Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Objective The clinical characteristics of 21 cases of nocardiosis were reviewed and antimicrobial resistance of Nocardia strains was analyzed in order to improve the accuracy of clinical diagnosis and treatment of nocardiosis.Methods Clinical data of patients diagnosed with nocardiosis in Zhoukou Central Hospital from 2019-2023 and the corresponding results of antimicrobial susceptibility testing were retrospectively analyzed to summarize the clinical characteristics and outcomes of patients.Results Overall,the 21 cases of nocardiosis included 9 males and 12 females,aged 2-91 years.Underlying disease was reported in 15 patients.Most common type of nocardiosis was pulmonary nocardiosis in 15 cases,followed by skin and soft tissue infection,pleurisy,lymphadenitis,and disseminated nocardiosis.Laboratory tests showed increased levels of WBC,neutrophils percentage,erythrocyte sedimentation rate,C-reactive protein,and procalcitonin.The 21 strains of Nocardia included 4 strains of Nocardia cyriacigeorgica,2 strains each of Nocardia brasiliensis,Nocardia abscessus,Nocardia asiatica,Nocardia otitidiscaviarum and Nocardia beijingensis,and 1 strain each of Nocardia puris,Nocardia asteroides,Nocardia farcinica,Nocardia pneumoniae,Nocardia amamiensis,and 2 strains of unclassified Nocardia.All of the Nocardia strains(100％)were susceptible to linezolid,amikacin,and trimethoprim-sulfamethoxazole,followed by various levels of susceptibility to cefotaxime,moxifloxacin,imipenem and ceftriaxone,and lower susceptibility rate to cefepime,minocycline,ciprofloxacin and clarithromycin.Antimicrobial susceptibility of Nocardia strains varied with different Nocardia species.Of the 21 patients,two were referred to other hospitals,another two died,two patients received unknown treatment,and the remaining 15 patients were improved after antibiotic treatment,including sulfonamides combined with other antibiotics in 11 cases,other antibiotics in 4 cases.Conclusions Immunocompromised patients or those with underlying diseases are more susceptible to nocardiosis.The clinical features are complex and diverse.Antimicrobial susceptibility of Nocardia strains varied with different Nocardia species.Accurate identification and antimicrobial susceptibility test are essential for prescribing effective antibiotic treatment.

Objective The clinical characteristics of 21 cases of nocardiosis were reviewed and antimicrobial resistance of Nocardia strains was analyzed in order to improve the accuracy of clinical diagnosis and treatment of nocardiosis.Methods Clinical data of patients diagnosed with nocardiosis in Zhoukou Central Hospital from 2019-2023 and the corresponding results of antimicrobial susceptibility testing were retrospectively analyzed to summarize the clinical characteristics and outcomes of patients.Results Overall,the 21 cases of nocardiosis included 9 males and 12 females,aged 2-91 years.Underlying disease was reported in 15 patients.Most common type of nocardiosis was pulmonary nocardiosis in 15 cases,followed by skin and soft tissue infection,pleurisy,lymphadenitis,and disseminated nocardiosis.Laboratory tests showed increased levels of WBC,neutrophils percentage,erythrocyte sedimentation rate,C-reactive protein,and procalcitonin.The 21 strains of Nocardia included 4 strains of Nocardia cyriacigeorgica,2 strains each of Nocardia brasiliensis,Nocardia abscessus,Nocardia asiatica,Nocardia otitidiscaviarum and Nocardia beijingensis,and 1 strain each of Nocardia puris,Nocardia asteroides,Nocardia farcinica,Nocardia pneumoniae,Nocardia amamiensis,and 2 strains of unclassified Nocardia.All of the Nocardia strains(100％)were susceptible to linezolid,amikacin,and trimethoprim-sulfamethoxazole,followed by various levels of susceptibility to cefotaxime,moxifloxacin,imipenem and ceftriaxone,and lower susceptibility rate to cefepime,minocycline,ciprofloxacin and clarithromycin.Antimicrobial susceptibility of Nocardia strains varied with different Nocardia species.Of the 21 patients,two were referred to other hospitals,another two died,two patients received unknown treatment,and the remaining 15 patients were improved after antibiotic treatment,including sulfonamides combined with other antibiotics in 11 cases,other antibiotics in 4 cases.Conclusions Immunocompromised patients or those with underlying diseases are more susceptible to nocardiosis.The clinical features are complex and diverse.Antimicrobial susceptibility of Nocardia strains varied with different Nocardia species.Accurate identification and antimicrobial susceptibility test are essential for prescribing effective antibiotic treatment.

Non-small cell lung cancer is one of the cancers with the highest incidence and mortality rate in the world, and precise prognostic models can guide clinical treatment plans. With the continuous upgrading of computer technology, deep learning as a breakthrough technology of artificial intelligence has shown good performance and great potential in the application of non-small cell lung cancer prognosis model. The research on the application of deep learning in survival and recurrence prediction, efficacy prediction, distant metastasis prediction, and complication prediction of non-small cell lung cancer has made some progress, and it shows a trend of multi-omics and multi-modal joint, but there are still shortcomings, which should be further explored in the future to strengthen model verification and solve practical problems in clinical practice.

Objective To explore the changes and significane of USP20 and HIF-α expression in breast cancer.Methods Following transfection of shRNA-USP20 lentivirus into breast cancer MDA-MB-231 cells,the gene and protein expression levels of USP20 were detected using fluorescence quantitative PCR and Western Blot.Subsequently,the overexpression of USP20 was observed to determine its effect on HIF-α expression.Similarly,siRNA-USP20 was used to knock down USP20 in breast cancer MDA-MB-231 cells,followed by detection of gene and protein expression levels using fluorescence quantitative PCR and Western Blot.The subsequent changes in HIF-α expression were then examined.Rusults The positive expression rates of USP20 and HIF-α in breast cancer tissues were 69.6%and 46.83%,respectively,while they were negatively expressed in the adjacent normal tissues,with statistically significant differences(P＜0.01).The positive expressions of USP20 and HIF-α were predomi-nantly observed in the cytoplasm of breast cancer tissue,with a smaller amount present in the nucleus.There was a significant positive correlation between USP20 and HIF-α in breast cancer.Following transfection of shRNA-USP20 lentivirus into MDA-MB-231 cells,both the protein and gene expression levels of USP20 significantly increased(P＜0.01).Over-expression of USP20 did not affect HIF-α mRNA levels but led to a significant increase in HIF-α protein expression(P＜0.01).Conversely,siRNA-USP20 interference resulted in a significant decrease in both the protein and gene expression levels of USP20(P＜0.01),without affecting HIF-α mRNA levels;however,it caused a notable reduction in HIF-α protein expression(P＜0.01).Conclusion The expression of USP20 exhib-ited a significant positive correlation with HIF-α in breast cancer.Overexpression of USP20 led to a substantial increase in HIF-α protein expression,while knock-down of the USP20 gene resulted in a significant decrease in HIF-α protein levels.Therefore,it can be inferred that USP20 may exert its influence on the development of breast cancer through modulation of HIF-α expression,thereby providing crucial experimental evidence for clinical treat-ment,prognosis,and further investigations.

Objective:To explore the role of information-based points system management platform in enhancing the medical management capabilities of laboratory medicine.Methods:A total of 106 personnel who were on duty from January 2021 to December 2022 in the clinical laboratory of Guangdong Provincial People′s Hospital were selected and divided into 8 professional groups, including 24 in Clinical Routine Lab, 22 in Clinical Biochemistry Lab, 11 in Clinical Immune Lab, 13 in Clinical Microbiology Lab, 10 in Clinical Molecular Lab, 9 in Flow Cytometry Lab, 9 in HuiFu Lab, and 8 in Interdisciplinary Lab. Information-based points system management platform was established by formulating the detailed rules for the assessment of this points system, and the points achieved by the 106 participants in 2021 and 2022 were obtained and analyzed. The points were divided into 6 intervals (<41, 41-45, 46-50, 51-55, 56-60 and>60).Results:The overall medical points of laboratory medicine was significantly higher in 2022 than in 2021 (52.15±5.48 vs 49.81±3.73, P<0.001). In 2022, the number of participants with points between 41-45 and 46-50 intervals was lower than those in 2021; with points 51-55, 56-60 and>60 intervals was higher than those in 2021 (χ2=10.479, P<0.05). In addition, the points of Clinical Molecular, Clinical Microbiology and HuiFu Lab were 57.46±7.40, 52.05±5.43 and 54.98±4.31 respectively, which were significantly higher than those of 2021 (50.16±4.14, 49.10±4.06, 49.23±4.28, respectively;all P<0.05). The number of report revisions has significantly decreased in 2022 (18) compared to that in 2021 (48), clinical communication and various levels of publicity and promotion were significantly increased from 52 and 58 (2021) to 108 and 137 (2022), respectively. Conclusion:The construction and application of the information-based points management system have effectively improved the enthusiasm and subjective initiative of laboratory personnel, enhanced the quality and service capabilities of laboratory medicine, and might serve as an important tool for standardized management of laboratory medicine.

Objective To Analyze tislelizumab(TIS)combined with sorafenib(SRF)as the first-line treatment regimen for unresectable hepatocellular carcinoma(HCC).Methods Clinical data of patients with unresectable HCC treated in Jinhua Hospital and Shulan(Hangzhou)Hospital affiliated to Zhejiang University School of Medicine from January 2020 to January 2023 were retrospectively analyzed.They were divided into a combined group(TIS combined with SRF)and a control group(SRF)according to the diagnosis and treatment protocol.The main observational indexes of the study were objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS)and overall survival(OS).In addition,attention was paid to the occurrence of adverse reactions during the treatment to assess safety.Results A total of 61 patients were included in the study,with 31 in the combined group and 30 in the control group.The difference in ORR between the two groups was not statistically significant(P＞0.05),while DCR was significantly higher in the combined group than in the control group(P＜0.05).Survival analysis showed that the median PFS and median OS of the combined group were significantly higher than those of the control group(P＜0.05).In terms of safety,there was no statistically significant difference in the incidence of hand-foot syndrome,transaminase elevation,loss of appetite,proteinuria,rash,diarrhea,thrombocytopenia,and malaise between the two groups(P＞0.05);whereas 8 cases of hypothyroidism(25.81％)and 4 cases of capillary hyperplasia(12.90％)occurred in the combined group,and no hypothyroidism or capillary hyperplasia occurred in the control group.In addition,no patients died or discontinued treatment due to adverse effects.Conclusion Compared to single drug SRF,the combination of TIS and SRF first-line treatment for unresectable HCC can improve DCR,prolong median PFS and OS,and the safety is controllable.

Objective To explore the influencing factors of the efficacy of programmed death-1(PD-1)inhibitor pembrolizumab in the treatment of cervical cancer.Methods The clinical data of cervical cancer patients admitted to the Department of Obstetrics and Gynecology of Anhui Women and Children's Medical Center from January 2020 to October 2023 were retrospectively analyzed and the patients were divided into the ineffective group and the effective group according to the pembrolizumab treatment efficacy.The clinical data of patients in the two groups were compared[age,tumor type,pathological type,lesion size,differentiation degree,number of pregnancies,number of births,number of miscarriages,menopausal status,tumor mutation load(TMB),DNA repair gene mutation status,PD-L1 expression,diabetes mellitus,hypertension,mode of treatment,body mass index,tumor-infiltrating lymphocyte(TIL)expression,neoantigen intra-tumor heterogeneity(ITH)status,presence of liver disease,and family history],and logistic regression analysis was used to determine the risk factors affecting the efficacy of pembrolizumab in cervical cancer patients.Results A total of 60 patients were included in the study,with 42 in the effective group and 18 in the ineffective group.The proportion of patients with TMB＜143/Mb,no mutation in DNA repair genes,low expression of PD-L1,simple immunotherapy,TIL negative,and high PTH in the ineffective group was higher than that in the effective group(P＜0.05).Multivariate Logistic regression analysis showed that TMB＜143/Mb,non-mutated DNA repair genes,low PD-L1 expression,simple immunotherapy,TIL negative,and high PTH were risk factors affecting the efficacy of pembrolizumab in cervical cancer patients(P＜0.05).Conclusion The efficacy of the PD-1 inhibitor pembrolizumab in cervical cancer patients is influenced by factors such as TMB,DNA gene mutations,PD-L1 expression,treatment mode,TIL,and ETH.

OBJECTIVE To study the repair effect and mechanism of Zhixu burn ointment on deep second-degree burned model rats. METHODS The deep second-degree burned model was established with a temperature-controlled apparatus. The model rats were randomly divided into model group， Jingwanhong ointment group and Zhixu burn ointment high-dose， medium-dose and low-dose groups （specifications were 20 g core+20 mL wetting agent， 10 g core+20 mL wetting agent， 5 g core+20 mL wetting agent， respectively）. Another blank control group （only dehairing treatment， no modeling） was set up， with 10 rats in each group. The rats in each administration group were given corresponding drugs， the rats in the blank control group were not treated， and the rats in the model group were given normal saline once a day for 21 d. The healing of burn wounds and histomorphological changes of burned skin in each group of rats were observed， and the healing rate of wounds was calculated； the levels of vascular endothelial growth factor （VEGF）， interleukin-1β （IL-1β）， IL-6 and tumor necrosis factor-α（TNF-α） in the wound skin tissue of rats were detected by enzyme-linked immunosorbent assay； immunohistochemical method was used to detect the expression levels of VEGF and platelet endothelial cell adhesion molecule-1 （CD31） protein in burned skin tissue. RESULTS Compared with model group， the wound area of the rats in the Jingwanhong ointment and Zhixu burn ointment groups gradually decreased and healed significantly by day 21， and the wound healing rate was significantly higher （P＜0.05 or P＜0.01）； thicker new epidermal layer was seen in the skin tissue， and connective tissue and new blood vessels were significantly increased in the dermis； the expression levels of IL-1β， IL-6 and TNF-α were significantly decreased （P＜0.05 or P＜0.01）， and the expression levels of VEGF and CD31 protein were significantly increased （P＜0.05 or P＜0.01） in the burned skin tissue. CONCLUSIONS Zhixu burn ointment can repair the skin of deep second-degree burned model rats， and the mechanism may be related to reducing the inflammatory response of burn wound and promoting the angiogenesis.

Subjective tinnitus refers to the subjective sound perception of patients in the absence of an external sound stimulus.Tinnitus patients are often accompanied by emotional disorders, such as depression and anxiety, which seriously affect the quality of life of patients.Therefore, understanding the mechanism underlying the occurrence of tinnitus emotional disorders can help relieve the pain of tinnitus.Tinnitus was considered a simple ear disease in the early stages, but with the progress of neuroimaging technology and the development of animal models, increasing attention has been given to the changes in the neural structure and function of tinnitus patients.As a powerful technique for in vivo investigation of neural activity in the brain, multimodal magnetic resonance has been widely used in the study of subjective tinnitus.By observing the changes of brain structure in subjective tinnitus patients, the neural mechanism of the occurrence and development of tinnitus has been explored.This article reviewed recent multimodal magnetic resonance imaging studies on the neuroimaging mechanisms of tinnitus with mood disorders, compared the differences in neural activity between subjective tinnitus patients and healthy people, and found that the limbic system, default mode network and other neural network abnormalities were closely related to the mood disorders of tinnitus.The application and development of multimodal magnetic resonance techniques in subjective tinnitus were also discussed to elucidate the neural mechanism of subjective tinnitus accompanied by mood disorders with the help of multimodal magnetic resonance techniques.