Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Objective To analyze dynamic contrast-enhanced MRI (DCE-MRI) radiomic features using machine learning algorithms, and to develop and validate a predictive model for HER-2 status in breast cancer. Methods The DCE-MRI images of 272 treatment-naive female patients with breast cancer between 2020 and 2022 were included in this study. Regions of interest (ROIs) were manually segmented using 3d-Slicer software, and radiomic features were extracted. All patients were randomly divided into training sets or validation sets at a ratio of 4∶1. The least absolute shrinkage and selection operator (LASSO) algorithm was used for feature screening on the training set, followed by the development of predictive models using six machine learning algorithms. Internal cross-validation was performed to compare the performance differences between the models. The best-performing model was selected, trained on the training set, and evaluated on the validation set. Evaluation metrics included area under the curve (AUC), sensitivity, specificity, precision, and recall rate. Results The clinical data of patients in the training set and validation set showed no significant differences. Five features were identified by the LASSO algorithm. With these features, six machine learning models were developed on the training set, and their predictive performance was internally cross-validated using the bagging method. XGBoost model had the highest mean AUC (0.696), followed by RF model (0.690); XGBoost model had the highest mean precision (0.756), followed by LR and RF models. Therefore, XGBoost was the optimal model. An HER-2 predictive model was built using the XGBoost algorithm on the training set and applied to the validation set. The AUC, precision, sensitivity, and specificity of the predictive model on the validation set were calculated, and ROC curves, precision-recall curves, calibration curves, and decision-making curves were plotted. Conclusion This study constructed and evaluated different DCE-MRI radiomics-based machine learning models for predicting HER-2 status in breast cancer. Among them, XGBoost algorithm performed the best and has the potential to become a new non-invasive method for preoperative prediction of HER-2 status, providing reliable evidence for personalized clinical diagnosis and treatment.

Objective:To report construction of Evidence-Based Guidelines for the Diagnosis and Treatment of Distal Radius Fractures in Adults (2024) using the Delphi method.Methods:Literature related to the study of adult distal radius fractures was fully searched for and evaluated. An expert group was established from representative experts from all over the nation. The related clinical issues were established by consulting the experts in the form of electronic questionnaires, strictly following the Delphi research method. After the first draft of Evidence-Based Guidelines for the Diagnosis and Treatment of Distal Radius Fractures in Adults (2024) was written, an expert consultation questionnaire was designed for the recommendation opinions to determine the recommendation strength.Results:The clinical issues were determined by 2 rounds of correspondence based on the Delphi method. For the both rounds of correspondence, the questionnaire recovery rates were respectively 88.68% (47/53) and 98.11% (52/53), and the expert authority coefficients >0.7. According to the screening criteria based on the importance of clinical issues (mean importance score <3.5 points or a coefficient of variation ≥0.25 points and a full score ratio <30%) and expert opinions, a total of 40 clinical issues were deleted in the first round of determination of clinical issues, and a total of 5 clinical issues deleted in the second round of determination of clinical issues. The reliability analysis of the results of the 2 rounds of questionnaires showed that the Cronbach α coefficient was >0.9. In the questionnaire to determine the recommendation strength, according to the screening criteria for the consistency of recommendation strength (consistency ≥ 70%) and expert opinions, a total of 26 recommendations were screened in the first round. In the second round when the remaining 4 recommendations were investigated, one recommendation reached the consistency of recommendation strength ≥ 70%. Eventually, 27 recommendations were formed.Conclusion:The Evidence-Based Guidelines for the Diagnosis and Treatment of Distal Radius Fractures in Adults (2024) constructed using the Delphi method shows good scientific validity, authority, and reliability, providing methodological references for guideline development and research.

Microbiota can be recognized by the human immune system,trigger specific immune responses,and play a significant role in the onset and progression of diseases through intricate regulatory mechanisms.The tumor microenvironment comprises the peritumoral extracellular matrix,immune cells,tumor-associated fibroblasts,and endothelial cells,among others.In this context,the tumor immune microenvironment,characterized by immune cells,significantly influences cancer progression and treatment.Notably,the tumor immune microenvironment is closely associated with the tumor microbiota.The presence of respiratory microbiota is correlated with the typing and staging of non-small cell lung cancer.This study investigated the mechanisms by which respiratory microbiota affect innate and adaptive immune cells within the tumor immune microenvironment and explored the role of respiratory microbiota in the immunotherapy of non-small cell lung cancer.The aim was to identify potential biomarkers that could enhance the diagnosis and treatment of non-small cell lung cancer.

Objective To establish a method for quantitative control of multi-pharmacological components in Kanggan Jiedu capsules,and to evaluate the quality of Kanggan Jiedu capsules by chemometrics and weighted technique for order preference by similarity to an ideal solution(TOPSIS)method.Methods HPLC was performed on an Apollo C18 column with acetonitrile-0.1%formic acid gradient elution as mobile phase.The volume flow rate was 1.0 mL/min,and the detection wavelength was 327,238 and 298 nm.The contents of 3,5-O-dicaffeoylquinic acid,4,5-dicaffeoylquinic acid,gardenoside,geniposide,3'-hydroxy puerarin,puerarin,3'-methoxy puerarin,baicalin,wogonoside,oxypeucedanin,imperatorin,isoimperatorin,pseudoaspidin and tetraalbaspidin ABBA in 15 batches of Kanggan Jiedu capsules were determined by quantitative analysis of multi-components by single marker(QAMS),and then statistical software was used to analyze the difference of 15 batches of samples to find out the main potential markers affecting the quality of Kanggan Jiedu capsules.Results The f value of the 3,5-O-dicaffeoylquinic acid was 0.9119,with 4,5-dicaffeoylquinic acid as the internal reference.The f of the gardenoside,3'-hydroxy puerarin,puerarin and 3'-methoxy puerarin were 1.4941,1.2423,0.9281 and 1.0860,respectively,with geniposide as the internal reference.The f of the baicalin,wogonoside,oxypeucedanin,isoimperatorin,pseudoaspidin and tetraalbaspidin ABBA were 1.4551,0.7414,0.8796,0.6949,1.3248 and 0.8240,respectively,with imperatorin as the internal reference.The f values of each component were robust.There was no significant difference in the content determined by the two methods.The chemometrics method results showed that 15 batches of Kanggan Jiedu capsules could be clustered into three categories,there were certain differences between batches.Baicalin,geniposide,imperatorin,puerarin,3,5-O-dicaffeoylquinic acid and wogonoside were the main potential markers affecting the quality of Kanggan Jiedu capsules.The results of weighted TOPSIS method results showed that the Ci values of 15 batches of samples were between 0.2018 and 0.7346,among which S13 ranked the top with Ci value of 0.7346.Conclusion The established method for quantitative detection of 14 pharmacodynamic components is convenient and accurate.The quality of Kanggan Jiedu capsules can be evaluated by chemometrics and weighted TOPSIS method.

OBJECTIVE To establish a multi-index quantitative detection method,and to evaluate the quality difference of Gleditsia sinensis from different producing areas.METHODS The contents of protocatechuic acid,vanillic acid,isoscopoletin,scoparone,isovitexin,fustin,taxifolin,fisetin,quercetin,kaempferol,echinocystic acid,betulinic acid,β-sitosterol and stigmasterol were detected by high performance liquid chromatography-quantitative analysis of multi-components by single marker(HPLC-QAMS).The chromatographic column was Kromasil C18,the mobile phase was 0.2％phosphoric acid-acetonitrile solution(gradient elution),the detection wavelengths were 254,360,210 nm for different index components,the column temperature was 30 ℃,the flow rate was 1.0 mL/min,and the sample injection volume was 10 μL.The contents of extract and total ash were detected according to the method of Chinese Pharmacopoeia.The quality differences of 30 batches of G.sinensis(No.S1-S30)from different producing areas were evaluated by chemometrics,weighted technique for order preference by similarity to an ideal solution(TOPSIS)analysis and Logistic regression model.RESULTS The linear ranges of 14 components were 1.55-77.50,0.71-35.50,0.28-14.00,0.96-48.00,1.77-88.50,0.09-4.50,4.65-232.50,1.49-74.50,0.37-18.50,1.18-59.00,7.35-367.50,3.58-179.00,0.49-24.50 and 0.21-10.50 μg/mL,respectively(all r＞0.999).The RSDs of precision,stability(24 h)and repeatability were less than 2.00％;the average recoveries were 96.99％-100.13％(all RSDs＜2.00％),and the relative correction factor had good repeatability.The contents of extract and total ash were 4.2％-12.5％and 0.5％-2.3％,respectively.There was no significant difference in the content of 14 components measured by QAMS method and extemal standard method(P＞0.05).The results of chemometrics showed that 30 batches of samples were clustered into 3 categories:S1 to S11 form one category,S12 to S20 form another category,and S21 to S30 constitute the third category.Echinocystic acid,betulinic acid,taxifolin,kaempferol,isovitexin,scoparone and protocatechuic acid may be the differential components affecting the quality of G.sinensis from different producing areas.The analysis results of the weighted TOPSIS method revealed that relative closeness(Jb)for 30 batches of G.sinensis ranged from 0.144 5 to 0.721 8,with S27 achieving the highest value(Jb)of 0.721 8.The analysis results of the Logistic regression model showed that S21-S30 batches of samples were of superior grade,S1-S11 were of intermediate grade,and S12-S20 were of inferior grade.CONCLUSIONS The established HPLC-QAMS method is simple and accurate.The comprehensive evaluation method is objective and comprehensive,and can be used to evaluate the quality difference of G.sinensis from different producing areas.

Objective To establish a method for quantitative control of multi-pharmacological components in Kanggan Jiedu capsules,and to evaluate the quality of Kanggan Jiedu capsules by chemometrics and weighted technique for order preference by similarity to an ideal solution(TOPSIS)method.Methods HPLC was performed on an Apollo C18 column with acetonitrile-0.1%formic acid gradient elution as mobile phase.The volume flow rate was 1.0 mL/min,and the detection wavelength was 327,238 and 298 nm.The contents of 3,5-O-dicaffeoylquinic acid,4,5-dicaffeoylquinic acid,gardenoside,geniposide,3'-hydroxy puerarin,puerarin,3'-methoxy puerarin,baicalin,wogonoside,oxypeucedanin,imperatorin,isoimperatorin,pseudoaspidin and tetraalbaspidin ABBA in 15 batches of Kanggan Jiedu capsules were determined by quantitative analysis of multi-components by single marker(QAMS),and then statistical software was used to analyze the difference of 15 batches of samples to find out the main potential markers affecting the quality of Kanggan Jiedu capsules.Results The f value of the 3,5-O-dicaffeoylquinic acid was 0.9119,with 4,5-dicaffeoylquinic acid as the internal reference.The f of the gardenoside,3'-hydroxy puerarin,puerarin and 3'-methoxy puerarin were 1.4941,1.2423,0.9281 and 1.0860,respectively,with geniposide as the internal reference.The f of the baicalin,wogonoside,oxypeucedanin,isoimperatorin,pseudoaspidin and tetraalbaspidin ABBA were 1.4551,0.7414,0.8796,0.6949,1.3248 and 0.8240,respectively,with imperatorin as the internal reference.The f values of each component were robust.There was no significant difference in the content determined by the two methods.The chemometrics method results showed that 15 batches of Kanggan Jiedu capsules could be clustered into three categories,there were certain differences between batches.Baicalin,geniposide,imperatorin,puerarin,3,5-O-dicaffeoylquinic acid and wogonoside were the main potential markers affecting the quality of Kanggan Jiedu capsules.The results of weighted TOPSIS method results showed that the Ci values of 15 batches of samples were between 0.2018 and 0.7346,among which S13 ranked the top with Ci value of 0.7346.Conclusion The established method for quantitative detection of 14 pharmacodynamic components is convenient and accurate.The quality of Kanggan Jiedu capsules can be evaluated by chemometrics and weighted TOPSIS method.

Microbiota can be recognized by the human immune system,trigger specific immune responses,and play a significant role in the onset and progression of diseases through intricate regulatory mechanisms.The tumor microenvironment comprises the peritumoral extracellular matrix,immune cells,tumor-associated fibroblasts,and endothelial cells,among others.In this context,the tumor immune microenvironment,characterized by immune cells,significantly influences cancer progression and treatment.Notably,the tumor immune microenvironment is closely associated with the tumor microbiota.The presence of respiratory microbiota is correlated with the typing and staging of non-small cell lung cancer.This study investigated the mechanisms by which respiratory microbiota affect innate and adaptive immune cells within the tumor immune microenvironment and explored the role of respiratory microbiota in the immunotherapy of non-small cell lung cancer.The aim was to identify potential biomarkers that could enhance the diagnosis and treatment of non-small cell lung cancer.

Objective:To report construction of Evidence-Based Guidelines for the Diagnosis and Treatment of Distal Radius Fractures in Adults (2024) using the Delphi method.Methods:Literature related to the study of adult distal radius fractures was fully searched for and evaluated. An expert group was established from representative experts from all over the nation. The related clinical issues were established by consulting the experts in the form of electronic questionnaires, strictly following the Delphi research method. After the first draft of Evidence-Based Guidelines for the Diagnosis and Treatment of Distal Radius Fractures in Adults (2024) was written, an expert consultation questionnaire was designed for the recommendation opinions to determine the recommendation strength.Results:The clinical issues were determined by 2 rounds of correspondence based on the Delphi method. For the both rounds of correspondence, the questionnaire recovery rates were respectively 88.68% (47/53) and 98.11% (52/53), and the expert authority coefficients >0.7. According to the screening criteria based on the importance of clinical issues (mean importance score <3.5 points or a coefficient of variation ≥0.25 points and a full score ratio <30%) and expert opinions, a total of 40 clinical issues were deleted in the first round of determination of clinical issues, and a total of 5 clinical issues deleted in the second round of determination of clinical issues. The reliability analysis of the results of the 2 rounds of questionnaires showed that the Cronbach α coefficient was >0.9. In the questionnaire to determine the recommendation strength, according to the screening criteria for the consistency of recommendation strength (consistency ≥ 70%) and expert opinions, a total of 26 recommendations were screened in the first round. In the second round when the remaining 4 recommendations were investigated, one recommendation reached the consistency of recommendation strength ≥ 70%. Eventually, 27 recommendations were formed.Conclusion:The Evidence-Based Guidelines for the Diagnosis and Treatment of Distal Radius Fractures in Adults (2024) constructed using the Delphi method shows good scientific validity, authority, and reliability, providing methodological references for guideline development and research.

Objective To elucidate the prediction ability of monocyte monolayer assay(MMA)used in hemolytic dis-ease of fetus and newborn(HDFN)caused by IgG anti-M.Methods Plasma from eight pregnant women containing IgG an-ti-M were collected,and were divided into two groups(4 cases with HDFN,with severe clinical symptoms such as fetal hy-drops,and 4 cases without HDFN)according to the clinical outcomes.M antigen positive cells were sensitized with dithioth-reitol(DTT)treated plasma from eight pregnant women respectively.MMA was performed by coincubation with monocytes and sensitized M cells,along with negative and positive control set up.T-test was conducted to compare the difference in phagocytic efficiency between two groups.Results The phagocytic efficiency in group with HDFN were 15.37%,13.05%,9.17%and 24.50%respectively,with the mean value of 15.52%,while the group without HDFN were 8.74%,11.07%,5.12%and 6.23%respectively,with the mean value of 7.79%.There was no significant difference in phagocytic efficiency between two groups(P>0.05).The mean values of both groups were not significantly different from the negative control(P>0.05),but both were significantly lower than positive control(P<0.05).Conclusion The low phagocytic efficiency couldn't convince that the MMA is an effective predictor for the HDFN caused by IgG anti-M,indicating that another mech-anism might be responsible for it rather than monocyte phagocytosis.The assessment of the peak systolic velocity in middle cerebral artery of the fetal should be considered in the management for pregnant women who produce IgG anti-M to estimate the situation of fetal anemia.