of the remaining four toes; the foot width was positively correlated to metatarsophalangeal joint strength in both positions. Conclusions The longer foot length, foot width, truncated foot length, and the lower arch height in normal range might be related to the larger foot muscle strength. The consideration of the differences in foot morphological characteristics in different positions during the measurement of foot morphology can provide references for predicting foot muscle strength and preventing foot injury.

Objective:To identify the factors associated with long-term survival and guide the decision for primary surgery in patients with advanced high-grade serous ovarian cancer(HGSOC).Methods:In this case-control study, clinical parameters, including surgical and non-surgical associated factors, were collected and compared between the patients with short-term (<2 years) and long-term (>5 years) survival who all underwent primary debulking surgery (PDS) followed by carboplatin and paclitaxel chemotherapy from January 2004 to December 2016. Univariate analysis was examined by chi-square test and multivariate analysis was performed by logistic regression analysis.Results:There were 95 cases long-term survival (LTS group) and 77 cases short-term survival (STS group) in 698 newly diagnosed HGSOC patients with International Federation of Gynecology and Obstetrics (FIGO) stage Ⅲc and Ⅳ who met include and exclude criteria. (1) Univariate analysis showed that the proportion of complete cytoreduction with no visible residual disease (R0) at PDS and platinum sensitivity in LTS group were significantly higher than those in STS group ( P<0.01). The surgical complexity score (SCS), the preoperative serum CA 125 level and the ascites volume in the LTS group were significantly lower than those of the STS group (all P<0.05). In the LTS group, the preoperative incidence of lesions in retrograde peritoneum of the bladder, serosal and mesangial membrane of the small intestine, upper abdominal peritoneum and liver parenchyma were significantly lower than those in the STS group (all P<0.05). Multivariate logistic regression analysis showed that platinum sensitivity ( OR=0.016, 95% CI: 0.004-0.063, P<0.01), ascites volume >500 ml ( OR=3.193, 95% CI: 1.285-7.930, P=0.012), and SCS ≥8 ( OR=17.433, 95% CI: 2.281-133.25, P=0.003) were independent factors affecting long-term survival ( P>0.05). (2) Totally 37 of 95 in long-term survival and 16 of 77 in short-term survival achieved R0 cytoreduction at PDS. Univariate analysis showed that preoperative serum CA 125 level, preoperative lesion score, preoperative lesion (DS) score, ascites volume, platinum sensitivity,and SCS were significantly correlated with the R0 PDS (all P<0.05). Multivariate analysis showed that ascites volume >500 ml ( OR=5.199, 95% CI: 2.015-13.409, P=0.001), DS >2 ( OR=15.264, 95% CI: 5.843-39.874, P<0.01) and SCS ≥4 ( OR=4.176, 95% CI: 1.618-10.777, P=0.003) were independent factors associated with R0 cytoreduction. In patients with DS ≤2 or SCS <4, but not those with DS >2 or SCS ≥4, R0 cytoreduction was significantly associated with long-term survival. Conclusion:The intrinsic biology of tumor is the factor influencing long-term survival of advanced HGSOC patients, and those who present with wide intraperitoneal metastases and need to remove multiple organs may not benefit from R0 cytoreduction.

Objective:To understand the current status of abortion and contraception among nonparous adolescent women and explore the influence of post-abortion care (PAC) services on their contraceptive choice and repeated abortion.Methods:A retrospective study was conducted on the nonparous adolescent women who had undergone induced abortion in outpatient clinics of Guangdong Women's and Children's Hospital from January to December 2018 was recruited. Through PAC consultation and follow-up, their contraceptive options and the incidence of repeated abortions before and after surgery were compared.Results:1) There were 1137 cases of induced abortion among nonparous adolescent women, accounting for 85.30% (1137/1333) of the total number of adolescent abortions, 29.51% (1137/3853) of the total number of abortions during the same period, among which 23.39% (266/1137) had abortion history before surgery, 5.54% (63/1137) had abortion ≥3 times, 2.73% (31/1137) had repeated abortion (≥2 times within 1 year) within half a year, and 6.86% (78/1137) had abortion ≥2 times within 1 year. 2) There was a significant increase in the choice of high-efficiency contraceptive methods after PAC compared with that before surgery (2.73% vs. 84.43%, P<0.001), in which the use of combined oral contraceptive (COC) and intrauterine device (IUD) increased significantly (2.73% vs. 83.46%, P<0.001; 0 vs. 0.97%, P=0.001), and the number of married women using IUD was higher than that of unmarried women (5.71% vs.0.86%, P=0.047). On the other hand, the rate of continued use of COC at 3, 6, and 12 months of post-operative nonparous adolescent women gradually decreased (83.01%, 5.95%, 2.46%), while the rate of continued use of IUD remained stable (0.97%, 1.14%, 1.23%). 3) The repeated induced abortion rate among nonparous adolescent women in the half of a year and one year after PAC significantly decreased compared with that before PAC (1.26% vs. 2.73%, P=0.022; 3.70% vs. 6.86%, P=0.003). Conclusion:Nonparous adolescent women have a higher rate of repeated abortions, while a lower rate of the use of high-efficiency contraceptive methods. PAC services can significantly improve the immediate implementation rate of high-efficiency contraceptives, and it is necessary to further increase the immediate implementation rate of IUD and the continued use rate of the COC.

Objective:To understand the current status of abortion and contraception among nonparous adolescent women and explore the influence of post-abortion care (PAC) services on their contraceptive choice and repeated abortion.Methods:A retrospective study was conducted on the nonparous adolescent women who had undergone induced abortion in outpatient clinics of Guangdong Women's and Children's Hospital from January to December 2018 was recruited. Through PAC consultation and follow-up, their contraceptive options and the incidence of repeated abortions before and after surgery were compared.Results:1) There were 1137 cases of induced abortion among nonparous adolescent women, accounting for 85.30% (1137/1333) of the total number of adolescent abortions, 29.51% (1137/3853) of the total number of abortions during the same period, among which 23.39% (266/1137) had abortion history before surgery, 5.54% (63/1137) had abortion ≥3 times, 2.73% (31/1137) had repeated abortion (≥2 times within 1 year) within half a year, and 6.86% (78/1137) had abortion ≥2 times within 1 year. 2) There was a significant increase in the choice of high-efficiency contraceptive methods after PAC compared with that before surgery (2.73% vs. 84.43%, P<0.001), in which the use of combined oral contraceptive (COC) and intrauterine device (IUD) increased significantly (2.73% vs. 83.46%, P<0.001; 0 vs. 0.97%, P=0.001), and the number of married women using IUD was higher than that of unmarried women (5.71% vs.0.86%, P=0.047). On the other hand, the rate of continued use of COC at 3, 6, and 12 months of post-operative nonparous adolescent women gradually decreased (83.01%, 5.95%, 2.46%), while the rate of continued use of IUD remained stable (0.97%, 1.14%, 1.23%). 3) The repeated induced abortion rate among nonparous adolescent women in the half of a year and one year after PAC significantly decreased compared with that before PAC (1.26% vs. 2.73%, P=0.022; 3.70% vs. 6.86%, P=0.003). Conclusion:Nonparous adolescent women have a higher rate of repeated abortions, while a lower rate of the use of high-efficiency contraceptive methods. PAC services can significantly improve the immediate implementation rate of high-efficiency contraceptives, and it is necessary to further increase the immediate implementation rate of IUD and the continued use rate of the COC.

OBJECTIVE：To provide method reference for scientifically eva luating the rationality of the use of saxagliptin . METHODS：Based on the drug instructions ，clinical guidelines ，clinical pathways ，related references ，clinical endocrinology department and pharmaceutical experts of a hospital jointly discussed and formulated the evaluation criteria for the rationality of the use of saxagliptin. AHP method was used to assign weights to various indexes of evaluation criteria ；TOPSIS method was used to analyze the use of saxagliptin of 106 cases in the hospital during Nov. 2018-Apr. 2019 retrospectively and evaluate rational drug use. RESULTS ：A total of 6 primary indicators and 12 secondary indicators were established. The first three indicators with a relatively high index weight were indications （with a weight of 0.25），dose and adjustment of administration （with a weight of 0.21）and frequency of administration （with a weight of 0.15）. Among 106 cases，39.6％ of drug use were reasonable ，51.0％ were basically reasonable and 9.4％ were unreasonable. Evaluation results made by weighted TOPSIS were consistent with the actual situation. CONCLUSIONS ：TOPSIS method weighted by AHP is reasonable and feasible for evaluating the rationality of saxagliptin use.

Objective:To observe the changes of peri-implant tissue around the individualized abutment that was grinded from zirconia provisional crown in one year.Methods:In this research, a prosthodontic-driven virtual implant planning and immediate provisionalization were conducted in computer assisted design software. And computer-aided design/computer-aided manufacturing (CAD/CAM) techniques were used to fabricate the zirconia provisional crown and surgical guide template before surgery. The implant was accurately placed with the surgical guide, and the zirconia provisional crown was immediately delivered after surgery. Three months later, the implant osseointegration was completed, and zirconia provisional crown was prepared intraorally to generate customized zirconia abutment for final prosthesis. The study included 30 patients with single anterior tooth loss, including 18 males and 12 females, aged from 26 to 50 years old, and the mean age was (36.2±6.1) years old. The patients were from the Center of Oral Implantology, The First Affiliated Hospital of Zhejiang University Medical College from January 2017 to February 2018. After cementation of the final prosthesis, the cases were followed up at 6 and 12 months time intervals. Implant survival rate, probing depth, bleeding on probing, marginal bone level loss and papilla index score (PIS) were recorded in every appointment.Results:The survival rate of 30 implants was 100%, and the probing depths were less than 5 mm. The bone resorption at 6 and 12 months follow-up after the final delivery was 0 (0, 0) mm and 0 (-0.2, 0) mm, respectively, and the difference was not statistically significant ( P>0.05). The PIS was 3.0 (2.0, 4.0), 3.0 (2.8, 4.0) and 3.0 (3.0, 4.0) on the final delivery, 6 and 12 months after final delivery, respectively. Conclusions:Marginal bone level and bone loss were stable with this new implant clinical protocol at the one-year follow-up.