Objective To implement the disease prevention and control strategy of being ^"proactive and grassroots-focused,^" and to enhance the overall effectiveness of general hospitals in the tertiary prevention of cervical cancer, this consensus aims to provide an actionable guiding framework for the standardized construction of ^"Integrated Outpatient Clinics for Cervical Cancer Prevention and Control^" in general hospitals at all levels. Methods This consensus systematically elaborates on the specific elements for establishing such integrated clinics and formulates the corresponding standards. Results It is anticipated that the consensus will promote the establishment of standardized, homogeneous, and high-efficiency frontline positions for cervical cancer prevention and control within general hospitals, thereby contributing to the strategic vision of accelerating the elimination of cervical cancer. Conclusion The formulation and promotion of the consensus aim to provide robust clinical practice support for accelerating the realization of China's strategic vision of eliminating cervical cancer.

Objective: To investigate the association between occupational stress and health-related quality of life (HRQoL) among grassroots medical personnels, so as to provide the reference for improving their physical and mental well-being. Methods: From March to May 2024, medical staff from nine street community health service centers in Liangxi District, Wuxi City, Jiangsu Province were selected by a convenient sampling method. Basic information was collected through questionnaire surveys. Occupational stress was assessed using the Core Occupational Stress Measurement Scale. Health utility value and the Visual Analog Scale (EQ-VAS) score were investigated using the European Quality of Life Five-Dimension Five-Level (EQ-5D-5L) questionnaire. The association between occupational stress and HRQoL was analyzed using multiple linear regression model. Results: A total of 909 individuals were surveyed, including 141 males (15.51%) and 768 females (84.49%). The average occupational stress score was (24.41±9.45) points. The average health utility value was (0.96±0.07), with 372 individuals (40.92%) experiencing health problems in at least one dimension. The primarily problems were pain/discomfort and anxiety/depression, with 249 (27.39%) and 265 (29.15%) individuals, respectively. The average EQ-VAS score was (86.62±13.84) points. Multiple linear regression analysis revealed that occupation (nurses, β'=0.101; pharmacists, β'=0.101; medical technicians, β'=0.090), professional title (intermediate, β'=-0.079; associate senior, β'=-0.081; senior, β'=-0.101), and occupational stress (β'=-0.288) were influencing factors for health utility value. Occupation (nurses, β'=0.087; pharmacists, β'=0.146; medical technicians, β'=0.073) and occupational stress (β'=-0.226) were influencing factors for EQ-VAS score. After adjusting for variables such as gender, age, educational level, occupation, professional title, work experience, and monthly income, grassroots medical personnels with higher occupational stress score had lower health utility values (β'=-0.296) and EQ-VAS score (β'=-0.237). Conclusions Occupational stress can reduce the HRQoL among grassroots medical personnels. It is recommended to regularly assess occupational stress levels and intervene early to address their psychological and physical health issues.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective:To explore glucose and lipid metabolism in obese children and its correlation with precocious puberty.Methods:A total of 65 obese children (obese group) and 65 children with normal body weight (control group) who underwent physical examination at the Beijing Luhe Hospital Affiliated to Capital Medical University from March 2021 to March 2023 were retrospectively selected. Glucose and lipid metabolism indexes of the two groups were detected, and precocious puberty was evaluated according to Tanner staging criteria. Spearman test was used to analyze the correlation between glucose and lipid metabolism indexes and precocious puberty. Logistic regression analysis was used to screen the risk factors of precocious puberty in obese children.Results:The levels of fasting blood glucose (FPG), 2-hour postprandial blood glucose(2 h PG), glycosylated hemoglobin (HbA 1c), fasting insulin (FINS), insulin resistance index (HOMA-IR), triacylglycerol (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and uric acid (UA) in the obese group were higher than those in the control group: 5.90(5.50, 6.50) mmol/L vs. 4.90(4.40, 5.30) mmol/L, (8.46 ± 1.38) mmol/L vs. (7.39 ± 0.87) mmol/L, 5.90(5.10, 6.70)% vs. 5.30(4.50, 5.70)%, (10.67 ± 2.46) mU/L vs. (5.14 ± 1.22) mU/L, 2.10(1.90, 2.30) vs. 1.10(1.00, 1.30), (141.95 ± 34.92) mmol/L vs. (95.21 ± 12.40) mmol/L, (153.82 ± 25.44) mmol/L vs. (143.59 ± 18.47) mmol/L, 80.50(72.10, 94.50) mmol/L vs. 65.10(59.30, 69.80) mmol/L, 293.20(271.80, 330.70) μmol/L vs. 250.90(210.80, 286.90) μmol/L; while the level of high-density lipoprotein cholesterol (HDL-C) was lower than that in the control group: 53.70(50.10, 58.00) mmol/L vs. 59.30(56.70, 62.60) mmol/L, there were statistical differences ( P<0.05). The incidence of precocious puberty in boys and girls in the obesity group was higher than those in the control group: 23.68%(9/65) vs. 0; 37.04%(10/65) vs. 7.41%(2/65), there were statistical differences ( P<0.05). The results of the Spearman test showed that the Tanner scores of testis and pubic hair in boys and breast and pubic hair in girls in the obesity group were positively correlated with FPG, 2 h PG, HbA 1c, FINS, HOMA-IR, TG, TC, LDL-C and UA ( P<0.05), and there was a negative correlation with HDL-C ( P<0.05). The results of multivariate Logistic regression analysis showed that increased levels of FPG, HbA 1c, FINS, HOMA-IR, TG, TC and UA were risk factors for precocious puberty in obese children ( OR>1, P<0.05). Conclusions:Obesity is associated with precocious puberty and the disorder of glucose and lipid metabolism is related to precocious puberty.

Microglia are specialized immune cells in the brain, primarily responsible for clearing debris and responding to inflammation. One of the pathological features of Alzheimer's disease (AD) is the extensive activation of immune system in the brain, and the dynamic changes and dysfunction of microglia could become key factors for AD progression. This article reviews the research progress of regulated effect of microglial on AD pathology, and summarizes its potential value in AD treatment, in order to provide theoretical basis for exploring new therapeutic strategies and intervention targets for AD.

Objective:To investigate the association between the triglyceride-glucose(TyG)index and the incidence and mortality of cardiovascular disease(CVD)in a large population-based cohort.Methods:Participants aged 40-79 years without a history of CVD at baseline were drawn from the CHi-nese Electronic health Records Research in Yinzhou(CHERRY)study between January 1,2010,and May 31,2020.The TyG index was calculated using baseline triglyceride and fasting blood glucose.Cox proportional hazards models were used to assess the association between the TyG index and the composite outcome of CVD(incidence and mortality),adjusting for age,gender,education,region,smoking sta-tus,body mass index,systolic blood pressure,and total cholesterol.Hazard ratios(HR)and 95％confi-dence intervals(CI)were calculated.Nonlinear associations between the TyG index and CVD were fur-ther evaluated using restricted cubic splines,and subgroup analyses by gender and age were conducted to explore potential differences.Results:A total of 226 406 individuals were included,with a mean age of(55.0±9.7)years at baseline,46.8％of whom were men,and a median TyG index of 8.68.Over a median follow-up of 7.99 years,9 815(4.34％)participants experienced CVD incidence or mortality.After adjusting for age,gender,education,region,smoking status,body mass index,systolic blood pressure and total cholesterol,the risk of CVD increased with higher TyG index levels(P＜0.001).The risk in the highest TyG quartile(TyG＞9.10)was 42％higher than in the lowest quartile(TyG ≤8.32)(HR=1.42,95％CI:1.34-1.51).Individuals under 60 years had a higher HR for CVD compared with those aged 60 years and above(HR:1.71 vs.1.27,P＜0.05).Restricted cubic spline analysis revealed a reverse L-shaped association between the TyG index and CVD risk in the overall population(P＜0.001 for nonlinear trend),with risk increasing after the TyG index exceeded 8.67.However,the threshold varied by gender,with a lower threshold in women(8.51)than in men(8.67).Conclusion:A significant nonlinear relationship was revealed between the TyG index and CVD risk,with a threshold effect.The risk of CVD increased once the TyG index surpassed a certain threshold,with a lower threshold in women than in men.These findings suggest that cardiovascular risk prediction and interven-tions based on the TyG index should be gender-stratified,and early intervention for individuals under 60 years old might have important public health implications.

Objective To explore the diagnostic value of serum sex hormone binding globulin(SHBG),in-sulin-like growth factor-1(IGF-1)and bone age index(BAI)in girls with precocious puberty(PP).Methods A total of 220 girls with PP who were treated in this hospital from January 2022 to August 2024 were selected as the research subjects.The research subjects were divided into 104 children with central preco-cious puberty(CPP,CPP group)and 116 children with simple premature thelarche(SPT,SPT group)accord-ing to the type of the patients' disease.Another 110 girls with normal physical examination and development during the same period were selected as the control group.The levels of serum SHBG and IGF-1 in each group were determined and BAI was calculated.The diagnostic efficacy of the combined detection of serum SHBG,IGF-1 and BAI for CPP was analyzed through the receiver operating characteristic curve,and the correlation between serum SHBG,IGF-1,BAI and sex hormone indicators in girls with PP was analyzed by Pearson corre-lation analysis.Results The levels of height,basal follicle-stimulating hormone(FSH),basal luteinizing hor-mone(LH),and estradiol(E2)in the CPP group and the SPT group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The serum SHBG levels in the CPP group and the SPT group were lower than those in the control group,and the differences were statistically significant(P＜0.05).The serum IGF-1 and BAI in the CPP group and the SPT group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The area under the curve(AUC)of the three combined diagnoses of PP in girls was 0.941,which was significantly larger than those of IGF-1 and BAI(Z=8.140,9.470,both P＜0.05).The AUC of the three combined diagnoses of CPP in girls was 0.958,which was significantly higher than those of the single tests of serum SHBG,IGF-1,and BAI(Z=2.821,7.363,6.412,all P＜0.05).The levels of serum SHBG in PP of girls were negatively correlated with those of IGF-1,BAI,basal FSH,basal LH and E2(P＜0.05).Serum IGF-1 was positively correlated with BAI,basal FSH and basal LH(P＜0.05),but not correlated with E2(P＞0.05).BAI was positively correla-ted with the levels of basal FSH,basal LH and E2(P＜0.05).Conclusion The combination of serum SHBG and IGF-1 with BAI has certain diagnostic value for PP in girls,especially for the diagnosis of CPP,which is significantly superior to a single test.

Objective:To investigate whether changes in CT pulmonary angiography (CTPA) parameters before and after balloon pulmonary angioplasty (BPA) are correlated with treatment effects in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods:A retrospective study was conducted, including patients with CTEPH who underwent BPA treatment at Beijing Anzhen Hospital from November 2021 to Febbruary 2024. Clinical data and CTPA parameters were analyzed before the initial BPA session and at least 6 months after the final BPA session. Clinical data included WHO functional class, 6-minute walk distance (6MWD), and plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. The CTPA parameters included the widest diameter of the pulmonary artery diameter (dPA), ascending aorta diameter (dAA), the widest transverse diameter of the right atrium (dRA), the widest short-axis diameter of the right ventricle (dRV), the widest short-axis diameter of the left ventricle (dLV), and the diameter of right ventricular free wall thickness(dRVW). Multiple linear regression was applied to identify variables associated with the decrease in mean pulmonary artery pressure (mPAP) among the CTPA parameters.Results:All CTEPH patients underwent a total of 115 BPA treatments. Postoperatively, the WHO functional class of the patients improved compared to preoperative levels ( χ2=5.01, P<0.001), 6MWD improved ( t=4.50, P<0.001), and NT-proBNP levels decreased ( Z=4.47, P<0.001). Hemodynamic parameters, including mPAP, pulmonary vascular resistance, cardiac output, and cardiac index, were significantly improved postoperatively (all P<0.001). CTPA-related parameters, including dPA, dRA, dRV, dRVW, dPA/dAA, dRV/dLV, and dRA/dPA, significantly decreased compared to preoperative values (all P<0.001). Multiple linear regression analysis showed that the decrease in dPA ( β=0.314, P=0.037) and dRA ( β=0.334, P=0.046) were significantly correlated with the improvement in mPAP. Conclusions:Exercise tolerance, hemodynamics, and CTPA parameters in patients with CTEPH significantly improved after BPA treatment. The decrease in dPA and dRA were significantly correlated with the improvement in mPAP, suggesting that CTPA is a potentially novel, objective, effective, and noninvasive method for evaluating the therapeutic efficacy of BPA.

This article reported the diagnosis and management of a case of a child with Kabuki syndrome. Kabuki syndrome is characterized by distinct facial features, skeletal anomalies, abnormal skin texture, and intellectual disabilities, and is primarily caused by heterozygous mutations in the lysine methyltransferase 2D(KMT2D) gene. The onset in this patient was insidious, presenting with short stature and intellectual impairment. Genetic testing identified a pathogenic heterozygous variant in the KMT2D gene. This article focuses on analyzing the necessity and appropriateness of growth hormone therapy in children with Kabuki syndrome, and includes a review of relevant literature to improve clinicians′ understanding of this rare condition.

Objective A scoping review of studies on pulmonary prehabilitation in cardiac surgery patients was conducted to provide evidence support for the construction of a preoperative pulmonary rehabilitation program for cardiac surgery patients that suitable for China's national conditions.Methods In accordance with the scope review's research methodologies,databases including PubMed,Embase,Web of Science,CINAHL,CNKI and Wanfang were searched by the computer for relevant studies.The deadline for retrieval is from the establishment of databases to June,2024.The included literature was systematically analyzed.Results 26 articles were finally included.Among them,4 were quasi-experiment studies,while the other 22 were randomized controlled trials.Forms of the intervention included comprehensive breathing exercises,inspiratory muscle training,positive expiratory pressure,incentive spirometer training and balloon blowing training.The intervention initiation ranged from 10 weeks to 1 day preoperatively;the outcome measures included postoperative pulmonary complications,lung function metrics,the 6-Minute Walk Test,duration of mechanical ventilation,length of hospital stay,patient-reported outcomes and so on.Conclusion There remains a deficiency in standardized protocols for preoperative pulmonary rehabilitation training among patients undergoing cardiac surgery.High-quality studies should be conducted,and intervention strategies for pulmonary prehabilitation in cardiac surgery patients should be optimized and a unified evaluation standard system should be established.