Alzheimer′s disease(AD), as a common cognitive impairment disorder in the elderly, has imposed a significant burden on the global public health system.The latest international diagnostic criteria emphasize defining AD from a biological perspective and viewing it as a continuous pathological and physiological change process.This article, guided by the principle of ′early diagnosis-precision intervention′, systematically elaborates on the current research status of AD regarding diagnostic criteria, biomarkers, new drug development, and the establishment of China-specific AD cohorts.It also provides an in-depth outlook on the future research directions and clinical application prospects of AD.

Alzheimer′s disease(AD), as a common cognitive impairment disorder in the elderly, has imposed a significant burden on the global public health system.The latest international diagnostic criteria emphasize defining AD from a biological perspective and viewing it as a continuous pathological and physiological change process.This article, guided by the principle of ′early diagnosis-precision intervention′, systematically elaborates on the current research status of AD regarding diagnostic criteria, biomarkers, new drug development, and the establishment of China-specific AD cohorts.It also provides an in-depth outlook on the future research directions and clinical application prospects of AD.

Objective To explore the effect of oral neuromuscular training combined with intermittent theta burst stimulation(iTBS)on dysphagia of nasopharyngeal carcinoma patients after chemoradiotherapy.Methods Seventy-six nasopharyngeal carcinoma patients with dysphagia who received chemoradiotherapy in The Second Affiliated Hospital of Air Force Medical University from March 2021 to March 2022 were enrolled and divided into two groups by random number table methods.Control group received conventional swallowing training,and observation group received oral neuromuscular training combined with iTBS.The swallowing function was assessed by video fluoroscopic swallowing study(VFSS)and Rosenbek penetration aspiration scale(PAS)at the baseline and after treatment.The quality of life and treatment effect were compared between the two groups.Results After intervention,the PAS score was decreased and the Swallowing Quality-of-Life Questionnaire(SWAL-QOL)score was increased in both groups(P＜0.05),with significant differences between the two groups(P＜0.05).The treatment efficacy of dysphagia in the observation group was significantly higher than that in the control group(86.84%vs 44.74%,P＜0.05).Conclusion Oral neuromuscular training combined with iTBS can effectively ameliorate dysphagia and improve the quality of life of patients with nasopharyngeal carcinoma after chemoradiotherapy.

Objective:To identify the influencing factors affecting the cosmetic facial injection treatments for cosmetic patients.Methods:Based on the purposeful sampling principle with maximum diversity and data saturation principle, patients who underwent facial injection cosmetic surgery in Plastic Surgery Hospital, Chinese Academy of Medical Sciences from June to September 2022 were selected for cross-sectional study. The qualitative study method was used to conduct semi-structured in-depth interviews with patients and collect data. After the interview, the 7-step analysis method of Colaizzi phenomenological data was used to extract the topic concepts.Results:A total of 16 patients were included, and their influencing factors for medical treatment could be divided into 5 related topics: (1) age-related; (2) occupation-related; (3) surrounding social-environment-related; (4) social media platforms contacted; (5) experience of negative appearance evaluation during adolescence.Conclusion:Many factors affect the treatment of injection patients. In the course of medical treatment, the influencing factors should be identified accurately, so as to guide patients to seek medical treatment scientifically.

Objective:To investigate the coverage of qualified iodized salt in catering service units where residents ate out in Shanxi Province, so as to provide a basis for taking targeted preventive measures timely and adjusting of intervention strategies scientifically, and to consolidate the achievements of eliminating iodine deficiency disorders (IDD) continuously.Methods:One prefecture level city from each of the five directions of east, west, south, north and middle in Shanxi Province in 2021 was selected. One mountainous county and one plain county were selected in each city. Each of the counties was divided into five sampled regions along five different geographic directions: east, west, south, north and middle. From each region, one town/street was selected randomly and then two canteens of enterprises and institutions (canteens), five medium-sized restaurants and five small restaurants were selected from each town/street. We investigated the basic information of catering service units, collected salt samples and then detected the iodine content of these salt samples. In addition, salt iodine testing data of county residents corresponding to catering service units in the 2021 iodine deficiency disorders monitoring were collected from the Shanxi Institute of Endemic Disease Prevention and Treatment, and compared with the survey results of catering service units.Results:A total of 660 salt samples were detected, the median value of salt iodine was 27.65 mg/kg, the coverage rate of iodized salt was 99.39%(656/660), and the coverage rate of qualified iodized salt was 90.76% (599/660). The median value of salt iodine was 26.70, 28.00 and 27.60 mg/kg in canteens, medium-sized restaurants and small restaurants, respectively, and the coverage rate of qualified iodized salt was 95.54% (107/112), 90.42% (236/261), and 89.20% (256/287), respectively. There was no significant difference in the coverage rate of qualified iodized salt among different types of catering service units (χ 2 = 3.92, P = 0.141). The median value of salt iodine was 28.00 and 27.20 mg/kg in mountainous counties and plain counties, respectively, and the coverage rate of qualified iodized salt was 88.67% (266/300) and 92.50% (333/360), respectively. There was no significant difference in the coverage rate of qualified iodized salt among the counties of different geographical types (χ 2 = 2.87, P = 0.090). The median value of salt iodine in catering service units and households was 27.65 and 23.50 mg/kg, respectively, and the coverage rate of qualified iodized salt was 90.76% and 95.91%, respectively. There was a statistically significant difference in the coverage rate of qualified iodized salt between catering service units and households (χ 2 = 31.19, P < 0.001). Conclusions:The coverage rate of qualified iodized salt in catering service units in Shanxi Province generally meets the national elimination standard (> 90%), but there are still some counties that do not meet the standard. The coverage rate of qualified iodized salt in small and medium-sized restaurants is also not optimistic. It is recommended to strengthen monitoring and supervision of edible salt in catering service units in the future.

Objective:To identify the influencing factors affecting the cosmetic facial injection treatments for cosmetic patients.Methods:Based on the purposeful sampling principle with maximum diversity and data saturation principle, patients who underwent facial injection cosmetic surgery in Plastic Surgery Hospital, Chinese Academy of Medical Sciences from June to September 2022 were selected for cross-sectional study. The qualitative study method was used to conduct semi-structured in-depth interviews with patients and collect data. After the interview, the 7-step analysis method of Colaizzi phenomenological data was used to extract the topic concepts.Results:A total of 16 patients were included, and their influencing factors for medical treatment could be divided into 5 related topics: (1) age-related; (2) occupation-related; (3) surrounding social-environment-related; (4) social media platforms contacted; (5) experience of negative appearance evaluation during adolescence.Conclusion:Many factors affect the treatment of injection patients. In the course of medical treatment, the influencing factors should be identified accurately, so as to guide patients to seek medical treatment scientifically.

Objective:To learn about the status of iodine deficiency disorders (IDD) and iodine nutrition of residents in Shanxi Province since the implementation of the standard of "Iodine Content in Edible Salt" (GB 26878-2011), to evaluate the level of prevention and control of IDD, and to provide scientific basis for adjusting prevention and control strategies.Methods:The data of core indicators monitored by Shanxi Province in accordance with the requirements of the national iodized salt and IDD monitoring program for each year from 2012 to 2021 were comprehensively reviewed, and the change trends of the indicators such as coverage rate of iodized salt, consumption rate of qualified iodized salt, children's median urinary iodine and goiter rate, and pregnant women's median urinary iodine were analyzed; the evaluation of IDD elimination in counties (cities and districts, hereinafter referred to as counties) was analyzed.Results:From 2012 to 2021, the coverage rate of iodized salt in Shanxi Province was remained > 95%; from 2012 to 2014 (transition period between new and old standard iodized salt), the consumption rate of qualified iodized salt had an upward trend (χ 2trend = 2 703.32, P < 0.001), with a downward trend from 2015 to 2017 (before and after the reform of the salt industry system, χ 2trend = 122.18, P < 0.001), and with an upward trend from 2018 to 2021 (after the reform of the salt industry system, χ 2trend = 455.11, P < 0.001), from 2018, the consumption rate of qualified iodized salt remained > 90%; from 2015 to 2021, the average content of salt iodine was between 23 - 25 mg/kg, and the coefficient of variation of salt iodine was 15% - 18%. From 2014 to 2021, the median urinary iodine of children in Shanxi Province remained at 200 - 250 μg/L, the median urinary iodine of pregnant women remained at 150 - 200 μg/L, and the goiter rate of children remained below 5%. Every year, iodine nutrition of pregnant women in some counties was insufficient. In 2016, the proportion of counties with insufficient iodine nutrition of pregnant women was high, reached 30.0% (12/40); from 2018 to 2021, the proportion of counties with insufficient iodine nutrition of pregnant women had a downward trend (χ 2trend = 9.37, P = 0.002), which was 11.1% (13/117) in 2021. In 2020, 117 counties in the province reached the IDD elimination standard, with a compliance rate of 100.0%. Conclusions:Since the implementation of the current salt iodine content standard for 10 years, the consumption rate of qualified iodized salt has gradually stabilized and remained at a high level, which can ensure that IDD is in a sustainable state of elimination in Shanxi Province, and the iodine nutrition of school-age children and pregnant women is generally at a suitable level. However, there are a certain number of counties with insufficient iodine nutrition of pregnant women. It is recommended to guide pregnant women to supplement iodine or set the average standard of salt iodine for pregnant women separately.

Objective:To investigate the prevalence of thyroid disease in adults in different water iodine areas and to explore the association between iodine and thyroid disease.Methods:In May of 2016, using cross-sectional survey, Gaoche Village and Maxi Village of Wenshui County were selected in Shanxi Province as a high-iodine area and a low-iodine area, respectively, Xiwenzhuang Village of Taiyuan City as an appropriate-iodine area. Questionnaire surveys, urinary iodine levels, thyroid ultrasound, determination of thyroid function and autoantibody were conducted for permanent residents aged 18 - 65.Results:A total of 898 people were investigated, including 288 in high-iodine area, 324 in low-iodine area and 286 in appropriate-iodine area. The medians urinary iodine were 417.8, 126.6 and 216.5 μg/L in high, low and appropriate-iodine areas, respectively, and the difference was statistically significant ( H = 288.61, P < 0.05). After age and sex standardization, the detection rates of hyperthyroidism in low, appropriate and high-iodine areas were 0.27%, 1.06% and 1.43%, respectively. The detection rates of sub-clinical hyperthyroidism were 0.57%, 0.31% and 0.30%, respectively. The detection rates of hypothyroidism were 1.45%, 1.15% and 1.85%, respectively. The detection rates of sub-clinical hypothyroidism were 19.34%, 28.50% and 32.76%, respectively. The detection rates of thyroid nodule were 20.51%, 20.17% and 33.78%, respectively. The positive rates of anti-thyroglobulin antibodies (TgAb) were 18.13%, 19.41% and 11.99%, respectively. The positive rates of thyroid peroxidase antibody (TPOAb) were 9.25%, 12.04% and 8.97%, respectively. The appropriate-iodine area was used as control, logistic regression analysis showed that only the detection rate of thyroid nodule in high-iodine area was significantly higher than that in appropriate-iodine area [odds ratio ( OR) = 0.488 5, 95% confidence interval ( CI) = 0.327 2 - 0.729 2 , P < 0.05]. Conclusion:In Shanxi Province, the detection rate of thyroid nodules is different in different areas of water iodine, and the detection rate of thyroid nodule in adults in high-iodine area is higher than that in other areas.

Objective:To study the relationship between thyroid volume (TV) and thyroid autoantibodies in patients with autoimmune thyroid disease (AITD), and to explore the factors affecting goiter in patients with AITD.Methods:The newly diagnosed AITD adult patients in the Affiliated Hospital of Shanxi Institute for Endemic Disease Prevention and Control from November 2019 to October 2020 were selected for questionnaire survey, physical examination, thyroid function and thyroid autoantibody test, determination of serum iodine content and thyroid ultrasound, and the correlation between thyroid volume and thyroid autoantibody was analyzed.Results:A total of 147 newly diagnosed adult AITD patients were included, including 63 cases of Graves' disease (GD, 30 males and 33 females) and 84 cases of chronic lymphocytic thyroiditis (HT, 29 males and 55 females). The TV of male and female patients with GD was positively correlated with the levels of thyrotropin receptor antibody (TRAb) ( rmen = 0.515, rwomen = 0.412, P < 0.05). The TV of male and female patients with HT was not correlated with the levels of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb, rmen = - 0.137, 0.168, rwomen = 0.184, - 0.088, P > 0.05). There were no correlation between TPOAb levels and TGAb levels in male and female HT patients ( rmen = 0.153, rwomen = 0.102, P > 0.05). The TV of male and female patients with GD or HT was not correlated with the serum levels of iodine ( rmen = 0.230, 0.013, rwomen = 0.096, 0.069, P > 0.05). Conclusion:TRAb level is positively correlated with the TV in GD patients.

Objective:To master the prevalence of thyroid nodule in adults in different water iodine areas and to explore the association between high iodine intake through drinking water and thyroid nodule prevalence.Methods:Xiwenzhuang Village of Taiyuan City was selected as iodine-adequate area, and Gaoche Village and Maxi Village of Wenshui County as high-iodine area and low-iodine area, respectively, in Shanxi Province. Questionnaire surveys were conducted, thyroid ultrasound was used and urinary iodine levels were determined of residents aged 18 to 65 years. Analysis of the prevalence of thyroid nodules in adults in different wated iodine areas.Results:A total of 868 person were investigated, including 286 in high-iodine area, 270 in iodine-adequate area and 312 in low-iodine area. The medians urinary iodine in high, adequate and low iodine areas were 418.7, 218.5 and 127.1 μg/L, respectively, and the differences were statistically significant ( H = 289.70, P < 0.05). The detection rate of thyroid nodule in adults with high, adequate and low iodine levels were 31.1% (89/286), 27.4% (74/270) and 19.2% (60/312), respectively, the differences were significant statistically among three groups (χ 2 = 11.65, P < 0.05). The detection rates of solitary nodule in adults were 17.8% (51/286), 14.1% (38/270), and 13.1% (41/312), respectively, the differences were not significant statistically among the three groups (χ 2 = 2.83, P > 0.05). The detection rate of multiple nodules in adults were 13.3% (38/286), 13.3% (36/270), and 6.1% (19/312), respectively, the differences were significant statistically among the three groups (χ 2 = 10.89, P < 0.05) high-iodine area and iodine-adequate area have higher detection rates than low-iodine area ( P < 0.05). The thyroid nodules were mainly the cyst nodules in high-iodine area. Conclusions:The detection rate of thyroid nodule in adults is the lowest in adequate iodine nutrition level. More iodine intake is probably a risk factor for thyroid multiple nodules.