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]To explore the diagnostic value of conventional ultrasound combined with shear wave elastography (SWE) for sarcopenia in patients with chronic kidney disease (CKD).[Methods]The study included 94 CKD patients (34 with sarcopenia and 60 without). All patient underwent the Simplified Assessment Rating Questionnaire (SARC-CalF),Mini Nutritional Assessment (MNA),Short Physical Performance Battery (SPPB),grip strength test,bioelectrical impedance analysis (BIA),conventional muscle ultrasound and SWE of the thighs. We then compared the differences in indicators between the sarcopenia group and non-sarcopenia group,used Spearman correlation analysis to assess the relationship between the two examinations (conventional ultrasound and SWE) and other clinical indicators,identified the diagnostic markers for sarcopenia,created receiver operating characteristic (ROC) curves,calculated the area under the curve (AUC) and determined the diagnostic performance of conventional ultrasound,SWE and their combination. Binary logistic regression was used to analyze the influencing factors of sarcopenia in CKD patients and a combined diagnosis model was established.[Results]The sarcopenia group showed lower upper arm circumference,calf circumference,6-meter walking speed and handgrip strength than non-sarcopenia group,and the differences were statistically significant (P<0.05). The sarcopenia group exhibited lower SARC-CalF and SPBB scores,as well as more compromised nutritional status. Statistically significant differences were observed in the ultrasound parameters between the two groups,including thickness of the subcutaneous fat and rectus femoris,combined thickness of the rectus femoris and vastus intermedius,rectus femoris cross-sectional area,elastic modulus of the rectus femoris and vastus medialis (all P<0.05). The muscle mass index had a moderate positive correlation with muscle thickness and cross-sectional area of the rectus femoris (0.3

Talent evaluation is an important part of the institutional mechanism for talent development. Based on the stakeholder theory, this study identified and defined the stakeholders in the evaluation of talents in public hospitals, and analyzed the needs of each party and their relationship with each other, and then built the evaluation path of talents in public hospitals. The stakeholders in the evaluation of talents in public hospitals included the government, society, hospitals and talents themselves. The strategic needs of talents of the government and the public welfare needs of talents of the society were transmitted to hospitals through policy orientation and functional positioning. Hospitals formed the evaluation implementation mechanism based on its own development needs through the establishment of talent evaluation index database and the setting of representative indexes of " field-oriented". Finally, the effectiveness of talent evaluation can be strengthened through the independent selection of the main evaluation categories and representative indicators by individual talents, as well as the personalized setting of relevant indicator weights by hospitals, in order to provide feedback on the evaluation needs of talents for the value of expertise. Constructing a talent evaluation system for public hospitals based on demand factors using a stakeholder theory analysis framework can provide reference for the reform of talent evaluation in public hospitals.

Invasive fungal infections threaten the lives and health of humans, especially immunodeficient patients or hospitalized patients with serious underlying diseases, and impose a heavy economic burden on society. The emergence of drug-resistant fungi, the formation of biofilms, and the limits and side effects of existing antifungal drugs increase the difficulty of clinical treatment, and there is an urgent need for the development of novel antifungal drugs. Therefore, based on previous kinase chemical library antifungal activity screening studies, this paper further investigates the activity of anaplastic lymphoma kinase (ALK) inhibitor 3-[5-chloro-2-({2-methoxy-4-[4-(4-methylpiperazin-1-yl)hexahydropyridin-1-yl]phenyl}amino)pyrimidin-4-yl]-1H-indole (HG-14-10-04, HG) against various fungi and elucidates its mechanism of action. The in vitro antifungal activity of HG was evaluated by micro liquid-dilution method, time-killing curve, mycelium formation and biofilm formation assays. The results showed that HG exhibited inhibitory and even fungicidal effects against sensitive and resistant Candida albicans, Candida krusei, Cryptococcus neoformans, Candida tropicalis, Candida glabrata and Candida parapsilosis (MICs = 8-16 μg·mL^-1); HG significantly inhibited the mycelium and biofilm formation, and destroyed the mature biofilm; and it exhibited synergistic antifungal effects with amphotericin B. The antifungal mechanism of HG was investigated by flow cytometry and transmission electron microscopy, etc. Sequencing analysis showed a total of 1 041 differentially expressed genes, of which 666 were up-regulated and 375 were down-regulated. According to the GO functional classification results, the up-regulated genes were mainly involved in ribosome production, oxidation-reduction and other functions, while the down-regulated genes were mainly involved in the synthesis of carbohydrate, glycoproteins, glycolipids and their metabolism, GPI anchor synthesis, and cytoskeleton and other functions. In addition, HG could significantly increase the level of reactive oxygen species (ROS), induce the fungal necrosis, block the cell cycle at the G0/G1 phase, and change the ultrastructure of the fungi, especially the structure of the fungal cell wall. Therefore, the enhanced inhibitory and fungicidal activity of HG may be related to the elevation of ROS, alteration of cellular ultrastructure (especially cell wall structure) and cell cycle arrest at the G0/G1 phase. Further optimization of its structure will provide a basis for the discovery of novel antifungal drugs or lead compounds.

Exosomes represent a class of nanoscale extracellular vesicles that facilitate the exchange of genetic information among various cells.Alzheimer's disease(AD)stands as a progressive neurodegenerative disorder characterized by its subtle and advan-cing onset,representing the foremost form of dementia lacking effective therapeutic interventions.Notably,investigations have illuminated the involvement of exosomes in the pathogenesis of AD,attributing diagnostic and therapeutic significance to their role,particularly concerning exosomal microRNAs(miRNA).The miRNAs carried by exosomes serve as potential biomarkers for AD,while also exhibiting potential benefits in ameliorating cognitive dysfunction in individuals afflicted by AD.This article aims to comprehensively review the origins of exosomes(encom-passing both mesenchymal cell-derived exosomes and brain-de-rived exosomes)and their potential as therapeutic agents targe-ting AD.

Panax notoginseng is the dried root and rhizome of Panax notoginseng(Burk.)F.H.Chen,a perennial erect herb of the genus Ginseng of the family Wujiaceae.As a traditional Chinese medicine in our country,Panax notoginseng has a good tonic effect,and the Dictionary of Traditional Chinese Medicines has the words that Panax notoginseng is used to tonify the blood,remove the blood stasis and damage,and stop epistaxis.It can also be used to pass the blood and tonify the blood with the best efficacy,and it is the most precious one of the prescription med-icines.Eaten raw,it removes blood stasis and generates new blood,subdues swelling and stabilizes pain,stops bleeding with-out leaving stasis,and promotes blood circulation without hurting the new blood;taken cooked,it can be used to replenish and strengthen the body.Notoginsenoside R1 is a characteristic com-pound in the total saponin of Panax ginseng.In recent years,China's aging has been increasing,and the incidence of neuro-logical disorders has been increasing year by year.Meanwhile,reports on notoginsenoside R1 in the treatment of neurological disorders are increasing,and its neuroprotective effects have been exerted with precise efficacy.The purpose of this paper is to review the treatment of neurological diseases and the mecha-nism of action of notoginsenoside R1,so as to provide a certain theoretical basis for clinical use and new drug development.

Concurrent chemoradiotherapy (CCRT) refers to the simultaneous treatment of chemotherapy and radiotherapy, and the effect of radiotherapy is enhanced with low-dose chemotherapy, which can reduce tumor recurrence and metastasis and improve clinical prognosis of patients. At present, the main factors for the increase of radiosensitivity of concurrent chemotherapy is that concurrent chemotherapy prevents the repair of tumor cells, and chemotherapy and radiotherapy act on different cell cycles and have synergistic effects. However, even for patients with locally advanced cervical cancer (LACC) who have undergone CCRT, the 5-year survival rate is only 60%, which is still not ideal. In order to improve the efficacy, researchers have conducted a series of exploratory studies, which consist of the combination of targeted drugs and immunodrugs, and neoadjuvant regimens before CCRT, etc. Although targeted or immunologic drugs are effective treatment of LACC, in view of the lack of large-scale evidence-based medical evidence, multi-center prospective and randomized phase III clinical trials and high-level articles are needed to improve the level of evidence-based medicine. This consensus summarizes several key evidence-based medical studies published recently, especially the clinical research progress in targeted and immunological therapies, providing reference for domestic peers.

Objective:To analyze the prognostic factors of children with septic shock in the pediatric intensive care unit.Methods:The clinical data of children diagnosed with septic shock in the pediatric intensive care unit of Guiyang Maternal and Child Health Hospital from April 2018 to April 2022 were retrospectively collected,and the children were divided into the death group and the survival group according to seven days regression.The basic data of the two groups were statistically compared，and the relationship between lactic acid，vasoactive-inotropic score one hour after admission，time of antibiotic initiation，serum potassium，serum sodium，serum calcium，serum troponin T，fluid resuscitation volume in the first hour，glutamyl aminotransferase，creatinine，total leukocyte count，C-reaction protein，brain natriuretic peptide were compared.The risk factors affecting the death of children were analyzed by Logistic regression.The relationship between fluid resuscitation volume in the first hour and prognosis was analyzed using the receiver operator characteristic (ROC) curve.Results:（1）A total of 67 children were included，19 died and 48 survived.（2）The first-hour liquid resuscitation dose in the survival group was lower than that in the death group，and the difference was statistically significant（ P<0.05）.（3）The ROC curve showed that the optimal cut-off of the first-hour liquid resuscitation dose was 25 mL/kg，with a sensitivity of 57.9% and a specificity of 72.9%.（4）In unifactorial analysis，lactic acid in the first hour of admission，early lactic acid after resuscitation，serum calcium，serum troponin T，alanine aminotransferase，combined septic encephalopathy，Glasgow coma score，and pediatric critical illness score were all risk factors for death in children within seven days（ P<0.05）.(5) Multivariate Logistic regression analysis showed that serum calcium（ OR=1.435， P=0.001）and lactic acid value after resuscitation（ OR=0.040， P=0.021）were independent risk factors for death in septic shock. Conclusion:The higher the total fluid resuscitation in the first hour，the higher the fatality rate.Serum calcium and early lactic acid after resuscitation are independent risk factors for death in children within seven days.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Objective:To investigate the predictive value of a nomogram based on multimodal CT parameters for the outcome of endovascular therapy (EVT) in patients with acute vertebrobasilar artery occlusion (AVBAO).Methods:Patients with AVBAO underwent EVT at Xuzhou Central Hospital from January 2021 to March 2024 were included retrospectively. At 90 days after EVT, the modified Rankin Scale was used to evaluate clinical outcome. 0-3 points were defined as good outcome and 4-6 points were defined as poor outcome. Multivariate stepwise logistic regression model was used to screen for predictive variables. Then a nomogram was drawn and the prediction model was evaluated. Results:A total of 91 patients with AVBAO were included. There were 60 males (65.9%), aged 69.09±10.57 years. Thirty-eight patients (41.8%) had good outcome, 53 (58.2%) had poor outcome, and 35 (38.5%) died. Univariate analysis showed that there were significant differences in white blood cell count, neutrophil count, National Institutes of Health Stroke Scale (NIHSS) score, Glasgow Coma Scale (GCS) score, posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS), Basilar Artery on Computed Tomography Angiography (BATMAN) score, core infarct volume, mismatched volume ratio, onset to door time between the poor outcome group and the good outcome group (all P<0.05). The above indicators were included in a binary multivariate stepwise logistic regression model. The results showed that higher NIHSS scores (odds ratio [ OR] 1.154, 95% confidence interval [ CI] 1.070-1.244; P<0.001), lower BATMAN scores ( OR 0.626, 95% CI 0.416-0.943; P=0.025), and larger core infarct volumes ( OR 1.147, 95% CI 1.046-1.258; P=0.004) on admission were the independent risk factors for poor outcome. A nomogram was plotted using the above three independent risk factors as predictor variables. Its area under the receiver operating characteristic curve for predicting poor outcome was 0.942 (95% CI 0.894-0.990). The sensitivity and specificity were 81.1% and 97.4%, respectively. The calibration curve fluctuates within a small range around the ideal curve. A mean absolute error was 0.027 and a mean square error was 0.001. The clinical decision curve suggested that the model had good clinical applicability. The dynamic nomogram is shown in: https://yuepeng.shinyapps.io/VBAO_model/. Conclusion:The nomogram prediction model based on multimodal CT parameters has good predictive performance for poor outcome in patients with AVBAO after EVT.