Objective: To explore the correlation between small intestinal bacterial overgrowth(SIBO) and cognitive impairment in patients undergoing peritoneal dialysis(PD). Methods: 60 PD patients and 46 non-dialysis patients with end-stage renal disease(ESRD) were included in this study. SIBO was detected by lactulose hydrogen methane breath test(LHMBT). The cognitive function levels of the subjects were evaluated using the Montreal cognitive assessment(MoCA) and mini-mental state examination(MMSE). The emotional states of the patients were assessed by self-rating anxiety scale(SAS) and self-rating depression scale(SDS). The gastrointestinal symptoms were evaluated using gastrointestinal symptom rating scale(GSRS). According to the results of LHMBT, the PD patients were further divided into two subgroups: SIBO-positive and SIBO-negative. The general conditions, laboratory data, and scores of each scale were compared between the two groups. Furthermore, according to the MoCA scores, the PD patients were divided into two groups: those with normal cognitive function and those with cognitive dysfunction. The positive rates of SIBO between the two groups were compared. Binary Logistic stepwise regression was used to explore whether SIBO was an independent risk factor for cognitive impairment in PD patients. At the same time, other independent influencing factors for cognitive impairment in PD patients were analyzed. Results: The positive rate of SIBO in PD patients was 40.00%. Among them, the positive rate of SIBO in the group with normal cognitive function during peritoneal dialysis was 27.27%, and the positive rate of SIBO in the group with cognitive dysfunction during peritoneal dialysis was 55.56%. There was a statistically significant difference in the positive rate of SIBO between the two groups(P=0.026). Further analysis by multivariate Logistic stepwise regression showed that in addition to age(OR=1.118, 95%CI 1.007-1.242, P=0.037), educational attainment(OR=0.655,95%CI 0.442-0.972,P=0.036), and hemoglobin(OR=0.946,95% CI 0.895-0.998,P=0.044), SIBO(OR=7.613,95% CI 1.160-49.979,P=0.034)was also an independent risk factor for cognitive impairment in PD patients. Conclusion The incidence of SIBO in PD patients is relatively high and is associated with multiple factors, among which SIBO may be closely related to cognitive dysfunction in PD patients.

Objective:To investigate the regulatory role and underlying mechanism of hepatic complement factor D(CFD) in obesity and adipose tissue metabolic disorders in high-fat diet(HFD)-induced obese mice.Methods:C57BL/6J mice were fed a HFD to induce obesity and subjected to tail vein or targeted virus injections to establish tissue-specific CFD overexpression or knockdown models. HE staining of adipose tissue was performed to evaluate adipocyte size and number. Immunohistochemical staining was used to evaluate uncoupling protein 1(UCP1) protein expression. qPCR and Western blot were conducted to detect the expression of genes related to lipid synthesis, thermogenesis, and downstream signaling pathway proteins in adipose tissue. In vitro, differentiated 3T3-L1 cells and primary stromal vascular fractions(SVF) from brown adipose tissue were treated with recombinant CFD protein combined with pathway inhibitors to verify the regulatory mechanism.Results:Liver-specific overexpression of CFD in mice led to increased adipose tissue mass ratio and aggravated insulin resistance under HFD conditions, accompanied by more severe fat accumulation and decreased energy expenditure compared with control mice. Conversely, liver-specific knockdown of CFD improved these metabolic abnormalities. Mechanistically, CFD exerted its metabolic regulatory effects by activating the C5aR-AKT signaling pathway in adipocytes. Furthermore, targeted knockdown of C5aR in adipose tissue attenuated the adverse metabolic effects induced by hepatic CFD overexpression.Conclusion:Hepatic CFD plays a critical role in the development of obesity and related metabolic disorders. These findings provide a potential novel therapeutic target for the management of obesity-associated metabolic diseases.

Objective:To investigate the iodine nutrition status of children aged 8 - 10 and pregnant women in Xining City, Qinghai Province.Methods:From 2019 to 2021, a stratified cluster sampling method was used to divide 7 counties (districts) under the jurisdiction of Xining City, Qinghai Province into 5 sampling areas according to east, west, south, north, and center each year. One township (town, street) was selected from each area. Forty non boarding students aged 8 to 10 from each primary school (half male and half female, age balanced) and 20 pregnant women from each township (town, street) location were selected to collect edible salt samples at home and a random urine sample to measure salt iodine and urinary iodine level. B-ultrasound was used to measure thyroid volume in children and the goiter rate was calculated.Results:A total of 6 534 samples of household edible salt were collected from children and pregnant women, with an average salt iodine concentration of 25.58 mg/kg. The coverage rate of iodized salt was 97.50% (6 371/6 534), and the qualified iodized salt consumption rate was 89.46% (5 845/6 534). A total of 4 362 urine samples were collected from children, with a median urinary iodine level of 183.10 μg/L. The difference between different years was statistically significant ( H = 20.27, P < 0.001). A total of 2 169 urine samples were collected from pregnant women, with a median urinary iodine level of 168.90 μg/L. The difference between different years was statistically significant ( H = 107.09, P < 0.001). A total of 3 336 cases of thyroid gland examination were conducted in children, including 33 cases of thyroid enlargement, with a goiter rate of 0.99%. There was a statistically significant difference between different years (χ 2 = 15.00, P < 0.001). Conclusion:From 2019 to 2021, children aged 8 to 10 and pregnant women in Xining City are at an appropriate level of iodine, and the achievements in prevention and treatment of iodine deficiency disorders still need to be continuously consolidated.

Objective:To estimate the burden of influenza-associated outpatient consultations in China from 2011 to 2021 surveillance years to provide a reference for developing influenza prevention, control strategies, and vaccination policies.Methods:Data on influenza-like illness (ILI) and virological confirmation of sentinel specimens from 2011 to 2021 surveillance years were extracted from China's national sentinel surveillance system. Generalized additive models were fitted to estimate influenza-associated excess ILI outpatient burden, accounting for seasonal baselines and meteorological factors.Results:Influenza was associated with an average of 1.66 (95% CI: 1.51-1.80) excess ILI consultations per 1 000 person-years (py) in China each year from 2011 to 2021 surveillance years. The influenza-associated outpatient burden was similar across different virus types/subtypes. Influenza A(H1N1)pdm09 led to a higher rate of influenza- associated ILI consultations [0.65 (95% CI: 0.53-0.76) per 1 000 py] compared to other types/subtypes. The age groups with the highest burdens were children aged 0-4 years and 5-14 years, with excess outpatient consultation rates of 15.23 (95% CI: 13.73-16.73) per 1 000 py and 13.53 (95% CI: 12.49-14.52) per 1 000 py, respectively. Conclusions:Influenza caused many outpatient consultations in China, particularly among children aged 0-14. Continuous influenza monitoring and disease burden assessment should be conducted, and close attention should be paid to the changing trends of various influenza virus types/subtypes. When formulating vaccination strategies, priority should be given to recommending vaccination for high-risk populations, such as children.

Objective:To investigate the regulatory role and underlying mechanism of hepatic complement factor D(CFD) in obesity and adipose tissue metabolic disorders in high-fat diet(HFD)-induced obese mice.Methods:C57BL/6J mice were fed a HFD to induce obesity and subjected to tail vein or targeted virus injections to establish tissue-specific CFD overexpression or knockdown models. HE staining of adipose tissue was performed to evaluate adipocyte size and number. Immunohistochemical staining was used to evaluate uncoupling protein 1(UCP1) protein expression. qPCR and Western blot were conducted to detect the expression of genes related to lipid synthesis, thermogenesis, and downstream signaling pathway proteins in adipose tissue. In vitro, differentiated 3T3-L1 cells and primary stromal vascular fractions(SVF) from brown adipose tissue were treated with recombinant CFD protein combined with pathway inhibitors to verify the regulatory mechanism.Results:Liver-specific overexpression of CFD in mice led to increased adipose tissue mass ratio and aggravated insulin resistance under HFD conditions, accompanied by more severe fat accumulation and decreased energy expenditure compared with control mice. Conversely, liver-specific knockdown of CFD improved these metabolic abnormalities. Mechanistically, CFD exerted its metabolic regulatory effects by activating the C5aR-AKT signaling pathway in adipocytes. Furthermore, targeted knockdown of C5aR in adipose tissue attenuated the adverse metabolic effects induced by hepatic CFD overexpression.Conclusion:Hepatic CFD plays a critical role in the development of obesity and related metabolic disorders. These findings provide a potential novel therapeutic target for the management of obesity-associated metabolic diseases.

Objective:To estimate the burden of influenza-associated outpatient consultations in China from 2011 to 2021 surveillance years to provide a reference for developing influenza prevention, control strategies, and vaccination policies.Methods:Data on influenza-like illness (ILI) and virological confirmation of sentinel specimens from 2011 to 2021 surveillance years were extracted from China's national sentinel surveillance system. Generalized additive models were fitted to estimate influenza-associated excess ILI outpatient burden, accounting for seasonal baselines and meteorological factors.Results:Influenza was associated with an average of 1.66 (95% CI: 1.51-1.80) excess ILI consultations per 1 000 person-years (py) in China each year from 2011 to 2021 surveillance years. The influenza-associated outpatient burden was similar across different virus types/subtypes. Influenza A(H1N1)pdm09 led to a higher rate of influenza- associated ILI consultations [0.65 (95% CI: 0.53-0.76) per 1 000 py] compared to other types/subtypes. The age groups with the highest burdens were children aged 0-4 years and 5-14 years, with excess outpatient consultation rates of 15.23 (95% CI: 13.73-16.73) per 1 000 py and 13.53 (95% CI: 12.49-14.52) per 1 000 py, respectively. Conclusions:Influenza caused many outpatient consultations in China, particularly among children aged 0-14. Continuous influenza monitoring and disease burden assessment should be conducted, and close attention should be paid to the changing trends of various influenza virus types/subtypes. When formulating vaccination strategies, priority should be given to recommending vaccination for high-risk populations, such as children.

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.

Background Hypertension is one of the chronic diseases with the highest prevalence in China, and a history of hypertension may potentially exacerbate hearing loss. Investigating the association between long-term blood pressure trends and hearing thresholds could contribute to hearing protection efforts for occupationally noise-exposed populations. Objective By investigating hearing thresholds and blood pressure levels among occupationally noise-exposed workers in an urban rail transit enterprise, and conducting a comprehensive analysis of the association between long-term blood pressure changes and hearing thresholds, to provide data references for health management strategies targeting occupationally noise-exposed workers. Methods Workers exposed to occupational noise at a rail transit enterprise were enrolled as study subjects and underwent pure-tone audiometry. Group-based trajectory modeling was employed to identify blood pressure trajectories. Categorical data were compared using chi-square tests, while normally distributed continuous variables were analyzed via t-tests and analysis of variance (ANOVA). Generalized linear mixed models (GLMMs) were subsequently applied toexamine associations between these trajectory groups and high-frequency hearing thresholds. Results Among 2 002 occupationally noise-exposed workers, the median (P₂₅, P₇₅) age was 32 (28, 35) years, with a median (P₂₅, P₇₅) working tenure of 7 (3, 10) years. In 2019, the positive hypertension rate was 9.04%, with a mean systolic blood pressure (SBP) of (122.97±11.60) mmHg and a mean diastolic blood pressure (DBP) of (76.37±9.02) mmHg. The hearing loss prevalence was 10.1%, showing bilateral high-frequency average hearing thresholds of (17.18±8.71) dB and speech-frequency average thresholds of (13.79±3.46) dB. Three distinct trajectory groups were identified for both SBP and DBP. Compared with other trajectory groups, the high-stable DBP group exhibited significantly higher hearing loss prevalence (χ²=6.34, P=0.042) and elevated high-frequency hearing thresholds (all Ps<0.05). Specifically, within the 30-39 age subgroup, the moderate-stable DBP group demonstrated 1.96 dB lower high-frequency thresholds than the high-stable group [β(95%CI): −1.96 (−3.61, −0.32), P=0.020]. Conclusion Among occupationally noise-exposed workers in a municipal rail transit enterprise, DBP trajectories demonstrated a positive association with high-frequency hearing thresholds. Notably, in young and middle-aged occupationally noise-exposed populations, DBP may exert a more critical influence than SBP on the progression of hearing loss.

Objective:To investigate the iodine nutrition status of children aged 8 - 10 and pregnant women in Xining City, Qinghai Province.Methods:From 2019 to 2021, a stratified cluster sampling method was used to divide 7 counties (districts) under the jurisdiction of Xining City, Qinghai Province into 5 sampling areas according to east, west, south, north, and center each year. One township (town, street) was selected from each area. Forty non boarding students aged 8 to 10 from each primary school (half male and half female, age balanced) and 20 pregnant women from each township (town, street) location were selected to collect edible salt samples at home and a random urine sample to measure salt iodine and urinary iodine level. B-ultrasound was used to measure thyroid volume in children and the goiter rate was calculated.Results:A total of 6 534 samples of household edible salt were collected from children and pregnant women, with an average salt iodine concentration of 25.58 mg/kg. The coverage rate of iodized salt was 97.50% (6 371/6 534), and the qualified iodized salt consumption rate was 89.46% (5 845/6 534). A total of 4 362 urine samples were collected from children, with a median urinary iodine level of 183.10 μg/L. The difference between different years was statistically significant ( H = 20.27, P < 0.001). A total of 2 169 urine samples were collected from pregnant women, with a median urinary iodine level of 168.90 μg/L. The difference between different years was statistically significant ( H = 107.09, P < 0.001). A total of 3 336 cases of thyroid gland examination were conducted in children, including 33 cases of thyroid enlargement, with a goiter rate of 0.99%. There was a statistically significant difference between different years (χ 2 = 15.00, P < 0.001). Conclusion:From 2019 to 2021, children aged 8 to 10 and pregnant women in Xining City are at an appropriate level of iodine, and the achievements in prevention and treatment of iodine deficiency disorders still need to be continuously consolidated.

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.