Background Repeated-sprint training in hypoxia (RSH) can improve athletic performance and reduce body fat in obese individuals. However, studies characterizing metabolic changes experienced by elite athletes before and after RSH are currently scarce in China. Objective To characterize the plasma metabolic profile alterations in elite athletes induced by a two-week RSH intervention using untargeted metabolomics, and to analyze the associations between differential metabolites and indices of blood lipids and body composition. Methods Blood samples from 11 elite athletes before and after 2 weeks of RSH were collected for metabolomics analysis and blood lipid analysis. Plasma metabolites were detected by liquid chromatographymass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS) combined technology, and the differential metabolites before and after training were screened out by differential analysis. Key metabolic pathways were identified by Kyoto Encyclopedia of Gene and Genome Database (KEGG) enrichment analysis. Then, the correlations of blood lipid indexes and body composition indexes with differential metabolites before and after training were evaluated. Results Finally 20 differential metabolites were identified, among which 17 lipid metabolites were significantly up-regulated, and amino acids and their derivatives (1 type) and sugar derivatives (2 types) were significantly down-regulated. The results of KEGG enrichment analysis showed that the differential metabolites were mainly involved in three pathways closely related to RSH, namely hypoxia inducible factor 1-alpha (HIF-1) signaling pathway, cyclic adenosine monophosphate (cAMP) signaling pathway, and sphingolipid signaling pathway. The post-training analysis revealed significant increases in total cholesterol (P<0.05) and high-density lipoprotein cholesterol (HDL-C) (P<0.001), as well as a significant decrease in triglycerides (P<0.01). There were minor decreases in body weight, body fat, body fat percentage, fat mass index (FMI), and fat-free mass (FFM) (P>0.05). After training, total cholesterol was negatively correlated with phosphatidylinositol (16:0/22:4) and D-fructose, HDL-C was negatively correlated with D-fructose and β-D-glucuronic acid, while body fat, body fat percentage, and FMI showed positive correlations with multiple carnitine fatty acid derivatives. Conclusion The 2-week RSH promotes the decomposition of lipid metabolites, increases the utilization of fatty acids, and reduces the accumulation of carbohydrate metabolites in elite athletes, which has a positive effect on the health of blood lipid metabolism. It may also help elite athletes regulate body fat by promoting lipid metabolism. Further research is needed in the future to validate these findings.

Objective: To explore the associations of moderate to vigorous intensity physical activity (MVPA) and sedentary behavior (SB) among primary and secondary school students and their parents, so as to provide a scientific basis for formulating targeted physical activity promotion strategies for children and adolescents. Methods: From 2021 to 2022, basic information and 24 h movement behaviors of 2 484 pairs of students and their parents were collected from five primary and secondary schools in Haizhu District, Guangzhou City, with a convenient sampling combining with cluster sampling method. Component regression models were constructed to analyze the relationship between parental MVPA, SB and primary and secondary school students MVPA and SB, and a component isochronous substitution model was used to explore the effects of mutual substitution between parental MVPA, residual components (time use components other than SB during the 24 h period), and SB on the behavioral activities of MVPA and SB in primary and secondary school students. Results: Parental MVPA and SB of students in grade 1 to 3 were positively correlated with both students MVPA and SB ( β=0.06, 0.12, P <0.01). The component isochronous substitution model showed that substituting 10 and 20 minutes of MVPA for SB by parents in grade 1 to 3 was associated with an increase in MVPA of students, and substituting 10 and 20 minutes of residual ingredients for SB was associated with a decrease in SB of students, with mean changes of 0.8 (95% CI =0.4-1.2) and 1.4 (95% CI =0.7-2.2) and -1.4 (95% CI =-1.7 to -1.1) and -2.9 (95% CI =-3.4 to -2.3)( P <0.05). No statistically significant associations were observed between parents of students in grades 4 to 6 and 7 to 9 and students physical activity and sedentary behaviour ( P >0.05). Conclusions Parents of students in grades 1 to 3 increases MVPA and decrease SB are beneficial to increase MVPA and decrease SB of students. Parents could promote physical activity among primary and secondary school students, and the intervention gateway should be advanced, with the low grades as the optimal intervention period.

Objective: To analyze the association between different sleep statuses and overweight/obesity among primary school students, so as to provide a basis for the development of childhood overweight and obesity prevention and control strategies. Methods: In November 2023, a total of 3 391 primary school students of grade 1-6 from seven schools in Baoan District, Shenzhen, were surveyed by questionnaires and physical examinations by using multistage cluster sampling. The Logistic regression analysis was used to explore the association between primary school students sleep status and overweight/obesity. Results: The detection rate of overweight/obesity in primary school students was 22.59%, the detection rate of overweight/obesity in boys (27.04%) was higher than that in girls (17.44%), the only child (25.81%) had higher rates than nononly child (21.76%), and the differences were statistically significant (χ2=51.48, 5.98, P＜0.05). Multivariate Logistic regression analysis showed that, after controlling for confounders, primary school students weekend nighttime sleep duration (OR=0.83, 95%CI=0.75-0.91), weekly average nighttime sleep duration (OR=0.76,95%CI=0.64-0.89), and weekend compensated sleep duration (OR=0.89,95%CI=0.81-0.97) were negatively associated with the risk of developing overweight/obesity (P＜0.05). Compared with to primary school students with school days nap durations <0.5 h, those whose napped for 0.5-＜1 h and ≥1 h on school days had a 20% (OR=1.20, 95%CI=1.02-1.42) and 37% (OR=1.37, 95%CI=1.02-1.83) increased risk of overweight/obesity, respectively (P＜0.05). Conclusions Increasing weekend nighttime sleep duration, average weekly nighttime sleep duration, and weekend compensatory sleep duration can reduce the risk of overweight and obesity in primary school students. School days nap duration is a risk factor for overweight/obesity among primary school students.

With the continuous deepening of medical insurance payment reform, the implementation of the ambulatory patient groups(APG) based point system for payment has posed new challenges to the quality management of outpatient electronic medical record writing, as well as the supervision and operation management of outpatient costs in hospitals. A certain hospital began information technology construction in July 2021. By introducing diagnostic grouping functions into the outpatient electronic medical record system, the hospital strengthened the standardization of medical record writing. It also established an intelligent audit system for medical insurance costs to conduct full-process supervision of outpatient medical expenses and developed an intelligent operation analysis system for outpatient APG to provide a basis for hospital operation management decisions and performance distribution. These measures effectively improved the quality of outpatient medical record, reduced outpatient medical costs, and optimized their structure. The application of the intelligent medical insurance audit system also effectively prevented certain non-compliant issues in medical insurance payments, which can provide a reference for other medical institutions.

Objective To review the application of user profiles in the health management of elderly patients with chronic diseases,and to provide references for nursing staff to apply this technology to manage chronic diseases in the elderly.Methods According to the scoping review methodology,a systematic search was conducted across 9 databases including Wanfang Database,CNKI,VIP,Chinese Biomedical Abstracted Database,PubMed,Embase,Web of Science,CINAHL and Cochrane Library.The search time was from the establishment of the database to January 2024.The literature was screened according to inclusion and exclusion criteria,and the information in the literature was independently extracted and summarized by 2 researchers.Results A total of 10 pieces of the literature were included in the study.The results showed that the process of constructing user profiles mainly includes data collection,user feature extraction,and profiles generation and visualization.User profiles are widely used in the health management of chronic diseases in the elderly,commonly used in the management of diabetes,heart failure and other chronic diseases in the elderly,including the formulation of personalised intervention plans,the provision of personalised health education and information,and the adjustment of health management strategies.User profiles significantly enhanced the accuracy of health information delivery and health services,improved user experience,enhanced patients'self-management ability and quality of life.Conclusion As an emerging health information integration tool,user profiles can merge and analyze multidimensional health data to provide personalized and precise health management for elderly patients with chronic diseases.This approach enhances remote monitoring,prevents and manages complications,improves treatment outcomes,and reduces medical costs,thereby demonstrating significant potential in the health management of elderly patients with chronic conditions.

Objective To investigate the application value of bedside ultrasound measurement of gastric antrum cross-sectional area(CSA)combined with acute gastrointestinal injury ultrasound(AGIUS)score in guiding early individualized enteral nutrition therapy for sepsis patients.Methods From January 2023 to July 2024,61 sepsis patients meeting diagnostic criteria were enrolled and divided into an observation group(n=30)and a control group(n=31).The observation group underwent bedside ultrasound monitoring of gastric antrum CSA to calculate gastric residual volume(GRV)and AGIUS score for formulating individualized en-teral nutrition strategies.The control group used gastric tube withdrawal method for GRV measurement to guide enteral nutrition.Clinical baseline characteristics,enteral nutrition-related complications,nutritional/in-fection indicators,and disease severity parameters were compared between groups.Predictive efficacy was ana-lyzed using receiver operating characteristic(ROC)curve and area under the curve(AUC).Results Both groups showed gradual increases in enteral nutrition feeding rates and total volumes over time,with the obser-vation group demonstrating significantly higher values than the control group at each time point(P＜0.05).The observation group started nasogastric feeding earlier than the control group(P＜0.05).Target calorie a-chievement rates on day 3,5,and 7 were better in the observation group(P＜0.05).The incidence of feeding intolerance progressively decreased in the observation group but increased in the control group over day 1,3,and 5,with significant intergroup differences at each time point(P＜0.05).By day 7,the observation group exhibited significantly higher prealbumin(PA),albumin(ALB),and transferrin(TF)levels compared to day 1 and the control group(P＜0.05).Both groups showed reductions in APACHE Ⅱ,SOFA,and AGI scores by day 7,with the observation group displaying significantly lower scores than the control group(P＜0.05).The observation group had shorter ICU stays[(10.83±3.26)d vs.(14.55±3.14)d,P＜0.05].The combination of gastric antrum CSA measurement and AGIUS scoring demonstrated excellent predictive value for feeding intolerance(AUC=0.920,95％CI:0.848-0.963),with 95.50％sensitivity and 82.50％specificity,achieving 87.60％predictive accuracy.Conclusion Bedside ultrasound measurement of gastric antrum cross-sectional area(CSA)combined with AGIUS scoring shows good effect as a safe and effective monitoring modality for guiding early individualized enteral nutrition therapy in sepsis patients.

Objective To investigate the relationship between different body position fixation tech-niques,umbilical plane volume change(ΔV),body weight change rate(ΔW%),and radiotherapy setup errors in cervical cancer patients,and to provide recommendations for determining the margin of planning target vol-ume(MPTV).Methods A retrospective analysis was performed on the clinical data of 57 cervical cancer pa-tients who underwent radiotherapy at this hospital from June 2022 to May 2023.Patients were divided into the observation group(fixed with body membrane+thermoplastic pad,n=24)and the control group(fixed with body membrane alone,n=33)based on different positioning fixation methods.They were also further strati-fied by median BMI into BMI≥23.82 kg/m2 and BMI<23.82 kg/m2 patients.Setup errors in the left-right(X),cranio-caudal(Y),and anterior-posterior(Z)directions were recorded.Meanwhile,the umbilical plane volume on the first CT positioning image and the patient's body weight before positioning were recorded,as well as umbilical plane volume of cone-beam CT(CBCT)verification images during weekly radiotherapy and body weight before scan,the ΔV and ΔW%were calculated.Setup errors were compared between two groups,and correlations between ΔV,ΔW%and setup errors were analyzed in all patients,in two groups(the obser-vation group and the control group)and in two BMI subgroups.MPTV values in X,Y,and Z directions were calculated,and receiver operating characteristic(ROC)curve determined the cut off values of ΔV and ΔW%when setup errors met the department's MPTV criteria.Results Compared with the control group,the ob-servation group showed significantly smaller setup errors in X,Y,and Z directions(P<0.05).Both ΔV and ΔW%were positively correlated with setup errors in X and Y direction in all patients,patients in the control group,and patients with BMI≥23.82 kg/m2(P<0.05).In the observation group,ΔW%was positively corre-lated with setup errors in Z direction in patients with BMI<23.82 kg/m2(P<0.05);In the control group,ΔV and ΔW%were positively correlated with setup errors in X and Y direction in patients with BMI≥23.82 kg/m2.ROC curve analysis showed that when setup errors in Y direction reached the department's MPTV criteria(8.41 mm),the cutoff values ΔV and ΔW%were 8.045 cm2 and 4.12%,respectively.Conclusion The body membrane+thermoplastic pad fixation technique reduces setup errors and mitigates the impact of ΔV and ΔW%on setup errors in X and Y directions.When ΔV or ΔW%exceeds the cutoff values,increasing CBCT verification frequency and re-fabricating the body membrane are recommended.

Objective To investigate the diagnostic value of combined detection of serum secreted frizzled-related protein 5(SFRP5),fibroblast growth factor-21(FGF-21)and kidney injury molecule-1(KIM-1)in di-abetic nephropathy(DN).Methods Patients with DN(n=53)who were treated in Jingnan Medical District,General Hospital of the People's Liberation Army from December 2021 to December 2023 were selected as the study group,and patients with simple diabetes(n=53)were selected as the control group.The levels of ser-um SFRP5,FGF-21 and KIM-1 were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression analysis was used to analyze the factors affecting the occurrence of DN.The receiver operating char-acteristic(ROC)curve was drawn to analyze the efficacy of serum SFRP5,FGF-21 and KIM-1 levels in the di-agnosis of occurrence of DN.Results Compared with the control group,the levels of fasting blood glucose,u-rine albumin/urine creatinine,urine microalbumin,FGF-21 and KIM-1 in the study group were significantly increased(P<0.05),while the levels of glomerular filtration rate and SFRP5 were significantly decreased(P<0.05).The area under the curve(AUC)of serum SFRP5,FGF-21 and KIM-1 in the diagnosis of occur-rence of DN was 0.977,which was larger than that of each index alone(Zthree combination-SFRP5=2.759,P=0.006,Zthree combination-FGF-21=2.936,P=0.003,Zthree combination-KIM-1=3.104,P=0.002).The sensitivity of combined diagno-sis was 96.23%,the specificity was 88.68%,and the Youden index was 0.849.SFRP5,FGF-21,KIM-1,fast-ing blood glucose,glomerular filtration rate,urine albumin/urine creatinine,urine microalbumin were the in-fluencing factors of occurrence of DN(P<0.05).Conclusion The serum SFRP5 level is decreased and FGF-21 and KIM-1 levels are increased in DN patients.The combination of the three has the best diagnostic effi-ciency for occurrence of DN.

Pyroptosis is a new type of programmed cell death that can efficiently enhance the immune response by inducing cell lysis and inflammation, thereby facilitating tumor immunotherapy. Recently, an increasing number of studies have revealed close relationships between pyroptosis and nanomedicine, which has been regarded as a new strategy for developing nanomedicine-based immunotherapy for highly effective therapy of various cancers. In this review, the development and associated signaling pathways for pyroptosis, including the correlation between pyroptosis and anti-tumor immunity, were first presented. Then, various nanomedicines that induce pyroptosis for tumor therapy, especially immunotherapy, were systematically discussed. Finally, the current challenges and constructive perspectives in this field were proposed.