Subjects: Mathematics >> Algebra and Number Theory submitted time 2024-06-08
Abstract： We give a kind of self-adjoint operator, whose spectrums are the set $S_ chi= {i( rho- frac{1}{2}) mid rho text{ is nontrivial zeros of $L$-function } L( chi,s) }$.
Peer Review Status:
Awaiting Review
Subjects: Nuclear Science and Technology >> Radiation Physics and Technology submitted time 2024-06-07
Abstract： 本文介绍了一种超疏水性三聚氰胺（ME）海绵（ME-g-PLMA），该海绵通过高能辐射诱导的原位共价接枝长烷基十二烷基甲基丙烯酸酯（LMA）到ME海绵上，以实现高效的油水分离。所得的ME-g-PLMA海绵具有优良的孔隙结构，具有超疏水性（水接触角为154°）和超亲油性，可吸收高达自身重量66-168倍的各类油脂。所得到的ME-g-PLMA海绵可以通过连接泵连续分离水面上的浮油，或者通过重力驱动装置分离水下的浮油。ME-g-PLMA海绵在长期浸泡在不同的腐蚀性溶液中，多次反复吸油后，也能保持其高疏水性。所得改性ME-g-PLMA海绵具有优异的分离性能，在溢油清理方面具有巨大的潜力。
Peer Review Status:Awaiting Review
Subjects: Nuclear Science and Technology >> Nuclear Science and Technology submitted time 2024-06-07
Abstract： Computational Fluid Dynamics (CFD) technology can be used for nuclear reactor core to understand and predict the fine thermal-hydraulic status, to obtain the optimizing design and operation, and improve the safety. However, CFD analysis of reactor core faces challenges such as difficulty in modelling huge amount of meshes, large amount of calculations, time consuming and resource requirements, etc. Moreover, the universality of CFD technology for reactor types is poor so that it requires the whole analysis process again when the reactor type is changed. Based on the characteristics of reactor structure and coolant flow feature, this paper develops a CFD supporting technology that is "specific" to the reactor core and "common" to different reactor types, which can decompose the CFD computing burden and effectively reduce the fine mesh modelling and calculation analysis. It has been successfully applied to the CFD analysis of the reactor cores with full number and whole height of fuel assemblies, such as the reactor core with wire-wound rod bundle assemblies, spacer grid rod bundle assemblies and plate element assemblies.
Subjects: Chemistry >> Nuclear Chemistry submitted time 2024-06-07
Abstract： Background: The Ir-192 brachytherapy source is a high dose rate gamma radiation source characterized by a high central dose rate and a rapid dose fall-off at the periphery. In clinical treatments, this dose distribution allows the Ir-192 source to effectively protect the normal tissues and organs surrounding the tumor. Objective To establish a detailed structural model of a domestically produced high-dose-rate Ir-192 brachytherapy source using Monte Carlo simulation software, based on the dosimetric parameters recommended by the American Association of Physicists in Medicine (AAPM) in TG43-U1, and to perform simulation calculations. Methods Using the Monte Carlo software, a detailed structural model of the domestically produced high-dose-rate Ir-192 brachytherapy source was established. The simulated dosimetric parameters included the dose rate constant Λ, air kerma rate per unit activity, radial dose function , and anisotropy function . Results The simulated dose rate constant was 1.105 cGy·h-1·U-1, with a difference of less than 1.2% from the literature values. Air kerma rate per unit activity was 9.788×10-8 UBq-1, with a difference of 0.23% from the literature values. The radial dose function was obtained for distances from 0.5 to 20 cm from the source axis, and an empirical formula was fitted. Conclusions The domestically produced Ir-192 source model established using the Monte Carlo software shows good consistency with the literature-reported dosimetric parameters, indicating that this model can be used for clinical practice applications of domestically produced Ir-192 sources and has certain guiding significance.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-07 Cooperative journals: 《中国全科医学》
Abstract： Background Primary medical institutions，with the characteristics of comprehensive，continuous，coordinated，convenient and economical，play an important role in the diagnosis and treatment of common and frequently#2; occurring children's diseases，planned immunization and child health management，and lay a solid foundation for children's health services. It is essential to improve the quality of child health services for children under the management of family doctor contract. There are regional differences in the ability of children's health services at primary institutions in China. Therefore， accurate evaluation of the quality of children's health services at primary institutions is helpful to find problems in time and promote the development of children's health services at a higher level. Objective To assess the quality of community children's health services for contracted children，analyze the quality problems and optimization strategies，and provide international vision and decision-making reference for further improving the quality. Methods Taking a district of Chengdu as a typical case，three community health service centers with stronger child health service ability in the district were selected as the sample institutions， and the parents of children contracted by the sample institutions were surveyed with the online questionnaire on the quality of community child health service by using the Chinese version of primary care assessment tool （PCAT）. Results Totally，3 631 parents of contracted children were investigated. The total PCAT score of community child health service quality in the sample centers was（58.72 ± 13.43）. The dimensions with relatively high PCAT scores of community child health service quality includes "continuity"，"community first consultation （service availability and service use）" and "comprehensive service （service provision）"，while the dimensions "children and family-Centered"，"comprehensive （available services）" and "coordination （referral）" had low scores. Conclusion It is suggested to strengthen the supply of diagnosis and treatment services for common pediatric diseases in the community，unblock the referral mechanism of Pediatrics，strengthen the awareness of parents of contracted children to be included in the contracted service team to participate in diagnosis and treatment decisions，and pay attention to the health services for children with non local registered residence.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-07 Cooperative journals: 《中国全科医学》
Abstract： Background Population aging has heightened，raising concerns about elderly health. Oral frailty，a novel frailty phenotype in the elderly，directly impacts the quality of life. A thorough grasp of oral frailty's prevalence in the elderly is crucial for formulating effective preventive and interventional strategies. Objective To systematically evaluate the prevalence of oral frailty in the elderly. Methods The CNKI，Wanfang Data，VIP，CBM，PubMed，Web of Science，Embase，CINAHL and Cochrane Library databases were searched for literature related to the study purpose with a time limit of the construction of the database to 19 April 2024. Literature was independently screened，information extracted and quality assessed by 2 researchers， and Meta-analysis was performed using Stata 14.0 software. Results A total of 19 cross-sectional studies were included，with a total sample size of 11 776 cases and a risk of bias quality score of 6-9，all of which were of moderate or high quality. Meta#2;analysis showed that the prevalence of oral frailty in elderly people was 29.5%（95%CI=24.1%-35.2%），and the prevalence of pre-oral frailty was 47.9%（95%CI=40.5%-55.4%）. Subgroup analyses showed that the progressive increase in the prevalence of oral frailty in the elderly with advancing age. Higher prevalence rates of oral frailty were observed in individuals screened using the Oral Frailty Index-8，Chinese elderly，elderly females，residents of medical and nursing care facilities，those withouta spouse，living alone，smokers，and elderly individuals with primary school education or lower（P<0.05）. Conclusion The prevalence of oral frailty is high in the elderly，warranting particular attention to the oral health status of elderly individuals in China who are advanced in age，female，residing in medical and nursing care facilities，living alone without a spouse， smokers，and have lower educational levels.
Subjects: Management Science >> Science ology and Management Subjects: Information Science and Systems Science >> Basic Disciplines of Information Science and Systems Science Subjects: Statistics >> Science and Technology Statistics submitted time 2024-06-07
Abstract： With the rapid development of the digital economy, optimal decision-making for enterprises has become possible, laying the foundation for the digital transformation of enterprises.Traditional decision support systems often lack interpretability and adaptability, cannot integrate macro expectations with the multiple micro-endowments of the enterprise itself to make globally optimized decisions. To address these shortcomings, this paper starts from micro mechanisms and combines digital twin technology with the concept of Agent-Based Modeling (ABM) to construct
an intelligent-interactive-integrated decision support system. This system comprehensively considers key factors such as production resources, sales, inventory, loan interest rates, labor hire,expectations, etc., and under various constraints, aims to make multi-category production and
investment decisions to maximize profits. The system possesses high interpretability and interactivity. Through validation, the system is reliable and meets real-world expectations. From a micro perspective, this system provides quantified decision support for enterprise production and
investment; from a meso perspective, it can provide reference for industry policy formulationthrough further building industrial chains; at the macro level, it can serve as part of the macroeconomic complex system, coordinate with other sectors, deduce and predict the effects of different policies.
Peer Review Status:Awaiting Review
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-07 Cooperative journals: 《中国全科医学》
Abstract： Obstructive sleep apnea（OSA）is prevalent in the elderly population due to the weakened neuromuscular function of the upper airway and unstable respiratory regulation in the elderly. OSA is a risk factor for a variety of common chronic diseases，and affects cognitive function and multi-system organ function in the elderly. Therefore，it is essential to provide effective therapeutic interventions for OSA in the elderly. The Sleep Medicine Branch of the Chinese Geriatrics Society，as the initiator，organized domestic experts in related fields to repeatedly discuss the operation process，requirements，specific ways and methods of noninvasive positive pressure ventilation（NPPV）treatment for elderly OSA patients with reference to domestic and international clinical studies，and finally made this expert consensus，which is aimed at standardizing the treatment of NPPV in elderly OSA patients in China to provide a reference.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-07 Cooperative journals: 《中国全科医学》
Abstract： Background Research has linked the physical constitution of overweight/obese individuals to obesity， with a potential bidirectional association. Although FATmax intensity exercise can boost their fitness，the exact magnitude of this benefit needs further study. Objective Systematic evaluation is needed to assess the impact of FATmax intensity exercise on physical fitness indicators among overweight or obese populations. Methods Retrieve RCTs from PubMed，Web of Science，Ebsco，CNKI，VIP，Wanfang（January 2001 to January 2024） on FATmax exercise effects on body composition， cardiovascular endurance，lipid metabolism in overweight/obese patients. Evaluate quality with Cochrane tool，Meta-analyze with RevMan5.4.Results A total of 16 randomized controlled trials were included，including 568 overweight or obese patients. The Meta-analysis results showed that compared with the control group，the FATmax intensity exercise intervention group significantly improved body composition（BMI：WMD=-1.82，P<0.01；BFR：WMD=-2.86，P<0.01；WHR：WMD=-0.04，P<0.01）， cardiovascular endurance（VO2max：WMD=3.34，P<0.01），and lipid metabolism except for TC（TG：WMD=-0.24， P<0.01；HDL-C：WMD=0.14，P<0.01；LDL-C：WMD=-0.27，P<0.01）. Conclusion FATmax exercise benefits body composition，cardiovascular endurance，and lipid metabolism（except TC）in overweight/obese patients. Optimal results vary： ≥ 12 weeks，3-5 times/week，60-minute running for body composition；≥ 12 weeks，5 times/week，<60 minutes combined for VO2max； ≥ 12 weeks，3 times/week，60-minute running for TG； <12 weeks，4 times/week，60-minute combined for HDL-C；<12 weeks，4 times/week，>60-minute combined for LDL-C.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-07 Cooperative journals: 《中国全科医学》
Abstract： Background Diabetes has a high incidence rate and many complications，which was an urgent public health problem，but the prevention and management is still not ideal. Objective To observe the effect of Three Division management on metabolic indicators and self-management levels of diabetes patients with different courses of disease. Methods One hundred and 81 type 2 diabetes patients from April 2021 to April 2022 were managed by the mode of Three Division management and followed up for more than 6 months. The patients were grouped according to the course of disease（Group A：course of disease<1 year；Group B：course of disease 1-5 years；Group C：course of disease 5-10 years；Group D： course of disease>10 years）；In outpatient，the three-division team composed of traditional Chinese medicine practitioners， endocrinologists and caregivers carries out comprehensive treatment such as physique identification，complication screening， medicine，food，exercises and emotion intervention；When patients are at home，the caregivers carry out intelligent management through intelligent Glucose meter equipment and mobile phone APP. We collected changes in blood glucose and body weight indicators in patients with different disease courses after six months of management. Additionally，we used a questionnaire to gather common issues in patient self-management and fill out the Summary of Diabetes Self-Care Activities Measure-6 （SDSCA-6）. Results Through the management of the Three Division management，Group A patients showed significant improvement in reducing fasting blood glucose and postprandial 2-hour blood glucose after the intervention（P<0.05）. The BMI and waist circumference of groups A，B，C，and D were all reduced compared to before the intervention（P<0.05）. Common dietary issues in patient self-management included an unreasonable dietary structure（38.12%），common exercise issues included insufficient exercise volume or intensity（36.46%），and common monitoring issues included insufficient monitoring（37.02%）. The self-management levels of groups A，B，C，and D in the four dimensions of "healthy eating" "self#2;monitoring" "adherence to medical advice" and "education and communication" all improved compared to before the intervention （P<0.001）. Conclusion The Three Division management can improve the self-management ability of diabetes patients and play a good comprehensive role in diabetes. Clinical practice should particularly emphasize the management of patients with a diabetes course of less than one year.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-07 Cooperative journals: 《中国全科医学》
Abstract： Medically unexplained symptoms （MUS） is a common problem in primary medical care. The etiology of MUS is unclear，which brings continuous pain to patients and affects the doctor-patient relationship. As a result，the management of MUS is a challenge for general practitioners. Combined with relevant literature and guidelines，this paper expounds the diagnosis and treatment ideas of MUS，so as to help general practitioners identify and manage MUS in clinical practice effectively，and finally achieve the purpose of improving the treatment effect of patients and building a harmonious doctor-patient relationship.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-07 Cooperative journals: 《中国全科医学》
Abstract： Background Muscle mass loss increases the risk of hyperglycaemia and sarcopenia in patients with type 2 diabetes mellitus（T2DM），and Chinese adults with T2DM are predominantly non-obese，who are more likely to be associated with muscle mass loss than the obese. Objective To establish an individualized Nomogram prediction model for the risk factorsof muscle mass loss in non-obese patients with T2DM. Methods A retrospective study was conducted to select 905 non-obese patients with T2DM admitted to the Affiliated Drum Tower Hospital，Nanjing University from January 2018 to September 2023. The patients were divided into a training set（n=633）and a validation set（n=272）using simple random sampling at a ratio of 7∶3，and the general data and clinical indexes of the two groups of patients were collected and compared. Multivariate Logistic regression analysis was performed to determine risk factors for muscle mass loss in the training set and a Nomogram prediction model was constructed. The predictive value and clinical utility of the Nomogram prediction model were evaluated using receiver operating characteristic（ROC）curve，Hosmer-Lemeshow calibration curve，and decision curve analysis（DCA）， respectively. Results The prevalence of muscle mass loss in non-obese patients with T2DM was 42.3%（383/905）. Comparison of the clinical indicators of the patients in the training and validation sets showed no statistically significant differences（P>0.05）. Multivariate Logistic regression analysis showed that age（OR=1.039，95%CI=1.010-1.070，P=0.009），male（OR=3.425，95%CI=2.133-5.499，P<0.001），BMI<23.5 kg/m2 （OR=19.678，95%CI=11.319-34.210，P<0.001），elevated HbA1c （OR=1.196，95%CI=1.081-1.323，P<0.001），increased visceral fat area（OR=1.021，95%CI=1.010-1.032，P<0.001） were independent risk factors for muscle mass loss in non-obese patients with T2DM. The area under curve（AUC）of the ROC for the Nomogram prediction model to predict the risk of muscle mass loss occurring in patients in the training and validation sets was 0.825（95%CI=0.793-0.856，P<0.001）and 0.806（95%CI=0.753-0.859，P<0.001），respectively. The Hosmer-Lemeshow test showed that the model had a good fit（training set：χ2 =11.822，P=0.159；validation set：χ2 =8.189，P=0.415）. Bootstrap method of plotting the calibration of the model showed that the calibration curves fitted well to the standard curves. The DCA curves showed that it was more beneficial to use the Nomogram prediction model to predict the incidence risk of muscle mass loss in patients with T2DM when the threshold probability of the patient was 0.06 to 0.94. Conclusion Age，male，BMI<23.5 kg/m2 ，elevated HbA1c，and increased visceral fat area are independent risk factors for muscle mass loss in non-obese patients with T2DM. The Nomogram prediction model established in this study can individually predict the risk of muscle mass loss in non#2;obese patients with T2DM，which facilitates the early identification of high-risk groups and the development of individualised interventions.
Subjects: Mathematics >> Control and Optimization. submitted time 2024-06-06
Abstract： For a 4th order 3-dimensional symmetric tensor with its entries $1$ or $-1$, we show the analytic sufficient and necessary conditions of its positive definiteness. By applying these conclusions, several strict inequalities is bulit for ternary quartic homogeneous polynomials.
Peer Review Status:Awaiting Review
Subjects: Management Science >> Science ology and Management Subjects: Library Science，Information Science >> Information Processing submitted time 2024-06-06
Abstract： Purpose To evaluate the coverage and accuracy of author identification number (author ID) of the major bibliographic databases and to assess whether they could be directly used in empirical research.
Methods The ground truth data set consists of articles from 825 Chinese scientists. The coverage, accuracy, and robustness of each author ID are calculated by retrieving and collecting the IDs of scientists and their respective publication information in the bibliographic databases. The validity of the author IDs for empirical research is assessed by replicating a top journal empirical article using the data collected through author IDs.
Results First, WOS, Scopus, AMiner, and OpenAlex can retrieve more than 90% of Chinese scientists’ identifiers, while ORCID’s coverage is less than 50%. Second, the accuracy of Scopus is the highest at 85.2%, and the accuracy of OpenAlex is the lowest at only 51.2%. Third, directly using the publication data collected through author IDs for empirical research will introduce non-negligible bias.
Limitations The ground truth data set is limited, because it is mainly composed of young scientists, and lack scientists from social sciences and humanities.
Conclusion At present, the author identification number of the major databases cannot be directly applied to the empirical research of large-scale data. A standardized information platform for scientists’ publications is needed to overcome the author-name disambiguation problem.
Peer Review Status:Awaiting Review
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-06 Cooperative journals: 《中国全科医学》
Abstract： Background With the acceleration of China's aging population，the prevalence of chronic diseases and comorbidity patterns pose significant challenges to global health. There is a close relationship between the prevalence of chronic diseases and individuals' self-rated health （SRH） status. However，there is limited research on the prevalence of chronic diseases and comorbidity patterns among middle-aged and elderly populations in rural areas of Xinjiang，China，and their impact on SRH status. Objective To understand the prevalence of chronic diseases and comorbidity patterns among middle#2;aged and elderly populations in rural areas of Xinjiang and to explore the impact of chronic diseases and comorbidity patterns on SRH status，providing effective reference for improving the health level of this population. Methods The data for this study were derived from the survey database of the National Social Science Foundation project （17BRK030） from 2016 to 2019. A questionnaire survey was conducted on the demographic characteristics，chronic disease status，and self-rated health status of male and female heads of households. Ordered logistics regression analysis was used to screen the influencing factors of SRH status. SOM network training analysis and partial least squares method were employed to evaluate the interrelationships among 14 chronic diseases and the degree of their impact on SRH status. Results A total of 3 400 middle-aged and elderly individuals were surveyed. Residents' SRH status varied significantly by geographical distribution，gender，age，education level，occupation， marital status，illness or disability，and chronic disease status（P<0.05）. Geographical region as southern Xinjiang，education level of primary school and below，and presence of chronic diseases were identified as risk factors for SRH status. Being male， aged 45-59 years，occupation as pastoralists，staff of government or public institutions，or technical workers，being divorced， and having illness or disability were identified as protective factors for SRH status. The prevalence of chronic diseases among middle-aged and elderly populations in rural areas of Xinjiang was 71.96%. The top three diseases were hypertension （36.67%）， arthritis or rheumatism（18.09%），and heart disease（11.91%）. The comorbidity rate of chronic diseases was 22.18%，with hypertension（23.19%），arthritis or rheumatism（19.62%），and heart disease（17.84%） being the top three comorbid diseases. The predominant comorbidity pattern was the co-occurrence of two chronic diseases（78.18%）. The most common comorbidity pattern among individuals with two chronic diseases was hypertension combined with heart disease，and among those with three chronic diseases was hypertension combined with heart disease and arthritis or rheumatism. The impact of chronic disease status on SRH status revealed that individuals with chronic diseases had significantly lower SRH status than those without chronic diseases，and individuals with two or more chronic diseases had lower SRH status than those with one chronic disease. Conclusion The prevalence of chronic diseases and comorbidity among middle-aged and elderly populations in rural areas of Xinjiang is high. Chronic respiratory diseases，arthritis or rheumatism，heart disease，anemia，and other chronic diseases have a significant impact on SRH status. Therefore，it is necessary to further strengthen the construction of chronic disease service systems，improve the health records of middle-aged and elderly individuals，establish specialized clinics for chronic disease comorbidity to detect and control the comorbidity of chronic diseases among middle-aged and elderly populations. Additionally， efforts should be made to enhance health education for middle-aged and elderly groups，increase awareness of chronic diseases， and promote active and healthy lifestyles to improve the health level and quality of life of middle-aged and elderly populations.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-06 Cooperative journals: 《中国全科医学》
Abstract： Background Nonalcoholic fatty liver disease（NAFLD）is a common digestive system disease，which is often diagnosed by imaging methods in clinical work. At present，there is a lack of research on the effectiveness evaluation of imaging diagnostic methods with histology as the gold standard. Objective To study the consistency of imaging and histological diagnosis of NAFLD，and to analyze the influencing factors of gallstone disease（GD）complicated with NAFLD. Method From January 2021 to July 2022，53 patients with GD who underwent simple cholecystectomy and liver biopsy were selected from the Department of Hepatobiliary surgery，Nanjing Hospital affiliated to Nanjing University of traditional Chinese Medicine. The demographic characteristics，BMI，systolic blood pressure（SBP）and diastolic blood pressure（DBP）of the subjects were collected，and the laboratory indexes，imaging and histological results were collected. The consistency of imaging and histological diagnosis of NAFLD was evaluated by Kappa consistency test. According to the histological diagnostic criteria，the subjects were divided into NAFLD group（n=15）and non-NAFLD group（n=38）. Multivariate Logistic regression analysis was used to explore the influencing factors of NAFLD in patients with GD. Results The imaging detection rate of NAFLD in GD patients was 20.7%（11/53），which was lower than that of histology（28.3%）（15/53）（Kappa=0.404，P=0.001）. The sensitivity of imaging diagnosis was 60.0%（9/15），the specificity was 94.7%（36/38），and the rate of missed diagnosis was 40.0%（6/15）. There were 8 cases of nonalcoholic fatty liver（NAFL），7 cases of nonalcoholic steatohepatitis（NASH） and no NASH associated cirrhosis in 15 patients with histological manifestation of NAFLD. The proportion of fibrosis in the NASH group was higher than that in the NAFL group. There were significant differences in the levels of BMI，SBP，fasting blood glucose（FPG）and aspartate aminotransferase（AST）between NAFLD group and non-NAFLD group（P<0.05）. Multivariate Logistic regression analysis showed that BMI（OR=1.5，95%CI=1.084~2.075，P=0.014）and FPG（OR=2.163， 95%CI=1.246~3.756，P=0.006）were the influencing factors of GD patients with NAFLD. Conclusion Compared with histological diagnosis，the missed diagnosis rate of imaging diagnosis of NAFLD is higher，and the incidence of NAFLD may be underestimated by imaging diagnosis as a means of epidemiological investigation. High BMI and high FPG are the main risk factors of GD complicated with NAFLD.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-06 Cooperative journals: 《中国全科医学》
Abstract： Background Adolescence is a high-risk period for obesity，and it is crucial and urgent to implement obesity control among adolescents. However，existing interventions commonly face challenges in sustainability and scalability. Asset assessment to identify and leverage existing community assets and strengths is essential to facilitate and maintain the implementation of these programs. Objective To assess assets for obesity control among middle school students，and to identify the advantages and deficiencies in the current policy，physical，social，and information environments，along with suggestions for improvements. Methods From 2023 to January 2024，purposive sampling method was adopted，face-to-face one-by-one interviews were conducted with 11 staff members involved in obesity control for middle school students from the Center for Disease Control and Prevention，Education Bureau，and three middle schools in a major city in East China. Additionally，eight parents and their children from each of the three schools were invited to participate in focus group discussions，with 6 groups and 8 participants per group. Thematic analysis was applied to analyze the interview data. Results This study found that the advantages in obesity control for middle school students primarily included policies and conditions ensured for obesity surveillance，nutritional school lunch and physical activity，along with media for health communication. The main deficiencies were the lack of specific policies for efficient obesity control，insufficient physical and social assets to support healthy eating and physical activity，and the quality and intensity of information assets supporting to facilitate changes in knowledge，attitude，and behaviors. In response to these challenges，participants suggested the implementation of both rigid regulations and flexible incentives，improvement of asset accessibility，encouragement of multi-stakeholder cooperation，and strengthening of health communication. Integrating existing assets and suggestions for improvement has formed an asset assessment checklist，corresponding to 10 assets from the policy environment，8 from the physical environment，20 from the social environment，and 12 from the information environment. Conclusion Several assets exist for obesity control among middle school students and identifies areas for improvement. Subsequent efforts in obesity control for middle school students should be made on promoting intervention strategies to better align with the context based on the asset assessment checklist to diagnose the current status of assets，thus enhancing the efficacy and sustainability of the program.
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2024-06-06 Cooperative journals: 《中国全科医学》
Abstract： Lumbar spinal stenosis is one of the most common causes of low back and leg pain. However，there is a lack of evidence-based guidelines for the treatment of lumbar spinal stenosis with integrated traditional Chinese medicine and western medicine. To standardize the diagnosis and treatment of lumbar spinal stenosis with a combination of traditional Chinese medicine and western medicine，this guideline strictly followed the relevant guiding principles for the development of guidelines both domestically and internationally. A multidisciplinary working group was established. We adopted the GRADE approach to grade the quality of evidence and the strength of recommendation. Finally recommendations on the treatment of lumbar spinal stenosis with integrated traditional Chinese medicine and western medicine were formed，aiming to standardize clinical practice. This guideline is for patients with all degrees of lumbar spinal stenosis.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-06 Cooperative journals: 《中国全科医学》
Abstract： General practitioners with sub-specialties can not only provide high-quality general medical services， but also provide a certain depth of specialized medical services. The combination of general practitioners with sub-specialties of different specialties can provide relatively comprehensive and certain depth of basic medical services for residents in their jurisdictions. Under the situation that the professional service capacity of mental health cannot meet the needs of residents，the necessity of encouraging some general practitioners to develop mental health subspecialties has become increasingly prominent. This article analyzes the necessity of training general practitioners with psychosis subspecialty; The advantages of developing psychosis subspecialty among general practitioners; The obstacles to promoting the development of psychosis sub-expertise of general practitioners in primary care are proposed：the construction of general practitioners training bases for psychosis sub#2;expertise; The learning platform for general practitioners with psychosis sub-expertise was expanded; Construction of sub-specialty teachers of psychosis; Policy and financial support，salary and promotion incentive policies，etc.，are expected to help general practitioners develop psychosis sub-expertise.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-06 Cooperative journals: 《中国全科医学》
Abstract： Background Central precocious puberty（CPP） is a common endocrine disease in children，which shows an increasing trend year by year in recent years. It can be divided into fast-progressing central precocious puberty（RP-CPP） and slow-progressing central precocious puberty（SP-CPP） through pubertal development. RP-CPP has great harm，but it is difficult to distinguish it from SP-CPP in early clinical stage，mainly relying on the progress of adolescent development and bone age during follow-up. At present，there is a lack of effective laboratory indicators to predict RP-CPP. Objective To investigate the relationship between luteinizing hormone（LH）/follicle-stimulating hormone （FSH） ratio and pubertal development. Methods CPP girls aged 4-10 years old（n=380） admitted to the Children's Hospital Affiliated to Zhengzhou University from January 2020 to May 2022 were regression selected and divided into RP-CPP group （n=130） and SP-CPP group（n=250 cases）according to indicators such as puberal development process. Clinical characteristics of the two groups were compared and analyzed. Univariate and multivariate Logistic regression analysis of the influencing factors of RP-CPP was performed，and ROC curve of LH/FSH ratio on the predictive value of RP-CPP was drawn. Results The height，weight，BMI，IGF-1，difference between bone age and actual age，bilateral ovarian volume，LH base value，estradiol level，LH base value /FSH base value， and LH peak /FSH peak value of girls in RP-CPP group were all higher than those in SP-CPP group，with statistical significance （P<0.05）. Regression analysis showed that CPP patients progressed to RP-CPP related serological indexes when LH base value and LH peak /FSH peak were detected. LH base /FSH base value and LH peak /FSH peak were positively correlated with height， IGF-1，LH base value，estradiol level，LH peak，ovarian volume and bone age（P<0.05）. ROC curve showed that the LH base /FSH base value and LH peak /FSH peak value were more sensitive and specific than other indexes to the predictive value of RP-CPP. When the LH base /FSH base value was 0.63，the Yoden index reached a maximum of 0.258（sensitivity 43.1%， specificity 82.7%，AUC=0.644）. When the LH peak /FSH peak was 1.39，the maximum Jorden index was 0.276（sensitivity 74.6%，specificity 53.0%，AUC=0.655）. The combined prediction model is better than the single index prediction model （AUC=0.668）. The basal gonadotropin levels of children without clinical intervention were analyzed after 6 months of follow#2;up. It was found that the height increase，ΔLH，ΔFSH，bone age increase and ovarian volume increase in RP-CPP group were significantly higher than those in SP-CPP group after 6 months of follow-up，and the difference was statistically significant （P < 0.05）. Conclusion LH base /FSH base value and LH peak /FSH peak are early predictors of RP-CPP. When LH/FSH base value ≥ 0.63 or LH peak/FSH peak ≥ 1.39，the possibility of RP-CPP should be considered，and the combined predictive value of the two indicators is better than that of a single indicator. It can be used as an auxiliary reference index for clinical application of gonadotropin-releasing hormone analogue therapy.
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