The spread of antibiotic resistance genes(ARGs)poses a serious threat to global public health.Recent studies have shown that in addition to the difficulty in antibiotic selection,many non-anti-biotic environmental pollutants,such as microplastics,heavy metals,nanomaterials and non-antibiotic drugs,can accelerate the spread of ARGs.This paper begins by outlining the influence of non-antibiotic environmental pollutants on the conjugative transfer of ARGs.Then,the mechanisms of ARGs are analyzed from the perspective of molecular biology,which include inducing the generation of large amounts of reactive oxygen radicals,triggering cellular oxidative stress,increasing intercellular contact,altering the permeability of cell membranes,affecting energy metabolism,triggering group sensing effects,and regulating the expression of genes related to the transfer of ARGs.Finally,the limitations of current studies are presented,and tips are given about future research.In conclusion,the effects of non-antibi-otic environmental pollutants on the spread and dispersal of ARGs need to be studied more extensively.

The spread of antibiotic resistance genes(ARGs)poses a serious threat to global public health.Recent studies have shown that in addition to the difficulty in antibiotic selection,many non-anti-biotic environmental pollutants,such as microplastics,heavy metals,nanomaterials and non-antibiotic drugs,can accelerate the spread of ARGs.This paper begins by outlining the influence of non-antibiotic environmental pollutants on the conjugative transfer of ARGs.Then,the mechanisms of ARGs are analyzed from the perspective of molecular biology,which include inducing the generation of large amounts of reactive oxygen radicals,triggering cellular oxidative stress,increasing intercellular contact,altering the permeability of cell membranes,affecting energy metabolism,triggering group sensing effects,and regulating the expression of genes related to the transfer of ARGs.Finally,the limitations of current studies are presented,and tips are given about future research.In conclusion,the effects of non-antibi-otic environmental pollutants on the spread and dispersal of ARGs need to be studied more extensively.

OBJECTIVE: This study aimed to explore the association between body mass index (BMI) and mortality based on the 10-year population-based multicenter prospective study. METHODS: A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023. Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality. Stratified analyses were performed based on the individual characteristics of the participants. RESULTS: Overall, 19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died. The underweight (< 18.5 kg/m ²) presented an increase in all-cause mortality (adjusted hazards ratio [ aHR] = 2.00, 95% confidence interval [ CI]: 1.66-2.41), while overweight (≥ 24.0 to < 28.0 kg/m ²) and obesity (≥ 28.0 kg/m ²) presented a decrease with an aHR of 0.61 (95% CI: 0.52-0.73) and 0.51 (95% CI: 0.37-0.70), respectively. Overweight ( aHR = 0.76, 95% CI: 0.67-0.86) and mild obesity ( aHR = 0.72, 95% CI: 0.59-0.87) had a positive impact on mortality in people older than 60 years. All-cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m ² ( aHR = 0.95, 95% CI: 0.92-0.98) and increased slightly above that value, indicating a U-shaped association. The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses. CONCLUSION This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years. Therefore, it is essential to consider age differences when formulating health and weight management strategies.
Humans ; Body Mass Index ; China/epidemiology* ; Male ; Female ; Middle Aged ; Prospective Studies ; Rural Population/statistics & numerical data* ; Aged ; Follow-Up Studies ; Adult ; Mortality ; Cause of Death ; Obesity/mortality* ; Overweight/mortality*

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 investigate the influencing factors associated with the risk of positive methylation levels of SHOX2/RASSF1A/PTGER4 genes in patients with pulmonary nodules with TCM susceptibility.Methods Using a cross-sectional study method,totally 165 patients with pulmonary nodules from the Respiratory Department of Wangjing Hospital,China Academy of Chinese Medical Sciences were included from May 2024 to December 2024.Clinical data such as patients'general medical history,nodule imaging reports,lung cancer gene methylation levels,and TCM constitution assessments were organized and statistically analyzed.On the basis of exploring the correlation between various variables and the risk of positive methylation of lung cancer genes through univariate correlation analysis,a binary logistic regression model was used for independent risk factor analysis.Results Univariate correlation analysis showed that age,gender,TCM susceptibility score,diameter of pulmonary nodules and upper lobe of the right lung were correlated with positive methylation levels of the SHOX2/RASSF1A/PTGER4 genes(P=0.03,P=0.02,P=0.01,P<0.01,P=0.03);and binary Logistic regression analysis showed that yang-deficiency quality,qi deficiency,qi depression and phlegm-dampness,the four pulmonary nodules susceptibility body scores were significantly and positively correlated with the risk of SHOX2/RASSF1A/PTGER4 gene methylation positivity.Compared with yang deficiency,phlegm-dampness and qi depression had a higher risk of gene methylation positivity for patients with pulmonary nodules(P=0.04,P=0.02).Conclusion Older age,males,and TCM susceptibility body correlated with the lung cancer gene methylation positive risk are correlated,in which phlegm dampness and qi depression are independent risk factors.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective To investigate the influencing factors associated with the risk of positive methylation levels of SHOX2/RASSF1A/PTGER4 genes in patients with pulmonary nodules with TCM susceptibility.Methods Using a cross-sectional study method,totally 165 patients with pulmonary nodules from the Respiratory Department of Wangjing Hospital,China Academy of Chinese Medical Sciences were included from May 2024 to December 2024.Clinical data such as patients'general medical history,nodule imaging reports,lung cancer gene methylation levels,and TCM constitution assessments were organized and statistically analyzed.On the basis of exploring the correlation between various variables and the risk of positive methylation of lung cancer genes through univariate correlation analysis,a binary logistic regression model was used for independent risk factor analysis.Results Univariate correlation analysis showed that age,gender,TCM susceptibility score,diameter of pulmonary nodules and upper lobe of the right lung were correlated with positive methylation levels of the SHOX2/RASSF1A/PTGER4 genes(P=0.03,P=0.02,P=0.01,P<0.01,P=0.03);and binary Logistic regression analysis showed that yang-deficiency quality,qi deficiency,qi depression and phlegm-dampness,the four pulmonary nodules susceptibility body scores were significantly and positively correlated with the risk of SHOX2/RASSF1A/PTGER4 gene methylation positivity.Compared with yang deficiency,phlegm-dampness and qi depression had a higher risk of gene methylation positivity for patients with pulmonary nodules(P=0.04,P=0.02).Conclusion Older age,males,and TCM susceptibility body correlated with the lung cancer gene methylation positive risk are correlated,in which phlegm dampness and qi depression are independent risk factors.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

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 investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]