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 enhance the qualified rate of preoperative bladder filling and improve the experience of embryo transfer by implementing a nursing intervention based on the root cause analysis and plan-do-check-act(RCA-PDCA)cycle.Methods A before-after comparative study was conducted among the patients who received embryo transfer at a Tire-ⅢA specialist hospital between January and April 2024.The patient who received embryo transfer between January and February 2024(n=130)were assigned to the control group with routine nursing.Those who received embryo transfer between March and April 2024 were assigned to the trial group(n=136)with nursing intervention based on RCA-PDCA.The two groups were compared in terms of the qualified rate of bladder filling,endometrial visualisation rate,instrument-assisted transfer rate and level of comfort.Results A total of 126 women in the control group and 131 in the trial group completed the study.The patient in the trial group demonstrated significantly higher qualified rate of bladder filling and endometrial visualisation rate in comparison with those in the control group(70.2％vs.38.1％,81.7％vs.51.6％,respectively).The trial group also had lower rates in both of the instrument-assisted transfer and the incidence of mild pain than those in the control group(2.3％vs.7.9％,32.1％vs.53.2％,respectively;P<0.05).Conclusion RCA-PDCA is effective in improving preoperative bladder filling and endometrial visualisation,reducing instrument-assisted transfer and enhancing preoperative bladder comfort in the women receiving embryo transfer.

Objective To enhance the qualified rate of preoperative bladder filling and improve the experience of embryo transfer by implementing a nursing intervention based on the root cause analysis and plan-do-check-act(RCA-PDCA)cycle.Methods A before-after comparative study was conducted among the patients who received embryo transfer at a Tire-ⅢA specialist hospital between January and April 2024.The patient who received embryo transfer between January and February 2024(n=130)were assigned to the control group with routine nursing.Those who received embryo transfer between March and April 2024 were assigned to the trial group(n=136)with nursing intervention based on RCA-PDCA.The two groups were compared in terms of the qualified rate of bladder filling,endometrial visualisation rate,instrument-assisted transfer rate and level of comfort.Results A total of 126 women in the control group and 131 in the trial group completed the study.The patient in the trial group demonstrated significantly higher qualified rate of bladder filling and endometrial visualisation rate in comparison with those in the control group(70.2％vs.38.1％,81.7％vs.51.6％,respectively).The trial group also had lower rates in both of the instrument-assisted transfer and the incidence of mild pain than those in the control group(2.3％vs.7.9％,32.1％vs.53.2％,respectively;P<0.05).Conclusion RCA-PDCA is effective in improving preoperative bladder filling and endometrial visualisation,reducing instrument-assisted transfer and enhancing preoperative bladder comfort in the women receiving embryo transfer.

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 investigate the association between chewing ability and frailty in elderly adults in communities of China. Methods A total of 12, 678 elderly people in community were selected from data of Chinese Longitudinal Healthy Longevity and Happy Family Study(CLHLS-HF) as the study subjects. Multivariate Logistic regression analysis was used to explore the relationship between chewing ability and frailty of elderly people in community, and restricted cubic spline (RCS) based on Logistic regression analysis was used to analyze the dose-response relationship between the number of teeth and frailty risk in elderly people in community of China. Results Of the 12, 678 community-dwelling older adults, the mean age was (83.62±11.16) years, with an age ranging from 65 to 117 years; there were 5, 848 (46.1%) men and 6, 830 (53.9%) women. The Results of the multifactorial Logistic regression analysis showed that after adjusting for the covariates including gender, age, marital status, place of residence, ethnicity, living arrangement, years of education, healthcare availability and occupation before age of 60, self-rated economic status, body mass index (BMI), smoking status, alcohol consumption status, exercise status, self-rating health status variables, and participation in the annual medical check-ups or not, the Results showed that the chewing ability of community-dwelling older adults was associated with the risk of frailty (P < 0.05). The RCS plot showed a linear correlation between the number of natural teeth and the risk of frailty, with the risk of frailty increasing when the number of natural teeth was less than 10, and the risk of frailty gradually increased as the number of teeth decreased. Conclusion Chewing ability is associated with the risk of frailty in Chinese older adults, and the number of natural teeth and the use of dentures are important for the development of frailty in older adults.

Abstract: Objective To analyze the epidemic characteristics and influencing factors of school influenza-like cases in 2011-2022 in Nanchang, so as to provide reference for the prevention and control of school influenza outbreaks. 　　　Methods The epidemiological relevant data of school influenza-like cases from 2011 to 2022 in Nanchang and the pathogen test results of respiratory tract samples were collected for epidemiological and etiology analysis. Results　From 2011 to 2022, a total of 142 influenza-like cases were reported in schools in Nanchang, with a cumulative morbidity of 2 880 cases and a morbidity rate of 1.89%. A total of 1 263 samples were collected, with an overall positive influenza nucleic acid detection rate of 58.91%. The highest proportion of outbreaks occurred in 2017-2019, while the lowest incidence was in 2011-2013. Outbreaks mainly occurred from November to March of the following year (accounting for 79.58%), presenting obvious seasonal characteristics. The distribution was mainly in primary schools, accounting for 70.42% (100/142) of all outbreaks. From 2011 to 2022, all types of influenza viruses were tested, and more than 2 types of influenza viruses were prevalent each year. The dominant strains alternated between influenza A H1N1, influenza A H3N2 and Victoria lineages of type B influenza viruses. From 2011 to 2019, the influenza epidemic in schools in Nanchang showed a continuous upward trend. During COVID-19 in 2020-2022, Nanchang adopted a variety of non-drug prevention and control measures for COVID-19, and both the number of influenza epidemics in various schools and the number of influenza virus nucleic acid positive cases decreased. The average number of classes involved in the epidemic was (3±2), and the average duration of the epidemic was (8±4) days. 　Conclusions The outbreaks of influenza-like illness in Nanchang schools is highly prevalent in winter and spring, , with urban primary schools being the high incidence locations. Non-drug prevention and control measures for COVID-19 have an impact on the epidemic trend of influenza, so the continuous monitoring of the school influenza virus activities and improving the timeliness of the report will be conducive to the rapid control of the epidemic.

Under the background of the comprehensively implementing the rule of law, the construction of legal practice of medical institutions in China is directly related to the sustainable and high-quality development of the medical service industry. However, at present, each medical institution lacked a systematic plan for the construction of legal practice, and the health administrative department mostly implemented the measures of inspection and punishment for illegal practice, which led to the situation that the illegal practice of medical institutions was " investigated but not corrected, and changed but invalid" . This paper creatively put forward the application research of administrative reconciliation theory in the legal practice management of medical and health institutions, for promoting medical and health institutions and medical staff to strengthen legal practice management, standardizing medical behavior, ensuring medical safety, and achieving high-quality development through the institutional incentive and guidance.

Objective:To investigate the relationship between brain derived neurotrophic factor (BDNF) gene polymorphism and the change of grey matter volume (GMV) and fractional amplitude of low-frequency fluctuation (fALFF) in cerebral small vessel disease (CSVD) patients with subcortical ischemic depression (SID).Methods:Eighty-seven CSVD patients in the First Affiliated Hospital of Anhui Medical University were enrolled from July 2017 to November 2020 and divided into CSVD-SID group [Geriatric Depression Scale (GDS) score>10] and CSVD-non - depression group (CSVD-ND group, GDS score≤10) according to GDS. Both GMV and fALFF were calculated based on structural and functional magnetic resonance imaging data, and the interactions between SID diagnosis and BDNF gene on brain function and structure alteration were explored.Results:GMV was significantly increased in the posterior default network (pDMN; such as posterior cingulate gyrus/precuneus and middle temporal gyrus) in the CSVD-SID group compared with the CSVD-ND group. On GMV property, significant interactions between BDNF gene and SID were found in the cuneus ( F=25.50, P<0.001), precuneus lobe ( F=13.61, P<0.001) and cerebellum ( F=17.23, P<0.001). In the aspect of fALFF, the brain functional activity in the superior frontal gyrus was significantly increased in the CSVD-SID group compared with that in the CSVD-ND group (0.363±0.648 vs -0.427±0.514,cluster size=48 voxels, t=5.63, P<0.001). But there was no significant interaction between diagnosis and BDNF genotype on brain function. Conclusions:Both the GMV and fALFF were increased in CSVD-SID, mainly located in the pDMN and frontal lobe. Significant interaction was found between CSVD-SID and BDNF genotype on GMV.

Objective:To investigate the impact of altering brain gray matter volume (GMV) on cognition and gait disorder in patients with amnestic mild cognitive impairment (aMCI).Methods:Thirty-six patients with aMCI, who admitted to the First Affiliated Hospital of Anhui Medical University from July 2018 to August 2020, were collected, and 33 normal controls (NC) matched with age, sex and education level were included in the same period. The neuropsychological assessment was done in all the subjects using Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment scale (MoCA), Cambridge Cognitive Examination-Chinese version (CAMCOG-C), Geriatric Depression Scale (GDS) and Activities of Daily Living scale (ADL). The timed up and go test (TUG), dual task of timed up and go test (D-TUG) and Berg Balance Scale (BBS) were used in the subjects for assessment. The parameters such as stride length, gait speed, gait frequency were collected by intelligent device for energy expenditure and activity. All the subjects received 3.0 T magnetic resonance imaging scan to obtain high-resolution T 1 structural images. Voxel-based morphometry (VBM) was used to compare the difference of GMV between aMCI patients and NC. Partial correlation analysis was performed among altering GMV in the regions of interest (ROI), cognitive score and gait parameters, respectively. Linear regression analysis was used between whole brain GMV and gait parameters. Results:The scores of MMSE, MoCA, CAMCOG-C and the subitems of CAMCOG-C in aMCI group were significantly lower than those in NC group ( P<0.05). In aMCI patients, both the test time of TUG and D-TUG increased, gait speed slowed down, stride length shortened, and stride frequency and BBS score decreased ( P<0.05).VBM analysis showed that the whole brain GMV in aMCI patients was obviously lower than that of NC. In the aMCI group, GMV in ROI1 (right hippocampus, right parahippocampal gyrus, right amygdala and right fusiform gyrus), ROI2 (right middle temporal gyrus), ROI3 (right angular gyrus), ROI4 (right occipital lobe), ROI5 (bilateral orbital frontal lobe), ROI6 (left middle frontal gyrus and rectus gyrus), ROI7 (left fusiform gyrus and left parahippocampal gyrus) was significantly decreased compared with the NC group [Gaussian random field (GRF) correction, two-tailed test, voxel level P<0.001, cluster level P<0.05). In the aMCI group, GMV in ROI1 was positively correlated with orientation ( r=0.437, P=0.012), memory ( r=0.360, P=0.043), execution ( r=0.414, P=0.019), and negatively correlated with ADL score ( r=-0.529, P=0.002). GMV in ROI2 was negatively correlated with ADL score ( r=-0.400, P=0.023). GMV in ROI4 and in ROI5 was positively correlated with the calculation ( r=0.370, P=0.037) and execution ( r=0.360, P=0.043), respectively. GMV in ROI6 was positively correlated with MMSE score ( r=0.357, P=0.045), CAMCOG-C total score ( r=0.503, P=0.003) and calculation ( r=0.395, P=0.025), and negatively correlated with ADL score ( r=-0.387, P=0.028). GMV in ROI5 was positively correlated with gait speed ( r=0.391, P=0.027). In the aMCI group, CAMCOG-C total score was negatively correlated with D-TUG results ( r=-0.387, P=0.035), executive function was negatively correlated with TUG results ( r=-0.450, P=0.013) and D-TUG results ( r=-0.553, P=0.002), and positively correlated with gait speed ( r=0.379, P=0.039). Attention was positively correlated with gait speed ( r=0.590, P=0.001), and computing was positively correlated with gait speed ( r=0.371, P=0.044). The linear regression of whole brain GMV and gait parameters showed negative correlation between the GMV of left occipital lobe and TUG results in the aMCI group. The GMV of bilateral prefrontal cortex, right occipital lobe and surrounding cortex was positively correlated with gait speed (GRF correction, two-tailed test, voxel level P<0.001, cluster level P<0.05). Conclusions:Patients with aMCI presented with gray matter atrophy, cognition impairment, and gait disorders. The cognition impairment was closely related to the atrophy of medial temporal lobe. Gait disorders were not only associated with cognition impairment but also with gray matter volume in the prefrontal lobe, occipital lobe and its surrounding cortex, and anterior central gyrus.

Objective:To monitor and evaluate in vivo dose changes of intensity-modulated radiotherapy (IMRT) in patients with cervical cancer in a real-time manner. Methods:Twelve patients with cervical cancer admitted to our hospital were enrolled in this study. The in vivo doses were monitored by PerFRACTION?. Electronic portal imaging device (EPID) were collected in each treatment fraction for two-dimensional in vivo dose verification[γ index and dose difference (DD) index]. Log files were recorded for three-dimensional in vivo dose verification (γ index). The correlation between in vivo dose and treatment duration was analyzed by Pearson correlation analysis. Results:A total of 206 sets of EPID images and corresponding Log files were collected. The three-dimensional in vivo dose verification γ 1%/1mm of all patients was not correlated with treatment fraction ( P>0.05). Among them, the absolute difference of γ 1%/1mm of 94.66% fractions was< 1%. The mean DD 3% of two-dimensional in vivo dose verification of all patients was negatively correlated with treatment fraction ( P<0.05). Among which, the average γ 3%/3mm of 9 patients was>89% in the treatment fractions, and the average γ 3%/3mm of 98.57% fractions of these 9 patients was>93%. The other 3 patients had an average γ 3%/3mm ranged from 38% to 100%. CBCT images showed that the bladder volume of these 3 patients was significantly decreased with the relative changes by 82.08%, 84.41% and 73.59%, respectively, and the target area was retracted significantly with the relative changes by 38.12%, 59.79% and 24.46%, respectively. Conclusion:Combined with γ index and DD index, PerFRACTION? can monitor the mechanical stability of accelerator and MU delivery accuracy during treatment fractions, and monitor the changes of in vivo dose in patients with cervical cancer, which can improve the safety and quality assurance of IMRT for cervical cancer patients and provide guidance for patients with adaptive radiotherapy.