Objective: To explore the comorbidity and associated factors of dental caries and overweight/obesity among primary and secondary school students in Guangxi, so as to provide a scientific basis for the development of targeted prevention strategies. Methods: A stratified cluster random sampling method was used to survey 178 700 students from the fourth grade of primary school to the third year of high school in Guangxi Zhuang Autonomous Region from September to November 2023, including physical examination, oral screening, and questionnaire survey. Chisquare tests and binary Logistic regression analysis were employed to investigate the related factors of the cooccurrence of dental caries and overweight/obesity among students. Results: The comorbidity rate of dental caries and overweight/obesity was 9.55%, with urban areas (9.95%) higher than rural counties (9.24%), boys (10.54%) higher than girls (8.54%), primary school students (11.49%) higher than senior high school students (8.92%) and junior high school students (8.05%), and nonboarding students (11.44%) higher than boarding students (7.94%), and all differences were statistically significant (χ2=26.07, 207.91, 471.54, 629.14,P<0.01). Multivariate Logistic regression analysis showed that consuming cereal for breakfast (OR=0.91, 95%CI=0.88-0.94), drinking milk in the past week (OR=0.89, 95%CI=0.83-0.95), meeting sleep standards (OR=0.95, 95%CI=0.91-0.99), and brushing teeth at least once a day (OR=0.82, 95%CI=0.73-0.93) had a lower risk of the comorbidity of dental caries and overweight/obesity. In contrast, drinking beverages in the past week (OR=1.14, 95%CI=1.09-1.20), consuming fried foods in the past week (OR=1.11, 95%CI=1.06-1.17), eating fruit ≥1 time every day (OR=1.06, 95%CI=1.02-1.11), consuming fruit ≥1 type every day (OR=1.07, 95%CI=1.01-1.12), and having fish, poultry, meat, or eggbased breakfasts (OR=1.03, 95%CI=1.05-1.13) had a higher risk of the comorbidity of dental caries and overweight/obesity (P<0.05). Conclusions Dietary habits and lifestyle behaviors are associated with the comorbidity of dental caries and overweight/obesity among primary and secondary school students in Guangxi. Guiding students to form healthy living habits is helpful to preven dental caries and overweight/obesity.

Objective Summarize domestic and international community health management models and characteristics for elderly hypertensive patients,providing references for the development of community health management in China.Methods Employ literature research to retrieve relevant documents on community health management models for elderly hypertensive pa-tients,and analyze the characteristics and applicability of different models through summarization and comparative analysis.Results In China,community health management models for elderly hypertensive patients include family doctor contracting serv-ices,Hospital-Community-Home health management model,traditional Chinese medicine health management model,"Internet+"health management model,PDCA cycle model,PRECEDE-PROCEED model,and comprehensive community management model.Foreign studies can be categorized into self-management model,Health Rise model,Community Health2(CH2)model,and community pharmacy management model.Conclusion Conducting hypertension health management for elderly patients at the community level is effective,serving as a widely applicable strategy for chronic disease prevention and control.Continued ex-ploration of the scientific and effective aspects of different management models,improving the efficiency and effectiveness of com-munity health management,can contribute more evidence for the formulation of scientific and effective strategies for chronic dis-ease prevention and control.

Objective:To evaluate the clinical efficacy and safety of ultrasound negative pressure suction with percutaneous nephroscope in the treatment of perirenal abscess.Methods:The clinical data of 11 patients with perirenal abscess admitted to Zhejiang Provincial People's Hospital from January 2013 to February 2021 were retrospectively analyzed. There were 4 males and 7 females. The average age was 59(51-76) years. The abscess was located on the left side in 4 cases and on the right side in 7 cases. The average diameter of abscess was 11.2(8.1-19.2) cm. All patients had fever, low back pain and abdominal mass, accompanied by bladder irritation in 6 cases, gross hematuria in 5 cases, abdominal distension, nausea and anorexia in 3 cases. There were 7 cases with type 2 diabetes, 2 cases with rheumatoid arthritis and 6 cases with ipsilateral kidney and ureter stone. Among the 11 patients, 6 had a history of urinary tract infection, 1 had a history of upper respiratory tract infection, 1 had secondary infection of perirenal hematoma after traumatic renal rupture, and 3 had secondary infection of perirenal hematoma after percutaneous nephroscopy. All patients were treated with ultrasound negative pressure suction with percutaneous nephroscope under local anesthesia by single operator. The operation time, intraoperative blood loss, drainage volume, drainage tube indwelling time, postoperative body temperature returned to normal time, postoperative hospital stay, therapeutic effect and complications were analyzed.Results:All operation procedures of 11 patients were successfully completed, including 8 cases of single channel, 2 cases of double channels and 1 case of three channels. The average operation time was 44(20-74)min, the average amount of blood loss was 15(10-20)ml, the average amount of pus was 325(200-500)ml, the average indwelling time of drainage tube was 8(6-12)d, the average time of body temperature returned to normal was 0.9(0.5-2.0)d, and the average hospitalization time was 9.6(7.0-14.0)d. Before discharge, CT reexamination showed that the perirenal abscess disappeared. There were no serious complications during and after operation. The average follow-up time was 4.4(3-8) months. There was no recurrence in all patients.Conclusions:Ultrasound negative pressure suction with percutaneous nephroscope is one of the safe and effective surgical methods for the treatment of perirenal abscess. It has the advantages of small trauma, quick recovery, complete drainage, exact effect and fewer complications.

Extrahepatic cholangiocarcinoma is a rare, aggressive malignancy of the digestive system with high recurrence rate and poor prognosis. With the development of modern medicine and radiotherapy technology, combined with surgery, chemotherapy, and biliary stent, etc., radiotherapy plays a more and more important role in the treatment of resectable and unresectable patients. At present, a large number of studies have shown that external beam radiotherapy, intraluminal brachytherapy, stereotactic body radiation therapy and other kinds of radiotherapy techniques have good safety and efficacy, but its clinical application is still controversial.

Objective:To describe the treatment of the first carpometacarpal arthritis in Eaton Ⅱ, Ⅲ combining the hemi excision of trapezium with tendon ball and evaluate its clinical efficacy.Methods:Data of patients with the first carpometacarpal arthritis who were treated by hemi excision of trapezium and tamponade of the tendon ball from March 2013 to October 2018 were retrospectively analyzed. Twelve patients were all females with an average age of 55±2.8 years (range, 48-61 years). There were 3 cases of left thumbs and 9 cases of right. The study was only researched with primary osteoarthritis patients, preoperative imaging Eaton stages, including 8 cases inⅡstage, 4 cases in Ⅲ stage. Postoperative X-ray examination was performed, and the subsidence rate of the first metacarpal bone was evaluated according to height of arthroplasty. Preoperative and postoperative pain was evaluated according to visual analogue scales (VAS) score and DASH score. Preoperative and postoperative finger movement was evaluated according to the changes in preoperative and postoperative grip and pinch force.Results:The average follow-up period was 12±4.8 months (range, 6-17 months). The mean score of VAS after operation was 1.2±1.0 which was lower than 6.3±1.5 before operation ( t=13.4, P=0.0001); DASH score after operation was 26.2±9.6 which was lower than 48.9±13.0 before operation ( t=5.7, P=0.0001); Grip force after operation was 25.5±6.8 kg which was higher than 15.0±2.9 kg before operation ( t=7.3, P=0.0001); Pinch force after operation was 3.2±0.8 kg which was higher than 2.1±0.4 kg before operation ( t=3.6, P=0.0045), and all of these four above data has statistic difference. At the latest postoperative follow-up, the height index of arthroplasty was 0.299±0.022, and there was no significant change ( F=1.337, P=0.276) when compared with 0.306±0.021 before surgery and 0.313±0.024 after surgery. After the operation, 2 patients presented with incision redness and swelling and exudation. It was considered that local hematoma in the intra-articular operation could not be completely absorbed. After several dressing changes, the redness and swelling subsided and the exudation was controlled. Conclusion:Preserving the proximal joint surface of trapezium and tamponading tendon ball, could reduce the subsidence rate of the first metacarpal bone and alleviate the pain of the first carpometacarpal joint, thus may effectively improve the joint function. It has a significant effect on the treatment of Eaton Ⅱ,Ⅲ stage of the first carpometacarpal arthritis.

Objective:To study the safety and efficacy of endoscopic combined intrarenal scopic surgery for complicated upper urinary calculi.Methods:The clinical data of 117 patients with complicated upper urinary calculi treated by simultaneous percutaneous nephroscopy combined with flexible ureteroscopy from March 2013 to February 2020 were retrospectively analyzed, including 71 males and 46 females, aged 31-73 years, with an average age of 45 years old. There were 29 cases of multiple kidney and ureteral stones, 22 cases of staghorn stones, 19 cases of postoperative residual stones, 18 cases secondary to urinary diversion, 13 cases of ureteral stricture with stones after kidney transplantation/ureteroplasty/endoscopic lithotripsy, 10 cases of isolated kidney, and 6 cases of caliceal diverticular stones. The maximum diameters of calculi were 13-45 mm, with an average of 27 mm.Results:All operative procedures of 117 patients were successful by one session. The mean operation time was (91.6±10.2) min. All cases were treated with single-channel lithotripsy combined antegrade percutaneous nephroscopy with retrograde flexibl eureteroscopy. An abdominal X-ray (KUB) or non-contrast CT was taken 3 to 7 days after the operation. There was no serious bleeding or infection after the operation, and the first-stage stone-free rate was 87.2% (102/117).Conclusions:The strategy of simultaneous antero-retrograde endoscopic combined intrarenal surgery for complicated upper urinary calculi can improve the success rate and first-stage stone-free rate, and reduce the number of percutaneous renal channel leading to the increasing safety of operation. It is an effective means of endourological management of urolithiasis.

Objective? To construct the "Internet +" based health management model for physical examination population. Methods? From September 2016 to September 2017, we constructed the primary"Internet +" health management model by literature review. Two rounds of consultation with 25 experts were carried out with the Delphi method to construct the "Internet +" health management model for physical examination population. Results? Among two rounds of consultation, the recovery rate of questionnaire was all 100%. The expert authority coefficient (Cr) was 0.87. The final "Internet +" health management model included 3 first-level indicators, 7 second-level indicators and 26 third-level indicators. Conclusions? The "Internet +"based health management model is reliable which can be intervention for health management model of physical examination population.

Objective To study the colonization rate and antibiotic resistance of group B Streptococcus (GBS) in gravidas during late pregnancy,and to evaluate the effectiveness of GBS screening in late pregnancy and intrapartum antibiotic prophylaxis (IAP) for the prevention of neonatal early-onset GBS disease (EOGBS).Methods A retrospective study was conducted to analyze the colonization rate and antibiotic resistance pattern of GBS in 14 204 gravidas who were screened for GBS at 35-37 gestational weeks during March 2016 to March 2018 in the University of Hongkong-Shenzhen Hospital (HKU-SZH).Differences in the incidence of EOGBS before and after GBS screening and IAP were analyzed using Chi-square or Fisher's exact test.Results Among the 14 204 gravidas,2 027 cases were GBS positive with a colonization rate of 14.27％.Incidence rates of EOGBS before and after GBS screening were 0.6‰ (4/6 356) and 0.07‰ (1/14 403),respectively (Fisher's exact test,P=0.033).GBS isolates were 100％ (2 027/2 027) sensitive to penicillin and vancomycin.Resistance rates to clindamycin and erythromycin were 67.2％(1 363/2 027) and 65.7％ (1 332/2 027),respectively.Conclusions Routine GBS screening in late pregnancy and IAP can significantly decrease the incidence of EOGBS.Penicillin is the optimal choice for prevention and treatment of GBS infection.

Objective To evaluate the clinical efficacy and safety of dual shockwave lithotripter in treating urinary calculi.Methods Data of 371 cases treated with Direx-Magna dual shockwave lithotripter was retrospectively collected from July 2016 to June 2017,including 263 male and 108 female.Their age ranged from 15 to 66 years old (mean 36.5 ± 11.0).There was 117 patients with kidney stone,183 patients with upper ureteral and 71 patients with middle or lower stone.The average diameter of stones was (11.3 ± 1.5)mm (ranging 6.9-16.3 mm).The lithotripter was set at 60 times/min/head.Comparative analysis was made between 106 cases in dual mode and 265 cases in single mode.Comparative items included shock frequency,treating time,treating energy,pain scale,stone clear successive rate and complication.Patients were followed by KUB or NCCT at 1 and 2 weeks after the procedure.Stone clear successfully was defined as stone free or with fragment ＜4 mm.Results The overall success rate was 87.3％ (324/371).Among the patients who failed in first session,21 cases were successful with a second session,7 cases were treated with retrograde intrarenal surgery.There were 19 cases lost.Clavien grade Ⅲ complication rate was 0.8％ and no server grade complications.The average treating time was (25.2 ± 8.4) minutes and the average shock was (1419 ±440)times.The dual shockwave subgroup achieved higher success rate [93.4％ (99/106) vs.84.9％ (225/265),P ＜ 0.05] with less treating time [(15.7 ± 3.8) min vs.(29.0 ± 6.5) min],lower energy [(8.9 ± 2.0) kV vs.(10.7 ± 2.8) kV] and fewer shocks (833 ± 149 vs.1 654 ± 261),compared with that of the single shockwave subgroup (P ＜ 0.01).Also,pain scales and other complications were less than those of single shockwave subgroup (P ＜ 0.01).Conclusions Our study shows the new dual shockwave lithotripsy is safe and effective in both dual and single shock wave mode.Dual mode has higher success rate and fewer complications.

Objective To investigate the blood lipid level of gout patients in Han population in Hainan and its health education management strategies.Methods A total of 300 gout cases from January to May 2016 from three hospitals (Affiliated Hospital of Hainan Medical College,Hainan Provincial People~ Hospital,Medical Center of Haikou Municipal People's Hospital were selected as observation group,and 300 normal controls were as control group,diversified and personalized health education were applied for the gout patients,and serum lipid levels (TC,TG,LDL-C,HDL-C) of patients and healthy people were compared.Compliance scores,gout master rate,blood uric acid and gout recurrence rate of patients after followed up for 1 month were compared.Results The observation group had higher TC,TG,LDL-C levels,and lower HDL-C levels than control group (P ＜ 0.05);After 1 month of health education management,compliance score and awareness rate of gout knowledge of gout patients was significantly higher,blood uric acid value levels and gout recurrence rate were lower than intervention before (P ＜ 0.05).Conclusion The blood lipid of Han gout patients in Hainan changes significantly,after health education management,patients' compliance and the self management ability are improved,and disease condition is relieved.