Objective To explore the effect of community pharmacy outpatient service on patients with type 2 diabetes mellitus. Methods A non-randomized controlled study was conducted, and type 2 diabetes patients managed in the community were divided into an intervention group of 112 cases and a control group of 110 cases. The control group received routine medication guidance during general practice outpatient visits, while the intervention group received comprehensive pharmacy outpatient service intervention based on routine medication guidance in general practice. Follow-up visits were conducted every 3 months. Repeated measurement analysis of variance and multivariate linear regression analysis were used to evaluate the intervention effect of the pharmacy outpatient service. Results Fasting blood glucose and glycosylated hemoglobin levels in the intervention group showed a decreasing trend with the increase of intervention time compared to pre-intervention time （P<0.01）, with increased duration of weekly exercise, decreased staple food intake, increased vegetable intake, and increased medication adherence score （P<0.01）. After adjusting for confounding factors through multivariate linear regression model, pharmacy outpatient intervention was found to be an independent protective factor for fasting blood glucose level （β=−0.891, P<0.01） and glycosylated hemoglobin level （β=−0.760, P<0.01） in the study subjects. Conclusion The community pharmacy outpatient service could enhance the self-management ability of patients with type 2 diabetes mellitus, and effectively improve patients’ fasting blood glucose and glycosylated hemoglobin.

Objective:To explore the current status and factors influencing physical activity among pre-frail and frail older adults in the community.Methods:Convenience sampling was used to select 207 pre-frail and frail older adults from Donghuashi community and Fangzhuang community in Beijing from April to June 2024 as study subjects. Older adults were surveyed for their general information, lifestyle behaviors, nutritional status, and physical activity. Binary Logistic regression was used to explore the factors influencing the level of physical activity among pre-frail and frail older adults in the community.Results:A total of 207 questionnaires were distributed and 204 valid questionnaires were recovered, with a valid recovery rate of 98.55%. The Physical Activity Scale for the Elderly score of the 204 community-based pre-frail and frail older adults was 86.87 (52.14, 125.00), and the form of activity was predominantly walking (98.5%, 201/204) and light domestic physical activity (85.8%, 175/204). Binary Logistic regression showed that taking a nap ( OR=3.614), abnormal nighttime sleep duration ( OR=4.077), fear of falling before or during exercise ( OR=7.895), and risk of malnutrition ( OR=9.263) were risk factors for levels of physical activity in pre-frail and frail older adults in the community ( P<0.05), and good exercise cognition ( OR=0.055) was a protective factor for physical activity levels ( P<0.05) . Conclusions:Pre-frail and frail older adults in the community have low levels of physical activity, which is dominated by walking and household activities. Community healthcare workers should strengthen the management of physical activity for pre-frail and frail older adults, cultivate their good living habits, improve their sleep quality, ensure sufficient night sleep, help them overcome the fear of falling before or during exercise, set up the correct concept of exercise, form a good cognition of exercise, and guide their family members to pay attention to the nutritional status of older adults, beware of the risk of malnutrition, and improve the level of physical activity to delay or even reverse the frail state.

Objective:To investigate the expression levels of serum receptor activator of nuclear factor-κB (RANK), RANK ligand (RANKL), and osteoprotegerin (OPG) in children with dental fluorosis.Methods:In April 2018, a case-control study was conducted to select 8 - 12 year old children diagnosed with dental fluorosis residing within 1.5 km of an aluminum smelting facility in Guangxi Zhuang Autonomous Region as the dental fluorosis group ( n = 49) according to the criteria of "Diagnosis of Dental Fluorosis" (WS/T 208-2011). The control group ( n = 98) comprised healthy children aged 8 - 12 years old without dental fluorosis lived more than 5.0 km from the aluminum smelting facility. Fasting venous blood samples were collected from all participants. Blood fluoride level were measured using an ion-selective electrode method. Serum RANK, RANKL, and OPG levels were determined using double-antibody sandwich enzyme-linked immunosorbent assay. Results:The levels of serum fluoride [ M ( Q1, Q3): 0.033 (0.032, 0.036) vs 0.026 (0.025, 0.028) mg/L], RANK [1.21 (0.87, 1.64) vs 0.73 (0.50, 1.13) μg/L], RANKL [81.3 (50.6, 118.6) vs 134.3 (98.1, 199.2) ng/L], OPG [433.3 (321.6, 574.3) vs 509.1 (406.8, 709.3) μg/L], and OPG/RANKL ratio [5.6 (3.1, 7.8) vs 3.6 (2.9, 5.0)] were compared between the fluorosis group and the control group, and the differences were statistically significant ( Z = 8.35, 3.83, 3.99, 2.35, 2.47, P < 0.05). Correlation analysis revealed that dental fluorosis severity was positively correlated with serum fluoride level( r s = 0.68, P < 0.001). Serum fluoride level was negatively correlated with both serum RANKL and OPG levels ( r s = - 0.49, - 0.17, P < 0.05). Conclusion:The level of serum RANK in children with dental fluorosis is higher than that in healthy children, while the levels of RANKL and OPG are lower than those in healthy children.

Objective:To explore the current status and factors influencing physical activity among pre-frail and frail older adults in the community.Methods:Convenience sampling was used to select 207 pre-frail and frail older adults from Donghuashi community and Fangzhuang community in Beijing from April to June 2024 as study subjects. Older adults were surveyed for their general information, lifestyle behaviors, nutritional status, and physical activity. Binary Logistic regression was used to explore the factors influencing the level of physical activity among pre-frail and frail older adults in the community.Results:A total of 207 questionnaires were distributed and 204 valid questionnaires were recovered, with a valid recovery rate of 98.55%. The Physical Activity Scale for the Elderly score of the 204 community-based pre-frail and frail older adults was 86.87 (52.14, 125.00), and the form of activity was predominantly walking (98.5%, 201/204) and light domestic physical activity (85.8%, 175/204). Binary Logistic regression showed that taking a nap ( OR=3.614), abnormal nighttime sleep duration ( OR=4.077), fear of falling before or during exercise ( OR=7.895), and risk of malnutrition ( OR=9.263) were risk factors for levels of physical activity in pre-frail and frail older adults in the community ( P<0.05), and good exercise cognition ( OR=0.055) was a protective factor for physical activity levels ( P<0.05) . Conclusions:Pre-frail and frail older adults in the community have low levels of physical activity, which is dominated by walking and household activities. Community healthcare workers should strengthen the management of physical activity for pre-frail and frail older adults, cultivate their good living habits, improve their sleep quality, ensure sufficient night sleep, help them overcome the fear of falling before or during exercise, set up the correct concept of exercise, form a good cognition of exercise, and guide their family members to pay attention to the nutritional status of older adults, beware of the risk of malnutrition, and improve the level of physical activity to delay or even reverse the frail state.

Objective:To investigate the expression levels of serum receptor activator of nuclear factor-κB (RANK), RANK ligand (RANKL), and osteoprotegerin (OPG) in children with dental fluorosis.Methods:In April 2018, a case-control study was conducted to select 8 - 12 year old children diagnosed with dental fluorosis residing within 1.5 km of an aluminum smelting facility in Guangxi Zhuang Autonomous Region as the dental fluorosis group ( n = 49) according to the criteria of "Diagnosis of Dental Fluorosis" (WS/T 208-2011). The control group ( n = 98) comprised healthy children aged 8 - 12 years old without dental fluorosis lived more than 5.0 km from the aluminum smelting facility. Fasting venous blood samples were collected from all participants. Blood fluoride level were measured using an ion-selective electrode method. Serum RANK, RANKL, and OPG levels were determined using double-antibody sandwich enzyme-linked immunosorbent assay. Results:The levels of serum fluoride [ M ( Q1, Q3): 0.033 (0.032, 0.036) vs 0.026 (0.025, 0.028) mg/L], RANK [1.21 (0.87, 1.64) vs 0.73 (0.50, 1.13) μg/L], RANKL [81.3 (50.6, 118.6) vs 134.3 (98.1, 199.2) ng/L], OPG [433.3 (321.6, 574.3) vs 509.1 (406.8, 709.3) μg/L], and OPG/RANKL ratio [5.6 (3.1, 7.8) vs 3.6 (2.9, 5.0)] were compared between the fluorosis group and the control group, and the differences were statistically significant ( Z = 8.35, 3.83, 3.99, 2.35, 2.47, P < 0.05). Correlation analysis revealed that dental fluorosis severity was positively correlated with serum fluoride level( r s = 0.68, P < 0.001). Serum fluoride level was negatively correlated with both serum RANKL and OPG levels ( r s = - 0.49, - 0.17, P < 0.05). Conclusion:The level of serum RANK in children with dental fluorosis is higher than that in healthy children, while the levels of RANKL and OPG are lower than those in healthy children.

Objective To explore the effect of jogging on the patients with depression disorder of liver-stagnation and spleen-deficiency.Methods 100 patients with liver-stagnation and spleen-deficiency depression disorder were randomly selected from Tongde Hospital of Zhejiang Province from March to September 2022.They were divided into observation group and control group(50 cases each)by random number table method.The control group received conventional antidepressant drug treatment,and the observation group was given jogging exercise regimen on the basis of the control group:exercise at least 4 times a week,30-60 min each time,and the heart rate was maintained at 110-120 times/min for 4 weeks.The depressive disorder of the patients was assessed by Zung's Self-rating Depression Scale(SDS)and 17-item Hamilton Depression Scale(HAMD-17).Results After jogging exercise intervention,the total effective rate of the observation group was 94%,which was significantly higher than that of the control group 80%(P<0.05).HAMD-17 score was significantly lower in the observation group than in the control group after intervention(F=12.575,P<0.05).The scores of cognitive impairment,block and sleep disturbance in the observation group were significantly lower than those in the control group after intervention(F=12.575,P<0.05).The body weight factor scores of the observation group and the control group were significantly higher after intervention than before intervention(P>0.05).Conclusions Jogging exercise intervention therapy can significantly improve the depression of patients with liver-qi and spleen-deficiency depression disorder,and jogging can be an effective method to prevent and treat depression disorder.

【Objective】 To explore the application value of different language assessment tools in the assessment of language development of 12-month-old high-risk infants, and to screen out simple and valid language assessment tools. 【Methods】 A total of 217 11- to 13-month-old high-risk infants who were followed up at the outpatient service for high-risk infants at the child health clinic of Guiyang Maternal and Child Health Hospital from March 2022 to May 2023 were selected as the study subjects. Their language was evaluated by Early Language Milestone Scale (ELMS), Putonghua Communicative Development Inventory (PCDI) and Ages and Stages Questionnaire-Third Edition (ASQ-3). With Gesell as the gold standard for the assessment of language, the area under receiver operating characteristic curve (AUC), sensitivity, specificity, accuracy, positive predictive value, negative predictive value, Youden index and Kappa value of the three tools were calculated. Spearman correlation analysis was used to analyze the correlation between the different language assessment scales. The Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was used to evaluate the three tools. 【Results】 1)Among 217 high-risk infants, 78 preterm infants was the most (35.94%). The rate of delayed language development detected by Gesell, ELMS, PCDI-comprehension, PCDI-expression, ASQ-3 were 5.5%, 7.8%, 36.4%, 30.0% and 11.5%, respectively. 2)ASQ-3 had the strongest correlation with Gesell language region (rs=0.607, P<0.01) and it had the most AUC (AUC=0.812, P<0.05). The consistency between ASQ-3 and Gesell was moderate (Kappa=0.56, P<0.01). ASQ-3 had the highest sensitivity(91.7%), accuracy(93.1%), negative predictive value(99.5%) and Youden index(0.85), and ELMS had the highest specificity(94.6%). 3) Comprehensive evaluation of three tools by the TOPSIS indicated that ASQ-3 was the best, followed by ELMS and PCDI-comprehension was the worse. 【Conclusion】 Among the three assessment tools, ASQ-3 has the highest value in assessing the language development of 11- to 13-month-old high risk infants, and it may be necessary to expand the age range and establish a national norm of ELMS and PCDI in the future.

Objective:To conduct a scoping review on gamified exercise interventions for elderly patients with cognitive impairment to provide insights for the application of gamification design in exercise programs for this population.Methods:Guided by the scoping review framework proposed by Arksey and O'Malley, a systematic search was conducted in databases including China National Knowledge Infrastructure, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, CINAHL, Web of Science, Scopus, ProQuest, and Wiley Online Library. The search covered the period from the establishment of the databases to June 12, 2024. An integrative analysis was performed on the included literature.Results:A total of 12 studies were included. The most commonly used gamification elements were achievement- and progress-oriented features, while the most frequently applied behavior change theories were behavior change techniques and social cognitive theory.Conclusions:Gamification-based exercise interventions can improve adherence to exercise programs in elderly patients with cognitive impairment, promote physical activity, and enhance cognitive function. Future research should focus on combining various theories with different gamification elements to encourage proactive exercise behavior in elderly individuals with cognitive impairment.

Objective:To dynamically study the iodine nutritional status of pregnant women in Guangxi Zhuang Autonomous Region (referred to as Guangxi), providing a basis for timely implementation of targeted prevention and control measures and scientific adjustment of intervention strategies.Methods:From 2015 to 2022, a survey was conducted in Guangxi on a county-by-county basis. One township/street was selected from each county based on the east, west, south, north, and center directions, and 20 pregnant women were selected from each township/street. Salt and urine samples were collected from the homes of pregnant women to detect salt and urine iodine levels.Results:A total of 78 034 pregnant women were surveyed from 2015 to 2022, with a median salt iodine concentration of 24.4 mg/kg. The overall coverage rate of iodized salt, qualification rate of iodized salt, consumption rate of qualified iodized salt, and the rate of non-iodized salt were 99.0% (77 250/78 034), 95.9% (74 105/77 250), 95.0% (74 105/78 034), and 1.0% (784/78 034), respectively. The comparison of qualified iodized salt consumption rates in different regions (cities) showed statistically significant difference (χ 2 = 3 801.28, P < 0.001), with Baise City had the highest (98.1%, 8 328/8 488) and Beihai City had the lowest (70.7%, 1 909/2 700); except for Beihai City, the consumption rate of qualified iodized salt in all other cities was over 90%. The median urinary iodine level among pregnant was 148 μg/L. The difference in urinary iodine levels among pregnant women between different years was statistically significant ( H = 2 516.52, P < 0.001), with the highest level in 2020 (169 μg/L) and the lowest level in 2015 (126 μg/L). From 2020 to 2022, the median urinary iodine level for pregnant women was ≥150 μg/L, while from 2015 to 2019, it was < 150 μg/L. There were statistically significant difference in urinary iodine levels among pregnant women in different regions (cities, H = 495.69, P < 0.001), with Liuzhou City and Guilin City had the highest levels (both at 156 μg/L), and Beihai City had the lowest level (132 μg/L). The median urinary iodine levels of pregnant women in the early, middle, and late stages of pregnancy were 154, 147, and 154 μg/L, respectively. There were statistically significant differences in urine iodine levels among pregnant women in different pregnancy stages ( H = 158.64, P < 0.001), with mid pregnancy being lower than early and late pregnancy ( P < 0.017). Conclusions:The overall iodine nutrition level of pregnant women in Guangxi is slightly insufficient, especially in coastal cities such as Beihai City. We should continue to adhere to the strategy of using iodized salt to prevent and control iodine deficiency disorders. At the same time, we should strengthen health education for pregnant women, and adopt targeted and precise iodine supplementation measures for pregnant women in different regions and during pregnancy.

Objective:To investigate the awareness and behavior of iodine deficiency disorders prevention and control knowledge among pregnant women in Guangxi Zhuang Autonomous Region (referred to as Guangxi), and provide a basis for further targeted health education.Methods:From June to August 2023, a cross-sectional study method was used conduct a questionnaire survey about the awareness and behavior of iodine deficiency disorders prevention and control knowledge on 819 pregnant women who underwent prenatal or inpatient examinations at county people's hospitals, maternal and child health centers, and township health centers in 14 counties of 7 cities in Guangxi.Results:A total of 819 valid questionnaires were collected in this survey. The score of iodine deficiency disorders prevention and control knowledge among pregnant women was (6.1 ± 2.8) points, with an awareness rate of 62.4% (511/819). There were statistically significant differences in the awareness rate of iodine deficiency disorders prevention and control knowledge among pregnant women of different ages, residence areas, fertility status, educational level, employmnet status, occupation, and per capita monthly income(χ 2 = 9.17, 37.51, 5.15, 87.12, 54.22, 50.17, 67.623, P < 0.05). There were statistically significant differences in various behaviors related to salt consumption habits, home salt packaging, awareness of which salt to eat, choices made when buying salt, salt preservation habits, whether or not the subject had eaten iodine-rich foods in the week before the survey, how often they had eaten iodine-rich foods in the year before the survey, and whether or not they had actively learned about iodine knowledge during pregnancy or before pregnancy between pregnant women with different levels of knowledge (χ 2 = 21.64, 12.81, 101.79, 123.20, 36.78, 59.76, 109.14, 98.10, P < 0.05). The main ways to obtain knowledge on prevention and control of iodine deficiency disorders were medical workers(71.3%, 381/534), traditional media(54.5%, 291/534), community advocacy(53.4%, 285/534), news client and new media(50.2%, 268/534). Conclusions:The overall awareness rate of iodine deficiency disorders prevention and control knowledge among pregnant women in Guangxi is not high. We should strengthen health education for pregnant women, especially young and multiparous women, those with low education and low income.