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 This study aims to explore the impact of esketamine combined with hip pericapsular nerve block on perioperative stress reactions,immune function,cognitive function,and postoperative analgesic efficacy in elderly patients undergoing total hip replacement.Methods From February 2022 to February 2025,110 elderly patients who received total hip arthroplasty in the hospital were enrolled as the research participants.They were allocated into a control group and an observation group by means of a random number table,with 55 cases in each group.All patients received total hip arthroplasty.Patients in the control group were given 20 mL of ropivacaine combined with pericapsular nerve block anesthesia of the hip joint,while those in the observation group were given esketamine combined with pericapsular nerve block anesthesia of the hip joint.The blood pres-sure,heart rate(HR),oxygen saturation(SpO?),and respiratory rate(RR)of the two groups were compared at admission(T1),immediately after anesthesia(T2),skin incision(T3),30 minutes after surgery initiation(T4),incision suture(T5),and immediately after surgery completion(T6).Both groups underwent detection,assess-ment,and comparison of immune function indices,serum stress markers,and cognitive function scores before the operation and 3 days post-surgery.The Visual Analogue Scale(VAS)pain scores at 3,6,and 9 hours after surgery were contrasted between the two groups.Additionally,statistical analysis was performed on the incidence of adverse reactions in both groups.Results The HR,mean arterial pressure(MAP),SpO?,RR,and bispectral index(BIS)of the two groups from T1 to T6 were compared using repeated measures analysis of variance.The results showed that:(1)There were statistically significant differences in HR,MAP,SpO?,and BIS at different time points(F=118.378,70.002,44.910,242.439,all P<0.001).(2)There were statistically significant differences in HR,MAP,SpO?,and BIS between the observation group and the control group(F=206.643,195.586,93.077,3.953,P<0.001,P<0.001,P<0.001,P=0.049).(3)There were statistically significant differences in the changing trends of HR,MAP,SpO?,RR,and BIS between the two groups(F=18.583,14.158,23.350,4.883,6.698,all P<0.001).At 3 days after surgery,the levels of CD4? and CD4?/CD8? in the observation group were lower than those in the control group(P<0.05).The levels of malondialdehyde(MDA),superoxide dismutase(SOD),and cortisol in the observation group were lower than those in the control group during surgery and immediately after surgery(P<0.05).The Montreal Cognitive Assessment(MoCA)scores and Mini-Mental State Examination(MMSE)scores of both groups decreased 3 days after surgery,and those in the observation group were higher than those in the control group(P<0.05).The VAS pain scores of the observation group at 3,6,9 and 12 hours after surgery were lower than those of the control group.The incidence of adverse reactions in the observation group was lower than that in the control group(12.73%vs.29.09%,P<0.05).Conclusion Esketamine combined with pericapsular nerve block of the hip joint can significantly inhibit the perioperative stress response in elderly patients undergoing total hip arthroplasty,optimize the postoperative anal-gesic effect,and reduce the incidence of adverse reactions.

Objective To establish a flow cytometry method for detecting C1s protein on platelet surface and preliminarily explore its potential application value in the auxiliary diagnosis of primary immune thrombocytopenia(ITP).Methods C1s-conjugated 2 μm car-boxylated magnetic beads(C1s beads)were prepared and used as quality control particles.Fluorescein isothiocyanate(FITC)-labeled anti-C1s antibody was employed as the detection antibody to develop a flow cytometric assay for detecting C1s protein expression on platelets.The intra-assay and inter-assay precision,as well as the dilution linearity of the method,were evaluated.Subsequently,the expression levels of C1 s protein on the surface of platelets were compared among the ITP group,the non-ITP thrombocytopenia group,and the healthy control group.Results Light microscopy showed that both unconjugated carboxylated magnetic beads(blank beads)and C1s-conjugated beads were uniformly dispersed without aggregation.Under fluorescence microscopy,C1s beads exhibited strong yellow-green fluorescence,whereas the blank beads showed no fluorescence signal.The established flow cytometry assay exhibited ac-ceptable precision,with intra-assay coefficient of variation(CV)values of 7.02％,7.12％,and 3.91％for low,medium,and high con-centrations of C1s beads,respectively,and inter-assay CV values of 13.49％,6.15％,and 0.78％,respectively.The dilution linearity was satisfactory,coefficient of determination(R2)=0.998 8.Clinical sample testing revealed that the proportion of C1s-positive plate-lets in ITP group(2.56±0.79)％was significantly higher than that in healthy control group(0.23±0.18)％and the non-ITP thrombo-cytopenia control group(0.22±0.10)％,with statistically significant differences(both P＜0.05).Conclusion This study successfully established a stable and reliable flow-cytometry method for quantifying C1s expression on platelet surface and preliminarily demonstrated that C1s expression is significantly elevated on platelets of ITP patients,suggesting that C1s could serve as a potential auxiliary diag-nostic marker for ITP.

Objective To construct a quality control model for cervical liquid-based thin cell smears using two different artificial intelligence(AI)techniques and to compare the total use of the two methods to improve the level of quality control of cervical liquid-based thin cell smears through the assistance of hybrid AI.Methods In this study,105 cervical liquid-based thin cell smear samples were used.Convolutional neural network(CNN)algorithm and Transformer network algorithm were used as specific AI algorithms in the AI model.The labeled features included the number of cells in the slice,excessive red blood cells,excessive inflammatory cells,and air bubbles.The smear samples were pre-processed and digitized by smear,followed by image segmentation and feature extraction.Using the labeled feature data,machine learning models were trained and optimized.Statistical AI and physician QC results were analyzed by calculating KAPPA index,sensitivity,specificity,area under the curve(AUC),and other indexes for AI QC results.Results CNN algorithm QC results in normal smear,inflammatory background and bloody background were significantly different from the expert review QC results(P＜0.001).Transformer algorithm QC results were similar to the expert review results,with no statistical difference(P＞0.05).General practitioner QC results were statistically different from the expert review QC results in normal smear detection rate and bloody background(P＜0.001).CNN algorithm Kappa value was 0.567,which had medium consistency with expert review results.Transformer algorithm Kappa value was 0.890,with the best consistency with expert review results.General practitioner Kappa value was 0.675,which had better consistency with expert review results.Using the expert review results as a reference standard,the predictive efficacy of the Transformer algorithm and the general practitioners' QC results was evaluated,and the predictive efficacy of the Transformer algorithm was higher than that of the general practitioners in detecting hemorrhagic backgrounds and normal smears(inflammatory backgrounds:AUC=1.000;normal smears:AUC=0.768)(hemorrhagic backgrounds:AUC=0.849;normal smears:AUC=0.849;normal smear:AUC=0.500).Conclusion In this study,we found that the Transformer algorithm was effective in improving the quality control of cervical liquid-based thin-layer cell smears by assisting doctors to perform smear quality control scoring and improving the efficiency and accuracy of smear sample quality control.It can be used as a new quality control method for cervical cancer cytological screening and has potential clinical applications.

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 evaluate the prognostic value of droplet digital PCR(ddPCR)in conjunction with multiparametric flow cytometry(MFC)for measurable residual disease(MRD)detection in predicting relapse risk in patients with acute myeloid leukemia(AML).Methods:In this retrospective cohort study,we have analyzed 78 newly diagnosed patients with AML who underwent combined MRD monitoring using MFC and ddPCR at The Affiliated Hospital of Hebei University(January 2018-January 2025).Clinical outcomes-including MRD negativity rates,cumulative incidence of relapse(CIR),relapse-free survival(RFS),and overall survival(OS)-were systematically evaluated.Prognostic discrim-ination between the MRD-negative and MRD-positive subgroups was compared across standalone and combined detection approaches.Results:With a median follow-up of 17 months(range:2.4-86.7)and a median of one mutation tracked per patient(range:1-3),both MFC-MRD and ddPCR-MRD negative subgroups demonstrated superior 2-year RFS compared with MRD-positive counterparts.Notably,com-bined MFC/ddPCR monitoring enhanced prognostic discrimination,with MRD-negative patients achieving significantly prolonged 2-year RFS compared with MRD-positive patients.MFC-MRD negativity independently predicted improved 2-year OS.Conclusion:ddPCR-based multi-gene MRD profiling provides significant independent prognostic value in patients with AML.The synergistic application of MFC and ddPCR enables superior predictive accuracy for relapse risk and survival outcomes,supporting its integration into standardized MRD monitoring protocols.

Objective This study aims to explore the impact of esketamine combined with hip pericapsular nerve block on perioperative stress reactions,immune function,cognitive function,and postoperative analgesic efficacy in elderly patients undergoing total hip replacement.Methods From February 2022 to February 2025,110 elderly patients who received total hip arthroplasty in the hospital were enrolled as the research participants.They were allocated into a control group and an observation group by means of a random number table,with 55 cases in each group.All patients received total hip arthroplasty.Patients in the control group were given 20 mL of ropivacaine combined with pericapsular nerve block anesthesia of the hip joint,while those in the observation group were given esketamine combined with pericapsular nerve block anesthesia of the hip joint.The blood pres-sure,heart rate(HR),oxygen saturation(SpO?),and respiratory rate(RR)of the two groups were compared at admission(T1),immediately after anesthesia(T2),skin incision(T3),30 minutes after surgery initiation(T4),incision suture(T5),and immediately after surgery completion(T6).Both groups underwent detection,assess-ment,and comparison of immune function indices,serum stress markers,and cognitive function scores before the operation and 3 days post-surgery.The Visual Analogue Scale(VAS)pain scores at 3,6,and 9 hours after surgery were contrasted between the two groups.Additionally,statistical analysis was performed on the incidence of adverse reactions in both groups.Results The HR,mean arterial pressure(MAP),SpO?,RR,and bispectral index(BIS)of the two groups from T1 to T6 were compared using repeated measures analysis of variance.The results showed that:(1)There were statistically significant differences in HR,MAP,SpO?,and BIS at different time points(F=118.378,70.002,44.910,242.439,all P<0.001).(2)There were statistically significant differences in HR,MAP,SpO?,and BIS between the observation group and the control group(F=206.643,195.586,93.077,3.953,P<0.001,P<0.001,P<0.001,P=0.049).(3)There were statistically significant differences in the changing trends of HR,MAP,SpO?,RR,and BIS between the two groups(F=18.583,14.158,23.350,4.883,6.698,all P<0.001).At 3 days after surgery,the levels of CD4? and CD4?/CD8? in the observation group were lower than those in the control group(P<0.05).The levels of malondialdehyde(MDA),superoxide dismutase(SOD),and cortisol in the observation group were lower than those in the control group during surgery and immediately after surgery(P<0.05).The Montreal Cognitive Assessment(MoCA)scores and Mini-Mental State Examination(MMSE)scores of both groups decreased 3 days after surgery,and those in the observation group were higher than those in the control group(P<0.05).The VAS pain scores of the observation group at 3,6,9 and 12 hours after surgery were lower than those of the control group.The incidence of adverse reactions in the observation group was lower than that in the control group(12.73%vs.29.09%,P<0.05).Conclusion Esketamine combined with pericapsular nerve block of the hip joint can significantly inhibit the perioperative stress response in elderly patients undergoing total hip arthroplasty,optimize the postoperative anal-gesic effect,and reduce the incidence of adverse reactions.

Objective To establish a flow cytometry method for detecting C1s protein on platelet surface and preliminarily explore its potential application value in the auxiliary diagnosis of primary immune thrombocytopenia(ITP).Methods C1s-conjugated 2 μm car-boxylated magnetic beads(C1s beads)were prepared and used as quality control particles.Fluorescein isothiocyanate(FITC)-labeled anti-C1s antibody was employed as the detection antibody to develop a flow cytometric assay for detecting C1s protein expression on platelets.The intra-assay and inter-assay precision,as well as the dilution linearity of the method,were evaluated.Subsequently,the expression levels of C1 s protein on the surface of platelets were compared among the ITP group,the non-ITP thrombocytopenia group,and the healthy control group.Results Light microscopy showed that both unconjugated carboxylated magnetic beads(blank beads)and C1s-conjugated beads were uniformly dispersed without aggregation.Under fluorescence microscopy,C1s beads exhibited strong yellow-green fluorescence,whereas the blank beads showed no fluorescence signal.The established flow cytometry assay exhibited ac-ceptable precision,with intra-assay coefficient of variation(CV)values of 7.02％,7.12％,and 3.91％for low,medium,and high con-centrations of C1s beads,respectively,and inter-assay CV values of 13.49％,6.15％,and 0.78％,respectively.The dilution linearity was satisfactory,coefficient of determination(R2)=0.998 8.Clinical sample testing revealed that the proportion of C1s-positive plate-lets in ITP group(2.56±0.79)％was significantly higher than that in healthy control group(0.23±0.18)％and the non-ITP thrombo-cytopenia control group(0.22±0.10)％,with statistically significant differences(both P＜0.05).Conclusion This study successfully established a stable and reliable flow-cytometry method for quantifying C1s expression on platelet surface and preliminarily demonstrated that C1s expression is significantly elevated on platelets of ITP patients,suggesting that C1s could serve as a potential auxiliary diag-nostic marker for ITP.

Objective This study aims to analyze the factors influencing per capita current health expenditure in Guizhou Province from 2016 to 2022 using the gray correlation analysis method.Methods Based on the"SHA2011"accounting results of current health expenditure in Guizhou Province,as well as data from the"Guizhou Statistical Yearbook"and"Guizhou Health Statistical Yearbook",the gray correlation analysis method was used to analyze the factors influencing per capita current health expenditure in Guizhou Province from 2016 to 2022.Results The factors with the highest correlation to per capita current health expenditure in Guizhou Province were health expenditure(0.829),followed by the number of health technical personnel per thousand people(0.715),the number of practicing(assistant)physicians per thousand people(0.705),and per capita GDP(0.704).The factor with the lowest correlation was the proportion of the tertiary industry to GDP(0.543).Conclusion Health expenditure investment has the strongest correlation with per capita current health expenditure in Guizhou Province.Health re-source investment and health service capacity are the main influencing factors of per capita current health expenditure in Guizhou Province.At the same time,the impact of economic and social factors on current health expenditure should be fully recognized.

Objective To construct a quality control model for cervical liquid-based thin cell smears using two different artificial intelligence(AI)techniques and to compare the total use of the two methods to improve the level of quality control of cervical liquid-based thin cell smears through the assistance of hybrid AI.Methods In this study,105 cervical liquid-based thin cell smear samples were used.Convolutional neural network(CNN)algorithm and Transformer network algorithm were used as specific AI algorithms in the AI model.The labeled features included the number of cells in the slice,excessive red blood cells,excessive inflammatory cells,and air bubbles.The smear samples were pre-processed and digitized by smear,followed by image segmentation and feature extraction.Using the labeled feature data,machine learning models were trained and optimized.Statistical AI and physician QC results were analyzed by calculating KAPPA index,sensitivity,specificity,area under the curve(AUC),and other indexes for AI QC results.Results CNN algorithm QC results in normal smear,inflammatory background and bloody background were significantly different from the expert review QC results(P＜0.001).Transformer algorithm QC results were similar to the expert review results,with no statistical difference(P＞0.05).General practitioner QC results were statistically different from the expert review QC results in normal smear detection rate and bloody background(P＜0.001).CNN algorithm Kappa value was 0.567,which had medium consistency with expert review results.Transformer algorithm Kappa value was 0.890,with the best consistency with expert review results.General practitioner Kappa value was 0.675,which had better consistency with expert review results.Using the expert review results as a reference standard,the predictive efficacy of the Transformer algorithm and the general practitioners' QC results was evaluated,and the predictive efficacy of the Transformer algorithm was higher than that of the general practitioners in detecting hemorrhagic backgrounds and normal smears(inflammatory backgrounds:AUC=1.000;normal smears:AUC=0.768)(hemorrhagic backgrounds:AUC=0.849;normal smears:AUC=0.849;normal smear:AUC=0.500).Conclusion In this study,we found that the Transformer algorithm was effective in improving the quality control of cervical liquid-based thin-layer cell smears by assisting doctors to perform smear quality control scoring and improving the efficiency and accuracy of smear sample quality control.It can be used as a new quality control method for cervical cancer cytological screening and has potential clinical applications.