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 analyze the commonalities and differences in the policies of the "Action Plan for Further Improving Nursing Services" in different regions.Methods:Search network platforms such as the official websites of the government, collect the policy texts of the "Action Plan for Further Improving Nursing Services" in different regions, and use the content analysis method to compare the basic characteristics, characteristic measures and evaluation indicators of the policy texts.Results:A total of 17 regional policy texts were obtained, and 46 characteristic measures were extracted from four dimensions: strengthening clinical nursing, improving nursing quality, expanding the field of nursing, and increasing support.Conclusions:There are differences among different regions in terms of the division of responsibilities, implementation steps, and the formulation of evaluation standards.

Objective:To analyze the commonalities and differences in the policies of the "Action Plan for Further Improving Nursing Services" in different regions.Methods:Search network platforms such as the official websites of the government, collect the policy texts of the "Action Plan for Further Improving Nursing Services" in different regions, and use the content analysis method to compare the basic characteristics, characteristic measures and evaluation indicators of the policy texts.Results:A total of 17 regional policy texts were obtained, and 46 characteristic measures were extracted from four dimensions: strengthening clinical nursing, improving nursing quality, expanding the field of nursing, and increasing support.Conclusions:There are differences among different regions in terms of the division of responsibilities, implementation steps, and the formulation of evaluation standards.

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 clinical efficacy of esmolol combined with atorvastatin on se-vere sepsis complicated with cardiac insufficiency.Methods This study was a prospective,double-blind,ran-domized controlled clinical trial.A total of 153 patients with severe sepsis complicated with cardiac insufficien-cy admitted to this hospital from January 2021 to December 2022 were selected and divided into groups A,B,and C by random number table method,with 51 cases in each.Patients in group A were given routine symp-tomatic supportive treatment after admission.On this basis,patients in group B and group C were given esmo-lol,esmolol+atorvastatin,respectively.The hemodynamic indexes,serological indexes and clinical prognosis of the three groups before and after intervention were compared.Results There was no significant difference in baseline data,and hemodynamic and serological indexes of three groups before intervention(P＞0.05).Compared with before intervention,after five days of intervention,heart rate,systemic vascular resistance in-dex(SVRI),blood levels of creatine kinase-MB(CK-MB),cardiac troponin Ⅰ(cTn Ⅰ),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and high sensitive C-reactive protein(hs-CRP)in three groups were de-creased,while the values of cardiac index(CI)were increased,and the differences were statistically significant(P＜0.05).After five days of intervention,the heart rate,SVRI,blood levels of CK-MB,cTn Ⅰ,TNF-α,IL-6,and hs-CRP in group C were lower than those in group A and group B,and the levels in group B were lower than those in group A;the value of CI in group C was higher than that in group A and group B,and group B was higher than that in group A,the differences were statistically significant(P＜0.05).After intervention,the length of stay in intensive care unit(ICU)in group C was the shortest,and that in group B was shorter than that in group A,the difference was statistically significant(P＜0.05).There was no significant difference in 28 d mortality among the three groups(P＞0.05).Conclusion Esmolol combined with atorvastatin can signif-icantly inhibit the inflammatory response in patients with severe sepsis complicated with cardiac insufficiency,relieve myocardial injury and promote rehabilitation,and the therapeutic effect is better than esmolol alone.

Objective:To clarify the immediate administration issues faced by hospitals in China in their implementing the diagnosis-related groups(DRG) payment as a reference for the reform.Methods:By using " DRG" , " hospital" , and " administration" as search terms, the authors systematically retrieved literature data from CNKI, Wanfang Data, PubMed, Embase and Web of Science from the establishment of the database to April 30, 2022. Based on such data, administration issues pertaining to the reform process were extracted and built into a co-word matrix. The social network analysis was used to measure the network density and network centrality of these administration issues. The entropy weight-technique for order preference by similarity to ideal solution(TOPSIS) method was used to comprehensively evaluate the indicator results of network centrality indicators.Results:Of the 32 literatures included, 25 issues in hospital administration during the reform of DRG payment method were extracted. As shown in the social network analysis, the network density was 0.717, while the top issues ranking by degree centrality, betweenness centrality and closeness centrality, were inappropriate main diagnosis selection(68, 8.842, 25), imperfect DRG grouping device setting(54, 8.361, 26), imprecise recording of other disease diagnosis and surgical operations(60, 6.885, 26), and poor professional knowledge of medical record managers(54, 6.991, 25). The top four issues as shown in the entropy weight-TOPSIS analysis were inappropriate main diagnosis selection(1.000), imperfect DRG grouping device setting(0.871), imprecise recording of other disease diagnosis and surgical operations(0.803), and poor professional knowledge of medical record managers(0.787).Conclusions:Fill-out errors of medical record homepage, imperfect formulation of DRG grouping plans and poor professional knowledge of medical record manage team, rank the tope administration issues of high priority in implementing the reform of DRG payment methods. It is imperative to strengthen quality control of the medical record homepages, to scientifically formulate the DRG grouping plans, and to improve the construction of medical records professional team, in an effort to the further smooth and orderly implementation of the reform.

Background; Sucralfate is a commonly used gastric mucosal protector in clinical practice. It can be dissociated into aluminum hydroxide and sucrose sulfate under the action of gastric acid. As a topical agent, sucralfate is mainly excreted with feces, and the tiny amount of sucralfate absorbed in gastrointestinal tract is excreted with urine in the form of disaccharide sulfate. Aims; To study the effect and safety of a domestic made oral sucralfate suspensoid gel on blood aluminum concentration. Methods; Twenty-three healthy volunteers participated in this study from June 2021 to September 2021 at the Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. All subjects received sucralfate suspensoid gel daily (1 h before breakfast in the morning, and before bedtime in the evening, 1 g each time) for 2 weeks. Blood samples were collected on day 1 (before sucralfate administration) and day 15 (after medication completion) for determination of blood aluminum concentration. Any adverse events (including abnormal laboratory indicators) were recorded. Results: No significant difference was existed in mean blood aluminum concentration of the healthy subjects between time points before and after sucralfate administration [(47. 66 ± 15. 64) μg/L vs. (39. 12 ± 2 0. 42) μg/L, P > 0. 0 5]. All the blood aluminum values after medication were within the reference range (70 μ g/L), so did the blood routine, urine routine and blood biochemical indicators before and after medication. No severe adverse events were reported. Conclusions; The domestic made sucralfate suspensoid gel used in this study for 2 weeks has no adverse effect on blood aluminum concentration in healthy subjects. It is considered to be safe and reliable, and is worthy for clinical application.

The electronic stethoscope combined with artificial intelligence (AI) technology has realized the digital acquisition of heart sounds and intelligent identification of congenital heart disease, which provides objective basis for heart sound auscultation and improves the accuracy of congenital heart disease diagnosis. At the present stage, the AI based cardiac auscultation technique mainly focuses on the research of AI algorithms, and the researchers have designed and summarized a variety of effective algorithms based on the characteristics of cardiac audio data, among which the mel-frequency cepstral coefficients (MFCC) is the most effective one, and widely used in the cardiac auscultation. However, the current cardiac sound analysis techniques are based on specific data sets, and have not been validated in clinic, so the performance of algorithms need to be further verified. The lack of heart sound data, especially the high-quality, standardized, publicly available heart sound database with disease labeling, further restricts the development of heart sound diagnostic analysis and its application in screening. Therefore, expert consensus is necessary in establishing an authoritative heart sound database and standardizing the heart sound auscultation screening process for congenital heart disease. This paper provides an overview of the research and application status of auscultation algorithm and hardware equipment based on AI in auscultation screening of congenital heart disease, and puts forward the problems to be solved in clinical application of AI auscultation screening technology.
Algorithms ; Artificial Intelligence ; Heart Auscultation/trends* ; Heart Defects, Congenital/diagnosis* ; Humans ; Mass Screening/methods*

Objective To explore the relationship between different smoking status and hypothyroidism in six iodine-suitable areas of China. Methods A total of 8187 residents were investigated by cluster sampling in six cities, and 7448 residents were included in the survey. The height, weight, waist circumference, and blood pressure were measured by filling out epidemiological questionnaire. Blood samples were collected to detect thyroid stimulating hormone ( TSH) , thyroid peroxidase antibody ( TPOAb) , and thyroglobulin antibody ( TgAb) . Results The mean TSH, TPOAb, and TgAb positive rates in passive smoking and active smoking groups were all lower than those in non-smoking group ( all P<0.01) . In the active smoking group, the TSH value decreased by 0.023 units for every unit increase in smoking index. The positive rates of TgAb and TPOAb in both passive smoking and active smoking groups were lower than those in non-smoking group (all P<0.01). Active and passive smoking reduced the prevalence of hypothyroidism (both P<0.01). Among women, the risks of clinical hypothyroidism and subclinical hypothyroidism were reduced in both active and passive smoking groups. Besides, the risk of subclinical hypothyroidism decreased significantly when the smoking index was more than 70. In male population, the risk of subclinical hypothyroidism in active and passive smoking group decreased. Besides, the risk of clinical hypothyroidism and subclinical hypothyroidism decreased significantly when the smoking index was more than 70. Conclusion Smoking in iodine-suitable areas may reduce TSH level and the positive rates of TPOAb and TgAb.

Congenital heart disease (CHD) is the most common birth defect at present. In recent years, the application of 3D printing in the diagnosis and treatment of CHD has been widely recognized, which presents CHD lesions in 3D solid model and provides a better understanding of the anatomy of CHD. In the future, 3D printing technology would improve the surgical proficiency, shorten the operation time, reduce the occurrence of perioperative complications, and create more personalized cardiovascular implants, therefore promote the precision of diagnosis and treatment for congenital heart disease. This article reviews the application of 3D printing technology in preoperative planning, intraoperative navigation and personalized implants of CHD, in surgical training and medical education, as well as in promoting doctor-patient communication and better understanding their condition for patients.
Heart Defects, Congenital ; Humans ; Models, Anatomic ; Preoperative Care ; Printing, Three-Dimensional