OBJECTIVE To explore the diagnostic value of combined detection of microRNA(miRNA)and alpha-fetoprotein(AFP),protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ)in ascites and serum ex-tracellular vesicles(EVs)for hepatitis B virus(HBV)-related primary hepatocellular carcinoma(HCC).METHODS From Nov.2023 to Nov.2024,41 patients with liver cancer and 26 patients with liver cirrhosis who underwent ascites placement or ascites concentration and reinfusion procedures at the Fifth Medical Center of Chi-nese PLA General Hospital were selected as study subjects.Ascites and serum samples were collected.Real-time quantitative reverse transcription polymerase chain reaction(qRT-PCR)was used to detect the expression levels of miR-21,miR-125a,miR-150 and miR-200a in EVs.Chemiluminescence was used to measure the levels of AFP and PIVKA-Ⅱ in ascites,serum and EVs from ascites and serum.An artificial neural network was utilized to con-struct a combined diagnostic model of serum and ascites markers.RESULTS The area under the curve(AUC)for distinguishing HCC from liver cirrhosis using a combination of serum and other indicators was 0.933.The AUC for distinguishing HCC from liver cirrhosis using a combination of ascites and other indicators was 0.912.By screening all detected indicators using an artificial neural network and incorporating indicators with a relative im-portance＞0.5 into the diagnostic model,the model included four indicators:ascites AFP,ascites EVs miR-21,ascites EVs miR-200a and serum EVs miR-200a.This model had a sensitivity of 80.77％,a specificity of 87.80％and an AUC of 0.960 for distinguishing HCC from liver cirrhosis patients.CONCLUSION The combined diagnos-tic markers of miRNA,AFP and PIVKA-Ⅱ in ascites and serum-derived EVs have good application value in the diagnosis of HCC.

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

The health of women and children serves as the cornerstone of comprehensive public health and represents a crucial barometer for measuring social progress and civilization. It directly impacts family well-being and social harmony. As a national-level guidance center for complex disease diagnosis and treatment, Beijing's critical maternal care center, and the designated consultation hospital for pregnancy complicated by rheumatic immune and endocrine disorders, Peking Union Medical College Hospital bears significant responsibilities in managing complex medical cases and implementing counterpart assistance programs. Confronted with diverse and complicated maternal sources, particularly emergency cases lacking standardized prenatal care, the hospital has established a multi-tiered, whole-process, and comprehensive maternal-infant safety management system. Through implementing high-risk maternal management protocols, optimizing critical care procedures, promoting informatization development, and enhancing multidisciplinary collaboration, Peking Union Medical College Hospital has substantially improved the efficiency of critical maternal care and maternal-infant safety assurance. This paper systematically summarizes the institutional development experience in maternal management and explores potential optimization approaches, aiming to provide valuable references for enhancing maternal-infant safety management systems in domestic healthcare institutions.

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 explore the diagnostic value of combined detection of microRNA(miRNA)and alpha-fetoprotein(AFP),protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ)in ascites and serum ex-tracellular vesicles(EVs)for hepatitis B virus(HBV)-related primary hepatocellular carcinoma(HCC).METHODS From Nov.2023 to Nov.2024,41 patients with liver cancer and 26 patients with liver cirrhosis who underwent ascites placement or ascites concentration and reinfusion procedures at the Fifth Medical Center of Chi-nese PLA General Hospital were selected as study subjects.Ascites and serum samples were collected.Real-time quantitative reverse transcription polymerase chain reaction(qRT-PCR)was used to detect the expression levels of miR-21,miR-125a,miR-150 and miR-200a in EVs.Chemiluminescence was used to measure the levels of AFP and PIVKA-Ⅱ in ascites,serum and EVs from ascites and serum.An artificial neural network was utilized to con-struct a combined diagnostic model of serum and ascites markers.RESULTS The area under the curve(AUC)for distinguishing HCC from liver cirrhosis using a combination of serum and other indicators was 0.933.The AUC for distinguishing HCC from liver cirrhosis using a combination of ascites and other indicators was 0.912.By screening all detected indicators using an artificial neural network and incorporating indicators with a relative im-portance＞0.5 into the diagnostic model,the model included four indicators:ascites AFP,ascites EVs miR-21,ascites EVs miR-200a and serum EVs miR-200a.This model had a sensitivity of 80.77％,a specificity of 87.80％and an AUC of 0.960 for distinguishing HCC from liver cirrhosis patients.CONCLUSION The combined diagnos-tic markers of miRNA,AFP and PIVKA-Ⅱ in ascites and serum-derived EVs have good application value in the diagnosis of HCC.

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 correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.