Objective: To investigate the current status and influencing factors of overweight and obesity among adults in Jiaxing City, Zhejiang Province, so as to provide a basis for developing targeted weight management measures. Methods: In 2024, a multistage stratified random cluster sampling method was employed to recruit permanent residents aged ≥18 years from Jiaxing City for questionnaire surveys. Data on basic information, lifestyle behaviors, and history of chronic diseases were collected. Height and body weight were measured, and overweight and obesity were determined based on body mass index (BMI). The influencing factors of overweight and obesity among adults were analyzed by a multivariable logistic regression model. Results: Totally 10 509 questionnaires were allocated, and 9 802 valid questionnaires were recovered, with an effective recovery rate of 93.27%. Among the respondents, 4 808 (49.05%) were males and 4 994 (50.95%) were females, with a mean age of (51.27±17.26) years. A total of 4 884 overweight and obesity individuals were identified, with a detection rate of 49.83%. Multivariable logistic regression analysis showed that gender (male, OR=1.719, 95%CI: 1.578-1.873), age (≥60 years, OR=0.802, 95%CI: 0.652-0.986), educational level (bachelor and above, OR=0.640, 95%CI: 0.518-0.791), marital status (being married/cohabiting, OR=1.224, 95%CI: 1.009-1.486), adequate nut intake (OR=0.910, 95%CI: 0.832-0.995), hypertension (OR=2.462, 95%CI: 2.219-2.732), and dyslipidemia (OR=1.629, 95%CI: 1.444-1.837) were statistically associated with overweight and obesity among adults. Conclusion The detected rate of overweight and obesity among adults in Jiaxing City was relatively high, and was mainly associated with gender, age, education level, marital status, nut intake, hypertension, and dyslipidemia.

Objective: To investigate the trend in mortality of injury in Jiaxing City, Zhejiang Province, from 2010 to 2022, so as to provide the evidence for developing injury prevention and intervention strategies. Methods: Data on injury mortality in Jiaxing City from 2010 to 2022 were obtained from the Jiaxing Chronic Disease Monitoring Information Management System. Crude mortality was calculated, and standardized mortality was computed using data of the Sixth National Population Census in 2010. Descriptive analysis of injury mortality and cause of injury death was conducted by gender and age. The average annual percent change (AAPC) was used to analyze the trend in mortality of injury from 2010 to 2022. Results: From 2010 to 2022, the crude injury mortality in Jiaxing City was 79.24/100 000, and the standardized mortality was 47.08/105. The crude injury mortality was higher in males than in females (80.51/100 000 vs. 78.01/100 000, P<0.05). The standardized injury mortality for the total population, males, and females showed significant declining trends (AAPC=-2.011%, -2.373% and -1.542%, all P<0.05). The crude injury mortality increased with age (P<0.05), peaking in the age group of ≥85 years (1 806.46/100 000). Decreasing trends were observed in the age groups of 0-<15 years, 15-<45 years, and 45-<65 years (AAPC=-7.794%, -4.698% and -4.521%, all P<0.05), while no significant trend was found in the age group of ≥65 years. The top five causes of injury death were falls (29.96/100 000), motor vehicle traffic accidents (17.81/100 000), drowning (6.50/100 000), suicide (5.40/100 000), and poisoning (0.69/100 000). Drowning was the leading cause of injury death in the age group of 0-<15 years, while falls were the primary cause in the age group of ≥65 years. Motor vehicle traffic accidents were the top cause of injury death in age groups of 15-<45 years and 45-<65 years. From 2010 to 2022, the standardized mortality of falls showed an upward trend (AAPC=1.094%, P<0.05), while the standardized mortality of motor vehicle traffic accidents, drowning, and suicide demonstrated downward trends (AAPC=-7.576%, -2.745% and -2.786%, all P<0.05). Conclusions The standardized injury mortality in Jiaxing City showed an overall downward trend from 2010 to 2022. Falls were the leading cause of injury death, and particular attention should be paid to the prevention and control of falls among the elderly aged ≥65 years.

Objective To evaluate the clinical efficacy of comprehensive treatment for synchronous primary advanced gastric and esophageal cancer by propensity score matching(PSM).Methods A total of 2 551 patients with advanced gastric cancer admitted to Jiangsu Province Hospital of Chinese Medicine from January 2013 to December 2022 were retrospectively analyzed.Among them,45 patients with synchronous primary esophageal cancer were distributed to the observation group,and 2 506 patients without esophageal cancer were distributed to the control group.Through the PSM method,the control group was matched with the observation group and the equilibrium samples of covariates between two groups were obtained.The overall survival(OS)between the two groups were compared.Results Both observation and control group contained 45 patients in this study.According to the treatment regimen,the patients in the observation group was divided into radical resection treatment subgroup(n=22)and chemoradiotherapy(CRT)subgroup(n=23).In the radical resection subgroup,4 patients underwent the simultaneous surgical resection of gastric and esophageal tumors through proximal gastrectomy with the Ivor Lewis operation.Eighteen patients underwent endoscopic submucosal dissection(ESD)of their esophageal tumors and gastric cancer radical resection.Radical resection of gastric cancer combined with preoperative chemoradiotherapy of esophageal cancer was performed in the CRT subgroup.Survival analysis showed that OS in the observation group was significantly shorter than that in the control group(P=0.042)and there was no significant difference in OS between the radical resection subgroup and the control group(P=0.799).The 1-,3-,and 5-year survival rates of the patients in the CRT subgroup were significantly lower than those of the control group(P=0.003).While the 1-,3-,and 5-year survival rates of the patients in the radical resection subgroup were not statistically significant,compared to those of the CRT subgroup(P=0.071).Conclusions Multidisciplinary and comprehensive treatment can significantly improve the prognosis of patients with synchronous primary advanced gastric and esophageal cancer.Radical resection of gastric cancer combined with ESD of esophageal cancer is an optional treatment for patients with gastric cancer complicated with early esophageal cancer.Radical resection of gastric cancer combined with CRT of esophageal cancer can improve the prognosis of patients with advanced gastric cancer complicated with unresectable esophageal cancer.

Objective:To analyze and summarize the application and significance of the computer-assisted surgery system in precision surgery of mediastinal tumors in children.Methods:The clinical data of 54 children that underwent mediastinal tumor resection surgery in the Affiliated Hospital of Qingdao University from August 2008 to November 2021 were collected.According to whether the Hisense CAS computer-assisted surgery system was used before the operation, the patients were divided into three-dimensional (3D) reconstruction group (29 cases, 53.70%) and two-dimensional (2D) CT group (25 cases, 46.30%). The surgical indicators, postoperative hospital stay, and the incidence of surgical complications were compared between the two groups.The t-test, Mann- Whitney U test, χ2 test or Fisher′ s exact test were carried out for statistical analysis.Simulated surgery and actual surgery were compared for both 3D reconstruction and 2D CT groups. Results:There were no significant differences in gender, age, height, weight, maximum tumor diameter and tumor location between the 3D reconstruction group and 2D CT group (all P>0.05). The operation time of the 3D reconstruction group was [(125.14±41.37) min] was shorter than that of the 2D CT group [(149.24±44.53) min] ( P=0.044). The intraoperative blood loss in the 3D reconstruction group [15.00(13.50, 25.00) mL] was less than that in the 2D CT group [36.00(30.00, 75.00) mL] ( P<0.001). In addition, the indwelling time the closed thoracic drainage tube [4.00 (3.00, 5.50) d] and postoperative hospitalization days [(8.83±3.39) d] in the 3D reconstruction group were shorter than those in the 2D CT group [7.00(5.00, 11.50) d, (11.00±4.10) d] ( P=0.001, 0.038). No significant difference in postoperative complication rates was found between the 3D reconstruction group and 2D CT group ( P>0.05). The simulated operation was consistent with the actual operation in the 3D reconstruction group. Conclusions:3D reconstruction by the computer-assisted surgery system can truly reveal the anatomical relationship between tumors and surrounding organs and blood vessels, and improve the accuracy and safety of surgical resection of mediastinal tumors in children.

Background::The risk for chronic kidney disease (CKD) is influenced by genetic predisposition, sex, and lifestyle. Previous research indicates that coffee is a potentially protective factor in CKD. The current study aims to investigate whether sex disparity exists in the coffee–CKD association, and whether genetic risk of CKD or genetic polymorphisms of caffeine metabolism affect this association.Methods::A total of 359,906 participants from the UK Biobank who were enrolled between 2006 and 2010 were included in this prospective cohort study, which aimed to estimate the hazard ratios for coffee intake and incident CKD using a Cox proportional hazard model. Allele scores of CKD and caffeine metabolism were additionally adjusted for in a subsample with qualified genetic data ( n = 255,343). Analyses stratified by genetic predisposition, comorbidities, and sex hormones were performed. Tests based on Bayesian model averaging were conducted to ascertain the robustness of the results. Results::Coffee was inversely associated with CKD in a dose-dependent manner. The effects of coffee did not differ across different strata of genetic risk for CKD, but were more evident among slower genetically predicted caffeine metabolizers. Significant sex disparity was observed ( P value for interaction = 0.013), in that coffee drinking was only associated with the risk reduction of CKD in females. Subgroup analysis revealed that testosterone and sex hormone-binding globulin (SHBG), but not estradiol, modified the coffee–CKD association. Conclusions::In addition to the overall inverse coffee–CKD association that was observed in the general population, we could also establish that a sex disparity existed, in that females were more likely to experience the benefit of the association. Testosterone and SHBG may partly account for the sex disparity.

Background::The increasing burden of non-alcoholic fatty liver disease (NAFLD) worldwide imposes an emerging public health issue. We perform the current study to estimate the global prevalence, incidence, disease progression, and clinical outcomes of NAFLD.Methods::A systematic search was conducted in Medline, Embase, Web of Science, Google Scholar, and Cochrane CENTRAL that screened articles in English language published from January 2000 to December 2021. NAFLD prevalence, incidence, rate of disease progression, and outcomes were calculated with the DerSimonian-Laird random effects model with arcsine transformation.Results::Our search identified 59,156 records, of which 578 studies fulfilled our inclusion criteria. The overall prevalence of NAFLD was 29.38% (95% confidence interval [CI] 28.09–30.69) regardless of the diagnostic techniques. Looking at the group in which the diagnosis was made by ultrasound exclusively, the pooled prevalence was 30.49% (95% CI 29.55–31.43). NAFLD has become more prevalent during the year 2011–2021 (31.63%, 95% CI 30.23–33.04) compared with year 2000–2010 (27.94%, 95% CI 26.23–29.69). The pooled estimation of non-alcoholic steatohepatitis prevalence was 8.26% (95% CI 1.13–21.01), 46.49% (95% CI 35.93–57.20), and 46.72% (95% CI 37.57–55.98) in general population, NAFLD patients, and severe/morbidly obese patients, respectively. Based on a total of 110,142 newly developed NAFLD patients, the pooled incident rate was estimated as 46.24 cases per 1000 person-years (95% CI 43.21–49.30). In patients with NAFLD, the incident rate of hepatocellular carcinoma was 1.46 (95% CI 0.90–2.03) cases per 1000 person-years. The overall pooled estimate of NAFLD related mortality was 23.91 (95% CI 13.55–37.18) death per 1000 person-years.Conclusions::The prevalence of NAFLD is increasing globally. It is contributing to poor clinical outcomes including hepatocellular carcinoma and death. Rising awareness and urgent actions are warranted to control the NAFLD pandemic across the globe.Registration::PROSPERO, No. CRD42020171104.

The causes of stroke in young people are diverse, most of which are cardiogenic. However, cerebral embolism caused by cardiac myxoma is rare. Intravenous thrombolysis is given in the time window, and the therapeutic effect depends on the nature of embolus. This case is a young female patient, with acute onset, excluding bleeding on the basis of the symptoms, signs and craniocerebral CT. After diagnosed as acute ischemic stroke, the patient was performed an immediate intravenous thrombolysis, though the curative effect was poor. Excluding contraindications six hours after onset, bridging mechanical thrombectomy was performed, postoperative embolus biopsy indicating myxoma. Atrial myxoma was removed in cardiac surgery two months later, and the pathology indicated atrial myxoma. The patient recovered well during the out-of-hospital follow-up, and no further embolization occurred. Therefore, it is suggested that bridging mechanical thrombectomy may be safe and effective for acute ischemic stroke caused by atrial myxoma when intravenous thrombolysis is ineffective, and myxoma resection should be performed immediately after the disease is stable.

Objective To explore the relationship of magnetic resonance imaging (MRI) performance in juvenile dermatomyositis (JDM) with clinical characteristics, especially serum muscle enzyme abnormalities. Methods The images of 50 cases of JDM were reviewed, and the affected skin, subcutaneous connective tissue, muscle fascia and muscle were evaluated. The range of muscle edema under MRI images was categorized into 1-3 grades from mild to complete involvement. By comparing the MRI classification with muscle enzyme, we aim to reveal the linkage between the degree of muscle damage and the levels of muscle enzymes. The sequence of MRI examination of the thigh included rapid spin echo sequence FSE T1W, and the fat suppression sequence STIR in both coronary and axial position. Results In the 50 cases of dermatomyositis, there were 49 cases of muscle edema, 28 cases of myofasciitis, 9 cases of subcutaneous connective tissue inflammation, and 4 cases of thickening skin. Of 49 cases of muscle edema, there are 16 cases in grade 1, 24 in grade 2 and 9 in grade 3. The median value of all muscle enzyme in the grade 2 group was higher than that in the other two groups, and the value of AST was statistically significant, P<0.05. Conclusions The detection rate of JDM using MRI is high, which can help judge the severity and range of involvement. The MRI findings of JDM mainly demonstrated muscle edema, mostly moderate degree, followed by muscular fasciitis.

Objective To develop a portable integral dental unit in the ship to fulfill medical service during canvoy operation.Methods The unit developed was modified based on WD6232-E dental unit,and comprised of a chair and accessories.An earth box and a seat box were under the chair,and a base was at one side of it.The accessories included a level bar,emesis basin,cold light and etc.The digital unit was modified,which involved in a miniature digital dental X-ray machine and a micro computer.Results The dental unit developed could fulfill dental auxiliary diagnosis and treatment similar to them in garrison hospital.Conclusion The unit gains advantages in portability and easy operation and adapts itself to dental service during expedition,and thus is worthy promoting practically.

Studies have shown that the clinical manifestation of patients with neuropsychiatric disorders might be related to the abnormal connectivity of brain functions. Psychogenic non-epileptic seizures (PNES) are different from the conventional epileptic seizures due to the lack of the expected electroencephalographically epileptic changes in central nervous system, but are related to the presence of significant psychological factors. Diagnosis of PNES remains challenging. We found in the present work that the connectivity between the frontal and parieto-occipital in PNES was weaker than that of the controls by using network analysis based on electroencephalogram (EEG) signals. In addition, PNES were recognized by using the network properties as linear discriminant nalysis (LDA) input and classification accuracy was 85%. This study may provide a feasible tool for clinical diagnosis of PNES.
Brain ; physiopathology ; Electroencephalography ; Epilepsy ; Humans ; Seizures ; diagnosis