Objective To investigate the status and influencing factors of psychological distress associated with weight loss among young and middle-aged adults with obesity,so as to provide a theoretical basis for developing personalized interventions and improving psychological well-being.Methods A convenience sampling method was used to select young and middle-aged obese patients who visited the weight management clinic of a Grade A tertiary hospital in Jiangxi Province from October 2024 to May 2025.Data were collected using a general information questionnaire,the distress thermometer,the perceived social support scale,the brief illness perception questionnaire,and the simplified coping style questionnaire.Binary logistic regression was applied to identify factors influencing psychological distress.Results A total of 204 valid questionnaires were collected.The detection rate of significant psychological distress was 58.82%(120 cases).Regarding weight loss methods,32.84%of participants opted for medication.The top five issues reported on the psychological distress problem list were:appearance/body image,work/studies,lack of time/energy to care for elderly parents or children,bathing/dressing,and relationship with a partner.Binary logistic regression indicated that age,body mass index,waist circumference,history of chronic disease,perceived social support,illness perception,and negative coping style were significant influencing factors of psychological distress(P﹤0.05).Conclusions The rate of significant psychological distress is relatively high among young and middle-aged obese patients and is influenced by multiple factors.Medical staff may develop personalized interventions based on these factors to reduce the incidence of psychological distress.

Objective To investigate the status and influencing factors of psychological distress associated with weight loss among young and middle-aged adults with obesity,so as to provide a theoretical basis for developing personalized interventions and improving psychological well-being.Methods A convenience sampling method was used to select young and middle-aged obese patients who visited the weight management clinic of a Grade A tertiary hospital in Jiangxi Province from October 2024 to May 2025.Data were collected using a general information questionnaire,the distress thermometer,the perceived social support scale,the brief illness perception questionnaire,and the simplified coping style questionnaire.Binary logistic regression was applied to identify factors influencing psychological distress.Results A total of 204 valid questionnaires were collected.The detection rate of significant psychological distress was 58.82%(120 cases).Regarding weight loss methods,32.84%of participants opted for medication.The top five issues reported on the psychological distress problem list were:appearance/body image,work/studies,lack of time/energy to care for elderly parents or children,bathing/dressing,and relationship with a partner.Binary logistic regression indicated that age,body mass index,waist circumference,history of chronic disease,perceived social support,illness perception,and negative coping style were significant influencing factors of psychological distress(P﹤0.05).Conclusions The rate of significant psychological distress is relatively high among young and middle-aged obese patients and is influenced by multiple factors.Medical staff may develop personalized interventions based on these factors to reduce the incidence of psychological distress.

Articular cartilage superficial zone (SFZ) is the top layer of articular cartilage and its injuries are common in clinic.Therefore its find in time and conducting the treatment can delay the progress rate of os-teoarthritis (OA) and alleviate the pain and economic burden of the patients.At present,MRI is the most sen-sitive noninvasive examination technique to evaluate articular cartilage injury.Conventional MRI is limited in the early detection of subtle degeneration before cartilage morphological changes existence,and articular carti-lage lesions can only be detected when the injury is in an irreversible stage.In recent years,with the develop-ment of high field intensity MRI techniques such as 3T and 7T,the detection of water molecules,collagen fi-bers and tissue anisotropy in cartilage has considerable advantages,which can make the quantitative analysis and functional imaging for the ultrastructure and biochemical composition changes of SFZ in articular carti-lage.This article reviews the latest research progress on diagnostic value of MRI on articular cartilage SFZ and injuries.

The standardized treatment of malignant tumor has always been the direction of continuous improvement of major medical institutions. In recent years, the basic research, prevention, screening and diagnosis and treatment level of gastric, gastroesophageal junction and esophageal cancer have been greatly improved, resulting in a significant improvement in the 5 years′ survival rate of patients, but there are still great differences in the diagnosis and treatment level among different regions. Chinese gastric cancer, gastroesophageal junction cancer and esophageal cancer differ greatly from European and American countries in etiology, pathological types, high incidence sites, etc. Therefore, the relevant guidelines of European and American countries cannot fully meet Chinese clinical practice. In 2021, Elsevier Publishing Group launched the Chinese edition of Elsevier clinical pathway for gastric, gastroesophageal junction and esophageal cancer, and the first update edition was made in 2022, which aims to promote the quality control of tumor diagnosis and treatment, standardize tumor diagnosis and treatment behaviors, promote the homogenization and standardization of tumor diagnosis and treatment, and ultimately improve the survival rate and quality of life of patients with malignant tumor. This pathway refers to the National Comprehensive Cancer Network clinical practice guidelines, the Chinese Society of Clinical Oncology guidelines, combines evidence-based medicine and clinical experience, and follows the scientific, universal, standardized and operable principles. It has been promoted and applied in clinical practice, and is constantly updated according to the latest research results.

Objective:To explore the risk factors of bortezomib-related peripheral neuropathy (BIPN) and the clinical and electrophysiological characteristics of patients in treatment of multiple myeloma (MM).Methods:The clinical data of 71 newly diagnosed MM patients treated with BD (bortezomib + dexamethasone) regimen in Yancheng First People's Hospital from March 2016 to December 2019 were retrospectively analyzed. The bone marrow morphology, immunology, cytogenetics, molecular biology (MICM), routine electrophysiological examination before and after treatment were performed. All patients were divided into the peripheral neuropathy (PN) group and the non-PN group according to the presence or not of BIPN, and the clinicopathological differences of both groups were also compared; a binary logistic regression model was used to analyze the factors affecting the occurrence of PN. The electrophysiological characteristics were summarized and fluorescence in situ hybridization (FISH) was used to detect karyotype of BIPN patients.Results:Among 71 MM patients, there were 40 cases (56.3%) of PN and 31 cases (43.7%) of non-PN. The proportion of patients at international staging system (ISS) staging Ⅲ, and the levels of IgA, IgG, IgM, serum creatinine, β 2-microglobulin (β 2-MG) in the PN group were higher than those in the non-PN group, and hemoglobin (Hb) level in the PN group was lower than that in the non-PN group, and the differences were statistically significant (both P < 0.05). Binary logistic regression analysis showed that increased IgA ( OR = 1.151, 95% CI 1.012-1.309, P = 0.033), increased IgG ( OR = 1.055, 95% CI 1.000~1.112, P = 0.049), increased IgM ( OR = 1.010, 95% CI 1.001-1.018, P = 0.022), increased serum creatinine ( OR = 1.037, 95% CI 1.011~1.065, P = 0.005), increased β 2-MG ( OR = 1.564, 95% CI 1.039-2.354, P = 0.032) were risk factors for BIPN. Among 40 patients with BIPN, 33 cases (82.5%) of sensory nerve conduction velocity (SCV) were abnormal, 23 cases (57.5%) of motor nerve conduction velocity (MCV) were abnormal; 31 cases (77.5%) showed demyelination damage, 9 cases (22.5%) had axonal damage. Among 40 patients with BIPN, 24 cases underwent FISH detection, including 19 cases (79.2%) with chromosomal mutations, of which 12 cases (50.0%) were mixed subtype abnormal. Conclusions:MM patients with high levels of β 2-MG, IgA, IgG, IgM and serum creatinine are more prone to PN when treated with bortezomib. The electrophysiology of patients with BIPN is mainly characterized by demyelination of sensory nerves.

Objective:To compare and analyze the effects of impulse oscillometry (IOS) and pulmonary function test (PFT) in the assessment of asthma control in children.Methods:A cross-sectional study of 323 children with bronchial asthma who visited the outpatient pediatric clinic of Shandong Provincial Hospital Affiliated to Shandong First Medical University from March to December 2020 was conducted.The patients were divided into the control group (123 cases) and the uncontrolled group (200 cases) according to the Childhood Asthma Control Test (C-ACT) score.In both groups, PFT and IOS were performed.The PFT test included the forced expiratory volume in one second (FEV 1), force expiratory volume in one second/forced vital capacity (FEV 1/FVC), peak expiratory flow (PEF), the instantaneous forced expiratory flow at 50% of forced vital capacity (FEF 50), the instantaneous forced expiratory flow at 75% of forced vital capacity (FEF 75), and maximum mid expiratory flow (MMEF). In the IOS test, the total respiratory impedance at 5 Hz (Z5), respiratory resistance at 5 Hz (R5), respiratory resistance at 20 Hz (R20), reactance at 5 Hz (X5), respiratory resistance at 5 Hz-respiratory resistance at 20 Hz (R5-R20), reactance area (AX), and resonance frequency (Fres) were measured.The data obtained were analyzed statistically using SPSS 25.0 software. ANOVA or Mann- Whitney U rank-sum test was used to compare data between groups.Receiver′s operating characteristic (ROC) curves were drawn to determine the predictive value of PFT and IOS parameters for uncontrolled asthma. Results:(1) According to the comparison results of PFT indexes between the two groups of children with asthma, the levels of FEV 1, FEV 1/FVC, PEF, FEF 50, FEF 75, MMEF in the control group were all higher than those in the uncontrolled group [(104.41±12.38)% vs.(98.89±16.61)%, 100.50 (94.40, 103.50)% vs.96.00 (89.83, 101.88)%, (100.29±15.31)% vs.(93.19±18.43)%, 85.60(70.60, 96.60)% vs.72.35 (57.08, 91.10)%, 67.20 (53.60, 81.70)% vs.56.80 (41.10, 74.73)%, 80.70 (66.80, 95.10)% vs.69.50 (54.03, 90.05)%] (all P<0.01). (2) According to the comparison results of IOS indices between the two groups, the levels of Z5, R5, R20, R5-R20, X5, AX and Fres in the control group were lower than those in the uncontrolled group {68.58 (63.29, 77.43)% vs.81.27(70.93, 91.96)%, 68.91(62.94, 77.60)% vs.80.61 (70.02, 89.29)%, 75.78 (67.50, 87.55)% vs.82.97 (71.50, 95.50)%, 0.51 (0.43, 0.59) [kPa/(L·S)] vs.0.62 (0.53, 0.74) [kPa/(L·S)], 69.31 (59.93, 79.14)% vs.86.48 (70.00, 102.48)%, 1.11 (0.76, 1.60) kPa/L vs.2.14 (1.42, 2.85) kPa/L, 18.21 (16.06, 19.56) Hz vs.20.56 (18.92, 22.81) Hz} (all P<0.01). (3) In the control group, 31 children (25.20%) had pulmonary dysfunction.(4) In the uncontrolled group, 95 children (47.50%) had pulmonary ventilation dysfunction.Only 20 children (10.00%) had a R5 larger than 120% of the predicted value and/or a R20 larger than 120% of the predicted value.(5) According to the ROC analysis results of the IOS indices for predicting asthma exacerbations, all of the areas under the ROC (AUC) of Z5, R5, R5-R20, X5, AX and Fres were greater than 0.7.AX had the highest value in predicting asthma exacerbations (AUC=0.785, 95% CI: 0.735-0.835), with sensitivity of 78.50% and specificity of 64.20%.All of the AUCs of PFT indices were smaller than 0.7.FEF 50 and MMEF had the largest AUC. Conclusions:PFT and IOS have good sensitivity in evaluating the level of asthma control in children, and IOS has good value in predicting asthma exacerbations.AX has the highest predictive value for asthma exacerbations.Asthma control levels of children should be evaluated using not only subjective (such as C-ACT score) but also objective (e.g.PFT, IOS) indices.

The standardized treatment of malignant tumor has always been the direction of continuous improvement of major medical institutions.In recent years,the basic research,prevention,screening and diagnosis and treatment level of gastric,gastroesophageal junction and esophageal cancer have been greatly improved,resulting in a significant improvement in the 5 years'survival rate of patients,but there are still great differences in the diagnosis and treatment level among different regions.Chinese gastric cancer,gastroesophageal junction cancer and esophageal cancer differ greatly from European and American countries in etiology,pathological types,high incidence sites,etc.Therefore,the relevant guidelines of European and American countries cannot fully meet Chinese clinical practice.In 2021,Elsevier Publishing Group launched the Chinese edition of Elsevier clinical pathway for gastric,gastroesophageal junction and esophageal cancer,and the first update edition was made in 2022,which aims to promote the quality control of tumor diagnosis and treatment,standardize tumor diagnosis and treatment behaviors,promote the homogenization and standardization of tumor diagnosis and treatment,and ultimately improve the survival rate and quality of life of patients with malignant tumor.This pathway refers to the National Comprehensive Cancer Network clinical practice guidelines,the Chinese Society of Clinical Oncology guidelines,combines evidence-based medicine and clinical experience,and follows the scientific,universal,standardized and operable principles.It has been promoted and applied in clinical practice,and is constantly updated according to the latest research results.

Objective:To investigate the familial inheritances, clinical features, treatments and outcomes of familial Waldenstrom macroglobulinemia (WM) patients.Methods:The clinical manifestations, laboratory examinations, diagnosis and treatments, and follow-up data of 6 familial WM patients who were admitted to Yancheng No.1 People's Hospital from June 2002 to July 2019 were retrospectively analyzed, and the literature was reviewed.Results:Among 6 WM patients, 4 patients had dizziness and fatigue at the onset, 1 patient had recurrent low-grade fever and abnormal sweating as the first manifestations, 1 patient was hospitalized due to pulmonary infection, and WM was found later. Two brothers of the patients were diagnosed with WM, another 2 brothers of the patients had IgM-type monoclonal gammopathy of undetermined significance (MGUS) during the physical examination. All the 6 patients were middle-aged/elderly men, with a median age of 63 years old (51-70 years old). The median follow-up time were 71.5 months (4-217 months), and by the end of the follow-up (June 2020), 2 cases died of pulmonary infection, and 1 of them developed acute myeloid leukemia; the other 4 cases were in regular chemotherapy. Two IgM-MGUS patients were followed up without symptoms.Conclusions:WM patients have familial aggregation, and their clinical manifestations are highly heterogeneous. Patients with family history may have poor prognosis. It is necessary to strengthen the awareness of WM and family history screening.

Objective:To investigate the clinical features, diagnosis and treatment of lymphoplasmacytic lymphoma (LPL) with biclonal M protein.Methods:The clinical data of one LPL patient with biclonal M protein at Yancheng First People's Hospital in January 2018 was retrospectively analyzed, and relevant literature was reviewed.Results:The patient was an elderly woman with clinical manifestations of lymphadenopathy, kidney damage, anemia, and bone destruction. The diagnosis was confirmed based on lymph node biopsy, immunofixation electrophoresis, bone marrow cytology, and genetic mutation testing (MYD88 L265P mutation-positive). Partial remission was achieved after 4 courses of treatment with bortezomib-based regimen.Conclusions:Clinically, LPL with biclonal M protein shows one characteristic of M protein, and the immunoglobulin IgM and IgA biclonal LPL is even rarer. The treatment scheme based on bortezomib has a certain therapeutic effect.

Objective:To investigate the independent correlation between serum IL-6 level and delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) and to evaluate its predictive value for DCI.Methods:Consecutive patients with aSAH admitted to the Affiliated Hospital of Jining Medical University from June 2017 to June 2019 were enrolled retrospectively. They were divided into DCI group and non-DCI group according to the diagnostic criteria of DCI. Multivariate logistic regression analysis was used to determine the independent correlation between serum IL-6 and DCI. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of serum IL-6 level for DCI. Results:A total of 160 patients with aSAH were enrolled. They aged 66.1±8.1 years, and 98 were males (61.3%); 76 patients (47.5%) had DCI. Multivariate logistic analysis showed that after adjusting for smoking, hypertension, systolic blood pressure, hyperlipidemia, and drug treatment, serum IL-6 (the first quartile as a reference, and the third quartile: odds ratio[ OR] 3.885, 95% confidence interval [ CI]1.361-7.189; the fourth quartile: OR 9.706, 95% CI 3.412-18.344), Glasgow Coma Scale score ( OR 2.174, 95% CI 1.325-4.538) and Fisher grade ( OR 3.267, 95% CI 1.638-6.725) were independently associated with DCI. The ROC curve showed that the area under the curve of serum IL-6 for predicting DCI was 0.777 (95% CI 0.706-0.849), and the optimal cut-off value was 13.01 ng/L. The sensitivity and specificity of predicting DCI were 72.4% and 71.4%, respectively. Conclusions:Serum IL-6 is an independent risk factor for DCI after aSAH, and has certain predictive value for DCI.