In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

Objective: To investigate the association between plant-based diet and different types of obesity, so as to provide references for obesity prevention. Methods: Residents aged 35-75 years from 33 counties (cities, districts) in Zhejiang Province were selected as study subjects using a multistage stratified random sampling method between April and December 2024. Demographic information and living behaviors were collected using questionnaire surveys. Height, weight and waist circumference were measured, and body mass index (BMI) was calculated. BMI ≥28.0 kg/m2 was defined as obesity, waist circumference ≥90 cm in males or ≥85 cm in females was defined as central obesity, and individual with obesity who also had central obesity was defined as having compound obesity. Food intake over a 3-day period was collected using the consecutive 3-day 24-hour dietary recall method. The plant diet index (PDI), healthful plant diet index (HPDI), and unhealthful plant diet index (UPDI) were calculated, and categorized into quintiles (Q1-Q5) based on their distribution. Association between the PDI, PDI, UPDI and different types of obesity were analyzed using multivariable logistic regression models. Results: A total of 4 882 individuals were surveyed, including 2 233 males (45.74%) and 2 649 females (54.26%). The average age was (55.42±12.14) years. There were 537 individuals of obesity, 1 718 individuals of central obesity, and 500 individuals of compound obesity, with detection rates of 11.00%, 35.19%, and 10.24%, respectively. Multivariable logistic regression analysis showed that, after adjusting for demographic information and living behaviors, compared with Q1 group, HPDI Q5 group showed a 29.6% lower risk of obesity (OR=0.704, 95%CI: 0.525-0.943) and a 32.1% lower risk of compound obesity (OR=0.679, 95%CI: 0.502-0.918). Conversely, the UPDI Q5 group exhibited a 39.5% higher risk of obesity (OR=1.395, 95%CI: 1.032-1.886) and a 39.8% higher risk of compound obesity (OR=1.398, 95%CI: 1.025-1.907). No statistically significant association was found between PDI and obesity, central obesity, and compound obesity (all P>0.05). As HPDI increased, the risks of obesity and compound obesity showed decreasing trends; as UPDI increased, the risks of obesity and compound obesity showed increasing trends (all Ptrend<0.05). Conclusion A healthful plant-based diet is associated with reduced risks of obesity and compound obesity, while an unhealthful plant-based diet is associated with increased risks of obesity and compound obesity.

Objective:To develop a self-efficacy scale of milk donation and test its reliability and validity, in order to provide a scientific evaluation tool for the corresponding study.Methods:According to Bandura′s self-efficacy theory and consensus-based standards for the selection of health measurement instruments, the scale was developed by means of literature search, article pool establishment and expert letter consultation. A pre-survey was conducted on 30 newborn bereaved women, a formal investigation was conducted on 231 newborn bereaved women, and 115 newborn bereaved women were selected for exploratory factor analysis. Confirmatory factor analysis was performed on 116 parturients with neonatal loss to determine the reliability and validity of the scale.Results:The final scale includes 3 dimensions and 13 items. Three common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 77.962%. A scale with three dimensions, included breast milk donation resilience, breast milk donation cognition and breast milk donation motivation, and 13 items was determined. Confirmatory factor analysis showed that the model fit of the scale was good ( χ2/ df = 1.390, RMSEA = 0.063, RMR = 0.046, NFI = 0.924, NNFI = 0.971, GFI = 0.924, CFI = 0.977). The content validity index was 0.835. Cronbach′s α coefficient of the total volume table was 0.919, and the coefficients of each dimension were 0.892, 0.905 and 0.844, respectively. The broken half reliability of the scale was 0.893, and the broken half reliability of each dimension was 0.857, 0.881 and 0.711, respectively. The retest reliability of the scale was 0.814, and the retest reliability of each dimension was 0.803, 0.825 and 0.767, respectively. Conclusions:The scale has good reliability and validity, and can be used to evaluate the self-efficacy of milk donation in lost newborns.

Objective:To develop a self-efficacy scale of milk donation and test its reliability and validity, in order to provide a scientific evaluation tool for the corresponding study.Methods:According to Bandura′s self-efficacy theory and consensus-based standards for the selection of health measurement instruments, the scale was developed by means of literature search, article pool establishment and expert letter consultation. A pre-survey was conducted on 30 newborn bereaved women, a formal investigation was conducted on 231 newborn bereaved women, and 115 newborn bereaved women were selected for exploratory factor analysis. Confirmatory factor analysis was performed on 116 parturients with neonatal loss to determine the reliability and validity of the scale.Results:The final scale includes 3 dimensions and 13 items. Three common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 77.962%. A scale with three dimensions, included breast milk donation resilience, breast milk donation cognition and breast milk donation motivation, and 13 items was determined. Confirmatory factor analysis showed that the model fit of the scale was good ( χ2/ df = 1.390, RMSEA = 0.063, RMR = 0.046, NFI = 0.924, NNFI = 0.971, GFI = 0.924, CFI = 0.977). The content validity index was 0.835. Cronbach′s α coefficient of the total volume table was 0.919, and the coefficients of each dimension were 0.892, 0.905 and 0.844, respectively. The broken half reliability of the scale was 0.893, and the broken half reliability of each dimension was 0.857, 0.881 and 0.711, respectively. The retest reliability of the scale was 0.814, and the retest reliability of each dimension was 0.803, 0.825 and 0.767, respectively. Conclusions:The scale has good reliability and validity, and can be used to evaluate the self-efficacy of milk donation in lost newborns.

Objective: To understand current status and related factors of breakfast among primary and secondary school students in Zhejiang Province, so as to provide a scientific basis for improving breakfast habits of primary and secondary school students. Methods: During May to November of 2023, 33 326 students from grade four to six of primary schools and grade one to two of secondary schools were selected from 90 counties and cities in Zhejiang Province by using the stratified cluster random sampling method. General information and breakfast consumption were collected by questionnaire. Multivariate Logistic regression was used to analyze the related factors of breakfast. Results: About 81.29% of the primary and secondary school students reported regular breakfast consumption. The rate of regular breakfast consumption was higher on the school days (92.23%) than on the weekends (85.17%), and higher in primary school students (85.83%) compared to secondary school students (74.71%), with statistically significant differences ( χ 2=827.42, 655.03, P <0.01). About 49.19% of primary and secondary school students had their breakfast within 10 minutes or less, and 83.30% of primary and secondary school students had 3-5 food groups for breakfast. The proportions of students who consumed cereals and potatoes, milk, and eggs were respectively 18.76%, 28.85%, 14.63%. About 22.84%, 28.00 %, 32.60% and 32.23% of the students had no meat, soybeans, vegetables and fruits in their breakfast. The results of multivariate Logistic regression analysis showed that girls, rural area, secondary school, place of living (dormitory, others), migrant parent (one or both outside the hometown), late bedtime (22:00-22:59, 23:00 and later) and late wake up time (9:00 and later) on the weekends were positively correlated with no having breakfast every day ( OR=1.22, 1.40, 1.46, 1.20, 1.20, 1.34, 1.36, 1.41 , 3.51, 2.32, P <0.05). The time of physical activity per day (30-<60, 60-<90, 90-120, >120 min), bedtime (21:00-21:59, 22:00-22:59) and wake up time (6:00-6:59, 7:00-7:59) on school days were negatively correlated with no having breakfast every day ( OR=0.75, 0.64, 0.67, 0.64, 0.77, 0.82, 0.75, 0.67, P <0.05). Conclusions There is a considerable number of primary and secondary school students with irregular breakfast consumption, which are related to multiple factors. Therefore, it is necessary to strengthen nutrition education and improve the behavior of breakfast for primary and secondary school students.

Objective To investigate the compliance status of ankle pump movement(APM)in high-risk patients with deep venous thrombosis(DVT)of the lower limbs and analysis the related influencing factors.Methods From January 2019 to March 2023,a total of 302 patients with high-risk lower limb DVT who admitted to our hospital were selected as the research objects.The APM compliance scale,clinical data sheet,visual analog scale(VAS),family support scale,self-efficacy scale,self-rating anxiety scale,and self-rating depression scale were used to evaluate the research subjects,and the evaluation results were analyzed.Results Among the 302 patients with high-risk DVT,171 patients had APM compliance,with a compliance rate of 56.62％.The results of univariate analysis showed that there were statistically significant differences in APM compliance among patients of different age groups,gender,education level,marital status,family economic income,work status,family support,medical insurance type,place of residence,reason for hospitalization,comorbidities,pain level,APM prescription time,self-efficacy,and psychological status(all P＜0.05).The results of multivariate Logistic analysis showed that comorbidities(≥2 types),pain(moderate and above),and prescription time(≥7d)were risk factors for APM compliance in DVT high-risk patients(all P＜0.05),while education level(college or above),family support(moderate and above),and self-efficacy(moderate and above)were protective factors for APM compliance(all P＜0.05).Conclusion The comorbidities,degree of pain,APM prescription time,educational level,family support,and patient self-efficacy can affect ankle pump compliance in high-risk patients with lower limb deep vein thrombosis,and should be given attention and targeted intervention.

Objective To investigate the current status of regulatory focus among the nurses in operating room,analyse the influencing factors and summarise nursing strategies to provide a reference for development of the programs in targeted nursing management.Methods A total of 681 operating room nurses from 18 hospitals of Grade ⅡA and above in Jiangsu Province were selected by convenience sampling method from Arprial to July 2023.The nurses who participated in the study were surveyed with a general information questionnaire,the nurse regulatory focus scale(NRFQ),spiritual climate scale(SCS),calling scale-12(CS-12),and perceived stress scale(CPSS).Results All 681 operating room nurses completed the study.The promotive focus score was lower than the defensive focus(23.57±2.64 vs.24.06±2.72).It was found that the promotive focus and defensive focus were positively correlated with spiritual climate and occupational call,and negatively correlated with perceived stress(P<0.01).Spiritual climate,occupational call and perceived stress were the influencing factors that affected the promotion focus,jointly explaining 28.00％of the variance(all P<0.05).While occupational call and perceived stress among the operating room nurses were the influencing factors to the defensive focus,jointly explaining 23.60％of the variance(both P<0.05).Conclusion This study has identified that spiritual climate of nurses in operating room positively influences promotive focus in the regulatory focus.The regulatory focus as a whole is positively regulated by occupational call and negatively influenced by perceived stress.Therefore,nursing administrators should create a favourable spiritual climate to enhance the sense of professional call,reduce the perceived stress and increase the promotive and defensive focus among the nurses in operating room,hence to increase the nursing efficiency,thereby improving the quality of nursing care.

【Objective】 To explore the correlation between abnormal thalamic functional connectivity (FC) and memory loss in maintenance hemodialysis patients with end-stage renal disease (ESRD). 【Methods】 An auditory verbal learning test (AVLT-H) was conducted on 22 patients with ESRD and 28 age-, sex-, and education-matched healthy controls (HC) to evaluate memory function. After that, resting-state functional magnetic resonance imaging (rs-fMRI) data were gathered, and a whole-brain FC analysis centered on the thalamus was executed to discern variations in thalamic FC between the two groups. Finally, Pearson and Spearman correlation analyses were carried out. 【Results】 Compared to the HC group, the ESRD group exhibited notably lower scores in IR-S (P=0.002), SR-S (P<0.001), and LR-S (P=0.005). Concurrently, the ESRD group demonstrated diminished FC of the right thalamus with the left superior frontal gyrus, the left parietal lobule, the right suproccipital gyrus, the right anterior cuneus, and the right middle frontal gyrus (P<0.05, TFCE correction). Additionally, reduced FC were observed between the left thalamus and the left gyrus rectus, the left parietal lobule, and the right parietal lobule in the ESRD group (P<0.05, TFCE correction). Moreover, the FC values between the left thalamus and the left gyrus rectus in the ESRD group displayed significant negative correlations with IR-S (r=-0.499), SR-S (r=-0.458), and LR-S (r=-0.455) (all P<0.05). 【Conclusion】 Memory impairment is evident in ESRD patients undergoing maintenance hemodialysis, and it appears to be intricately linked to anomalous FC within the left thalamus and the left gyrus rectus. These findings offer potential imaging markers for monitoring memory dysfunction in individuals with ESRD.

infC gene encodes the translation initiation factor IF3 in bovine Pasteuella multocida,but it whether or not regulation to the virulence and cross-protection in P.multocida is still not well understood.In this study,the infC gene mutant(△infC)derived from bovine P.multocida type A strain CQ2 was constructed using by homologous recombination method.Compared with wild strain,the △infC showed significant increasing in biofilm formation,but the capsule produc-tion,virulence and bacterial loading in organs were significant decreased,and the IL-1β secretion of mouse peritoneal macrophage increased.Along with the infC gene deletion,the expression of genes related to capsule synthesis and LPS synthesis and transport were significantly down-regulated,while that of genes related to biofilm synthesis and outer membrane protein were significantly up-regulated.The inactivated vaccines of wild type and mutant were prepared and mice were immu-nized twice then challenged with wild type strains,respectively.The immuno-protection rate of△in fC inactivated vaccine against bovine P.multocida type A,B and F were 100.0％,83.3％and 0.0％,respectively,and the immuno-protection rate that against rabbit type P.multocida was 33.3％.The results indicated that infC gene could affect the virulence of P.multocida by regula-ting the production of capsule and the expressions of virulence related factors,and the deletion of infC gene conferred a certain cross-protection property of strains.This study provided a certain foundation for the development of P.multocida vaccine.

Objective To investigate the current status of regulatory focus among the nurses in operating room,analyse the influencing factors and summarise nursing strategies to provide a reference for development of the programs in targeted nursing management.Methods A total of 681 operating room nurses from 18 hospitals of Grade ⅡA and above in Jiangsu Province were selected by convenience sampling method from Arprial to July 2023.The nurses who participated in the study were surveyed with a general information questionnaire,the nurse regulatory focus scale(NRFQ),spiritual climate scale(SCS),calling scale-12(CS-12),and perceived stress scale(CPSS).Results All 681 operating room nurses completed the study.The promotive focus score was lower than the defensive focus(23.57±2.64 vs.24.06±2.72).It was found that the promotive focus and defensive focus were positively correlated with spiritual climate and occupational call,and negatively correlated with perceived stress(P<0.01).Spiritual climate,occupational call and perceived stress were the influencing factors that affected the promotion focus,jointly explaining 28.00％of the variance(all P<0.05).While occupational call and perceived stress among the operating room nurses were the influencing factors to the defensive focus,jointly explaining 23.60％of the variance(both P<0.05).Conclusion This study has identified that spiritual climate of nurses in operating room positively influences promotive focus in the regulatory focus.The regulatory focus as a whole is positively regulated by occupational call and negatively influenced by perceived stress.Therefore,nursing administrators should create a favourable spiritual climate to enhance the sense of professional call,reduce the perceived stress and increase the promotive and defensive focus among the nurses in operating room,hence to increase the nursing efficiency,thereby improving the quality of nursing care.