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.

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.

OBJECTIVES: Gastrointestinal endoscopy plays an important role in the diagnosis and treatment of gastrointestinal diseases. The satisfaction degree of gastrointestinal endoscopy can directly affect the patient's compliance and further impact the treating effect. At present, there is no scale to evaluate the satisfaction degree of gastrointestinal endoscopy in China. This study aims to develop a satisfaction scale of gastrointestinal endoscopy suitable for national conditions and to evaluate its reliability and validity, which provides a tool for clinic to evaluate patients' satisfaction with gastrointestinal endoscopy. METHODS: The original gastrointestinal endoscopy satisfaction scale was compiled by literature review, consulting senior endoscopists and experts. Through the first round of survey about 120 patients, the original scale was analyzed and modified according to the results to get the gastrointestinal endoscopy satisfaction scale (formal scale). The formal scale was used to conduct the second round of survey about 200 patients. The reliability and validity of the scale were analyzed and evaluated according to the survey results. RESULTS: The reliability of the original scale was good but the validity was poor. The formal scale had 2 dimensions and 10 items, the Cronbach's alpha and split-half reliability were 0.889 and 0.823. The structure validity index χ²/df was 2.513, root mean square error of approximation (RMSEA) was 0.094, goodness of fit index (GFI) was 0.914, adjusted goodness of fit index (AGFI) was 0.861, comparative fit index (CFI) was 0.946, normed fit index (NFI) was 0.915. The aggregate validity was general, the discriminative validity was good, and the direct score of patients was strongly correlated with the total score of the scale. CONCLUSIONS The gastrointestinal endoscopy satisfaction scale has good reliability and validity, which can be used as a tool to evaluate patients' satisfaction with gastrointestinal endoscopy in China.
Humans ; Reproducibility of Results ; China ; Endoscopy, Gastrointestinal ; Patient Compliance ; Personal Satisfaction

Objective:Digestive endoscopy is an important diagnostic and therapeutic tool for digestive system diseases.The artificial intelligence(AI)-assisted system in endoscopy(hereinafter referred to as AI in digestive endoscopy)has broad application prospects in the field of digestive endoscopy.The trust and acceptance of endoscopic subjects are the cornerstone of the research,application,and promotion of AI in digestive endoscopy.Currently,the tools for measuring the acceptance of AI in digestive endoscopy by subjects are limited at home and abroad.This study aims to develop a scale for measuring the acceptance of AI in digestive endoscopy by subjects,then to evaluate its reliability and validity. Methods:By conducting literature research,an item pool and dimensions were constructed,and a preliminary scale was constructed using Delphi method.Through the first stage of the survey on the subjects,the reliability and validity of the scale were tested,and the revised scale was used for the second stage of survey on the subjects to further verify the structural validity of the scale. Results:The acceptance scale for AI in digestive endoscopy included 11 items in 3 dimensions:accuracy,ethics,benefit and willingness.In the first stage of the survey,351 valid questionnaires were collected,and the Cronbach's α was 0.864.The correlation coefficient between the total score of the scale and the score of the test item was 0.636,and the Kaiser-Meyer-Olkin(KMO)value in exploratory factor analysis was 0.788.In the second stage of the survey,335 valid questionnaires were collected,and in confirmatory factor analysis,the χ2/df was 3.774,while the root mean squared error of approximation(RMSEA)was 0.091. Conclusion:Acceptance scale for AI in digestive endoscopy by subjects developed in this study has good reliability and validity.

Objective:To analyze the application value of noninvasive prenatal testing (NIPT) in screening fetal chromosome aneuploidy in cautious population.Methods:The data of 19 590 pregnant women who voluntarily received NIPT in the Department of Gynecology and Obstetrics, General Hospital of Tianjin Medical University from October 2016 to June 2020 were retrospectively analyzed. The patients were divided into groups according to age, type of pregnancy and number of fetuses. The screening efficiency of NIPT was compared among different groups. Meanwhile, the screening efficacy of second trimester serum screening (STSS), STSS combined with NIPT and direct NIPT screening was compared and analyzed.Results:The positive predictive values of NIPT for trisomy 21, trisomy 18 and trisomy 13 were 87.18%, 54.84% and 41.18%, respectively. In pregnant women with advanced age (≥35 years old), in vitro fertilization and embryo transfer (IVF-ET) and twin pregnancy, NIPT sensitivity was all 100%, specificity was 99.79%, 99.82% and 100%, positive predictive value was 85.25%, 50.00% and 100%, respectively. The positive predictive value of ≥35 years old patients was significantly higher than that of <35 years old patients (61.54%, P=0.003), and the other indicators were similar to those of the young (<35 years old), conceived naturally and singleton group (all P>0.05). Compared with STSS, combined screening and direct NIPT screening had higher positive predictive value (1.20%, 68.75%, 73.74%; all P<0.001) and lower false positive rate (27.83%, 0.19%, 0.17%; all P<0.001). Conclusion:NIPT has high sensitivity, specificity and positive predictive value for fetal chromosome aneuploidy screening in pregnant women with advanced age, STSS high risk, IVF-ET and twin pregnancy, which greatly relieves the pressure of prenatal diagnosis and reduces the birth rates of children with chromosome disease.

Objective:To analyze the application value of noninvasive prenatal testing (NIPT) in screening fetal chromosome aneuploidy in cautious population.Methods:The data of 19 590 pregnant women who voluntarily received NIPT in the Department of Gynecology and Obstetrics, General Hospital of Tianjin Medical University from October 2016 to June 2020 were retrospectively analyzed. The patients were divided into groups according to age, type of pregnancy and number of fetuses. The screening efficiency of NIPT was compared among different groups. Meanwhile, the screening efficacy of second trimester serum screening (STSS), STSS combined with NIPT and direct NIPT screening was compared and analyzed.Results:The positive predictive values of NIPT for trisomy 21, trisomy 18 and trisomy 13 were 87.18%, 54.84% and 41.18%, respectively. In pregnant women with advanced age (≥35 years old), in vitro fertilization and embryo transfer (IVF-ET) and twin pregnancy, NIPT sensitivity was all 100%, specificity was 99.79%, 99.82% and 100%, positive predictive value was 85.25%, 50.00% and 100%, respectively. The positive predictive value of ≥35 years old patients was significantly higher than that of <35 years old patients (61.54%, P=0.003), and the other indicators were similar to those of the young (<35 years old), conceived naturally and singleton group (all P>0.05). Compared with STSS, combined screening and direct NIPT screening had higher positive predictive value (1.20%, 68.75%, 73.74%; all P<0.001) and lower false positive rate (27.83%, 0.19%, 0.17%; all P<0.001). Conclusion:NIPT has high sensitivity, specificity and positive predictive value for fetal chromosome aneuploidy screening in pregnant women with advanced age, STSS high risk, IVF-ET and twin pregnancy, which greatly relieves the pressure of prenatal diagnosis and reduces the birth rates of children with chromosome disease.

The morbidity of inflammatory bowel diseases (IBD) is rising rapidly but no curative therapies to prevent its recurrence. Cell death is crucial to maintaining homeostasis. Necroptosis is a newly identified programmed cell death and its roles played in IBD need to be explored. Necroptosis is mediated by receptor interacting protein kinase 1 (RIPK1), RIPK3, and mixed lineage kinase domain-like protein (MLKL), which resulted in cell swelling, plasma membrane rupture, intracellular content leaking, and eventually cell death as well as the promotion of inflammation. Studies have found that inhibiting necroptosis alleviated IBD in animal models and IBD patients with an increased level of necroptosis in inflammatory tissues, indicating that necroptosis is related to the pathogenesis of IBD. However, due to the complexity in regulation of necroptosis and the involvement of multiple functions of relevant signaling molecules, the specific mechanism remains elusive. Necroptosis may play a vital regulatory role in the pathogenesis of IBD, which provides a new idea and method for further exploring the therapeutic target of IBD.

Objective To explore the association of serum bilirubin level at the time of admission with the compos?ite outcome（disability or death）in discharged patients with acute ischemic stroke. Methods In a retrospective cohortstudy from June 1st 2009 to May 31st 2012, we continuously included 3151 patients with acute ischemic stroke and col?lected demography,lifestyle,clinical manifestations and laboratory test data. Functional outcome was measured with themodified Rankin scale (mRS) when subjects were discharged. Disability was defined as mRS≥3 and composite outcomewas defined as mRS≥3 or death. Serum bilirubin was divided into four groups according to the quartile. Multiple Coxregression analysis was used to assess the independent relation between serum bilirubin and disability death and the com?posite outcome. Results There were 407 disabled patients，the disability rate was 12.9%；and 104 patients were dead，the fatality rate was 3.3%.After adjusting for multiple factors, we found the risks of composite outcome with total bilirubin in the four quartile were higher than that in the first quartile, aHR and 95%CI were 1.335(1.047～1.702) respectively；The risks of composite outcome with indirect bilirubin in the four quartile were higher than that in the first quartile, aHR and 95%CI were 1.355(1.062～1.728) respectively; The risks of composite outcome with bilirubin direct in the third and the forth quartile were higher than that in the first quartile, aHR and 95% CI were11.403(1.089～1.807)and 1.431 (1.118～1.833) respectively.With the increase of total bilirubin，indirect bilirubin and direct bilirubin level，the compos?ite outcome of discharged patient was on the increase. Conclusions The study indicated that higher serum bilirubincould increase the risk of composite outcome in ischemic stroke patients, there was dose-response relationship ,and bili?rubin was a independent risk factor.

Objective To investigate the prevalence rate of hyperlipidemia in the middle-aged and elderly in Guangxi Hei Yi Zhuang population. Methods A total of 657 people of Hei Yi Zhuang nationality aged 40 years and over were surveyed. Blood pressure, body height, body weight, serum lipid and apolipoprotein levels were measured, and both body surface areas and body mass index were calculated. The results were compared with those in 520 people of Han nationality who also live in that district. Results The prevalence of hypercholesterolemia, hypertriglyceridemia, and hyperlipidemia in Hei Yi Zhuang vs. Han population were 28.9% vs. 35.8%(P0.05), and 36.2% vs. 42.3%(P0.05) respectively. Conclusions Prevalence of hyperlipidemia of Hei Yi Zhuang is lower than that of Han ethnic group, which might results from different dietary habit, life style, physical activity, and even genetic background.