Objective To evaluate the evidence about impact of physical activity(PA)on glycemic control and related health out-comes in patients with type 2 diabetes mellitus(T2DM).Methods Adhering to PRISMA guideline,systematic reviews and meta-analyses published between 2017 and 2024 were retrieved from the databases such as Medline,Embase and Cochrane Library.Two researchers independently ex-tracted data and assessed the quality using AMSTAR2.The included systematic reviews were systematically re-viewed.Results Eight systematic reviews were included,with six rated as high quality and two as low quality.Various forms of PA interventions,such as aerobic exercise,resistance training,combined training and high-intensity interval train-ing,might significantly reduce glycated hemoglobin,enhance cardiorespiratory fitness,lower cardiovascular risk factors(such as body mass,blood pressure and blood lipids),and decrease the risk of diabetes-related complica-tions and mortality in T2DM patients.Combined training and high-intensity training seemed to be better.Profes-sionally supervised PA was more effective.Conclusions Regular and multimodal PA is effective on glycemic control,and cardiovascular and metabolic risk factors in T2DM patients.It is advocated an individualized,diversified,adequately dosed(encouraging higher total dos-es),intensity-appropriate(promoting higher intensity),combined-mode and supervision-integrated PA strategies.

Objective To explore the value of high-frequency ultrasound in the detection of metastatic hepatocellular carcinoma and displaying lesion characteristics. Methods A total of 38 paitients with hepatocellular carcinoma satellite lesions within 40 mm of subcutaneous tissue were underwent low-frequency (1-5 MHz) and high-frequency (6-9 MHz) ultrasound. Detection rates and ultrasonic features were compared. Results High-frequency grayscale ultrasound had a higher detection rate (71.1% vs. 36.8%, P＜0.001). Subgroup analysis showed higher detection rates with chemotherapy history (88.9% vs. 33.3%, P＝0.002), fatty liver (71.9% vs 31.3%, P＜0.001) or superficial lesion (within 20 mm, 76.5% vs 41.2%, P＝0.031). High-frequency ultrasound also showed clearer margins (P＝0.004) and more arterial-phase rim enhancement (P＝0.007). Conclusions 6-9 MHz ultrasound detects metastatic hepatocellular carcinoma, especially superficial lesions, more effectively than 1-5 MHz ultrasound and better visualizes characteristics.

Objective To analyze the physical activity and health-related policies and guidelines for type 2 diabetes mellitus(T2DM)issued by international organizations and countries,including World Health Organization(WHO),Euro-pean Union,the United States,Canada,Australia and China.Methods A content analysis and a comparative study were conducted to examine physical activity-related policies and guidelines at international and national levels.Results International organizations and countries all recognized physical activity as a key measure for preventing and controlling T2DM and improving population health.WHO established clear global targets and monitoring indica-tors.The United States,Canada and Australia closely integrated community interventions,healthcare incentives and structured exercise programs,while China combined national fitness initiatives with public health services.International T2DM-related exercise guidelines recommended>150 minutes of moderate-intensity aerobic exer-cise per week combined with resistance training.Conclusion At both international and national levels,T2DM-related physical activity and health policies aim to increase participation in physical activity,improve population health,and effectively reduce the incidence and mortality of chronic diseases such as T2DM.Guidelines emphasize a multidisciplinary collaboration model to enhance practi-cal applicability,implementation effectiveness and the sustainability of health-related physical activity.Future de-velopment priorities will include establishing personalized physical activity programs for T2DM based on indi-vidual needs,and building an integrated health-related service system that combines physical activity,community health,chronic disease management and digital technologies.

Objective To analyze the physical activity and health-related policies and guidelines for type 2 diabetes mellitus(T2DM)issued by international organizations and countries,including World Health Organization(WHO),Euro-pean Union,the United States,Canada,Australia and China.Methods A content analysis and a comparative study were conducted to examine physical activity-related policies and guidelines at international and national levels.Results International organizations and countries all recognized physical activity as a key measure for preventing and controlling T2DM and improving population health.WHO established clear global targets and monitoring indica-tors.The United States,Canada and Australia closely integrated community interventions,healthcare incentives and structured exercise programs,while China combined national fitness initiatives with public health services.International T2DM-related exercise guidelines recommended>150 minutes of moderate-intensity aerobic exer-cise per week combined with resistance training.Conclusion At both international and national levels,T2DM-related physical activity and health policies aim to increase participation in physical activity,improve population health,and effectively reduce the incidence and mortality of chronic diseases such as T2DM.Guidelines emphasize a multidisciplinary collaboration model to enhance practi-cal applicability,implementation effectiveness and the sustainability of health-related physical activity.Future de-velopment priorities will include establishing personalized physical activity programs for T2DM based on indi-vidual needs,and building an integrated health-related service system that combines physical activity,community health,chronic disease management and digital technologies.

Objective To analyze the innovative model and effectiveness of the four-level prevention of stroke in Nantong Medical and Prevention Collaborative Center for Cardiovascular and Cerebrovascular Disease,so as to provide new practical experience for the prevention and treatment of cerebrovascular disease.Methods In practice,Nantong city has explored the"53343"mode of collaborative treatment and prevention of cardiovascular and cerebrovascular diseases,and innovatively integrated this mode into four-level prevention to form a practice mode of zero-level guidance,first-level monitoring,second-level coordination and three-level leading.Data from the China Health Statistics Yearbook from 2011 to 2022 and the monitoring data of cardiovascular and cerebrovascular events in Nantong City on the Jiangsu Provincial Chronic Disease Management Information Platform from 2017 to 2023 were collected and processed by using Excel and SPSS 24.0,to analyze the changes of stroke surveillance data and effectiveness in Nantong City after applying the model.Results According to the monitoring data of cardiovascular and cerebrovascular events in Nantong City from the Jiangsu Provincial Chronic Disease Management Information Platform,despite the continuous increase in the number of monitored individuals over five years,the monitoring data for stroke from the Nantong Medical and Prevention Collaborative Center for Cardiovascular and Cerebrovascular Disease witnessed a decline in the number of monitored individuals for the first time in 2022.The stroke monitoring data from the same monitoring agency showed a more stable fluctuation trend compared to the number of national stroke patients discharged from 2017 to 2021.We established a coherent health service operation mechanism,cultivated 14 interdisciplinary talents,held a special continuing education class on stroke,strengthened the in-depth collaboration between clinical and public health,and provided a practical and innovative model for effective prevention and treatment of stroke.Conclusions The four-level prevention based on the medical and preventive collaboration center for cardiovascular and cerebrovascular diseases can achieve process and cycle health management,effectively slow down the upward trend of stroke,and improve the ability and level of scientific research and teaching.

Objective To evaluate the evidence about impact of physical activity(PA)on glycemic control and related health out-comes in patients with type 2 diabetes mellitus(T2DM).Methods Adhering to PRISMA guideline,systematic reviews and meta-analyses published between 2017 and 2024 were retrieved from the databases such as Medline,Embase and Cochrane Library.Two researchers independently ex-tracted data and assessed the quality using AMSTAR2.The included systematic reviews were systematically re-viewed.Results Eight systematic reviews were included,with six rated as high quality and two as low quality.Various forms of PA interventions,such as aerobic exercise,resistance training,combined training and high-intensity interval train-ing,might significantly reduce glycated hemoglobin,enhance cardiorespiratory fitness,lower cardiovascular risk factors(such as body mass,blood pressure and blood lipids),and decrease the risk of diabetes-related complica-tions and mortality in T2DM patients.Combined training and high-intensity training seemed to be better.Profes-sionally supervised PA was more effective.Conclusions Regular and multimodal PA is effective on glycemic control,and cardiovascular and metabolic risk factors in T2DM patients.It is advocated an individualized,diversified,adequately dosed(encouraging higher total dos-es),intensity-appropriate(promoting higher intensity),combined-mode and supervision-integrated PA strategies.

Objective To analyze the innovative model and effectiveness of the four-level prevention of stroke in Nantong Medical and Prevention Collaborative Center for Cardiovascular and Cerebrovascular Disease,so as to provide new practical experience for the prevention and treatment of cerebrovascular disease.Methods In practice,Nantong city has explored the"53343"mode of collaborative treatment and prevention of cardiovascular and cerebrovascular diseases,and innovatively integrated this mode into four-level prevention to form a practice mode of zero-level guidance,first-level monitoring,second-level coordination and three-level leading.Data from the China Health Statistics Yearbook from 2011 to 2022 and the monitoring data of cardiovascular and cerebrovascular events in Nantong City on the Jiangsu Provincial Chronic Disease Management Information Platform from 2017 to 2023 were collected and processed by using Excel and SPSS 24.0,to analyze the changes of stroke surveillance data and effectiveness in Nantong City after applying the model.Results According to the monitoring data of cardiovascular and cerebrovascular events in Nantong City from the Jiangsu Provincial Chronic Disease Management Information Platform,despite the continuous increase in the number of monitored individuals over five years,the monitoring data for stroke from the Nantong Medical and Prevention Collaborative Center for Cardiovascular and Cerebrovascular Disease witnessed a decline in the number of monitored individuals for the first time in 2022.The stroke monitoring data from the same monitoring agency showed a more stable fluctuation trend compared to the number of national stroke patients discharged from 2017 to 2021.We established a coherent health service operation mechanism,cultivated 14 interdisciplinary talents,held a special continuing education class on stroke,strengthened the in-depth collaboration between clinical and public health,and provided a practical and innovative model for effective prevention and treatment of stroke.Conclusions The four-level prevention based on the medical and preventive collaboration center for cardiovascular and cerebrovascular diseases can achieve process and cycle health management,effectively slow down the upward trend of stroke,and improve the ability and level of scientific research and teaching.

Objective:To analyze the disease burden of Parkinson's disease (PD) in China from 1990 to 2021 and predict the disease burden of PD from 2022 to 2030.Methods:Based on the data of PD incidence in China from the Global Burden of Disease Study 2021 (GBD 2021), changes in PD disease burden from 1990 to 2021 were analyzed. Age-period-cohort model was used to analyze the independent influences of age, period and cohort in PD incidence (according to age group of 5 years, patients were divided into 15 groups: group of 20-24 years, group of 25-29 years..., and group of 90-94 years; according to a 5-year period, patients were divided into 6 groups: group of 1992-1996, group of 1997-2001..., and group of 2017-2021; because of birth cohort=period-age, patients were divided into 20 birth cohorts: birth cohort of 1897-1906, birth cohort of 1902-1911..., and birth cohort of 1992-2001). Nordpred model was used to predict the disease burden of PD from 2022 to 2030.Results:(1) From 1990 to 2021, number of PD patients, and PD incidence and standardized incidence in China showed upward trends. The standardized incidence increased by 89.68% for the total population, 89.71% for males, and 77.64% for females. (2) PD incidence was low in young subjects and increased obviously in subjects aged 60 years. PD incidence in subjects aged 20-24 years or 90-94 years was 0.07/100 000 and 643.31/100 000, respectively. Compared with female subjects, male subjects aged 60-94 years had higher PD incidence. (3) The onset relative risk increased from 0.71 (95% CI: 0.69-0.73) in group of 1992-1996 to 1.17 (95% CI: 1.16-1.19) in group of 2017-2021 in the total population, increased from 0.68 (95% CI: 0.66-0.70) to 1.18 (95% CI: 1.16-1.21) in males, and increased from 0.75 (95% CI: 0.73-0.77) to 1.14 (95% CI: 1.12-1.16) in females. (4) Onset relative risk was 0.40 (95% CI: 0.33-0.48) in the earliest birth cohort (1897-1906), which increased to 1.81 (95% CI: 0.95-3.43) in the latest birth cohort (1992-2001). (5) Number of PD patients in males, females and total population in China would increase to 455 010, 301 173 and 756 183, respectively, and the standardized incidence would increase to 56.45/100 000, 32.28/100 000 and 43.40/100 000, respectively, till 2030. Conclusion:PD disease burden in China from 1990 to 2021 is severe, particularly among males and the elderly; the disease burden is projected to continue rising up till 2030.

Objective:To clarify the changes of intrahepatic ultrasound hemodynamics before and after hepatic artery thrombosis (HAT) after liver transplantation (LT), providing early warning and anticoagulation guidance to clinicians.Methods:The clinical data of patients who underwent liver transplantation at Zhongshan Hospital of Fudan University between June 2006 and October 2022 were retrospectively analyzed, 47 patients with a diagnosis of HAT confirmed by DSA (digital subtraction angiography) were included in the HAT group, and 71 patients without vascular complications were included in the non-HAT group. Differences in peak flow velocity (PSV), resistance index (RI), and portal vein velocity (PVV) were compared between the two groups. Logistic regression analysis was used to determine the relationship between postoperative PSV decline and HAT occurrence, while ROC curve were used to determine the critical value and evaluate the diagnostic efficacy. Patients with HAT were divided into well-treatment group and poor-treatment group according to whether the blood flow was restored after multiple surgeries or thrombolytic treatments. The changes of early intrahepatic hemodynamics after surgical or thrombolytic therapy were compared between the two groups.Results:①A decrease in PSV of the transplanted hepatic artery was measured 1 d before HAT, and PSV<0.39 m/s predicted thrombus formation with a sensitivity of 0.70, specificity of 0.86, and the AUC was 0.83. ②After treatment, PSV in the HAT group increased immediately, approaching the normal level on the 2nd day. In the well-treatment group, PSV and PVV reached normal levels on the first day after treatment, which were significantly higher than the corresponding values in the poor-treatment group ( P=0.030, 0.021). Conclusions:In the early stage after liver transplantation, a PSV<0.39 m/s is related to the occurrence of HAT thrombosis 1 d later. A significant increase in PSV on the first day after treatment indicates a good treatment response, and there is no need for further DSA re-examination or increasing the number of thrombolysis.

Objective:To explore the application of online challenge training mode and analyze its application effect in standardized training of new nurses.Methods:Using the map training mode of the online training platform, a challenge game was designed and applied in the standardized training of new nurses. Using the convenience sampling method, 309 new nurses who joined Beijing Friendship Hospital, Capital Medical University from 2020 to 2021 were selected and grouped according to their starting date. The 103 nurses who joined in 2020 were set as the control group and traditional training was used. The 206 nurses who joined in 2021 were set as the research group and a challenge training mode was used. The scores and pass rates of theoretical assessment and OSCE assessment as well as the scores of core competency were compared between the two groups after training. A self-made questionnaire for satisfaction survey was used to investigate the satisfaction of nurses in the research group with the challenge training mode. The t-test and chi-square test were perform using SPSS 23.0. Results:Compared with the control group, the research group showed significantly higher score [(83.32±6.30) vs. (81.59±7.62)] and pass rate (94.66% vs. 83.50%) of theoretical assessment, significantly higher score [(92.19±5.08) vs. (90.66±5.47)] and pass rate (100.00% vs. 97.09%) of OSCE assessment, and a significantly higher total score of core competencies [(193.61±34.94) vs. (177.55±36.91)] ( P<0.05). Moreover, 98.06% (202) of nurses believed that the challenge training mode could stimulate learning interest and motivation, and preferred the online challenge mode training method. Additionally, 93.69% (193) of nurses believed that online learning was more efficient, and 96.60% (199) of nurses thought that online training saved time. Conclusions:The online challenge training mode can effectively stimulate the learning interest of new nurses, improve their core abilities, and increase their satisfaction with the training. This method is worth implementing and promoting in standardized nurse training.