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 assess the value of artificial intelligence（AI）assisted system in the diagnosis of malignancy in follicular thyroid tumours，and to compare with the diagnostic results of doctors with different levels of experience.Methods:A total of 101 nodules were retrospectively collected from 86 patients with follicular thyroid tumours who underwent surgical treatment at Peking Union Medical College Hospital，Chinese Academy of Medical Sciences，Peking Union Medical College from May 2016 to January 2018.The nodules were classified into risk group（29 patients，34 nodules，including 15 follicular carcinomas and 19 follicular tumours of indeterminable malignant potential）and benign group（59 atients，67 nodules，including 15 follicular adenomas and 52 nodular goitre adenomatoid hyperplasia）. The sensitivities，specificities and accuracies of the AI system，two doctors of different seniorities（one junior A and one senior B），and guidelines of thyroid ultrasound malignancy risk stratification［including the 2015 American Thyroid Guidelines（ATA），the 2017 American College of Radiology Thyroid Imaging Reporting and Data System（ACR TI-RADS），the 2020 Chinese Society of Ultrasound，Thyroid Imaging Reporting and Data System（C-TIRADS）］（classified by a senior doctor C）for diagnosing follicular tumours in the risk group and follicular carcinomas were calculated and compared.Results:The AI system showed a sensitivity of 46.7%，specificity of 89.6% and accuracy of 81.7% for diagnosing follicular carcinoma；and a sensitivity of 32.4%，specificity of 89.6% and accuracy of 70.3% for diagnosing follicular neoplasms（risk group）. Compared with junior doctor A，the specificity of AI system in diagnosing follicular cancer and follicular neoplasms（risk group）was higher（89.6% vs. 83.6%， P=0.020；89.6% vs. 73.1%， P=0.020），and the differences of sensitivity were not significant（46.7% vs. 32.4%， P=0.181；32.4% vs. 11.8%， P=0.073）. The difference of sensitivity and specificity were not statistically significant between the AI system and senior doctor B（all P＞0.05）.The differences in area under the curve for diagnosis of follicular carcinoma and follicular tumour（risk group）were not statistically significant between the AI system compared to junior doctor A，senior doctor B，the C-TIRADS，ATA guideline，and ACR TI-RADS（all P＞0.05）. Conclusions:Ultrasound-based AI-assisted diagnostic system is similarly efficient in diagnosing follicular thyroid tumours as experienced doctors，and the AI system diagnostic specificity is superior to that of junior doctors.

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 assess the value of artificial intelligence（AI）assisted system in the diagnosis of malignancy in follicular thyroid tumours，and to compare with the diagnostic results of doctors with different levels of experience.Methods:A total of 101 nodules were retrospectively collected from 86 patients with follicular thyroid tumours who underwent surgical treatment at Peking Union Medical College Hospital，Chinese Academy of Medical Sciences，Peking Union Medical College from May 2016 to January 2018.The nodules were classified into risk group（29 patients，34 nodules，including 15 follicular carcinomas and 19 follicular tumours of indeterminable malignant potential）and benign group（59 atients，67 nodules，including 15 follicular adenomas and 52 nodular goitre adenomatoid hyperplasia）. The sensitivities，specificities and accuracies of the AI system，two doctors of different seniorities（one junior A and one senior B），and guidelines of thyroid ultrasound malignancy risk stratification［including the 2015 American Thyroid Guidelines（ATA），the 2017 American College of Radiology Thyroid Imaging Reporting and Data System（ACR TI-RADS），the 2020 Chinese Society of Ultrasound，Thyroid Imaging Reporting and Data System（C-TIRADS）］（classified by a senior doctor C）for diagnosing follicular tumours in the risk group and follicular carcinomas were calculated and compared.Results:The AI system showed a sensitivity of 46.7%，specificity of 89.6% and accuracy of 81.7% for diagnosing follicular carcinoma；and a sensitivity of 32.4%，specificity of 89.6% and accuracy of 70.3% for diagnosing follicular neoplasms（risk group）. Compared with junior doctor A，the specificity of AI system in diagnosing follicular cancer and follicular neoplasms（risk group）was higher（89.6% vs. 83.6%， P=0.020；89.6% vs. 73.1%， P=0.020），and the differences of sensitivity were not significant（46.7% vs. 32.4%， P=0.181；32.4% vs. 11.8%， P=0.073）. The difference of sensitivity and specificity were not statistically significant between the AI system and senior doctor B（all P＞0.05）.The differences in area under the curve for diagnosis of follicular carcinoma and follicular tumour（risk group）were not statistically significant between the AI system compared to junior doctor A，senior doctor B，the C-TIRADS，ATA guideline，and ACR TI-RADS（all P＞0.05）. Conclusions:Ultrasound-based AI-assisted diagnostic system is similarly efficient in diagnosing follicular thyroid tumours as experienced doctors，and the AI system diagnostic specificity is superior to that of junior doctors.

This article explores the shortcomings and proposes research directions from the overview of mobile medicine and its application in the prevention, self-management, and health education of female stress urinary incontinence, with a view to providing new ideas and methods for the prevention and treatment of female stress urinary incontinence.

Objective To compare diagnostic values of the 2015 American Thyroid Association (ATA) Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer with the thyroid imaging reporting and data system (TI-RADS) for sonographic malignancy risk stratification of thyroid nodules.Methods From November 2011 to December 2015,485 thyroid nodules in 331 patients (mean age,42.9 years± 10.4)were included in this study.Characteristics includingsize,composition,shape(nonparallel or parallel),margin,echogenicity,calcifications and extrathyroidal extension of thyroid nodules were evaluated.Every nodule was stratificated by criteria set by TI-RADS and ATA guidelines,and malignant rate of each risk stratification were calculated and analysed.With pathology as the gold standard,different cutoff were taken to diagnose malignant nodules,and the sensitivity,specifity,positive predictive value,negativepredictive value and accuracy of the two methodologies were calculated at each cutoff.And the two methodologies were evaluated and measured by ROC curve.Finally their Kappa value were calculated at the best cutoff.Results Of the 485 thyroid nodules,96 were benign and 389 were malignant.The malignancy rates under TI-RADS category 2,3,4a,4b,4c,and 5 nodules were 0,12.0％ (3/25),22.2％ (10/45),29.8％ (14/47),99.2％ (261/363) and 100％ (101/101).Malignancy rates under ATA guidelines of benign,very low,low,intermediate,and high suspicion for malignancy were 0,12.5％ (1/8),16.1％ (10/62),27.7％ (13/47),and 99.2％ (365/368).There were significant differences inside each patterns (P ＜ 0.01) respectively and high correlation between risk stratification with TI-RADS (r=0.70) and ATA guidelines (r=0.83).Areas under the ROC curve of the TI-RADS and ATA guidelines classifications were 0.966 and 0.959.Best cut-off point for diagnosing malignant by TI-RADS and ATA guideline classifications were ≥ 4c and ≥ high suspicion,and at that point,diagnostic value of TI-RADS and ATA guidelines were nearly the same(sensitivity,93.1％vs 93.8％;specificity,97.9％ vs 96.9％;PPV,99.5％ vs 99.2％;NPV,75.7％vs 79.5％;and accuracy,94.0％vs94.4％),and there was no significant differences (P=0.50,P=0.50,P=0.50,P=0.53,P=0.55),Kappa=0.97.Conclusions Both TI-RADS and the ATA guidelinesprovide effective malignancy risk stratification for thyroid nodules.The diagnosticvalue of TI-RADS when considering ≥ 4c and ATA guidelines when considering ≥ high-suspicion nodules as malignant were nearly the same and both high.

Objective To investigate the turnover intention of nursing staff in a Beijing tertiary traditional Chinese medicine ( TCM ) hospital. Methods Self-designed questionnaire was used to investigate 295 nursing staff from a tertiary TCM hospital. The questionnaire included the general information of nurses, problems that nurses faced with and turnover intention. Results Nurses satisfied with current job or somewhat satisfied with current job accounted for 80%; 86% of nurses once had job burnout; and 35% of nurses had turnover intention. Influencing factors of nurses′ turnover intention contained wages, working pressure, large workload, etc. Conclusions Labor unions of hospitals and the administrative departments should be more concerned about the nurses, provide relief measures, and improve the social benefits of nurses.

Objective To observe the urine analysis test paper evaluation method for the determination of the sensitivity of medical equipment cleaning effect,for cleaning quality evaluation method.Methods To perform standard manual processing equipment in the experiments,the first use of ATP monitoring method and the analysis of urine test paper test mid experiment data,calculate its whether there is relationship and ATP test method,and can instruct the cleaning quality results;Second use visual method,ATP bioluminescence method and the analysis of urine test paper test the end of the experiment data,the analysis to determine the urine test paper measurement indicator cleaning qualified evaluation threshold.Results The ATP test paper method and urine analysis had showed positive correlation,0.30 ≤r≤0.75,and to complete the standard cleaning process 300 pieces of department of gynaecology attractor visual analysis method,ATP bioluminescence method and the analysis of urine test paper measurement inspection group (the -),cleaning the percent of pass was 95.67％(287/300),86.33％(259/300) and 83.37％(251/300) respectively,therefore,urine analysis test paper assay to detect the - was the cleaning threshold quality qualification evaluation,urine analysis test paper test the percent of pass was 14.46％ lower than the visual observation,x2=63.35,P＜0.05.Conclusions Urine analysis test paper test results,test method is simple,low cost,and can be widely used in medical equipment cleaning quality evaluation method of semi-quantitative daily monitoring.

Objective To evaluate the clinical value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions. Methods Thirty-four patients with 36 pancreatic lesions in Shanghai First People′s Hospital Afifliated to Shanghai Jiao Tong University from February 2012 to November 2013 underwent conventional ultrasound-guided percutaneous core needle biopsy using automatic gun and 18-gauge biopsy needles. The site, size, internal and surrounding vascularity, the sampling number of the lesions, and whether the specimens′ quality was satisfied were recorded. Then specimens were sent for pathological examination, and all above observations were compared with the ifnal diagnosis. Results The number of lesions with 2, 3 and 4 samplings was 32, 2 and 2, respectively. The average number of sampling was 2.2 (mean, 2.17;standard deviation, 0.51) and the acquisition rate of satisifed specimens was 89%(32/36). The pathological results of biopsy were malignant in 31 of 36 lesions including 27 cases of ductal adenocarcinoma, 2 cases of lymphoma, 1 case of small cell neuroendocrine carcinoma and 1 case of uterine leiomyosarcoma metastasis. The other 5 lesions were non-malignant including 3 cases of benign lesion, 1 cases of atypical hyperplasia and 1 cases of granulation tissue. The 36 lesions were ifnally diagnosed as 34 cases of pancreatic malignancy, 2 cases of non-malignant neoplasm. The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions were 91%(31/34), 100%(2/2), 92%(33/36), 100%(31/31) and 40%(2/5), respectively. Youden index was 0.91. Two patients had mild upper abdominal pain and 1 patient had transient elevated serum amylase. No pancreatitis, pancreatic fistula, peritonitis, bleeding or dispersion of malignant cells along the penetrating channel or other serious complications occurred. Conclusion Ultrasonography guided percutaneous core needle biopsy is a simple, rapid, safe and effective diagnostic method in pancreatic lesions with high clinical value.

Objective To isolate enterovirus 71 from a death children,and analyze whether the neurovirulence was related to the variation of nucleotide and amino acid. Methods Enterovirus 71 was isolated from throat swabs which were colleted from Shandong Linyi People's Hospital. The full length genome was sequenced by amplification with RT-PCR and sequencing of 9 overlapped gene fragments covering full length of the genomes. The nucleotide and amino acid sequenced was aligned by BLAST, Bioedit and MEGA 4. Results A strain of enterovirus 71 was isolated and named as SDLY107. The full length was 7405 bp. The results of homology analysis of overall nucleotide sequence showed that strain Fuyang. Anhui. P. R. C/17.08/2 had highest homology (98.6%)with strain SDLY107, and the homology was 80.0% between strain SDLY107 with prototype strain BrCr/70,and 86. 5% between strain SDLY107 with nerve strain MS/87. Phylogenetic analysis showed that the phylogeny was close between SDLY107 with some isolated strains from Chinese Mainland, such as Beijing, Henan, Guangxi, Sbenzhen, Lanzhou, Fuyang, Chongqing and Zhejiang strains, which was clustered for C4 subtype. The results of amino acid sequence analysis showed that there were 2 mutations, E947D and K1873R, for strain SDLY107. Conclusion SDLY107 belonged to C4 subtype, amino acid mutations E947D and K1873R of which may be relevant to the pathogenicity of EV71.