Objective To compare the efficacy and safety of computed tomography (CT)-guided percutaneous versus electromagnetic navigation bronchoscopy (ENB)-guided microwave ablation (MWA) for the treatment of pulmonary nodules. Methods A retrospective analysis was conducted on the data of high-risk pulmonary nodule patients who underwent MWA at the Nanjing Drum Tower Hospital between 2022 and 2023. The pathological diagnosis rate, complications, and progression-free survival (PFS) rate were compared between the CT group and the ENB group. Results There were 61 patients in the CT group, including 30 males and 31 females, with an average age of (67.22±9.13) years. There were 53 patients in the ENB group, including 29 males and 24 females, with an average age of (65.29±13.76) years. The pathological diagnosis rate in the CT group was slightly higher than that in the ENB group (88.52% vs. 71.69%, P=0.03). However, the ENB group exhibited a lower incidence of perioperative complications, including pneumothorax (16.39% vs. 3.77%, P=0.03), hemoptysis (19.67% vs. 5.66%, P=0.05), and pain (22.95% vs. 7.55%, P=0.03). There was no statistically significant difference in PFS rate between the two groups [HR=1.17, 95%CI (0.23, 5.81), P=0.85]. Conclusion Both CT-guided and ENB-guided MWA are effective treatment modalities for high-risk pulmonary nodules.

Objective:To evaluate the effect of a health management model based on the Integrated Theory of Health Behavior Change (ITHBC) on body mass index (BMI), blood lipids, quality of life, and self-management ability in elderly community-dwelling patients with chronic coronary syndrome (CCS).Methods:This randomized controlled trial enrolled elderly CCS patients attending the general outpatient clinic at Fangzhuang Community Health Service Center of Fengtai District, Beijing, between March 2023 and May 2024. Participants were randomly assigned to either an intervention group or a control group. The control group received routine care, while the intervention group received ITHBC-based health management for 12 months. Primary endpoints included BMI, blood lipid profiles (total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)), quality of life (assessed across 5 domains: disease perception, physical limitation, angina stability, angina frequency, and treatment satisfaction), and patient self-management ability (assessed across 7 domains: symptom management, harmful habit management, emergency management, disease knowledge management, daily life management, treatment adherence management, and emotional cognition management).Results:A total of 140 patients were enrolled, with the age of 71.0(67.0, 75.0) years; 85 (60.71%) were male. Seventy patients were assigned to each group. At the 12-month follow-up, levels of TC, TG, and LDL-C in the intervention group were significantly lower than those in the control group (all P<0.05). No statistically significant differences were observed in BMI or HDL-C levels between the two groups (all P>0.05). Regarding quality of life, the intervention group had a significantly lower score in the disease perception domain than the control group ( P=0.007). No significant intergroup differences were found in the scores for physical limitation, angina stability, angina frequency, or treatment satisfaction (all P>0.05). For self-management ability, the symptom management score was significantly higher in the intervention group than in the control group ( P=0.030). No significant differences were observed between the groups in the remaining self-management domains (all P>0.05). Conclusions:The ITHBC-based health management model can improve blood lipid management in elderly community-dwelling CCS patients, with superior effects compared to routine care, although it doesn′t significantly improve BMI. The model also shows potential to improve patients′ quality of life and self-management ability; however, its effects in these areas are not significantly superior to those of routine care.

Metabolic associated fatty liver disease(MAFLD)is a type of fatty liver disease associated with systemic metabolic disorders,and its prevalence has been increasing year by year,becoming a major challenge to global public health.The development of MAFLD is associated with various factors,including obesity,dyslipidemia,diabetes and other factors.Excessive body fat,particularly increased visceral adiposity,contributes to hepatic fat accumulation.Abnormal blood lipid levels can also disrupt liver fat metabolism.The risk of MAFLD in patients with diabetes is greatly increased due to insulin resistance and other problems.Dietary interventions are considered an effective strategy for the prevention and treatment of MAFLD.In recent years,several dietary patterns,such as low-carbohydrate diets,intermittent fasting,and the Mediterranean diet,have been applied in clinical practice.Their primary mechanisms include reducing oxidative stress,regulating gut microbiota,and inducing fat autophagy.However,the responses to different dietary patterns vary among individuals due to differences in genes,lifestyle,and disease severity.Therefore,systematically evaluating the effects and mechanisms of these dietary patterns in the prevention and treatment of MAFLD has significant clinical importance.This review compares the effects of different dietary patterns on improving liver function,hepatic fat content,blood glucose,and lipid levels,and analyzes their underlying mechanisms of intervention,to explore how to select personalized dietary strategies based on individual differences.It is intended to provide new insights for the precise prevention and treatment of MAFLD,thereby improving patients' outcomes and alleviating the burden on public health.

Metabolic associated fatty liver disease(MAFLD)is a type of fatty liver disease associated with systemic metabolic disorders,and its prevalence has been increasing year by year,becoming a major challenge to global public health.The development of MAFLD is associated with various factors,including obesity,dyslipidemia,diabetes and other factors.Excessive body fat,particularly increased visceral adiposity,contributes to hepatic fat accumulation.Abnormal blood lipid levels can also disrupt liver fat metabolism.The risk of MAFLD in patients with diabetes is greatly increased due to insulin resistance and other problems.Dietary interventions are considered an effective strategy for the prevention and treatment of MAFLD.In recent years,several dietary patterns,such as low-carbohydrate diets,intermittent fasting,and the Mediterranean diet,have been applied in clinical practice.Their primary mechanisms include reducing oxidative stress,regulating gut microbiota,and inducing fat autophagy.However,the responses to different dietary patterns vary among individuals due to differences in genes,lifestyle,and disease severity.Therefore,systematically evaluating the effects and mechanisms of these dietary patterns in the prevention and treatment of MAFLD has significant clinical importance.This review compares the effects of different dietary patterns on improving liver function,hepatic fat content,blood glucose,and lipid levels,and analyzes their underlying mechanisms of intervention,to explore how to select personalized dietary strategies based on individual differences.It is intended to provide new insights for the precise prevention and treatment of MAFLD,thereby improving patients' outcomes and alleviating the burden on public health.

Objective:To evaluate the effect of a health management model based on the Integrated Theory of Health Behavior Change (ITHBC) on body mass index (BMI), blood lipids, quality of life, and self-management ability in elderly community-dwelling patients with chronic coronary syndrome (CCS).Methods:This randomized controlled trial enrolled elderly CCS patients attending the general outpatient clinic at Fangzhuang Community Health Service Center of Fengtai District, Beijing, between March 2023 and May 2024. Participants were randomly assigned to either an intervention group or a control group. The control group received routine care, while the intervention group received ITHBC-based health management for 12 months. Primary endpoints included BMI, blood lipid profiles (total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)), quality of life (assessed across 5 domains: disease perception, physical limitation, angina stability, angina frequency, and treatment satisfaction), and patient self-management ability (assessed across 7 domains: symptom management, harmful habit management, emergency management, disease knowledge management, daily life management, treatment adherence management, and emotional cognition management).Results:A total of 140 patients were enrolled, with the age of 71.0(67.0, 75.0) years; 85 (60.71%) were male. Seventy patients were assigned to each group. At the 12-month follow-up, levels of TC, TG, and LDL-C in the intervention group were significantly lower than those in the control group (all P<0.05). No statistically significant differences were observed in BMI or HDL-C levels between the two groups (all P>0.05). Regarding quality of life, the intervention group had a significantly lower score in the disease perception domain than the control group ( P=0.007). No significant intergroup differences were found in the scores for physical limitation, angina stability, angina frequency, or treatment satisfaction (all P>0.05). For self-management ability, the symptom management score was significantly higher in the intervention group than in the control group ( P=0.030). No significant differences were observed between the groups in the remaining self-management domains (all P>0.05). Conclusions:The ITHBC-based health management model can improve blood lipid management in elderly community-dwelling CCS patients, with superior effects compared to routine care, although it doesn′t significantly improve BMI. The model also shows potential to improve patients′ quality of life and self-management ability; however, its effects in these areas are not significantly superior to those of routine care.

Objective:To investigate the effectiveness of a tiered progressive training model in the standardized residency training of general practice in primary care institutions.Methods:A tiered progression teaching plan was applied for 26 general practice residents who attended the rotation of general practice residency training in Beijing Fangzhuang Community Hearlth Service Center from June 2022 to May 2023. The plan defined the teaching objectives and requirements for different stages, and the Leicester Assessment Package (LAP) and narrative medicine were included in the teaching methods. The effectiveness of the tiered progression training was evaluated through a questionnaire survey on the post competency of general practice residents.Results:There were 12 primary stage residents, 9 intermediate stage residents and 5 advanced stage residents. The post-training scores of general practice residents in all three stages of residents were significantly higher than the pre-training scores ( t=-3.627,-2.073,-5.277,all P<0.05). The scores of basic medical and health services, basic public health services, information utilization ability and management ability, medical knowledge and lifelong learning, interpersonal communication and teamwork, professional quality after six post competency training were significantly higher than those before training in all three stages of residents. The scores of basic medical and health services, basic public health services, medical knowledge and lifelong learning, in primary residents were significantly improved compared with those before training ( t=-3.457,-3.428,-3.063, all P<0.05);the scores of basic public health services, interpersonal communication and teamwork, and professional quality in intermediate residents were significantly higher than those before training ( t=-2.328,-2.100,-1.997, all P<0.05); the scores of basic medical and health services, basic public health services, information utilization ability and management ability, medical knowledge and lifelong learning, interpersonal communication and teamwork, and professional quality in senior residents were significantly higher than those before training ( t=-5.707,-4.542,-2.952,-1.753,-2.705,-2.805, all P<0.05). Conclusion:The application of tiered and progressive training model in the standardized residency training is helpful to improve the post competency of general practice residents.

Objective: To explore the relation of eating behavior to family health and personality traits in adolescents, and to provide empirical support for personality based prediction of adolescents susceptibility to poor eating behavior and family intervention. Methods: A total of 563 adolescents aged 12 to 17 years old from nuclear families, who were selected from "Survey of Chinese Family Health Index(2021)". A general characteristic questionnaire, Short form of Family Health Scale, 10 item Big Five Inventory, and Short form of Sakata Eating Behavior Scale were used to collect information. The relationships of eating behavior to family health and personality traits were analyzed by structural equation modeling. Results: Group comparison indicated that there was a significant difference in scores of the big five personalities and eating behaviors among adolescents from diverse family health statuses( P <0.01). Additionally, there were significant correlations among family health, personality traits, and eating behavior( P <0.01). Structural equation modeling showed that family health resources (-0.34), conscientiousness (-0.17), extraversion ( 0.14 ), agreeableness (-0.13) directly affected eating behavior( P <0.05). Meanwhile, family external social support associated with eating behavior by affecting extraversion (0.22), and family health resources associated with eating behavior by affecting agreeableness(0.12)( P <0.05). Conclusion Not only could family health directly affect eating behavior, but it could indirectly associate with eating behavior by affecting personality traits among adolescents in nuclear families. The role of the family in improving adolescent poor eating behavior should be emphasized.

Objective:To investigate the incidence, clinical characteristics and risk factors of growth retardation in pediatric onset IBD patients.Methods:A cross-sectional study was conducted. IBD patients with the age at diagnosis younger than 18 years old were recruited and screened in the Wechat group of patients in 8 IBD medical centers across the country. Demographic, clinical and growth-related data were collected through questionnaire survey, and the incidences of growth retardation at the time of diagnosis and investigation were calculated. According to whether there was growth retardation at the time of investigation, the patients were divided into growth retardation group and non-growth retardation group. The influencing factors of growth retardation were analyzed by the univariate analysis and multivariate Logistic regression analysis.Results:A total of 97 patients were involved including 8 ulcerative colitis (UC) and 89 Crohn′s disease (CD). There was no growth retardation in UC patients. Among 89 patients with CD, there were 48 males and 41 females, and the age was 15.5 (1.0, 21.0) years old. At the time of investigation, 14 patients (15.7%) with growth retardation were set as the growth retardation group, and 75 without growth retardation were set as the non-growth retardation group. The incidence of growth retardation was 19.0% (16/84) at the time of diagnosis. Univariate analysis results showed that compared with non-growth retardation group, patients in growth retardation group had lower diagnostic age [5.0 (1.0, 13.8) years old vs. 14.0 (12.0, 16.0) years old, P = 0.003], severer disease activity ( P = 0.006), higher proportion of acute gastrointestinal perforation [28.6% (4/14) vs. 2.7% (2/75), P = 0.005], higher proportion of patients in using glucocorticoids [64.3% (9/14) vs. 33.3% (25/75), P = 0.029), and longer time of using glucocorticoids [1.5 (0, 6.5) months vs. 0 (0, 3.0) months, P = 0.040], while the proportion of patients using biological agents was lower [42.9% (6/14) vs. 80.0% (60/75), P = 0.010], and the time of using biological agents was shorter [0 (0, 6.3) months vs. 7.0 (1.0, 12.0) months, P = 0.006]. Logistic regression analysis revealed that the age at diagnosis of CD was still a risk factor for growth retardation after correcting other factors ( OR = 6.909, 95% CI: 1.250-38.195, P = 0.027) . Conclusion:The pediatric onset IBD patients with low diagnostic age are prone to growth retardation, which should be paid attention to.

Objective:To investigate the incidence, clinical characteristics and risk factors of growth retardation in pediatric onset IBD patients.Methods:A cross-sectional study was conducted. IBD patients with the age at diagnosis younger than 18 years old were recruited and screened in the Wechat group of patients in 8 IBD medical centers across the country. Demographic, clinical and growth-related data were collected through questionnaire survey, and the incidences of growth retardation at the time of diagnosis and investigation were calculated. According to whether there was growth retardation at the time of investigation, the patients were divided into growth retardation group and non-growth retardation group. The influencing factors of growth retardation were analyzed by the univariate analysis and multivariate Logistic regression analysis.Results:A total of 97 patients were involved including 8 ulcerative colitis (UC) and 89 Crohn′s disease (CD). There was no growth retardation in UC patients. Among 89 patients with CD, there were 48 males and 41 females, and the age was 15.5 (1.0, 21.0) years old. At the time of investigation, 14 patients (15.7%) with growth retardation were set as the growth retardation group, and 75 without growth retardation were set as the non-growth retardation group. The incidence of growth retardation was 19.0% (16/84) at the time of diagnosis. Univariate analysis results showed that compared with non-growth retardation group, patients in growth retardation group had lower diagnostic age [5.0 (1.0, 13.8) years old vs. 14.0 (12.0, 16.0) years old, P = 0.003], severer disease activity ( P = 0.006), higher proportion of acute gastrointestinal perforation [28.6% (4/14) vs. 2.7% (2/75), P = 0.005], higher proportion of patients in using glucocorticoids [64.3% (9/14) vs. 33.3% (25/75), P = 0.029), and longer time of using glucocorticoids [1.5 (0, 6.5) months vs. 0 (0, 3.0) months, P = 0.040], while the proportion of patients using biological agents was lower [42.9% (6/14) vs. 80.0% (60/75), P = 0.010], and the time of using biological agents was shorter [0 (0, 6.3) months vs. 7.0 (1.0, 12.0) months, P = 0.006]. Logistic regression analysis revealed that the age at diagnosis of CD was still a risk factor for growth retardation after correcting other factors ( OR = 6.909, 95% CI: 1.250-38.195, P = 0.027) . Conclusion:The pediatric onset IBD patients with low diagnostic age are prone to growth retardation, which should be paid attention to.

Objective:To explore the application of three-dimensional (3D) printing technology in oral and maxillofacial surgery, so as to optimize and standardize its design and application.Methods:From January 2010 to December 2020, 40 cases of mandibular tumor surgery (20 cases of conventional group and 20 cases of guide plate group), 20 cases of temporomandibular joint replacement surgery (10 cases of conventional group and 10 cases of guide plate group), 20 cases of malocclusion surgery (10 cases of conventional group and 10 cases of guide plate group), 20 cases of radioactive particle implantation surgery (10 cases of CT guided group and 10 cases of guide plate group) were analyzed. All patients in the guide plate group were scanned with spiral CT, and the 3D models of the jaw and the donor bone area were reconstruction. According to the purpose of surgical guide, the design and clinical application of osteotomy guide, in place forming guide and puncture positioning guide were analyzed respectively. The design time of guide plate, the performance and printing time of guide material, the sterilization method of guide and its influence on accuracy, and the influence of guide application on operation time and accuracy were analyzed.Results:The design time of orthognathic guide plate was (2.9±1.8) d, and the design time of mandibular transplantation guide plate was (2.8±1.8) d, that of the temporomandibular joint replacement guide plate and the puncture guide plate was (2.2±0.3) and (0.9±0.3) d. The average printing time of the 40 maxilla model was (11.1±1.6) h, and that of the 40 mandible models was (2.6±0.4) h. The average printing time of the 40 sets of osteotomy and positioning guide plate was (2.5±0.8) h, and that of the 10 puncture positioning guide plate (1.1±0.4) h. The operation time of the conventional group was (6.99±1.10) and (6.02±0.55) h. In the CT guided group, the operation time was (1.91±0.55) h and (0.89±0.15). The operation time of mandible tumor operation and radioactive particle implantation in the guide plate group was less than that in the control group ( P<0.05), and there was no significant difference in the operation time of orthognathic surgery and joint replacement between the two groups ( P>0.05). The displacement distance of the mark points in the TMJ replacement and mandibular tumor operation guide group was less than that in the control group ( P<0.05), and the error of the guide plate in orthognathic operation and particle implantation operation was basically less than 1 mm. Conclusions:The application of the surgical guide plate made by 3D printing technology helps to complete the operation more safely, accurately and quickly, But its design, manufacture and disinfection still need to be further standardized and improved.