Objective:To investigate the association of blood lipids and body mass index (BMI) with hyperuricemia (HUA) in the elderly.Methods:It was a cross-sectional study. A total of 114 391 elderly individuals received health examinations at primary healthcare institutions in Wujin District from January to December in 2022. The health examination included questionnaire survey, physical examination and laboratory examination. The multivariate logistic regression and restricted cubic spline (RCS) plots were used to analyze the association and dose-response relationship of blood lipid and BMI with HUA. The mediating effect model was used to explore the mediation effect of BMI on the association between blood lipid and HUA.Results:Among the 112 415 subjects, 18 506 (16.46%) were checked with HUA. After adjusting for relevant confounders, total cholesterol (TC) ( OR=1.20, 95% CI: 1.16-1.23), triglyceride (TG) ( OR=1.46, 95% CI: 1.44-1.49), high density lipoprotein cholesterol (HDL-C) ( OR=0.74, 95% CI: 0.73-0.76), low density lipoprotein cholesterol (LDL-C) ( OR=1.14, 95% CI: 1.12-1.15) and BMI ( OR=1.42, 95% CI: 1.39-1.44) were all associated with HUA (all P0.05). The RCS analysis revealed that TG, HDL-C, and LDL-C each exhibited a nonlinear dose-response relationship with HUA, the inflection points was 3.00 mmol/L, 1.57 mmol/L and 2.50 mmol/L, respectively (all P-nonlinear0.001). The results of interaction showed that there were additive interaction between high TC( S=1.27 , 95% CI: 1.17-1.37), high TG( S=1.32 , 95% CI: 1.25-1.40), high LDL-C( S=1.23 , 95% CI: 1.14-1.34) and overweight/obesity with HUA (all P0.05). The results of mediation effect analysis showed that the mediation effect of BMI on the association between blood lipids (HDL-C, LDL-C, TG and TC) and HUA, from high to low, were as follows: 22.5% (95% CI: 20.8%-24.2%), 13.9% (95% CI: 12.0%-16.2%), 13.5% (95% CI: 12.7%-14.4%) and-3.9% (95% CI:-6.6%--1.8%). Conclusion:The blood lipid levels and BMI are positively correlated with HUA in the elderly.

Purpose To explore the clinical and imaging characteristics of central nervous system candidiasis due to Candida albicans in immunocompetent infants children.Materials and Methods A retrospective analysis was conducted on immunocompetent children with central nervous system candidiasis diagnosed at Beijing Children's Hospital,Capital Medical University from October 2012 to October 2022,and their clinical and MRI characteristics were analyzed.Results Among the 26 enrolled children,88.5%(23 cases)were under one year old,and 88.5%(23 cases)had high-risk factors.Premature birth was the most common high-risk factor(16 cases,61.5%).All 26 cases had positive MRI examinations,with the main manifestations being meningeal thickening and enhancement(25 cases,96.2%),57.7%(15 cases)involving the skull base meninges,23.1%(six cases)involving the cranial nerves,intracranial localized granulomas(16 cases,61.5%),hydrocephalus(14 cases,53.8%),cerebral infarction(four cases,15.4%),subdural effusion(six cases,23.1%)and cerebral abscess(two cases,7.7%);13 cases of magnetic resonance angiography and magnetic resonance venography examinations were performed,and 10 cases of magnetic resonance angiography abnormalities were found,mainly due to thinning,narrowing or reduced branches of the arterial trunk,and one case of magnetic resonance venography transverse sinus thrombosis.Conclusion Central nervous system candidiasis mostly exists in children younger than one year old.MR imaging shows a more characteristic invasion of the skull base,often causing enhancement of the skull base meninges and cranial nerves,as well as localized granulomas and hydrocephalus.Imaging examination is of great significance for early diagnosis.

Objective The aim is to understand the common scenarios of non-medical use of prescription opioids(NMUPO)and analyze the potential facilitating and hindering factors in the regulatory process of NMUPO from the perspective of healthcare professionals.Methods Healthcare professionals in local hospitals were surveyed through a two-stage purposive sampling from June to August 2022 in Ningbo,China.The survey was conducted using a semi-structured questionnaire on topics,and thematic analysis were used to identify and summarise key themes and patterns.Results A total of 75 participants were included,the average age was(43.9±7.2)years,and 54(72.0%)were male.The most common NMUPO scenarios involved middle-aged males pretending acute severe pain to obtain injectable opioids.The facilitating and hindering factors related to the regulation of NMUPO can be categorized into three types:institutional governance,technical support,and individual behaviors.At the institutional level,facilitating factors included strict national prescribing policies and local"narcotic drug card"systems,while barriers comprised incomplete lists of controlled substances.At the technological support level,facilitating factors included the establishment of regional health information platforms,while barriers included the lack of standardized prescription guidelines and diagnostic decision-support tools.At the individual level,facilitating factors included the public's cautious attitude toward drug misuse,while barriers included strained doctor-patient relationships.Conclusion China still faces significant challenges in addressing NMUPO and urgently needs to improve the existing regulatory system.It is recommended that reforms be carried out in areas such as pharmaceutical control mechanisms,drug treatment and rehabilitation services,preventive health education activities,and the optimized use of health information systems.

With the rapid development of medical big data and artificial intelligence,Clinical Prediction Models(CPMs)have become pivotal tools for disease prevention,diagnosis,and treatment.Current research predominantly focuses on the economic analysis of pharmacological or public health interventions,yet a comprehensive methodological framework for the economic evaluation of CPMs has been notably absent.The Guidelines for Economic Evaluation of Clinical Prediction Models(hereafter the Guidelines),jointly initiated by the Chinese Research Hospital Association and Peking University,Tsinghua University,and Capital Medical University,adheres to the WHO Handbook for Guideline Development and the Reporting Items for Practice Guidelines in Healthcare(RIGHT)standards.A multidisciplinary collaboration,including a steering committee,expert panel,secretariat,and external review group,was established to develop the guideline following evidence-based principles and procedures.Consensus recommendations were formulated through the Delphi method.It describes the background,objectives,target group,and the development methodology and process,ensuring the entire compilation process of the Guidelines is transparent and standardized.Through comprehensive evidence retrieval,systematic evidence appraisal,and a scientific approach to forming recommendations,the scientific rigor and validity of the Guidelines were further enhanced.

Objective:To explore the potential profile characteristics of cancer-related worries in patients after surgery for early-stage lung cancer, and the influencing factors of different categories, provide reference for patients to formulate individualized rehabilitation programs and psychological intervention measures.Methods:A cross-sectional survey method was used to conveniently select patients who received outpatient follow-up after lung cancer surgery at Shanghai Pulmonary Hospital Affiliated to Tongji University from October 2022 to October 2023 as the survey subjects. The general information questionnaire, the Chinese version of Brief Cancer-related Worry Inventory, the Chinese version of the MD Anderson Symptom Inventory, Brief Illness Perception Questionnaire, 10-item Connor Davidson Resilience Scale and Medical Coping Modes Questionnaire were examined. Latent profile analysis was performed on the cancer-related worry scores of lung cancer surgery patients, and its influencing factors were explored by binary Logistic regression analysis.Results:A total of 302 patients after lung cancer surgery were included, including 111 males and 191 females, aged 18-83(52.73 ± 13.07) years, and the Chinese version of the Brief Cancer-related Worry Inventory scored 380.00 (130.00, 720.00) points. The cancer-related worry of patients after lung cancer surgery could be divided into two potential profile categories: "high worry type" (138 patients accounted for 45.70%) and "low worry type" (164 patients accounted for 54.30%). Symptom burden ( OR=1.055, 95% CI 1.039-1.072), illness perception ( OR=1.190, 95% CI 1.127-1.256), resilience ( OR=0.933, 95% CI 0.886-0.983), and coping modes of confrontation ( OR=0.857, 95% CI 0.757-0.971) and acceptance-resignation ( OR=1.247, 95% CI 1.050-1.481) were influencing factors for grouping cancer related worry profiles (all P<0.05). Conclusions:There was significant heterogeneity in the level of cancer-related worries among patients after surgery for early-stage lung cancer. It is recommended that medical staff provide targeted continuity care measures based on the characteristics of worries of different categories of patients to improve patients' postoperative mental health and quality of life.

With the rapid development of medical big data and artificial intelligence,Clinical Prediction Models(CPMs)have become pivotal tools for disease prevention,diagnosis,and treatment.Current research predominantly focuses on the economic analysis of pharmacological or public health interventions,yet a comprehensive methodological framework for the economic evaluation of CPMs has been notably absent.The Guidelines for Economic Evaluation of Clinical Prediction Models(hereafter the Guidelines),jointly initiated by the Chinese Research Hospital Association and Peking University,Tsinghua University,and Capital Medical University,adheres to the WHO Handbook for Guideline Development and the Reporting Items for Practice Guidelines in Healthcare(RIGHT)standards.A multidisciplinary collaboration,including a steering committee,expert panel,secretariat,and external review group,was established to develop the guideline following evidence-based principles and procedures.Consensus recommendations were formulated through the Delphi method.It describes the background,objectives,target group,and the development methodology and process,ensuring the entire compilation process of the Guidelines is transparent and standardized.Through comprehensive evidence retrieval,systematic evidence appraisal,and a scientific approach to forming recommendations,the scientific rigor and validity of the Guidelines were further enhanced.

Purpose To explore the clinical and imaging characteristics of central nervous system candidiasis due to Candida albicans in immunocompetent infants children.Materials and Methods A retrospective analysis was conducted on immunocompetent children with central nervous system candidiasis diagnosed at Beijing Children's Hospital,Capital Medical University from October 2012 to October 2022,and their clinical and MRI characteristics were analyzed.Results Among the 26 enrolled children,88.5%(23 cases)were under one year old,and 88.5%(23 cases)had high-risk factors.Premature birth was the most common high-risk factor(16 cases,61.5%).All 26 cases had positive MRI examinations,with the main manifestations being meningeal thickening and enhancement(25 cases,96.2%),57.7%(15 cases)involving the skull base meninges,23.1%(six cases)involving the cranial nerves,intracranial localized granulomas(16 cases,61.5%),hydrocephalus(14 cases,53.8%),cerebral infarction(four cases,15.4%),subdural effusion(six cases,23.1%)and cerebral abscess(two cases,7.7%);13 cases of magnetic resonance angiography and magnetic resonance venography examinations were performed,and 10 cases of magnetic resonance angiography abnormalities were found,mainly due to thinning,narrowing or reduced branches of the arterial trunk,and one case of magnetic resonance venography transverse sinus thrombosis.Conclusion Central nervous system candidiasis mostly exists in children younger than one year old.MR imaging shows a more characteristic invasion of the skull base,often causing enhancement of the skull base meninges and cranial nerves,as well as localized granulomas and hydrocephalus.Imaging examination is of great significance for early diagnosis.

Objective The aim is to understand the common scenarios of non-medical use of prescription opioids(NMUPO)and analyze the potential facilitating and hindering factors in the regulatory process of NMUPO from the perspective of healthcare professionals.Methods Healthcare professionals in local hospitals were surveyed through a two-stage purposive sampling from June to August 2022 in Ningbo,China.The survey was conducted using a semi-structured questionnaire on topics,and thematic analysis were used to identify and summarise key themes and patterns.Results A total of 75 participants were included,the average age was(43.9±7.2)years,and 54(72.0%)were male.The most common NMUPO scenarios involved middle-aged males pretending acute severe pain to obtain injectable opioids.The facilitating and hindering factors related to the regulation of NMUPO can be categorized into three types:institutional governance,technical support,and individual behaviors.At the institutional level,facilitating factors included strict national prescribing policies and local"narcotic drug card"systems,while barriers comprised incomplete lists of controlled substances.At the technological support level,facilitating factors included the establishment of regional health information platforms,while barriers included the lack of standardized prescription guidelines and diagnostic decision-support tools.At the individual level,facilitating factors included the public's cautious attitude toward drug misuse,while barriers included strained doctor-patient relationships.Conclusion China still faces significant challenges in addressing NMUPO and urgently needs to improve the existing regulatory system.It is recommended that reforms be carried out in areas such as pharmaceutical control mechanisms,drug treatment and rehabilitation services,preventive health education activities,and the optimized use of health information systems.

Objective:To explore the potential profile characteristics of cancer-related worries in patients after surgery for early-stage lung cancer, and the influencing factors of different categories, provide reference for patients to formulate individualized rehabilitation programs and psychological intervention measures.Methods:A cross-sectional survey method was used to conveniently select patients who received outpatient follow-up after lung cancer surgery at Shanghai Pulmonary Hospital Affiliated to Tongji University from October 2022 to October 2023 as the survey subjects. The general information questionnaire, the Chinese version of Brief Cancer-related Worry Inventory, the Chinese version of the MD Anderson Symptom Inventory, Brief Illness Perception Questionnaire, 10-item Connor Davidson Resilience Scale and Medical Coping Modes Questionnaire were examined. Latent profile analysis was performed on the cancer-related worry scores of lung cancer surgery patients, and its influencing factors were explored by binary Logistic regression analysis.Results:A total of 302 patients after lung cancer surgery were included, including 111 males and 191 females, aged 18-83(52.73 ± 13.07) years, and the Chinese version of the Brief Cancer-related Worry Inventory scored 380.00 (130.00, 720.00) points. The cancer-related worry of patients after lung cancer surgery could be divided into two potential profile categories: "high worry type" (138 patients accounted for 45.70%) and "low worry type" (164 patients accounted for 54.30%). Symptom burden ( OR=1.055, 95% CI 1.039-1.072), illness perception ( OR=1.190, 95% CI 1.127-1.256), resilience ( OR=0.933, 95% CI 0.886-0.983), and coping modes of confrontation ( OR=0.857, 95% CI 0.757-0.971) and acceptance-resignation ( OR=1.247, 95% CI 1.050-1.481) were influencing factors for grouping cancer related worry profiles (all P<0.05). Conclusions:There was significant heterogeneity in the level of cancer-related worries among patients after surgery for early-stage lung cancer. It is recommended that medical staff provide targeted continuity care measures based on the characteristics of worries of different categories of patients to improve patients' postoperative mental health and quality of life.

Objective:To investigate the association of blood lipids and body mass index (BMI) with hyperuricemia (HUA) in the elderly.Methods:It was a cross-sectional study. A total of 114 391 elderly individuals received health examinations at primary healthcare institutions in Wujin District from January to December in 2022. The health examination included questionnaire survey, physical examination and laboratory examination. The multivariate logistic regression and restricted cubic spline (RCS) plots were used to analyze the association and dose-response relationship of blood lipid and BMI with HUA. The mediating effect model was used to explore the mediation effect of BMI on the association between blood lipid and HUA.Results:Among the 112 415 subjects, 18 506 (16.46%) were checked with HUA. After adjusting for relevant confounders, total cholesterol (TC) ( OR=1.20, 95% CI: 1.16-1.23), triglyceride (TG) ( OR=1.46, 95% CI: 1.44-1.49), high density lipoprotein cholesterol (HDL-C) ( OR=0.74, 95% CI: 0.73-0.76), low density lipoprotein cholesterol (LDL-C) ( OR=1.14, 95% CI: 1.12-1.15) and BMI ( OR=1.42, 95% CI: 1.39-1.44) were all associated with HUA (all P0.05). The RCS analysis revealed that TG, HDL-C, and LDL-C each exhibited a nonlinear dose-response relationship with HUA, the inflection points was 3.00 mmol/L, 1.57 mmol/L and 2.50 mmol/L, respectively (all P-nonlinear0.001). The results of interaction showed that there were additive interaction between high TC( S=1.27 , 95% CI: 1.17-1.37), high TG( S=1.32 , 95% CI: 1.25-1.40), high LDL-C( S=1.23 , 95% CI: 1.14-1.34) and overweight/obesity with HUA (all P0.05). The results of mediation effect analysis showed that the mediation effect of BMI on the association between blood lipids (HDL-C, LDL-C, TG and TC) and HUA, from high to low, were as follows: 22.5% (95% CI: 20.8%-24.2%), 13.9% (95% CI: 12.0%-16.2%), 13.5% (95% CI: 12.7%-14.4%) and-3.9% (95% CI:-6.6%--1.8%). Conclusion:The blood lipid levels and BMI are positively correlated with HUA in the elderly.