Objective: To explore the influencing factors for implementation of weight management services in primary medical and healthcare institutions, so as to provide references for implementing sustainable services of weight management. Methods: From May to June 2025, Pinghu City, Zhejiang Province was selected as the survey site. Personnel responsible for weight management in primary medical and healthcare institutions were selected as the survey subjects using a combined method of purposive sampling and snowball sampling. Based on the five core domains of the consolidated framework for implementation research (CFIR), a semi-structured interview outline for weight management services in primary medical and healthcare institutions was designed. Original data was collected through face-to-face semi-structured interviews. Interview data was organized and analyzed using framework analysis. Factors affecting weight management services were quantitatively analyzed by referencing CFIR's structural rating criteria. Results: A total of 21 participants completed interviews, covering positions in nutrition, endocrinology, traditional Chinese medicine, general practice, maternal health, and public health. There were 9 males and 12 females. Fifteen participants (71.43%) were aged 35 years and above, 18 (85.71%) held a bachelor's degree or higher, and 15 (71.43%) were frontline medical staff. Fifteen factors affecting weight management services were identified across five domains: innovation, outer setting, inner setting, individuals, and implementation process. Six barrier factors were identified: difficulties in policy implementation, time-consuming interventions, limited incentive measures, lack of professional skills, unclear weight-loss plans and goal setting, and imperfect follow-up and evaluation mechanisms. Three neutral factors were identified: the development and refinement of policies and regulations, the implementation of weight management training, and the optimization of the referral process within integrated healthcare systems (medical alliances / communities). Six facilitating factors were identified: the relatively significant advantages of lifestyle interventions, collaboration and coordination across multiple departments, cooperative communication among different units within the institution, the inherent convenience of primary care settings, a strong sense of professional responsibility, and the establishment of multidisciplinary teams. Conclusions The delivery of weight management services in primary medical and healthcare institutions is influenced by a wide array of factors across multiple domains. It requires policy support, multi-department coordination, a practice-oriented training system, optimized team resource allocation, incentives, and improved professional skills of medical staff to jointly promote long-term implementation.

Objective To investigate the intervention effects of a progressive upper limb exercise rehabilitation program based on the multi-process action control theory on upper limb function,rehabilitation compliance,and quality of life in patients with permanent pacemaker implantation(PPI).Methods A total of 130 patients scheduled for PPI from March to August 2024 were selected using a convenience sampling method.Among them,65 patients admitted from June to August were assigned to the experimental group,and 65 patients admitted from March to May formed the control group.The experimental group received the progressive upper limb exercise program in addition to routine care,while the control group received routine care only.The intervention lasted for 3 months.The differences were compared between the 2 groups in terms of primary outcome measures,including the Shoulder Pain and Disability Index(SPADI)and grip strength.The secondary outcome measures were the Quality of Life Instrument for Chinese Patients with Pacemaker(QLICPP),hospital stay and incidence of complications.Results A total of 122 patients(62 in the experimental group and 60 in the control group)completed this study.Repeated-measures analysis of variance showed significant interaction effects between time and group for the total SPADI score and its pain and disability dimensions,as well as for the physical function,psychological function,and total score of QLICPP(P＜0.001).Simple effects analysis indicated that the experimental group had better grip strength than the control group at l month postoperatively,and lower SPADI scores and total score than the control group at 1 and 3 months postoperatively.At 1 month postoperatively,the total QLICPP score and each dimension of the experimental group were higher than those of the control group(P＜0.05).There were no significant differences between the 2 groups in the incidence of complications and length of hospital stay(P＞0.05).Conclusion The progressive upper limb exercise rehabilitation program developed in this study effectively addressed the issue of low rehabilitation compliance in PPI patients,improved their upper limb function and quality of life,and it was safe.It provides a feasible and effective new pathway for the rehabilitation of PPI patients.

Objective To investigate the intervention effects of a progressive upper limb exercise rehabilitation program based on the multi-process action control theory on upper limb function,rehabilitation compliance,and quality of life in patients with permanent pacemaker implantation(PPI).Methods A total of 130 patients scheduled for PPI from March to August 2024 were selected using a convenience sampling method.Among them,65 patients admitted from June to August were assigned to the experimental group,and 65 patients admitted from March to May formed the control group.The experimental group received the progressive upper limb exercise program in addition to routine care,while the control group received routine care only.The intervention lasted for 3 months.The differences were compared between the 2 groups in terms of primary outcome measures,including the Shoulder Pain and Disability Index(SPADI)and grip strength.The secondary outcome measures were the Quality of Life Instrument for Chinese Patients with Pacemaker(QLICPP),hospital stay and incidence of complications.Results A total of 122 patients(62 in the experimental group and 60 in the control group)completed this study.Repeated-measures analysis of variance showed significant interaction effects between time and group for the total SPADI score and its pain and disability dimensions,as well as for the physical function,psychological function,and total score of QLICPP(P＜0.001).Simple effects analysis indicated that the experimental group had better grip strength than the control group at l month postoperatively,and lower SPADI scores and total score than the control group at 1 and 3 months postoperatively.At 1 month postoperatively,the total QLICPP score and each dimension of the experimental group were higher than those of the control group(P＜0.05).There were no significant differences between the 2 groups in the incidence of complications and length of hospital stay(P＞0.05).Conclusion The progressive upper limb exercise rehabilitation program developed in this study effectively addressed the issue of low rehabilitation compliance in PPI patients,improved their upper limb function and quality of life,and it was safe.It provides a feasible and effective new pathway for the rehabilitation of PPI patients.

According to the International League Against Epilepsy (ILAE) standards, the Newborn Working Group of the ILAE put forward 6 necessary questions about the management of neonatal anti-seizure medication and gave evidence-based recommendations in 2023. The basic framework is systematic review+expert consensus. The clinical recommendations of ILAE guidelines 2023 and the similarities and differences between ILAE guidelines 2023 and ILAE guidelines 2011 were analyzed and interpreted in this paper, in order to provide reference for colleagues involved in neonatal convulsion management in China.

Objective To evaluate the clinical outcomes of partial lateral patellar facetectomy ( PLPF ) combined with lateral retinaculum release ( LRR ) for treatment of patellofemoral osteoarthritis ( PFOA ). Methods From June 2017 to March 2018, 30 PFOA patients underwent PLPF combined with LRR at Department of Orthopedics and Traumatology, Foshan Hospital of Traditional Chinese Medicine. They were 7 men and 23 women with an average age of 56.4 ± 9.7 years. Their patellar position, patellofemoral joint function, overall knee function, and quality of life were assessed by comparing preoperation and last follow-up in patellofemoral congruence angle ( PFCA ) , lateral patellofemoral angle ( LPFA ) , modified Kujala score, The Western Ontario and Mcmaster Universities Osteoarthritis Index ( WOMAC ) , and SF-12 quality of life scale. Results All the patients were followed up for an average of 7.6 ± 3.4 months ( from 4 to 13 months ). The PFCA was improved from preoperative 22.9°± 7.6°to 12.4°± 4.2°at the last follow-up, the LPFA from preoperative 3.2°± 3.7° to 12.9°± 6.0° at the last follow-up, the modified Kujala score from preoperative 17.1 ± 9.8 to 34.3 ± 5.7 at the last follow-up, the WOMAC from preoperative 14.1 ± 5.2 to 5.9 ± 1.7 at the last follow-up, the stiffness index from preoperative 5.5 ± 3.2 to 2.7 ± 1.2 at the last fol-low-up, daily functional index from preoperative 43.9 ± 9.0 to 25.2 ± 5.4 at the last follow-up, and the SF-12 scores from preoperative 31.3 ± 5.2 to 55.7 ± 6.0 at the last follow-up. All the above comparisons showed a significant difference ( P ＜0.05 ) . Conclusion PLPF combined with LRR is a minimally invasive, easy-to-master and effective knee joint preserving procedure for PFOA as it can significantly relieve joint pain and maximally keep patellar functions.

The present study aimed to explore the neuroprotective effect and possible mechanisms of rhGLP-1 (7–36) against transient ischemia/reperfusion injuries induced by middle cerebral artery occlusion (MCAO) in type 2 diabetic rats. First, diabetic rats were established by a combination of a high-fat diet and low-dose streptozotocin (STZ) (30 mg/kg, intraperitoneally). Second, they were subjected to MCAO for 2 h, then treated with rhGLP-1 (7–36) (10, 20, 40 µg/kg i.p.) at the same time of reperfusion. In the following 3 days, they were injected with rhGLP-1 (7–36) at the same dose and route for three times each day. After 72 h, hypoglycemic effects were assessed by blood glucose changes, and neuroprotective effects were evaluated by neurological deficits, infarct volume and histomorphology. Mechanisms were investigated by detecting the distribution and expression of the nuclear factor erythroid-derived factor 2 related factor 2 (Nrf2) in ischemic brain tissue, the levels of phospho-PI3 kinase (PI3K)/PI3K ratio and heme-oxygenase-1 (HO-l), as well as the activities of superoxide dismutase (SOD) and the contents of malondialdehyde (MDA). Our results showed that rhGLP-1 (7–36) significantly reduced blood glucose and infarction volume, alleviated neurological deficits, enhanced the density of surviving neurons and vascular proliferation. The nuclear positive cells ratio and expression of Nrf2, the levels of P-PI3K/PI3K ratio and HO-l increased, the activities of SOD increased and the contents of MDA decreased. The current results indicated the protective effect of rhGLP-1 (7–36) in diabetic rats following MCAO/R that may be concerned with reducing blood glucose, up-regulating expression of Nrf2/HO-1 and increasing the activities of SOD.
Animals ; Blood Glucose ; Brain ; Diet, High-Fat ; Hypoglycemic Agents ; Infarction ; Infarction, Middle Cerebral Artery ; Malondialdehyde ; Neurons ; Neuroprotective Agents ; Phosphotransferases ; Rats* ; Reperfusion ; Reperfusion Injury* ; Streptozocin ; Superoxide Dismutase

Objective:To compare the maxillary sinus mucosa's stress distribution when elevated by three lift materials.Methods:Three Finite element models of maxillary sinus mucosa with 0.3 mm thickness elevated by implant,grafting autogenous cancellous bone and hydroxyapatite respectively were established in the specific units.ANSYS finite element analysis software was used to evaluate maxillary sinus mucosa deformation by the simulated closed sinus lift surgery.Differences of Von Mises stress values of mucosa surface were calculated when maxillary sinus mucosa lift height was increased from 1 mm to 5 mm according to the a large deformation theory. Results:The Von Mises stress values on membrane surface elevated by implant,grafting autogenous cancellous bone and hydroxyapa-tite bone substitute materials showed no difference within 5 mm elevation.Conclusion:Closed maxillary sinus floor lifting operation with implant elevating the maxillary sinus membrane directly is a simple and minimally invasive way for sinus floor elevation.

BACKGROUND:How to avoid iatrogenic maxil ary sinus mucosal perforation after closed maxil ary sinus augmentation.
OBJECTIVE:To compare the influence of maxil ary sinus mucosa at different thicknesses on the mucosal perforation in closed maxil ary sinus augmentation operation by using finite element analysis.
METHODS:Three finite element models of maxil ary sinus mucosa at different thicknesses of 0.3 mm, 0.5 mm, 0.8 mm respectively and implant with 4.2 mm diameter were established in the SHELL63 units. ANSYS finite element analysis software was used to evaluate maxil ary sinus mucosal deformation by the simulated closed maxil ary sinus augmentation surgery. Differences of Von Mises maximum stress values of mucosa surface were calculated according to the non-linear large-deformation theory.
RESULTS AND CONCLUSION:When maxil ary sinus mucosa height was increased from 1 mm to 5 mm, the large deformation was observed in the center of mucosa center. The maximum stress curve slope was shifted mild between 1-4 mm deformation, while shifted abruptly after 4 mm. There was no difference in the value of Von Mises maximum stress values between three maxil ary sinus mucosa at 0.3 mm, 0.5 mm, 0.8 mm thickness, when the lift height was increased from 1 mm to 5 mm (P>0.05). Maxil ary sinus mucosa are faced with a higher risk of mucosal perforation and elastic elongation when maxil ary sinus height is increased more than 4 mm. Maxil ary sinus mucosa at 0.3-0.8 mm thickness are faced the similar risk of mucosal perforation in closed maxil ary sinus augmentation operation within 5 mm. While more considerations should be paid on patients with less than 0.3 mm maxil ary sinus mucosa thickness.

Objective To explore the expression of Topo Ⅱα and COX-2 in breast cancer tissues and investigate their correlations to clinicopathologic feature of breast cancer. MethodsThe expression of Topo Ⅱα and COX-2 in 50 specimens of breast cancer and their normal tissues were detected by immunohistochemistry. Their correlation to clinicopathologic features of breast cancer were analyzed.ResultsThe positive rates of Topo Ⅱα were 64 % (32/50) and 22 % (11/50) and COX-2 were 68 % (34/50) , 14 %(7/50) in breast cancer and normal tissue (P＜0.05). The expression of Topo Ⅱα was correlated to degree of differentiation (P ＜0.05), not correlated to patient age, tumor size, clinical stage and lymph node metastasis(P ＞0.05). The expression of COX-2 was correlated to tumor size, degree of differentiation, clinical stage and lymph node metastasis (P ＜0.05), not correlated to patient age (P ＞0.05). Conclusion Topo Ⅱα and COX-2 expression can be used as an indicator for predicting the differentiation, infiltration and metastasis characteristics of breast cancer.

Objective: To observe the effect of ATENS on distance and near vision and stereopsis in amblyopic children patients.Methods: 80 eyes from 70 patients with amblyopia were randomly divided into two groups: the group of ATENS and the group of western medicine.The difference of distance,near vision and stereopsis before and after treatment and between two groups after treatment were observed.Results: Distance and near vision improved and stereopsis diminished significantly after treatment in the TENS group and the western medicine group(P0.05).The curative effect and improving stereopsis in the western medicine group were better than that in the TENS group(P