Objective: To explore the association between mental health and muscle strength among Chinese adolescents aged 13- 18, providing a theoretical foundation and intervention strategies for mental health promotion. Methods: Data were obtained from the 2019 Chinese National Survey on Students Constitution and Health, including 98 631 Chinese adolescents aged 13- 18. Psychological distress was assessed by using the Kessler Psychological Distress Scale (K10), and mental well being was measured with the Warwick-Edinburgh Mental Well being Scale (WEMWBS). Based on the gender and age specific Z scores of various test items [grip strength, standing long jump, pull ups (for males), and sit ups (for females)], muscle strength index (MSI) was constructed to evaluate the comprehensive level of muscle strength in adolescents. According to the Dual factor Model (DFM) of mental health, participants were categorized into four groups:troubled, symptomatic but content, vulnerable, and complete mental health. Gender differences were analyzed by using Chi-square tests, trends were tested with Cochran-Armitage tests, and multinomial Logistic regression models were applied to assess associations between muscle strength and mental health among adolescents. Results: In 2019, 37.4% of Chinese adolescents aged 13-18 were reported of high mental distress, and 59.9% were reported of low mental well being. Boys had significantly lower rates of high mental distress (35.3%) and low mental well being (55.6%) compared to girls (39.4%, 64.3%), and the differences were of statistical significance ( χ 2=176.13, 780.42, both P <0.05). In 2019, the rate of complete mental health among adolescents showed a downward trend with increasing age ( χ 2 trend = 258.47) and a gradual upward trend with increasing muscle strength levels ( χ 2 trend =123.14)，and both boys and girls exhibited similar trends ( χ 2 trend =103.83, 168.46; 57.00 , 67.34) (all P <0.05). The results of the unordered multiclass Logistic regression model showed that after controlling for confounding factors such as age and gender, when the completely pathological group as a reference, for every 1 unit increase in MSI in adolescents, the likelihood of being in a completely mental health state increased by 29% ( OR = 1.29); for every unit increase in the Z-score for pull ups, the likelihood of being in a completely mental health state increased by 6% ( OR =1.06) among boys; for every 1 unit increase in sit up Z score, the likelihood of being in a completely mental health state increased by 19% ( OR =1.19) among girls (all P <0.05). Conclusions The mental health status of Chinese adolescents is not good enough. Muscle strength is positively associated with mental health.

Objective To evaluate the predictive abilities of the triglyceride and glucose(TyG)index,metabolic insulin resistance score(METSIR),and ratio of triglyceride to high-density lipopro-tein cholesterol(TG/HDL-C)for the risk of onset and severity of lesions in patients with acute coro-nary syndrome(ACS)complicated with multivessel coronary artery disease.Methods A retrospec-tive analysis was conducted on the clinical data of 260 ACS patients admitted to Yunnan Provincial Third People's Hospital,and the patients were divided into multivessel disease group(n=160)and non-multivessel disease group(n=100);based on the SYNTAX score,the multivessel disease group was further divided into high-risk group with 71 cases(score＞22.5)and low-risk group with 89 cases(score ≤22.5).Results The multivessel disease group had significantly higher proportions of males,history of diabetes,history of smoking,TyG index,METSIR,and TG/HDL-C compared to the non-multivessel disease group(P＜0.05).Correlation analysis showed that the TyG index and TG/HDL-C were significantly positively correlated with the SYNTAX score(P＜0.05),while MET-SIR had no correlation with the SYNTAX score(P＞0.05).Logistic regression analysis indicated that METSIR was an independent risk factor for ACS complicated with multivessel coronary artery disease(P＜0.05),and TyG,METSIR and TG/HDL-C were all independent factors for predicting the severity of lesions(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that TyG had the highest predictive value for ACS complicated with multivessel coronary artery dis-ease and its severity(area under the curve was 0.804).Conclusion The TyG index,METSIR,and TG/HDL-C are of great significance in the early identification and assessment of ACS complicat-ed with multi vessel coronary artery disease,with TyG having the highest predictive value.

BACKGROUND: The urban-rural disparities in overweight and obesity among children and adolescents are narrowing, and there is a need for long-term and updated data to explain this inequality, understand the underlying mechanisms, and identify priority groups for interventions. METHODS: We analyzed data from seven rounds of the Chinese National Survey on Students Constitution and Health (CNSSCH) conducted from 1985 to 2019, focusing on school-age children and adolescents aged 7-18 years. Joinpoint regression was used to identify inflection points (indicating a change in the trend) in the prevalence of overweight and obesity during the study period, stratified by urban/rural areas and sex. Annual percent change (APC), average annual percent change (AAPC), and 95% confidence interval (CI) were used to describe changes in the prevalence of overweight and obesity. Polynomial regression models were used to predict the prevalence of overweight and obesity among children and adolescents in 2025 and 2030, considering urban/rural areas, sex, and age groups. RESULTS: The prevalence of overweight and obesity in urban boys and girls showed an inflection point of 2000, with AAPC values of 10.09% (95% CI: 7.33-12.92%, t = 7.414, P <0.001) and 8.67% (95% CI: 6.10-11.30%, t = 6.809, P <0.001), respectively. The APC for urban boys decreased from 18.31% (95% CI: 4.72-33.67%, t = 5.926, P = 0.027) to 4.01% (95% CI: 1.33-6.75%, t = 6.486, P = 0.023), while the APC for urban girls decreased from 13.88% (95% CI: 1.82-27.38%, t = 4.994, P = 0.038) to 4.72% (95% CI: 1.43-8.12%, t = 6.215, P = 0.025). However, no inflection points were observed in the best-fit models for rural boys and girls during the period 1985-2019. The prevalence of overweight and obesity for both urban and rural boys is expected to converge at 35.76% by approximately 2027. A similar pattern is observed for urban and rural girls, with a prevalence of overweight and obesity reaching 20.86% in 2025. CONCLUSIONS The prevalence of overweight and obesity among Chinese children and adolescents has been steadily increasing from 1985 to 2019. A complete reversal in urban-rural prevalence is expected by 2027, with a higher prevalence of overweight and obesity in rural areas. Urgent action is needed to address health inequities and increase investments, particularly policies targeting rural children and adolescents.
Humans ; Child ; Adolescent ; Female ; Male ; Rural Population/statistics & numerical data* ; Overweight/epidemiology* ; Prevalence ; China/epidemiology* ; Pediatric Obesity/epidemiology* ; Obesity/epidemiology* ; Urban Population

Objective:To develop outcome indicators for the implementation of comprehensive inter-ventions targeting the multimorbidity of myopia and obesity in children and adolescents,providing a basis for the co-prevention of multimorbidity and the outcome measurement of implementation research in children and adolescents.Methods:Based on the RE-AIM framework,a preliminary set of indicators was constructed.The Delphi method was employed,with experts scoring and providing feedback on the proposed indicators via questionnaires.After each round of consultation,expert enthusiasm index,authority coefficient,coordination degree,and consensus level were calculated.Expert opinions were col-lected and analyzed to modify,delete,or add indicators based on consultation results and screening crite-ria.Two Delphi rounds were conducted until consensus was achieved.Results:A total of 28 experts par-ticipated actually in both rounds.The Kendall's W coefficients for the two rounds of expert consultation were0.352(x2=413.952,P＜0.001)and 0.499(x2=405.044,P＜0.001),both statistically sig-nificant.The final outcome indicators for implementation research on comprehensive interventions for myopia and obesity comorbidity in children and adolescents included five primary dimensions with 13 secondary and 20 tertiary indicators.The dimension of reach included the number of children and adoles-cents involved,participant representativeness,and full-course participation representativeness.The di-mension of effectiveness included multimorbidity incidence,myopia incidence,spherical equivalent,body mass index(BMI),overweight and obesity prevalence,waist-to-height ratio,comprehensive health knowledge score,and comprehensive health behavior score.The dimension of adoption covered school representativeness and representativeness of school nurses and teachers involved in implementation.The dimension of implementation included fidelity,content modification,and cost.The dimension of mainte-nance included individual health outcomes and organizational sustainment.Conclusion:This study developed implementation outcome indicators for comprehensive interventions targeting multimorbidity of myopia and obesity among the children and adolescents based on the RE-AIM framework.These indica-tors can serve as a reference for optimizing intervention research strategies related to common multimor-bidity among children and adolescents in China.

Objective:To develop outcome indicators for the implementation of comprehensive inter-ventions targeting the multimorbidity of myopia and obesity in children and adolescents,providing a basis for the co-prevention of multimorbidity and the outcome measurement of implementation research in children and adolescents.Methods:Based on the RE-AIM framework,a preliminary set of indicators was constructed.The Delphi method was employed,with experts scoring and providing feedback on the proposed indicators via questionnaires.After each round of consultation,expert enthusiasm index,authority coefficient,coordination degree,and consensus level were calculated.Expert opinions were col-lected and analyzed to modify,delete,or add indicators based on consultation results and screening crite-ria.Two Delphi rounds were conducted until consensus was achieved.Results:A total of 28 experts par-ticipated actually in both rounds.The Kendall's W coefficients for the two rounds of expert consultation were0.352(x2=413.952,P＜0.001)and 0.499(x2=405.044,P＜0.001),both statistically sig-nificant.The final outcome indicators for implementation research on comprehensive interventions for myopia and obesity comorbidity in children and adolescents included five primary dimensions with 13 secondary and 20 tertiary indicators.The dimension of reach included the number of children and adoles-cents involved,participant representativeness,and full-course participation representativeness.The di-mension of effectiveness included multimorbidity incidence,myopia incidence,spherical equivalent,body mass index(BMI),overweight and obesity prevalence,waist-to-height ratio,comprehensive health knowledge score,and comprehensive health behavior score.The dimension of adoption covered school representativeness and representativeness of school nurses and teachers involved in implementation.The dimension of implementation included fidelity,content modification,and cost.The dimension of mainte-nance included individual health outcomes and organizational sustainment.Conclusion:This study developed implementation outcome indicators for comprehensive interventions targeting multimorbidity of myopia and obesity among the children and adolescents based on the RE-AIM framework.These indica-tors can serve as a reference for optimizing intervention research strategies related to common multimor-bidity among children and adolescents in China.

Acute kidney injury during pregnancy (P-AKI) threatens the health of both the mother and fetus, which should be given sufficient attention. During pregnancy, the kidneys undergo a series of physiological changes to adapt to the demands from the mother and infant, leading to the kidneys more susceptible to damage than non pregnant individuals. This article analyzes the pathophysiological changes, causes, diagnostic criteria, related diseases, and therapeutic measures of P-AKI. It also points out that for severe preeclampsia, thrombocytopenia syndrome, and acute fatty liver disease, the pregnancy should be terminated upon diagnosis. While for thrombotic thrombocytopenic purpura and hemolytic uremic syndrome, plasma exchange should be the main treatment. Further analysis of the dialysis indications for P-AKI is aimed at providing reference for accurate clinical diagnosis and effective treatment, thereby improving the survival rates of pregnant women and fetuses.

Acute kidney injury during pregnancy (P-AKI) threatens the health of both the mother and fetus, which should be given sufficient attention. During pregnancy, the kidneys undergo a series of physiological changes to adapt to the demands from the mother and infant, leading to the kidneys more susceptible to damage than non pregnant individuals. This article analyzes the pathophysiological changes, causes, diagnostic criteria, related diseases, and therapeutic measures of P-AKI. It also points out that for severe preeclampsia, thrombocytopenia syndrome, and acute fatty liver disease, the pregnancy should be terminated upon diagnosis. While for thrombotic thrombocytopenic purpura and hemolytic uremic syndrome, plasma exchange should be the main treatment. Further analysis of the dialysis indications for P-AKI is aimed at providing reference for accurate clinical diagnosis and effective treatment, thereby improving the survival rates of pregnant women and fetuses.

【Objective】 To introduce a surgical technique modified by our center, the establishment of a robot-assisted radical prostatectomy (RARP) channel with extraperitoneal three-port method, and discuss its methods, skills, safety and efficacy. 【Methods】 Clinical data of 21 patients with early and intermediate prostate cancer treated with this surgery during Aug.2022 and Jun.2023 were retrospectively analyzed.Surgical time, intraoperative bleeding volume, postoperative complications, drainage tube retention time, postoperative hospital stay, and follow-up results were observed. 【Results】 All 21 cases of surgery were successfully completed by the same surgeon, without peritoneal rupture or addition of auxiliary holes.The time to establish the extraperitoneal gap and install robotic arm was 20.2 (16.0-28.0) min, the operation time was 107.0(60.0-161.0) min, the amount of intraoperative bleeding was 52.8 (31.0-121.0) mL.All patents resumed eating and drinking the next day after operation.The drainage tube indwelling time was 3.9 (2.0-6.0) d, and the postoperative hospital stay was 4.9 (3.0-7.0) d.No serious complications occurred.The urinary catheter was removed 10 days after operation.One month after operation, 20 patients (95.2%) achieved satisfactory urinary control.The postoperative pathology was prostate adenocarcinoma in all cases, with negative margins, and the prognostic grouping of ISUP was 2 cases in group 1, 6 cases in group 2, 10 cases in group 3, 2 cases in group 4, and 1 case in group 5. 【Conclusion】 RARP by extraperitoneal three-hole method is safe and feasible, with exact establishment of extraperitoneal space, few collisions between instruments, low surgical costs, fast postoperative intestinal recovery, aesthetic incision, and satisfactory recovery of urinary control.

On May 25, 2024, Shanghai Municipal Administration for Market Regulation released Shanghai local standard Requirements for Outdoor Smoking Areas Setting Up and Management (DB 31/T 1482‒2024) (hereinafter referred to as Standard), which scheduled for official implementation from September 1, 2024. This article provided an interpretation of the key provisions in the Standard, with a particular emphasis on the scope of application, establishment and management requirements. In addition, the significance and potential difficulties and challenges during subsequent implementation of the Standard was summarized and outlined simultaneously, so as to provide a guarantee for users to fully comprehend and effectively implement the Standard.

Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.