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.

This study aimed to comprehensively examine the association of gallstones, cholecystectomy, and cancer risk. Multivariable logistic regressions were performed to estimate the observational associations of gallstones and cholecystectomy with cancer risk, using data from a nationwide cohort involving 239 799 participants. General and gender-specific two-sample Mendelian randomization (MR) analysis was further conducted to assess the causalities of the observed associations. Observationally, a history of gallstones without cholecystectomy was associated with a high risk of stomach cancer (adjusted odds ratio (aOR)=2.54, 95% confidence interval (CI) 1.50-4.28), liver and bile duct cancer (aOR=2.46, 95% CI 1.17-5.16), kidney cancer (aOR=2.04, 95% CI 1.05-3.94), and bladder cancer (aOR=2.23, 95% CI 1.01-5.13) in the general population, as well as cervical cancer (aOR=1.69, 95% CI 1.12-2.56) in women. Moreover, cholecystectomy was associated with high odds of stomach cancer (aOR=2.41, 95% CI 1.29-4.49), colorectal cancer (aOR=1.83, 95% CI 1.18-2.85), and cancer of liver and bile duct (aOR=2.58, 95% CI 1.11-6.02). MR analysis only supported the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer. This study added evidence to the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer, highlighting the importance of cancer screening in individuals with gallstones.
Humans ; Mendelian Randomization Analysis ; Gallstones/complications* ; Female ; Male ; Cholecystectomy/statistics & numerical data* ; Middle Aged ; Risk Factors ; Aged ; Adult ; Neoplasms/etiology* ; Stomach Neoplasms/epidemiology*

Objective To construct an assay for early infection diagnosis of Angiostrongylus cantonensis based on gold nanorod polymerization.Methods Stable gold nanorods were synthesized by the gold seed growth method,and labeled with different concentrations of sulfhydrylated crude and purified antigens of lar-vae and adults of Angiostrongylus cantonensis,and their excretory and secretory antigens,and then scanned the longitudinal surface plasmon resonance(LSPR)of the stable gold nanorods by ultraviolet-visible(UV-Vis)spectrophotometry,and screened for the optimal labeled antigens for the detection of different infection time after infection of rats with Angiostrongylus cantonensis.The displacement changes were screened to se-lect the best labeled antigens for the detection of serum antibodies and positive sera of series of dilution gradi-ents at different infection times(5,7,14,21 d)after infection with Angiostrongylus cantonensis in rats,and at the same time,the enzyme-linked immunosorbent assay(ELISA)was set up for the same test.Kappa test was used to compare the consistency of the two assays.Results Gold nanorods with stable aspect ratio were suc-cessfully prepared.The gold nanorods labeled with 10 μg/mL of adult purified antigen had a maximum LSPR shift of 40 nm,and were able to detect serum antibodies in rats 5 d after mild,moderate and severe infection with Angiostrongylus cantonensis,as well as positive sera at a maximum dilution of 1∶600.The ELISA was able to detect serum antibodies in rats after 14 d of mild infection,and 7 d of moderate and severe infection,as well as positive sera at a maximum dilution of 1∶200.The ELISA detected positive serum antibodies in rats after 14 d of mild infection and 7 d of moderate and severe infection,as well as in rats at a maximum dilution of 1∶200.The Kappa value of the two methods was 0.750(P<0.01),and the results of the two methods had strong consistency.Conclusion A polymerized gold nanorod assay for early and rapid diagnosis of An-giostrongylus cantonensis infection is successfully constructed.

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 establish a comprehensive and detailed evaluation index system for clinical practice bases of nursing graduate students majoring in midwifery, providing reference for promoting the construction of clinical practice bases for nursing graduate students majoring in midwifery in China.Methods:Based on the theoretical framework of international midwifery practice basic skills, an evaluation index system for clinical practice bases of nursing graduate students majoring in midwifery was established through literature analysis and Delphi method. Analytic hierarchy process was used to calculate the weights of indicators at all levels.Results:This study conducted two rounds of consultation with 20 experts. In the two rounds of consultation, the positivity coefficients of experts were 84.38% and 74.07%, and the authority coefficients of the expert groups were 0.91 and 0.94, respectively. The total Cronbach's α coefficients of the index system were 0.930 and 0.965, respectively, and the Kendall harmony coefficients of the overall indicators were 0.230 and 0.297 ( P<0.01). The final evaluation index system for clinical practice bases of nursing graduate students majoring in midwifery included five primary indicators, 14 secondary indicators, and 76 connotation indicators. Conclusions:Based on the service purpose of maternal and child health and the functional positioning of the base, this study constructs a scientific and reliable evaluation index system for clinical practice bases of nursing graduate students majoring in midwifery.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

Malnutrition is highly prevalent in patients with inflammatory bowel disease, which can be life-threatening when refeeding syndrome occurs. This article reports a patient with Crohn′s disease admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine who developed refeeding syndrome due to long-term malnutrition and complicating lymph node tuberculosis. After the discussion, diagnosis and treatment of multidisciplinary team including Departments of Gastroenterology, Nutrition, Colorectal Surgery and Oncology, and Pathology, the patient was improved significantly.

Objective:To study the effects of short-term (30 d) exposure to different levels of PM 2.5 on oocyte quality, embryo quality and pregnancy outcomes in patients with early-follicular phase downregulation scheme. Methods:From December 2018 to February 2019, and from July to September 2019, 348 patients with early-follicular phase downregulation scheme who underwent assisted reproduction and assisted pregnancy in the Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine were selected as the research objects in this retrospective cohort study. According to PM 2.5 new air quality standard, with 115 μg/m 3 as the cut-off value, the patients were divided into high exposure group ( n=94) and low exposure group ( n=254). During the period from the start of ovulation induction to the pregnancy test day, the activity areas of the patients are in the urban area of Shiyan City. The PM 2.5 of atmospheric fine particles during this period was calculated, including total amount and daily average amount. The effects of fine particulate matter PM 2.5 on ovum abnormality rate, embryo quality (number of available embryos, number of high-quality embryos, high-quality embryo rate, and blastocyst formation rate) and pregnancy outcome (pregnancy rate, abortion rate, live birth rate and proportion of low birth weight infants) were compared between the two groups. Results:Compared with the low exposure group, the number of available embryos (3.9±1.1 vs. 4.3±1.2, P=0.005), the number of high-quality embryos (2.9±1.5 vs. 3.4±1.7, P=0.001), high-quality embryo rate [35.5% (352/992) vs. 40.4% (792/1 959), P=0.009] and proportion of low birth weight infants [21.4% (12/56) vs. 5.13% (8/156), P<0.001] in the high exposure group were significantly decreased, and there was no significant difference in other data. Conclusion:Short-term exposure to high levels of PM 2.5 had significant negative effects on the number of available embryos, the number of high-quality embryos, the rate of high-quality embryos and proportion of low birth weight infants in the early-follicular phase down-regulation scheme.

Objective:To study the effects of short-term (30 d) exposure to different levels of PM 2.5 on oocyte quality, embryo quality and pregnancy outcomes in patients with early-follicular phase downregulation scheme. Methods:From December 2018 to February 2019, and from July to September 2019, 348 patients with early-follicular phase downregulation scheme who underwent assisted reproduction and assisted pregnancy in the Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine were selected as the research objects in this retrospective cohort study. According to PM 2.5 new air quality standard, with 115 μg/m 3 as the cut-off value, the patients were divided into high exposure group ( n=94) and low exposure group ( n=254). During the period from the start of ovulation induction to the pregnancy test day, the activity areas of the patients are in the urban area of Shiyan City. The PM 2.5 of atmospheric fine particles during this period was calculated, including total amount and daily average amount. The effects of fine particulate matter PM 2.5 on ovum abnormality rate, embryo quality (number of available embryos, number of high-quality embryos, high-quality embryo rate, and blastocyst formation rate) and pregnancy outcome (pregnancy rate, abortion rate, live birth rate and proportion of low birth weight infants) were compared between the two groups. Results:Compared with the low exposure group, the number of available embryos (3.9±1.1 vs. 4.3±1.2, P=0.005), the number of high-quality embryos (2.9±1.5 vs. 3.4±1.7, P=0.001), high-quality embryo rate [35.5% (352/992) vs. 40.4% (792/1 959), P=0.009] and proportion of low birth weight infants [21.4% (12/56) vs. 5.13% (8/156), P<0.001] in the high exposure group were significantly decreased, and there was no significant difference in other data. Conclusion:Short-term exposure to high levels of PM 2.5 had significant negative effects on the number of available embryos, the number of high-quality embryos, the rate of high-quality embryos and proportion of low birth weight infants in the early-follicular phase down-regulation scheme.