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.

Objective This review aims to investigate the application of eye tracking(ET)in patients with speech impairment in the ICU.The review summarizes the current status and prospects of ET technology applications.Methods Following the scoping reviews framework,a systematic search was conducted across Web of Science,PubMed,Cochrane Library,Embase,CINAHL,CNKI,Wanfang Data,Chinese Medical Database,and Chinese biomedical database.The search covered publications from the inception of each database to October 29th,2024.The included studies were comprehensively analyzed.Results A total of 12 pieces of the literature were included,including 4 prospective cohort studies,4 experimental studies,3 prospective observational studies,and 1 randomized controlled trial.The application population of ET in the ICU mainly includes patients on mechanical ventilation,those at high risk of delirium,patients with spinal cord injury,etc.The types of integrated ET system equipment are mainly head-mounted and fixed;the types of ET involve gaze,blinking,etc.;the functions include standardized scale assessment,free interaction,and eye-movement model recognition.The main outcome indicators of the research are feasibility,physical symptoms and social-psychological status.Conclusion ET is applicable to a specific group of ICU patients with aphasia,and has shown good feasibility and effectiveness in the expression of patients'basic needs,self-assessment of symptoms and improvement of psychosocial status.

Objective This review aims to investigate the application of eye tracking(ET)in patients with speech impairment in the ICU.The review summarizes the current status and prospects of ET technology applications.Methods Following the scoping reviews framework,a systematic search was conducted across Web of Science,PubMed,Cochrane Library,Embase,CINAHL,CNKI,Wanfang Data,Chinese Medical Database,and Chinese biomedical database.The search covered publications from the inception of each database to October 29th,2024.The included studies were comprehensively analyzed.Results A total of 12 pieces of the literature were included,including 4 prospective cohort studies,4 experimental studies,3 prospective observational studies,and 1 randomized controlled trial.The application population of ET in the ICU mainly includes patients on mechanical ventilation,those at high risk of delirium,patients with spinal cord injury,etc.The types of integrated ET system equipment are mainly head-mounted and fixed;the types of ET involve gaze,blinking,etc.;the functions include standardized scale assessment,free interaction,and eye-movement model recognition.The main outcome indicators of the research are feasibility,physical symptoms and social-psychological status.Conclusion ET is applicable to a specific group of ICU patients with aphasia,and has shown good feasibility and effectiveness in the expression of patients'basic needs,self-assessment of symptoms and improvement of psychosocial status.

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.

Objective:To investigate the prevalence of adult skeletal fluorosis caused by drinking tea-type endemic fluorosis in Yushu Tibetan Autonomous Prefecture (hereinafter referred to as Yushu Prefecture), Qinghai Province, and provide scientific basis for prevention and control of the disease.Methods:In August 2021, one village was selected as a survey site in six counties (cities) in Yushu Prefecture, including Nangqian, Chindu, Yushu, Zadoi, Qumarlêb, and Zhiduo. Drinking water samples and 10 brick tea samples were collected from each village to determine the fluoride content in water and brick tea; at least 100 permanent residents aged ≥ 25, who had a habit of drinking brick tea and had lived in the local area for more than 5 years, were selected for X-ray imaging to examine the prevalence of adult skeletal fluorosis.Results:A total of 75 samples of residential drinking water were collected, with a fluoride content of (0.21 ± 0.05) mg/L, ranging from 0.11 to 0.34 mg/L; 60 samples of brick tea, with a fluoride content of (626.70 ± 157.27) mg/kg, ranging from 324.00 to 2 102.00 mg/kg. A total of 1 136 adults were examined, and 318 cases of skeletal fluorosis were diagnosed, with a detection rate of 27.99%. Among them, the detection rates of mild, moderate, and severe skeletal fluorosis were 20.95% (238/1 136), 6.07% (69/1 136), and 0.97% (11/1 136), respectively, with mild symptoms being the main. The detection rates of skeletal fluorosis in males and females were 29.09% (121/416) and 27.36% (197/720), respectively, with no statistically significant difference between the gender (χ 2 = 0.39, P = 0.533). Comparison of the skeletal fluorosis in different gender, the differences were statistically significant (χ 2 = 22.31, P < 0.001). The detection rates of skeletal fluorosis in the age groups of 25 - 35, 36 - 45, 46 - 55, 56 - 65, 66 - 75, and ≥76 years old were 6.86% (7/102), 22.37% (51/228), 24.02% (92/383), 37.44% (73/195), 43.48% (70/161), and 37.31% (25/67), respectively. The differences between the groups were statistically significant (χ 2 = 59.84, P < 0.001). Moreover, there was a statistically significant difference in the composition of skeletal fluorosis among different age groups ( H = 37.66, P < 0.001). The Spearman correlation analysis results showed that the severity of adult skeletal fluorosis was positively correlated with age ( r = 0.34, P < 0.001). Conclusions:There is a certain degree of prevalence of adult skeletal fluorosis in Yushu Prefecture. And as age increases, the condition of skeletal fluorosis becomes more severe.

Objective:To compare the hotspots and frontiers related to polypharmacy research at home and abroad, understand the current research status of polypharmacy and provide reference for improving the current situation of polypharmacy.Methods:Taking "polypharmacy" and "polymedication" as search terms in both Chinese and English, CiteSpace 5.8.R3 software was used to analyze the publication volume, national and institutional cooperation network analysis, and publication journal analysis of the relevant literature included in the CNKI and the core collection database of Web of Science from September 1st, 2006 to September 1st, 2022. The keywords were conducted co-occurrence, clustering and burst analysis.Results:A total of 412 valid Chinese literatures and 1 447 English literatures were retrieved, and the literature focused on the field of geriatrics. The overall number of publications at home and abroad increased, showing a trend of multi-disciplinary cooperation, but the cooperation among domestic organizations was weaker than that of foreign countries. Foreign research focused on the health outcomes and control strategies of polypharmacy, and the influence of polypharmacy on social psychology and quality of life was a trend. Domestic research focused on the influencing factors of polypharmacy and medication compliance.Conclusions:Domestic scholars should pay more attention to the hotspots and trends in the field of polypharmacy and carry out deeper scientific research.

Objective:To investigate the effects of dexmedetomidine on vital signs during recovery from general anesthesia in gynecological patients undergoing general anesthesia surgery and analysis of risk factors for complications.Methods:A total of 80 gynecological patients undergoing general anesthesia surgery who received treatment in Lishui People's Hospital from March 2021 to March 2022 were included in this study. They were randomly divided into an observation group and a control group ( n = 40/group). All patients were subjected to general anesthesia. The observation group was infused with 0.5 μg/kg dexmedetomidine intravenously 15 minutes before induction of anesthesia and then infused with dexmedetomidine at a rate of 0.2 μg/kg per hour until 20-30 minutes before the end of the operation. The control group was identically given 0.9% normal saline. The recovery quality, vital signs before surgery and during recovery from general anesthesia (systolic blood pressure, diastolic blood pressure, heart rate, body temperature), and complications during recovery from general anesthesia were compared between the two groups. These patients were divided into a complication group and a non-complication group according to whether there were complications during recovery from general anesthesia. Univariate and multivariate Logistic regression analyses were performed to analyze the high-risk factors for complications occurring during recovery from general anesthesia in gynecological patients undergoing general anesthesia surgery. Results:The time to awaken, time to recover spontaneous respiration, and time to extubation in the observation group were significantly shorter than those in the control group ( t = 3.74, 2.97, 2.56, all P < 0.05). Systolic blood pressure, diastolic blood pressure, and heart rate measured during recovery from general anesthesia were significantly lower in the observation group compared with the control group ( t = 5.71, 4.53, 4.53, all P < 0.001). Body temperature ( t = 4.40, P < 0.001) and the incidence of complications ( χ2 = 5.69, P < 0.05) were significantly lower in the observation group compared with the control group. These patients were divided into complication ( n = 22) and non-complication ( n = 58) groups according to whether they had complications during recovery from general anesthesia. Univariate and multivariate logistic regression analyses showed that American Association of Anesthesiologists grade II, presence of underlying diseases, abnormal leukocyte count, and no use of dexmedetomidine were the risk factors for postoperative complications in gynecological patients undergoing general anesthesia surgery ( OR = 2.38, 2.86, 2.17, 3.60, all P < 0.05). Conclusion:Dexmedetomidine can improve awakening quality and vital signs and reduce complications during recovery from general anesthesia. American Association of Anesthesiologists grade, underlying disease, abnormal white blood cell count, and no use of dexmedetomidine are the risk factors for complications occurring during recovery from general anesthesia in gynecological patients undergoing general anesthesia surgery.

Objective:To observe the effects of glucagon-like peptide-1 receptor agonist(GLP-1RA) combined with metformin on glucolipid metabolism and reproductive function in overweight/obesity polycystic ovarian syndrome(PCOS) patients.Methods:Retrospectively analyzed changes in clinical parameters of body measurements, glucolipid metabolism, menstrual cycle, hormones, and polycystic ovary in 200 overweight/obese PCOS Patients who received 12 weeks of treatment(liraglutide+ metformin or exenatide+ metformin) in the Department of Endocrinology at the Second Affiliated Hospital of Army Medical University from July 2017 to July 2022.Results:In terms of metabolism improvement, body weight, body mass index, waist circumference, hip circumference, waist-hip ratio, glutamic-oxalacetic transaminase, γ-glutamyltransferase, glycosylated hemoglobin, fasting blood glucose, insulin(including fasting, 30, 60, 120, and 180 minutes), homeostasis model assessment for insulin resistance, area under curve-insulin, triglyceride, and total cholesterol were significantly decreased after treatment( P<0.05 or P<0.01 or P<0.001). In terms of reproductive function, testosterone, luteinizing hormone, follicle stimulating hormone/luteinizing hormone and free androgen index were decreased( P<0.001), while sex hormone-binding globulin was increased( P<0.01). There were no significant differences in progesterone, prolactin, follicle-stimulating hormone and dehydroepiandrosterone sulfate compared with before treatment( P>0.05). The proportion of subjects with regular menstrual cycle increased from 23.53% to 57.52%( P<0.05). The proportion of subjects with polycystic ovarian changes decreased from 65.30% to 50.32%, and the proportion with dominant follicles increased from zero to 18.30%( P<0.05 or P<0.01). Some patients(25.49%) experienced adverse reactions such as nausea, diarrhea, abdominal distension, and vomiting after medication. Conclusion:The combination of GLP-1RA and metformin effectively improves glucose lipid metabolism disorder and reproductive dysfunction in overweight/obese PCOS patients.

Objective:To analyze the risk factors of persistent atelectasis in patients undergoing radical resection of lung cancer and construct a predictive model for persistent atelectasis after lung cancer surgery.Methods:Using the convenient sampling method, a total of 332 patients undergoing video-assisted thoracic surgery (VATS) at Department of Thoracic Surgery in Shanghai Pulmonary Hospital affiliated to Tongji University were selected from July 2019 to June 2020. Patients were divided into non-persistent atelectasis group ( n=104) and persistent atelectasis group ( n=228). Logistic regression analysis was used to investigate the independent predictors of perioperative persistent atelectasis in patients undergoing radical lung cancer surgery, and a predictive model was established. Results:Body mass index, tumor TNM stage, pathological category, history of chronic obstructive pulmonary disease and preoperative neoadjuvant therapy (chemotherapy, immunotherapy, and targeted therapy) were independent predictors of persistent atelectasis after VATS ( P<0.05). Based on the above predictive factors, a predictive model of persistent atelectasis during the perioperative period was established. Logit ( P) = 2.015 + 0.836 × body mass index + 2.515 × history of chronic obstructive pulmonary disease-1.451 × pathological type-1.700 (stage Ⅰ) /1.146 (stage Ⅱ) × tumor TNM stage + 3.312 × neoadjuvant therapy history. Conclusions:The predictive model constructed in this study can provide a theoretical basis for screening high-risk patients with persistent atelectasis and provide a reference for clinical medical staff to take preventive treatment and nursing care for high-risk patients in time.

Objective:To explore the current status of medication adherence among the elderly with polypharmacy in the community, analyze its influencing factors, so as to provide a reference for improving the medication adherence of the elderly on polypharmacy in the community.Methods:From July to September 2021, 600 elderly people with polypharmacy in the community were selected by convenience sampling in Hangzhou as the research object. The General Information Questionnaire, the Medication Knowledge and Medication Belief Questionnaire, and the Chinese version of the 8-item Morisky Medication Adherence Scale (MMAS-8) were used to investigate the elderly. A total of 600 questionnaires were distributed, 510 valid questionnaires were recovered, and the valid recovery rate was 85.0%.Results:Among the 510 elderly patients with polypharmacy in the community, 191 elderly patients (37.5%) had good adherence, 187 elderly patients (36.7%) had moderate adherence, and 132 elderly patients (25.9%) had poor adherence. The results of univariate analysis showed that there were statistical differences in age, gender, educational level, family monthly income, type of medication, medication belief and medication knowledge ( P<0.05) . Logistic regression analysis showed that educational level, medication knowledge, and medication belief were the independent influencing factors of medication adherence among the elderly with polypharmacy, and the difference was statistical difference ( P<0.05) . Conclusions:Medication adherence among the elderly with polypharmacy in the community of Hangzhou is poor, and medication knowledge and medication belief need to be improved. Medical and nursing staff should strengthen medication guidance, and use comprehensive interventions to conduct regular follow-up and health guidance, so as to improve medication adherence of elderly patients with polypharmacy.