Objective: To investigate the status and associated factors of sports supplement usage among grade 9 students, so as to provide a scientific basis for targeted supervision and health education regarding sports supplement usage among junior high school students. Methods: From June to September 2025, a stratified cluster random sampling method was used to select 2 261 grade 9 students from 10 provinces (autonomous regions, municipalities) in China. A questionnaire survey was conducted on their sports supplement usage and related factors. The Chi square test was used to compare the usage rates of sports supplements among different groups of students, and binary Logistic regression analysis was employed to investigate the related factors of sports supplement usage among grade 9 students. Results: Totally 59.7% of the grade 9 students used sports supplements. The usage rate (62.5%) was higher among boys than girls (56.3%), higher among students from rural areas and towns/counties (66.5%, 66.2%) than those from urban districts (52.9%), higher among boarding students (65.2%) than non resident students (54.3%), higher among students whose parents occupations were businessmen and workers (fathers: 65.0%, 63.7%; mothers: 63.6%, 61.1%) than those whose parents were farmers and civil servants (fathers: 57.5%, 54.1%; mothers: 58.8%, 55.7%), higher among students with a monthly family income of 5 000- 10 000 yuan (66.3%) than those in other income groups, and higher among students in the high score zone for the entrance physical examination to senior high school (67.7%) than those in the medium and low score zones ( 56.3% , 56.5%) ( χ 2=8.99, 42.21, 27.98, 20.55, 8.20, 22.74, 24.70, respectively, all P <0.05). Binary Logistic regression analysis showed that boys ( OR =1.26), those from rural areas ( OR =1.59), boarding students ( OR =1.36), those with a monthly family income of 5 000- 10 000 yuan ( OR =1.41), and those in the high score zone for entrance physical examination to senior high school ( OR =1.34) were more likely to use sports supplements during the entrance physical examination to senior high school; the probability of sports supplement usage was lower among students whose fathers were civil servants ( OR =0.74) (all P <0.05). Conclusions The usage of sports supplements is relatively common among grade 9 students. Intervention measures should be targeted at specific populations to reduce the risk of misuse.

ObjectiveTo compare the clinical efficacy of traditional Chinese medicine （TCM） manipulative reduction combined with small splint fixation versus surgical treatment for type A distal radius fracture （DRF） and to explore the factors influencing the choice of treatment. MethodsA multi-center retrospective study was conducted， collecting data from 1237 type A DRF patients treated in 11 hospitals in Jiangsu province from September， 2023 to April， 2025. Among them， 851 patients in the TCM group received manipulative reduction combined with small splint fixation， and 386 patients in the surgical group underwent open reduction and internal fixation. Visual analog scale （VAS） scores for pain and radiographic indicators including palmar tilt， ulnar deviation， and radial height were compared before treatment， 5-7 days after treatment， and 4-6 weeks after treatment. The wrist joint function scores including Dienst and Gartland-Werley scores at 12 weeks after treatment were recorded. Subgroup analysis was conducted for the excellent rate of Dienst and Gartland-Werley scores， stratified by age （＜50， 50-59， 60-69， ≥70 years old） and AO subtypes （A1， A2， A3）. A multivariate logistic regression model was used to identify independent factors influencing treatment choice. ResultsOn 5-7 days after treatment， the surgical group had lower VAS scores than the TCM group， while 4-6 weeks after treatment， the TCM group showed lower VAS scores than the surgical group （P＜0.01）. In terms of radiographic indicators， except for the palmar tilt before treatment being higher in the surgical group than in the TCM group （P＜0.01）， there were no significant differences in palmar tilt， ulnar deviation， and radial height at other timepoints （P＞0.05）. Twelve weeks after treatment， the surgical group had a higher average Gartland-Werley score and the excellent rate than the TCM group （P＜0.01）. Subgroup analysis showed that in patients with A2 type DRF aged 50-59 and 60-69 years old， the excellent rates of Dienst and Gartland-Werley scores in the TCM group were higher than those in the surgical group （P＜0.05）. Multivariate logistic regression analysis revealed that age， palmar tilt， ulnar deviation， and the degree of swelling on the affected side were independent factors influencing the choice of treatment （P＜0.05）. ConclusionBoth TCM manipulative reduction combined with small splint fixation and surgical treatment for type A DRF can achieve good therapeutic effects. TCM manipulative reduction combined with small splint fixation has certain advantages in medium- and long-term pain relief， especially in elderly patients， where wrist joint function recovery is more stable. Age， palmar tilt， ulnar deviation， and swelling degree are the main factors influencing the treatment choice.

ObjectiveTo observe the clinical efficacy and radiographic outcomes of manipulative reduction combined with small splint fixation in the treatment of distal radius fractures. MethodsThe clinical data of 1051 patients with distal radius fractures were retrospectively collected from five hospitals included in the Jiangsu Diagnosis and Treatment Data Platform for Traditional Chinese Medicine（TCM） Dominant Diseases. Propensity score matching at a 1∶4 ratio was applied， resulting in 580 cases selected for final analysis， which comprised 448 patients in the TCM group（manipulative reduction plus small splint fixation） and 132 in the surgical treatment group（open reduction and internal fixation）. Each group was further stratified into type A， B， and C subgroups based on AO fracture classification. Radiographic indicators including palmar tilt， radial inclination， and radial height were compared between groups before treatment and 1 day， 1 week， and 4-6 weeks after treatment， and pain visual analog scale（VAS） scores before treatment and 1 week and 4-6 weeks after treatment were also compared. Wrist joint function was assessed 12 weeks after treatment， using the Dienst wrist function score and the Gartland and Werley（G-W） wrist function score. Additionally， the radiographic indicators at different timepoints and the 12-week wrist function levels were compared between groups across different fracture types. ResultsNo statistically significant difference was observed in radiographic indicators and VAS scores at all timepoints before and after treatment， as well as wrist joint function grades assessed by the Dienst score and the G-W score at 12 weeks after treatment （P＞0.05）. Compared to those before treatment， both groups showed increased palmar tilt， radial inclination， and radial height 1 week and 4-6 weeks after treatment， and decreased VAS scores （P＜0.05）. Compared to those 1 week after treatment， both groups showed a decrease in palmar tilt， an increase in radial inclination and radial height， and a reduction in VAS score 4-6 weeks after treatment（P＜0.05）. In type A and B subgroups， the surgical treatment group had a higher radial inclination than the TCM group 4-6 weeks after treatment， while in the type C subgroup， a higher radial height was shown in the surgical treatment group than in the TCM group 4-6 weeks after treatment（P＜0.05）. In type C subgroup， there was significant difference between groups in the wrist joint function by G-W scores 12 weeks after treatment（P＜0.05）. ConclusionManipulative reduction combined with small splint fixation can maintain fracture alignment and alleviate pain in treating distal radius fractures， which achieves therapeutic outcomes comparable to surgical treatment. It is particularly suitable for type A and B fractures and can be considered an effective treatment option for distal radius fractures.

ObjectiveTo construct an automatic measurement model for palmar tilt and radial inclination suitable for traditional Chinese medicine （TCM） clinical scenarios， and to validate its accuracy and efficiency in TCM manipulative reduction settings. MethodsData on anteroposterior （AP） and lateral X-rays of distal radius fractures were collected from patients admitted to 18 TCM/ integrated TCM and western medicine hospitals in Jiangsu province between September 1st， 2023， and September 1st， 2024， via the Jiangsu Diagnosis and Treatment Big Data Platform for TCM Dominant Diseases. A medical image segmentation framework based on multi-scale feature fusion and edge-awareness was employed， combined with anatomical knowledge specific to TCM orthopedics， to optimize the feature extraction strategy of an artificial intelligence （AI） model. This framework enabled automatic segmentation of fracture regions and measurement of distal radius palmar tilt and radial inclination. The accuracy of the AI model in measuring radial inclination and volar tilt was validated， and the measurement time and average time gain rate of the AI model were compared to those of manual measurement. ResultsA total of 15,444 AP and lateral X-ray images of distal radius fractures were collected， and were divided into a training set （11,144 images， 5066 AP and 6078 lateral）， a validation set （3700 images， 1840 AP and 1860 lateral）， and an independent test set （600 images， 300 AP and 300 lateral） after preprocessing. In the measurement of 300 AP X-rays in the independent test set for radial inclination， when the degree error between AI measurement and manual measurement was ＜3° and ＜5°， AI measurement accuracy was 83% and 93%， respectively. In 300 lateral X-rays in the test set for palmar tilt， when AI measurements had an error of ＜3° and ＜5° compared to manual measurements， corresponding accuracy rate was 78% and 90%， respectively. For 50 X-ray images， AI measurement time was （1.37±0.05） min for radial inclination while manual measurement time was （22.57±2.52） min （P＜0.001）； in terms of palmar tilt， the AI measurement time was （1.33±0.14） min， shorter than （23.70±2.80） min for manual measurement time （P＜0.001）. Average time gain rates for manual and AI measurements were 93.93% and 94.39% respectively. ConclusionAn automatic measurement model for palmar tilt and radial inclination in distal radius fractures has been established， enabling more accurate and efficient assessment as well as providing a tool to support the quantitative evaluation of the efficacy of TCM manipulative reduction and large-sample clinical research.

The rapid development of artificial intelligence (AI), especially generative AI (GenAI), has already brought, and will continue to bring, revolutionary changes to our daily production and life, as well as create new opportunities and challenges for diagnostic and therapeutic practices in the medical field. Haihe Hospital of Tianjin University collaborates with the National Supercomputer Center in Tianjin, Tianjin University, and other institutions to carry out research in areas such as smart healthcare, smart services, and smart management. We have conducted research and development of a full-process disease diagnosis and treatment assistance system based on GenAI in the field of smart healthcare. The development of this project is of great significance. The first goal is to upgrade and transform the hospital's information center, organically integrate it with existing information systems, and provide the necessary computing power storage support for intelligent services within the hospital. We have implemented the localized deployment of three models: Tianhe "Tianyuan", WiNGPT, and DeepSeek. The second is to create a digital avatar of the chief physician/chief physician's voice and image by integrating multimodal intelligent interaction technology. With generative intelligence as the core, this solution provides patients with a visual medical interaction solution. The third is to achieve deep adaptation between generative intelligence and the entire process of patient medical treatment. In this project, we have developed assistant tools such as intelligent inquiry, intelligent diagnosis and recognition, intelligent treatment plan generation, and intelligent assisted medical record generation to improve the safety, quality, and efficiency of the diagnosis and treatment process. This study introduces the content of a full-process disease diagnosis and treatment assistance system, aiming to provide references and insights for the digital transformation of the healthcare industry.
Artificial Intelligence ; Humans ; Delivery of Health Care ; Generative Artificial Intelligence

The 97th Annual Meeting of the Japanese Gastric Cancer Association was held from March 12 to March 14,2025,in Nagoya,Japan.The conference was chaired by Professor Kazuhiro Uyama from Fujita Medical University and attracted nearly 2 000 scholars from around the world,including Japan,China,the republic of Korea,the United States,and Europe.With the theme of"Digital Innovation in Gastric Tumors,"the conference focused on the application of artificial intelligence,robotic surgery,and other innovations in the treatment of gastric cancer.It explored how high-precision and highly reproducible robotic surgical techniques are transforming traditional approaches to gastric cancer surgery,along with topics such as digital innovation,future medical policies,and strategies that herald a new era in healthcare.The meeting featured one main venue and 60 sub-venues with different themes,ultimately accepting 1 003 submissions.A total of 158 oral presentations covering 80 topics and 203 poster presentations were delivered.Among them,approximately 145 lectures were related to robotic surgery for gastric cancer,and when including poster presentations,nearly 255 topics were associated with gastric cancer robotic surgery.Additionally,the 7th edition of the Japanese Gastric Cancer Treatment Guidelines was released during the meeting.Our team had the honor of participating in this prestigious event.Drawing from our experience at both this conference and the 17th Annual Meeting of the Japanese Society for Robotic Surgery held in Utsunomiya,Japan,from March 7 to March 8,2025,we provide a detailed report on the latest advancements in robotic surgery for gastric cancer,hoping to offer valuable insights and references for fellow surgeons both in China and abroad.

The aim of this updated guideline is to provide comprehensive recommendations for the management of gout in patients with common comorbidities, such as chronic kidney disease(CKD), cardiovascular disease(CVD), diabetes, osteoarthritis(OA), and gastrointestinal disorders. This guideline was developed by a multidisciplinary expert panel consisting of specialists in endocrinology, rheumatology, nephrology, cardiology, gastroenterology, and methodology. The development process adhered to standard methodologies, including PICO(population, intervention, comparator, and outcomes) question deconstruction, systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) for evidence and recommendation evaluation, Delphi voting, and expert consensus. The guideline presents 26 evidence-based recommendations addressing 7 clinical questions for patients with hyperuricemia and gout in the context of comorbidities. Key recommendations include the maintenance of strict serum urate targets, particularly for patients with CKD stage≥3, chronic gouty arthritis, and OA, in order to prevent disease progression. In patients with CVD or diabetes, intra-articular triamcinolone is preferred over systemic glucocorticoids. Prioritized anti-inflammatory treatments for patients with CKD, gastrointestinal diseases and OA are recommended. The guideline also introduces emerging therapies, such as interleukin-1 inhibitors and selective urate transport inhibitors, as potential treatment options for refractory cases. The update offers a comprehensive, patient-centered approach to managing gout, particularly in individuals with associated comorbidities. Multidisciplinary collaboration and emerging new treatments and evidence ensure the optimization of the recommendations.

McCune-Albright syndrome(MAS) is a postzygotic somatic mutation disorder caused by activating mutations in the GNAS gene, which encodes the α subunit of the stimulatory G protein. Its clinical features typically include polyostotic fibrous dysplasia, cafe-au-lait skin pigmentation, and endocrine hyperactivity, such as Cushing′s syndrome, hyperthyroidism, and growth hormone excess. Here, we report two rare cases of MAS complicated with adrenocorticotropic hormone(ACTH)-independent Cushing syndrome, and provide a review and analysis of previously reported MAS cases associated with Cushing′s syndrome.

Objective:To analyze the epidemiological characteristics of mumps in China under the immunization strategies of different doses of mumps-containing vaccines(MuCV) by analyzing the national mumps surveillance data from 2020 to 2023.Methods:Based on the national mumps surveillance data from 2020 to 2023, a comparative analysis was conducted on the mumps incidence and the distribution characteristics of mumps cases in time, region and population in the three different periods of 2004-2007 (without MuCV implementation), 2008-2019 (one-dose MuCV implementation) and 2020-2023 (two-dose MuCV implementation) in China.Results:From 2020 to 2023, the annual incidence rate of mumps was 6.48-9.20/100 000, and the annual number of reported cases was 91 303-129 120 cases. After the implementation of the 2-dose MuCV immunization strategy, the epidemiological characteristics of mumps in China have changed to some extent. Compared with the period of 2004-2007 and 2008-2019, the traditional seasonal epidemic pattern of mumps disappeared from 2020 to 2023, with no obvious epidemic peak throughout the year. There was no significant regional difference in the incidence of mumps. Children and adolescents under 15 years of age were the main population of mumps (accounting for 85.46%), of which children aged 5-9 years accounted for 45.07%. Compared with the period of 2004-2007 and 2008-2019, the proportion of mumps cases in the 0-4 years old group showed an increasing trend, the proportion of mumps cases in the 10-14 years old group showed a decreasing trend, and the proportion of adult cases over 40 years old also increased from 2020 to 2023. The age group with the highest incidence of mumps was found to have shifted from 7 years old to 4 years old.Conclusions:The 2-dose MuCV immunization strategy has effectively reduced the incidence of mumps in China. It is necessary to strengthen the surveillance of mumps in kindergartens and primary school children.

Objective:To evaluate the role of silent information regulator factor 2-related enzyme 1 (SIRT1)/Klotho signaling pathway in renal injury induced by myocardial ischemia-reperfusion (I/R) in diabetic rats.Methods:Forty SPF healthy male rats, aged 6-8 weeks, weighing 140-170 g, were divided into 5 groups ( n=8 each) by the random number table method: non-diabetic sham operation group (NS group), non-diabetic I/R group (NIR group), diabetic sham operation group (DS group), diabetic I/R group (DIR group), and diabetic I/R + SIRT1 inhibitor EX-527 group (DIR+ EX-527 group). Diabetes mellitus was induced by intraperitoneal streptozotocin 60 mg/kg. The myocardial I/R was produced by temporary ligation of the left anterior descending branch of coronary artery for 30 min followed by 120 min reperfusion. EX-527 5 mg/kg was intraperitoneally injected before ischemia and at 10 min before reperfusion in DIR+ EX-527 group. Serum levels of lactic dehydrogenase (LDH), cardiac troponin I (cTnI), malondialdehyde (MDA), superoxide dismutase (SOD), blood urea nitrogen (BUN) and creatinine (Cr) were determined at the end of reperfusion. Renal tissues were collected for observation of the pathological changes and for detection of the expression of SIRT1, Klotho, and interleukin-1 β (IL-1β) by Western blot. Results:Compared with NS group, the serum levels of LDH, cTnI, BUN and MDA were significantly increased, the serum levels of SOD were decreased, the expression of Klotho and SIRT1 was down-regulated, the expression of IL-1β was up-regulated ( P<0.05), and the pathological damage to renal tissues was marked in NIR group and DS group. Compared with DS group and NIR group, the serum levels of LDH, cTnI, BUN, Cr and MDA were significantly increased, the serum levels of SOD were decreased, the expression of Klotho and SIRT1 was down-regulated, the expression of IL-1β was up-regulated ( P<0.01), and the pathological damage to renal tissues was aggravated in DIR gruop. Compared with DIR gruop, the serum levels of LDH, cTnI, BUN, Cr and MDA were significantly increased, the level of serum SOD was decreased, the expression of Klotho and SIRT1 was down-regulated, the expression of IL-1β was up-regulated ( P<0.01), and the pathological damage to renal tissues was aggravated in DIR+ EX-527 group. Conclusions:Weakened activation of SIRT1/Klotho signaling pathway may be involved in the mechanism of myocardial I/R-induced renal injury in diabetic rats.