Objectives:To investigate the association between normal-weight central obesity with new-onset cardiovascular disease and all-cause mortality risk. Methods:A prospective cohort study was conducted,selecting a total of 93885 participants from the Kailuan Study who had their first physical examination in 2006-2007.According to waist circumference (central obesity:male waist circumference ≥90 cm,female waist circumference ≥85 cm;no central obesity:male waist circumference<90 cm,female waist circumference<85 cm) and body mass index (BMI,normal weight:18.5 kg/m2≤BMI<24.0 kg/m2;overweight/obesity:BMI ≥24.0 kg/m2),the participants were divided into 4 groups:normal weight no central obesity group (G1 group),normal weight central obesity group (G2 group),overweight/obesity no central obesity group (G3 group) and overweight/central obesity group (G4 group);Using the Kaplan-Meier method,the cumulative incidence of new-onset cardiovascular diseases (including hemorrhagic stroke,ischemic stroke and myocardial infarction) and all-cause mortality in different groups was calculated,and the Log-rank test was used for intergroup comparisons.Furthermore,the associations between the different groups and the risk of new-onset cardiovascular diseases and all-cause mortality were analyzed using the multivariate Cox proportional hazard regression model. Results:After a median follow-up of 14.97 (14.55,15.17) years,the cumulative incidence of new-onset cardiovascular diseases in G1 group,G2 group,G3 group and G4 group was 7.62％,10.84％,8.67％,12.91％ respectively (log-rank P<0.05) and the cumulative incidence of all-cause mortality was 12.83％,19.72％,10.65％,16.33％ respectively (log-rank P<0.01).After adjusting for confounding factors,Cox regression analysis showed that the HR (95％CI) of new-onset cardiovascular diseases in G2 group,G3 group and G4 group were 1.14 (1.04-1.25),1.07 (1.01-1.14),1.27 (1.21-1.34),respectively compared with G1 group (all P<0.05).The HR (95％CI) of all-cause mortality were 1.06 (1.00-1.14),0.90 (0.85-0.95),0.97 (0.93-1.01) compared with G1 group,and P values were 0.07,<0.01,0.15,respectively.The results of sensitivity analysis were consistent with the above major studies after excluding overweight/obesity and cancer participants during follow-up. Conclusions:Normal-weight central obesity increases the risk of new-onset cardiovascular diseases and all-cause mortality.

Objective:To retrieve, summarize, evaluate and integrate the best evidence for the prevention and management of center venous catheter dysfunction in hemodialysis patients.Methods:The relevant literature on prevention of center venous catheter dysfunction in hemodialysis patients was systematically searched in UpToDate, BMJ Best Practice, Cochrane Library, National Guideline Clearinghouse, Guidelines International Network, National Kidney Foundation, PubMed, CNKI and other databases, including guidelines, clinical decision-making, evidence summary, systematic evaluation and expert consensus. The search period was from January 1st, 2013 to March 1st, 2023. Two researchers independently evaluated the quality of the literature, evaluated the quality of the included literature and extracted evidence.Results:A total of 15 articles were included, including three guidelines, three clinical decision-making, five expert consensus, two systematic evaluations, one evidence summary and one government document. Ultimately, seven themes and 32 best evidence were formed, including personnel training and management, evaluation and monitoring, catheter insertion, catheter maintenance, drug prevention, catheter dysfunction management and health education.Conclusions:This study summarizes the best evidence for the prevention and management of center venous catheter dysfunction in hemodialysis patients. Medical staff can choose and apply this evidence-based basis based on clinical situations and patient preferences, thereby reducing the incidence of catheter dysfunction.

Objective:To analyze the research status, hotspots and frontiers of symptom nursing of inflammatory bowel disease (IBD) .Methods:The Web of Science core collection database was searched, and CiteSpace 6.2.R4 software was used to analyze the literature visually.Results:A total of 350 articles were included. The number of articles on symptom nursing of inflammatory bowel disease showed an upward trend year by year. The author with the most significant number of articles was Christine. The authors were scattered and had not yet formed a core group. The country with the most significant number of articles was the United States. The keywords formed a total of 11 clusters, among which the home symptom monitoring of inflammatory bowel disease as a chronic disease, the current status of symptoms in inflammatory bowel disease patients and their relationship with other variables, the symptoms of active patients, and symptom intervention based on theoretical frameworks were research hotspots. The effectiveness of symptom-coping strategies and tools was at the forefront of research.Conclusions:The symptom nursing of inflammatory bowel disease shows a rapid development trend. In the future, researchers should develop more accurate symptom measurement tools based on previous research and construct precise symptom response strategies.

Objective To investigate the relationship between the expression of matrix metalloproteinase(MMP)-2,MMP-9,MMP-13 and disease activity in pemphigus patients.Methods A total of 60 pemphigus patients treated in the dermatology department of the hospital from January 2021 to January 2023 were select-ed as the study group,and another 60 healthy volunteers who underwent physical examination in the same pe-riod were recruited as the control group.The levels of MMP-2,MMP-9 and MMP-13 in serum and the expres-sion of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells were compared between the two groups,and the relationship between the expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells of patients with pemphigus was analyzed.Pemphigus patients were divided into acute phase group(n=22),chronic phase group(n=23)and stable phase group(n=15)according to their disease activi-ty.The expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells of the three groups were compared,as well as the correlation between the three indexes and disease activity.Receiver operating characteristic(ROC)curve was plotted for analysis.Results The levels of MMP-2,MMP-9 and MMP-13 in serum and the expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells in the study group were higher than those in the control group,with statistical significance(P＜0.05).The expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells in severe patients were higher than those in moderate and mild patients,and the difference was statistically significant(P＜0.05).The expression of MMP-2,MMP-9 and MMP-13 and disease activity scores of mononuclear cells in acute attack group were higher than those in chronic attack group,and the differences were statistically significant(P＜0.05).The ex-pression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells were positively correlated with disease activity(rMMP-2=0.545,rMMP-9=0.592,rMMP-13=0.580,P＜0.05).ROC curve analysis showed that compared with the single diagnostic efficacy of MMP-2,MMP-9 and MMP-13 expression in peripheral blood mononuclear cells,the three combined diagnostic efficacy was better.Conclusion The expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells of pemphigus patients is related to the disease activity,and these three indicators can be used as reference indicators for the diagnosis of pemphigus disease activity.

Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.

Objective:To analyze the influence of lifestyle changes on body weight and metabolic parameters during the early stage of corona virus disease 2019 (COVID-19) epidemic and regular epidemic prevention period in physical examination population.Methods:A total of 801 subjects from Nanjing enterprises and institutions who underwent physical examination in the Department of Health Promotion Center, the First Affiliated Hospital of Nanjing Medical University in May of 2019 to 2021 were included in this study. The basic information and data of body mass index, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride and uric acid were collected. Information about dietary and exercise habits was obtained through pre-examination questionnaires. The data of 2019 was set as baseline data, data of 2020 represented information during the early stage of COVID-19 epidemic and data of 2021 represented information in regular epidemic prevention period. The subjects were divided into underweight group, normal weight group, overweight group, and obese group according to the body mass index at baseline. The Friedman test was applied to compare changes in body mass index and metabolic parameters across the population. Chi-square test was used to compare changes in dietary and exercise habits. Multivariate logistic regression analysis was adopted to explore the influencing factors of body mass index changes.Results:During the early stage of COVID-19 epidemic, the proportion of weight gain was the highest in the underweight group (42.9%), the proportion of weight loss was the highest in the overweight group (24.2%), and the obese group has the most stable body weight (70.6%) ( P=0.004). Men ( OR=0.56, 95% CI: 0.36-0.87) were less likely to gain weight than women ( P=0.010). There was no significant differences in weight change among all groups in the regular epidemic prevention period ( P=0.380). During the early stage of COVID-19 epidemic, the levels of fasting blood glucose, total cholesterol and LDL-C were significantly lower than those of baseline [4.98 (4.66, 5.42) vs 5.23 (4.91, 5.66) mmol/L, 4.98 (4.36, 5.67) vs 5.11 (4.54, 5.77) mmol/L, 2.90 (2.45, 3.33) vs 3.23 (2.77, 3.74) mmol/L], and the uric acid level was higher [333.0 (275.5, 397.0) vs 311.0 (257.5, 368.0) μmol/L] (all P<0.001). In regular epidemic prevention period, the levels of body mass index, fasting blood glucose, total cholesterol and LDL-C were significantly higher than those in the early stage of the epidemic [24.0 (21.9, 26.3) vs 23.8 (21.7, 26.1) kg/m 2, 5.18 (4.85, 5.62) vs 4.98 (4.66, 5.42) mmol/L, 5.12 (4.42, 5.76) vs 4.98 (4.36, 5.67) mmol/L, 3.06 (2.59, 3.57) vs 2.90 (2.45, 3.33) mmol/L], while the uric acid was significantly lower [319.0 (265.0, 377.0) vs 333.0 (275.5, 397.0) μmol/L] (all P<0.001). During the early stage of the epidemic, the reduction proportion of unhealthy diet in the home group was significantly higher than that in the outing group (19.5% vs 11.4%), and the increment proportion of exercise in the outing group was significantly higher than that in the home group (5.1% vs 1.6%) (both P<0.05). In regular epidemic prevention period, the increase rate of unhealthy diet in the home group was significantly higher than that in the outing group (26.8% vs 13.0%) ( P<0.001), and there was no significant difference in exercise between the two groups ( P=0.325). During the early stage of COVID-19 epidemic and in the regular epidemic prevention period, unhealthy diet>3 times per week ( OR=3.85, 3.01, 95% CI: 1.74-8.51, 1.41-6.39) was positively correlated with weight gain, and regular exercise ( OR=4.35, 2.61, 95% CI: 2.05-9.23, 1.15-5.91) was positively correlated with weight loss (all P<0.05). Conclusions:During the early stage of COVID-19 epidemic and in the regular epidemic prevention period, the lifestyle in the physical examination population has an impact on body weight and metabolic indicators. In the early stage of the epidemic, unhealthy diet and exercise decreased, and metabolic indicators such as blood glucose and lipids decreased. People with low body weight tend to gain weight. In the regular epidemic prevention period, the subjects′ exercise increased but unhealthy diet also increased, and blood glucose, lipid and body weight elevated significantly.

Objective: To investigate the motivation for weight self-management and analyze its influencing factors among pregnant women in a tertiary hospital in Hohhot City, Inner Mongolia Autonomous Region, so as to provide insights into body weight management during pregnancy. Methods: Pregnant women at ages of 18 years and older that underwent prenatal examinations in a tertiary hospital in Hohhot City from January to March, 2022 were sampled using a convenience sampling method. Subjects' age, height, weight, occupation, residence, monthly household income, history of gestation and childbirth and gestational period were collected, and the motivation for weight self-management was evaluated among pregnant women using a pregnancy weight management protein motivation scale. The factors affecting the motivation for weight self-management were identified among pregnant women using a multivariable linear regression model. Results: Totally 969 pregnant women were recruited, including 841 women at ages of <35 years (86.79%), 780 women with an educational level of diploma and above (80.50%), 794 women living in urban areas (81.94%), 729 primiparas (75.23%), 421 women in the third trimester of gestation (43.45%) and 758 women with pre-pregnancy body mass index (BMI) of <25 kg/m2 (78.22%). The mean score of motivation for weight self-management was 127.53±14.60 among the pregnant women. Multivariable linear regression analysis showed that an educational level of high school and below (β′=-0.201), unemployed/self-employed individuals (β′=-0.077), living in rural areas (β′=-0.059), monthly household income of <10 000 yuan (<5 000 yuan, β′=-0.238; 5 000 to 10 000 yuan, β′=-0.169), in the third trimester of gestation (β′=-0.135), pre-pregnancy BMI of 25 kg/m2 and higher (β′=-0.214) and reduced the motivation for weight self-management among pregnant women. Conclusion The motivation for weight self-management correlates with gestational period, pre-pregnancy BMI, residence, occupation, educational level and monthly household income among pregnant women.

Objective:To explore the early application effect of the bedside sitting respiratory training in patients with respiratory failure and noninvasive positive pressure ventilation of the acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 102 patients with respiratory failure and noninvasive positive pressure ventilation of the AECOPD treated in Shanghai Public Health Clinical Center from June 2018 to December 2019 were selected and divided into the control group and the research group by random digits table method with 51 cases in each group. The control group was given the conventional treatment and nursing measures; and the research group was given the bedside sitting respiratory training. Pulmonary functional and blood -gas analysis parameters, clinical outcome of patients, etc. before and after the intervention between the two groups were compared. Results:After the intervention, the forced expiratory volume in one second (FEV 1), forced vital capacity(FVC), FEV 1/FVC were (1.79±0.22) L, (3.09±0.28) L, (62.16±5.94)% in the research group, and (1.43±0.18) L, (2.66±0.23) L, (53.48±5.31)% in the control group, the differences were statistically significant(t values were 8.36, 8.00, 7.19, P<0.01). Arterial partial pressure of carbon dioxide (PaCO 2) and arterial partial pressure of oxygen (PaO 2) in blood gas analysis were (51.14±3.79) mmHg(1 mmHg=0.133 kPa), (71.07±5.49) mmHg in the research group, and (57.52±3.86) mmHg, (65.62±5.27) mmHg in the control group, the differences were statistically significant ( t values were -7.78, 4.72, P<0.01). The non-invasive positive pressure ventilation time, hospital stays were (7.41±1.76) d, (11.27±2.41) d in the research group, and (9.79±2.11) d, (15.46±3.12) d in the control group, the differences were statistically significant ( t values were -5.71, -6.70, P<0.01). The incidence of adverse events was 3 cases in the research group, 1 case in the control group, the difference was no statistically significant ( P>0.05). Conclusions:The application of the bedside sitting respiratory training in patients with respiratory failure and noninvasive positive pressure ventilation of the AECOPD can effectively improve the pulmonary physiological function, shorten the noninvasive positive pressure ventilation time and hospitalization time, which has clinical application value.

Objective:To evaluate the clinical efficacy of multi-disciplinary single center's CCCG-HB-2016 regimen in the treatment of hepatoblastoma (HB) in children.Methods:Clinical data of 36 HB patients treated with CCCG-HB-2016 program from Aug 2016 to March 2020 were analyzed.Results:These 36 patients included 20 boys and 16 girls. The serum AFP was all higher than 2 792 ng/ml,there was a correlation between AFP and tumor risk stratification ( H=14.973, P<0.05). Twenty eight cases (77.78%) were epithelial type and 8 cases (22.22%) were mixed epithelial mesenchymal type.All children were treated by tumor resection combined with chemotherapy, and there was a correlation between tumor risk stratification and surgical resection of liver lobe ( H=8.847, P<0.05). The probability of bone marrow suppression in the low-risk group was 58.33% (35/60),that in the intermediate-risk group was 73.49% (61/83) and in the high-risk group was 80.23% (69/86).All 36 cases were followed up to March 31, 2020,with an average follow-up of 21.9 months and the median survival was 22.5 months.The overall survival rate (OS) and event-free survival rate (EFS) were 97.2% and 83.3% respectively. Conclusions:The multidisciplinary CCCG-HB-2016 regimen was with a high success rate and along with a high incidence of bone marrow suppression.

Objective:To investigate the association between oxygen saturation (SpO 2) and risk of 3-year all-cause mortality among Chinese older adults aged 65 or over. Methods:The participants were enrolled from Healthy Aging and Biomarkers Cohort Study in year of 2012 to 2014 in 9 longevity areas in China. In this prospective cohort study, 2 287 participants aged 65 or over were enrolled. Data on SpO 2 and body measurements were collected at baseline in 2012, and data on survival outcome and time of mortality were collected at the follow-up in 2014. Participants were divided into two groups according to whether SpO 2 was abnormal (SpO 2<94% was defined as abnormal). Results:The 2 287 participants were (86.5±12.2) years old, 1 006 were males (44.0%), and 315 (13.8%) were abnormal in SpO 2. During follow-up in 2014, 452 were died, 1 434 were survived, and 401 were lost to follow-up. The all-cause mortality rate was 19.8%, and the follow-up rate was 82.5%. The mortality rate of SpO 2 in normal group was 21.1%, and that of abnormal group was 41.6% ( P<0.001). After adjusting for confounding factors, compared to participants with normal SpO 2, participants with abnormal SpO 2 had increased risk of all-cause mortality with HR (95% CI) of 1.62 (1.31-2.02); HR (95 % CI) was 1.49 (0.98-2.26) for males and 1.71 (1.30-2.26) for females in abnormal SpO 2group, respectively; HR (95% CI) was 2.70 (0.98-7.44) for aged 65-79 years old, 1.22 (0.63-2.38) for aged 80-89 years old, and 1.72 (1.35-2.19) for aged over 90 years old in abnormal SpO 2 group, respectively. Conclusion:Abnormal SpO 2 was responsible for increased risk of 3-year all-cause mortality among Chinese elderly adults.